Background:Previous studies on penile color Doppler ultrasound (CDU) examination after intracavernosal injection (ICI) have included a small number of patients and rarely focused on the effects of intracavernous communicating branches and persistent rigid erection. This study aimed to explore these issues using a large institutional database of erectile dysfunction (ED) patients. Methods:We conducted a retrospective study of 9,109 ED patients who underwent CDU examination after ICI with prostaglandin E1 (PGE1) at our Department of Andrology. Results:Obvious communicating branches between the bilateral cavernous arteries were observed in 200 patients, and the blood flow of the main trunk of the cavernous artery was significantly better than that of the main branch. Another 19 patients remained in a phase of persistent rigid erection and showed no obvious blood flow in at least one cavernous artery. Based on the peak systolic velocity (PSV) and end diastolic velocity (EDV), the remaining 8,890 patients were allocated to non-vascular, arterial, and venous ED groups. Based on the erection duration, the patients in the non-vascular ED group were allocated to persistent erection and non-persistent erection subgroups. The data of each group were standardized and statistically analyzed according to the age gradient. The PSV of the persistent erection, arterial ED, and venous ED groups showed a negative correlation with age, while the EDV of the arterial ED and venous ED groups showed a positive correlation with age. Conclusions:The CDU parameters were found to be correlated with age. Additionally, the communicating branches between bilateral cavernous arteries and persistent rigid erection significantly affected the CDU results.

Background Premature ejaculation (PE) is linked with abnormal brain activity that is modifiable by electroacupuncture (EA).Aim In this study we aimed to explore the central pathological mechanism underlying EA in treating PE.Methods Six-week-old male Sprague-Dawley rats were divided into a PE group (n = 8) and a control group (n = 8) according to ejaculatory frequency during copulatory behavior. All rats underwent EA at the Zusanli acupoint (ST-36) for 4 weeks. Magnetic resonance imaging data were collected before and after EA.Outcomes The behavioral parameters, plasma norepinephrine levels, fractional amplitude of low frequency fluctuation (fALFF), and regional homogeneity (ReHo) were evaluated.Results The PE group ejaculated more times with shorter latency compared with controls. After EA, the ejaculation frequency of the PE group decreased, and the ejaculation latency period increased, with no changes observed in the control group. Norepinephrine levels were higher in the PE group than in the controls and were positively correlated with ejaculation frequency and negatively correlated with ejaculation latency. The PE group showed lower fALFF in the right striatum and higher ReHo in the brainstem compared with controls. After EA, controls showed decreased fALFF in the right striatum, left olfactory bulb, and dorsal fornix and increased ReHo in the right interpeduncular nucleus, as well as decreased ReHo in the left striatum, prelimbic system, right basal forebrain region, septal region, and olfactory bulb, while the model group exhibited increased fALFF in the right hypothalamic region, decreased fALFF in the left globus pallidum and right basal forebrain region and increased ReHo in the right interpeduncular nucleus, as well as decreased ReHo in the left striatum, olfactory bulb, basal forebrain region, dentate gyrus, right dysgranular insular cortex, and striatum. Compared with the controls after EA, the model group showed increased ReHo of the right hypothalamic region and decreased ReHo of the right dysgranular insular cortex.Clinical Implications These findings might enhance the understanding of PE and contribute to new, targeted therapies for PE.Strengths and Limitations The therapeutic effects might be achieved by EA inhibiting the activity in brain regions involved in ejaculatory behavior. However, the curative effect of acupuncture might be underestimated due to some curative effects of sham acupuncture used in the control group.Conclusion In conclusion, the ejaculatory frequency of rats may be reduced and ejaculation latency could be extended by EA at ST-36, which might be achieved by the effects of this treatment on brain activity.

OBJECTIVE:To analyze the blood flow parameters of the cavernous arteries of ED patients after injection of vasoactive drugs, and to explore the differences in blood flow of the cavernous arteries in different erectile states. METHODS:Retrospectively analyzed the penile cavernous arterial blood flow parameters of 2568 adult male ED patients after injection of the vasoactive drug (alprostadil). The patients were divided into three groups: maintaining erection group with EHS (erection hardness score) ≥ 3 and sustained erection time ≥ 20 minutes (967 cases), nonpersistent erection group with EHS≥3 and sustained erection time<5 minutes (788 cases), and incomplete erection group with EHS<3 (813 cases). Compared the parameters of age, EHS, duration of erection, cavernous artery peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) among the three groups respectively. The maintaining erection group was divided into the youth group (757 cases) which aged less than 40 years old and the middle-aged and elderly group (210 cases) with 40 years old or over. The parameters of PSV, EDV and RI between the two groups were compared. The incomplete erection group were divided into the good blood supply group (407 cases) with the bilateral PSV ≥35cm/s and the insufficient blood supply group (252 cases) with the bilateral PSV<35cm/s. The parameters of age, EHS, EDV and RI between the two groups were compared. RESULTS:The age, PSV, EDV and RI of the three groups were significantly different (P<0.01). In the maintaining erection group, the PSV of the young group was significantly higher than that of the middle-aged and elderly group (P<0.05), but there was no statistically significant difference in EDV and RI (P>0.05). In the incomplete erection group, the EHS, PSV, EDV, and RI of the good blood supply group were significantly higher than those of the insufficient blood supply group (P<0.05), while the age was significantly lower than that of the latter (P<0.01). CONCLUSION:The injection of vasoactive drugs combined with color Doppler ultrasound can directly reflect the blood supply of the cavernous arteries of the penis. The better the erection state, the better the blood supply of cavernous arteries. The middle-aged and elderly people are more likely to have cavernous arteries problem of insufficient blood supply than the young people.

Previous studies have proved that nose size has a positive correlation with stretched penile length but stretched penile length does not fully represent erectile penile length. It is considered that the formation and growing ability of the penis is determined by the action of androgen in the fetal period and nose size has also been determined to some extent before birth. If the nose size is indeed related to the length of the penis, there must be a common mechanism behind it. To further confirm the relationship between nose size and penile length, especially erectile penile length, a correlation analysis was carried out by collecting general data and the data related to the nose, ears, and genitals of 377 males aged 20–56 years, including erectile penile length and erectile penile circumference. The results revealed that nose size had the highest correlation with erectile penile length (r = 0.507, p = 0 ) and flaccid penile length (r = 0.451, p = 0 ). Therefore, it is believed that nose size is an independent predictor of flaccid and erectile penile length, and the common factors that contribute to this correlation may appear in the fetal period.

目的 探讨低强度脉冲式超声波(LIPUS)治疗男性勃起障碍(ED)的疗效.方法 回顾性分析 2020 年 6 月—2022 年 6 月在南京大学医学院附属鼓楼医院就诊的 ED患者 121 例.根据 IIEF-EF评分将 ED患者分为轻(17～25 分)、中(11～16 分)、重(0～10 分)三个亚组.分析 LIPUS 治疗前、治疗后 4 周和 12 周时三组的总有效率、勃起硬度评级(EHS)、性生活日记问题(SEP)、总体评估问卷(GAQ)、收缩期峰值流速(PSV)、舒张末期流速(EDV)和不良反应等指标.结果 119 例患者完成随访.治疗后第 4、12 周与治疗前相比,IIEF-EF评分及 EHS情况均有明显提升(P<0.05).LIPUS治疗后第 4、12 周总有效率分别为69.75%、76.47%,治疗后 4、12 周轻度和中度组患者的总有效率均显著高于重度组(P<0.05).SEP2、SEP3 回答"能"的患者在治疗 4 周时分别为 91.60%、71.43%,治疗后第 12 周占比分别为 92.44%、78.15%,均显著高于治疗前(52.10%、27.73%,P<0.05).GAQl和 GAQ2 在治疗后第 4 周回答"有"的患者占比分别为 84.87%、71.43%,治疗后第 12 周分别为 82.35%、70.59%,治疗后 2 次随访比较差异无统计学意义.患者在治疗后 12 周 PSV 水平较治疗前升高[(48.85±14.11)cm/s vs.(41.42±14.90)cm/s],差异有统计学意义(P<0.05);治疗后 12 周 EDV水平较治疗前降低[(-0.57±7.01)cm/s vs.(2.25±5.68)cm/s],差异有统计学意义(P<0.05).结论 LIPUS对于 ED患者具有良好的治疗效果且无明显不良反应.

目的 观察勃起功能障碍患者行超声检查时多普勒角度变化对阴茎海绵体动脉血流检测结果的影响,探讨最佳检测多普勒角度.方法 勃起功能障碍患者41例,均于阴茎注射前列地尔阴茎勃起达最大硬度后行彩色多普勒超声检查,分别测量多普勒角为0°、30°、60°、75°时阴茎海绵体动脉收缩期峰值流速(peak systolic velocity,PSV)及舒张末期流速(end diastolic velocity,EDV)并进行比较.结果 左、右侧阴茎海绵体动脉PSV在多普勒角为0°[(31.00±7.33)、(32.85±8.68)cm/s]、30°[(35.79±8.47)、(37.93±10.03)cm/s]、60°[(61.99±14.66)、(65.69±17.36)cm/s]时均低于75° 时[(119.68±28.31)、(126.81±33.52)cm/s](P＜0.05),0°、30°时均低于 60°时(P＜0.05),0°时均低于 30° 时(P＜0.05).左、右侧阴茎海绵体动脉 EDV 在多普勒角为 0°[(-3.82±1.21)、(-4.34±2.40)cm/s]、30°[(-4.41±1.40)、(-5.01±2.77)cm/s]、60°[(-7.63±2.42)、(-8.68±4.80)cm/s]时均高于 75°时[(-14.73±4.67)、(-16.76±9.27)cm/s](P＜().05),0°、30°时均高于 60°时(P＜0.05),0.时均高于 30° 时(P＜0.05).结论 多普勒角为60°.且角度校正线与阴茎海绵体动脉走向平行时测得PSV、EDV结果较为准确,多普勒角度改变尤其是增至75°时明显影响检测结果.

OBJECTIVETo compare the result of the artificial intelligence (AI) recognition-based fluorescence method and that of traditional flow cytometry in the examination of the sperm DNA fragmentation index (DFI) and assess the reliability of the AI-based fluorescence detection.METHODSUsing flow cytometry and the AI-based fluorescence method, we examined the sperm DFI in the semen samples collected from 338 outpatients. We analyzed the correlation between the results and compared the positive rates detected by the two methods. We repeated the AI-based fluorescence method twice for each semen sample to observe its technical stability in the detection of sperm DFI.RESULTSThe result of flow cytometry was well correlated with that of the AI-based fluorescence method in the detection of sperm DFI (R2 = 0.7131), but poorly correlated for low-concentration, sticky semen and some other extreme samples (R2 = 0.2065). No statistically significant difference was found between the two methods in the positive rate of detection. The AI-based fluorescence method exhibited an excellent technical stability (R2 = 0.9671).CONCLUSIONThe AI-based fluorescence method has an excellent technical stability in the detection of sperm DFI and the result is not significantly different from that of traditional flow cytometry.

目的 考察精子DNA碎片指数(DFI)与精液常规参数的相关性,评价其在男性精子质量评估中的临床意义.方法 选取2020年1月至9月南京大学医学院附属鼓楼医院生殖医学中心和男科门诊治的4943例男性患者作为研究对象.共收集4943例男性精液标本,采用精子染色质结构分析法(SCSA)进行精子DFI和高DNA着色性(HDS)检测.根据DFI值将样品分为DFI≤15％组、15％15％组,分别分析DFI、HDS与精液参数的关系.根据精液参数的参考值将其分为正常组和精液异常性疾病组.异常组再根据精子浓度、前向运动精子百分率(PR)、正常形态精子百分率分为少精子症组、弱精子症组、畸形精子症组、少弱精子症组、少畸精子症组、弱畸精子症组和少弱畸精子症组,比较精液异常性疾病组与正常组精子DFI、HDS的差异.结果 DFI≤15％组、15％15％组的精子浓度、PR、正常形态精子百分率、TZI、DFI比较,差异具有极显著性统计学意义(P<0.01).DFI、HDS均与精子浓度、PR和精子正常形态率负相关,且DFI与年龄、精液体积、TZI和HDS呈正相关,HDS只与TZI呈正相关.弱精子症组、畸形精子症组、少弱精子症组、弱畸精子症组和少弱畸精子症组的DFI、HDS与正常组比较,差异具有统计学意义(P≤0.05).结论 精子DFI与精液常规参数有显著相关性且其在不同精液异常性疾病中有显著性差异,精子DFI对临床评估男性精子质量有重要意义.

OBJECTIVE:To study the semen parameters of the patients with Y chromosome microdeletions and their impacts on the spermatogenesis of the patients.METHODS:We selected 151 male infertility patients with Y chromosome microdeletions from those diagnosed and treated in our hospital and retrospectively analyzed the influence of their semen parameters on the spermatogenic function.RESULTS:Of the 151 cases of Y chromosome microdeletions, AZFc was involved in 102 (66.89%), AZFb in 6 (3.97%), AZFa in 5 (3.31%), AZFa+c in 1 (0.66%), AZFb+c in 6 (3.97%), AZFc+d in 1 (0.66%), AZFb+c+d in 13 (8.61%), AZFa+b+c+d in 12 (7.95%), sY127 in 3 (1.99%), sY134 in 1 (0.66%) and sY86 in 1 (0.66%). Among the total number of the infertility patients, 48 (31.78%) were diagnosed with azoospermia, 74 (49%) with cryptozoospermia, 28 (18.54) with oligoasthenozoospermia and 1 (0.66%) with asthenoteratozoospermia.CONCLUSIONS:Y chromosome microdeletions may lead to decreased sperm quality, and different types of deletion have different impacts on the spermatogenic function of the patients.

PURPOSE:Premature ejaculation (PE) is one of the most common male sexual dysfunctions. Local anesthetics (LAs) and dapoxetine are frequently used to treat PE; however, previous studies show variable efficacy. This study aims to determine the efficacy of LAs and dapoxetine using a novel classification based on neurophysiological tests. MATERIALS AND METHODS:This multicenter cohort study enrolled adult men (568) with an intravaginal ejaculatory latency time (IELT) ≤2 minutes. Patients were divided into 4 groups according to the results of neurophysiological tests and assigned different treatments for 12 weeks: 1) penile sensory hyperexcitability type (Sens)-LAs; 2) penile sympathetic hyperexcitability type (Symp)-dapoxetine; 3) mixed type (Mixed)-both LAs and dapoxetine; 4) normal type (Norm)-both LAs and dapoxetine. Self-estimated IELT and patient-reported outcomes were recorded. RESULTS:The total percentage of men achieving IELT >2 minutes and ≥5 minutes after treatment were 82.7% and 76.7%, respectively. For men with abnormal results of neurophysiological tests, 401 (86.6%) had improved IELT >2 minutes after the 12-week treatment course, in which 375 (81.0%) achieved IELT ≥5 minutes. All patient-reported outcome measures improved in each group after 12 weeks of treatment, with greater improvements among those with abnormal neurophysiological tests. CONCLUSIONS:The efficacy of LAs and dapoxetine increased in PE patients with abnormal results of neurophysiological tests. This novel classification of PE using neurophysiological tests could help guide and improve efficacy of PE therapies.

Objective To explore the clinical value of phosphodiesterase type-5 inhibitors (PDE-5i) combined with RigiScan-based audiovisual sexual stimulation (AVSS) test in comparison with that of nocturnal penile tumescence (NPT) test in evaluation of erectile function. METHODS A total of 166 ED patients, aged 21－63 (mean 31) years, with a disease course of 3 months to 10 years (mean 14 months), underwent NPT test or PDE-5i + RigiScan-based AVSS test from 2017 to 2018. We compared the results of the diagnostic strategies. Normal NPT patterns were presumed to indicate psychogenic and abnormal ones to indicate organic ED. RESULTS Compared with the results of NPT test, no statistically significant difference was observed in the accuracy rate between Viagra + AVSS test and Cialis + AVSS test (P > 0.05). PDE-5i + RigiScan-based AVSS test achieved a sensitivity of 78.9% and a specificity of 90.7% in the diagnosis of psychogenic ED and an overall accuracy rate of 81.9%. According to the results of PDE-5i + RigiScan-based AVSS test, the patients fell into a normal and an abnormal erection group, with significant differences between the two groups in age, disease course, IIEF-5 score and maintenance time of penile tip rigidity ≥60% (P < 0.05). ROC curve analysis indicated that PDE-5i + RigiScan-based AVSS test accurately manifested the erectile function of the patients. CONCLUSIONS Compared with NPT test, PDE -5i combined with RigiScan-based AVSS test is simple, inexpensive, practical and with a high sensitivity and specificity, and therefore can be used as the first-choice strategy for etiological diagnosis of ED.

目的 探讨非血管性勃起功能障碍勃起易疲软者的阴茎交感皮肤反应(penis sympathetic skin response,PSSR)变化.方法 阴茎勃起硬度评分4级、阴茎海绵体动脉收缩期峰值流速≥35 cm/s、舒张末期流速≤0 cm/s、PSSR能正常牵引出的勃起功能障碍患者71例,以阴茎海绵体注射血管活性药物后持续勃起时间＞20 min者44例为勃起坚挺组,持续勃起时间＜5 min者27例为勃起易疲软组.比较2组年龄、收缩期峰值流速、舒张末期流速及PSSR潜伏期、波幅差异.结果 2组年龄、舒张末期流速、PSSR波幅比较差异均无统计学意义(P＞0.05).勃起易疲软组左、右侧阴茎海绵体动脉收缩期峰值流速[(52.50±14.68)、(53.25±17.78) cm/s]低于勃起坚挺组[(66.23±18.38)、(64.36±19.40)cm/s](P＜0.05),PSSR潜伏期[(1 198.15±109.34)ms]短于勃起坚挺组[(1 410.11±140.53)ms](P＜0.05).结论 阴茎勃起易疲软者PSSR潜伏期缩短,可能存在交感神经高兴奋性,PSSR神经电生理检查可用于交感神经兴奋性较高的非血管性勃起功能障碍的辅助检测.

OBJECTIVE:To compare the hemodynamic indexes of penile cavernosal arteries in different phases of penile erection and determine the optimal time for color Doppler ultrasonography of the penis. METHODS:Forty healthy adult male volunteers with normal erectile function received intracavernous injection of 10 μg Alprostadil together with visual and auditory stimuli. Within the next 30 minutes, we monitored dynamically the blood flow in the bilateral penile cavernosal arteries, and recorded and compared the peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) in the phases of latency, tumescence, full erection and rigid erection. RESULTS:Fourteen of the subjects experienced latency, tumescence and full erection only, but failed to achieve rigid erection. PSV and RI were significantly higher while EDV remarkably lower in the tumescence and full erection phases than in the latency phase (all P < 0.01). Statistically significant differences were observed between the tumescence and full erection phases in EDV and RI (both P < 0.01) but not in PSV (P > 0.05). Among the 26 males that achieved rigid erection, PSV, EDV and RI showed significant differences between the full and rigid erection phases (all P < 0.01), but not between the left and right cavernosal arteries in the same phase (P > 0.05). CONCLUSIONS:The blood flow in the penile cavernosal arteries changes dynamically in the process of penile erection, and the hemodynamic indexes obtained in the full erection phase can better reflect the function of penile cavernous vessels.

生物灰岩油藏储层特点是生物礁体本身具有良好的储集空间,但是酸化后,生物灰岩油藏易形成较大的孔洞及缝,势必会造成地层严重漏失;而且注水见效后孔洞内腔被水和气体占据,封堵作业不仅堵剂用量大且易发生堵剂与地层水、地层气置换,难以留塞.如何做好酸蚀生物灰岩油藏的封堵就成为当前的主要问题.为此分析近年来王徐庄油田生物灰岩封堵施工的成功和失败原因,总结和优化施工工艺,提出一种酸蚀生物灰岩封堵作业新思路,提高了现场封堵一次成功率.

OBJECTIVE:To investigate the influence of mycoplasma genitalium (MG) infection on semen parameters and seminal plasma biochemical indicators in infertile men and the relationship of MG infection with male infertility.METHODS:This retrospective study included 420 male patients with idiopathic infertility confirmed in our hospital from February 2016 to February 2018. We examined the MG RNA in the urine of the patients by nucleic acid amplification test, analyzed the semen parameters using the computer-assisted semen analysis system, observed the sperm morphology by modified Shorr staining, and determined the activities of α-glucosidase (α-Glu), fructose (Fru), zinc and γ-L-glutamyl transpeptidase (γ-GT) in the seminal plasma.RESULTS:Of the 420 cases of idiopathic infertility, 101 were MG-positive and the other 319 MG-negative. Compared with the MG-negative patients, the MG-positive group showed a remarkably decreased semen volume (［3.57 ± 1.36］ vs ［3.20 ± 1.30］ ml, P = 0.016) but no statistically significant differences in sperm concentration (［57.36 ± 40.88］ vs ［54.80 ± 36.54］ ×10⁶/ml, P > 0.05), the percentage of progressively motile sperm (［45.33 ± 20.42］% vs ［41.29 ± 18.71］%, P > 0.05) and the percentage of morphologically normal sperm (［5.87 ± 2.97］% vs ［5.67 ± 2.86］%, P > 0.05). Nor were there any significant differences between the MG-negative and -positive groups in the activities of α-Glu (［338.82 ± 126.36］ vs ［352.47 ± 213.34］ U/L, P > 0.05), Fru (［15.62 ± 6.35］ vs ［14.93 ± 6.53］ mmol/L, P > 0.05), zinc (［2.82 ± 1.23］ vs ［2.98 ± 1.30］ mmol/L, P > 0.05), and γ-GT (［1993.98 ± 556.03］ vs ［1925.64 ± 593.41］ U/L, P > 0.05) in the seminal plasma.CONCLUSIONS:MG infection can reduce the semen volume but has no significant influence on the other semen parameters and seminal plasma biochemical indicators in male infertility patients.

OBJECTIVE:To explore the clinical selection and application of cell suspension examination (CSE) or histopathological technique (HPT) in detecting sperm in the testis tissue obtained by testicular sperm aspiration (TESA) in patients with non-obstructive azoospermia (NOA).METHODS:Totally, 1 006 NOA patients underwent TESA and their testis tissues were subjected to CSE or HPT for sperm detection. Based on the results of CSE, the testicular tissue samples were divided into groups A (with sperm, n = 567) and B (without sperm, n = 439) and the results were compared with those of HPT.RESULTS:HPT showed 508 cases with but 59 without sperm in group A, and 403 with and 36 without sperm in group B. The consistency rate of CSE with that of HPT was 90.56% (Kappa =0.809), and CSE exhibited a significantly higher rate of sperm detection than HPT (56.36% vs 54.08%, P=0.023).CONCLUSIONS:CSE combined with HPT for detecting sperm in the testis tissue of NOA patients undergoing diagnostic TESA helps clinical diagnosis and treatment. The results of CSE have a decisive significance for assisted reproductive therapy, while those of HPT may provide some definite etiological evidence for drug therapy or surgery.

在小修作业中,为了保证油井的正常生产要对油井进行必要的维护作业:检泵.抽油泵在日常生产过程中,受到机械磨损及地层砂、蜡、气、水等不同腐蚀侵害,使抽油泵各部件受到不同程度损害,甚至漏失或蜡卡、泵杆断脱等使油井减产、停产等.其中泵杆断脱、砂卡砂堵、稠油等检泵会伴随着灌肠起管的风险.随着《环保法》的颁布,环境污染问题日常严峻,对于以往灌肠提管的现象将严厉禁止,而如何防止灌肠提管则成了目前急需解决的难题,本文章首先介绍分析了几种常见检泵原因,然后就管柱优化及现用泄油器的优缺点进行了对比,并在此基础上设计出一种剪切式泄油器.

目的:对FASA全自动精子分析仪检测出的可疑无精子症精液标本进一步分析,降低无精子症的误诊率.方法:使用FASA全自动精子分析仪分析后未检测出精子的388例精液标本,取50 μL,重复2次涂片后,在高倍显微镜下逐个视野观察,未观察到精子的标本以3 000 g离心15 min后取沉淀进一步涂片观察.结果:388例标本中,离心前镜检未观测到精子成分239例(61.60%),其中10例于离心后镜检发现精子,1例检测到1条前向运动(PR)精子,9例检测到1～2条不动(IM)精子;离心前镜检观测到精子成分149例(38.40%),其中检测到PR精子102例,未检测到PR精子的标本中47例,检测到非前向运动(NP)精子3例,只检测到IM精子44例.结论:FASA全自动精子分析仪检测出的可疑无精子症精液标本,可通过镜检及离心后镜检的方法进一步分析,降低无精子症的误诊率.

Objective To evaluate the safety and efficacy of tadalafil on demand or on time treatment in medium-elderly men with erectile dysfunction. Methods Totally 83 patients were divided into two groups:on-demand group with 43 patients,treated by tadalafil at 20 mg on demand before sexual activity,and on-time group with 40 patients, treated with tadalafil at 10 mg on time on alternate days. Before and 4 weeks after treatment,the safety and therapeutic efficacy of the two groups were compared by the scores on International Index of Erectile Function(IIEF-15), Sexual Encounter Profile(SEP-2/SEP-3),the Global Assessment Questionnaire(GAQ1/GAQ2)and colour Doppler ultrasound of the penis. Results Four weeks after treatment,the IIEF-IS and IIEF-EF scores were improved in both the on-time and on-demand groups(P<0.05);The YES answers to SEP-2/SEP-3 were improved in both the on-time and on-demand groups(P<0.05);The average value of peak systolic velocity(PSV)of penis was improved in both the on-time and on-demand groups(P<0.05), esecially in on-time group. The YES answers to GAQ1/GAQ2 were significantly higher in the medium age men compared with the elderly men after tadalafil treatment on-time or on-demand(P<0.05).In elderly men with ED,the YES answers to GAQ1/GAQ2 were significantly higher in the on-time group than those in on-demand groups after treatment(P<0.05). There was no significant differences in adverse reaction between the two groups. Conclusions Both on-time and on-demand dosing of tadalafil are efficacious and well tolerated in the treatment of ED,and on-time dosing of tadalafil has an even better effect than on-demand dosing for the elderly men with ED.

对油田开采出现的溢流或者井涌甚至井喷情况所有原油开采公司都在想方设法进行防范与控制,并制定了有效可行的应急措施以应对溢流的加剧化程度,工人在井下作业时需要时刻警惕,留心观察井下的时实情况和做好井控工作,来防止溢流事故的出现甚至加剧化,从而确保了工人在井下作业的安全性.本文笔者总结了以往油田井下作业各种情况的经验,根据井下作业实际情况发现了井下作业存在的种种问题,最终提出井下作业井控问题及解决的途径.