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Sansone A, Yuan J, Hou G, Zhang L, Gao M, Zhang Z, Jiang H, Wang F, Guo J, Geng Q, Wang M, Zhang X, Yu X, Zhang Y, Liu JC, Duan YG, Nagrale D, Chen Z, Jannini EA, Colonnello E, Ciocca G, Limoncin E, Mollaioli D, Dun X, Yuan J, Lin H, Zhang H. From Waterloo to the Great Wall: A retrospective, multicenter study on the clinical practice and cultural attitudes in the management of premature ejaculation, in China. Andrology 2024; 12:247-258. [PMID: 36748824 DOI: 10.1111/andr.13403] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/30/2022] [Accepted: 01/27/2023] [Indexed: 02/08/2023]
Abstract
Premature ejaculation (PE), despite its wide prevalence, is largely underdiagnosed and undertreated. Being a multifactorial dysfunction with strong cultural characteristics, PE requires skillful attitudes in the psychosexological support, necessary to manage the patient's and the couple's expectations, as well as in the medical treatment. Dapoxetine is a short-acting selective serotonin reuptake inhibitor approved for use in lifelong and acquired PE in a number of countries. Opinions, not always generated by the evidence-based medicine, impacted the attitudes of Western andrologists, as a nocebo effect which produced a drug's Waterloo, characterized by low prescription rates much more built on the patients' and doctors' expectations than on costs, side effects, and efficacy. In the present study, we retrospectively reviewed real-life data from eight Andrology and Sexual Medicine Public Centers in China to assess the prevalence of PE among attending patients, its association with erectile dysfunction, its subtype, and the proposed treatments. In 2019, among 156,486 patients coming to the centers, 32,667 visits having PE as the chief complaint were performed (20.9%). Almost all patients received treatment prescriptions (32,641 patients, 99.92%); 23,273 patients came back for a follow-up visit in the subsequent 12 months (71.2% of those who initially received treatment). Dapoxetine, either alone or in combination with another therapy, was the most prevalent treatment, prescribed to 22,767 patients (69.7% of treated patients), followed by traditional Chinese medicine (TCM) (39.4%). At follow-up, 8174 patients were unsatisfied with treatment, and a new treatment was proposed (35.12%). Dapoxetine was the best treatment, with an overall 27.1% switching rate when used either alone or in combination: Although the switching rate for Dapoxetine alone was 44.2%, the association of the same drug with psychotherapy resulted in much lower rates (19.5%) and reached a minimum of 12% when also combined with TCM demonstrating how cultural aspects and medical attitudes may dramatically impact on the therapy of a multifaceted, complex, and culture-grounded sexual symptom such as PE. In conclusion, taking switching rates as surrogate markers of treatment failure, this real-life study-the largest in the field-shows that in a more patient-oriented (as in Chinese medical culture), and less symptom-oriented (as in Western medical attitudes), Dapoxetine is a successful treatment for PE patients, with higher reliability when used alone or as part of combined and integrated therapies.
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Affiliation(s)
- Andrea Sansone
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Jianlin Yuan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Guangdong Hou
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
- Department of Andrology, Xi'an Daxing Hospital, Xi'an, China
| | - Lei Zhang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Ming Gao
- Department of Andrology, Xi'an Daxing Hospital, Xi'an, China
| | - Zhe Zhang
- Peking University 3rd Hospital, Beijing, China
| | - Hui Jiang
- Peking University 1st Hospital, Beijing, China
| | - Fu Wang
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jun Guo
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiang Geng
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Ming Wang
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xiansheng Zhang
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xi Yu
- Department of Infertility and Sexual Medicine, 3rd Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yan Zhang
- Department of Infertility and Sexual Medicine, 3rd Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jin-Chuan Liu
- Shenzhen Key Laboratory of Fertility Regulation, Center of Assisted Reproduction and Embryology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Yong-Gang Duan
- Shenzhen Key Laboratory of Fertility Regulation, Center of Assisted Reproduction and Embryology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Dinesh Nagrale
- A. Menarini Asia-Pacific Medical Affairs, Singapore, Singapore
| | - Zhiguo Chen
- A. Menarini China Medical Affairs, Shanghai, China
| | - Emmanuele A Jannini
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Elena Colonnello
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giacomo Ciocca
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Erika Limoncin
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Daniele Mollaioli
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Xinlong Dun
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jiarui Yuan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | | | - Hui Zhang
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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Yi Y, Hai F, Guo J, Gao X, Chen W, Tian X, Tang W, Hua W, Li M. Electrochemical Enhancement of Lithium-Ion Diffusion in Polypyrrole-Modified Sulfurized Polyacrylonitrile Nanotubes for Solid-to-Solid Free-Standing Lithium-Sulfur Cathodes. Small 2023; 19:e2303781. [PMID: 37544919 DOI: 10.1002/smll.202303781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/17/2023] [Indexed: 08/08/2023]
Abstract
The energy density of lithium-sulfurized polyacrylonitrile (Li-SPAN) batteries has chronically suffered from low sulfur content. Although a free-standing electrode can significantly reduce noncapacity mass contribution, the slow bulk reaction kinetics still constrain the electrochemical performance. In this regard, a novel electrochemically active additive, polypyrrole (PPy), is introduced to construct PAN nanotubes as a sulfur carrier. This hollow channel greatly facilitates charge transport within the electrode and increases the sulfur content. Both electrochemical tests and simulations show that the SPANPPy-1% cathode possesses a larger lithium-ion diffusion coefficient and a more homogeneous phase interface than the SPAN cathode. Consequently, significantly improved capabilities and rate properties are achieved, as well as decent exportations under high-sulfur-loading or lean-electrolyte conditions. In-situ and semi-situ characterizations are further performed to demonstrate the nucleation growth of lithium sulfide and the evolution of the electrode surface structure. This type of electrochemically active additive provides a well-supported implementation of high-energy-density Li-S batteries.
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Affiliation(s)
- Yikun Yi
- Shaanxi Key Laboratory of Energy Chemical Process Intensification, School of Chemical Engineering and Technology, Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shannxi, 710049, China
| | - Feng Hai
- Shaanxi Key Laboratory of Energy Chemical Process Intensification, School of Chemical Engineering and Technology, Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shannxi, 710049, China
| | - Jingyu Guo
- Shaanxi Key Laboratory of Energy Chemical Process Intensification, School of Chemical Engineering and Technology, Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shannxi, 710049, China
| | - Xin Gao
- Shaanxi Key Laboratory of Energy Chemical Process Intensification, School of Chemical Engineering and Technology, Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shannxi, 710049, China
| | - Wenting Chen
- Shaanxi Key Laboratory of Energy Chemical Process Intensification, School of Chemical Engineering and Technology, Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shannxi, 710049, China
| | - Xiaolu Tian
- Shaanxi Key Laboratory of Energy Chemical Process Intensification, School of Chemical Engineering and Technology, Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shannxi, 710049, China
| | - Wei Tang
- Shaanxi Key Laboratory of Energy Chemical Process Intensification, School of Chemical Engineering and Technology, Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shannxi, 710049, China
| | - Weibo Hua
- Shaanxi Key Laboratory of Energy Chemical Process Intensification, School of Chemical Engineering and Technology, Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shannxi, 710049, China
| | - Mingtao Li
- Shaanxi Key Laboratory of Energy Chemical Process Intensification, School of Chemical Engineering and Technology, Xi'an Jiaotong University, No. 28, Xianning West Road, Xi'an, Shannxi, 710049, China
- Xi'an Jiaotong University Suzhou Institute, No. 99 Renai Road, Suzhou Industrial Park, Jiang Su, 215000, China
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Chen D, Gong W, Wang J, Hao J, Zhao R, Zheng M. Diagnosis of thoracic outlet syndrome with the lower trunk compression of brachial plexus by high-frequency ultrasonography. BMC Musculoskelet Disord 2023; 24:690. [PMID: 37644436 PMCID: PMC10463735 DOI: 10.1186/s12891-023-06762-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/28/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Thoracic outlet syndrome (TOS) with the lower trunk compression of brachial plexus (BP) is difficult to diagnosis. This study aimed to summarize the features of thoracic outlet syndrome (TOS) with the lower trunk compression of brachial plexus observed on high-frequency ultrasonography (HFUS). METHODS The ultrasound data of 27 patients who had TOS with the lower trunk compression of brachial plexus were collected and eventually confirmed by surgery. The imaging data were compared, and the pathogenesis of TOS was analyzed on the basis of surgical data. RESULTS TOS occurred predominantly in females (70.4%). Most cases had unilateral involvement (92.6%), mainly on the right side (66.7%). The HFUS features of TOS can be summarized as follows: (1) Lower trunk compression. HFUS revealed focal thinning that reflected compression at the level of the lower trunk; furthermore, the distal part of the nerve was thickened for edema (Affected side: 0.49 ± 0.12 cm vs. Healthy side: 0.38 ± 0.06, P = 0.009), and the cross-sectional area of brachial plexus cords was markedly greater on the injured side than on the healthy side (0.95 ± 0.08 cm² vs. 0.65 ± 0.11 cm², P = 0.004). (2) Hyperechoic fibromuscular bands behind the compressed nerve (mostly the scalenus minimus muscle). (3) Abnormal bony structures: cervical ribs or elongated transverse processes of the 7th cervical vertebra (C7). Surgical results showed that the etiological factors contributing to TOS were (1) muscle hypertrophy and/or fibrosis (100%) and (2) cervical ribs/elongated C7 transverse processes (20.7%). CONCLUSION TOS with the lower trunk compression of brachial plexus can be diagnosed accurately and reliably by high-frequency ultrasound.
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Affiliation(s)
- Dingzhang Chen
- Department of Ultrasound, Xijing Hospital, the Fourth Military Medical University, No. 127 Changle West Road, Xi'an, 710032, China
| | - Wenqing Gong
- Department of Ultrasound, Xijing Hospital, the Fourth Military Medical University, No. 127 Changle West Road, Xi'an, 710032, China
| | - Jing Wang
- Department of Ultrasound, Xijing Hospital, the Fourth Military Medical University, No. 127 Changle West Road, Xi'an, 710032, China
| | - Jikun Hao
- Department of Ultrasound, Xijing Hospital, the Fourth Military Medical University, No. 127 Changle West Road, Xi'an, 710032, China
| | - Rui Zhao
- Department of Hand-Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an, China
| | - Minjuan Zheng
- Department of Ultrasound, Xijing Hospital, the Fourth Military Medical University, No. 127 Changle West Road, Xi'an, 710032, China.
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