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Objective: To explore the topological properties of the betweenness centrality of the nodes and edges in the brain white matter network of premature ejaculation (PE) patients and analyze the correlation of the importance of the key brain regions and interregional white matter structural connectivity with the ejaculatory function of the patients.Method: We collected the demographic and clinical data, along with the T1 and MR diffusion tensor imaging (MR-DTI) data, on 18 PE patients and 22 normal controls matched in age, sex and education. After preprocessing of the data obtained, we divided the whole brain into 90 symmetrical cortical and subcortical regions (defined as nodes of the brain network) by automated anatomical labeling, examined the structural connectivity between different brain regions by probabilistic white matter fiber tracking (defined as edges of the brain network), and calculated the betweenness centrality of the nodes and edges using the brain connection toolbox. Then, we performed the Mann-Whitney U test on the betweenness centrality of the nodes and edges, subjected the results to false discovery rate (FDR) correction, and assessed the correlation of the attribute values of between-group differences with the ejaculatory function of the patients., Results: Compared with the normal controls, the PE patients showed a significantly decreased betweenness centrality of the right superior occipital gyrus (SOG) (281.18 ± 255.26 vs 67.78 ± 58.98, Z = －3.49, FDR-corrected P < 0.05), but increased betweenness centrality of the right superior temporal gyrus (STG) (222.91 ± 155.60 vs 557.00 ± 322.65, Z = 3.55, FDR-corrected P < 0.05) and betweeness centrality of the edge between the right rolandic operculum and right insula (4.23 ± 8.39 vs 23.83 ± 23.91, Z = 3.84, FDR-corrected P < 0.05). The betweenness centrality of the right SOG was correlated negatively with the level of difficulty in delaying ejaculation (r = －0.51, P = 0.03) and the probability of ejaculation before expectation (r= －0.61, P = 0.01), while that of the right STG positively with PE-related frustration (r = 0.54, P = 0.02) and the level of concern about PE-related distress of the partner (r = 0.47, P = 0.04)., Conclusions: Abnormalities of structural connections were found in the visual stimulus- and emotion processing-related regions in the right cerebral hemisphere of PE patients, which might be associated with rapid ejaculation or decreased ejaculation control and lead to a series of psychological problems.

Objective: To evaluate the role of gray-white-matter ratio (GWR) on neurological outcome in patients with coma after cardiopulmonary resuscitation (CPR) post-respiratory and cardiac arrest (CA)., Methods: Respiratory and CA patients with restoration of spontaneous circulation (ROSC) and coma after CPR admitted to Nanjing Drum Tower Hospital Clinical Medical College of Nanjing Medical University from February 2013 to June 2016 were enrolled. All patients were subjected to target temperature management (TTM) after CPR, and received cranial CT within 5 days after ROSC. Attenuation (hounsfield units) was measured at special sites (basal ganglia, centrum semiovale), and specific locus (caudate nucleus, put amen, corpus callosum, posterior limb of internal capsule, medial cortex, medial white matter). The GWR was calculated for basal ganglia and cerebrum. Neurological outcome was judged according to the Glasgow-Pittsburgh cerebral performance category (CPC) at 3 months after ICU discharge. CPC 1-3 were divided into good prognosis, CPC 4-5 were divided into poor prognosis. The receiver-operating characteristic (ROC) curve was drawn to evaluate the prognostic value of GWR in patients with respiratory and CA., Results: Forty-three patients were enrolled, including 26 males and 17 females; age (63±15) years old; 14 good prognosis and 29 poor prognosis. Compared with the good prognosis group, the basal ganglia GWR (GWR bg ) and the average GWR (GWR av ) were significantly lowered in the poor prognosis group (1.064±0.103 vs. 1.163±0.818, 1.068±0.087 vs. 1.128±0.071, both P < 0.05), the centrum semiovale GWR (GWR ce ) was similar to that in the good prognosis group (1.072±0.077 vs. 1.092±0.075, P > 0.05). It was shown by ROC curve analysis that the GWR bg , GWR av could evaluate the neurological outcomes of patients, but GWR ce could not. The area under the ROC curve (AUC) of GWR bg was 0.756 [95% confidence interval (95%CI) = 0.607-0.905, P = 0.007], the cut-off value was 1.13, the sensitivity was 71.4%, and specificity was 69.0%; the AUC of GWR av was 0.701 (95%CI = 0.532-0.869, P = 0.035), the cut-off value was 1.13, the sensitivity was 71.4%, and specificity was 65.5%; the AUC of GWR ce was 0.590 (95%CI = 0.405-0.775, P = 0.344)., Conclusions: Respiratory and CA patients receiving TTM with high GWR had favorable neurological outcome. GWR, especially GWR bg could provide help for clinical treatment and prognostic value of survival after CA.