Viagra has become the first line drug for the treatment of erectile dysfunction since it was first introduced in 1998. Its efficacy and safety have been sidely acclaimed as being definite. This article presents a brief review about the advances in the studies of Viagra, including its therapeutic effect and safety, its protection of penile health, and its promotion of self-esteem and sexual relationship.
Erectile Dysfunction ; drug therapy ; Humans ; Male ; Penile Erection ; drug effects ; Personal Satisfaction ; Phosphodiesterase Inhibitors ; pharmacology ; therapeutic use ; Piperazines ; pharmacology ; therapeutic use ; Purines ; pharmacology ; therapeutic use ; Sildenafil Citrate ; Sulfones ; pharmacology ; therapeutic use

Sexual dysfunction is common among male adults. Here we summarized the recent papers and provided the outline of diagnosis and treatment on male sexual dysfunction.
Adult ; Erectile Dysfunction ; diagnosis ; therapy ; Humans ; Male

AIMTo determine the age-adjusted prevalence of erectile dysfunction (ED) in 3 big cities of China and to explore its potential sociodemographic, medical and lifestyle correlates.

METHODSA cross-sectional, population-based survey was conducted in three cities of China. Structured questionnaires were administered to 2 226 men, aged 20 - 86 years, by trained interviewers.

RESULTSThe age-adjusted prevalence of ED was 28.34 % (mild 15.99 %, moderate 7.14 %, severe 5.21 %). In the men above 40, the prevalence was 40.2 %. Age was positively correlated with ED (P<0.01). Education was negatively correlated with ED (P<0.01). Spouse companionship, living condition were positively correlated with ED (P<0.01). Histories of cardiovascular disease, diabetes, and hyperlipidemia were positively correlated with ED (P<0.01). Cigarette smoking was not correlated with ED (P>0.05), while the cigarette consumption and duration were positively correlated with ED (P<0.01). Alcohol drinking is negatively correlated with ED (P<0.01). The duration of drinking was positively correlated with ED (P<0.01). Weekly alcohol consumption was not correlated with ED (P>0.05).

CONCLUSIONThe prevalence of ED increased with age. Cardiovascular disease, diabetes and hyperlipidemia were positively correlated with the increased prevalence. Sociodemographic and lifestyle factors, such as education, spouse companionship, living condition, cigarette and alcohol consumption or duration also have association with the prevalence of ED.

Adult ; Age Factors ; Aged ; Alcohol Drinking ; adverse effects ; Cardiovascular Diseases ; complications ; epidemiology ; China ; Cross-Sectional Studies ; Diabetes Mellitus ; epidemiology ; Education ; Erectile Dysfunction ; epidemiology ; Humans ; Hyperlipidemias ; complications ; epidemiology ; Life Style ; Male ; Marriage ; Middle Aged ; Population ; Risk Factors ; Smoking ; physiopathology ; Socioeconomic Factors ; Surveys and Questionnaires

OBJECTIVETo investigate the knowledge of and attitude to sexual dysfunction in aged men, and to discuss the status and needs of male healthcare.

METHODSTwo thousand seven hundred and twenty-eight men (40-70 years old) were surveyed on sexual dysfunction using the randomized questionnaire in Xicheng District, Beijing.

RESULTSThe prevalence of erectile dysfunction (ED) was 41.2%, and only 12.1% ED patients were to see the doctor. 52.4% aged men thought the sexual life was important or very important during the life, and 55.6% thought ED would exert negative impact on the quality of life and the partner relationship. Although 27.4% knew that ED was a kind of disease, 49.0% thought ED was a nature rule. Compare to the 41.2% ED prevalence, only 9.7% male were dissatisfied with their sexual life, and later ratio was 14.1% among the partner.

CONCLUSIONIn China, the status of the knowledge of and attitude to sexual dysfunction in aged men was unsatisfactory to some extent. There is a lot of work to do especially in sexual healthcare education and improvement on diagnostic and treatment of sexual dysfunction.

Adult ; Aged ; China ; epidemiology ; Coitus ; Erectile Dysfunction ; epidemiology ; psychology ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Prevalence ; Quality of Life ; Surveys and Questionnaires

OBJECTIVETo explore the clinicopathological characteristics and prognostic factors of primary gastric lymphoma (PGL).

METHODSThe clinical data of 204 patients with PGL was reviewed and analyzed. There were 106 males and 98 females, their age were 19 to 85 years (average age was 53.7 years). The Focal areas included gastric fundus lesions 41 cases (20.1%), stomach body lesions 127 cases (62.3%), distal gastric lesions 105 cases (51.5%), cardia lesions 13 cases (6.4%), duodenal bulb lesion 1 cases (0.5%). The clinical characteristics and the outcomes in patients with influence were analysed.

RESULTSIn 204 PGL patients, the most common complaints were abdominal pain (62.3%) and weight loss (52.9%). Most of the PGL patients appeared ulcerative (76.0%) and results showed that 62.7% patients involved single location. As to the factors of cellulate grading and pathological characteristics, most patients (87.7%) show low-grade or intermediate-grade lymphoma, Musshoff stages I and II (74.0%). In 186 patients with complete follow-up data, survival rates of 1-, 3- and 5-year were 75.8%, 63.4% and 60.2% respectively. The median overall survival time was 50.0 months. In univariate survival analysis, age (χ(2) = 5.030), level of LDH (χ(2) = 40.084), cellulate grading (χ(2) = 35.238), Musshoff stage (χ(2) = 71.601), tumor diameter (χ(2) = 12.018) and option of managements (χ(2) = 14.140) were obviously correlated with the prognosis (all P < 0.05). Musshoff stage (RR = 2.230, 95%CI: 1.372 - 3.625) and cellulate grading (RR = 1.892, 95%CI: 1.010 - 3.543) were independent prognostic factors in multivariable analysis (both P < 0.05). There was no prognostic difference between surgery and chemotherapy in stage I and II (χ(2) = 1.223, P = 0.542).

CONCLUSIONSMusshoff stage and grade malignancy are independent prognostic factors. For patients with stage I and II, surgical resection is not the first-choice for clinical therapy.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymphoma, Non-Hodgkin ; diagnosis ; pathology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; diagnosis ; pathology ; Young Adult

OBJECTIVETo explore the risk factors for early recurrence (recurrence within 2 years) of proximal gastric cancer after radical resection.

METHODSThe clinical data of 367 proximal gastric cancer patients who underwent radical resection in the Cancer Institute and Hospital of Tianjin Medical University between January 2000 and May 2006 were reviewed. Among them, there are 71 patients (19.3%) with early recurrence. Univariate analysis and multivariate analysis were applied to investigate risk factors for early recurrence.

RESULTSUnivariate analysis showed that Borrmann type (P<0.01), histology type (P<0.01), depth of invasion (P<0.05), negative lymph nodes count (P<0.05) were risk factors for early recurrence of proximal gastric. On multivariate analysis, histology type (P<0.05), depth of invasion (P<0.05), negative lymph nodes counts (P<0.05) were independent risk factors for early recurrence of proximal gastric cancer. Negative lymph nodes in early recurrence patients were 8.4 ± 7.2, which were significantly less as compared to patients without early recurrence (10.7 ± 8.7) (P<0.05).

CONCLUSIONFor T3 proximal gastric adenosquamous cancer, extended resection and lymphadenectomy should be considered. Intraoperative or postoperative adjuvant treatment should be administered as routine.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; pathology ; Postoperative Period ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; pathology ; surgery

OBJECTIVESTo establish the chronic prostatitis symptom index which more suitable for Chinese to refine and standardize evaluation of current symptoms in men with "chronic prostatitis".

METHODSThe literature of previous work was reviewed to develop a symptom index instrument. There were 18 questions representing three broad categories: pain symptoms, urinary symptoms and other symptoms. To evalute the clinical utility and applicability for Chinese people of this tool, we used it in 100 patients with chronic prostatitis and 100 control patients (40 with benign prostatic hyperplasia, BPH; 30 with infertility; 30 with erectile dysfunction).

RESULTSOf the three aspects symptoms, the primary component was pain. But pain in lower back and lower abdomen had less specificity. Pain in the rectal area was not very common but it could well distinguish patients with prostatitis from those BPH, infertility and ED. Urinary symptoms were also common. We used 5 symptom questions in urinary aspect in the last version of this index. In other symptoms, we dropped the question of uncomfortable of waist and back at last. It could not distinguish patients with prostatitis from those infertility and erectile dysfunction. Finally we analyzed the result and modified the new version of chronic prostatitis symptom index. It included 5 pain symptom questions, 5 urinary symptom questions and 2 other symptom questions. There are 12 questions in total.

CONCLUSIONSThe chronic prostatitis symptom index we developed was validated and useful in clinical practice as well as research protocols. Moreover, it was more suitable for Chinese people.

Adult ; Aged ; Asian Continental Ancestry Group ; Chronic Disease ; Humans ; Male ; Middle Aged ; Pain ; etiology ; Prostatitis ; ethnology ; physiopathology ; Severity of Illness Index

OBJECTIVESTo evaluate the efficacy and safety of PGE1 cream[Befar, NexMed Pharmaceuticals(Zhongshan) Ltd] on men with ED of various etiologies in China.

METHODSThis was a double-blind, randomized (1:1, placebo: PGE1 cream), placebo-controlled clinic study of PGE1 cream performed at Peking University Pepole's Hospital for 8 weeks. A total of 42 subjects suffered from erectile dysfunction of psychologic, organic or mixed etiology were screened and randomized, and visited occurred at weeks -4, 0, 2 and 4 weeks covering a 4-week no treatment run-in period and a 4-week period of double blind treatment.

RESULTSAt week four PGE1 cream was shown to be significantly (P < 0.01) effective over placebo in the sexual function endpoints analyses. The primary efficacy variables (Questions 3 and 4 from IIEF) revealed a statistically significant (P < 0.01) improvement over placebo along with a clinical efficacy change score with an effective rate of 63.16% on PGE1 cream vs 9.52% on placebo. The secondary efficacy variables supported the conclusion of the primary efficacy (assessing the proportion of successful attempts at sexual intercourse 68.42% on PGE1 cream vs 19.05% on placebo), and the global assessment question (treatment had improved their erections, 73.68% on PGE1 cream vs 19.05% on placebo). PGE1 cream was well tolerated when given prn. Subjects in the study had a low discontinuation rate (4.76%), only one subject (2.38%) discontinued due to adverse events. The incidence of adverse events was higher for PGE1 cream (30.00%) than for placebo (4.76%). The common adverse events were mild pain of penis and urethra.

CONCLUSIONSPGE1 cream is an effective, safe and well-tolerated treatment in subjects with erectile dysfunction of organic, psychologic or mixed etiology.

Adult ; Aged ; Alprostadil ; adverse effects ; therapeutic use ; Double-Blind Method ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Vasodilator Agents ; adverse effects ; therapeutic use

OBJECTIVETo explore the prognostic factors and to compare chemotherapy alone versus surgical resection plus chemotherapy for early stage primary gastric diffuse large B-cell lymphomas (DLBCL).

METHODSClinical data of 75 patients who were diagnosed as primary gastric DLBCL between January 1993 and August 2008 in Cancer Institute and Hospital of Tianjin Medical University were reviewed retrospectively.

RESULTSAmong these 75 patients, 20 patients received chemotherapy alone and 55 underwent surgical resection plus chemotherapy. Complete remission rates were 65.0% (13/20) and 83.6% (46/55), effective rates were 75.0% (15/20) and 92.7% (51/55), and 5-year survival rates were 86.9% and 78.7% respectively in chemotherapy alone group and resection plus chemotherapy group, while the differences were not statistically significant (all P>0.05). Multivariate Cox regression model showed that international prognosis index (IPI) was the only independent prognostic factor (P<0.05, HR=11.350, 95%CI:1.011-127.371).

CONCLUSIONSIn early stage of DLBCL, IPI is the only independent prognostic factor. The clinical outcomes are comparable between chemotherapy alone and surgical resection plus chemotherapy.

Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; therapy ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; therapy ; Treatment Outcome

The most appropriate time to introduce androgen deprivation therapy for prostate cancer remains controversial. Our aim was to evaluate the effects of early versus delayed surgical castration on prostate cancer progression and survival in the transgenic adenocarcinoma of the mouse prostate (TRAMP) model. TRAMP mice were randomly divided into three groups: the early castration group (on which castration was performed at the age of 4 weeks), the delayed castration group (on which castration was performed when abdominal tumours could be palpated), and the sham-castrated group. Mice were monitored daily throughout their lives until cancer-related death or the development of an obviously moribund appearance, at which time the individual mouse was killed. Androgen receptor expression in prostate tumours was also evaluated. The results shows that the average lifespan in early castration, delayed castration and sham-castrated groups were 54.1 weeks, 59.9 weeks and 39.1 weeks, respectively. Both early castration and delayed castration conferred a statistically significant survival advantage when compared with the sham-castrated group (P<0.001). However, the difference in lifespan between the early castration group and the delayed castration group was not statistically significant (P=0.85). The increase in lifespan in the TRAMP mice that received either early or delayed castration correlated with lower G/B value (genitourinary tract weight/body weight) at death than the sham-castrated mice. In conclusion, early and delayed castrations in TRAMP mice prolonged survival to a similar extent. This finding may provide a guide for clinical practice in prostate cancer therapy.
Adenocarcinoma ; mortality ; pathology ; surgery ; Animals ; Body Weight ; Disease Models, Animal ; Kaplan-Meier Estimate ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Transgenic ; Orchiectomy ; Organ Size ; Prostate ; metabolism ; pathology ; surgery ; Prostatic Neoplasms ; mortality ; pathology ; surgery ; Receptors, Androgen ; metabolism ; Time Factors ; Transgenes ; genetics