Objective： To observe the clinical effect of Manlyman Spray combined with biofeedback therapy in the treatment of premature ejaculation (PE)．Methods： A total of 60 primary premature ejaculation patients with stable sexual partners and regular sexual activity (≥１ times per week) from April 2021 to October 2022 were involved in the clinical observation, The patients' age is (34.3 ± 4.9) years old, and the course of the disease is (112.5 ± 65.5) months, and Manlyman Spray combined with biofeedback therapy was used to treat patients for 8 weeks. Manlyman Spray was sprayed 3 times on the surface of the penisqd for 4 weeks, and Biofeedback therapy is treated twice a week according to the AI setting module, for a total of 8 weeks. Before and 8 weeks after medication and at 4 weeks after drug withdrawal, the Intravaginal Ejaculation Latency Time (IELT), Premature Ejaculation Diagnostic Tool (PEDT) scores and Clinical Global Impression of Change (CGIC) scores were Obtained and compared. Results： After 8 weeks of treatment, the IELT of the patients was significantly prolonged (［351.4 ± 76.7］ vs ［87 ± 16.8］,P<0.05) and at 4 weeks after drug withdrawal, the therapeutic effect still existed (［345.9 ± 80.3］ vs ［87 ± 16.8］,P<0.05), the PEDT scores were significantly improved after treatment (［18.2 ± 1.1］ vs ［9.0 ± 1.4］,P<0.05)and at 4 weeks after drug withdrawal(［18.0 ± 1.2］ vs ［9.0 ± 1.4］,P<0.05), and so were the CGIC scores (［13.4 ± 1.3］ vs ［3.3 ± 1.4］,P<0.05, and ［12.6 ± 1.6］ vs ［3.3 ± 1.4］,P<0.05). Conclusion： The combination of Manlyman Spray and biofeedback therapy can effectively treat primary premature ejaculation, with a long duration of treatment and good safety, and the specific mechanism needs further study.

Animal studies demonstrated that paternal alcohol exposure before conception increases the risk of adverse neurodevelopment in offspring, but limited evidence is known in humans. Based on Shanghai-Minhang Birth Cohort Study, we aimed to examine associations between preconceptional paternal alcohol consumption and child behavioral problems. Paternal alcohol consumption during the last 3 months before conception was obtained by maternal report. Children born to fathers who drank alcohol at least once a week were classified as exposed. Child behavioral problems were assessed using the Child Behavior Checklist (CBCL) at age of 2, 4, and 6. Negative binomial regression was used to estimate the rate ratio (RR) of CBCL raw scores in 796 offspring. The risks of rating scores on anxious/depressed were increased by 33% (RR 1.33, 95% CI 1.09, 1.61) and 37% (RR 1.37, 95% CI 1.02, 1.84) among boys in the exposed group at age of 4 and 6, respectively. We also found that risks of somatic complaints were increased by 18% (RR 1.18, 95%CI 1.00, 1.40) and 65% (RR 1.65, 95%CI 1.14, 2.38) among girls in the exposed group at age of 4 and 6. The increased risks of sleep problems (RR 1.25, 95% CI 1.00, 1.55) in girls at age 4, thought problems (RR 1.32, 95% CI 1.01, 1.73) in girls at age 6, rule-breaking behaviors (RR 1.35, 95% CI 1.09, 1.67) in boys at age 6 were also found. The risks of CBCL scores on anxious/depressed and sleep problems in girls at age 4, as well as the risks of somatic complaints and rule-breaking behaviors in boys at age 6 increased with the level of exposure to paternal alcohol consumption. Our findings provided preliminary evidence that preconceptional paternal alcohol consumption may increase risks of child behavioral problems.

The effects of prenatal PBDEs exposure, especially at low levels, on childhood obesity are scarce. No previous studies have investigated the effect modification by breastfeeding on the associations of PBDEs exposure with childhood obesity. We aimed to investigate the associations of prenatal PBDEs exposure with adiposity measures in children up to 6 years, and the effect modification by breastfeeding. Participants were mother-child pairs from the Shanghai-Minhang Birth Cohort study. Nine PBDE congeners were assessed in cord blood plasma. We obtained information about child weight (0-6 years), height (0.5-6 years), arm circumference (0-6 years), and waist circumference (0-6 years) at each follow-up visit. Breastfeeding duration was collected when children were aged 1 year and was categorized as short (≤6 months) and adequate (>6 months). Multiple linear regression models were used to examine the associations of PBDE concentrations with adiposity measures of the children at each age. Generalized estimating equation (GEE) models were used to estimate the overall associations of PBDEs exposure with adiposity measures. We examined the effect modification by breastfeeding using stratified analyses and by including interaction terms into GEE models. For boys, there was a general profile of positive associations of several PBDE congeners exposure with adiposity measures. Especially, boys with higher BDE-153 concentration had higher adiposity measures at each time point. For girls, we also found positive associations of BDE-100 and -153 exposure with adiposity measures. The GEE models showed consistent patterns for BDE-153 in boys and for BDE-100 and -153 in girls. In breastfeeding-stratified analyses, stronger associations of PBDEs exposure with adiposity measures were generally found in children who were shortly breastfed. Our findings suggest that prenatal exposure to PBDEs at low levels may influence childhood adiposity measures, and the potential effects of PBDEs were attenuated by adequate breastfeeding.

Findings from epidemiological studies on the associations between prenatal perfluoroalkyl substances (PFASs) exposure and children's neurodevelopment were inconclusive, and most studies did not account for the co-exposure to multiple PFASs with strong inter-correlations. The present study aimed to assess the effects of prenatal multiple PFAS exposure on children's neurobehavioral development based on 614 mother-infant pairs in the Shanghai-Minhang Birth Cohort Study. Eight PFAS concentrations were measured in maternal plasma at 12-16 weeks of gestation. Children's neurobehavioral development at 2 and 4 years of age was assessed by the Child Behavior Checklist for Ages 1.5-5. In Bayesian kernel machine regression (BKMR) analyses that could address the inter-correlations between multiple PFASs, PFAS mixture appeared to be associated with fewer Somatic Complaints and more Externalizing Problems in boys, but more Somatic Complaints and Sleep Problems in girls. There were suggestive associations of PFNA and PFOS with decreased risk of Somatic Complaints and of PFUdA and PFTrDA with increased risk of Externalizing Problems in boys; trends of increased risk in girls were observed between PFUdA and Somatic Complaints and between PFTrDA and Sleep Problems. Overall, we found no clear evidence that prenatal exposure to PFASs had negative effects on neurobehavioral development in children. However, the modest associations still suggested the potential developmental neurotoxicity of prenatal PFAS exposure.

IMPORTANCE The associations of maternal history of spontaneous abortion (SA) and stillbirth with congenital heart disease (CHD) remain elusive. OBJECTIVE To evaluate the associations of maternal history of pregnancy loss with CHD in offspring and the role of maternal type 2 diabetes. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study included singleton live offspring born between January 1, 1977, and December 31, 2016, identified through Danish national health registries. Statistical analysis was performed from October 1, 2019, through September 1, 2021. EXPOSURES Maternal history of SA, with frequency varying from 1 or 2 to 3 or more episodes, and maternal history of single and multiple stillbirths. MAIN OUTCOMES AND MEASURES Overall CHD identified by hospital diagnosis. Cox proportional hazard regression was used to estimate the hazard ratio (HR) of CHD. Diabetes was evaluated as a potential confounder and a potential effect modifier. RESULTS Among 1 642 534 included offspring (mean [SD] age, 14.11 [8.39] years; 843 265 male [51.35%]), 246 669 (15.02%) were born to mothers with a history of SA and 9750 (0.59%) were born to mothers with a history of stillbirth. The HRs of CHD were 1.16 (95% CI, 1.13-1.20) for offspring with a maternal history of SA and 1.49 (95% CI, 1.32-1.68) for offspring with a maternal history of stillbirth. Significant dose-response associations were observed among offspring with a maternal history of 3 or more episodes of SA (HR, 1.60; 95% CI, 1.39-1.84) and those with maternal history of multiple stillbirths (HR, 2.75; 95% CI, 1.63-4.65). If only inpatient CHD cases were included, the risk of CHD was higher than that found in the main analysis, with HRs of 1.24 (95% CI, 1.19-1.30) for maternal history of SA and 1.78 (95% CI, 1.51-2.11) for maternal history of stillbirth. The observed associations were strengthened by maternal prepregnancy type 2 diabetes (HR for maternal history of SA, 1.65 [95% CI, 1.37-1.97]; HR for maternal history of stillbirth, 1.74 [95% CI, 1.06-2.85]). CONCLUSIONS AND RELEVANCE These findings suggest that offspring born to mothers with a previous SA or stillbirth, especially multiple episodes, or with prepregnancy type 2 diabetes were at a higher risk of being diagnosed with CHD. These findings may help identify women at increased risk in whom detailed fetal heart assessment may be cost-effective and highlight the importance of screening for type 2 diabetes in women of reproductive age.

BackgroundEvidence from animal studies has indicated that neonatal thyroid function is vital for the reproductive development. Anogenital distance (AGD), a sensitive biomarker of the fetal hormonal milieu, can be used to predict adult reproductive disorders. However, few human studies have examined the association between neonatal thyroid function and AGD. We aimed to explore their associations in a birth cohort study.MethodsConcentrations of thyroid stimulating hormone (TSH) and thyroid hormones (THs), including total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), and free thyroxine (FT4) were measured in cord plasma in the Shanghai-Minhang Birth Cohort. The offspring AGD (AGDAP [anus–penis] and AGDAS [anus–scrotum] for boys and AGDAC [anus–clitoris] and AGDAF [anus–fourchette] for girls), body weight and anogenital index (AGI = AGD/weight [mm/kg]) were obtained at each follow-up visit. In total, 344 children (194 boys and 150 girls) with cord plasma concentrations of THs and TSH and at least one AGD measurement at birth and at 6, 12, and 48 months of age were included. Multiple linear regression and generalized estimating equation (GEE) models were used to examine the associations of cord plasma concentrations of THs and TSH with AGI.ResultsMultiple linear regression models showed inverse associations of TT4, FT3, and FT4 with female AGI, although statistical significance was only reached at birth, 6 and 48 months of age. These associations were also found in GEE models: higher TT4 and FT4 concentrations were associated with lower AGIAC (TT4: β = -0.27, 95% CI: -0.50, -0.03 for middle vs. lowest tertile; FT4: β = -0.38, 95% CI: -0.61, -0.16 for middle and β = -0.30, 95% CI: -0.55, -0.04 for highest vs. lowest tertile). Besides, girls with the highest tertile of FT3 concentrations had lower AGIAF than those with the lowest tertile (the highest vs. lowest tertile: β = -0.22, 95% CI: -0.36, -0.08). Positive associations between TSH and AGI at birth and at 12 months of age were observed in boys.ConclusionsThis study provides further evidence on the effects of neonatal thyroid function on reproductive development at an early life stage.

Objective:To evaluate the clinical efficacy of autologous bone marrow nucleated cell transplantation on ovarian dysfunction-related diseases.Methods:From September 2020 to August 2021, we conducted a before-after study in Shanghai Institute of Planned Parenthood Research Hospital and Shanghai New Hongqiao International Medical Center. A total of 28 patients with premature ovarian insufficiency, perimenopausal syndrome or repeated assisted reproduction failure were treated with ultrasound-guided autologous bone marrow nucleated cell transplantation into the ovaries. Clinical efficacy was evaluated by comparing the patients' self-reported symptoms, endometrial thickness, bilateral ovarian volume, the number of bilateral ovarian follicles, the maximum diameter of bilateral ovarian follicles, and the level of plasma estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, prolactin, and testosterone.Results:After autologous bone marrow nucleated cell transplantation, the number of bilateral ovarian follicles and the maximum diameter of bilateral ovarian follicles statistically significantly increased by an average of 1.26±2.12 ( P=0.005) and (5.40±8.92) mm ( P=0.006), respectively. Endometrial thickness and bilateral ovarian volume increased after treatment although without statistically significance (all P>0.05). However, the ovarian volume, the number of follicles, and the maximum diameter of follicles with greater changes between the left and right sides of the treatment, were found to statistically significantly increase after treatment ( P=0.007, P<0.001, P=0.002). Besides, the levels of FSH, LH, progesterone, and prolactin decreased with no statistical significance (all P>0.05). The stratified analysis of disease types found that endometrial thickness, the number of bilateral ovarian follicles, and the maximum diameter of bilateral ovarian follicles after treatment tended to increase, but only the number of bilateral follicles and the maximum diameter of bilateral ovarian follicles in patients with perimenopausal syndrome showed statistical significance ( P=0.008, P=0.047). Conclusion:The present study suggested that autologous bone marrow nuclear cell therapy could improve ovarian function to some extent, and is expected to be a new treatment method for patients with premature ovarian insufficiency, perimenopausal syndrome, and repeated assisted reproduction failure. However, further studies with larger sample sizes are needed to corroborate the findings.

[背景]全氟化合物(PFASs)被广泛应用于工业生产和日常生活用品,有报道称孕妇及胎儿体内可检测到PFASs,但检出水平结果不一致.[目的]了解浙江省嘉兴市嘉善地区孕妇外周血中PFASs的暴露水平,探讨孕妇外周血PFASs暴露水平与社会人口学特征及膳食因素的关系.[方法]基于2016年9月-2018年4月开展的嘉善出生队列,以942例孕妇为研究对象,在孕妇怀孕16～24周产前检查时收集其外周肘静脉血,应用高效液相色谱-串联质谱法检测孕妇外周血中13种常见PFASs的质量浓度(后称浓度),使用结构式问卷调查孕妇的社会人口学特征、生活方式、健康状态、饮食方式以及怀孕期间环境污染物接触史等信息.采用多因素线性回归,以自然对数转换后的PFASs浓度为应变量,分析孕妇人口学特征、生活方式及膳食因素对外周血PFASs浓度的影响.计算影响PFASs浓度相关因素的β值及其95％可信区间,并对估计值进行指数转换,以代表自变量每变化一个单位后PFASs浓度几何均数的比值(GM ratio).[结果]孕妇外周血中共检测出11种PFASs,包括全氟辛烷磺酸(PFOS)、全氟己烷磺酸(PFHxS)、全氟辛酸(PFOA)、全氟十一烷酸(PFUdA)、全氟壬酸(PFNA)、全氟癸酸(PFDA)、全氟庚酸(PFHpA)、全氟十二烷酸(PFDoA)、全氟十三烷酸(PFTrDA)、全氟十四烷酸(PFTeDA)、十一氟己烷磺酸(PFHxA),全氟癸烷磺酸(PFDS)和全氟十六烷酸(PFHxDA)未检出.其中前9种检出率高达90％以上.总的PFASs中位浓度为37.95μg·L-1,各类PFASs中PFOA的中位浓度最高,为 11.99μg·L-1,其次为 PFOS、PFHxS、PFDA、PFUdA、PFNA、PFDoA、PFTrDA和 PFHpA.孕妇外周血中 PFOS、PFHxS、PFOA、PFDA、PFNA、PFHpA、PFUdA、PFDoA和 PFTrDA的浓度之间呈不同程度的相关性(r=0.35～0.94);其中PFDA和PFUdA之间的相关性最强(r=0.94),其次是PFOS和PFDA(r=0.90).孕妇PFASs暴露水平随着孕妇年龄、孕前体重指数(BMI)、受教育程度的增加而增加至 1.42(95％CI:1.05～1.93)～10.06(95％CI:5.01～20.20)倍,经产妇外周血中PFOA的浓度低于初产妇(GM ratio=0.73,95％CI:0.57～0.93).孕期摄入鱼类、蛋类、动物内脏和豆制品频率较高的孕妇外周血中某些PFASs浓度增加至1.56(95％CI:1.01～2.43)～5.28(95％CI:2.40～11.58)倍,而摄入粗粮频率较高的孕妇外周血中PFOA浓度降低(GM ratio=0.67,95％CI:0.46～0.99),主要饮用桶装纯净水的孕妇外周血中各种PFASs的浓度均降低(GM ratio:0.15～0.50).[结论]嘉善地区孕妇广泛暴露于多种PFASs.除传统PFOA、PFOS的暴露外,各种新型的PFASs在该地区暴露水平也较高.孕妇年龄、孕前BMI、受教育程度、产次和膳食因素与体内的PFASs暴露水平有关.

Objective: To evaluate the results of general intervention on condom use in women of reproductive age and to explore influential factors related to condom use. Methods: A community-based intervention study was conducted in Xuhui District, Shanghai. Four streets (Fenglin, Hunan, Hongmei and Changqiao) were selected by cluster sampling. In the intervention group, health education and service of condom use were implemented, while routine family planning program was conducted in the control group. Knowledge about reproductive tract infection and condom practices were compared before and after the intervention. Results: After the project, the increase of condom use frequency in the intervention group was higher than that in the control group (OR=1.90, 95%CI: 1.34-2.45). The women aged from 30 to 40 years old had a higher use of condom than those who were less than 30 years old after intervention. The increase in the condom use after intervention was low among the women who had a higher use of condom at the start, and had elder husbands and husbands who had higher incomes. Conclusion: It is an effective way to conduct a community-based intervention to increase women's condom use frequency. The women's use of condom at the baseline and their age, their husbands' age and incomes had impact on intervention effects.

Objective:To understand the effects of synthetic reproductive tract infection(RTI)intervention on the notion and attitude to RTI.Methods:A community-based intervention study was conducted in Xuihui district,Shanghai.Four streets(Fenglin,Hunan,Hongmei and Changqiao)were selected by cluster sampling.In the intervention group,health education and counseling service of RTI were implemented,while routine family planning program was conducted in control group.The notions,attitudes and knowledge about RTI were compared before and after the intervention.Results:After the project,the improvement of notion about whether husbands should take responsibility or not for women’s infections and attitude towards sexually transmitted disease(STD)patients in the intervention group were both higher than those in control group(the former:OR= 1.43,95%CI:1.06-1.92;the latter:OR=1.57,95%CI:1.17-2.10).Conclusion:It was an effective way to conduct community-based intervention to improve women’s notions and attitudes about RTI.

Objective: To observe the effect of the Traditional Chinese Medicine——Yidanneiyifang on treating endometriosis. Methods: A total of 127 infertile women with endometriosis (EMs) diagnosed by laparoscopy were collecte, and divided into two groups, 66 infertile women (experimental group) received water decoction of Yidanneiyifang orally, one dosage was taken for twice a day; 61 infertile women (control group) were treated with traditional Danazol decoction, 50 mg, bid. The curative effect was observed after 6 months. Results: After treated, the pregnancy rate and the total effective rate were 53.0% and 87.9% respectively in experimental group, there was a significant diference compared with those in control group (30.0% and 52.5%, P<0.05). In immunoregulation, the transnegative rate of antiendometrial antibody (EMAb) was 100%, it was significantly different from the control (53.8%, P<0.01). The value of CA125 was decreased in both groups during administration, there was a significant difference between before and after administration of self-control drug in the two groups, respectively. Conclusion: The effect of Yidanneiyifang on treating EMs is credibility, it has no toxicity and side effect and will not influence natural ovulation and impregnation during administration.

子宫肌瘤是妇女最常见的良性生殖器肿瘤之一.为了探讨子宫肌瘤的早期诊断与治疗方法的选择等问题,现将我院2002年2月-2005年2月收治的452例经手术和病理证实的子宫肌瘤分析如下.

我院6年间对46例难治性多囊卵巢综合征(PCOS)患者施行腹腔镜下卵巢打孔术(LOD)后配合用克罗米芬(CC)或用二甲双胍进行治疗,取得较好的效果,现将结果报道如下.