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。     

两种新型西地那非同系物对MCF-7/ADR细胞对阿霉素耐药的影响

目的探讨两种新型西地那非同系物对人乳腺癌MCF-7/ADR细胞耐阿霉素的逆转作用。方法采用GENMED磷酸二酯酶5（PDE5）活性酶测定试剂盒检测两种同系物对5型磷酸二酯酶（PDE5）的抑制作用,用MTT法检测西地那非、西地那非同系物、阿霉素以及西地那非同系物与阿霉素联合作用对人乳腺癌耐药细胞MCF-7/ADR和敏感株MCF-7的抑制率及IC50值,运用Western blot检测P-gp蛋白的表达。结果两种同系物与西地那非相比具有较低的PDE5抑制活性;10μmol·L^-1两种西地那非同系物对MCF-7/ADR细胞耐药性的逆转倍数分别是6.36和5.58,20μmol·L^-1两种西地那非同系物对MCF-7/ADR细胞耐药性的逆转倍数分别是11.83和13.47;两种同系物作用对P-gp蛋白的表达无明显影响。结论两种新型西地那非同系物具有较低的PDE5抑制活性,一定浓度的西地那非同系物可显著逆转MCF-7/ADR细胞对阿霉素的耐药。     

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.     

基于总处方量的3种磷酸二酯酶抑制剂的安全性分析

目的：基于总处方量,比较和探讨上市后3种磷酸二酯酶抑制剂（西地那非、伐地那非、他达那非）可疑不良反应发生的特点,旨在对临床规范用药提供有益借鉴。方法：查阅WHO药品不良反应数据库,检索并分析比较3种药物的不良反应报告。结果：3种药物致不良反应报告主要集中在心血管、神经、消化等系统。每种药物的不良反应各有特点,严重不良反应如异常勃起的报告率逐年下降。结论：应该继续规范3种药物的临床应用,以尽量减少死亡、异常勃起等严重不良反应的发生,对肺动脉高压、神经再生、女性性功能障碍等病症的应用研究更应该谨慎进行