中老年人认知功能与未来跌倒事件的关联研究

目的 探究中国社区中老年人认知功能与未来跌倒事件的关系。 方法 根据2013年和2015年中国健康与养老追踪调查(China Health and Retirement Longitudinal Study, CHARLS)数据分析社区中老年人跌倒的危险因素,采用多阶段的二分类logistic回归模型探究认知功能与跌倒的关系。 结果 共纳入中老年人4095例,年龄均≥45岁,认知功能得分(11.27±3.85)分。我国社区中老年人两年内跌倒发生率为19.41%。多阶段logistic回归结果显示,控制其他因素后,在认知功能的四个维度中,记忆力降低会增加跌倒风险,而时间定向力、注意力和视觉空间能力对跌倒的影响均无统计学意义(均P<0.05)。结论 我国社区中老年人的跌倒发生率较高,值得关注。早期记忆力损害可作为预测中老年人跌倒的因素之一。     

Erectile dysfunction. Is an oral medication during the diagnostic pathway indicated?

For patients with erectile dysfunction oral medication seems to be the most comfortable form of application. This can also be seen in the expectations looking forward to Sildenafil and other drugs in development. We present a prospective examination with the oral medication of 100 mg acecarbamol, 30 mg extract of cortex quebracho and 33 mg tocopherol acetate (Afrodor) in 100 patients complaining secondary erectile dysfunction. The patients were treated unselected with 3 x 1 tablet/day during the diagnostic schedule. 14% of the patients were able to perform satisfying sexual intercourse after 4 weeks of medication and another 15% showed an increased libido. Therefore we suggest, that the application of an oral medication, might be useful, especially during the time of diagnostics. Especially for those patients who gain without invasive diagnostic tools as intracavernous injection.     

Cross-cultural development of a quality of life measure for men with erection difficulties

Erection difficulties have a profound effect on a man's quality of life, however, the emotional consequences are often overlooked in quantitative research where most sex-related questionnaires focus on a man's functional ability. Consequently, we developed a cross-cultural instrument to measure quality of life specific to male erection difficulties (QOL-MED). The items in the QOL-MED originated from interviewing forty men with erection difficulties in Seattle and Boston. Twelve men in the USA and 29 men in England helped us refine the instrument. Testing the QOL-MED's psychometric properties involved two administrations over a two-week period in the USA (n=40) and the UK (n=29). For discriminant validity, we predicted quality of life would worsen with increased self-perceived severity of the condition. After controlling for years with erection difficulties in a linear regression model, we found a significant negative association between self-perceived severity and quality of life for men in the UK only (p<0.01). The expectation that the measure would produce evidence for convergent validity by being more closely correlated to well-being than functional status was not confirmed. Both the USA and UK instruments were internally consistent (Cronbach's =0.94 and 0.96, respectively), and reproducible (0.78 and 0.95, respectively). This instrument provides a promising tool for studying therapies and understanding quality of life in patients with erectile dysfunction.This research was supported from a research grant from Syntex, Inc.Mr. Wagner is now a doctoral student at the University of California at Berkeley, Berkeley, CA, USA.     

国产枸橼酸西地那非片治疗男性勃起功能障碍疗效和安全性的临床研究

目的评价口服国产枸橼酸西地那非片治疗男性勃起功能障碍的临床有效性和安全性。方法采用多中心、随机、双盲、安慰剂、平行对照的方法，对240例患进行为期8周的临床观察，评价标准包括：国际勃起功能指数(IIEF)、记事本、总评题。结果西地那非组皿亚评分明显高于安慰剂组(P＜0．01)，记事本、总评题结果西地那非组亦明显优于安慰剂组，无不良反应中断研究。结论国产枸橼酸西地那非片是治疗男性勃起功能障碍的有效和安全的药物。     

宫血净口服液治疗崩漏的止血机理研究

目的:探讨宫血净口服液治疗崩漏的止血机理.方法:通过宫血净口服液与血康口服液对气虚血淤动物模型作用的相关指标的测定,采用单因素方差分析的统计学方法来分析宫血净口服液治疗崩漏的止血机理.结果:宫血净口服液能降低大鼠全血粘度比、血浆粘度、全血低切还原粘度、全血低切相对粘度,宫血净大剂量组与模型组对照,全血低切相对粘度、全血低切还原粘度数数值有极显著差异(P＜0.01),全血粘度比(高低切)、血浆粘度有显著性差异(P＜0.05);其中全血粘度比(低切)与血康组比较有显著性差异(P＜0.05);宫血净小剂量组与模型组对照全血低切相对粘度、全血低切还原粘度值有极显著性差异(P＜0.01),全血粘度比(高、低切)、血浆粘度有显著性差异(P＜0.05),与血康组比较,全血粘度比(高、低切)有显著性差异(P＜0.05);明显延长BT、CT,以小剂量组明显(P＜0.01);宫血净口服液大剂量组使E2上升,与模型组E2对照,有显著性差异(P＜0.05);宫血净口服液小剂量组有增强大鼠子宫收缩力的作用,使子宫平滑肌收缩幅度提高,活动力增强;阳性对照组有抑制子宫收缩幅度及收缩活动力的作用.结论;宫血净口服液治疗崩漏的止血机理上是一综合作用.     

Development and initial validation of a new preference-based disease-specific health-related quality of life instrument for erectile function

Health-related quality of life instruments may be generic or specific. In general, only generic instruments use preference-based scoring. We report on a novel approach to combine in one instrument the strengths of the specific approach, greater disease relevance and responsiveness, with those of preference-based scoring, generalizability through utilities. OBJECTIVES: The primary objective was to develop a self-administered, preference-based instrument capable of measuring utilities in the disease-specific context of erectile dysfunction (ED). METHODS: Content derivation/validation began with a literature review. Eight attributes (domains) were selected to provide clinical experts structure for focus group discussion. Four levels describing a continuum of dysfunction-function were defined for each domain. Each domain, including functional levels, was reviewed and modified until consensus was achieved regarding content. This content was then integrated into a preference based scoring instrument using two visual analogue scales (VAS) with which patients rated three 'marker' health states (representing mild, moderate and severe ED), their self-state and a previously validated external marker state. The instrument was pilot tested, and implemented in a clinical trial. Initial validation analyses have been performed. RESULTS: A self-administered, preference-based, VAS instrument was developed for use in the ED population, and the instrument was feasible to complete, was reliable beyond the threshold of acceptability established a priori and demonstrated good validity. Evidence of these properties accumulates over time and this study begins that process with this instrument. Responsiveness is being assessed in the context of a clinical trial.     

Clinical observations on electroacupuncture treatment of unstable bladder

目的:对电针治疗不稳定膀胱进行临床疗效评价.方法:将患者随机分为电针组和对照组,根据治疗前后临床症状积分和生活质量评分的改善情况进行疗效评价.结果:观察指标两组治疗后均较治疗前显著降低(P＜0.05),两组间比较临床症状积分无显著性差异(P＞0.05);生活质量评分电针组较手法组下降明显(P＜0.05).结论:两种治疗方法对不稳定膀胱均有改善,其中电针组生活质量满意度要优于手法组,临床症状积分有低于手法组的趋势.     

Longitudinal Patterns of Occurrence and Remission of Erectile Dysfunction in Men With Type 1 Diabetes

BackgroundMen with diabetes are at greater risk of erectile dysfunction (ED).AimTo describe the natural history of ED in men with type 1 diabetes.MethodsWe examined up to 30 years of prospectively collected annual ED status and demographic and clinical variables from 600 male participants in the Diabetes Control and Complications Trial (DCCT; 1983–1993) and its follow-up study, the Epidemiology of Diabetes Interventions and Complications (1994–present; data in this study are through 2012).OutcomesYes vs no response to whether the participant had experienced impotence in the past year and whether he had used ED medication.ResultsSixty-one percent of men reported ED at least once during the study. For some men, the initial report of ED was permanent. For others, potency returned and was lost multiple times. Visual display of the data showed four longitudinal ED phenotypes: never (38.7%), isolated (6.7%), intermittent (41.8%), and persistent (12.8%). Men who never reported ED or in only 1 isolated year were younger, had lower body mass index, and better glycemic control than men in the intermittent and persistent groups at DCCT baseline. In a multivariable logistic model comparing men at their first year reporting ED, men who were older had lower odds of remission and men who were in the conventional DCCT treatment group had higher odds of remission.Clinical TranslationIf validated in other cohorts, such findings could be used to guide individualized interventions for patients with ED.Strengths and LimitationsThis is the first examination of ED with repeated measures at an annual resolution, with up to 30 years of responses for each participant. However, the yes vs no response is a limitation because the real phenotype is not binary and the question can be interpreted differently depending on the participant.ConclusionsAge, glycemic control, and BMI were important longitudinal predictors of ED. We have described a more complex ED phenotype, with variation in remission patterns, which could offer insight into different mechanisms or opportunities for intervention. If validated in other cohorts, such findings could be used to establish more accurate prognostication of outcomes for patients with ED to guide individualized interventions.Palmer MR, Holt SK, Sarma AV, et al. Longitudinal Patterns of Occurrence and Remission of Erectile Dysfunction in Men With Type 1 Diabetes. J Sex Med 2017;14:1187–1194.     

壮阳药效动物实验评价方法的改进

目的 对壮阳药效评价方法进行优化,以探求更为有效的候选药物筛选方法.方法 模型组大鼠均灌胃给予西地那非10 mg/kg,对照组大鼠给予相同容量的生理盐水灌胃,每天1次,连续灌胃给药14 d.每次给药后连续记录2h内大鼠阴茎勃起、阴部理毛、爬背次数和参与动物数,并计算PEI值.采用改良的壮阳药效评价方法,整个过程采用摄像头观察并在不同时间段给予雌鼠诱导.结果 在雌鼠诱导组中,模型组大鼠给药后2 h PEI值较对照组明显升高(P＜0.05).在模型组中,与人为观察组相比,摄像头观察组大鼠给药后2 h PEI值明显升高(P＜0.05)；与非雌鼠诱导组相比,雌鼠诱导组大鼠给药后2 h PEI值明显升高(P＜0.05)；与持续诱导组相比,间断诱导组2h PEI值无明显差异,但60 ～ 120 min时间段PEI值明显升高(P＜0.05).结论优化后的壮阳药效评价方法能更为有效的评价候选药物的壮阳药效.