Association of Erectile Dysfunction and Hypogonadism with Metabolic Syndrome in Men with Lower Urinary Tract Symptoms of Younger and Older Age Groups

The aim of this study was to evaluate the incidence and severity of erectile dysfunction (ED) and hypogonadism in 193 men presenting with lower urinary tract symptoms (LUTSs) in the younger (20 - 39 years old) and older (40 - 60 years old) age groups depending on the presence of metabolic syndrome (MetS). Triglycerides, glucose and high-density lipoprotein cholesterol, serum total testosterone (TT), sex hormone-binding globulin, prostate-specific antigen, pituitary hormones levels were measured in serum. Standardized criteria (2009) were used to determine the prevalence of MetS. Patients were assessed based on the International Prostate Symptom Score (IPSS) and the IPSS-Quality of Life (IPSS-QoL) for LUTSs and the International Index of Erectile Function (IIEF) for ED. Hypogonadism was determined in accordance with the ISA, ISSAM, EAU, EAA and ASA recommendations. In men with MetS in the younger age group the incidence of ED was 2.4 times higher, and that of low TT level and hypogonadism was 8.4 times higher compared to men without the syndrome. In the older age group, an increased incidence of ED and low TT level in men with MetS compared to men without the syndrome was on the trend level, but the incidence of hypogonadism was for sure higher (by 1.6 times). In conclusion, the study showed that ED and hypogonadism are associated with MetS by a high degree of certainty in young men with LUTSs. In men of the older age group with LUTSs, the presence of MetS is not so clearly associated with ED and hypogonadism due to the fact that the incidence of these urogenital diseases is also high in men without MetS.

农村小学生“低龄寄宿”现象的成因、影响与对策

在城乡二元结构逐渐弱化、大量农村人口进城务工的背景下,我国很多农村出现了大量的留守儿童,加上有些农村地区基础教育不完善甚至日渐凋敝,导致城市中出现了一个新的"低龄寄宿"农村小学生群体。"低龄寄宿"对小学生的早期社会化产生诸多不良影响。解决这一问题,除了依靠学生所在的家庭、学校外,加强农村社会工作者队伍建设也是一个重要方面。

Age exerts a continuous effect in the outcomes of Asian breast cancer patients treated with breast-conserving therapy

Background:Asians are diagnosed with breast cancer at a younger age than Caucasians are.We studied the effect of age on locoregional recurrence and the survival of Asian breast cancer patients treated with breast-conserving therapy.Methods:Medical records of 2492 patients treated with breast-conserving therapy between 1989 and 2012 were reviewed.The Kaplan-Meier method was used to estimate locoregional recurrence,breast cancer-free survival,and breast cancer-specific survival rates.These rates were then compared using log-rank tests.Outcomes and age were modeled by Cox proportional hazards.Fractional polynomials were then used to test for non-linear relationships between age and outcomes.Results:Patients≤40 years old were more likely to have locoregional recurrence than were older patients(Hazard ratio[HR]=2.32,P<0.001).Locoregional recurrence rates decreased year-on-year by 4%for patients with luminal-type breast cancers,compared with 8%for those with triple-negative cancers.Similarly,breast cancer-free survival rates increased year-on-year by 4%versus 8%for luminal-type and triple-negative cancers,respectively.Breast cancer-spe-cific survival rates increased with age by 5%year-on-year.Both breast cancer-free survival and breast cancer-specific survival rates in patients with luminal cancers exhibited a non-linear(“L-shaped”)relationship-where decreasing age at presentation was associated with escalating risks of relapse and death.The influence of age on overall survival was confounded by competing non-cancer deaths in older women,resulting in a“U-shaped”relationship.Conclusions:Young Asian breast cancer patients have a continuous year-on-year increase in rates of disease relapse and cancer deaths compared with older patients with no apparent threshold.

AGE, ARTERIAL STIFFNESS AND CARDIOVASCULAR RISK

The recent researches on the structure and function of large artery find that increasing pulse pressure is associated with greater cardiovascular risk, especially risk of coronary events. Such risk is not explicable on the basis of increasing systolic pressure with age, and is apparent even when the major reason for increased pulse pressure is a relative decrease of diastolic pressure. The finding challenges the conventional approach to arterial pressure where diastolic pressure is traditionally viewed as the most robust indicator of caridovascular risk. An explanation is available. This is based on the perception of Harriet Dustan that hypertension in the older popula-