Phosphodiesterase-5 inhibitors (PDE5i) have been used as the first-line treatment for erectile dysfunction (ED) in recent years. However, with the increased clinical application of PDE5i, the incidence rate of PDE5i-induced adverse reactions is on the rise, which may involve the cardiovascular, digestive, nervous, respiratory, and reproductive systems. Most of the adverse reactions are mild to moderate, occasionally with serious or rare complications. The probability and severity of the adverse reactions are associated with the dosage and frequency of medication as well as with individual differences. Therefore individualized medication is necessitated and, for the patients with cardiovascular disease, epilepsy, psychosis, or anaphylactic conditions, PDE5i should be cautiously given or avoided. This review provides an overview of PDE5i-induced adverse reactions and countermeasures in the treatment of ED.
Erectile Dysfunction ; drug therapy ; Humans ; Male ; Phosphodiesterase 5 Inhibitors ; administration & dosage ; adverse effects

Testicular germ cell tumor (TGCT) is a most common testicular malignancy with an increasing incidence, and its pathogenesis and mechanisms are not yet clear. The next generation sequencing has become the main tool to uncover the underlying mechanisms of TGCT. The differential gene expressions, gene mutation, predisposing gene-dominated signaling pathways, and changes of the relevant genes in the sex chromosome are largely involved in the occurrence and development of TGCT. Studies on the genomics of TGCT contribute a lot to identifying the pivotal pathogenic genes and paving a theoretical ground for the early screening and targeted therapy of TGCT. This paper summarizes the advances in the studies of the genomics of TGCT so as to reveal thetmechanisms of the disease at the genetic level.
Genomics ; High-Throughput Nucleotide Sequencing ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal ; genetics ; Testicular Neoplasms ; genetics

Psoriasis is a chronic inflammatory disease involving several systems. Recent epidemiological studies show that psoriasis is closely related to erectile dysfunction (ED) and may be an independent factor of ED. Psoriasis-induced ED may be associated with vascular endothelial injury, oxidative stress, mental depression, and so on. An insight into the incidence and pathogenesis of psoriasis-related ED will help to improve psoriasis patients' early understanding of ED, prevent its development and progression, and improve the patients' quality of life.
Depression ; complications ; Endothelium, Vascular ; physiopathology ; Erectile Dysfunction ; complications ; Humans ; Incidence ; Male ; Oxidative Stress ; Psoriasis ; complications ; Quality of Life ; Risk Factors

Objective: To systematically analyze the correlation between psoriasis and erectile dysfunction (ED). METHODS: We searched the Cochrane Library, EMbase, PubMed, OVID, Medline, VIP, WanFang, China National Knowledge Infrastructure (CNKI), and Chinese Biomedical Literature Database (CBM via SinoMed) for the published literature about the relationship between psoriasis and ED up to June 2016. According to inclusion and exclusion criteria, two researchers respectively extracted the relevant data and made a meta-analysis on the correlation of psoriasis with ED and IIEF-5 scores using the Review Manager 5.3 software. RESULTS: A total of 6 studies were included in this analysis. The analysis with the fixed-effects model revealed a significant correlation between psoriasis and ED (OR = 1.92, 95% CI: 1.53－2.40, P <0.01), and that on 3 of the studies with the random-effects model showed that the IIEF-5 scores were significantly lower in psoriasis patients than in non-psoriasis males (MD = －3.11, 95% CI: －4.85－－1.37, P <0.01). CONCLUSIONS There is a certain correlation between psoriasis and ED. Psoriasis patients may have a higher incidence of ED though it is to be further confirmed by more higher-quality studies.
Erectile Dysfunction ; complications ; epidemiology ; Humans ; Male ; Psoriasis ; complications ; epidemiology

Objective: To screen lentiviral vectors carrying siRNA which can specifically down-regulate the gene expression of the sphingosine-1-phosphate receptor 3 (S1PR3) in the corpus cavernosum smooth muscle (CCSM) cells of rats with spontaneous hypertension (SHT) and investigate the influence of the vectors on the signaling pathways of ROCK1, ROCK2 and eNOS in the CCSM cells of SHT rats. METHODS: Using the S1PR3 mRNA sequence of the rat as an interfering target, we designed and synthesized three pairs of siRNA sequences (siRNA1, 2 and 3) targeting S1PR3 and one pair of negative control, and then constructed and packaged them into lentiviral vectors. We cultured the CCSM cells of SHT and Wistar-Kyoto (WKY) rats in vitro and randomly divided them into groups A (SHT untransfected control), B (SHT transfected and carrying negative control virus), C (SHT transfected and carrying siRNA1 targeting S1PR3), D (SHT transfected and carrying siRNA2 targeting S1PR3), E (SHT transfected and carrying siRNA3 targeting S1PR3), and F (WKY untransfected control). With the multiplicity of infection (MOI) = 60, we transfected the CCSM cells of the SHT rats with the lentiviral vector and then determined the expression of the green fluorescent protein (GFP) as well as the mRNA and protein expressions of S1PR3, ROCK1, ROCK2 and eNOS in the CCSM cells of the SHT and WKY rats by RT-PCR and Western blot. RESULTS: Gene sequencing proved the successful construction of the lentiviral vector. The transfection efficiency of the CCSM cells of the rats was >80% in groups B, C, D and E. Compared with group A, the mRNA and protein expressions of S1PR3, ROCK1 and ROCK2 exhibited no significant difference in group B but were remarkably decreased in groups C, D, E and F (P< 0.05), most significantly in group E, with the inhibition rates of the mRNA and protein expressions of S1PR3 of (34.2±2.9) and (77.7±4.7)%, those of ROCK1 of (33.3±1.4) and (51.1±7.3)%, and those of ROCK2 of (30.8±3.6) and (58.32±5.5)%, respectively. The mRNA and protein expressions of eNOS in group A showed no significant difference from those in groups B, C, D and E (P>0.05) but remarkably lower than those in group F (P< 0.05). Compared with group F, the mRNA and protein expressions of S1PR3, ROCK1 and ROCK2 were not significantly different from those in group E (P>0.05) but markedly increased in groups A, B, C and D (P< 0.05), while those of eNOS remarkably decreased in groups A, B, C, D and E (P< 0.05). CONCLUSIONS The three constructed lentiviral vectors carrying siRNA targeting different loci of the S1PR3 gene could significantly inhibit the expression of S1P3 as well as RhoA/Rho kinase signaling pathways in the CCSM cells of SHT rats, and the vector carrying siRNA3 exhibited the highest inhibitory effect.
Animals ; Down-Regulation ; Gene Expression ; Genetic Vectors ; Green Fluorescent Proteins ; metabolism ; Lentivirus ; genetics ; Male ; Myocytes, Smooth Muscle ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Penis ; metabolism ; RNA, Messenger ; RNA, Small Interfering ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Inbred WKY ; Receptors, Lysosphingolipid ; genetics ; metabolism ; Signal Transduction ; Sphingosine-1-Phosphate Receptors ; Transfection ; rho-Associated Kinases ; metabolism

OBJECTIVETo investigate the clinical effect of fast-track surgery combined with Chinese medicine treatment in devascularization operation for cirrhotic esophageal varices.

METHODSSeventy-two patients with cirrhotic esophageal varices were selected from January 2009 to June 2013, and randomly assigned to a conventional group and a fast-track group (fast-track surgery combined with Chinese medicine treatment) using a randomized digital table, 36 cases in each group. Operation and anesthesia recovery time, postoperative hospitalization and quality of life were recorded and compared between groups during the perioperative period.

RESULTSCompared with the conventional group, the fast-track group had longer operation time (253.6±46.4 min vs. 220.6±51.0 min) and anesthesia recovery time (50.5±15.9 min vs. 23.5±9.6 min; P<0.01); less bleeding (311.3±46.8 mL vs. 356.2±57.5 mL; P<0.01) and less transfusion (1932.3±106.9 mL vs. 2045.6±115.4 mL; P<0.01); as well as faster recovery of gastrointestinal function, shorter postoperative hospitalization and higher quality of life. There were no serious postoperative complications and no further bleeding occurred.

CONCLUSIONFast-track surgery combined with Chinese medicine treatment is a safe and feasible approach to accelerate the recovery of patients with cirrhotic portal hypertension in perioperative period of devascularization operation.

Adult ; Aged ; Anesthesia Recovery Period ; Blood Loss, Surgical ; Blood Transfusion ; Chronic Disease ; Esophageal and Gastric Varices ; surgery ; therapy ; Female ; Humans ; Length of Stay ; Liver Cirrhosis ; complications ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Operative Time ; Postoperative Complications ; Postoperative Period ; Quality of Life ; Splenectomy

Objective: To observe the gadolinium imaging findings of inner ear in patients with sudden deafness and to analyze its clinical features. Methods: From November 2017 to July 2020, 21 patients with sudden deafness in the People's Hospital of Dongsheng District, Ordos City were selected as the research objects, including 14 males and 7 females, aged 36-76 years, with a median age of 50 years. The course of disease was 1-19 days, with an average of 5.5 days. The patients received audiology tests, laboratory examination, and intravenous gadolinium angiography, each of whom was scanned twice by 3D-FLAIR sequence: once before intravenous gadolinium injection, and once again 4.5-6.0 h after intravenous gadolinium injection. The following corresponding clinical treatment was given. The imaging manifestations and clinical features were observed. Results: Among 21 cases of sudden deafness in acute stage, the signal intensity of 11 cases was significantly higher than that of the contralateral ear, and 2 cases had vestibular labyrinthine hydrops. In laboratory examination, only 2 cases of total deafness had increased WBC count and faster erythrocyte sedimentation rate, and the rest had no abnormality. The hearing types of 21 patients with sudden deafness were: total deafness in 8 cases, flat decline in 10 cases, low frequency decline in 1 case, high frequency decline in 2 cases. The total effective rate was 57% (12/21). The hearing types of 11 patients with abnormal gadolinium angiography were total deafness in 5 cases, flat decline in 5 cases and high frequency decline in 1 case. The total effective rate was 64% (7/11). Conclusion: Gadolinium angiography is abnormal in some patients with sudden deafness, and the permeability of blood labyrinth barrier may be increased, which is worthy of further study.
Angiography ; Deafness ; Female ; Gadolinium ; Hearing Loss, Sudden/diagnostic imaging* ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Vestibule, Labyrinth