It is reported that plenty of men,especially the aged,have been bothering in penile erectile dysfunction(ED).There are series of treatments for ED.Oral erectogenic agents have become the first-line treatment options,including drugs that act on the central and peripheral nervous systems,testosterone,traditional Chinese medicine and so on.Sidenafil,apomorphine and yohimbine are the only three oral therapies currently available for the treatment of this disorder.The second therapy includes intracavernosum injection,transurethral medications,transdermal medications etc.Intracavernosum injection of PGE 1 is an effective approach at the present.With the rapid understanding of erectile physiology and etiology of ED and the introduction of new effective oral agents,the future of pharmacotherapy for ED will extend.In this review,we have highlighted the advances in current treatments and therapeutic approaches in male erectile dysfunction.

Background:Tissue microarray has been increasingly used in research of malignancies. It has been revealed that TGF-β signaling pathway contributes to the tumorigenesis and progress of malignancies. Aims:To determine the expressions of Runx3,Smad4,Cdk2 and p21,the key molecules in TGF-β signaling pathway by tissue microarray,and investigate their correlations with clinicopathological features and prognosis of gastric cancer. Methods:A total of 378 paraffin embedded tissue blocks,including 130 gastric cancer tissue and 248 para-cancer tissue from 130 patients undergoing radical resection of gastric cancer were obtained. Tissue microarray and immunohistochemistry were used to determine the expressions of Runx3,Smad4,Cdk2 and p21. Results:The aberrant expression rates of Runx3,Smad4, Cdk21 and p21 in gastric cancer tissue were significantly higher than those in para-cancer tissue(67. 7% ,35. 4% , 63. 8% and 70. 0% vs. 14. 1% ,12. 5% ,18. 1% and 37. 1% ,P < 0. 05,respectively). Aberrant expression of Runx3 was closely correlated with histological grade and lymph node metastasis of gastric cancer( P < 0. 05),while aberrant expressions of Smad4 and p21 were correlated with histological grade only(P < 0. 05);aberrant expression of Cdk2 was correlated with histological grade,lymph node metastasis and TNM staging(P < 0. 05). Pairwise correlations were seen among aberrant expressions of Runx3,Smad4 and p21 in gastric cancer,while Cdk2 was correlated with Runx3 only. Kaplan-Meier survival curve showed that 5-year survival rates in Runx3,Smad4 and p21 aberrant expression groups were significantly lower than those in normal expression groups(P <0. 05). Furthermore,Cox proportional hazard model indicated that Runx3 and Smad4 were independent prognostic factors for gastric cancer. Conclusions:Runx3,Smad4,Cdk2 and p21 might play pivotal roles in tumorigenesis and progression of gastric cancer. As interactions occurred among these four proteins,whether Runx3 and Smad4 could be used for predicting the prognosis of gastric cancer needs to be further studied.

Objective:This study aimed to analyze the factors affecting the outcome of cancer pain in patients with moderate and severe chronic cancer pain for clinical decision making. Methods: Data were collected from 426 cancer patients with moderate and severe chronic cancer pain, and the factors affecting pain treatment were analyzed. Results:A total of 85.6%of patients had good pain control in 3 days (NRS≤3). Multivariate logistic regression models showed that the pain of patients with bone metastases (P=0.026), breakthrough pain after stable pain control (P<0.001), and high MEDD (P<0.001) was poorly controlled. Moreover, age, sex, TNM stage, cause of pain, and medication ladder were not risk factors of pain control (P>0.05). Opioid combination with NSAIDs contributed to easier pain control (P=0.024). Digestive system tumors, pain intensity, limb pain, neuropathic pain, use of transdermal fentanyl matrix patch, multiple metastases in stage-IV patients were suggested to be risk factors of pain control in univariate logistic regression models (P<0.05). Conclusion: Bone metastases, breakthrough pain after pain relief, and high dose of MEDD were independent risk factors. Opioid combination with NSAIDs was a protective factor of pain control.

Objectives To investigate the expression of mTOR signaling pathway in pancreatic cancer and export its signification. Methods 6 samples of pancreatic cancer and its paracancerous tissues specimens confirmed by surgery and pathologic examination were selected. RNA was extracted and expression profiles experiment was performed by using Agilent human whole genomic oligonucleotide microarrays. The expression of mTOR signaling pathway in pancreatic cancer was analyzed by bioinformatics. Results Totally 1276 differential gene were selected, and 691 were up-regulated in cancer tissue, while 585 were down-regulated.The highest score of KEGG pathway's Enrichment and gene count was hsa04150 in mTOR signaling pathway,with its Enrichment of 4.5622519 and gene count of 9, and the percentage of gene count was 1.15%, the EASE Score P value was 6.23 E-04, which had the most biological significance. Among those, there was significantly difference of expression of nine key genes including ULK2, PIK3R3, PDPK1, EIF4EBP1, PGF,VEGFB, ULK3, RICTOR and PIK3 R5 (P ＜ 0.05). Conclusions The pathogenesis of pancreatic cancer is related to the activation of the mTOR signaling pathway.

Objective To evaluate the impact of rosiglitazone (Ros) on liver expression of peroxisome proliferator-activated receptor γ (PPARγ),nuclear factor (NF-κB) and cyclooxygenase-2(COX-2) in treatment of nonalcoholic steatohepatitis (NASH) rats.Methods Thirty Sprague-Dawley rats were divided into normal group,model group and Ros treated group with 10 each.Except the normal group,the other two groups were given high fat diet for 12 weeks for NASH model.The rats in Ros treated group were gavaged 4 mg/kg of Ros daily at the 12th week for 8 weeks.All rats were sacrificed at the 20th week for blood sample and liver tissue.Biochemical parameters of liver function,lipid metabolism,glycometabolism and antioxidant enzyme activities were measured.The histological change of the liver were assessed with HE and Masson staining.The level of tumor necrosis factor (TNF)-α and prostaglandin E2 (PGE2) was measured using ELISA.The expression of PPARγ,NF-κB and COX-2 was detected with immunohistochemistry.The mRNA and protein expressions of COX-2 were tested by real-time PCR and Western blotting,respectively.Results In comparison with model group,Ros treated group showed significant improvement in hepatic steatosis,inflammation and fibrosis(all P value<0.05).In model group,the serum levels of fasting blood glucose,insulin and HOMA-insulin resistance index (HOMA-IRI),total cholesterol (TC),total triglyeride (TG),lowdensity lipoprotein cholesterol (LDL-C) and free fatty acids were increased,but HDL-C level was decreased.All above parameters markedly improved after Ros treatment.The levels of ALT and AST,total anti-oxidation competence,superoxide dismutase,catalase,glutathione peroxidase and malondialdehyde in Ros treated group were significantly ameliorated when compared with those in model group.Immunohistochemistry showed that the expression of NF-κB and COX-2 was significantly elevated,but PPARγ was decreased in model group.Real-time PCR and Western blot revealed that the mRNA and protein expressions of COX-2 were higher in the model group than those in normal group (0.57±0.08 vs 0.38±0.03;2.83±0.24 vs 1.00±0.03,P=0.000 and P=0.004,respectively),but significantly lower in Ros treated group (0.55±0.06 and 1.84±0.13,P<0.01).Conclusions Ros can reduce oxidative stress and insulin resistance in NASH rats by activing PPARγ expression and inhibiting expression of NF-κB and cyclooxygenases.

The main clinical symptoms of Parkinson's disease (PD) are resting tremor, muscle rigidity, bradykinesia, and so on. There is no effective treatment for PD yet, and dyskinesia symptoms affect the life qualities of PD patients. The therapy used for reinforcing kidney and activating blood circulation in treatment of PD can achieve good clinical effects.

genes related to pancreatic cancer was mainly associated with biological process,cellular location,molecular function,which suggested the development of pancreatic cancer was caused by multiple genes.

OBJECTIVETo investigate the effects of the metabolite produced by Trichomonas vaginalis on human sperm motility in vitro.

METHODSTrichomonas vaginalis having been cultured, the culture solution containing metabolite was obtained by removing the protozoa, then diluted into 3 kinds of concentration. Sperm was obtained from 10 healthy fertile men by masturbation and prepared by swim-up technique to produce a spermatozoon solution of high motility. Every sperm sample was divided into 4 groups (A, B, C, D). Unused culture solution was added to Group A as control, and the other 3 groups (B, C, D) were respectively incubated with the above used culture solution at 3 kinds of concentration (1.2 x 10(9)/L, 6 x 10(8)/L, 1.2 x 10(8)/L). Measurements were carried out at 30 s, 1 h, 2 h, 4 h, 6 h by CASA.

RESULTSSperm motility decreased in both Group B and C markedly, and the effects displayed a concentration- and time-dependent manner.

CONCLUSIONThe metabolite of Trichomonas vaginalis can reduce human sperm motility in vitro, and may be one of the causes of infertility.

Objective To evaluate the role of gray-white-matter ratio (GWR) on neurological outcome in patients with coma after cardiopulmonary resuscitation (CPR) post-respiratory and cardiac arrest (CA).Methods Respiratory and CA patients with restoration of spontaneous circulation (ROSC) and coma after CPR admitted to Nanjing Drum Tower Hospital Clinical Medical College of Nanjing Medical University from February 2013 to June 2016 were enrolled. All patients were subjected to target temperature management (TTM) after CPR, and received cranial CT within 5 days after ROSC. Attenuation (hounsfield units) was measured at special sites (basal ganglia, centrum semiovale), and specific locus (caudate nucleus, put amen, corpus callosum, posterior limb of internal capsule, medial cortex, medial white matter). The GWR was calculated for basal ganglia and cerebrum. Neurological outcome was judged according to the Glasgow-Pittsburgh cerebral performance category (CPC) at 3 months after ICU discharge. CPC 1-3 were divided into good prognosis, CPC 4-5 were divided into poor prognosis. The receiver-operating characteristic (ROC) curve was drawn to evaluate the prognostic value of GWR in patients with respiratory and CA.Results Forty-three patients were enrolled, including 26 males and 17 females; age (63±15) years old; 14 good prognosis and 29 poor prognosis. Compared with the good prognosis group, the basal ganglia GWR (GWRbg) and the average GWR (GWRav) were significantly lowered in the poor prognosis group (1.064±0.103 vs. 1.163±0.818, 1.068±0.087 vs. 1.128±0.071, bothP < 0.05), the centrum semiovale GWR (GWRce) was similar to that in the good prognosis group (1.072±0.077 vs. 1.092±0.075,P >0.05). It was shown by ROC curve analysis that the GWRbg, GWRav could evaluate the neurological outcomes of patients, but GWRce could not. The area under the ROC curve (AUC) of GWRbg was 0.756 [95％ confidence interval (95％CI) =0.607-0.905,P = 0.007], the cut-off value was 1.13, the sensitivity was 71.4％, and specificity was 69.0％; the AUC of GWRav was 0.701 (95％CI = 0.532-0.869,P = 0.035), the cut-off value was 1.13, the sensitivity was 71.4％, andspecificity was 65.5％; the AUC of GWRce was 0.590 (95％CI = 0.405-0.775,P = 0.344).Conclusions Respiratory and CA patients receiving TTM with high GWR had favorable neurological outcome. GWR, especially GWRbg could provide help for clinical treatment and prognostic value of survival after CA.

To investigate the role of ligustrazine on relaxation of the isolated rabbit corpus cavernosum tissue in vitro, the effects of ligustrazine on the corpus cavernosum were observed by using experimental method of smooth muscle strips. Concentration-responses to phenylephine (PE) and KCl were recorded. The results showed that ligustrazine concentration-dependently depressed the contraction response of smooth muscle strips induced by PE. The maximum percentage relaxation of cavernosal strips by ligustrazine was 74.1% ±6.2 % (compared with control: 21.9 % ±5.6 %, P ＜0.01). Ligustrazine concentration-dependently reduced the amplitude of the contraction induced by cumulative doses of PE or KCl, shifted the cumulative concentration response curves of PE and KCl to the right and depressed their maximal responses. It was concluded that ligustrazine could significantly relax the cavernosal muscle contraction induced by PE in vitro. The results suggested that ligustrazine inhibited calcium ion influx.