抗哮喘药

摘要： 目的 探讨匹多莫德联合孟鲁司特钠治疗支气管哮喘的疗效及对患者炎性因子水平、免疫功能的影响.方法 收集诸暨市人民医院2019年2月至2020年2月收治的支气管哮喘患者102例为研究对象,按随机数字表法分为观察组、对照组各51例.两组在常规治疗的基础上,对照组给予孟鲁司特钠治疗,观察组联合匹多莫德治疗.观察比较两组患者的临床疗效、肺功能指标、炎性因子、T淋巴细胞亚群、不良反应发生率等.结果 观察组总有效率为90.20％(46/51),高于对照组的74.51％ (38/51)(x2=4.317,P=0.038);治疗后观察组患者第一秒用力呼气量(FEV1)、用力肺活量(FVC)、最大呼气流速(PEF)分别为(82.89±6.94)％、(3.89±0.45)L、(3.49±0.49) L/s,均高于对照组的(77.89±6.79)％、(3.58±0.43)L、(3.21 ±0.45) L/s(t=7.370、5.753、4.239,均P＜0.05);治疗后观察组患者的炎性因子指标包括血清降钙素原(PCT)、白细胞介素6(IL-6)、C反应蛋白(CRP),分别为(1.45±0.49)μg/L、(9.87±2.65) mg/L、(5.79±1.48) mg/L,低于对照组的(1.79±0.55) μg,/L、(12.34±2.97) mg/L、(7.23±1.68)mg/L(t =4.624、6.542、8.090,均P＜0.05);治疗后观察组患者的CD3+、CD4、CD4+/CD8+均为(53.43±5.43)％、(46.34土5.31)％、(1.54±0.23),高于对照组的(48.09±5.17)％、(41.89±5.15)％、(1.26±0.22),而CD8+为(30.65土3.54)％,低于对照组的(33.72±3.69)％,两组差异均有统计学意义(t=3.901、4.080、4.072、5.967,均P＜0.05);治疗期间观察组、对照组不良反应发生率分别为15.69％ (8/51)、9.80％ (5/51),组间差异无统计学意义(x2=0.793,P=0.373).结论 匹多莫德联合孟鲁司特钠对支气管哮喘的治疗效果显著,能够改善患者的肺功能,降低炎性因子水平,提高机体免疫功能,安全性良好.

摘要： Kilogram scale synthesis of 8-Benzyloxy-5-(2-bromoacetyl) carbostyril,the intermediate of anti-asthma drugs,was studied from 8-hydroxyquinolin-N-oxide(Ⅱ) via isomerisation,Fries rearrangement,benzylation and bromination.Thus reflux reaction of Ⅱ (2.5 kg) and acetic anhydride(12 kg) for 4 h gave 8-acetoxyquinolone(Ⅲ).And then Ⅲ mixed with anhydrous AlCl3 (3.8 kg),acetylchloride(75 g) and dichloroethane(55 kg) into slurry and conducted Fries reaction at 75-85 °C for 4 h to produce 5-acetyl-8-hydroxylquinolone(Ⅳ).Subsequently,under the catalysis of KI/K2CO3,benzylation with benzylchloride (1.5 kg) in DMF was carried out to produce 8-benzyl-5-acetylquinolone (Ⅴ);Finally,BF3/Et2O catalyzed reaction of Ⅴ with bromine(1.9 kg) at 30-35 °C for 1 h to obtain 3.3 kg target product with purity of 98.4％ and the total yield of 56.5％.%研究了以8-羟基喹啉-N-氧化物为起始原料,经转位、Fries重排、苄基化和溴化等反应合成了抗哮喘药中间体8-苄氧基-5-(2-溴乙酰基)喹诺酮的千克级工艺.2.50 kg 8-羟基喹啉-N-氧化物和12 kg乙酰酐回流反应4h生成8-乙酰氧基喹诺酮,然后与3.8 kg无水AlCl3、75 g乙酰氯和55 kg二氯乙烷混合成浆状,加热到75～85°C进行Fries反应4h,得到5-乙酰基-8-羟基喹诺酮;5-乙酰基-8-羟基喹诺酮与1.5 kg氯化苄在DMF中,KI/K2 CO3催化下苄基化得到8-苄氧基-5-乙酰基喹诺酮,与1.9 kg液溴在30～35°C、BF3 /Et2O催化下反应1h,得到3.3 kg目标产物,质量分数98.4％,总收率56.5％.

摘要： AIM To estimate the effectiveness and safety of reslizumab in treating patients with asthma.METHODS The randomized controlled trials (RCT) of reslizumab treatment in patients with asthma were searched from PubMed,EMbase,ClinicalTrials.gov,CNKI,Wanfang database,VIP Chinese by Computer.Data were collected from inception to February 2017.The relevant references were also retrieved manually.Bias risk of RCT and quality of documents were evaluated by using modified Jadad rating scale.All data were analyzed with RevMan 5.3.RESULTS Five RCTs involving 1 666 patients were included.Meta-analysis showed improved (FEV1) (WMD =0.10,95％ CI (0.05,0.15),P =0.000 2),asthma quality-of-life questionnaire (MD =0.27,95％ CI (0.13,0.42),P =0.000 2),asthma control questionnaire (MD =-0.35,95％ CI (-0.38,-0.32),P=0.000 1),reducing the use of first aid (WMD =-0.13,95％CI (-0.31,0.05),P=0.16],the incidence of adverse reactions was similar (OR =0.62,95％CI (0.50,0.78),P ＜ 0.000 1),the incidence of serious adverse reactions was similar (OR =0.81,95％ CI (0.56,1.18),P =0.28).CONCLUSION In the treatment of patients with asthma,reslizumab can significantly improve lung function symptoms and quality of life and it is safety.%目的 系统评价瑞利珠单抗治疗哮喘的疗效和安全性.方法 计算机检索PubMed、EMbase、ClinicalTrials.gov、中国知网、万方数据库、维普中文数据库,收集瑞利珠单抗治疗哮喘的临床随机对照试验(RCT),检索时间为建库至2017年2月,同时手工检索相关研究的参考文献,通过改良Jadad量表评分对所纳入的RCT进行偏倚风险评估,及对文献进行质量评价,并通过RevMan5.3软件进行Meta分析.结果 共纳入符合标准的5个RCT研究,总计患者1 666例.Meta分析结果显示:与安慰剂相比,改善患者第1秒用力呼气容积[WMD=0.10,95％CI (0.05,0.15),P=0.000 2],哮喘生活质量调查问卷评分[WMD=0.27,95％CI (0.13,0.42),P=0.000 2],哮喘控制问卷评分[WMD=-0.35,95％CI(-0.38,-0.32),P=0.000 1],减少急救药物的使用[WMD=-0.13,95％CI(-0.31,0.05),P=0.16],不良反应发生率减少[OR=0.62,95％CI (0.50,0.78),P＜0.000 1],严重不良反应发生率相当[OR=0.81,95％CI (0.56,1.18),P=0.28].结论 瑞利珠单抗治疗哮喘可明显改善患者肺功能、症状和生活质量,且安全有效.

摘要： There is a strong association between chronic rhinosinusitis (CRS) and asthma.Approximately 10％-50％ of CRS patients also have comorbid asthma.These patients are more likely to have severe CRS and asthma and higher recurrence rates after sinus surgery.Also there may be acute asthma attack during the perioperative period.Therefore, we should pay more attention to these patients.Assessment of the control level of asthma and pulmonary function should be performed preoperatively.And asthma needs to be fully managed in the perioperative period to avoid acute asthma attack.Extensive sinus surgery is recommended in these patients to reduce the inflammation load.Long-term medical treatment and regular follow-up are suggested to achieve well control of CRS and asthma.%慢性鼻-鼻窦炎(CRS)与哮喘存在强烈的相关性,约10％～ 50％的CRS患者患有哮喘.此类患者CRS和哮喘病情都更为严重,鼻窦手术术后复发比例更高;围手术期可能出现哮喘的严重发作,因此应给予特殊关注.在术前评估中,应考虑哮喘的控制状态以及肺功能的情况.围手术期注意充分地哮喘药物治疗,警惕哮喘的急性发作.在术式的选择上,更倾向于扩大化的鼻窦手术,以降低炎症负荷.术后随访强调长期药物治疗和定期随访以达到鼻窦炎和哮喘的控制.

摘要： Objective To discuss the clinical curative effect and pharmacoeconomics of inhaled glucocortico-steroids(ICS)in the treatment of children with cough variant asthma(CVA),in order to provide the reference for reasonable and economic drug -use of clinic treating children with CVA.Methods 128 children with CVA were divided into A,B,C three groups according to random number table method in our hospital from March 2013 to May 2014.The children with CVA of A,B,C groups were respectively given budesonide aerosol(200 -800μg/day,twice per day),fluticasone propionate aerosol(50 -100μg/time,twice per day),beclometasone dipropionate aerosol(50 -100μg/time,three times per day)on the basis of bronchodilator,smooth wheezing and expectorant.The clinical effica-cy and cost -effectiveness was evaluated after 12 weeks of treatment.Results The clinical total effective rates of A, B,C group were 90.0%,93.4%,90.7% respectively,and there were no statistically significant difference(χ2 =25.215,22.878,21.336,all P >0.05 ).The per capita cost of A,B,C group were 498.68yuan,671.20yuan, 541.14yuan respectively,and A group had the lowest cost -effectiveness ratio(C /E =5.54).Conclusion Budes-onide aerosol has better economy in treating of children with CVA.%目的：探讨吸入型糖皮质激素（ICS）治疗儿童咳嗽变异性哮喘（CVA）的临床疗效，同时进行药物经济学评价，为儿童 CVA 的临床合理、经济用药提供参考。方法将2013年3月至2014年5月就诊的128例 CVA 患儿按照随机数字表法分成 A、B、C 三组。在给予支气管扩张剂、平喘及祛痰药的基础上，A、B、C三组患儿分别给予布地奈德气雾剂吸入（200～800μg／d，分2次使用）、丙酸氟替卡松气雾剂吸入（50～100μg／次，2次／d）、丙酸倍氯米松气雾剂吸入（50～100μg／次，3次／d），治疗12周后评价临床疗效，并采用成本-效果分析法进行药物经济学研究。结果 A、B、C 三组的临床总有效率分别90．0％、93．4％、90．7％，差异有统计学意义（χ2＝25．215、22．878、21．336，均 P ＞0．05），A、B、C 三组的人均成本分别是498．68元、671．20元、541．14元，A 组具有最低的成本-效果比（C ／E ＝5．54）。结论布地奈德气雾剂治疗儿童 CVA 具有较好的经济性。

摘要： 一支烟就会削弱药效，这并非耸人听闻。以哮喘药为例，烟味就是它的“死对头”。

摘要： 目的：观察妥洛特罗贴剂联合吸入布地奈德混悬液雾化吸入治疗小儿支气管哮喘急性发作的临床疗效。方法选取支气管哮喘患儿78例，分为治疗组40例，对照组38例，2组患儿均采用相同的综合性治疗，如抗感染、止咳、平喘、维持水电解质平衡等治疗。治疗组在上述综合治疗基础上加用妥洛特罗贴剂（0．6～3岁，每天0．5mg／贴；3～6岁，每天1．0mg／贴；睡前贴于前胸或后背），对照组给予盐酸丙卡特罗糖浆（0．2mL／kg，12 h 1次）口服，疗程为5～7 d。结果治疗组喘憋消失时间、肺部哮鸣音消失时间及住院天数均短于对照组，差异有统计学意义（ P ＜0.05）；治疗组显效率为65％，对照组显效率50％，差异有统计学意义（ P ＜0.01）；治疗组不良反应发生率为12％，对照组为34％，差异有统计学意义（ P ＜0．01）。结论妥洛特罗贴剂联合吸入布地奈德混悬液雾化吸入治疗小儿支气管哮喘急性发作的疗效确切，不良反应少，依从性佳。%Objective To evaluate the clinical efficacy of tulobuterol tape‐inhalation of pulmicort respules in the control of acute asthma in infants and young children .Methods A total of 78 infants and young children with acute asthma episode were allocated to treatment group ( n =40)and controls( n =38) .Two groups of children were using the same comprehensive treatment ,such as antibiotics ,removing cough ,eliminating asthma ,and other treatments the balance of water ,sodium and other electrolytes .At the same time ,the treatment group received al‐so tulobuterol tape (0.5 mg/paste ,0.6‐3 years ,1.0 mg/paste ,3‐6 years ,bedtime affixed to the chest or back ) , and the control group received procaterol hydrochloride syrup (0.2 mL/kg ,12 h 1 times) orally .The course was 5‐7 days in two groups.Results The disappearance time of wheezing ,lung wheeze and the number of days of hos‐pitalization of treatment group was shorter than those in the control group .The difference was significant ( P<0 . 05);the efficiency of treatment group was 65% ,the control group was 50% ,and the difference was statistically significant ( P <0 .01) ;Rate of side effect was 12% in the treatment group ,and rate of side effect in the control group was 34% .The difference was significant ( P<0 .01) .Conclusion Tulobuterol tape‐inhalation of pulmicort inhalation therapy in infants and young children with bronchial asthma attacks was of significant efficacy ,and the compliance is very good .

摘要： 目的 调查上海市社区医院平喘药物使用情况,了解社区医院在哮喘和慢性阻塞性肺病诊治指南执行中存在的问题,并探讨原因.方法 收集上海市某区5家社区医院2013年度平喘药物的使用量.以药物限定日剂量(DDD值)为依据对用药量进行换算,计算出药物的用药频度(DDDs)及不同类别药物构成比.并与同区的1家二级和1家三级医院的数据进行比较.结果 3个级别医院口服平喘药使用比例差异不明显,社区、二级、三级医院分别为20％、20％和22％.但口服药物的品种在二、三级医院以白三烯受体拮抗剂为主(56％和73％),社区医院全部为口服茶碱类和β2受体激动剂.在吸入平喘药物中,二、三级医院以糖皮质激素为主(50％和68％),社区医院全部为短效β2受体激动剂.吸入装置中,二、三级医院以干粉吸人剂为主(64％和83％),一级医院全部为定量压力气雾剂.结论 上海市社区医院平喘药物的使用与指南要求有较大距离.需要从完善医院药品配置、加强医务人员继续教育、改变患者用药观念和提高国内药企生产雾化剂积极性等方面提高.%Objective To observe the usage of antiasthmatic drugs and seek problems of following the guidelines of asthma and COPD prevention & treatment in community hospitals.Methods The prescribed quantity in 2013 of antiasthmatic drugs was recorded for 5 community hospitals in a district of Shanghai.Basing on the defined daily dose (DDD),the dosing frequency of drugs (DDDs) and the percentages of each category of drugs were calculated.Then comparisons were made with the data of a grade Ⅱ hospital and a grade Ⅲ hospital in the same district.Results Among three level hospitals,no significant difference existed in the percentages of oral antiasthmatic drugs.But the major category of oral drugs at grades Ⅱ-Ⅲ hospitals was leukotriene receptor antagonist whereas only oral theophylline and oral β2-receptor agonists were available at community hospitals.Among inhaled drugs,inhaled corticosteroids (ICS) dominated at grades Ⅱ-Ⅲ hospitals.But at community hospitals,inhaled short-acting beta-agonists (SABA) predominated.Among inhalants,dry powder inhaler (DPI) dominated at grades Ⅱ-Ⅲ hospitals and metered dose inhaler (MDI) at community hospitals.Conclusions The usage of antiasthmatics at community hospitals is not consistent with the guidelines.Optimizing drug purchasing at hospitals,strengthening continued medical education,modifying the medication concept of patients and boosting the production of domestic inhalants should be urgently undertaken.

摘要： 目的：了解完全控制哮喘患者的用药情况,并探讨不同用药情况对哮喘急性发作的影响。方法选取2007年1月—2013年12月在武汉大学人民医院呼吸内科门诊就诊或治疗后出院的501例完全控制哮喘患者为研究对象。根据用药情况,以单纯采用吸入药物进行治疗的患者为吸入治疗组,以联合采用口服药物和吸入药物进行治疗的患者为联合治疗组。入组后两组患者均维持达到完全控制时的治疗方案,随访24周。记录患者随访期间的临床表现、哮喘控制测试量表( ACT)得分、肺功能以及因哮喘急性发作退出试验的病例数、存在1次及以上急性发作的病例数、累计急性发作次数。结果共有371例患者按要求完成了24周随访,吸入治疗组和联合治疗组分别为208例(占56．1%)和163例(占43．9%)。两组完成24周随访患者的性别、平均年龄、第1秒用力呼气容积( FEV1)占预计值百分比、第1秒用力呼气容积占用力肺活量百分比( FEV1/FVC)及FEV1改善率比较,差异均无统计学意义( P>0．05)；而25%~75%用力肺活量时呼吸流速(FEF25%~75%)占预计值百分比比较,差异有统计学意义(P0. 05 ) in gender, average age, the ratio of FEV1 to the predicted value, FEV1/FVC and the improvement rate of FEV1 of the patients who completed the 24 weeks′follow-up; the two groups were not significantly different in the ratio of FEF25% ~75% to predicted value ( P<0. 05) . Among the 163 patients who were administrated with both oral drugs and inhaled drugs, 131 (80. 4%) were orally administrated with theo - dur, and 124 ( 76. 1%) patients inhaled high - dose glucocorticoids but were not completely controlled. The two groups were significantly different ( P <0. 05 ) in the number of patients who quitted study due to acute episoded asthma, the number of patients who had times of acute episoded asthma≥1 and the accumulated number of times of acute episode among the patients who completed 24 weeks of follow -up. Conclusion Inhalation therapy is still the primary therapy for the asthma control. For patients who are only administrated with inhalation therapy but cannot be completely controlled, the combined use of oral drugs could be considered. Theo-dur is the common oral medication for asthma treatment. Compared with the patients who only take inhaled drug, the patients who take both oral drugs and inhaled drugs have low level in acute episoded asthma.

摘要： 支气管哮喘是妊娠期女性常见的合并症之一。有报道显示，妊娠合并哮喘的发病率己由10年前的0.4%-1.0%逐年上升至3.7%-8.4%,严重威胁着妊娠期女性及胎儿的健康。由于妊娠期及哺乳期的特殊性，治疗要兼顾母亲与胎儿的安全。对妊娠期及哺乳期用药知识的缺乏常使众多医务工作者身处两难境地。为此，本文参考国外近期相关文献，总结了常用的抗哮喘药物对妊娠期及哺乳期的影响，为医务工作者及广大患者提供较为安全的用药指导。

摘要： 哮喘是由慢性炎症引起的气道收缩,可导致呼吸困难、喘息、胸闷和咳嗽等症状,易反复发作.为了考察抗哮喘新药的临床试验中血药浓度和药效值的采集时间和次数对药效评价和预测的影响,本文采用仿真模拟的方法比较不同试验设计的优劣,为哮喘临床试验的药物动力学、药效学建模提供优化试验设计方案.首先假设新药X符合口服一室药物动力学模型和Emax药效模型,通过仿真生成虚拟患者,然后考察不同试验设计(即不同的血药浓度和药效数据采集时间和次数)对药物动力学/药效学模型参数拟合的影响,通过比较拟合参数与假设参数间的偏差选择哮喘药物临床试验的优选方案.

摘要： 哮喘是由慢性炎症引起的气道收缩,可导致呼吸困难、喘息、胸闷和咳嗽等症状,易反复发作.为了考察抗哮喘新药的临床试验中血药浓度和药效值的采集时间和次数对药效评价和预测的影响,本文采用仿真模拟的方法比较不同试验设计的优劣,为哮喘临床试验的药物动力学、药效学建模提供优化试验设计方案.首先假设新药X符合口服一室药物动力学模型和Emax药效模型,通过仿真生成虚拟患者,然后考察不同试验设计(即不同的血药浓度和药效数据采集时间和次数)对药物动力学/药效学模型参数拟合的影响,通过比较拟合参数与假设参数间的偏差选择哮喘药物临床试验的优选方案.

摘要： 哮喘是由慢性炎症引起的气道收缩,可导致呼吸困难、喘息、胸闷和咳嗽等症状,易反复发作.为了考察抗哮喘新药的临床试验中血药浓度和药效值的采集时间和次数对药效评价和预测的影响,本文采用仿真模拟的方法比较不同试验设计的优劣,为哮喘临床试验的药物动力学、药效学建模提供优化试验设计方案.首先假设新药X符合口服一室药物动力学模型和Emax药效模型,通过仿真生成虚拟患者,然后考察不同试验设计(即不同的血药浓度和药效数据采集时间和次数)对药物动力学/药效学模型参数拟合的影响,通过比较拟合参数与假设参数间的偏差选择哮喘药物临床试验的优选方案.

摘要： 哮喘是由慢性炎症引起的气道收缩,可导致呼吸困难、喘息、胸闷和咳嗽等症状,易反复发作.为了考察抗哮喘新药的临床试验中血药浓度和药效值的采集时间和次数对药效评价和预测的影响,本文采用仿真模拟的方法比较不同试验设计的优劣,为哮喘临床试验的药物动力学、药效学建模提供优化试验设计方案.首先假设新药X符合口服一室药物动力学模型和Emax药效模型,通过仿真生成虚拟患者,然后考察不同试验设计(即不同的血药浓度和药效数据采集时间和次数)对药物动力学/药效学模型参数拟合的影响,通过比较拟合参数与假设参数间的偏差选择哮喘药物临床试验的优选方案.

摘要： 本发明描述了局部吸入的包括抗胆碱能药组分优选格隆溴铵和糖皮质激素组分的药物制剂的组合，及其在呼吸道疾病的症状性治疗和预防性治疗中的用途，尤其是具有阻塞性构成或基础炎症的呼吸道疾病如哮喘和慢性阻塞性肺病(COPD)。进一步包括该组合以局部应用(吸入)的制剂呈现和在吸入装置例如Novolizer中的应用。

摘要： 提供对广泛耐药结核菌有效的抗XDR-TB药和对耐多药结核菌有效的抗耐多药结核菌MDR-TB药以及对针对现有的抗结核药敏感的结核菌有效的并用抗结核药。本发明为包含由下述结构式(1)表示的化合物的抗XDR-TB药、包含由下述结构式(1)表示的化合物的抗耐多药结核菌药以及并用含有由下述结构式(1)表示的化合物的药物和从含有利福平的抗结核药和含有异烟肼抗结核药中选择的至少一种抗结核药的并用抗结核药。

摘要： 本发明涉及将WecA及其直系同源的活性阻碍剂、与MurX及其直系同源的活性阻碍剂和RNA合成阻碍剂中的至少一种并用的并用抗抗酸菌药、抗抗酸菌药的筛选方法、和WecA及其直系同源的活性阻碍剂。

摘要： 本发明涉及基于抗胆碱能药、β2-肾上腺素受体激动剂、PDE 4抑制剂、糖皮质激素和白细胞三烯-受体拮抗剂的新组合，它们的生产方法和它们在治疗炎性疾病、优选呼吸系统疾病如支气管哮喘和慢性阻塞性肺病(COPD)或风湿性疾病或自身免疫性疾病中的应用。

摘要： 本发明公开了一种普仑司特中间体N‑(2‑氰基‑4‑氧代‑4

摘要： 本发明描述了局部吸入的包括抗胆碱能药组分优选格隆溴铵和糖皮质激素组分的药物制剂的组合，及其在呼吸道疾病的症状性治疗和预防性治疗中的用途，尤其是具有阻塞性构成或基础炎症的呼吸道疾病如哮喘和慢性阻塞性肺病(COPD)。进一步包括该组合以局部应用(吸入)的制剂呈现和在吸入装置例如Novolizer中的应用。

摘要： 通式Ⅰ的新的特异性亲免蛋白配体具有抗哮喘和免疫抑制作用并适于制药。

摘要： 提供对广泛耐药结核菌有效的抗XDR-TB药和对耐多药结核菌有效的抗耐多药结核菌MDR-TB药以及对针对现有的抗结核药敏感的结核菌有效的并用抗结核药。本发明为包含由下述结构式(1)表示的化合物的抗XDR-TB药、包含由下述结构式(1)表示的化合物的抗耐多药结核菌药以及并用含有由下述结构式(1)表示的化合物的药物和从含有利福平的抗结核药和含有异烟肼抗结核药中选择的至少一种抗结核药的并用抗结核药。

摘要： 本发明涉及将WecA及其直系同源的活性阻碍剂、与MurX及其直系同源的活性阻碍剂和RNA合成阻碍剂中的至少一种并用的并用抗抗酸菌药、抗抗酸菌药的筛选方法、和WecA及其直系同源的活性阻碍剂。

摘要： 本发明涉及基于抗胆碱能药、β2－肾上腺素受体激动剂、PDE 4抑制剂、糖皮质激素和白细胞三烯－受体拮抗剂的新组合，它们的生产方法和它们在治疗炎性疾病、优选呼吸系统疾病如支气管哮喘和慢性阻塞性肺病(COPD)或风湿性疾病或自身免疫性疾病中的应用。