马兜铃酸对大鼠肾功能和组织病理学影响及川芎嗪与苯那普利的干预作用

目的:通过动物实验,观察大鼠灌胃马兜铃酸(AA)后,肾功能及肾脏组织病理学改变,及川芎嗪、苯那普利对肾损害的干预作用.方法:雄性Wistar大鼠98只,SPF级,随机分为4组:正常对照组20只,实验组分为模型组、川芎嗪组、苯那普利组,每组26只;各实验组按AA 20 mg·kg-1·d-1关木通浸膏灌胃,2 h后按分组灌胃给药.川芎嗪50 mg·kg-1·d-1,苯那普利1.8 mg·kg-1·d-1;正常对照组、模型组灌胃饮用水.各组每周测量体重,分别于第4、8、12周处死动物;腹主动脉采血分离血清,检测肾功能;取肾组织进行病理形态学检查.结果:AA灌胃4周后各组血肌酐/体重水平明显增加,与正常对照组比较有统计学差异;与模型组比较,川芎嗪、苯那普利组血肌酐/体重水平显著降低,提示有改善肾功能作用.肾脏组织病理学可见模型组早期有明显的肾小管坏死,部分小管结构紊乱较严重,空泡变性明显;后期出现间质灶性纤维化,纤维化面积＞30%.川芎嗪、苯那普利治疗组的肾功能和组织学损害程度较轻微,纤维化程度约15%～20%.结论:马兜铃酸对大鼠肾脏具有肾毒性,可导致小管间质损害和肾纤维化.川芎嗪、苯那普利对马兜铃酸肾损害有保护作用,能减轻马兜铃酸造成的肾组织病理损害,减少肾纤维化程度.     

百乐眠胶囊治疗失眠症的临床研究

目的评价百乐眠胶囊治疗失眠症的疗效。方法对40例失眠症患者进行开放性治疗,用睡眠评定量表(SDRS)进行疗效评价。结果治疗后1周和2周,患者SDRS评分中位数均较治疗前明显降低(P<0.01),2周时降低更明显(P<0.01)。1周时有效率为20%,2周时有效率为85%(P<0.01)。SDRS评定结果显示各临床表现均较治疗前明显好转(P<0.01)。结论百乐眠胶囊是治疗失眠症安全有效的药物。     

Sexual function in patients presenting to a urogynecology practice

The purpose of this study was to evaluate sexual function in women referred to a urogynecology practice. All new patients were mailed an optional female sexual function index (FSFI) in conjunction with their history forms; other sexual function information was obtained during the physician interview. Over 6 months, four hundred fifty new patients were enrolled. Of these, 243 (54%) were not sexually active. Reasons listed for sexual inactivity included partner problems/no partner (32%), low desire (14%), prolapse (10%), and pain (10%). There were several differences between sexually active and non-sexually active participants; however, after a multivariate analysis, only age, marital status, and stage/grade 1–2 of prolapse remained significant. One hundred nine sexually active patients completed the FSFI; the majority was sexually active two to four times per month. Female sexual dysfunction was noted in 70 (64%) patients. Lowest scores were noted for the domain of desire, followed by arousal, orgasm, lubrication, satisfaction, and pain. Reduced frequency of intercourse was the only factor significantly associated with dysfunction. Ninety-four percent were not embarrassed by the survey. Overall, sexual inactivity is common in patients presenting for urogynecologic care. Those that are sexually active report low rates of sexual activity and high rates of sexual dysfunction. Most sexually active patients will accept a sexual function questionnaire as part of their routine assessment.This research was presented at the American College of Obstetricians and Gynecologists annual clinical meeting, May 10, 2005, San Francisco, CA, USA.     

呋塞米与多巴胺联合应用对肝移植术无肝期肾功能及尿量的影响

目的比较背驮式原位肝移植术中持续输注小剂量多巴胺或呋塞米和多巴胺联合应用对无肝期肾功能和尿量的影响。方法背驮式原位肝移植术患者42例,ASAⅢ~Ⅳ级,随机分为多巴胺组(D组)和呋塞米-多巴胺组(F组),每组21例。两组均于麻醉诱导后静脉泵注多巴胺(2~5μg.kg-1.min-1)至术毕,F组则在无肝期开始时静注呋塞米0.1mg/kg。观察无肝期输液量、血液动力学和尿量,检测血清肌酐(Cr)和肌酐清除率(CCr)。结果与D组比较,F组无肝期尿量明显增多(P<0.05);两组无肝期时间、输液量和心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)、每搏量(SV)、心输出量(CO)、全身血管阻力(TSVR)、Cr、CCr差异无显著意义。结论肝移植术中持续泵注多巴胺和呋塞米联合应用可明显增加无肝期尿量。     

骨调素和单核细胞趋化蛋白在大鼠梗阻性肾病中的表达及可能作用

目的:探讨骨调素(OPN)和单核细胞趋化蛋白(MCP-1)在大鼠梗阻性模型中的表达及其在肾脏纤维化发病机制中的作用.方法:采用-单侧输尿管结扎制造梗阻性肾病模型,分别于造模后7 d、14 d取肾组织,应用HE染色观察肾脏病理改变,免疫组化方法检测肾组织畔OPN和MCP-1蛋白的表达,应用逆转录-聚合酶链式反应(RT-PCR)法观察肾组织中OPN mRNA和MCP-1 mRNA的变化.结果:OPN、MCP-1表达主要位于肾小管上皮细胞,随着梗阻时间的延长,肾组织中OPN、MCP-1蛋白和mRNA表达明显增加.结论:OPN、MCP-1蛋白和mRNA在梗阻性肾病大鼠肾组织表达明显增加介导炎症过程,参与肾间质纤维化.     

IIEF-5与NEVA检测在阴茎勃起功能障碍诊断中的意义

目的探讨应用国际勃起功能评分5(IIEF-5)问卷表结合夜间阴茎勃起测定系统(NEVA)筛选勃起功能障碍(ED)的可行性及意义。方法148例门诊ED病人,应用IIEF-5问卷表评分,再通过NEVA测定仪监测夜间阴茎勃起情况,次日数据输入主机回放并分析。结果93例为心理性ED;在19~69岁的5个年龄组中,重度ED的比例由11.8%到55.0%,NEVA中度异常者IIEF积分(12.98±2.58)分,NEVA重度异常者IIEF积分(7.32±1.04)分。结论NEVA能有效地鉴别心理性与器质性ED,IIEF-5评分值与NEVA检测阴茎勃起时血容量变化值有相关性。IIEF-5与NEVA检测结合,能提高诊断和评估ED的可靠性。     

衰老对大鼠阴茎组织NO-cGMP通路及端粒酶活性的影响研究

目的探讨衰老对大鼠阴茎组织结构、NO(nitric oxide)-cGMP(cvclic Guanosine Monophosphate)通路及端粒酶活性的影响作用。方法本课题以不同月龄大鼠阴茎组织及培养的平滑肌细胞为研究对象,检测不同月龄大鼠阴茎组织中NO量、NOS(Nitric Oxide Synthase)活性、cGMP量、端粒酶活性及海绵体结构的变化,并比较大鼠、人阴茎组织及大鼠原代海绵体平滑肌细胞的端粒酶活性。结果(1)大鼠阴茎组织中NO量、NOS活性均先升高后降低,各月龄组间有显著差异。阴茎组织cGMP含量逐渐降低,各月龄组间差别显著；(2)随龄增加,平滑肌纤维逐渐减少,胶原纤维增多,粗大成团,窦状隙变少、变窄：(3)大鼠阴茎组织端粒酶活性以2月龄活性最高,随龄增加逐渐下降。人阴茎组织中无端粒酶活性。结论(1)衰老对大鼠阴茎组织结构、NO．cGMP通路及端粒酶活性有显著影响,提示衰老与ED关系密切；(2)大鼠阴茎组织有端粒酶活性,可作为研究细胞衰老与ED关系有关端粒酶的模型。     

Steroid pulse therapy impaired endothelial function while increasing plasma high molecule adiponectin concentration in patients with IgA nephropathy.

BACKGROUND: Decreased plasma adiponectin is associated with impaired endothelial function and, thereby, increased risk for cardiovascular events. Glucocorticoid (GC) affects vascular endothelial cells either favourably or harmfully depending upon the dosages and duration. We examined the effect of GC pulse therapy on vascular endothelial function. METHODS: Fourteen young patients with IgA nephropathy were evaluated for flow-mediated vasodilation (FMD), plasma levels of adiponectin both in high molecular weight (HMW adiponectin) form and in single molecular form (total adiponectin), hepatocyte growth factor (HGF), asymmetric dimethylarginine (ADMA), and high-sensitive C-reactive protein, before and after a course of GC pulse therapy. RESULTS: GC pulse therapy significantly decreased FMD (from 7.2 +/- 2.6 to 5.7 +/- 2.5%, P < 0.01). Meanwhile, plasma adiponectin levels were significantly augmented (total adiponectin: from 10.2 +/- 4.0 to 12.1 +/- 6.3 microg/ml, P < 0.05; HMW: from 6.5 +/- 3.2 to 7.7 +/- 3.3 microg/ml, P < 0.05). In parallel, elevated concentrations of serum HGF (from 0.28 +/- 0.12 to 0.63 +/- 0.38 ng/ml, P < 0.01) and plasma ADMA (from 0.45 +/- 0.07 to 0.53 +/- 0.04 nmol/ml, P < 0.05) were observed. CONCLUSIONS: GC pulse therapy impaired endothelial function while increasing plasma adiponectin levels, which may in turn restore the endothelial function in patients with IgA nephropathy.     

中药口服与灌肠配合氦-氖激光治疗老年人慢性肾功能衰竭临床观察

观察调中益肾活血通腑中药口服与灌肠配合低能量氦 -氖激光血管内照射(ILIB)疗法对老年人慢性肾功能衰竭 (CRF)的疗效。治疗组予中药口服与灌肠配合ILIB疗法 ,并与阳性对照药依那普利作比较。结果 :两组病例在Scr、BUN、尿蛋白方面均有显著降低 ,但治疗组在改善临床症状、提高红细胞SOD及血浆免疫球蛋白方面均优于对照组。结论 :调中益肾活血通腑中药口服与灌肠配合ILIB疗法具有明显改善老年CRF的肾功能、调整胃肠机能、提高机体免疫能力的作用。     

Laparoscopic cholecystectomy and time-course changes in renal function

Background: Recently, the retraction method has been used to reduce intraabdominal pressure (IAP) during laparoscopic surgery. The purpose of this study was to determine the serial changes in renal function during laparoscopic cholecystectomy (LC) using the retraction method. Methods: Urine output, effective renal plasma flow (ERPF), and glomerular filtration rate (GFR) were measured serially in seven patients who underwent LC with 12 mmHg pneumoperitoneum (High-IAP group) and five who underwent LC using the retraction method with 4 mmHg pneumoperitoneum (Low-IAP group). Results: Urine output, ERPF, and GFR were decreased during pneumoperitoneum in the High-IAP group, whereas no significant changes in any of these parameters were observed in the Low-IAP group. Conclusions: Our findings demonstrate that reduction of IAP to 4 mmHg using the retraction method prevents the transient renal dysfunction caused by prolonged 12 mmHg pneumoperitoneum during LC, suggesting that the retraction method reduces the risk of perioperative renal dysfunction during laparoscopic surgery. Received: 26 March 1996/Accepted: 27 July 1996