Although premature ejaculation (PE) is a common type of male sexual dysfunction, to date we lack a unified definition of PE. The multidimensional definition of PE has been accepted by more and more clinicians. Intravaginal ejaculatory latency time (IELT) is one of the three important dimensions (time to ejaculation, inability to control or delay ejaculation, and negative consequences) for defining PE. Rapid ejaculation is one of the core symptoms of PE and IELT is an objective measurement as well as an important tool for the evaluation of PE. This article reviews estimated IELT, stopwatch-measured IELT, the correlation between estimated and stopwatch-measured IELT, and the factors affecting IELT in the general male population, PE patients, and those complaining of PE.
Coitus ; Ejaculation ; physiology ; Humans ; Male ; Premature Ejaculation ; etiology ; physiopathology ; Reaction Time ; physiology ; Time Factors

Adolescent ; Adult ; Atropine ; therapeutic use ; Female ; Foodborne Diseases ; drug therapy ; Humans ; Insecticides ; poisoning ; Male ; Muscarinic Antagonists ; therapeutic use ; Organophosphorus Compounds ; Pesticide Residues ; poisoning ; Pesticides ; poisoning ; Treatment Outcome

0. 05). Conclusion: The HCAPl can be expressed in both normal peripheral white blood cells and the leukemic cells, and there is no difference in the protein levels between them.

Objective To evaluate the diagnostic value of intraductal ulstrasonography(IDUS)in non-opaque bile duct stones.Methods Between January 2009 and August 2010 in the Department of Gastroenterology at Shanghai 10th People's Hospital,a total of 183 patients(male:102 cases,mean age 69 years； female:81 cases,mean age 71 years)were enrolled,who were suspected of bile duct stones or stenosis which could not be diagnosed by abdominal CT,MRI,and abdominal B-mode ultrasound.All the patients underwent endoscopic retrograde cholangiopancreatography(ERCP)first,and then patients with non-opaque bile duct stones followed by IDUS.Results A total of 134 cases (73.2％)of bile duct stones were diagnosed by ERCP,49 cases(26.8％)were negative.And then the 49 patients underwent IDUS,of whom 24 patients with sand-like stones,11 patients with lowdensity stones,6 patients with ampullary cancer,2 patients with pancreatic cancer,6 patients with sclerosing cholangitis.The diagnostic accuracy of IDUS in the position and quality of bile duct stones was 100％,higher than that of ERCP,which was 80％.After ERCP,pancreatitis occurred in 3 patients and improved after conservative treatment,there was no complications like perforation and bleeding.Conclusion The diagnostic accuracy of IDUS in the position and quality of bile duct stones is high,which can make up for the misdiagnosis by ERCP without increasing the complications.IDUS can provide reliable basis for the diagnosis of clinical bile duct stones.

Objective To evaluate the effects of the laryngeal mask airway for spontaneous breath-ing in short pediatric operation under Sevoflurane inhalation anesthesia.Methods Eighty children undergo-ing hernia surgery, of whom ASA Ⅰ or Ⅱ, in accordance with the random number table, were randomly divided into two groups( each 40 cases):the laryngeal mask airway for spontaneous breathing with Sevoflu-rane inhalation anesthesia in group A,and tracheal intubation for controlled ventilation with Sevoflurane inha-lationa nesthesia in group B.Children in the two groups were fasting for 6 hours and without drinking for 4 hours before anesthse ia.Anestheis a was induced with Sevoflurane inhalation fro all patients.The laryngela mask airway was insertde soon afet r induction of anesthesia with Sevoflurane inhalation,and anse thesia main-tained with Sevoflurane in halta ion in gor up A.P atients in gruo p B wereg iven cisatracurium 0.15 mg/kg intravenous injectio n before tracheal intubation, and anesthesia maintained with Sevoflurane inhalation, 40 minutes before the end of the surgeryt o sot p using muscle relaxant.Ten minutes before the end of the operation to stop Sevoflurane inhalation,in two groups.The end-tidal carbon dioxide partial pressure(PETCO2 ), mean blood pressure,heart rate,respiratory rate,pulse oxygen saturation and end-tidal sevoflurane partial pres-sure(PETSev) were recorded one minute before the induction of anesthesia,15 min,30 min,45 min,and 60 min after the induction of anesthesia.Both the time to regain consciousness and the time to remove laryngeal mask airway or tracheal catheter were recorded in two groups.Results The mean blood pressure, heart rate decreased in two groups after the induction of anesthesia(P<0.05).The value of PaCO2 increased and that of base excess decreased in 30 min after the induction of anesthesia in group A(P<0.05).The value of PETCO2 increased, and that of pH decreased in 45 min after the induction of anesthesia in group A (P<0.05).The movements of the limbs and head induced by operative stimulation in group A were more than those in group B(P<0.05),but the incidences of cough and laryngospasm induced by removing the laryngeal mask airw ay or tracheal catheter in group B were higher than those in group A(P<0.05).Both the time to regain consciousness and the time to remove laryngeal mask airway or tracheal catheter were shorter in group A than those in group B ( P<0.05 ) .Conclusion It is safe that the laryngeal mask airway for spontaneous breathing with Sevoflurane inhalation anesthesia in short pediatric operation.The time of anesthe-sia is beyond half an hour during operation and the artificial respiration sholu d be implemented.

graduate from self-study examination of nursing,the quality evaluation scale for graduation thesis of undergraduate from serf-study examination of nursing was developed.Methods The quality evaluation scales,which involving the scale using for faculty advisers,the scale using for reviewing teachers and the scale using for thesis defense teachers,for graduation thesis of undergraduate from self-study examination of nursing were constructed by adopting literature method,and so on.The scales were evaluated by reliability analysis,validity analysis,correlation analysis and factor analysis.Results The scale using for faculty advisers included 5 first-level indicators and 16 second-level indicators.The scale using for reviewingteachers included 4 first-level indicators and 14 second-level indicators.The scale using for thesis defense teachers included 5 first-level indicators and 14 second-level indicators.Their content validity indexes were respectively 0.909,0.952 and 0.864.Their construct validity cumulative contribution rates of the dimensions factors were respectively 72.77％,66.19％ and 63.79％.Their internal consistency reliability coefficients Cronbach α were respectively 0.953,0.810 and 0.926.The correlations between each factor and total score were significant.Conclusions three evaluation scales have good reliability and validity,which could be used to evaluate graduation thesis quality of undergraduate from self-study examination of nursing.

The use of immune checkpoint inhibitors (ICIs) has changed the clinical outcome of non-small cell lung cancer (NSCLC), with the widespread application of ICIs, immune-related adverse events (irAEs) have also appeared. Immune checkpoint inhibitor pneumonitis (CIP) is a serious adverse event of ICIs treatment that needs attention. Therefore, early identification of high-risk groups of CIPs and early intervention can reduce the occurrence of permanent drug withdrawal and severe CIPs, thereby improving patients′ prognosis.

Objective To investigate the factors predicting endoscopic stone extraction complications during operation and 1 week within operation. Methods The clinical data of 136 patients with common duet stones during endoscopic procedures and 1 week within procedures were collected, and the impacts of the number, size of stones, and the first-attack versus recurrent-attack stone, with or without cholangeitis on the complications during operation and 1 week within operation were analyzed, and the effect of nasobiliary drainage was investigated. Results The success rate in single-stone group was high, the incidences of complications during endoscopy including sphincter hemorrhage, cardiac laceration, hyperamylasemia, acute pancreatitis were significantly lower than those in the multi-stones group ( P < 0. 05 ). The group of < 2 cm stone also had high success rate of stone extraction, the incidences of complications including sphincter hemorrhage, stone impaction, cardiac laceration, hyperamylasemia, acute pancreatitis were significantly lower than those in the ≥2 cm group. The first-attack group had low success rate of stone extraction, the incidences of complications including sphincter hemorrhage, stone impaction, hyperamylasemia, acute pancreatitis and biliary infection were significantly higher than those in the recurrent-attack group. The patients with cholangeitis had low success rate of stone extraction, the incidences of complications including sphincter hemorrhage, hypoxemia, hyperamylasemia, acute pancreatitis and biliary infection were significantly higher than those without cholangeitis. After nasobiliary drainage, the incidences of hyperamylasemia, acute pancreatitis and biliary infection significantly decreased while the incidence of sphincter hemorrhage significantly increased. Conclusions The number, size of stones, and the first-attack versus recurrent-attack stone, symptoms with orwithout cholangeitis could predict the complications of stone extraction;post-ERCP nssobiliary drainage could decrease the complications, but increase the possibility of sphincter hemorrhage.

BACKGROUND:The intracel ular accumulation of reactive oxygen species leads to oxidative stress. Hypoxia is widespread in physiological and pathological condition. Variation of bone proliferation and differentiation when bone tissues cultured or bone cel s induced toxicity by reactive oxygen species under hypoxia have not yet been reported. OBJECTIVE:To observe the biological characteristics of MC3T3-E1 pretreated with different concentrations of hydrogen peroxide (H2O2) in hypoxia, thus understanding the cel mechanism underlying prolonged bone healing in the elderly with osteoporosis and diabetes. METHODS:The MC3T3-E1 cel s pretreated with different concentrations of H2O2 were cultured in different oxygen concentrations. The proliferation of MC3T3-E1 was detected by cel counting kit-8. The cel differentiation was detected through alkaline phosphatase staining and alizarin red staining. Total RNAs were extracted and used for analyzing the mRNA levels of col age type 1, alkaline phosphatase and Cbfa1. RESULTS AND CONCLUSION:When MC3T3-E1 pretreated with 200μmol/L H2O2 for 6 hours, the cel proliferation was increased with time, but lower than that in the control group. The alkaline phosphatase activity was weakened, and the number of mineralized nodes was decreased at the early stage of differentiation. When MC3T3-E1 pretreated with 400μmol/L H2O2 for 6 hours, the cel proliferation was decreased obviously. The alkaline phosphatase activity was stil weakened, and the number of mineralized nodes was decreased further, but not affected by hypoxia. When MC3T3-E1 pretreated with 400μmol/L H2O2 for 6 hours and then cultured in hypoxia, the mRNA expression of Cbfa1 was decreased, but the mRNA expressions of col age type 1 and alkaline phosphatase were significantly increased. These results suggest that MC3T3-E1 pretreated with low concentration of H2O2 show a significant decrease in proliferation, while MC3T3-E1 pretreated with a high concentration of H2O2 and cultured in hypoxia show a decrease in osteogenic differentiation, especial y at the early stage of alkaline phosphatase formation.

Objective To quantitatively analyze the early warning value of laboratory indexes for death risk in children with criti ‐cal hand foot and mouth disease (HFMD) .Methods The univariate and multivariate Logistic regression analysis were conducted to explore the independent risk factors of death in critical HFMD children .Then the area under receiver operating characteristic curve (AUC) was applied to give the comprehensive assessment of the test model ,as well as the early warning capacity and the optimal cut‐off level of laboratory indexes in critical HFMD children .Results The AUC of the Logistic regression model (Y ) established based on white blood cell ,neutrophil ,myoglobin ,creatinine for early predicting the death risk in critical HFMD children patients was 0 .847 (95% CI :0 .783 - 0 .911) ,which indicating that its diagnostic value was superior to single index .Conclusion The diag‐nostic value of the Y model established based on four indexes of white blood cell count ,neutrophile granulocytes count ,myohemo‐globin and creatinine is superior to any single index ,which has the better early warning value for the death risk in children with crit‐ical HFMD .