Objective To cladfy the dependence of neural nitric oxide synthase mRNA (nNOSmRNA) and endothelial nitric oxide synthase mRNA (eNOSmRNA) on androgens (testosterone [T] and dihydrotestosterone [DHT]).Methods 160 male Sprague Dawley (SD) rats were divided into Groups A (56 rats, 5 weeks old), B (50rets,10 weeks old) and C (54 rats, 58 weeks old).Groups A, B and C were all subdivided respectively into five Subgroups. Subgroup 1: intact osntrels;Subgroup 2: castrated; Subgroup 3: castrated with testosterone ubdecanoate 25 mg/kg·mon-1,intramuscular injection, Subgroup 4: castrated with testosterone undecanoate 50 mg/kg·mon-1,intramuscular injection and Subgroup 5: treated with finaeteride 4.5 mg/kg·day-1, orally. Four and ten weeks after treatments described above, one half of the rats were killed. Serum samples were token for measurements of T, free testosterone (FT) and DHT by raclioimmunoassay. Penile samples were treated with liquid nitrogen and then stored at-80℃.nNOSmRNA and eNOSmRNA were detected by semiquantitative reveres-transcription polymerase chain reaction (RT-PCR) and Dot blot.Resulte There was no significant difference between Subgroup 1 and Subgroup 2 or Subgroup 5 in all Groups A, B and C. The expression of penile eNOSmRNA of Group A was significantly increased (4 weeks model) (P＜0.05) or increased (10 weeks model) (P＞0.05) in Subgroup 2 or 5 compared with those in Subgroup 1.There wes no significant difference between Subgroup 1 and Subgroup 2 or Subgroup 5 of Group B in 4 weeks model (P＞0.05).There was an elevation when animals were castrated or treated with finasteride in the 10 weeks model.The expreseion of penile eNOSmRNA of Group C was significantly increased (10 weeks model) (P＜0.05)or increased (4 weeks model) in Subgroup 2 compared with those in Subgroup 1.The production of eNOSmRNA in Subgroup 5 was also increased (including 4- and 10-week models). When T was supplied for castration, the penile eNOSmRNA was desreased to some extent; the greater the dose of T given, the lower penile eNOSmRNA was observed.Conclusions The expression of eNOSmRNA in SD rat penile tissue increases while T or DHT diminishes.Sometimes androgens medaulate penile eNOSmRNA in opposite directions. There is no srrelation between theexpression of nNOSmRNA and androgens (including Tand DHT) . Androgens give rise to penile erectionprobably not via the NOS pathway.

This study sought to assess the prognostic signiifcance of the degree of extranodal extension (ENE) and several other risk factors in pathological ENE penile carcinoma. We analyzed prospectively collected data on a consecutive series of 31 chemotherapy-naive patients with proven ENE who underwent therapeutic regional lymphadenectomy. Postoperative external radiotherapy was then performed. We studied the extent of ENE utilizing a novel grading system and correlated patient grades with their outcome measures. ENE was graded as 1-if the capsule of the lymph node (LN) was ruptured less than one-third of its circumference or 2 - if the capsule was disrupted more than one-third of its circumference or the entire LN was disrupted. We estimated overall survival (OS) using the Kaplan-Meier method. Multivariate analysis was performed according to the Cox proportional hazards model using factors that were identiifed as statistically signiifcant in univariate analysis. The incidence rate of ENE was 51.8%in patients with pathological node-positive carcinoma of the penis. The median OS and 5-year survival were 18 months (95%conifdence interval (CI), 14.4-21.6) and 23%, respectively. Prognostic variables on univariate analysis were ENE grade 2,≥3 LNs with ENE, maximal LN≥35 mm,≥5 positive LNs and pelvic LN involvement. On multivariate analysis, only ENE grade 2 remained associated with decreased OS (hazard ratio (HR):6.50). In conclusion, patients with ENE have a poor outcome, and ENE grade 2 is an independent predictive factor of poor OS in patients with pathological ENE penile carcinoma.

一例罕见的巨大阴茎鳞癌的外科治疗

Penile squamous cell carcinoma has been commonly reported in the past decades. We describe a rare case of a huge squamous cell carcinoma of the penis in a 65-year-old patient with a 4-year history of tumor growth, for which total penectomy, perineal urethrostomy and bilateral inguinal lymphadenectomy were carried out. We suggest that aggressive surgical intervention should be recommended for those with well-differentiated penile carcinoma regardless of the size of the tumor.

韩国红参对治疗勃起功能障碍的疗效研究

Aim: To examine the treatment efficacy of Korean Red Ginseng (KRG) in impotent men with erectile dysfunction (ED). Methods: A total of 60 patients presenting mild or mild to moderate ED were enrolled in a double-blind,placebo-controlled study in which the efficacies of KRG and a placebo were compared. The patients received either 1 000 mg (3 times daily) of KRG or a placebo. Results: The five-item version of the International Index of Erectile Function (IIEF-5) score after the treatment was significantly higher in the KRG group compared with that before the treatment (from 16.4 ± 2.9 to 21.0 ± 6.3, P ＜ 0.0001). In contrast, there was no difference before and after the treatment in the placebo group (from 17.0 ± 3.1 to 17.7 ± 5.6, P ＞ 0.05). In the KRG group, 20 patients (66.6%),reported improved erection, significant in the global efficacy question (P ＜ 0.01); in the placebo group there was no significance. Scores on questions 2 (rigidity), 3 (penetration), 4 and 5 (maintenance), were significantly higher for KRG than those for the placebo when those questions were answered after 12 weeks of each treatment (P ＜ 0.01).When the score in the KRG group was compared to the placebo group after the treatment, there was a significant improvement in total score (IIEF-5 score) in questions 3 and 5 for the KRG-treated group (P ＜ 0.001 and P ＜ 0.0001,respectively). The levels of serum testosterone, prolactine and cholesterol after the treatment were not statistically significant different between the KRG and the placebo group (P ＞ 0.05). Conclusion: Our data show that KRG can be an effective alternative to the invasive approaches for treating male ED.