The vacuum erectile device (VED) uses negative pressure to increase blood inflow into the corpora cavernosum, with a ring at the base of the penis to maintain erection for intercourse or without a ring for penile rehabilitation. Owing to the limitation of phosphodiesterase 5 inhibitors (PDE5I) shown in the treatment of refractory erectile dysfunction (ED), the use of VED has resurged and is becoming the first line therapy in the treatment of ED following radical prostatectomy (RP). Currently, the combination therapy of VED with PDE5I and that of VED with intracavernous injection are advocated for post-RP ED. Hereby, we review the role of VED in penile rehabilitation, its underlying mechanisms, and the combination therapies for it.
Coitus ; Combined Modality Therapy ; methods ; Erectile Dysfunction ; drug therapy ; etiology ; rehabilitation ; Humans ; Male ; Penile Prosthesis ; Penis ; blood supply ; Phosphodiesterase 5 Inhibitors ; therapeutic use ; Prostatectomy ; adverse effects ; Regional Blood Flow ; Vacuum

Objective:To explore the effects of serum cystatin C (Cys C) and uric acid (UA) concentrations before treatment on the prognosis of small cell lung cancer (SCLC) patients.Methods:A total of 196 patients diagnosed with SCLC in Affiliated Hospital of Qingdao University from April 2015 to December 2018 were selected, and hematological indicators such as serum Cys C and UA before treatment were collected. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off values of Cys C and UA. The Kaplan-Meier method was used for survival analysis. Cox proportional hazards model was used for univariate and multivariate analysis.Results:The optimal cut-off values of serum Cys C and UA before treatment were 0.775 mg/L and 296.45 μmol/L, respectively. Survival analysis showed that with the optimal cut-off value, the median progression-free survival (PFS) of patients with high concentrations of serum Cys C and UA (5.49 months vs. 8.57 months, χ2=35.943, P<0.001; 6.67 months vs. 8.20 months, χ2=8.047, P=0.005) and overall survival (OS) (13.37 months vs. 23.95 months, χ2=21.355, P<0.001; 14.13 months vs. 20.97 months, χ2=11.333, P=0.001) were shorter than those of patients with low concentrations. Univariate analysis showed that factors related to PFS were smoking history ( HR=0.707, 95% CI: 0.518-0.965, P=0.029), staging ( HR=1.776, 95% CI: 1.329-2.373, P<0.001), first-line medication ( HR=1.596, 95% CI: 1.072-2.376, P=0.021), chest radiotherapy ( HR=2.407, 95% CI: 1.803-3.214, P<0.001), Cys C ( HR=3.602, 95% CI: 1.716-7.561, P=0.001), UA ( HR=1.002, 95% CI: 1.000-1.003, P=0.036), and alkaline phosphatase ( HR=1.010, 95% CI: 1.004-1.016, P=0.001); factors related to OS included smoking history ( HR=0.577, 95% CI: 0.382-0.870, P=0.009), staging ( HR=1.846, 95% CI: 1.295-2.630, P=0.001), chest radiotherapy ( HR=2.041, 95% CI: 1.426-2.921, P<0.001), Cys C ( HR=9.506, 95% CI: 3.278-27.564, P<0.001) and UA ( HR=1.003, 95% CI: 1.001-1.005, P=0.006). Multivariate analysis showed that chest radiotherapy ( HR=2.553, 95% CI: 1.774-3.672, P<0.001), Cys C ( HR=4.538, 95% CI: 1.875-10.982, P=0.001) and alkaline phosphatase ( HR=1.011, 95% CI: 1.005-1.018, P=0.001) were independent prognostic factors for PFS; Cys C ( HR=9.028, 95% CI: 2.680-30.413, P<0.001) was an independent prognostic factor for OS. Conclusion:Both serum Cys C and UA concentrations before treatment in SCLC patients have a certain relationship with the prognosis of the patients. Those with elevated concentrations have shorter PFS and OS and poor prognosis. The high concentration of serum Cys C before treatment may indicate a rapid progression of the disease and a short survival time. It is necessary to pay attention to disease progression and recurrence.

Objective: To investigate the epidemiological features of notifiable infectious diseases in Zhejiang Province in 2021, so as to provide the evidence for formulating infectious disease control measures. Methods: The data pertaining to notifiable infectious diseases reported in Zhejiang Province in 2021 were retrieved from the Infectious Disease Surveillance System of China Information System for Disease Control and Prevention. The incidence and mortality of notifiable infectious diseases in Zhejiang Province in 2021 were descriptively analyzed. Results: Totally 29 types of notifiable infectious diseases with 396 623 cases and 391 deaths were reported in Zhejiang Province in 2021, with a reported incidence of 614.28/105 and a reported mortality of 0.605 6/105, respectively. There were 93 204 cases with class B notifiable infectious diseases, with a reported incidence rate of 144.35/105 and 303 419 cases with class C notifiable infectious diseases, with a reported incidence rate of 469.92/105; while no cases with class A notifiable infectious diseases were reported. Syphilis (39.45/105), tuberculosis (37.12/105), viral hepatitis (31.90/105) and gonorrhea (26.34/105) were the four most common class B notifiable infectious diseases, and AIDS (0.477 0/105) and pulmonary tuberculosis (0.116 2/105) were the two most deadly class B notifiable infectious diseases, while hand, foot and mouth disease (192.00/105), other infectious diarrhea (184.24/105) and influenza (86.45/105) were the three most common class C notifiable infectious diseases. According to the transmission route, intestinal and respiratory infectious diseases were the two most common infectious diseases, with reported incidence rates of 384.10/105 and 133.73/105, respectively; and according to the reported region, the highest incidence of class B notifiable infectious diseases was reported in Zhoushan and Ningbo cities, and the highest incidence of class C notifiable infectious diseases was reported in Ningbo City. Totally 1 101 COVID-19 cases were reported in Zhejiang Province in 2021, including 712 confirmed cases and 389 asymptomatic cases, and no deaths occurred. Conclusions The reported incidence of notifiable infectious diseases declined in Zhejiang Province in 2021 as compared to that prior to COVID-19 epidemics, with remarkable reductions in the incidence of respiratory and intestinal infectious diseases. The management of pulmonary tuberculosis, viral hepatitis and AIDS requires to be reinforced during the containment of COVID-19, to prevent the seasonable epidemic of influenza, hand, foot and mouth disease and other infectious diarrhea in Zhejiang Province.

Objective: To analyze the epidemiological characteristics of overseas imported cases with coronavirus disease 2019 (COVID-19) in Zhejiang Province, so as to provide insights into containment of overseas imported COVID-19. Methods: The pertaining to overseas imported COVID-19 cases in Zhejiang Province during the period between January 1, 2020 and May 31, 2022 were captured from the Chinese Disease Prevention and Control Information System. The temporal, spatial and population distributions, the duration from entry to the first time of positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid test, and COVID-19 vaccination of overseas imported COVID-19 cases were analyzed using a descriptive epidemiological method. Results: A total of 1 535 overseas imported COVID-19 cases were reported in Zhejiang Province during the period between January 1, 2020 and May 31, 2022, including 596 confirmed cases and 939 asymptomatic infections, and all reported cases were imported from 102 countries and territories. Overseas imported COVID-19 cases were reported in each month during the period between March 2020 and May 2022 except May 2020, and the mean monthly number of reported overseas imported COVID-19 cases was 125 during the period between December 2021 and May 2022. Overseas imported COVID-19 cases were reported across 11 cities of Zhejiang Province, with the largest numbers reported in Hangzhou (978 cases) and Jiaxing cities (177 cases), and imported cases were reported in 76.09% of counties (districts) in Zhejiang Province. The overseas imported COVID-19 cases were predominantly identified among individuals with Chinese nationality (88.79%), at ages of 20 to 39 years (59.09%), and students (21.82%), workers (17.20%) and business servants (17.00%) were predominant occupations among the overseas imported COVID-19 cases. The median duration from entry to the first time of positive SARS-CoV-2 nucleic acid test was 3.98 (7.06) d during the period between January 1, 2020 and May 31, 2022, and was 3.23 (4.97) d during the period between December 1, 2021 and May 31, 2022, which was significantly shorter than that during the period between January 1, 2020 and November 30, 2021 (P<0.001). The proportion of normal and more severe types of COVID-19 was 15.69% among cases without COVID-19 vaccination, which was significantly higher than that (7.77%) among those receiving booster vaccination (χ2=5.345, P=0.021), but was not significantly different from that (12.65%) among those receiving full-dose vaccination (χ2=0.971, P=0.324). Conclusions Students with Chinese nationality, workers and business servants were predominant among overseas imported COVID-19 cases in Zhejiang Province until May 31, 2022. The duration from entry after December 1, 2021 to identification of overseas imported COVID-19 cases shortened, and booster COVID-19 vaccination facilitated the alleviation of severity of clinical symptoms. There is a long-term risk of overseas importation of COVID-19 in Zhejiang Province, and the containment of imported COVID-19 requires to be sustainably implemented among entry personnel.

Objective: To investigate the characteristics of public health emergencies and related information in schools of Zhejiang Province from 2012 to 2021, so as to provide insights into the management of public health risks in schools. Methods: The public health emergencies and related information in schools of Zhejiang Province during the period from 2012 to 2021 were retrieved from the Public Health Emergency Management Information System of Chinese Disease Prevention and Control Information System. The type, temporal distribution and regional distribution of the events and the type of schools were analyzed, and the trends in disease attack rates were evaluated. Results: A total of 1 284 public health emergencies and related information were reported in schools of Zhejiang Province from 2012 to 2021, accounting for 72.34% of all public health emergencies and related information, and a total of 40 562 cases were reported, accounting for 87.72% of all cases; no death was recorded. There were 1 276 infectious disease events reported, accounting for 99.38%, and norovirus enteritis (649 cases), varicella (281 cases), influenza (181 cases), hand, foot and mouth disease (94 cases) and mumps (22 cases) were predominant infectious diseases, accounting for 95.56% of all public health emergencies and related information in schools. The number of public health emergencies and related information in schools peaked during the period between March and June (361 events, 28.12% of all events) and the period between November and December each year from 2012 to 2021 (629 events, 48.99% of all events), and the events occurred across 11 cities of Zhejiang Province, with the largest number of events reported in Hangzhou City (507 events). In addition, there were 627, 328 and 242 events reported in primary schools, kindergartens, and middle schools, accounting for 93.22%, and the events predominantly occurred in city schools. Nevertheless, there were no significant changes in the trends for attack rates of norovirus enteritis, varicella, influenza and hand, foot and mouth disease and mumps in schools of Zhejiang Province from 2012 to 2021. Conclusions Norovirus enteritis, varicella, influenza, hand, foot and mouth disease and mumps were the predominant types of public health emergencies and related information in schools of Zhejiang Province from 2012 to 2021, and the largest number of events were reported in primary schools.

Objective: To establish a prediction model of herpangina epidemic trend based on Baidu index and hand, foot and mouth disease, so as to provide insights into analyses of communicable disease epidemics with limited or missing surveillance data. Methods: The incidence of hand, foot and mouth disease in Zhejiang Province during the period from the first week of 2015 through the 39th week of 2021 was retrieved from the China Information System for Disease Control and Prevention, and the Baidu index of hand, foot and mouth disease and herpangina was collected via the Baidu search engine during the same period. The correlation between the Baidu index and time series of hand, foot and mouth disease was examined using wavelet analysis. In addition, a random forest training model was created based on the Baidu index and incidence of hand, foot and mouth disease, and the fitting effectiveness was evaluated using the mean percentage error, while the Baidu index of herpangina was included in the model to predict the epidemic trend of herpangina during the study period. Results: The Baidu index of herpangina and hand, foot and mouth disease, and the Baidu index and incidence of hand, foot and mouth disease all appeared two peaks at the 26th and 52th week. The phase difference was less than 0.1 week between the Baidu index and time series of hand, foot and mouth disease, and the mean percentage error of the training model was 13.07%, with high concordance between the predicted number and actual report number of cases with hand, foot and mouth disease. The numbers of herpangina cases were predicted to be 28 822, 27 341, 28 422, 51 782, 52 457 and 5 691 from 2015 to 2020, and there were totally 48 702 herpangina cases reported until the 39th week of 2021. Like hand, foot and mouth disease, the incidence of herpangina peaked between May and July. Conclusion The random forest training model based on the Baidu index and incidence of hand, foot and mouth disease is feasible to predict the epidemic trend of herpangina.

Objective: To investigate epidemiological characteristics of notifiable infectious diseases in Zhejiang Province in 2023, so as to provide the evidence for strengthening prevention and control of infectious diseases. Methods: Data pertaining to notifiable infectious diseases reported in Zhejiang Province in 2023 were retrieved from the Infectious Disease Surveillance System of Chinese Disease Prevention and Control Information System. The incidence and mortality were analyzed according to the classification of notifiable infectious diseases and transmission routes, and epidemiological characteristics of infectious diseases were descriptively analyzed. Results: Thirty types of notifiable infectious diseases with 2 955 699 cases and 427 deaths were reported in Zhejiang Province in 2023, with a reported incidence rate of 4 493.93/105 and a reported mortality rate of 0.649 2/105. A total of 679 notifiable infectious disease emergencies were reported, with 26 514 cases and 1 case death (rabies). The emergencies mainly occurred in schools and preschool institutions, with 621 cases accounting for 91.46%. There were 1 case of cholera reported in class A notifiable infectious diseases and no death, 22 types of class B notifiable infectious diseases, with a reported incidence rate of 552.46/105 and a reported mortality rate of 0.644 7/105, and 8 types of class C notifiable infectious diseases, with a reported incidence rate of 3 941.48/105 and a reported mortality rate of 0.004 6/105. The incidence rates of respiratory, intestinal, blood-borne and sexually transmitted, natural and insect-borne infectious diseases were 4 028.67/105, 381.59/105, 81.15/105 and 1.35/105, respectively, according to transmission routes. Influenza (3 561.78/105) and COVID-19 (423.77/105) reported the highest incidence, and AIDS (0.477 4/105) and tuberculosis (0.130 8/105) reported the highest mortality. Conclusion The incidence rates of respiratory and intestinal infectious diseases were high in Zhejiang Province in 2023, and schools and preschool institutions were the main places of diseases occurred.

Objective: To investigate the characteristics of public health emergencies in Zhejiang Province in 2023, so as to provide the reference for public health risk management. Methods: Data of public health emergencies and related information in Zhejiang Province from January 1 to December 31, 2023 was collected through Emergency Public Reporting System of Chinese Disease Prevention and Control Information System. Attack rates, disease types, distribution of time and places, and responses were descriptively analyzed. Results: A total of 718 public health emergencies were reported in 2023 in Zhejiang Province, and all were infectious disease events. There were 27 128 reported cases and 3 deaths, with an attack rate of 3.22%. The top five infectious diseases with the highest number of reported events were influenza, norovirus infection, monkeypox, varicella and hand, foot and mouth disease, accounting for 95.54% of total reported events. There were 355 public health emergencies with less than 30 cases each, accounting for 49.44%. The reported emergencies peaked from February to March (186 events, 25.91%) and from November to December (327 events, 45.54%), and mainly occurred in schools and preschool institutions (651 events, 90.67%). The median responding time, reporting time and duration of emergencies were 6.50 (interquartile range, 10.84) h, 0.53 (interquartile range, 0.63) h and 7.24 (interquartile range, 11.71) d, respectively. Conclusion Public health emergencies in Zhejiang Province in 2023 were mainly caused by influenza and norovirus infection, with February, March, November and December being the peak reporting periods, and schools and preschool institutions being the main places where these events occurred.

BACKGROUNDPrevious studies have demonstrated that acupuncture could modulate various brain systems in the resting brain networks. Graph theoretical analysis offers a novel way to investigate the functional organization of the large-scale cortical networks modulated by acupuncture at whole brain level. In this study, we used wavelets correlation analysis to estimate the pairwise correlations between 90 cortical and subcortical human brain regions in normal human volunteers scanned during the post-stimulus resting state.

METHODSThirty-two college students, all right-handed and acupuncture naïve, participated in this study. Every participant received only one acupoint stimulation, resulting in 16 subjects in one group. Both structural functional magnetic resonance imaging (fMRI) data (3D sequence with a voxel size of 1 mm(3) for anatomical localization) and functional fMRI data (TR = 1500 ms, TE = 30 ms, flip angle = 90°) were collected for each subject. After thresholding the resulting scale-specific wavelet correlation matrices to generate undirected binary graphs, we compared graph metrics of brain organization following verum manual acupuncture (ACU) and sham acupuncture (SHAM) groups.

RESULTSThe topological parameters of the large-scale brain networks in ACU group were different from those of the SHAM group at multiple scales. There existed distinct modularity functional brain networks during the post-stimulus resting state following ACU and SHAM at multiple scales.

CONCLUSIONSThe distinct modulation patterns of the resting brain attributed to the specific effects evoked by acupuncture. In addition, we also identified that there existed frequency-specific modulation in the post-stimulus resting brain following ACU and SHAM. The modulation may be related to the effects of verum acupuncture on modulating special disorder treatment. This preliminary finding may provide a new clue to understand the relatively function-oriented specificity of acupuncture effects.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Analgesia ; Brain ; physiology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Nerve Net

Objective To investigate the mechanisms of sacroiliac joint pain after lumbar fusion surgery and to present the clinical outcomes after a combining intra-and peri-articular injection.Methods Totally 20 male and 15 female patients (48-75 years old) from January 2013 to December 2016 were retrospectively included in the present study.The patients were all with sustained low back and hip pain after prior posterior lumbar interbody fusion surgery.Nine cases were diagnosed with lumbar disc herniation,22 cases with lumbar stenosis,and 4 cases with degenerative lumbar spondylolisthesis.Ten cases were performed with single level fusion,16 cases with two level fusion,9 cases with 3 or more level fusion.Autogenous iliac bone graft was not applied in any of those patients.The pain of the patients was confirmed from the sacroiliac joint through specific symptoms and signs.They were divided into two groups and were treated with either standard intra-articular injection (17 cases) or a combine of intra-and peri-articular sacroiliac injection (18 cases).Peri-articular injection was conducted at 1 cm above the inferior margin of the sacroiliac joint.Recover ratios of visual analogue scale (VAS) and Oswestry disability index (ODI) at 2 weeks post-operatively were recorded and were compared between the two groups.Results No statistical difference was found in gender,fusion location,fusion levels,pre-operative VAS and ODI score between the two groups (P ＞ 0.05).The combination of intra-and peri-articular sacroiliac injection showed significantly better results than the single intra-articular injection in VAS score immediately after injection (t=2.159,P=0.038),VAS score at 2 weeks after injection and ODI score at 2 weeks after the injection (t=2.705,P=0.011;t=2.156,P=0.039,respectively).Conclusion Both intra-and extra-sacroiliac joint diseases may lead to sacroiliac joint pain after lumbar fusion surgery.A single intra-articular sacroiliac injection could not provide optimistic outcomes.Further extra-articular injection is required at approximate 1 cm above the inferior margin of the sacroiliac joint.The technique combining intra-and peri-articular injection could guarantee improved early clinical outcomes.