老年人胆囊炎胆石症的临床特点探讨

目的：探讨老年人胆囊炎胆石症的特点。方法：收集胆囊炎胆石症患者,分为60岁以上老年组,45岁以下青壮年组,将两组资料进行分析,结果：老年胆囊炎胆石症患者临床表现不典型,胆石好部位以胆管多见,并发症多,结论：老年胆石症患者应尽早手术治疗。     

中老年男性体内睾酮与生长激素关系探讨

目的观察中老年睾酮(testosterone,T)与生长激素(growth hormone,GH)水平之间的关系。方法 80例体检发现T水平低下的中老年男性随机分两组,治疗组38例予以T补充治疗,对照组42例无特殊处理,观察1年,检测治疗前后T及胰岛素样生长因子(IGF)-1浓度的变化。结果实验前两组T及IGF-1无明显差异,1年后,治疗组T、IGF-1浓度较治疗前增加,差异有统计学意义(P0.001);相关性分析显示T与IGF-1成正相关(r=0.330,P=0.003)。结论中老年男性血清T水平与GH水平密切相关。     

MSM人群HIV感染状况及高危行为影响因素分析

目的了解自贡市男男性行为者(MSM)的HIV感染情况及影响因素,为制定MSM人群干预策略提供依据。方法采用问卷调查法对参与自愿咨询检测的366例MSM人员进行调查并采集静脉血液样本进行HIV抗体、梅毒抗体检测。结果自贡市MSM人群的HIV阳性检出率为24.32%,梅毒阳性检出率4.64%,年龄、文化程度、艾滋病知识知晓率、是否接受过艾滋病干预、首次性行为年龄、最近6个月男性性伴侣数、安全套的使用率、寻找性伴侣的场所是高危行为影响因素。结论自贡市MSM人群知识知晓情况较好,但高危行为较为普遍,安全套使用率较低,存在知行分离。MSM人群艾滋病防治形势严峻,需要根据男男性行为特征制定切实可行的干预措施,以遏制艾滋病的传播。     

Mental Health and Substance Use Disorder Comorbidity among Methamphetamine-Using Men Who have Sex with Men

Men who have sex with men (MSM) exhibit elevated rates of mental health and substance use disorder relative to their non-MSM male counterparts. Methamphetamine use in particular has been associated with both neuronal damage and mental health disorders among MSM, and this study reports on the prevalence and comorbidity of DSM-5 mental health and substance use disorders in a sample of methamphetamine-using MSM. From March 2014 through January 2015, 286 methamphetamine-using MSM enrolled in a study to reduce methamphetamine use and sexual risk behaviors. At baseline, participants demonstrated high rates of current major depressive episode (35.8%), antisocial personality disorder (23.9%), suicide risk (23.2%), obsessive-compulsive disorder (23.2%), and social phobia (20.4%), as well as methamphetamine use disorder (89.1%), marijuana use disorder (41.0%), alcohol use disorder (39.6%), cocaine use disorder (30.9%), and inhalants use disorder (15.4%). Analyses revealed significant (p < 0.05) associations between methamphetamine use disorder severity and all listed mental health disorders, as well as between alcohol use disorder and all listed mental health disorders. Mental health disorder prevalence and substance use disorder severity were both elevated, and both methamphetamine and alcohol use disorder severity were associated with increased likelihood of comorbid mental health disorder.     

军人创伤后应激障碍与适应障碍患者的P_(300)研究

目的探讨军人创伤后应激障碍(PTSD)与适应障碍(AD)患者事件相关电位P300的变异特点。方法对33例PTSD和34例AD患者以及30名健康军人(对照组),使用美国NicoletBravo脑电生理仪,以听觉靶刺激和非靶刺激序列为诱发事件运用oddball模式完成P300检测。结果三组CZ脑区P3与PZ脑区N2靶潜伏期,以及PZ脑区P3靶波幅和CZ脑区P2非靶波幅的差异有显著性(P<0.05,0.01);PTSD组CZ脑区P3与PZ脑区N2靶潜伏期延迟或前移,与对照组和AD组的差异有显著性(P<0.01);PTSD组PZ脑区P3靶波幅和CZ脑区P2非靶波幅均降低,与对照组及AD组的差异有显著性(P<0.05,0.01)。结论P300作为反映PTSD认知功能障碍的客观生理指标,可作为PTSD辅助诊断的一个脑电生理学标志。     

PADAM患者补充雄激素改善勃起功能的临床观察

目的探讨PADAM患者补充雄激素治疗的疗效和产生疗效的时间。方法收集135例门诊病人,采用前后对比,分别在治疗前后记录IIEF评分、PADAM症状评分以及雄激素的变化。结果采用雄激素治疗后IIEF评分、PADAM评分以及雄激素均明显优于治疗前。1个月时即可改善患者症状,3个月左右发挥最大疗效。结论 PADAM患者通过补充雄激素,可以改善勃起功能。     

Contingency management among homeless,out-of-treatment men who have sex with men

Homeless men who have sex with men are a particularly vulnerable population with high rates of substance dependence, psychiatric disorders, and HIV prevalence. Most need strong incentives to engage with community-based prevention and treatment programs. Contingency management (CM) was implemented in a community HIV prevention setting and targeted reduced substance use and increased health-promoting behaviors over a 24-week intervention period. Participants in the CM condition achieved greater reductions in stimulant and alcohol use (χ² = 27.36, p < .01) and, in particular, methamphetamine use (χ² = 21.78, p < .01) and greater increases in health-promoting behaviors (χ² = 37.83, p < .01) during the intervention period than those in the control group. Reductions in substance use were maintained to 9- and 12-month follow-up evaluations. Findings indicate the utility of CM for this high-risk population and the feasibility of implementing the intervention in a community-based HIV prevention program.     

The influence of vitamin C on antipyrine pharmacokinetics in elderly men

The influence of vitamin C on the pharmacokinetics of antipyrine was investigated in eleven elderly men aged 65–74. Antipyrine (15 mg kg^?1) was administered intravenously on three separate occasions over a 7-week period: (a) before dietary vitamin C restriction, (b) after approximately 5 weeks of dietary vitamin C restriction, and (c) after 2 weeks of vitamin C supplementation (500 mg orally twice daily). The mean plasma and leucocyte vitamin C levels (±S.D.) before vitamin C restriction were 1·26 ± 0·31 mg dl^?1 and 26·6 ± 6·7 μg 10^?8 leucocytes, respectively. These values decreased and then increased significantly following vitamin C restriction and supplementation, respectively. The mean plasma half-life of antipyrine was 10·2h and the mean plasma clearance was 2·561h^?1 1·73 m^?2 before vitamin C restriction. No significant changes in the clearance, volume of distribution, or half-life of antipyrine occurred during the study, indicating that short-term alterations in vitamin C intake do not affect the pharmacokinetics of antipyrine in elderly males.     

青年人肾病综合征28例分析

目的:分析青年人肾病综合征的临床和病理特点,以期提高诊治水平.方法:分析28例青年肾病综合征患者的临床、病理及治疗情况.结果:28例患者病理表现为IgA肾病的17例,非IgA系膜增生性肾炎的8例,局灶节段性肾小球硬化性肾炎1例,另2例未行肾活检.其中,28例均使用足量强的松+环磷酰胺冲击.辅于ACEI、潘生丁等综合治疗.3个月完全缓解率50%(14/28),部分缓解率35.7%(10/28),总缓解率85.7%(24/28).6个月完全缓解率42.8%(12/28),部分缓解率39.2%(11/28),总缓解率82.1%(23/28).半年复发率74.0%(20/27).结论:青年人肾病综合征患者中IgA肾病居多,通过激素+环磷酰胺治疗后可有效缓解,但半年复发率高.     

An examination of places where African American men who have sex with men (MSM) use drugs/drink alcohol: A focus on social and spatial characteristics

BackgroundDrug and alcohol use are risk factors for HIV transmission. Much of the HIV behavioural research has focused on risk without consideration of the social and spatial context of the behaviour. Yet, risk may be specific or unique to place. The purpose of this study was to examine the social and spatial characteristics of places where African American men who have sex with men (AA MSM) use drugs and/or alcohol. Specifically, we examined spatial intensity and clustering of drug/alcohol places and characteristics of their social networks at these places.MethodsParticipants were recruited using outreach, on-line advertisements and word-of-mouth referrals. Inclusion criteria were: age 18 or older and sex with a man in the prior 90 days. Participants (n = 51) completed a socio-spatial inventory in which they provided addresses of n = 187 places where they most recently used drugs and/or drank alcohol. Participants described characteristics of people who were at these places.ResultsThe mean age of participants was 36.5 years (SD = 10.9). Half (51%) identified as gay, 31% bisexual, 4% heterosexual and 10% as not sure/questioning and 27% self-reported HIV positive status. Drug/alcohol places were spatially concentrated in the inner part of the city and evidence of clustering by participant characteristics was present. Of n = 187 places named where the participant drank alcohol or used drugs, 68% were described as a residence (participants or “someone one else's house”), 20% were bars/clubs or restaurants, 8% were outside places and 4% were miscellaneous (e.g. on the bus/car). There were differences in the characteristics of social network members by place-type. At residential places, a greater proportion of networks listed were sex partners or kin, compared to other place-types. A greater proportion of networks listed at bars/clubs/restaurants were gay, knew that the participant had sex with men, and were younger compared to other place-types.ConclusionAA MSM drink alcohol and use drugs in a variety of place-types and with various social network members. Little research has been done on factors that shape the geography of AA MSM substance use. Future research is needed to explore these complex associations.     

Family functioning and gambling problems in young adulthood: the role of the concordance of values

Background: Although young adult men are at an elevated risk for gambling problems (GP), compared to adolescents and adults in general this group is still largely unresearched. The current study investigates whether family functioning, which is associated with reduced risk for GP in adolescence, also affects gambling in young adults, who are more independent than minors. It analyses the relationship between GP and two core components of family functioning, the effectiveness of problem-solving in the family and perceived concordance of values.

Methods: Data came from the baseline, 12- and 24-month follow-up assessments of Munich Leisure-time Study (MLS), a longitudinal online study in young male gamblers. Young men were recruited via the Munich citizens’ registry (n?=?2,693) and Facebook invites (n?=?105). In total, n?=?173 individuals positively screened for frequent and/or regular gambling participated in the study. The hypothesised relations between problem-solving, concordance of values and GP were investigated with a path model controlling for non-planning impulsiveness and psychological distress.

Results: Higher concordance of family values was significantly related to less GP in cross-sectional and longitudinal analyses. It mediated the relation between the effectiveness of problem-solving and GP.

Conclusions: While previous studies indicated good family functioning as a factor preventive of GP, the current results indicate that this association is mediated by the perceived concordance of family values. In families with effective problem-solving, common family values might facilitate recognition of and reaction to first signs of problems. Perceived discordance may lead to feelings of shame and concealment of GP.     

不育男性睾丸超声表现及测量分析

本文应用B超测量睾丸体积。正常生育力男性睾丸体积 B 超测量左侧为11.1±2.4cm~3,右侧为11.1±2.7cm~3。B 超检查见不育男性睾丸内部回声低,不均匀,结构疏松,体积明显小于正常生育力男性睾丸。提示:B 超测量睾丸体积是一种准确、可靠实用的方法,为研究不孕男性患者睾丸的病理学提供信息。     

Estimation of lean body weight in older community-dwelling men

AIMS

Lean body weight (LBW) decreases with age while total body fat increases, altering drug pharmacokinetics. The aim of this study was to evaluate the ability of the LBW equation to predict dual-energy X-ray absorptiometry (DXA)-derived fat free mass (FFM_DXA) in older community-dwelling males compared with that of two existing FFM equations: the Heitmann and Deurenberg equations.

METHODS

Data were obtained from 1655 older men enrolled in the Concord Health and Ageing in Men Project. The predictive performance of the LBW and FFM equations to predict FFM_DXA accurately was assessed graphically using Bland–Altman plots and quantitatively for precision and bias using the method of Sheiner and Beal in all participants and in frailty and body mass index (BMI) subgroups.

RESULTS

The LBW and Heitmann equations consistently overestimated FFM_DXA for all frailty and BMI subgroups with a mean difference [95% confidence interval (CI)] of 5.5 kg (−0.65, 11.63 kg) and 3.34 kg (−2.84, 9.64 kg), respectively. The Deurenberg equation overestimated FFM_DXA for overweight participants but underestimated FFM_DXA for not-frail participants, with a mean difference (95% CI) of 1 kg (−7.23, 5.25 kg) for all participants.

CONCLUSION

LBW and FFM estimated using these equations give results comparable to DXA-derived FFM. The LBW and Heitmann equations provide a more consistent estimate of FFM_DXA in all frailty and BMI groups despite the Deurenberg equation having the smallest mean difference. Further studies to determine whether the LBW equation is a clinically useful substitute for weight when determining drug dose in older people appear warranted.     

Chemsex behaviours among men who have sex with men: A systematic review of the literature

Background‘Chemsex’ is the use of drugs before or during planned sexual events to facilitate, enhance, prolong and sustain the experience. Drugs associated with chemsex are methamphetamine, GHB/GBL, mephedrone, cocaine and ketamine. This review syntheses published research on the antecedents, behaviours and consequences associated with chemsex behaviours among men who have sex with men (MSM).MethodsPapers from high income countries which were published between January 2000 and September 2018 reporting the use of chemsex drugs before or during sex were identified through Medline, Web of Science, CINAHL and Central. Results were synthesised using a narrative approach and conceptualised using a behavioural analysis framework.ResultsThe search identified 2492 publications, of which 38 were included in the final synthesis. There were wide variations in chemsex prevalence estimates due to the heterogeneous sampling in the studies. Chemsex participants have expectations that the drugs will positively affect their sexual encounters and HIV positive MSM are more likely to engage in the behaviour than HIV negative MSM. There were wide ranging prevalence estimates on injecting drugs for sexual purposes and the sharing of injecting equipment with some evidence of unsafe injecting practices. Participants were more likely to engage in condomless anal intercourse than men who do not engage in chemsex. This may increase the risk of transmission for HIV and other sexually transmitted infections.ConclusionA minority of MSM appear to engage in chemsex behaviours but they are at risk of this negatively impacting on their health and well-being. Further research is required to examine high risk chemsex behaviours, impact of chemsex on psycho-social well-being and if chemsex influences uptake of PrEP, PEP and sexual health screening.