Objective:To assesss the effectiveness of dapoxetine in the treatment of premature ejaculation.Methods:Both English and Chinese studies involving men with prematrue ejaculation who were treated with dapoxetine from the Cochrane Library,MEDLINE,EMBASE and CNKI,CBM,VIP between 1979 and 2009.were included in the randomized controlled trials(RCTs) and the data processed by RevMan.Results:Five RCTs involving 4433 patients were included in the Meta analysis,of which 3 were of grade A and 2 were of grade B according to the quality evaluation of methodology.Intravaginal ejaculatory latency time(IELT),patient-reported global impression of change(PGI),satisfaction with sexual intercourse(SWSI),perceived control over ejaculation(PCOE),personal distress related to ejaculation(PDRE) were used for assessment.Meta analysis based on included studies of patients having been treated with dapoxetine for 9-24 weeks showed that:(1) the difference of the patients' IELT between treatment group and control group was statistically significan [P

Objective To explore the cause and treatment of chronic pain after tension-free repair of inguinal hernia.MethodsThe clinical data of 426 cases with inguinal hernia underwent the tension-free hernioplasty during February 2002 to September 2007 were retrospectively analyzed.ResultsTension-free hernioplasty was performed to all patients.According to operative methods,they were divided into two groups:polypropylene filling group(n=210)and expanded polytetrafluoroethylene(e-PTFE)mycromesh group(n=216).The chronic pain rate after operation,polypropylene filling group(9.0%,19/210)was significantly higher than e-PTFE mycromesh group(4.2%,9/216),P

Objective To review the clinical operation methods of abdominal incisional hernia. Methods Classification, operation method and fellow-up of 78 patients with abdominal incisional hernia were retrospectively analyzed. Results The average time of fellow-up was 26 months. Nineteen cases were repaired with simple suture with 3 cases (15.8%) recurrence, 57 cases were repaired with man-made material with 2 case (3.4%) recurrence. Conclusions Individual operation method should be chosen according to body condition, classification of the size of abdominal loss and abdominal hypertension. It is an effective method to repair the hernia of abdominal incision with man-made material.

Decoction of Lysimachiae and Artemisia was adopted for the treatment of 54 cases with severe hepatitis in our department from Mar. 1985 to Nov. 1987. The curative rate of 70.33％ was significantly higher than that of the control group of 52 cases(p

Objective To investigate the relationship between accompanying infection and the change of immunologic function in type 2 diabetes mellitus ( T2DM) patients.Methods One hundred and fifteen T2DM patients with infection and 95 T2DM patients with no infection were selected,and 102 subjects with no history of dia-betes were selected as no diabetetes with infection group.The venous blood of all groups were sampled after an over-night fast of 12h.Glycosylated hemoglobin a1c(HbA1c) level was tested by glycosylated hemoglobin automatic analy-zer.The levels of T cell subsets including CD3 ,CD4 ,CD8 ,NK cell and B cell ratio were tested by flow cytometry,Ig and complement level was tested by immune nephelometry.Results The level of body mass indices(BMI) in T2DM patients with infection group[(27.39 ±9.18) kg/m2 ] and with no infection group[(26.15 ±7.39) kg/m2 ] were higher than no diabetes with infection group (24.21 ±5.37)kg/m2 (t =2.548,4.702,all P <0.05).The levels of IgG,IgA,IgM,C3 ,C4 in T2DM with infection group were (11.83 ±3.92)mg/mL,(3.02 ±0.96)mg/mL,(3.38 ± 0.82)mg/mL,(1.70 ±0.38)mg/mL,(0.52 ±0.18)mg/mL,which in T2DM with non infection group were (12.46 ± 2.47)mg/mL,(2.63 ±1.37)mg/mL,(2.91 ±1.79)mg/mL,(1.58 ±0.43)mg/mL,(0.46 ±0.31)mg/mL,which in no diabetetes with infection group were (13.26 ±3.74)mg/mL,(2.06 ±1.86)mg/mL,(2.49 ±1.01)mg/mL, (1.19 ±0.82)mg/mL,(0.30 ±0.05)mg/mL.In T2DM with non infection group and T2DM with infection group, humoral immunity index including the level of IgG was lower and IgA,IgM,C3 ,C4 levels were higher than no dia-betetes with infection group,the differences were statistically significant(t =7.052,23.059,12.617,18.326,8.730, all P <0.05).The levels of CD4 ,CD8 ,NK,CD4 /CD8 ,CD3 were (37.68 ±8.39)%,(31.58 ±6.98)%,(10.76 ± 6.49)%,(1.19 ±0.75),(62.83 ±5.28)% in T2DM with infection group,which in T2DM with non infection group were (39.23 ±10.28)%,(27.61 ±5.65)%,(14.89 ±7.12)%,(1.39 ±1.01),(64.19 ±6.46)%,which in no diabetes with infection group were (42.91 ±5.67)%,(25.17 ±7.25)%,(16.39 ±6.24)%,(1.86 ±0.82), (73.65 ±9.10)%.Cellular immunity index containing CD4 ,CD8 ,NK,CD4 /CD8 ,CD3 levels decreased more signifi-cantly than no diabetic group,T2DMI group compared with T2DM group,the levels of IgG,CD4 ,CD8 ,NK,B cell ratio, CD4 /CD8 ,CD3 decreased obviously,while the levels of IgA,IgM,C3 declined greatly,there were significant differences (t =11.038,8.237,18.549,25.871,2.436,all P <0.05).Conclusion Patients with T2DM have humoral and cellular immunity abnormalities,T2DM patients with infection is closely related with the imbalance of immunologic function.

To prokaryotic express prokaryotically and to purify the efaA protein from Enterococus faecalis so as to provide the basis for the further study on the pathogenesis and clinical sero-diagnosis of endocarditis caused by E.faecalis, efaA gene of E.faecalis was amplified by PCR, the PCR-amplified product was digested with restriction enzymes and cloned into prokaryotic vector pET32a to construct the recombinant plasmid pET30a/efaA. This recombinant plasmid was confirmed by double enzyme digestion with BamhI and Xhol and then subjected to sequencing, and transformed to E.coli BL21 (DE3). Expression of the fusion protein was induced by IPTG, and analyzed by SDS-PAGE and Western blotting. The recombinant fusion protein was purified by His-binding affinity chromatography.It was shown that efaA gene of 943 bp in size was amplified from Enterococus faecalis and the recombinant plasmid pET30a,/ efaA was successfully constructed and expressed in E.coli BL21. The purified product was found to be 34 kDa in molecular weight as demonstrated by SDS-PAGE and Western blotting. It is evident that the efaA protein of E.faecalis can be successfully expressed and purified.

Objective To detect the expression of SDF-1 and CD34,and MVD changes at slen der narrow pedicle flap of hypoxia and ischemia during the survival process,and to investigate the role of SDF-1 at flap neovascularization.Methods The slender narrow pedicle flaps,which pedicle's length-breadth ratio were 4 ∶ 2,and the flap size of each took an area of 2 cm × 2 cm (group A),3 cm ×3 cm (group B),4 cm × 4 cm (group C),5 cm × 5 cm (group D) and 6 cm × 6 cm (group E),were designed and elevated on each pigs' double dorsum.The flaps were served as a hypoxia/ischemia flap model.The survival area,histologic analysis,SDF-1 and CD34 enzyme-linked immunosorbent assay at the distal flap were evaluated at days 0,3,5,7,and 14 after operation,respectively.Results In the each group of flaps,the expression of SDF-1,CD34 and MVD increased with time,reached the plateau level after 5 days (maximal values of SDF-1:124.80 ± 4.05 ingroup A,137.85 ±3.03 in group B,166.53 ± 2.98 in group C,72.80 ± 2.63 in group D and 62.79 ± 2.20 in group E),7 days ( maximal values of CD34:16.76 ± 0.62,17.60 ± 0.72,18.48 ± 0.55,12.70 ± 0.60,and 11.51 ± 0.70,each group),and 7 days (maximal values of MVD:52.45 ± 2.78,59.34 ± 3.12,61.14 ± 3.35,25.25 ± 3.78,and 24.46 ± 7.46,each group),and then gradually decreased.In the different groups of flaps,when the flap area increased,the expression of SDF-1,CD34 and MVD increased,but the parameters decreased at the area of 5 cm × 5 cm,and the flaps were partial necrosis.Conclusions SDF-1 may play an adjusted role in the survival process of the slender narrow pedicle flap.

Objective To characterize the image morphology and time-intensity curve of renal cell cancer and angiomyolipoma on contrast-enhanced harmonic sonography. Methods A total of 57 patients with 58 renal masses were enrolled in this study prospectively. The renal masses included 47 renal cell carcinomas (RCC) and 11 angiomyolipomas (AML). All patients were evaluated by tradi-tional gray-scale sonography, color Doppler sonography and contrast-enhanced harmonic sonography. Imaging findings and time-intensity curves of all renal masses were analyzed. The contrast-enhance-ment features between RCC and AML were analyzed. Results 57.4% of RCCs were hyperechoic masses and peripheral surrounding vessels and / or penetrating vessels were noted in 83.0% of RCCs on color Doppler sonography. 54.5 % of AMLs were hyperechoic masses while peripheral surrounding vessels and / or penetrating vessels were only noted in 27.3% of AMLs on color Doppler sonography. On contrast-enhanced harmonic sonography, hyper- or iso-enhancement were noted in 83.0% of RCCs, while hypo-enhancement were noted in 81.8% of AMLs (P<0.01). Statistically significant differences were noted between RCC and AML in the values of peak time (P=0.03), wash time (p= 0.02), peak intensity-basic intensity (P=0. 01), AT/R (△A tumor/△A renal) (P=0.00), k (P= 0.02), and Aok (P=0.02). Conclusions Contrast-enhanced sonography is useful in the differentia-tion of renal masses. Most RCCs are hyper- or iso-enhanced while most AMLs are hypo-enhanced. Time-intensity curves are helpful in differentiating RCC and AML.

Objective To understand teicoplanin concentration in cerebrospinal fluid (CSF)during intravenous in-fusion in patients following neurosurgery operation,and evaluate whether drug concentration can be increased if blood-brain barrier was damaged, and effect of continuous pump of drug on drug concentration in CSF. Methods The post-neurosurgical surgery patients with surgical site/ventricular drainage were enrolled in the study, patients were divided into routine administration group(a dose of teicoplanin of 400 mg/12 h was administered for 30 min)and continuous administration group (a dose of 400 mg teicoplanin was administered for 30 min followed by a continuous infusion of 200 mg/6 h).CSF specimens were collected at respective time points of administration, teicoplanin concentration in specimens was measured.Results For routine administration group,drug concentration in CSF was (0.004 ± 0.0123 )mg/L immediately after teicoplanin was bumped,the peak concentration was (0.712 ± 1.028)mg/L after 1-hour bumping,then concentration decreased gradually,which were (0.254 ±0.222),(0.173 ± 0.152),and (0.355±0.207)mg/L at 12,18,and 24 hours of bumping respectively.For continuous administration group, drug concentration in CSF was(0.017±0.020))mg/L immediately after teicoplanin was bumped,the peak concentration reached (0.587±0.255)mg/L after 4-hour bumping,then concentration were (0.429±0.416),(0.325±0.254),(0.476 ±0.686),and (0.318 ±0.464)mg/L at 6,12,18,and 24 hours of bumping respectively,teicoplanin concentration was relatively stable 6 hours later,which were (0.318±0.464)mg/L-(0.476±0.686)mg/L.The area under the curve during 24 hours (AUC0-24 )in routine administration group and continuous administration group were 5.590 mg/L·h and 9.082 mg/L·h respectively.For two groups of patients,teicoplanin concentration only at the area near peak value a-chieved 50% minimum inhibitory concentration(MIC50 )for coagulase negative staphylococcus (CNS),but the time for a-chieving concentration higher than CNS MIC50 was far less than 50% of total administration time;teicoplanin concentration in CSF of both groups of patients didn’t achieve MIC50 for Staphylococcus aureus .Conclusion After continuous infusion of teicoplanin,drug concentration in CSF can be increased compared with routine administration group,but still can’t achieve the effective MIC;the increase of blood drug concentration is benefit to drug concentration in CSF,it is necessary to in-crease the dose appropriately to achieve clinical effectiveness.

PurposeTo evaluate the effect of right ventricular septum (RVS) and right ventricular apex (RVA) pacing on the left atrial systolic function in patients with atrioventricular block by using real-time three-dimensional echocardiography (RT-3DE).Materials and Methods Fifty-one patients with atrioventricular block who were candidates for implanted atrioventricular sequential pacemaker were randomly divided into RVS group (n=31) and RVA group (n=20). The minimum left atrium volume (LAVmin), maximum left atrium volume (LAVmax), and left atrium volume before contraction (LAVprep) were measured by RT-3DE at pre-operation, the 1st month, 3rd month, 6th month, and 12th month after pacemaker implantation. Accordingly, the left atrial total ejection fraction (LATEF) and the left atrial active ejection fraction (LAAEF) were calculated.Results The LAVmin at the 3rd month, 6th month, 12th month after implantation were significantly lower than that at the 1st month and pre-operation in both groups (RVA group:t=2.97 and 2.74,P<0.05; RVS group:t=3.24 and 2.86,P<0.05). LAVprep at the 6th month, 12th month in RVA group, and LAVprep at the 3rd month, 6th month, 12th month in RVS group reduced when compared with that of pre-operation (RVA group:t=3.20,P<0.05; RVS group:t=2.71,P<0.05). LATEF and LAAEF in both groups at the 3rd month, 6th month, 12th month increased when compared with that of pre-operation (RVA group:t=2.87 and 9.68,P<0.05; RVS group:t=3.56 and 8.22,P<0.05). The LATEF and LAAEF in RVS group at the 6th month and 12th month after implantation were significantly larger than that in RVA group at the same time (t=2.90, 5.22, 3.03 and 3.55, P<0.05).Conclusion Atrioventricular sequential pacing is helpful to recovering the left atrial systolic function in patients with atrioventricular block. Compared with RVA pacing, RVS pacing is able to increase LATEF and LAAEF more greatly.