Effect of Chronic Administration of PDE5 Combined with Glycemic Control on Erectile Function in Streptozotocin‐Induced Diabetic Rats

IntroductionChronic treatment with phosphodiesterase type 5 inhibitors (PDE5) is effective in an animal model of diabetes‐induced erectile dysfunction (DMED). In addition, recent research indicates that glycemic control can restore DMED.AimsWe evaluated the effect of chronic administration of PDE5 combined with glycemic control on DMED.MethodsSprague‐Dawley rats (8 weeks old) were divided into five groups (n = 10 each): normal control (C), diabetes (DM), DM treated with insulin (DM‐I), DM treated with PDE5 (DM‐P), and DM treated with insulin and PDE5 (DM‐I + P). Rats in the diabetic groups received an injection of streptozotocin (45 mg/kg). After 10 weeks of induced diabetes, the DM‐I group was treated with a daily injection of neutral protamine Hagedorn, and the DM‐P group was treated with a daily dosage of 20 mg/kg PDE5 (DA‐8159) for 4 weeks. The DM‐I + P group was treated with both treatments simultaneously. After 14 weeks of induced diabetes, an evaluation of erectile function and histological and biochemical markers of corporal tissue was performed.Main Outcome MeasuresErectile function and histological and biochemical markers in corporal tissue.ResultsRats in the DM group showed markedly lower erectile parameters than those in the C group, whereas rats in the DM‐I and DM‐P groups showed intermediate erectile function between the DM and C groups. Rats in the DM‐I + P group showed restored erectile function, comparable with group C. A comparison of apoptotic index, expression of the endothelial marker, and phosphorylation of endothelial nitric oxide synthase and Akt displayed a similar pattern with the results from cavernosometry (DM < DM‐I = DM‐P < DM‐I + P = C, P < 0.05). The distribution of phosphorylated myosin phosphatase target subunit 1 was in the reverse order.ConclusionsChronic administration of PDE5 or glycemic control with insulin resulted in restoration of overt DMED. The combination of both treatments was superior to monotherapy with insulin or PDE5. Choi WS, Kwon OS, Cho SY, Paick J‐S, and Kim SW. Effect of chronic administration of PDE5 combined with glycemic control on erectile function in streptozotocin‐induced diabetic rats. J Sex Med 2015;12:600–610.     

经自然腔道取标本手术在结直肠外科手术中的应用进展

随着腔镜技术的进一步发展以及微创理念应用于结直肠外科疾病的诊治中,结直肠相关疾病的诊治发生了翻天覆地的变化。由传统的经腹手术到腹腔镜手术、经自然腔道手术,再到经自然腔道取标本手术(NOSES),结直肠疾病的外科诊治在微创领域取得了巨大成果。NOSES技术是目前结直肠外科在微创领域前沿的手术方式之一,它通过经直肠、阴道取标本来避免了腹壁的辅助取标本切口,从而将结直肠外科手术进一步微创化。NOSES技术集传统腹腔镜手术的优势与现代微创外科的理念于一体,它在确保手术效果的基础上集中体现了微创、加速康复外科、功能外科、"无疤"等理念的特点。本文主要就国内外各中心开展NOSES技术在结直肠外科诊治开展中的相关经验、心得和体会进行综述。     

脑出血后血肿周围组织的磁共振灌注成像研究

目的:利用磁共振灌注成像观察脑出血后组织血流动力学变化,并对其机制和意义进行初步探讨。方法:10例发病2周以内脑出血患者行磁共振动态磁化增强灌注成像。6例发病24h脑出血患者行流动敏感交互式反转恢复(FAIREST)磁共振灌注成像。结果:血肿周围MTT较对侧延长,平均延长(0.458±0.945)s(P<0.01),MTT延长与血肿体积无明显相关性(r=0.32,P=0.08)。6例行FAIREST灌注成像2例血肿周围CBF较对侧明显减低,3例变化不明显,1例上升。结论:本组磁共振灌注成像未发现脑出血周围组织不可逆转的缺血,但存在血肿周围组织血量减少。FAIREST技术有一定的临床实用价值。     

展望受体低氧预适应在原位肝移植中的应用

了解原位肝移植过程中无肝期门静脉淤血引起的肠道淤血性缺氧对肝完全缺血再灌注损伤的影响以及肠道缺氧低氧耐受的内源性保护机制。采用文献回顾的方法加以综述。对肝移植受体肠道黏膜屏障功能的保护可减轻移植肝脏再灌注损伤。受体低氧预适应可能为移植肝脏再灌注损伤的保护提供一条全新的途径。     

外源性p53对不同LET辐射诱导人黑色素瘤细胞系A375死亡途径的影响

目的 观察外源性P53蛋白对不同传能线密度(LET)射线辐照诱导肿瘤细胞凋亡和坏死的影响,并探讨其可能的机制。方法 人黑色素瘤细胞系A375(wild-type p53)经携带人野生型p53基因的腺病毒载体(AdCMV-p53)感染后分别给予X射线和碳离子束照射,采用克隆形成法测定细胞辐射敏感性,Hoechst 33258和吖啶橙-溴化乙锭双染荧光显微镜下观察细胞凋亡和坏死。结果1高LET辐照时,A375细胞和转导人野生型p53基因的A375细胞(A375/p53)的辐射敏感性没有明显差异;2虽然辐射诱导细胞凋亡比例的增加依赖于LET升高,但是无论高LET或低LET,外源性P53蛋白均可有效诱导细胞凋亡。3高LET辐照时,A375细胞的坏死细胞明显高于A375/p53细胞。结论 尽管高LET辐射对A375和A375/p53细胞的存活无明显影响,但是对细胞凋亡的诱导却部分依赖于P53蛋白的功能,P53蛋白可能在调节细胞死亡类型中发挥重要作用。这对临床应用高LET辐射联合p53基因治疗恶性黑色素瘤有一定参考意义。     

全直肠系膜切除术治疗直肠癌--附168例报告

目的　探讨全直肠系膜切除术在预防直肠癌术后局部复发中的作用 ,以及同该操作相关的一些并发症。方法　回顾性分析 16 8例直肠癌的临床资料。结果　全组无手术死亡 ,术后随访1～ 36月 ,局部复发 6例 (3.6 % ) ,术后吻合口漏 13例 (10 .7% ) ,多数保肛患者出现便频、便急等症状。结论　全直肠系膜切除术能有效降低直肠癌术后局部复发率 ,提高保肛率 ,但存在吻合口漏 ,控便功能等问题需进一步解决。     

锁孔入路显微手术的临床应用

目的探讨锁孔入路显微手术在神经外科的应用. 方法采用相应锁孔入路对鞍区占位13例,脑膜瘤6例,高血压性脑出血5例,胼胝体区胶质瘤2例,听神经瘤2例,脑转移瘤、硬膜外血肿和C2椎管内占位各1例实施手术. 结果 25例肿瘤全切19例,次全切除6例;脑出血5例和硬膜外血肿1例均彻底清除.1例听神经瘤术后第3天因瘤腔再次出血死亡,切口下皮下积液2例,一过性尿崩3例. 结论锁孔手术具有脑暴露少,损伤小,并发症少,恢复快等优点.     

日本血吸虫感染小鼠脾细胞IL—2及IFN—γ动态观察

本文观察８ｗｋ龄Ｃ５７ＢＬ／６小鼠感染日本血吸虫尾蚴后不同时期脾细胞经ＳＥＡ或ＣｏｎＡ刺激，体外诱生的ＩＬ－２和ＩＦＮ－γ活性变化。结果表明两种细胞因子活性均在感染后第４－６ｗｋ开始上升，第６—８ｗｋ达高峰，第１２—１４ｗｋ恢复至感染前水平。ＩＦＮ－γ高峰时间略先于ＩＬ－２。非特异性刺激原诱生组和特异性刺激原诱生组各阶段细胞因子活性动态基本一致，前组活性高于后组。提示ＩＦＮ－γ与ＩＬ－２活性与血吸虫卵肉芽肿的诱导、成熟与维持有密切关系。