[Objective]To summarize the traditional Chinese medicine theoretical basis for treating erectile dysfunction(ED)from the five visceral organs,and to explore its potential scientific connotations from the perspective of integrated traditional Chinese and western medicine,in order to provide scientific basis for the clinical treatment.[Methods]This paper retrieved relevant literature on the treatment of ED based on the theory of the five visceral organs from databases such as CNKI and PubMed in the past 30 years,and summarized the theoretical basis of traditional Chinese medicine(TCM)for treating ED based on the theory of the five visceral organs,as well as related research progress.[Results]Dysfunction of the five visceral organs can all lead to ED.The scientific basis for treating ED from the perspective of the five visceral organs primarily involves the neuro-endocrine-immunity(NEI)network,endothelial dysfunction,inflammation/oxidative stress,mitochondrial function and autophagy,and metabolic disorders.It encompasses the nitric oxide/cyclic guanosine monophosphate(NO/cGMP)pathway,the cyclic adenosine monophosphate/protein kinase A(cAMP/PKA)pathway,and the Ras homolog gene family member A/Rho-associated coiled-coil forming protein kinase(RhoA/ROCK)pathway which regulate penile erection.Treating ED from the kidney perspective is primarily related to the NEI network,stem cells(SCs)and vitamin D.Treating ED from the liver perspective is mainly associated with prolactin(PRL),cyclic adenosine monophosphate(cAMP)and the smooth muscle system.Treating ED from the spleen perspective is primarily linked to abnormal lipid metabolism and mitochondrial autophagy decline.Treating ED from the heart perspective is mainly related to vascular endothelial dysfunction.The scientific basis for treating ED from the lung perspective remains to be studied.[Conclusion]The theoretical foundation of TCM for ED caused by dysfunction of the five visceral organs is abundant,and its pathological and physiological processes involve multiple signaling pathways and regulatory networks.Studying its scientific connotation can provide more ideas and basis for clinical treatment.

Objective To observe the clinical and imaging manifestations of disseminated nontuberculosis mycobacteria(NTM)disease involved multiple skeletons of non-HIV-infected patients.Methods Totally 11 cases of non-HIV-infected patients with disseminated NTM involved multiple skeletons(NTM group)and 30 patients of bone tuberculosis with multisite skeletal involvement(TB group)were retrospectively analyzed.Clinical and imaging manifestations were analyzed and compared between groups.Results Nine cases(9/11,81.82％)in NTM group were found with systemic underlying disease,including 5 cases of chronic anemia,4 cases of rheumatic immune diseases and 1 case of gout.NTM group had longer disease duration,lower incidence of fever and soft tissue masses,lower hemoglobin and higher erythrocyte sedimentation rate than TB group(all P＜0.05).NTM group exhibited higher incidences of pulmonary patchy/linear shadows,"skip-like"manifestations in spine and patchy/nodular high-density shadows in the affected bones,but lower incidences of pulmonary hematogenous/bronchial dissemination foci,polymorphic lung lesions and bone destruction with sequestrum/surrounding soft tissue abscesses than TB group(all P＜0.05).The thoracic vertebrae,shoulder joints and pelvis were most commonly affected in NTM group,while the thoracic and lumbar vertebrae were most commonly affected in TB group.Significant difference of skeletal involvement site was found between groups(P=0.035).After drug treatment,the conditions of 9 cases(9/11,81.82％)in NTM group improved,with better outcomes in bone destruction and surrounding soft tissue swelling,and bone hardening was more obvious than before.Conclusion Disseminated NTM disease involved multiple skeletons in non-HIV-infected patients was prone to secondarily develop in those with chronic anemia and rheumatologic immune diseases,characterized by prolonged disease duration and mild pulmonary manifestations,often revealed multiple skeletons destruction in thoracic spine,shoulder joints and pelvis,distributed in a"skip-like"pattern,with or without bone sclerosis and adjacent soft tissue swelling.

[Objective]To summarize the traditional Chinese medicine theoretical basis for treating erectile dysfunction(ED)from the five visceral organs,and to explore its potential scientific connotations from the perspective of integrated traditional Chinese and western medicine,in order to provide scientific basis for the clinical treatment.[Methods]This paper retrieved relevant literature on the treatment of ED based on the theory of the five visceral organs from databases such as CNKI and PubMed in the past 30 years,and summarized the theoretical basis of traditional Chinese medicine(TCM)for treating ED based on the theory of the five visceral organs,as well as related research progress.[Results]Dysfunction of the five visceral organs can all lead to ED.The scientific basis for treating ED from the perspective of the five visceral organs primarily involves the neuro-endocrine-immunity(NEI)network,endothelial dysfunction,inflammation/oxidative stress,mitochondrial function and autophagy,and metabolic disorders.It encompasses the nitric oxide/cyclic guanosine monophosphate(NO/cGMP)pathway,the cyclic adenosine monophosphate/protein kinase A(cAMP/PKA)pathway,and the Ras homolog gene family member A/Rho-associated coiled-coil forming protein kinase(RhoA/ROCK)pathway which regulate penile erection.Treating ED from the kidney perspective is primarily related to the NEI network,stem cells(SCs)and vitamin D.Treating ED from the liver perspective is mainly associated with prolactin(PRL),cyclic adenosine monophosphate(cAMP)and the smooth muscle system.Treating ED from the spleen perspective is primarily linked to abnormal lipid metabolism and mitochondrial autophagy decline.Treating ED from the heart perspective is mainly related to vascular endothelial dysfunction.The scientific basis for treating ED from the lung perspective remains to be studied.[Conclusion]The theoretical foundation of TCM for ED caused by dysfunction of the five visceral organs is abundant,and its pathological and physiological processes involve multiple signaling pathways and regulatory networks.Studying its scientific connotation can provide more ideas and basis for clinical treatment.

Objective To observe the clinical and imaging manifestations of disseminated nontuberculosis mycobacteria(NTM)disease involved multiple skeletons of non-HIV-infected patients.Methods Totally 11 cases of non-HIV-infected patients with disseminated NTM involved multiple skeletons(NTM group)and 30 patients of bone tuberculosis with multisite skeletal involvement(TB group)were retrospectively analyzed.Clinical and imaging manifestations were analyzed and compared between groups.Results Nine cases(9/11,81.82％)in NTM group were found with systemic underlying disease,including 5 cases of chronic anemia,4 cases of rheumatic immune diseases and 1 case of gout.NTM group had longer disease duration,lower incidence of fever and soft tissue masses,lower hemoglobin and higher erythrocyte sedimentation rate than TB group(all P＜0.05).NTM group exhibited higher incidences of pulmonary patchy/linear shadows,"skip-like"manifestations in spine and patchy/nodular high-density shadows in the affected bones,but lower incidences of pulmonary hematogenous/bronchial dissemination foci,polymorphic lung lesions and bone destruction with sequestrum/surrounding soft tissue abscesses than TB group(all P＜0.05).The thoracic vertebrae,shoulder joints and pelvis were most commonly affected in NTM group,while the thoracic and lumbar vertebrae were most commonly affected in TB group.Significant difference of skeletal involvement site was found between groups(P=0.035).After drug treatment,the conditions of 9 cases(9/11,81.82％)in NTM group improved,with better outcomes in bone destruction and surrounding soft tissue swelling,and bone hardening was more obvious than before.Conclusion Disseminated NTM disease involved multiple skeletons in non-HIV-infected patients was prone to secondarily develop in those with chronic anemia and rheumatologic immune diseases,characterized by prolonged disease duration and mild pulmonary manifestations,often revealed multiple skeletons destruction in thoracic spine,shoulder joints and pelvis,distributed in a"skip-like"pattern,with or without bone sclerosis and adjacent soft tissue swelling.

Objective: To examine the effectiveness and safety of application of the ureteral access sheath in the treatment of middle or lower ureteral calculi in patients with large-volume benign prostatic hyperplasia above grade Ⅲ, which is expected to avoid the simultaneous or staged treatment of benign prostatic hyperplasia via eliminate the difficult angle and resistance of ureteroscopy caused by severe prostatic hyperplasia. Methods: From April 2018 to December 2020, the clinical data of 27 patients with massive benign prostatic hyperplasia above grade Ⅲ and middle and lower ureteral calculi treated with indwelling ureteral access sheath plus ureteroscopy holmium laser lithotripsy at Department of Urology, Zhejiang Quhua Hospital were retrospectively analyzed and followed up. All the patients were male, aged (69.7±12.8) years (range: 55 to 87 years). Prostate volume measured by transrectal ultrasound was (94.8±16.2) cm³ (range: 85 to 186 cm³). The ureteral access sheath was indwelled in advance, and then the semirigid ureteroscopy was introduced through the working channel of the sheath. Holmium laser lithotripsy was performed, and intraoperative and postoperative complications were recorded. Urinary abdominal plain X-ray or CT urography were performed at 1-and 2-month postopaerative to evaluate the residual stones and clinical efficacy. Results: The ureteral access sheath was placed and holmium laser lithotripsy under a semirigid ureteroscopy was performed successfully in all the 27 patients. In 2 patients, a second session of auxiliary procedure was required due to the large load of preoperative stones and residual stones after surgery, among whom 1 patient received extracorporeal shock wave lithotripsy and 1 patient underwent extracorporeal shock wave lithotripsy plus ureteroscopic lithotripsy. The stone free rate at 1-and 2-month postoperative were 92.6% (25/27) and 100% (27/27), respectively. There were no severe complications such as ureteral avulsion and perforation, perirenal hematoma, septic shock, severe hematuria, urinary retention, iatrogenic ureteral stricture occurred during and after the surgery. The ureteral calculus was wrapped by polyps heavily in 1 patient, he was diagnosed as ureteral stenosis 1 month postoperative, receiving laparoscopic resection of ureteral stricture plus anastomosis 3 months postoperative. Conclusions: In the operations of middle and lower ureteral calculi in patients with large-volume prostatic hyperplasia above grade Ⅲ, the ureteral access sheath can be placed first to effectively eliminate the difficult angle and resistance of ureteroscopy caused by severe prostatic hyperplasia, and then semirigid ureteroscopic lithotripsy can be safely performed. It could avoid the treatment of benign prostatic hyperplasia at the same time or by stages.
Aged ; Aged, 80 and over ; Humans ; Lithotripsy ; Lithotripsy, Laser ; Male ; Middle Aged ; Prostatic Hyperplasia/complications* ; Retrospective Studies ; Treatment Outcome ; Ureteral Calculi/surgery* ; Ureteroscopy

To analyze the effectiveness and safety of intermittent lung inflation combined with rigid ureteroscopy in the treatment of upper ureteral stones that were not fully visible. The clinical and imaging data of 56 patients with upper ureteral stone undergoing rigid ureteroscopic lithotripsy combined with intermittent lung inflation in Zhejiang Quhua Hospital from March 2016 to October 2017 were retrospectively analyzed.Intermittentt lung inflation was used to change and stabilize the position of ureteral calculi during the operation,so as to ensure the visual field of ureteroscopy.Holmium laser lithotripsy was performed to remove the stones.Urinary tract abdominal plain X-ray or CT urography was performed 1 and 3 months after the operation to evaluate the residual stones and the clinical efficacy. Stones were successfully removed after a single attempt in 48 patients.In 5 patients,stones escaped into the kidney during ureteroscopic lithotripsy,and thus flexible ureteroscopy were performed.In 3 patients,a second session of auxiliary procedure was required,among whom 2 patients received extracorporeal shock wave lithotripsy and 1 patient underwent extracorporeal shock wave lithotripsy+ureteroscopic lithotripsy.The stone-free rates 1 and 3 months after surgery were 94.6%(53/56)and 100%(56/56),respectively.No severe complication such as ureter perforation,gross hematuria,septic shock,or pneumothorax occurred during and after surgery. Intermittent lung inflation in tracheal intubation under general anesthesia in patients with proximal ureteral stones that can not be fully visible during rigid ureteroscopic lithotripsy was feasible and reliable.It can effectively change the location of stones and thus enable safe and effective lithotripy.It expands the indications of rigid ureteroscopy for treating upper ureteral stones.
Humans ; Lithotripsy, Laser ; Retrospective Studies ; Ureteral Calculi ; diagnostic imaging ; Ureteroscopes ; Ureteroscopy

OBJECTIVETo identify the active material of anti-hepatic fibrosis from Amydae Carapax.

METHODSMembrane separation technology was adopted to screen active fraction in Amydae Carapax, and the active components were isolated from the active fraction using gel chromatography and high performance liquid chromatography. The purified active components in Amydae Carapax were further analyzed using 4700 series time-of-flight mass spectrometer.

RESULTSProteins and peptides of Amydae Carapax with molecular weight less than 6000 were proved to have biological activity. 8 components (Bj1-Bj8) were isolated from the active fraction. Bj4, Bj6 and Bj7 were screened as active components. Bj7 was further purified, resulting in 7 components (Bj701-Bj707). Bj704 and Bj707 showed significant biological activity. Mass spectrometry showed three molecular ion peaks with highest abundance, i.e. m/e 526, 542 and 572, i.e. m/e 526, 542 and 572, in Bj707 -A The amino acid sequences of above three peptide compounds were NDDY (Asn-Asp-Asp-Tyr), NPNPT (Asn-Pro-Asn-Pro-Thr), and HGRFG (His-Gly-Arg-Phe-Gly), respectively. And M572 was the most abandunt components.

CONCLUSIONThree active peptide compounds of anti-hepatic fibrosis of Amydae Carapax were identified.

Animals ; Cell Line ; Humans ; Liver Cirrhosis ; Medicine, Chinese Traditional ; Tissue Extracts ; isolation & purification ; pharmacology