低能量冲击波治疗勃起功能障碍疗效及安全性:随机对照试验的meta分析

目的:依据现有临床证据评价低能量冲击波(LI-ESWT)治疗勃起功能障碍(ED)的临床疗效及安全性。方法:通过计算机检索PubMed、Medline、EMBASE、Cochrane图书馆和CNKI、VIP、CBM、万方数据库建库至2018年6月有关LI-ESWT治疗ED的随机对照试验(RCT),由2名研究者按照纳入与排除标准进行文献筛选、资料提取和质量评价,并采用RevMan 5.3软件进行meta分析。结果:共纳入来自8项随机双盲对照研究的595例ED患者,其中LI-ESWT治疗组362例,对照组233例。meta分析结果显示,与对照组相比较,LI-ESWT治疗可显著提高ED患者的IIEF评分[WMD=1.70, 95%CI (0.44, 2.96),P=0.008]和勃起硬度分级(EHS)[RR=11.72, 95%CI (5.13, 26.80),P0.01]。进一步分析表明LI-ESWT治疗后随访4周和24周ED患者的IIEF评分均显著提高[WMD=1.43, 95%CI (0.10, 2.75),P=0.03; WMD=3.09, 95%CI (1.49, 4.68),P=0.000 2];LI-ESWT治疗10～12次ED患者的IIEF评分显著提高,而治疗5～6次IIEF评分并未显示出明显增加[WMD=1.81, 95%CI (0.31, 3.31),P=0.02; WMD=1.88,95%CI (-2.10, 5.86),P=0.35];基线IIEF≥12分ED患者LI-ESWT治疗后IIEF评分明显增加而基线IIEF≤11分治疗后IIEF评分并未显示出明显增加[WMD=2.13, 95%CI (0.51, 3.75),P=0.01; WMD=1.04, 95%CI (-0.96, 3.03),P=0.31]。8项研究报告了LI-ESWT治疗后均无明显不良反应发生。结论:LI-ESWT作为一种非侵入性治疗手段,其可明显改善ED患者的IIEF评分和EHS分级,临床应用安全有效。     

精液中生精细胞与白细胞四种鉴别方法的比较与评价

本文报告了精液中生精细胞四种鉴别方法，根据生精细胞与体细胞的分裂规律，采用染色体荧光原位杂交技术，根据细胞表面标志，采用鼠抗人ＣＤ４５、ＣＤ３，ＣＤ４，ＣＤ８，ＭｃＡｂ进行识别；根据细胞形态特征，用瑞－姬染色法识别，各实验室可根据条件，选择两种以上检测方法，以提高精液中白细胞检测水平。     

皮肤病学文献数据库及其检索系统的初步研究

本文介绍了应用FOXBASE2.1中文数据库设计、建立的皮肤病文献专题数据库及其检索系统。该系统具有多种检索方式,可提供著者、分类、关键词等项目的检索,并具有数据的追加、修改、删除、查询、备份及打印等功能。     

记忆合金环抱器在复杂骨折治疗中的应用

对于一些特殊类型骨折以及严重的粉碎性骨折，传统的内、外固定方式难以固定，或固定效果不确切，不利于早期功能锻炼，影响骨折的愈合。NiTi记忆合金是近年来应用于骨折固定的新型内固定材料，自1998～2003年我们采’用记忆合金环抱器治疗各种复杂骨折17例，取得了满意的疗效。     

128对不育夫妇血清、精浆抗精浆免疫抑制物抗体与精液检查关系的分析

我们检测了８９对生育夫妇和１２８对不育夫妇血清、精浆中抗精浆免疫抑制物抗体（ＳＰＩ—Ａｂ）的水平。结果表明，不育夫妇血清、精浆ＳＰＩＭ—Ａｂ的水平和检出率均明显高于生育组（Ｐ＜０．０１）；精浆ＳＰＩＭ—Ａｂ水平增高者的精子密度、精子活率、精子运动速度和ＳＰＩＭ活性均明显降低（Ｐ＜０．０１）。提示：ＳＰＩＭ—Ａｂ水平增加可能影响生育。     

RGD多肽接枝聚复合导管桥接神经缺损的实验研究

Objective To investigate the effect of RGD peptide conjugated poly[ LA-(Glc-Lys) ]/βTCP/PLA nerve conduit for bridging peripheral nerve regeneration defect. Methods Forty-five male Wister rots were randomly divided into 3 groups, with 15 rats each. A 10 mm defect was created in the right sciatic nerve. In group A the gap was bridged by PLA tube. In group B RGD peptide conjugated poly[ LA-(Glc-Lys) ]/β-TCP/PLA nerve conduit was used to repair the defect. Autologous nerve graft was done in group C which served as control. Twelve weeks postoperatively nerve regeneration was evaluated by gross observation,electrophysiology, muscle weight and muscle morphometry of triceps surae, and ultrastructure of the regenerating nerve. Results Twelve weeks after the operation, nerve conduction velocity and muscle weight recovery of group B were better than those of group A. The differences were statistically significant( P < 0.05). There was no significant difference between group B and group C ( P > 0. 05). The results of histology and ultrastructure showed that nerve regeneration in group B and group C was significantly superior to that in group A.Conclusion RGD peptide conjugated poly[LA-(Glc-Lys)]/β-TCP/PLA conduit can achieve similar results in repairing sciatic nerve defect to that of autogentic nerve graft. It may be an ideal material to repair nerve defect.     

空心加压螺纹钉结合钢丝治疗髌骨体部横形骨折

髌骨骨折在骨科领域属常见骨折，一般累及髌骨的中1/3，常伴有分离移位，需手术内固定治疗。由于是关节内骨折，后关节面不平整容易造成创伤性关节炎，故对复位要求较高。单纯钢丝环扎因固定欠牢靠，需辅助长时间外固定，不利于膝关节早期功能锻炼，目前逐步摒弃而被张力带取代。我院自2003年2月至2006年10月采用2枚空心加压螺纹钉结合钢丝治疗髌骨体部横形骨折25例，取得良好效果。[第一段]     

THE ACTION OF RADIX REHMANNIAE AND PLASTRUM TESTUDINIS ON BETA- ADRENERGIC RECEPTOR-cAMP SYSTEM

Mouse and rat pathological models were pro duced by injections of thyroid hormone (T3 0r T4, Model. I) or hydrocortisone (HC, Model II). A single subcutaneous dose of isoproterenol (ISO) caused plasma cAMP to peak in 5-15 min which was significantly higher in mouse Models I and II than in normal mice. Daily oral administration of a decoction of two Yin tonics-Radix Rehmanniae (RR) and Plastrum Testudinis (PT) reduced peak cAMP in both models. 3H.DHA binding assay re vealed significant elevations of the number of 3 adrenergic receptors in rat Models I and II. Decoc- tion RR and PT restored the peaks to normal range. Yang tonics Radix Aconiti praeparata (RAP) and Cortex Cinnamomi (CC) showcd contradictory effects on these models. It seems unlikely that the action of the two tonics promotes the dlearance of injected hormones, since injected hormone RIA iii plasma showed no differences between Yin tonics treated and untreated models. The therapeutic effects of these two Yin tonics on "Yin deficiency" syndrome of hyperthyroidism or hyperfunction of the adrenal cortex is very probably related to their actions on the O-adrenoreceptor-cAMP system as stated.