Category: Statistics

Zhonghua Nan Ke Xue. 2025 Feb;31(2):144-149.

ABSTRACT

OBJECTIVE: To investigate the effect of psychological intervention based on the extension and expansion of positive psychology (PERMA) model on sexual psychological resilience (PR) and erectile function in patients with psychogenic erectile dysfunction (pED).

METHODS: This prospective, single-blind, randomized controlled trial included 122 cases of pED diagnosed in our hospital from September 2023 to August 2024, which were equally divided into a trial and a control group, the former treated by PERMA-based psychological intervention in addition to drug therapy, while the latter by drug therapy only. After 2, 4 and 8 weeks of treatment, we obtained the scores of the patients on IIEF-5, Connor-DavidsonResilience Scale (CD-RISC), Self-Esteem and Sexual Relationship Satisfaction Scale (SESRS) and the quality of sexual life, and compared them between the two groups before and after intervention.

RESULTS: At 2, 4 and 8 weeks after treatment, the IIEF-5 scores were significantly lower in the trial than in the control group (P<0.05). There were no statistically significant differences in the baseline scores on any dimensions of CD-RISC between the two groups, while after 8 weeks of treatment, the scores on personal abilities, stress resistance, control, mental influence and total CD-RISC scores were all remarkably higher in the trial group than in the control (P<0.05). No statistically significant differences were observed between the two groups before treatment either in the SESRS scores, or in the average number of effective erections, average duration of each erection and average erection hardness. After 8 weeks of treatment, the patients in the trial group, compared with the controls, showed marked increases in self-esteem, sexual relationship satisfaction and total SESRS scores, as well as in the average number of effective erections, average duration of each erection and average erection hardness (P<0.05).

CONCLUSION: For the treatment of pED, PERMA-based psychological intervention in addition to active medication contributes to elevating the psychological resilience and improving the erectile function of the patients.

PMID:40783959

Zhonghua Nan Ke Xue. 2024 Dec;30(12):1128-1134.

ABSTRACT

OBJECTIVE: To explore the effects of Qiwei No.3 combined with sildenafil on Rho kinase activity and AKT/eNOS pathways in the penile cavernous tissue of male rats with diabetic erectile dysfunction (DED).

METHODS: We constructed a model of DED in 24 SD male rats by intraperitoneal injection of streptozotocin solution and injecting apomorphine into the neck after 8 weeks of feeding, equally randomized the model rats into a model control (MC), a sildenafil (S), a low-dose Qiwei No.3 combined with sildenafil (LQ+S) and a high-dose Qiwei No.3 combined with sildenafil (HQ+S) group, and took another 6 normal male rats as blank controls (BC). We treated intragastrically the animals in the BC and MC groups with normal saline, and those in the S, LQ+S and HQ+S groups with sildenafil (5 mg/kg/d), Qiwei No.3 (10 g/kg/d) + sildenafil (5mg/kg/d), and Qiwei No.3 (20g/kg/d) + sildenafil (5mg/kg/d), respectively. After 6 weeks of treatment, we recorded the number of penile erections of all the rats by injecting apomorphine into the neck, and measured the activity of Rho kinase and expressions of p-AKT and eNOS proteins in the corpus cavernosum by Western blot.

RESULTS: Compared with the blank controls, all the DED model rats showed evidently elevated blood glucose and reduced body weight. The number of penile erections was significantly increased in the S, LQ+S and HQ+S groups in comparison with that in the model controls (P< 0.05), even higher in the HQ+S than in the S group (P< 0.05). The activity of Rho kinase in the penile cavernosum was significantly higher in the MC than in the BC group (P<0.05), but lower in the HQ+S than in the S group (P< 0.05). No statistically significant difference was observed in the expression level of the p-AKT protein in the penile cavernosum among the five groups of rats (P > 0.05). The expression of eNOS was remarkably up-regulated in the BC and HQ+S groups (P< 0.05) compared with that in the MC group, even more significantly in the HQ+S than in the LQ+S and S groups (P< 0.05).

CONCLUSION: The combination of high-dose “Qiwei No. 3” and sildenafil can improve erectile function in DED rats, which may be attributed to its effect of releasing more nitric oxide (NO) by inhibiting the activity of Rho kinase and up-regulating the expression of the e-NOS protein.

PMID:40783925

Zhonghua Nan Ke Xue. 2024 Dec;30(12):1122-1127.

ABSTRACT

OBJECTIVE: To evaluate the clinical efficacy and safety of Wuziyuye Decoction in the treatment of type-II diabetes mellitus (DM) with qi-yin deficiency complicated by asthenospermia.

METHODS: We selected 100 cases of type-II DM with qi-yin deficiency complicated by asthenospermia treated in the First Hospital Affiliated to Ningbo University from January 2023 to March 2024, and randomly assigned them to receive Wuziyuye Decoction (the trial group, n = 50) and oral L-carnitine solution (the control group, n = 50) in addition to Western medicine to reduce fasting blood glucose to normal in both groups. After 12 weeks of medication, we followed up the patients for 24 weeks, obtained their semen parameters, traditional Chinese medicine (TCM) syndrome scores and levels of reproductive hormones, and the clinical pregnancy outcomes of their partners, followed by comparison of the data collected between the two groups before and after treatment.

RESULTS: After 12 weeks of treatment, the trial group showed significant improvement over the baseline in the percentage of progressive motility (PR%) (［35.5±6.1］% vs ［18.0±4.2］%, P<0.05), sperm concentration (［54.0±33.4］ vs ［40.0±36.1］ × 10⁶/ml, P<0.05), and TCM syndrome score (4.5±2.3 vs 18.5±5.2, P<0.05), but no statistically significant difference in the semen volume (［2.85±0.36］ vs ［2.84±0.59］ ml, P>0.05), while the controls exhibited markedly improved percentage of PR% (［29.5±6.2］% vs ［18.5±4.5］%, P<0.05) and sperm concentration (［45.0±34.1］ vs ［42.0±38.3］ × 10⁶/ml, P<0.05), but no statistically significant difference in the semen volume (［3.04±0.89］ vs ［2.90±0.78］ ml, P>0.05) and TCM syndrome score (17.2±4.5 vs 17.8±4.8, P>0.05). The patients treated with Wuziyuye Decoction achieved even more significant improvement than the controls in the percentage of PR%, sperm concentration and TCM syndrome score (P<0.05), but there were no statistically significant differences in the reproductive hormone levels and clinical pregnancy outcomes between the two groups of patients after treatment (P>0.05). And no severe adverse reactions were observed in either group.

CONCLUSION: Wuziyuye Decoction is safe and effective for the treatment of type-II DM with qi-yin deficiency complicated by asthenospermia by improving the sperm motility and concentration of the patient.

PMID:40783924

Zhonghua Nan Ke Xue. 2024 Dec;30(12):1110-1116.

ABSTRACT

OBJECTIVE: To explore the role of the CMTM2 gene in regulating testicular spermatogenesis in the mouse model of experimental autoimmune orchitis (EAO).

METHODS: We constructed an EAO model in CMTM2 knockout and wild-type (WT) mice, studied the immunological reproductive phenotype and examined the number, morphology and activity of the sperm generated in the CMTM2 knockout mice. We assessed the infiltration of macrophages and lymphocytes in the testis tissue sections and Leydig cells, and determined the expression levels of CMTM2 in the homozygous knockout (KO), heterozygous and WT mice by RT-PCR, Western blot and Northern blot.

RESULTS: Statistically significant differences were observed in the long testicular axis and the number of sperm generated between the KO and WT mice after reaching adulthood (P<0.05). The total numbers of macrophages and lymphocytes were markedly increased, while sperm motility and the percentage of morphologically normal sperm remarkably decreased in the testis of the KO mouse model compared with those in the WT mouse model of EAO.

CONCLUSION: The CMTM2 gene, as a regulator of spermatogenesis, is highly expressed in adult male mice and plays an important role in the maintenance of spermatogenesis. Moreover, decreased expression products of the CMTM2 gene may weaken spermatogenesis under chronic inflammation conditions.

PMID:40783922

Zhonghua Nan Ke Xue. 2024 Dec;30(12):1086-1090.

ABSTRACT

OBJECTIVE: To compare the effects of normal-pressure drainage (norPD) and negative-pressure drainage (negPD) after laparoscopic radical prostatectomy (LRP) in the treatment of PCa.

METHODS: We retrospectively analyzed the clinical and follow-up data on 87 cases of PCa treated by LRP from October 2019 to October 2022, 46 receiving norPD and the other 41 negPD postoperatively. We indwelt an F20 pelvic drainage tube for each of the patients, which were connected to an anti-reflux drainage bag for those in the norPD group and a 200 ml negative pressure ball for those in the negPD group, and removed the tubes at the drainage volume ≤30 ml/d. We compared the operation time, intraoperative blood loss, drainage volume on the first day after surgery, total postoperative drainage volume, drainage tube-indwelling duration, drainage tube-related nursing time, urinary catheter removal time, wound healing time, and incidence of postoperative complications between the two groups of patients.

RESULTS: No statistically significant differences were observed between the two groups in terms of operation time, intraoperative blood loss, wound healing time, and postoperative complications (P>0.05). The drainage volume on the first postoperative day and the total postoperative drainage volume were significantly lower, and the drainage tube-indwelling duration and drainage tube-related nursing time markedly shorter in the norPD than in the negPD group (all P<0.05).

CONCLUSION: Normal-pressure drainage is a safe and effective drainage method after laparoscopic radical prostatectomy, which can significantly reduce the postoperative drainage volume, drainage tube-indwelling duration and drainage tube-related nursing time.

PMID:40783918

Zhonghua Nan Ke Xue. 2024 Dec;30(12):1081-1085.

ABSTRACT

OBJECTIVE: To investigate the clinicopathological features and prognosis of urinary bladder urothelial carcinoma (UBUC) with incidental prostate cancer (IPCa).

METHODS: We retrospectively analyzed the clinicopathological features of 65 cases of UBUC and 38 cases of UBUC + IPCa after radical cystoprostatectomy (RCP) from January 2017 to February 2020. We compared their expressions of the immunohistochemical markers androgen receptor (AR) and (human epidermal growth factor receptor 2,HER2) between the two groups of patients, and analyzed their clinicopathological characteristics by chi-square test and their survival rates using the Kaplan-Meier method and log-rank test.

RESULTS: The detection rate of UBUC + IPCa was 16.5%, and that of clinically significant IPCa was 39.5%, with preoperative PSA≥4 μg/L in 23.7% of the patients. Compared with the patients with UBUC, most of the UBUC + IPCa cases had no smoking history (73.8% vs 92.1%, P = 0.024), and fewer had histological variants (43.1% vs 10.5%, P = 0.003). The incidence rate of vascular invasion was significantly higher in the UBUC than in the UBUC + IPCa group (49.2% vs 21.1%, P = 0.005), and so was the rate of advanced cases (67.7% vs 31.6%, P<0.001). In comparison with the patients of the UBUC group, those of the UBUC + IPCa group showed remarkably higher expressions of AR (9.2% vs 31.6%, P = 0.004) and HER2 (43.1% vs 71.1%, P = 0.006). The mean overall survival time was longer in the UBUC + IPCa than in the UBUC group (48.8 mo ［95% CI: 2.5－42.6 mo］ vs 39.9 mo ［95% CI: 2.8－34.5 mo］), but with no statistically significant difference between the two groups (P = 0.608).

CONCLUSION: Standardized sampling of prostate samples after RCP helps to improve the detection rate of IPCa. Preoperative level of PSA is not a good predictor of IPCa. Few patients with UBUC + IPCa have a history of cigarette smoking, and the predominant histological type of the malignancy is high-grade invasive urothelial carcinoma, which is not significantly different from UBUC in prognosis. The expressions of HER2 and AR are significantly higher in UBUC + IPCa than in UBUC, suggesting that UBUC + IPCa may benefit from HER2- and AR-targeted therapy.

PMID:40783917

Environ Geochem Health. 2025 Aug 10;47(9):369. doi: 10.1007/s10653-025-02685-5.

ABSTRACT

The combined impact of high iodine and high fluoride exposure has garnered increased attention. To determine whether exposure to high levels of fluoride and iodine in water has adverse effects on children’s teeth. In this study, 582 children aged 8 to 12 from rural Jiangsu, China, were divided into three groups based on the concentrations of iodine and fluoride in their drinking water: a high fluoride and high iodine group (HFHI), a high fluoride group (HF), and a control group (CONTROL). We employed the ion-selective electrode method to measure fluoride levels in urine samples and used inductively coupled plasma mass spectrometry to assess urinary iodine (UI) levels. The prevalence and severity of dental fluorosis (DF) were determined using Dean’s Index in accordance with WHO criteria. A logistic regression model was used to analyze factors related to dental fluorosis. The urinary fluoride (UF) regression coefficients were compared using the Z-test to assess their influence. The results indicate that the prevalence of DF was 52.5, 33.5, and 4.1% in the HFHI, HF, and CONTROL groups, respectively. There were statistically significant differences in both the prevalence and severity of DF among the groups (P < 0.001 for both). The dental fluorosis indexes (DFI) were calculated as 1.2, 0.7, and 0.1 for the HFHI, HF, and CONTROL groups, respectively. UF levels were positively associated with DF in the HFHI and HF groups, with adjusted odds ratios (OR) of 5.30 and 3.12, respectively. The Z-test results showed statistically significant differences (HFHI vs. CONTROL, P < 0.001; HF vs. CONTROL, P = 0.048; HFHI vs. HF, P < 0.001). UF levels > 1.4 mg/L and UI > 300 μg/L demonstrated a significant interaction in the HFHI group (OR = 9.62, 95% CI 2.70-18.36, P < 0.001) and Overall (OR = 9.15, 95% CI 2.71-16.58, P < 0.001). Simultaneous exposure to high iodine and high fluoride in water adversely impacts the incidence of DF in school-age children. It is recommended that monitoring of UI levels in children from high fluoride regions be enhanced.

PMID:40783901 | DOI:10.1007/s10653-025-02685-5

Eur J Orthop Surg Traumatol. 2025 Aug 10;35(1):343. doi: 10.1007/s00590-025-04460-9.

ABSTRACT

INTRODUCTION: There is limited evidence to guide treatment strategies for native and periprosthetic distal femoral nonunions. The aim was to determine factors associated with failure of distal femoral nonunion repair.

METHODS: All adult patients undergoing operative repair for a distal femoral nonunion from 2004 to 2023 at two Level 1 Trauma Centers with ≥ 6 months follow-up were identified. The primary outcome was additional nonunion surgery. Univariate logistic regression was performed to determine associations of patient, initial fracture, nonunion, and treatment characteristics with additional nonunion surgery.

RESULTS: Eighty-six patients (median age 63 years, 63% female) were included. Definitive fixation was most often a non-augmented lateral locking plate (LLP, 52%), 95-degree-blade-plate (BP, 29%), or augmented LLP (15%). Augmented fixation was defined as the addition of a medial or endosteal plate or intramedullary nail. Fourteen patients (16%) required additional nonunion surgery. In univariate logistic regression analysis, initial high-energy injuries (OR: 4.18, p = 0.044), increasing number of previous surgeries (OR: 1.94, p = 0.007), and treatment with retention of previous implants (OR: 5.25, p = 0.010) or bone morphogenetic protein use (OR: 5.82, p = 0.005) were associated with increased odds of additional nonunion surgery; whereas treatment with BP constructs (vs. non-augmented LLPs, OR: 0.11, p = 0.044) reduced odds. Rates of additional nonunion surgery were 12/45 (27%) for non-augmented LLP, 1/13 (7.7%) for augmented LLP, and 1/25 (4.0%) for BP constructs. When excluding patients treated with retention of previous implants, rates were 7/35 (20%) for non-augmented LLP, 0/8 (0%) for augmented LLP, and 1/25 (4%) for BP constructs. There were differences across constructs, including for rates of initial intra-articular fractures (49% vs. 0% vs. 13%), and use of autograft (51% vs. 62% vs. 16%) and bone morphogenetic protein (44% vs. 31% vs. 8.0%).

CONCLUSIONS: Approximately 1 in 6 patients required additional nonunion surgery. In unadjusted analyses, initial high-energy injuries and more prior surgeries were associated with increased odds for additional nonunion surgery, suggesting that the severity of the initial injury is associated with subsequent nonunion treatment outcomes. The current study findings suggest that distal femoral nonunion repair should be based on revision fixation using augmented lateral locking plate (dual-plate or nail-plate) or blade plate constructs. However, these findings are based on unadjusted comparisons. Larger studies with sufficient power to correct or stratify for confounding are needed to further define optimal treatment.

PMID:40783877 | DOI:10.1007/s00590-025-04460-9

Zhonghua Nan Ke Xue. 2024 Nov;30(11):1019-1024.

ABSTRACT

OBJECTIVE: This study aims to evaluate the clinical efficacy and safety of Dibai Yijing Formula (DYF) in the treatment of male infertility with essence deficiency in the kidney and damp-heat in the essence chamber (Abbreviation: kidney deficiency and damp-heat type).

METHODS: This study employed a randomized, controlled clinical trial design, recruiting 72 male patients with infertility due to kidney deficiency and damp-heat type. Patients were randomly assigned to an treatment group (36 patients) and a control group (36 patients) using a random number table. The control group received oral Clomiphene Citrate Capsules (50 mg, twice daily), while the treatment group received oral DYF (one dose daily, 200 ml each time, 30 minutes after breakfast and dinner). Both groups underwent a 12-week treatment period. After treatment, sperm concentration (SC), percentage of progressively motile sperms (PR), total sperm motility ［PR + percentage of non-progressively motile sperms (NP)］, and semen volume (SV) were compared between the two groups before and after treatment. Additionally, the total score of Traditional Chinese Medicine (TCM) syndrome score and sperm DNA fragmentation index (DFI) and pregnancy outcomes of the patients’ spouses were compared between the two groups.

RESULTS: Three patients dropped out from the treatment group and four from the control group. There were no statistically significant differences in semen parameters between the two groups ( P>0.05). After treatment，the patients in the treatment group showed significant difference in the percentage of SC (［19.42±5.30］×10⁶/ml vs ［10.75±2.41］×10⁶/ml）, PR(［27.72±6.62］% vs ［20.04±4.10］%）, PR+NP(［49.86±10.68］ % vs (33.74±5.58) %］, DFI(［12.33±3.43］ % vs ［15.06±3.98］ %） and TCM symtom score(［7.45±1.82］ vs ［13.85±1.91］）, and the difference was statistically significant (P<0.05). The patients in the control group showed significant difference in the percentage of SC(［19.56±5.24］×10⁶/ml vs ［11.31±2.08］×10⁶/ml ） and TCM symptom score (［12.81±1.86］ vs ［14.06±1.64］）. But no significant changes were observed in the PR (［21.75±5.93］ % vs ［20.05±4.67］ %）, PR+NP (［34.23±7.15］ % vs ［32.35±4.09］ %）, SV (［3.19±1.08］ ml vs ［3.12±1.13］ ml）, and DFI (［15.11±4.76］ % vs ［15.51±4.35］ %）were not statistically significant （P > 0.05). Improvements in PR, PR+NP, TCM symptom score and DFI in the treatment group were better than those in the control group after treatment (P < 0.05); the differences in SC and SV and spousal pregnancy in the treatment group were not statistically significant compared with those in the control group (P > 0.05). No serious adverse events occurred in both groups during the treatment period.

CONCLUSION: The treatment of male infertility with DYF is effective and safe.

PMID:40783872

Zhonghua Nan Ke Xue. 2024 Nov;30(11):1015-1018.

ABSTRACT

OBJECTIVE: To investigate the clinical application value of liquid wound dressing in circumcision.

METHODS: This retrospective study included 200 cases of redundant prepuce or phimosis undergoing circumcision in the Affiliated Hospital of Nanjing University of Chinese Medicine between August 2021 and December 2022. We divided the patients into two groups of an equal number to receive wound care with liquid wound dressing (the observation group) and iodine gauze dressing (the control group), respectively. We compared the operation time, postoperative bleeding, edema, infection, incision exudation and scarring, and pain scores during dressing change at 4, 24 and 72 hours after surgery. Results： No statistically significant differences were observed between the observation and control groups in the operation time (［16.22 ± 3.15］ vs ［17.01 ± 3.37］ min, P > 0.05) or postoperative bleeding (12 vs 14 cases, P > 0.05). The patients in the observation group, compared with the controls, showed significantly lower incidences of postoperative edema (9 vs 23 cases), infection (6 vs 17 cases), incision exudation (7 vs 21 cases) and scarring (5 vs 14 cases), and lower pain scores during dressing change at 4 hours (6.71 ± 1.02 vs 7.04 ± 0.92), 24 hours (5.38 ± 1.45 vs 5.87 ± 1.35) and 72 hours after surgery (3.65 ± 1.53 vs 4.26 ± 1.63) (all P < 0.05). Conclusion： For postoperative wound care of the patients undergoing circumcision, liquid wound dressing can evidently reduce postoperative pain, incision bleeding, edema, infection and scarring, and therefore deserves clinical promotion.

PMID:40783871