性感集中训练法联合西地那非治疗早泄的临床观察

目的 观察应用性感集中训练法联合西地那非治疗早泄的疗效.方法 32例早泄患者应用性感集中训练法治疗4周,并于性交前0.5～1 h口服西地那非50 mg,观察患者治疗前后、停药后4周及8周的阴道内射精潜伏期时间、阴道内射精潜伏期评分、患者性生活满意度、配偶性生活满意度.结果 治疗后,阴道内射精潜伏期时间及其评分、患者性生活满意度、配偶性生活满意度与治疗前比较,差异有统计学意义[(3.84±0.42)min比(0.72 ±0.20) min,(1.86±0.28)分比(2.52±0.21)分,(9.8±1.3)分比(4.8±1.5)分,(9.5±1.2)分比(4.6±1.3)分,P＜0.01或P＜0.05],停药后4、8周上述指标与治疗后比较,差异均无统计学意义(P＞0.05).结论 性感集中训练法联合西地那非对早泄有较好的治疗效果,能延长阴道内射精潜伏期、提高患者夫妻双方性生活满意度,且治疗效果稳定、复发率低.     

手术和脱敏及药物三种方法治疗原发性早泄的临床对比研究

目的对比手术、脱敏及药物3种方法治疗原发性早泄的临床疗效。方法选取2009年3月至2011年8月我院收治的原发性早泄患者450例,完全随机分为手术、患者组、脱敏组和药物组,每组150例。手术组行阴茎背神经选择性切断术,脱敏组进行早泄脱敏训练,药物组口服盐酸舍曲林片（商品名：佐洛复）50mg／d。比较3组患者射精潜伏期患者及其配偶性生活满意度评分患者性功能评价表（CIPE-5）评分及治疗后的总有效率。结果治疗后手术组、脱敏组和药物组患者射精潜伏期均较治疗前长[（14．38±2．26）min比（1．28±0.16）min,（10．26±1．88）min比（1．33±0．21）min,（8．93±3．42）min比（1．26±0．19）min,均P〈0．05],患者性生活满意度[（12．1±1．1）分比（5．8±1．3）分,（10．4±1．1）分比（5．7±0．9）分,（9．2±1．4）分比（5．9±1．1）分]、配偶性生活满意度评分[（11．2±1．4）分比（4．2±0．8）分,（10．9±0．9）分比（4．3±0．8）分,（9．7±0．8）分比（4．3±0．9）分]及CIPE-5评分[（21．1±4．0）分比（9．9±2．1）分,（18．1±3．0）分比（9．7±1．4）分,（16．9±1．2）分比（9．9±1．4）分]均较治疗前高,差异均有统计学意义（均P〈0．05）;治疗后3组问比较,手术组患者射精潜伏期较脱敏组和药物组长,患者、配偶性生活满意度评分及CIPE-5评分也较其余2组高,差异均有统计学意义（均P〈0．05）。3组患者总有效率分别为96．7％（145／150）、83．3％（125／150）和78．7％（118／150）,手术组的总有效率明显高于脱敏组和药物组,差异均有统计学意义（均P〈0．05）。结论手术、脱敏和药物均能有效治疗原发性早泄,但采用阴茎背神经选择性切断术的手术疗法疗效更好。     

早泄患者的药物治疗方案研究

目的比较舍曲林联合多沙唑嗪及他达拉非治疗早泄的疗效及不良反应。方法选择2013年10月~2014年5月在我院收治的早泄患者240例,将患者随机分为A、B、C三组,每组80例。三组均服用服用舍曲林50mg,每日下午1次。B组患者加服多沙唑嗪4mg,1次/d(性生活前8~9h服用);C组患者于性生活前1h加服他达拉非20mg。连续治疗12周为1个疗程,记录三组患者治疗前后的平均阴道内射精潜伏期、性生活满意度和不良反应。结果治疗12周后,A、B、C三组患者的射精潜伏期均有所提高(P<0.05),B、C组患者射精潜伏期明显高于A组,差异有统计学意义(P<0.05),B、C组差异无统计学意义(P>0.05)。治疗后,患者对性生活满意度均有显著性提高(P<0.05),B、C两组患者的满意率明显高于A组(P<0.05),差异具有统计学意义。B、C组患者的不良反应发生率显著高于A组,差异有统计学意义(P<0.05)。结论舍曲林联合多沙唑嗪或他达拉非治疗早泄比单独使用舍曲林在加长射精潜伏期、提高性生活满意度方面更加有效,但是联合用药也会导致一定的不良反应,如胃部不适、头疼、性欲下降等。     

达克罗宁胶浆联合双倍剂量盐酸坦洛新缓释片治疗早泄的临床研究

目的分析采取达克罗宁胶浆与双倍剂量盐酸坦洛新缓释片联合治疗早泄的临床效果。方法98例早泄患者,随机分为对照组和试验组,各49例。对照组患者在阴茎头及冠状沟外用涂抹盐酸达克罗宁胶浆治疗,试验组在对照组基础上给予盐酸坦洛新缓释片治疗。比较两组患者临床满意度、治疗前后阴道内射精潜伏期和中国早泄患者性功能评价表(CIPE)评分。结果试验组患者总满意度93.88%高于对照组的75.51%,差异具有统计学意义(P<0.05)。治疗后,试验组患者阴道内射精潜伏期(3.96±0.38)min长于对照组的(2.42±0.36)min,中国早些患者性功能评价表(CIPE)评分(38.82±4.03)分高于对照组的(30.72±3.37)分,差异均具有统计学意义(P<0.05)。结论对早泄患者采用达克罗宁胶浆联合双倍剂量盐酸坦洛新缓释片具有明显改善疗效,在临床中值得进一步借鉴。     

舍曲林联合伐地那非治疗早泄的疗效分析

目的探讨舍曲林联合应用伐地那非治疗早泄的疗效。方法将85例早泄患者随机分为综合组(服用舍曲林和伐地那非)和对照组(服用舍曲林),以治疗前、治疗2w以及治疗4w后的阴道内射精潜伏期时间(ILET)、患者性生活满意度评分(IIEF)来评价疗效。结果与治疗前相比,两组患者在治疗2w、治疗4w时的ILET和IIEF均提高,但治疗2w和4w相比无显著性差异(P>0.05);两组患者相比较,在治疗2w和4w后,综合组患者的ILET和IIEF均比对照组高,差异有统计学意义(P<0.05)。结论治疗早泄患者,舍曲林联合伐地那非能提高疗效。     

盐酸舍曲林联合心理辅导治疗早泄及对患者性生活满意度改善效果的回顾性研究

摘 要 目的： 观察盐酸舍曲林治疗早泄及对患者性生活满意度改善的效果。方法: 采用回顾性研究方法,280例早泄患者根据治疗方法不同分为观察组和对照组。对照组140例采用采用常规心理治疗;观察组在对照组基础上加用盐酸舍曲林胶囊50 g·d^-1,po。比较治疗1个月后两组患者的射精潜伏期、中国早泄患者性功能评价表（CIPE）评分、汉密尔顿抑郁量表（HAMD）评分、国际勃起功能评分表（IIEF-5）评分,以及两组患者和配偶的性生活满意度、药品不良反应发生情况等。结果: 治疗后,两组患者射精潜伏期、CIPE评分、HAMD评分、IIEF-5评分等各项指标均较治疗前明显改善（P<0.05）,且观察组患者明显优于对照组（P<0.05）。观察组患者及配偶的总满意率明显高于对照组（P<0.05）。观察组患者药品不良反应发生率明显高于对照组（P<0.05）,但均较轻微可耐受。结论:在传统的心理辅导行为基础上给予盐酸舍曲林治疗早泄,能显著改善患者射精潜伏期、CIPE评分、HAMD评分、IIEF 5评分等各项指标,提高患者及配偶的满意度,不良反应症状较轻微,值得临床推广。     

阴茎背神经选择性切断术提高治疗原发性早泄96例效果观察

目的观察阴茎背神经选择性切断术治疗原发性早泄的效果。方法对本院门诊就诊的原发性早泄患者96例,采用阴茎背神经选择性切断术,分别观察术前及术后45d患者射精潜伏期、配偶性生活满意度。结果 96例手术均成功,阴茎局部外观无变化,所有患者均未影响阴茎勃起功能。2例患者术后感觉局部轻微疼痛。96例原发性早泄患者中术后射精潜伏期显效为67例(69.8%),好转25例(26.0),总有效率为95.8%(92/96),无效4例,无效率为4.2%。患者配偶性交满意度在术前评分为(8.1±1.5),术后为(10.3±1.2),患者配偶的性交满意度评分在术后较术前显著提高,经统计学分析,差异有显著性意义(P<0.05)。结论采用阴茎背神经选择性远端切断术进行治疗原发性早泄能有效延长阴道内射精潜伏期,改善性伴侣满意率,疗效理想。且手术安全、简单,创伤小,值得临床推广应用。     

伐地那非联合表面麻醉剂治疗勃起功能障碍伴早泄的临床研究

目的探讨伐地那非联合表面麻醉剂治疗勃起功能障碍(ED)伴有早泄患者的临床效果和安全性。方法 60例诊断为合并ED的早泄患者,按需每次服用伐地那非20 mg,并将复方利多卡因乳膏于性交前均匀涂搽龟头处,共治疗12周。以阴道内射精潜伏期评价早泄治疗效果,并评估ED的总体疗效和治疗满意度,比较治疗前后的国际勃起功能指数-5(IIEF-5)评分。结果治疗12周后,38例患者报告早泄有好转,有效率达63.3%,平均阴道内射精潜伏时间(IEL-T)由治疗前(0.43±0.31)min延长至(4.2±2.1)min;性交满意度评分由(7.6±2.5)分上升至(10.2±1.9)分,差异均有显著性(P<0.01)。勃起功能改善者共46例,总改善率为76.7%,IIEF-5评分从治疗前的平均11.2(11.2±4.9)分上升到治疗后的平均19.1(19.1±4.1)分,差异有显著性(P<0.01)。不良反应共有8例(13.3%),均为轻度或中度的,未经处理即自行缓解。结论对合并ED的早泄病人,伐地那非联合表面麻醉剂能安全有效地改善其勃起功能,并能显著改善其早泄症状。     

舍曲林联合特拉唑嗪治疗早泄临床研究

目的探讨舍曲林联合特拉唑嗪治疗早泄的疗效。方法将2011年8月至2013年9月收治的120例早泄患者随机分为观察组、对照组Ⅰ和对照组Ⅱ,各40例。观察组口服舍曲林,每次50 mg,每晚1次,连服4周,同时口服特拉唑嗪,每次2mg,每晚1次,连服4周;对照组Ⅰ口服舍曲林,每次50 mg,每晚1次,连服4周;对照组Ⅱ口服特拉唑嗪,每次2 mg,每晚1次,连服4周。观察各组治疗后射精潜伏期、配偶性生活满意率等。结果观察组患者治疗后射精潜伏期、配偶性生活满意率均优于对照组Ⅰ、Ⅱ,差异均有统计学意义（P〈0.05）。结论舍曲林联合特拉唑嗪治疗早泄临床疗效较好,预期效果满意,值得推荐使用。     

达泊西汀联合坦洛新治疗慢性前列腺炎伴早泄患者的临床观察

目的探讨达泊西汀联合坦洛新治疗慢性前列腺炎伴早泄患者的临床观疗效。方法门诊治疗的慢性前列腺炎伴早泄患者,随机分为研究组(n=53)和对照组(n=52)。观察组:达泊西汀联合坦洛新;对照组:单用坦洛新。两组均以8周为1治疗周期。观察两组患者治疗前后前列腺炎症状指数(NIH-CPSI)评分、早泄诊断工具(PEDT)评分、阴道内射精潜伏期(IVELT)变化及安全性评价。结果治疗后患者前列腺炎症状指数(NIH-CPSI)评分显著改善,差异有统计学意义(P<0.05),患者早泄诊断工具(PEDT)评分显著改善,差异有统计学意义(P<0.05),患者治疗后阴道内射精潜伏期(IVELT)明显延长,差异有统计学意义(P<0.05),治疗过程中未见明显恶心、乏力等药物不良反应发生。结论达泊西汀联合坦洛新治疗慢性前列腺炎伴早泄患者的疗效较单纯应用坦洛新治疗效果更佳,能更明显降低前列腺炎症状指数(NIH-CPSI)、早泄诊断工具(PEDT)评分,延长阴道内射精潜伏期(IVELT)时间,提高慢性前列腺炎伴早泄患者的治愈率。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

---

Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.