Multicentricity and its associated clinicopathological risk factors in renal cell carcinoma

Yidiyin, a Chinese Herbal Decoction, Improves Erectile Dysfunction in Diabetic Patients and Rats through the NO-cGMP Pathway

“…Additionally, Yidiyin, as a safe drug, was not found to have severe side effects, such as chest pain, dyspnea, larynx edema, or asthma in alleviating diabetic patients' ED, quite differently from inhibitors of PDE5. 11,12) Although the pathophysiological causes of diabetic ED are multifactorial, including hyperglycemia and nonenzymatic glycation of proteins, increased oxidative stress and production of reactive oxygen species, altered angiogenesis, dyslipidaemia, psychological stress, impaired endothelial-and neurogenic-regulated relaxation of penile smooth muscle, [31][32][33] the endothelial-and neurogenic-mediated relaxation of the penile smooth muscle has been identified to be crucial to the initiation and maintenance of normal erectile function. A growing body of evidence indicates that the erectile tissue of diabetic men and experimental type 1 and 2 diabetes animals manifests an inability to relax in response to the activation of nerves or the endothelium.…”

“…However, they also have side effects, including headache, cutaneous flushing, and even serious adverse events including chest pain, dyspnea, larynx edema, and asthma. 11,12) Moreover, quite a number of diabetic ED patients and diabetic rats show a poor response to PDE5 inhibitor therapy. 13,14) Hence the utilization of drugs is sharply limited, especially for patients with angiocardiopathy.…”

Practical Approaches to Treat ED in PDE5i Nonresponders

“…In conclusion, changes in the dosing and sexual attempt behavior in patients taking tadalafil on demand and patient preferences for tadalafil suggest that on-demand tadalafil may be superior to sildenafil and an important strategy for treating PDE5i nonresponders. Unfortunately, in ED patients who do not respond to the maximum dose of sildenafil or vardenafil, the recommended maximum dose of tadalafil (20 mg) did not significantly improve the IIEF-5, SEP-2, SEP-3, or GAQ score by the end point [53]. However, it has been shown that daily tadalafil can serve as a rescue therapy in previous on-demand tadalafil nonresponders [46].…”