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1.
陈莎  季杰  袁颖  姜凯  舒小华 《西部医学》2022,34(10):1487-1491
目的 探讨外周血淋巴细胞绝对计数(ALC)与老年弥漫大B细胞淋巴瘤(DLBCL)患者临床特征和R-CHOP方案化疗效果的关系。 方法 回顾性分析2017年1月~2021年2月广元市中心医院血液内科收治的老年DLBCL患者127例的相关资料,均经病理组织学确诊DLBCL且成功接受≥4个疗程R-CHOP方案化疗。依据DLBCL确诊时的ALC测定水平,将入选患者分成低ALC组(ALC<1.0×10 9/L,n=51)和高ALC组(ALC≥1.0×10 9/L,n=76),整理并比较两组系列临床特征指标的差异。依据化疗4个疗程后的疗效评估结果,将入选患者分成缓解组(完全缓解+部分缓解,CR+PR,n=92)和未缓解组(稳定+进展,SD+PD,n=35),并分析ALC水平与R-CHOP方案化疗效果的相关性。 结果 低ALC组临床分期Ⅲ~Ⅳ期、IPI评分3~5分的比重明显高于高ALC组(P<0.05),化疗前ALC水平与IPI评分呈明显负相关(r=-0.720,P<0.05)。低ALC组R-CHOP方案化疗缓解率明显低于高ALC组(P<0.05)。二元Logistic回归分析显示,临床分期Ⅲ~Ⅳ期(OR=1.691,95%CI:1.147~2.540)、IPI评分3~5分(OR=2.457,95% CI:1.561~3.713)和ALC<1.0×10 9/L(OR=1.803,95%CI:1.283~2.615)均是影响R-CHOP方案化疗效果的独立危险因素(P<0.05)。 结论 ALC不仅与老年DLBCL患者临床分期、病情危险分层紧密相关,而且ALC降低是影响R-CHOP方案化疗效果的危险因素。  相似文献   
2.
Infertility is a major health issue affecting over 48.5 million couples around the world, with the male factor accounting for about 50% of the cases. The conventional semen analysis recommended by the World Health Organization (WHO) is the cornerstone in the evaluation of male fertility status. It includes macroscopic and microscopic evaluation of the ejaculate, which reflects the production of spermatozoa in the testes, the patency of the duct system and the glandular secretory activity. Evaluation of seminal fructose, sperm vitality and leucocytes (Endtz test) are useful adjuncts to semen analysis that provide information on specific clinical conditions. Though several computer-assisted sperm analysis (CASA) systems have been developed, conventional methods for semen analysis are still widely accepted in clinical practice. This review summarises the conventional techniques used in routine semen analysis and their diagnostic value in clinical andrology.  相似文献   
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Male congenital hypogonadotropic hypogonadism (CHH) is a heterogenous group of genetic disorders that cause impairment in the production or action of gonadotropin releasing hormone (GnRH). These defects result in dysfunction of the hypothalamic-pituitary-gonadal hormone axis, leading to low testosterone levels and impaired fertility. Genetic testing techniques have expanded our knowledge of the underlying mechanisms contributing to CHH including over 30 genes to date implicated in the development of CHH. In some cases, non-reproductive signs or symptoms can give clues as to the putative genetic etiology, but many cases remain undiagnosed with less than 50% identified with a specific gene defect. This leads to many patients labelled as “idiopathic hypogonadotropic hypogonadism”. Medical and family history as well as physical exam and laboratory features can aid in the identification of hypogonadotropic hypogonadism (HH) that is associated with specific medical syndromes or associated with other pituitary hormonal deficiencies. Genetic testing strategies are moving away from the classic practice of testing for only a few of the most commonly affected genes and instead utilizing next generation sequencing techniques that allow testing of numerous potential gene targets simultaneously. Treatment of CHH is dependent on the individual’s desire to preserve fertility and commonly include human chorionic gonadotropin (hCG) and recombinant follicle stimulating hormone (rFSH) to stimulate testosterone production and spermatogenesis. In situations where fertility is not desired, testosterone replacement therapies are widely offered in order to maintain virilization and sexual function.  相似文献   
5.
The objective of this study was to investigate the impact of male age, semen quality and days of ejaculatory abstinence on embryo morphokinetics. A total of 1,220 zygotes obtained from 139 couples in a private in vitro fertilisation centre were analysed. The timing of specific events from the point of insemination, such as timings to pronuclei appearance and fading, to two, three, four, five, six, seven and eight cells and to blastulation were recorded. Multivariate linear regression analysis was used to evaluate the influence of paternal factors on embryo morphokinetic events. Paternal age was positively correlated with delayed cell cleavage and blastulation, and negatively associated with implantation rate, and clinical pregnancy and live–birth chances. The ejaculatory abstinence was inversely correlated with the implantation rate. Inverse relationships were observed between semen parameters (sperm count, progressive sperm motility, total motile sperm count and morphology) and the timing of specific events during embryo development. Sperm morphology was also positively associated with implantation rate and pregnancy and live–birth chances. Increased paternal age and ejaculatory abstinence, and poor semen quality correlate with delayed cell cleavage and blastulation and negatively impact intracytoplasmic sperm injection outcomes.  相似文献   
6.
目的探讨封闭负压引流术(VSD)结合重组人表皮生长因子(rhEGF)治疗老年性糖尿病溃疡创面的临床疗效。方法选择2017年8月—2019年6月64例老年性糖尿病慢性溃疡创面患者为研究对象,随机分成观察组32例与对照组32例,观察组采用封闭负压引流术+重组人表皮生长因子的方法,对照组采用封闭负压引流术+常规换药的方法,比较两组的创面愈合时间和换药次数。结果两组64例治疗后慢性溃疡创面全部瘢痕愈合。观察组创面愈合时间24~45 d,平均愈合时间(32.06±7.76)d,对照组创面愈合时间33~56 d,平均愈合时间(44.14±9.67)d,两组数据比较差异有统计学意义(t=4.652,P<0.05)。观察组换药次数11~23次,平均(16.73±4.21)次,对照组换药次数18~33次,平均(25.09±6.34)次,两组数据比较差异有统计学意义(t=6.214,P<0.05)。结论封闭负压引流术结合重组人表皮生长因子的方法能有效促进老年性糖尿病溃疡创面愈合。  相似文献   
7.
目的探讨麝香通心滴丸治疗高龄冠心病并肺部感染患者的疗效及对白细胞介素-6(IL-6)、降钙素原(PCT)水平的影响。方法前瞻性选取2018年9月至2020年8月秦皇岛市第二医院收治的120例冠心病并肺部感染患者,随机数字表法分成常规组与研究组,各60例。常规组给予基础治疗,研究组在基础治疗上加麝香通心滴丸治疗。观察并记录2组患者治疗前、治疗4周后的每周心绞痛发作次数及持续时间、肺部啰音持续时间及退热时间及血浆IL-6、PCT水平,并评估整体临床疗效。结果治疗前,2组患者心绞痛发作次数及持续时间、肺部啰音持续时间、退热时间比较,差异均无统计学意义(P>0.05);治疗4周后,研究组患者心绞痛发作次数[(6.04±1.31)次/周]明显少于常规组[(3.31±0.86)次/周],心绞痛发作持续时间、肺部啰音持续时间、退热时间为(2.35±0.52)min、(6.38±1.27)d、(2.13±0.72)d,均明显短于常规组[(5.24±0.73)min、(9.53±1.93)d、(4.85±1.03)d],差异均有统计学意义(P<0.05)。治疗4周后,研究组总有效率为96.67%,显著高于常规组的78.33%,差异有统计学意义(P<0.05)。治疗前,2组患者血浆IL-6、PCT水平比较,差异均无统计学意义(P>0.05);治疗4周后,研究组患者血浆IL-6、PCT水平为(11.36±5.21)ng/L、(3.15±0.22)μg/L,均明显低于常规组[(19.61±6.45)ng/L、(5.77±1.06)μg/L],差异均有统计学意义(P<0.05)。结论麝香通心滴丸可改善冠心病与肺部感染症状,并具有较好的炎症反应抑制作用,是临床治疗高龄冠心病合并肺部感染的有效药物。  相似文献   
8.
Male infertility is a multifactorial condition associated with different genetic abnormalities in at least 15%–30% of cases. The purpose of this study was to identify suspected correlations between infertility and polymorphisms in mitochondrial NADH dehydrogenase subunits 3 and 4L (MT-ND3 and MT-ND4L) in subfertile male spermatozoa. Sanger sequencing of the mitochondrial DNA target genes was performed on 68 subfertile and 44 fertile males. Eight single nucleotide polymorphisms (SNPs) in MT-ND3 (rs2853826, rs28435660, rs193302927, rs28358278, rs41467651, rs3899188, rs28358277 and rs28673954) and seven SNPs in MT-ND4L (rs28358280, rs28358281, rs28358279, rs2853487, rs2853488, rs193302933 and rs28532881) were detected and genotyped. The genotypes and allele frequencies of the study population have shown a lack of statistically significant association between MT-ND3 and MT-ND4L SNPs and male infertility. However, no statistically significant association was found between the asthenozoospermia, oligozoospermia, teratozoospermia, asthenoteratozoospermia, oligoasthenoteratozoospermia and oligoteratozoospermia subgroups of subfertile males. However, rs28358278 genotype of the MT-ND3 gene was reported in the subfertile group but not in the fertile group, which implies a possible role of this SNP in male infertility. In conclusion, the investigated polymorphic variants in the MT-ND3 and MT-ND4L genes did not show any significant association with the occurrence of male infertility. Further studies are required to evaluate these findings. Moreover, the subfertile individuals who exhibit a polymorphism at rs28358278 require further monitoring and evaluation.  相似文献   
9.
淫羊藿是一种常用的中药材,淫羊藿苷是从淫羊藿中提取的一种黄酮类化合物,也是淫羊藿中最主要的活性物质。研究发现,淫羊藿苷具有促进成骨细胞的生成和活化、调节免疫、抗衰老和抗炎等多种功能。临床上淫羊藿(苷)用于治疗生殖系统、骨关节系统、呼吸系统、神经系统、心血管系统和免疫系统等多种疾病。淫羊藿(苷)对男性生殖系统的作用及机制主要包括具有雄性激素样作用,促进睾内睾酮的合成和分泌。淫羊藿(苷)通过改善精子发生的微环境、增强睾丸抗氧化作用促进精子生成,增加精子密度,改善精子活力,减缓生殖衰退。此外,淫羊藿(苷)可促进阴茎勃起,治疗勃起功能障碍及早泄。  相似文献   
10.
[目的] 讨论桂枝加龙骨牡蛎汤方证病机,并阐发其男科应用。[方法] 以《金匮要略》桂枝加龙骨牡蛎汤条文为研究对象,结合《内经》《血证论》《金匮悬解》《订正仲景全书金匮要略注》等相关著作论述,从经方方证的不同见解、脾胃虚衰角度的经方条文内涵讨论、“失精”男科涵义与应用拓展以及方证内涵与中虚精变理论的契合性等方面,阐发其男科应用。[结果] 桂枝加龙骨牡蛎汤方证病机以阴阳俱虚为前提,历代医家具有肝肾亏损、心肾失交、脾胃不足等不同见解,但经过方药功效的反推后,提示其根本病机应在于阴阳俱虚之脾胃不足,经方条文诸症可分别对应到脾虚不摄、不运和不温中。经方所治“失精”虽有广义与狭义之分,但皆可从脾虚角度解释,桂枝加龙骨牡蛎汤借助于补益脾胃,对“失精”起到治疗作用。同时,立足桂枝加龙骨牡蛎汤方证内涵与中虚精变理论的契合性,可将其纳入中虚精变理论指导下的方剂范畴,并用以临床治疗。 [结论] 桂枝加龙骨牡蛎汤立足补益中焦、兼顾收敛固摄,从而达到治疗“失精”的目的,对男科临证的理解和经方运用,具有启发价值。  相似文献   
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