Peyronie's disease:a silent consequence of diabetes mellitus

Aim:To investigate the clinical characteristics of patients with Peyronie's disease(PD)and diabetes mellitus(DM).Methods:During an 8-year period,a total of 307 men seen at our outpatient clinic were diagnosed with PD.Clinicalcharacteristics,penile deformities and the erectile status of patients with PD and DM together(n=102)were retro-spectively analyzed and compared to patients with PD alone with no risk factors for systemic vascular diseases(n=97).Results:The prevalence of PD among men with DM and sexual dysfunction was 10.7%.The mean ageof diabetic patients with PD was(55.9±8.9)years;in the no risk factor group it was(48.5±9.0)years(P<0.05).The median duration of DM was 5 years.The majority of diabetic patients with PD(56.0%)presented in the chronicphase(P<0.05),and they were more likely to have a severe penile deformity(>60°)than the no risk factor group(P<0.05).In the diabetic group,the most common presenting symptom was penile curvature(81.4 %),followedby a palpable nodule on the shaft of the penis(22.5%)and penile pain with erection(14.7 %).A total of 19.6 % ofpatients were not aware of their penile deformities in the diabetic group.Erectile function,provided by history and inresponse to intracavernosal injection and a stimulation test,was significantly diminished in patients with PD and DM(P<0.05).Conclusion:DM probably exaggerates the fibrotic process in PD.Diabetic patients with PD have ahigher risk of severe deformity and erectile dysfunction(ED).PD seems to be a silent consequence of DM andshould be actively sought in diabetic men.(Asian J Androl 2006 Jan;8:75-79)     

Renal function and 25-hydroxyvitamin D concentrations predict parathyroid hormone levels in renal transplant patients.

BACKGROUND: Recent guidelines suggest supplementation with ergocalciferol (vitamin D(2)) in chronic kidney disease stages 3 and 4 patients with elevated parathyroid hormone (PTH) levels and 25-hydroxyvitamin D (25OHD) levels <75 nmol/l. These guidelines are also applied to renal transplant patients. However, the prevalence rates of 25OHD deficiency and its association with PTH levels in renal transplant populations have not been extensively examined. We aimed to document the prevalence rates of 25OHD deficiency [defined by serum levels <40 nmol/l (<16 ng/ml)] and insufficiency [<75 nmol/l (<30 ng/ml)] in a single renal transplant centre, and examine its relationship with PTH levels. METHODS: Serum 25OHD and PTH concentrations were measured in 419 transplant patients attending a single renal transplant clinic over a 4-month period. Demographic and biochemical data were also collected, including serum creatinine, calcium, phosphate and albumin. Simple and multiple linear regression analysis were performed. RESULTS: In 27.3% of the patients, 25OHD deficiency was present, and 75.5% had insufficiency. On univariate analysis, 25OHD, serum albumin and estimated glomerular filtration rate (eGFR) were significantly associated with PTH levels (P < 0.0001, P = 0.004 and P < 0.0001, respectively). Multiple linear regression demonstrated that only 25OHD, eGFR and serum phosphate were significantly predictive of PTH levels (R(2) = 0.19, P < 0.0001). In this model, a 75 nmol/l increase in 25OHD will only result in a maximal reduction in PTH of 2.0 pmol/l. CONCLUSIONS: We conclude that 25OHD deficiency and insufficiency are common in renal transplant patients and may exacerbate secondary hyperparathyroidism. However, 25OHD, eGFR and phosphate only account for 19% of the variability in PTH levels. In addition, even a large increase in serum 25OHD levels is likely to result in only a small reduction in PTH. Therefore, alternative approaches to managing hyperparathyroidism in renal transplant recipients rather than supplementation with ergocalciferol are warranted.     

CT对肾结核的诊断意义探讨

目的探讨肾结核的CT表现，分析CT检查在肾结核诊断中的意义。方法对42例肾结核患者进行CT检查及增强扫描并结合其他临床资料作综合分析。结果CT检查肾内有低密度病灶，空洞形成，多发空洞有特征性改变。结论肾结核的CT表现有一定的特征性，CT检查优于其他方法，在肾结核的诊断中有重要意义。     

血清S100ββ变化与老年患者腹部手术后认知功能障碍的关系

目的观察老年患者腹部手术后S100β蛋白的变化以及术后认知功能障碍（POCD）的发生情况，并探讨二者的关系。方法26例65岁以上的老年患者ASAⅡ～Ⅲ级，行腹部手术。监测术前、术毕、术后6、24、48、72h血清S100β的变化，并评定术前及术后1周内的认知功能。结果老年患者血清S100β蛋白在术毕最高（P〈0．01），术后6h和24h逐渐下降，但术后48h、再次上升（P〈0．01），术后72h回复至术前水平。26例老年患者腹部手术后1周内有7例发生POCD。POCD组与非POCD组相比，术毕及术后6h血清S100β蛋白水平明显增高（P〈O．05）。结论老年患者腹部手术后POCD的发生与血清S100β蛋白的变化有密切关系。血清S100β蛋白可作为评估老年患者术后发生POCD的重要指标。     

补肾排毒合剂治疗慢性肾衰竭营养不良60例临床观察

目的:观察补肾排毒合剂治疗慢性肾衰竭营养不良的疗效.方法:90例慢性肾衰竭营养不良患者随机分为治疗组60例和对照组30例,并设健康对照组30例.治疗组和对照组在综合治疗的基础上,治疗组加用补肾排毒合剂,对照组加用爱西特和百令胶囊.比较两组肾功能、营养状态和血浆瘦素、神经肽Y的变化.结果:治疗组治疗后BUN、Scr明显降低,与治疗前及对照组相比均有统计学差异(P<0.05).治疗组营养状态好转,与治疗前及对照组相比均有统计学差异(P<0.05).两组慢性肾衰竭营养不良患者治疗前Leptin、NPY水平均高于健康组(P<0.05),治疗后治疗组Leptin、NPY较治疗前下降,有统计学意义(P<0.05),但与对照组相比无统计学差异(P＞0.05).结论:补肾排毒合剂治疗慢性肾衰竭营养不良疗效明显,可降低BUN、Scr,改善营养不良状态.     

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.     

甘草酸及肾十方治疗慢性马兜铃酸肾病26例疗效观察

目的观察甘草酸及复方中药肾十方对慢性马兜铃酸肾病的疗效。方法26例符合慢性马兜铃酸肾病的患者，给予甘草酸二铵150mg加中药复方汤剂肾十方治疗3个疗程。观察治疗前后尿素氮（BUN）、血肌酐（SCr）、尿酶及24h尿蛋白排泄量，血红蛋白、红细胞压积。结果治疗后患者临床症状有显著改善，总有效率80.76％；BUN、SCr、尿N-乙酰葡萄胺酶（NAG）、β2-微球蛋白（β2-MG）均显著下降（P〈0．05），血红蛋白、红细胞压积较治疗前升高（P〈0．05）。结论甘草酸及复方中药肾十方对慢性马兜铃酸肾病有确切的疗效。