Objective:To investigate the factors associated with constipation in patients with schizophrenia. Methods:This retrospective study analysed medical records of hospitalised patients with schizophrenia admitted to a psychiatric department in Wuhan between January and December 2023. Demographic and clinical data were collected and cross-checked by psychiatrists. Logistic regression analysis was used to identify independent risk factors. Results:Among 904 patients, 268 (29.65%) had constipation, including incomplete intestinal obstruction (5.97%), anal fissures (20.89%) and haemorrhoids (38.10%). The prevalence was higher in women (33.59%) than in men (26.73%). Multivariate logistic regression identified poverty (odds ratio [OR] = 1.60, 95% CI: 1.14-2.23, P = 0.006), disease duration ≥10 years (OR = 4.13, 95% CI: 2.41-7.07, P < 0.001), clozapine use (OR = 2.56, 95% CI: 1.67-3.94, P < 0.001), combined drug therapy (OR = 2.58, 95% CI: 1.67-3.99, P < 0.001), comorbid anxiety disorders (OR = 2.64, 95% CI: 1.79-3.88, P < 0.001), comorbid hypertension (OR = 3.84, 95% CI: 2.73-5.39, P < 0.001), dyslipidaemia (OR = 1.81, 95% CI: 1.21-2.71, P = 0.004) and smoking (OR = 1.57, 95% CI: 1.13-2.20, P = 0.008) as independent risk factors. Subgroup analyses showed stronger associations between clozapine and constipation in women and between long disease duration and constipation in older patients. Conclusion:The prevalence of constipation in patients with schizophrenia is high. For high-risk groups with the above factors, early intervention should be implemented to prevent the onset of constipation and improve patients' quality of life.

BACKGROUND:Lithium carbonate has a narrow therapeutic window for the treatment of manic episodes and is mainly excreted via the kidneys. Hypertension may impair lithium clearance, although evidence from relevant studies is insufficient. Based on previous research on the association between hypertension and the lithium concentration-to-dose (C/D) ratio, this study further performed a large-sample stratified analysis to evaluate the independent effects of hypertension on steady-state lithium pharmacokinetics, C/D ratio, rate of achieving therapeutic lithium levels, and risk of lithium toxicity in patients with mania. METHODS:A single-center retrospective cohort study was performed, enrolling 210 patients with mania, who were assigned to a hypertension group (n = 90) or a non-hypertension group (n = 120). The t-test, chi-square test, and multiple linear regression were used to evaluate the relevant parameters. RESULTS:There was no significant difference in the mean daily dose of lithium carbonate between the two groups. However, the hypertension group had significantly higher steady-state serum lithium concentrations and C/D ratios than the non-hypertension group (p < 0.001). The rate of achieving therapeutic lithium levels in the hypertension group was only 42.22%, markedly lower than the 65.83% in the non-hypertension group, while the incidence of lithium toxicity was 11.11% in the hypertension group, significantly higher than the 2.50% in the control group. Multiple regression analysis confirmed that hypertension (β = 0.215), age, and daily dose were independent influencing factors for the C/D ratio, with elderly hypertensive patients showing a more pronounced increase in the C/D ratio. The type of antihypertensive medication did not affect lithium metabolism. CONCLUSION:Hypertension can reduce renal lithium excretion and elevate both the C/D ratio and the risk of toxicity; therefore, in clinical practice, the initial lithium dose should be reduced and therapeutic drug monitoring should be intensified for patients with comorbid hypertension, while elderly patients should receive stratified management with lower serum concentration ranges.

Objective:To explore the effects of hypertension, uric acid (UA) level, and other physiological factors on blood lithium concentration/dose ratio (C/D; a measure of lithium pharmacokinetics) values in patients experiencing manic episodes. Methods:A total of 644 patients with manic episodes were treated at the study hospital between January and June 2022. Patients were divided into groups according to their systolic and diastolic blood pressure (BP) as well as blood glucose, triglyceride, and UA levels. The effects of these factors on blood lithium C/D values after lithium carbonate treatment were examined. Results:The mean blood lithium C/D value of all study participants was 0.832 ± 0.248 mmol·L-1·g-1·d. There was no significant difference in blood lithium C/D value between patients with abnormal and normal diastolic BP (p > 0.05). However, patients with an abnormal systolic BP (>130 mmHg) had lower lithium C/D values than those with normal systolic BP (p < 0.05). Systolic BP was negatively correlated with C/D value (r = -0.232; p = 0.001), as was UA level (r = -0.114; p = 0.013). Conclusion:Hypertension and elevated UA levels can affect the blood lithium C/D value in patients with manic episodes. Personalized treatment approaches that take these physiological factors into account may help reduce treatment risks.

Objective:Currently, there are situations where there is discordance between the identified diagnosis and the previous clinical diagnosis for psychiatric identification, causing extensive discussion. Therefore, the purpose of this study is to systematically analyze the consistency between forensic psychiatric identification diagnosis (referred to as identification diagnosis) and previous psychiatric diagnosis (referred to as previous diagnosis) in criminal cases. Methods:Using a retrospective study design, 78 criminal cases evaluated as having no mental illness by the Forensic Evaluation Department of Wuhan Mental Health Center in 2021-2022 were selected as research subjects. Diagnostic agreement was evaluated using the kappa coefficient. Results:(1) Among 78 cases, 43 had a history of mental illness, with a prevalence rate of 55.13%; (2) The evaluation diagnosis was consistent with the previous diagnosis in 12 cases (27.91%) and inconsistent in 31 cases (72.09%), with Kappa=0.243 (P<0.05), indicating poor consistency; (3) Schizophrenia (21 cases, 48.84%) and mood disorders (14 cases, 32.56%) were the most common in previous diagnoses; (4) Evaluation diagnoses were mainly no mental illness (38 cases, 48.72%) and physiological passion (8 cases, 10.26%). Conclusion:In criminal cases where the forensic evaluation diagnosis is no mental illness, the consistency between the evaluation diagnosis and the previous diagnosis is low, which is closely related to the differences in thinking patterns and assessment focus between forensic evaluation and clinical diagnosis. It is recommended to strengthen the standardized construction of forensic evaluation and improve the quality of evaluation.

BACKGROUND:Diabetes mellitus-induced erectile dysfunction (DMED) has become a common disease in adult men that can seriously reduce the quality of life of patients, and new therapies are urgently needed. miRNA-100 has many targets and can induce autophagy and reduce fibrosis by inhibiting the mTOR pathway and the TGF-β pathway. However, no research has been conducted with miR-100 in the field of DMED, and the specific mechanism of action is still unclear. OBJECTIVES:To ascertain the effects of miR-100 on corpus cavernosum tissue of DMED rats and vascular endothelial cells in a high glucose environment and to elucidate the relevant mechanisms in autophagy, fibrosis and inflammation to find a new approach for the DMED therapy. METHODS:Thirty rats were divided into three groups: the control group, the DMED group, and the DMED + miR-100 group. Using intraperitoneal injections of streptozotocin, all rats except the control group were modeled with diabetes mellitus, which was verified using the apomorphine (APO) test. For rats in the DMED + miR-100 group, rno-miR-100-5p agomir (50 nmol/kg, every 2 days, 6 times in total) was injected via the tail vein. After 13 weeks, the erectile function of each rat was assessed using cavernous manometry, and the corpus cavernosum tissue was harvested for subsequent experiments. For cellular experiments, human coronary microartery endothelial cells (HCMEC) were divided into four groups: the control group, the high-glucose (HG, 40 mM) group, the HG + mimic group, and the HG + inhibitor group. The cells were cultured for 6 days and collected for subsequent experiments 2 days after transfection. RESULTS:Diabetic modeling impaired the erectile function in rats, and miR-100 reversed this effect. By measuring autophagy-related proteins such as mTOR/Raptor/Beclin1/p62/LC3B, we found that miR-100 could suppress the expression of mTOR and induce autophagy. The analysis of the eNOS/NO/cGMP axis function indicated that impaired endothelial function was improved by miR-100. By evaluating the TGF-β1/CTGF/Smad2/3 and NF-κB/TNF-α pathways, we found that miR-100 could lower the level of inflammation and fibrosis, which contributed to the improvement of the erectile function. Cellular experiments can be used as supporting evidence for these findings. CONCLUSION:MiR-100 can improve the erectile function by inhibiting mTOR and thus inducing autophagy, improving the endothelial function through the eNOS/NO/cGMP axis, and exerting antifibrotic and anti-inflammatory effects, which may provide new ideas and directions for the treatment of DMED.

Objective: The aim of the study was to investigate the therapeutic effects of modified electroconvulsive therapy (MECT) in combination with risperidone tablets and psychotherapy in the treatment of patients with treatment-resistant schizophrenia (TRS). Methods: Patients with TRS admitted to the psychiatric department of our hospital between January 2018 and December 2019 were selected as study participants. They were randomly divided into a control group and a study group, with the control group receiving risperidone tablets and psychotherapy, and the study group undergoing MECT as well as the control group treatment. The mood scores, efficacy, and side effects of the 2 groups were compared. Results: After treatment, the Hamilton Anxiety Rating Scale (t = 2.316, P = .021) and Hamilton Depression Rating Scale (t = 2.919, P = .013) scores of the study group were significantly lower than those of the control group. The overall remission rate in the study group was 96.3%, which was higher than that of the control group (chi 2= 9.319, P = .007). The Positive and Negative Syndrome Scale (t = 8.126, P = .003),Traumatic Exposure Severity Scale (t = 13.210, P = .002), and Brief Psychiatric Rating Scale (t = 6.412, P = .001) scores were significantly lower in the study group than in the control group. The Wechsler Memory Scale score was higher in the study group than in the control group (t = 3.971, P = .002). Conclusion: The use of MECT in combination with risperidone tablets and psychotherapy can effectively improve patient mood, increase efficacy, reduce adverse effects, promote memory recovery, and shorten recovery time in patients with TRS.

OBJECTIVE:To investigate the effects of electroacupuncture combined with paliperidone palmitate long-acting injection (PP-LAI) on withdrawal symptoms and neurotransmitters in methamphetamine (MA) addicts. MATERIALS AND METHODS:A total of 109 methamphetamine addicts, who were treated in the hospital from October 2021 to October 2022, were selected. According to the random number table, the patients were divided into the study group (n=54) and the control group (n=55), in which the control group was treated with PP-LAI and the study group was treated with electroacupuncture on the basis of the control group; the methamphetamine withdrawal symptom score scale was used to assess the therapeutic effect before treatment and within 12 months after treatment; the changes of brain neurotransmitters dopamine, γ-aminobutyric acid, serotonin, acetylcholine values were compared between the two groups. RESULTS:1) There was no statistical difference in MA withdrawal symptom scores between the two groups before treatment (p>0.05); 2) MA withdrawal symptom scores have a statistically significant difference between the study group and the control group after 3 and 6 months of treatment; 3) dopamine levels in the study group were significantly higher than those in the control group after 6 months of completion of treatment, and γ-aminobutyric acid values and 5- serotonin values in the study group were significantly lower than those in the control group (p<0.05). CONCLUSIONS:Electroacupuncture combined with PP-LAI can partially improve the withdrawal symptoms and anxiety of methamphetamine addicts. This is a potential treatment for preventing relapse of withdrawal symptoms.

Background Psychological stress and its two stress response systems, the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS), are closely related to psychogenic erectile dysfunction (pED). However, the analyses of perceived stress and stress systems in pED patients need to be more in-depth, especially the interactions between them. Methods Our study included 75 patients with pEDs and 75 healthy men. The International Index of Erectile Function-5 (IIEF-5) and the 10-item Perceived Stress Scale (PSS-10) were used for assessing the severity of ED and perceived stress. All participants collected saliva samples on three consecutive days at eight specific times with strict reference to the time of morning awakening for measuring cortisol parameters and wore electrocardiography for 24 h to derive heart rate variability (HRV). Results The PSS-10 scores of pED patients were significantly higher than the control group (p<0.001). Although PSS-10 and IIEF-5 scores were negatively correlated in pED patients, there was no statistical significance between them (r=−0.049, p=0.677). Compared with the control group, the HRV parameters of pED patients were significantly increased in LF/HF ratio (p=0.014) but significantly decreased in LF, HF, and pNN50 (p<0.001). However, the two groups had no statistically significant differences in cortisol variables (all p>0.05). The interaction between sympathovagal modulation (HF, rMSSD) and cortisol awakening response (CAR AUCi) explained significantly greater variance in perceived stress than either stress system alone. Higher parasympathetic activity combined with a higher cortisol awakening response was associated with greater perceived stress. Conclusion Our results suggested that the interrelation between ANS and HPA axis activity might enhance our comprehension of how stress affected the physical and mental health of pED patients.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), also known as National Institutes of Health (NIH) type III prostatitis, is a common disorder with an unclear etiology and no known curative treatments. Based on the presence or absence of leukocytes in expressed prostatic secretion (EPS), CP/CPPS is classified further into IIIa (inflammatory) and IIIb (noninflammatory) subtypes. However, the severity of symptoms is not entirely consistent with the white blood cell (WBC) count. Following the preliminary finding of a link between inflammatory cytokines and CP/CPPS, we performed this clinical study with the aim of identifying cytokines that are differentially expressed according to whether the prostatitis subtype is IIIa or IIIb. We found that granulocyte colony-stimulating factor (G-CSF), interleukin-18 (IL-18), and monocyte chemoattractant protein-1 (MCP-1) levels were significantly elevated and interferon-inducible protein-10 (IP-10) and platelet-derived growth factor-BB (PDGF-BB) levels were downregulated in the EPS of patients with type IIIa prostatitis. In a word, it is a meaningful study in which we investigate the levels of various cytokines in EPS according to whether prostatitis is the IIIa or IIIb subtype. The combination of G-CSF, IL-18, MCP-1, IP-10, and PDGF-BB expression levels could form a basis for classification, diagnosis, and therapeutic targets in clinical CP/CPPS.

Cel pracyNiniejsze badanie ma na celu zbadanie efektu terapeutycznego powtarzalnej przezczaszkowej stymulacji magnetycznej (rTMS) na negatywne objawy przewlekłej schizofrenii i neurotroficznego czynnika pochodzenia mózgowo-mózgowego (BDNF).MetodaW sumie 86 pacjentów z przewlekłą schizofrenią hospitalizowanych od marca do października 2019 r. zostało losowo przydzielonych do aktywnej grupy rTMS i pozorowanej rTMS, po 43 pacjentów w każdej grupie. Wszystkim pacjentom podawano doustnie paliperydon w dawce 3–6 mg/dobę, a leczenie rTMS zastosowano w grupie aktywnej rTMS. Wynik w Skali Zespołów Pozytywnych i Negatywnych (PANSS) oraz stężenie BDNF w surowicy obliczono w obu grupach na początku badania oraz po dwóch i czterech tygodniach leczenia.WynikiNie było statystycznie istotnych różnic w wynikach PANSS i stężeniach BDNF w surowicy między dwiema grupami przed leczeniem (P > 0,05). Jednak po czterech tygodniach leczenia zmiana wyniku w skali objawów negatywnych w grupie z aktywnym rTMS była większa niż w grupie pozorowanej rTMS (p < 0,05), a poziomy BDNF w surowicy w grupie z aktywnym rTMS były wyższe niż w grupie pozorowanej rTMS (P < 0,05).WnioskiCztery tygodnie ciągłego leczenia rTMS mogą skutecznie złagodzić objawy negatywne schizofrenii, a stężenie BDNF w surowicy wzrasta wraz ze wzrostem czasu leczenia rTMS.

Supplementary Data from Flightless I Homolog Represses Prostate Cancer Progression through Targeting Androgen Receptor Signaling

Objective:Our study aimed to investigate the effects of computer-assisted cognitive remediation therapy (CCRT) on cognitive function, social function and quality of life in patients with vascular dementia (VD).Methods:Ninety-eight patients with VD were treated with CCRT in four 45-minute sessions per week over a course of 40 sessions to exercise four cognitive functions, including flexibility, working memory, plan execution and social cognition. The Mini-Mental State Examination (MMSE), Social Disability Screening Schedule (SDSS), Personal and Social Performance Scale (PSP), and Generic Quality of Life Inventory-74 (GQOL-74) were used to assess before and after treatment.Results:(1) The scores of orientation (5.60 ± 1.35), calculation (2.20 ± 0.79), verbal ability (7.10 ± 0.36), spatial ability (0.78 ± 0.42), immediate memory (2.42 ± 0.53), short-term memory (1.17 ± 0.78) and MMSE (23.36 ± 2.98) were all improved after treatment (P < 0.05) compared with those before treatment; (2) The scores of SDSS, PSP and Activities of Daily Living (ADL) after treatment were 8.23 ± 0.94, 81.36 ± 14.23, and 32.7 ± 12.1, and all of which improved (P < 0.05); (3) The scores of physical health were 68.24 ± 7.44, mental health were 69.75 ± 7.15, social function were 69.08 ± 7.43, material life were 37.46 ± 4.85 and the total score were 230.79 ± 9.56, all of which improved (P < 0.05).Conclusion:For patients with VD, CCRT can improve their cognitive function, social function, daily life ability and quality of life.

Objective To examine the bactericidal effects of three different states of medical ozone (liquid, gas, and oil) against drug-resistant strains of common bacteria on burn wounds, which could as a clinical reference. Methods Three multidrug-resistant strains of methicillin-resistant Staphylococcus aureus, pan-resistant Pseudomonas aeruginosa, and ESBLs Klebsiella pneumoniae were identified from burn wounds. The colonies of the three varieties of bacteria were each carried out using the pour plate method prior to the start of the experiment. Then, depending on the state of ozone, different treatment procedures are applied. Group of ozone gas: in a closed glass jar, the bacterial liquid was injected into a single layer of sterile gauze, and the ozone gas concentration was held at 50 g/mL. The bacterial liquid was diluted and combined directly with ozone water in the ozone water group. Ozone is a type of oil: after the emulsifier was added to the oil group. The gas, water, and oil groups were rapidly neutralized and counted again after 5, 10, and 30 minutes. Results Ozone gas and oil groups totally eliminated multidrug resistant bacteria in the above study within 30 minutes. (2) At 5 and 10 minutes, the difference in bactericidal effect between ozone gas group and ozone water and oil group was statistically significant (P<0.05), and there was no significant difference between ozone water and oil groups (P>0.05); at the time of 30 minutes, the effects of bactericidal effect between ozone water group and ozone gas and oil had no significance (P> 0.05). Conclusion Ozone has the ability to kill bacteria, depending on the treatment time, different ozone types should be chosen for sterilization and disinfection in clinical application.

Background There are still few studies on the clinical characteristics and related risk factors of schizophrenia patients with intestinal obstruction. Our aim is to explore the clinical characteristics and related risk factors of schizophrenia patients with intestinal obstruction. Methods This study focused on schizophrenia patients with intestinal obstruction who were hospitalized in the psychiatric department of a hospital in Wuhan from January 2007 to December 2020 as the main research object. We intend to retrospectively analyze the clinical characteristics and related risk factors of schizophrenia patients with intestinal obstruction. Results In the 1937 persons with schizophrenia included in this study, 97 patients were complicated with intestinal obstruction, and the incidence was 5.01%.The results of the study showed that patients with age ≥ 60 years old, visiting time ≥ 24 h, hospital stay ≥ 90 days, history of abdominal surgery, course of disease ≥ 5 years, male, and patients with cardiovascular and cerebrovascular diseases are prone to intestinal obstruction; Logistic multiple regression analysis showed that the related risk factors of schizophrenia patients with intestinal obstruction mainly included the patient's age, visiting time, length of hospital stay, history of abdominal surgery, course of disease and gender. Conclusion The older the age, the longer the hospital stay, the longer the course of the disease, the history of previous surgery, and the male schizophrenia who do not see a doctor within 24 h of the onset, the risk of intestinal obstruction is higher, and it is easy to be misdiagnosed and even life-threatening.

BackgroundMental stress and imbalance of its two neural stress systems, the autonomic nervous system (ANS) and the hypothalamic–pituitary–adrenal (HPA) axis, are associated with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED). However, the comprehensive analyses of psychological stress and stress systems are under-investigated, particularly in CP/CPPS patients complicated by lower urinary tract symptoms (LUTS) and ED.Materials and methodsParticipants were 95 patients in CP/CPPS+ED group, 290 patients in CP/CPPS group, 124 patients in ED group and 52 healthy men in control group. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the International Index of Erectile Function-5 (IIEF-5) and the International Prostate Symptom Score (IPSS) were used for assessing the disease severity of CP/CPPS, LUTS and ED. Psychometric self-report questionnaires including the Beck Anxiety Inventory (BAI), Perceived Stress Scale (PSS), Type A Personality Test (TAPT) and Symptom Checklist 90 (SCL-90) were completed for distress from physical symptoms. Twenty-five subjects per group were randomly selected for further investigating the changes of the HPA axis and ANS. Saliva samples were taken on 3 consecutive days at 8 specific times with strict reference to time of morning awakening for evaluation of free cortisol. Heart rate variability (HRV) as marker of the ANS was measured using 24 h electrocardiography, and time-and frequency-domain variables were analyzed.ResultsThe BAI and SCL-90 scores were significantly higher in the CP/CPPS+ED, CP/CPPS and ED groups compared with the control group (p < 0.01). The PSS scores of both groups with ED were significantly higher than the control group (p < 0.01). Compared with the CP/CPPS group, the differences of PSS, SCL-90 and TAPT scores were statistically significant in CP/CPPS+ED patients (p < 0.01). The IPSS scores were shown to have significantly positive correlations with BAI (r = 0.32, p < 0.0001), PSS (r = 0.18, p < 0.01) and SCL-90 (r = 0.19, p < 0.01) in the CP/CPPS patients. However, in all subjects, the IIEF-5 scores were shown to have significantly negative correlations with BAI (r = −0.17，p < 0.001), PSS (r = −0.25，p < 0.0001), SCL-90 (r = −0.20，p < 0.001) and quality of life score in NIH-CPSI (r = −0.14，p = 0.0075). Cortisol awakening response (CAR) parameters and diurnal cortisol levels did not significantly vary between the four groups. Time-dependent parameters of HRV also did not differ significantly across groups. In the frequency domain analysis, low frequency (LF) was significantly lower in ED patients when compared with CP/CPPS+ED patients (p = 0.044) and healthy controls (p = 0.005), high frequency (HF) power was significantly higher in healthy controls compared to patients with ED (p < 0.001), CP/CPPS (p < 0.001) and CP/CPPS+ED (p < 0.001), and the CP/CPPS+ED group had significantly higher LF/HF ratio than the control group (p = 0.001).ConclusionCP/CPPS and ED patients score exceedingly high on most psychosocial variables. The symptom scores of LUTS and ED positively correlate with the severity of psychological stress. Our findings also suggest that the ANS sympathovagal imbalance is associated with ED and LUTS in CP/CPPS, whereas HPA axis activity is not.

To investigate the value of edible horticultural therapy (EHT) for long-term-hospitalized (LTH) female patients who suffered from schizophrenia. 60 female schizophrenic patients hospitalized in our hospital were randomly divided into EHT group and control group, with 30 cases in each group. The EHT group was combined with EHT on the basis of drug treatment, and the control group was only treated with drug treatment. The Brief Psychiatric Rating Scale (BPRS), the Chinese version Scale of Social Functioning for Psychotic Inpatients (SSFPI), and the Life Satisfaction Index A (LSIA) were compared and analyzed between two groups. After 6 weeks of treatment, the SSFPI score of EHT group increased and was significantly higher than that of the control group. After treatment, the LSIA index of EHT group was higher than that of the control group, and the difference between the two groups was statistically significant (P < 0.05). The BPRS index of EHT group was significantly lower than that before treatment, but there was little change in the control group. There was significant difference between the two groups (P < 0.05). EHT maybe valuable for improving clinical symptoms of schizophrenia and recovery of social function. Clinical registration number:researchregistry7590

Background: Previous studies have shown that oxidative stress contributes to hyperglycemia-induced erectile dysfunction. A preferential direct inhibitor of NOX1 and NOX4, GKT-137831, exhibited a strong anti-oxidative role via blockade of reactive oxygen species (ROS) generation in endothelial cells, but whether GKT-137831 could improve erectile function was not clear. Aim: Our study was designed to investigate the effect of NOX1/4 inhibition on improving diabetic erectile dysfunction (ED) in rats. Methods: We used streptozotocin to induce type 1 diabetes mellitus (DM) in 32 male Sprague Dawley (SD) rats (8 weeks old). Eight weeks later, type 1 diabetes mellitus-induced erectile dysfunction (DMED) in rats was confirmed using an apomorphine test. Our study consisted of 3 groups: (i) nondiabetic control group (n = 8), (ii) DMED + vehicle group (DMED group; n = 8), and (iii) DMED + GKT-137831 group (n = 9); GKT-137831 was given as a once-daily intraperitoneal injection for 4 weeks. Cavernous nerve electrostimulation was used to evaluate erectile function. Western blot, ELISA, immunohistochemistry, and immunofluorescence were used to measure expression of specific proteins, and DHE fluorescent probe was performed to detect ROS level. Outcomes: Intracavernous pressure (ICP), nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) signaling pathway, oxidative stress level, inflammatory response, corporal autophagy, and apoptosis were measured. Results: Erectile function in the DMED group was significantly impaired compared to the nondiabetic control group, whereas this impairment was improved with GKT-137831 treatment by 70%. Similarly, endothelial function and overactivated oxidative stress in the corpus cavernosum (CC) of the DMED + GKT-137831 group were improved. The DMED group showed serious inflammatory responses and excessive autophagy, which were inhibited by GKT-137831 treatment in the DMED + GKT-137831 group. Clinical Translation: Our study showed improvement in erectile function with GKT-137831 in a diabetic rat ED model. Strength and Limitations: This study suggested for the first time that GKT-137831, an NOX1/4 inhibitor undergoing clinical trials, is effective in improving erectile function in rats with type 1 DMED. However, we only investigated GKT-137831 treatment of streptozotocin-induced type 1 diabetic rats, and therapeutic evidence in other types of diabetes is lacking. Conclusion: GKT-137831 improves erectile function by 70% in type 1 DMED rats and constitutes a promising compound for the treatment of type 1 DMED, likely by inhibition of overactivated oxidative stress, down-regulation of proinflammatory factors, and amelioration of excessive autophagy and endothelial function. Copyright (C) 2021, International Society of Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Objective: To explore the clinical efficacy of paliperidone palmitate long-acting injection combined with electroacupuncture in the treatment of methamphetamine addicts. Methods: This study focused on methamphetamine addicts who were admitted to our hospital from January 2020 to December 2020 as the main research object, with a total of 89 cases. The patients were divided into a control group of 45 cases and a study group of 44 cases according to the treatment method. The control group was treated with electroacupuncture, and the study group was treated with paliperidone palmitate long-acting injection on the basis of electroacupuncture in the control group. After 6 months of continuous treatment, the treatment effect of methamphetamine withdrawal symptom score before and after treatment was used; Hamilton Anxiety Scale score and Hamilton Depression Scale were used to compare the anxiety and depression situation of the two groups; the brain wave α and θ wave situation of the two groups were compared. Result: The results showed that there was no significant difference in the scores of Ma withdrawal symptoms, Hamilton Anxiety and Hamilton Depression between the two groups before treatment ( p < 0.05); after 3 and 6 months of treatment, the scores of Ma withdrawal symptoms, Hamilton Anxiety and Hamilton Depression in the study group were significantly lower than those in the control group and the difference was statistically significant ( p < 0.05); 6 months after the completion of the treatment, the α wave amplitude and Fourier transformed α brain wave (FFT α ) in the study group were significantly higher than those in the control group, and the difference was statistically significant ( p < 0.05). Conclusion: Paliperidone palmitate long-acting injection combined with electroacupuncture is better than electroacupuncture alone in the treatment of methamphetamine addicts, and can significantly improve anxiety, depression and brain waves, thereby preventing addicts from relapse.

Iatrogenic injury to the vas deferens is an indication for vasovasostomy (VV). Various surgical approaches, including pure microsurgical VV (MVV), pelviscrotal laparoscopic-assisted VV (LAVV), and intra-abdominal robot-assisted VV (RAVV), have been reported to restore vasal patency. MVV is often faced a formidable challenge to provide tension-free VV due to an inadequate vas deferens length. Alternatively, pelviscrotal LAVV is much more effective for the identification and retrieval of the pelvic vas deferens prior to performing MVV. However, vasal laparoscopic mobilization could still be limited by insufficient vasal length for extracorporeal transfer in some cases. The addition of robotic assistance, on the other hand, allows the performance of "in-situ" vasal anastomoses and offers unique features compared with pure MVV/LAVV. However, few such approaches have been described in the literature. This study presents the initial results and validation of robot-assisted VV in an Asian population who had undergone triple herniorrhaphy. Briefly, Intra-operative findings demonstrated a large defect of the vas deferens, and a two-layer bilateral tension-free RAVV was performed to pursue the possibility of naturally achieved pregnancy. With our promising results, intra-abdominal RAVV may be described as a practical approach for cases with iatrogenic large defects of the vas deferens within the inguinal canal.