阴茎背深静脉包埋术治疗勃起功能障碍5例

目的 :评价阴茎背深静脉包埋术治疗勃起功能障碍 (ED)的疗效。　方法 :对 3例静脉性和 2例动静脉混合性ED病人施行阴茎背深静脉包埋术 ,术后随访疗效。　结果 :术后 2个月首次随访 ,3例静脉性ED病人获得满意性交 ,2例动静脉混合性ED病人基本能勃起 ,口服西地那非 5 0mg后可以完成性交。 5例术后随访 3～ 12个月(平均 7个月 )保持以上疗效。　结论 :阴茎背深静脉包埋术创伤小 ,几乎无并发症 ,是治疗静脉性ED的有效疗法     

西地那非治疗勃起功能障碍的有效性:中文文献的meta分析

目的评价西地那非治疗ED的有效性。方法通过中国生物医学文摘光盘(CBMdisc 2004新版)和清华同方数据库中CHKD期刊全文库检索公开发表的中文文献。凡摘要或方法中出现随机对照字样,无论有无盲法均予纳入。对纳入的试验设计特征用Jadad计分评价。以IIEF中Q3和Q4评分及IIEF总评分为疗效指标,采用RevMan4．1软件进行Meta分析。结果共有9个随机对照试验被纳入。其中6个为Jadad计分3分以上高质量试验。5个试验的IIEF Q3和Q4评分meta分析,OR=8．83,95％CI为(6．67,11．69),P<0．0001。4个高质量试验的IIEF总评分meta分析OR=13．76,95％CI为(9．50,19．92),P<0．0001。显示西地那非能够显著提高ED患者的疗效指标。结论西地那非能有效改善男性勃起功能,是一种有效治疗ED的口服药物。     

Additive Antinociception between Intrathecal Sildenafil and Morphine in the Rat Formalin Test

The possible characteristics of spinal interaction between sildenafil (phosphodiesterase 5 inhibitor) and morphine on formalin-induced nociception in rats was examined. Then the role of the opioid receptor in the effect of sildenafil was further investigated. Catheters were inserted into the intrathecal space of male Sprague-Dawley rats. For induction of pain, 50 µL of 5% formalin solution was applied to the hind-paw. Isobolographic analysis was used for the evaluation of drug interaction between sildenafil and morphine. Furthermore, naloxone was intrathecally given to verify the involvement of the opioid receptor in the antinociception of sildenafil. Both sildenafil and morphine produced an antinociceptive effect during phase 1 and phase 2 in the formalin test. The isobolographic analysis revealed an additive interaction after intrathecal delivery of the sildenafil-morphine mixture in both phases. Intrathecal naloxone reversed the antinociception of sildenafil in both phases. These results suggest that sildenafil, morphine, and the mixture of the two drugs are effective against acute pain and facilitated pain state at the spinal level. Thus, the spinal combination of sildenafil with morphine may be useful in the management of the same state. Furthermore, the opioid receptor is contributable to the antinocieptive mechanism of sildenafil at the spinal level.     

国产枸橼酸西地那非片治疗男性勃起功能障碍疗效和安全性的临床研究

目的评价口服国产枸橼酸西地那非片治疗男性勃起功能障碍的临床有效性和安全性。方法采用多中心、随机、双盲、安慰剂、平行对照的方法，对240例患进行为期8周的临床观察，评价标准包括：国际勃起功能指数(IIEF)、记事本、总评题。结果西地那非组皿亚评分明显高于安慰剂组(P＜0．01)，记事本、总评题结果西地那非组亦明显优于安慰剂组，无不良反应中断研究。结论国产枸橼酸西地那非片是治疗男性勃起功能障碍的有效和安全的药物。     

高效液相色谱-串联质谱联用法检测保健食品中西地那非的方法研究

目的应用高效液相色谱-串联质谱联用法和固相萃取技术测定保健食品中的西地那非。方法在样品前处理步骤中应用固相萃取净化技术,于液相色谱仪上进行样品分离,用三重四极杆串联质谱检测器作定性和定量检测。结果固相萃取技术减少了杂质对质谱仪的污染,串联质谱检测器降低了基质对测定的干扰,方法的检测限为0.01 ng,变异系数<5.0%,回收率在90.2%~97.0%之间。结论方法测定特异性好,灵敏度高,定性定量准确,结果令人满意。     

Enhanced dissolution of sildenafil citrate as dry foam tablets

Dry foam formulation technology is alternative approach to enhance dissolution of the drug. Sildenafil citrate was suspended in sodium dodecyl sulfate solution and adding a mixture of maltodextrin and mannitol as diluent to form a paste. Sildenafil citrate paste was passed through a nozzle spray bottle to obtain smooth foam. The homogeneous foam was dried in a vacuum oven and sieved to obtain dry foam granules. The granules were mixed with croscarmellose sodium, magnesium stearate and compressed into tablet. All formulations were evaluated for their physicochemical properties and dissolution profiles. All the tested excipients were compatible with sildenafil citrate by both differential scanning calorimetry (DSC) and infrared (IR) analysis. There are no X-ray diffraction (XRD) peaks representing crystals of sildenafil citrate observed form dry foam formulations. The hardness of tablets was about 5?kg, friability test <1% with a disintegration time <5?min. The sildenafil citrate dry foam tablet had higher dissolution rate in 0.1 N HCl in comparison with commercial sildenafil citrate tablet, sildenafil citrate prepared by direct compression and wet granulation method. Sildenafil citrate dry foam tablet with the high-level composition of surfactant, water and diluent showed enhanced dissolution rate than that of the lower-level composition of these excipients. This formulation was stable under accelerated conditions for at least 6 months.     

Persistent pulmonary hypertension of the newborn

Failure of the normal circulatory adaptation to extrauterine life results in persistent pulmonary hypertension of the newborn (PPHN). Although this condition is most often secondary to parenchymal lung disease or lung hypoplasia, it may also be idiopathic. PPHN is characterized by elevated pulmonary vascular resistance with resultant right-to-left shunting of blood and hypoxemia. Although the preliminary diagnosis of PPHN is often based on differential cyanosis and labile hypoxemia, the diagnosis is confirmed by echocardiography. Management strategies include optimal lung recruitment and use of surfactant in patients with parenchymal lung disease, maintaining optimal oxygenation and stable blood pressures, avoidance of respiratory and metabolic acidosis and alkalosis, and pulmonary vasodilator therapy. Extracorporeal membrane oxygenation is considered when medical management fails. Although mortality associated with PPHN has decreased significantly with improvements in medical care, there remains the potential risk for neurodevelopmental disability which warrants close follow-up of affected infants after discharge.     

高频通气联合西地那非治疗新生儿持续性肺动脉高压的临床疗效

目的：探讨高频通气联合西地那非治疗新生儿持续性肺动脉高压临床疗效。方法选取2012年1月至2014年12月期间杭州美中宜和妇儿医院收治的60例持续性肺动脉高压新生儿,采用随机数字表法将其分成对照组和观察组,每组患者30例,其中对照组患儿仅给予高频通气治疗,观察组患儿在高频通气治疗的基础上给予西地那非治疗。比较两组患儿的临床治疗效果、治疗前后血气指标及肺动脉压和体循环收缩压改善情况,住院时间和费用,以及呼吸机使用时间。结果观察组患儿治愈率（66．7％）明显高于对照组（40．0％）,χ2＝8．473,P＜0．05,观察组患儿死亡率（3．3％）明显低于对照组（20．0％）,χ2＝6．549, P＜0．05;观察组患儿治疗后PaO2（67．4±6．7mmHg）及 SaO2（97．3±13．8％）明显高于对照组（60．3±9．3mmHg,90．7±13．5％）,t值分别为4．78和5．43,均P＜0．05,观察组患儿治疗后PaCO2（32．3±4．1mmHg）明显低于对照组（43．7±4．6mmHg）, t＝5．12,P＜0．05;观察组患儿治疗后肺动脉压（27．5±2．3mmHg）明显低于对照组（57．2±3．2mmHg）,t＝14．99,P＜0．05;观察组患儿住院时间、呼吸机使用时间以及住院费（14．2±2．4d,4．3±1．3d,7030±1310元）,均明显低于对照组（17．8±3．2d,8．8±2．3d,7840±1430元）,t值分别为7．83,14．92和8．76,均P＜0．05。结论高频通气联合西地那非能够明显改善新生儿持续性肺动脉高压临床症状,疗效显著,值得临床推广应用。