男性青年性兴奋前后生殖器和性激素的测定

作者对３１例健康男性青年（年龄２１－２５岁，平均２３岁）进行了性兴奋前后生殖器和血清性激素水平测定。结果阴茎牵长与勃起时长度呈高度正相关（ｒ＝０．９７５），性兴奋后较性兴奋前睾丸容积轻度增加，血清Ｔ水平明显增高，ＦＳＨ，ＬＨ和Ｅ２变化不大。提示：可用阴茎牵长替代勃起时长度的测量。在性兴奋期血清Ｔ起主导作用，与ＦＳＨ，ＬＨ和Ｅ２无明显关系。     

老年男性性激素与骨密度测定

目的　为了解老年男性的骨密度和性激素水平,以探讨性激素在老年男性骨质疏松症发病机理中的作用。方法　６３ 例老年男性分为骨质疏松组与非骨质疏松组,测定骨密度（ＢＭＤ）、血清睾酮（Ｔ）、雌二醇（Ｅ２）、黄体生成素（ＬＨ）、促卵泡刺激素（ＦＳＨ）水平,并与３７ 例青年男性对照。结果　老年男性之ＢＭ Ｄ、Ｔ、Ｅ２ 明显低于青年对照组,而ＬＨ、ＦＳＨ 增高明显。老年男性骨质疏松症的发病率为３９．６８％ 。骨质疏松组与非骨质疏松组比较,Ｔ、Ｅ２ 明显降低,ＬＨ、ＦＳＨ 明显增高,尤以Ｔ 降低明显。结论　由于增龄性激素不足引致骨丢失,雄激素降低可能是老年男性骨质疏松症的主要原因。     

生殖激素检测在男性不育症诊断中的意义

本文报道了我院对３１５例男性不育症患者在第一次就诊时进行血清生殖激素ＦＳＨ、ＬＨ、Ｔ、ＰＲＬ、Ｅ２水平的检测，并进行详细的病史询问、常规体检和精液分析等检查。结果显示血清Ｔ值在不同的精子密度层次的男性不育症患者均呈正态分布。睾丸容积减少，ＦＳＨ、ＬＨ上升，Ｔ／ＬＨ下降，提示睾丸功能损害，并且Ｔ／ＬＨ的比值更能反映间质细胞的功能。血清ＰＲＬ和Ｅ２值在诊断高催乳素血症不育有意义，但在男性生育者和不生育者之间无明显差别。而且ＦＳＨ值在鉴别睾丸原发性与梗阻性无精子症是一项重要指标。作者讨论了血清生殖激素测定在不育症诊断中、在判定睾丸功能的损害程度中的意义。     

白血病患者异基因骨髓移植后性激素含量的变化

观察了１９例白血病患者异基因骨髓移植后的性腺功能，测定了卵泡刺激素（ＦＳＨ）、黄体生成素（ＬＨ）和睾丸酮（ＴＴ）及雌二醇（Ｅ２）的血清浓度，结果女性患者都有性腺功能低下的临床表现，Ｅ２极低，均低于１８．４ｐｍｏｌ／Ｌ，ＦＳＨ和ＬＨ显著增高；男性患者性功能无明显减退，ＬＨ和ＴＴ正常或接近正常，９例男性患者ＦＳＨ增高。     

围绝经期妇女骨矿含量及其与骨代谢指标相关性研究

为了解围绝经期妇女骨矿含量及其相关骨代谢指标的变化，为早期防治骨质疏松症提供依据，本文随机选取３５岁以上妇女１７５人，分别测定了骨密度（ＢＭＤ）、血清雌二醇（Ｅ２）、促卵泡刺激素（ＦＳＨ）、促黄体生成素（ＬＨ）、降钙素（ＣＴ）及骨钙素（ＢＧＰ）。结果显示：围绝经期妇女ＢＭＤ及血清Ｅ２水平较正常对照组明显下降，年均骨丢失率达９．１％，居各组最高值，骨质疏松症伴发率达２３．８％，ＦＳＨ、ＬＨ分别是对照组２．４及２．１倍。血清ＢＧＰ水平较正常对照组有上升，ＣＴ水平有下降，然而两组间差异未见显著性。相关性分析示ＢＭＤ与Ｅ２呈显著正相关，与ＦＳＨ、ＬＨ、年龄及绝经年限呈显著负相关，与ＢＧＰ及ＣＴ未见相关关系。提示围绝经期妇女垂体－性腺轴功能状态的改变是ＢＭＤ急剧下降的主要原因之一；骨质疏松症防治的最佳时期至少应在围绝经期早期。     

人胎垂体组织培养及移植治疗席汉氏病

将水囊引产死胎的垂体组织进行体外培养后，其细胞形态正常，用放射免疫测培养２－２１天的培养液中均含有生长激素（ＧＨ）、催乳激素（ＰＲＬ）、催乳激素（ＰＲＬ）、黄体生成素（ＬＨ）、卵泡刺激素（ＦＳＨ）、促甲状腺激素（ＴＳＨ）等５种垂体激素。用培养５－１２天的垂体组织给５例席汉氏病患者进行三角肌内注射移植，患者的症状改善，血中垂体激素（ＰＲＬ、ＬＨ、ＦＳＨ及ＴＳＨ）及靶腺激素（Ｔ３、Ｔ４、Ｅ２）水平均有     

隐睾患儿手术前后血中性激素的变化

目的：探讨丘脑－垂体－睾丸轴与隐睾症的关系。方法：采用放射免疫法对４０例隐睾患儿术前、术后外周静脉血清睾酮（Ｔ）、５α－双氢睾酮（５α－ＤＨＴ）、雌二醇（Ｅ２）、黄体生成素（ＬＨ）、卵泡刺激素（ＦＳＨ）和催乳素（ＰＲＬ）进行测定,并与２４例正常儿童进行比较。结果：隐睾症患儿术前组血清Ｔ、５α－ＤＨＴ值明显低于正常儿童（Ｐ＜０．０５）,而Ｅ２、ＬＨ均显著升高（Ｐ＜０．０５）,ＦＳＨ升高则更明显（Ｐ＜     

去势大鼠骨质疏松症的实验研究

１２月龄雌性大鼠２２只，分为２组：实验组切除双侧卵巢，对照组行假手术，１３周后测定两组的血清雌二醇（Ｅ２）、睾酮（Ｔ）、促卵泡刺激素（ＦＳＨ）、黄体生成素（ＬＨ）、钙（Ｃａ）、磷（Ｐ）、碱性磷酸酶（ＡＫＰ）、骨钙素（ＢＧＰ），并行骨生物力学及形态计量学观察。结果表明：实验组Ｅ２、Ｔ、股骨抗弯能力，湿重、干重、灰重及成骨细胞表面均明显降低，ＦＳＨ、ＬＨ、ＡＫＰ、ＢＧＰ及骨吸收表面增高。认为去势鼠骨丢失是由于雌激素缺乏导致骨吸收与骨转换增加所引起     

精浆表皮细胞生长因子放免测定的临床应用

用放免法测定７３例不育男性和３９例正常对照ＥＧＦ、ＬＨ、ＦＳＨ、Ｔ水平。不育少精组ＥＧＦ含量明显高于正常对照组（Ｐ＜０．０１），Ｔ明显低于正常对照组（Ｐ＜０．０１），提示ＥＧＦ对睾丸生成雄性激素有明显的抑制作用，影响精子的生成。     

隐睾儿童青春期前内分泌环境和雄激素受体水平的研究

近年来，我们采用放射免疫分析法对４６例年龄为１５个月至１４岁的隐睾儿童的血清ＦＳＨ、ＬＨ、ＰＲＬ、Ｔ和Ｅ２进行了测定，其中１３例在手术时采取外阴部皮肤、进行成纤维细胞培养后，以３Ｈ－Ｒ１８８１为配体，用完整细胞测定法测定雄激素受体的特异性结合量和每个细胞的雄激素受体量。研究结果：（１）隐睾儿童血清ＦＳＨ值升高可能与早期已存在的睾丸曲精小管损害有关，（２）血清Ｅ２显著增高是本组隐睾儿童垂体－性腺轴内分泌功能最突出的改变，（３）隐睾儿童的雄激素受体的特异性结合量和每个细胞的雄激素受体量与正常对照组无显著性差异。研究表明，隐睾儿童存在高雌激素血症，可能是隐睾发生的重要致病因素之一，而靶器官雄激素受体无明显改变，表明隐睾可能不属于雄激素不敏感症的范畴     

Serum fluoride in children anaesthetized with enflurane

The serum inorganic fluoride concentration (SF) was measured in 40 children aged 22 days to 11 yrs (five infants) undergoing enflurane anaesthesia lasting 20-200 min, at an inspiratory concentration of 0.8 or 1.0%. Regardless of age, SF peaked at 2-8 mumol l-1 after 20-40 min of enflurane exposure, and at 4-10 mumol 1-1 and 6-10 mumol l-1 after 41-90 min and 91-200 min of exposure, respectively. The highest individual value was 12.5 mumol l-1. Another 23 children, aged 1-16 yrs, received 0.8% enflurane for 60 min. The increase in SF was 3-9 mumol l-1, with no clear dependence on age. Altogether, the increase in SF was comparable to that detected in adults after anaesthesia of equal duration.     

A novel testosterone gel formulation normalizes androgen levels in hypogonadal men,with improvements in body composition and sexual function

OBJECTIVE: To compare the safety and efficacy of two doses of a new testosterone gel formulation (Testim Auxilium Pharmaceuticals, Inc., Norristown, PA, USA) to a permeation-enhanced testosterone patch (Andropatch), GlaxoSmithKline, UK) for treating men with confirmed low serum testosterone levels, and associated signs and symptoms of hypogonadism. PATIENTS AND METHODS: In all, 208 men were randomized and treated at 29 centres in Denmark, Germany, Netherlands, Sweden and the UK. The men were treated for 90 days, and the pharmacokinetics and treatment effectiveness of Testim at two doses (50 and 100 mg/day, delivering a daily dose of 5 and 10 mg testosterone, respectively) and Andropatch (2 x 2.5 mg patches, each delivering 2.5 mg testosterone and containing 12.2 mg of testosterone) were compared. Pharmacokinetic profiles were obtained, body composition measured, and mood and sexual function data recorded. RESULTS: Testim produced dose-dependent improvements in all pharmacokinetic variables compared with Andropatch. The mean increases from baseline to 90 days in testosterone were 12.41, 6.54 and 3.82 nmol/L for Testim 100 and 50 mg/day and the Andropatch, respectively. Both doses of Testim significantly improved positive and negative mood over baseline; Andropatch did not. All three treatments increased lean body mass, and the higher dose of Testim produced a significant decrease in percentage body fat. At all sample times both doses of Testim significantly improved sexual performance, sexual motivation, sexual desire and spontaneous erections. Andropatch provided insignificant improvements from baseline at all sample times for sexual desire, an inconsistent improvement in sexual motivation, but no effect on spontaneous erections. These results are similar to those previously reported for testosterone replacement therapy in hypogonadal men, suggesting that normalization of serum testosterone restores sexual function. However, the present data suggest that higher serum testosterone levels may further improve sexual function. Gel treatment was well tolerated, while patch treatment produced higher rates of application-site reactions and study discontinuation. CONCLUSION: The favourable pharmacokinetic profile and treatment outcome, combined with the enhanced tolerability of Testim, suggest that this new gel formulation is a safe and effective treatment in men with low serum testosterone levels and associated signs and symptoms of hypogonadism.     

肝脏良性实质性占位病变的鉴别诊断及外科治疗

目的：提高肝脏良性实质性占位病变的鉴别诊断水平,减少因误诊导致的不必要手术及不当的手术方式。方法：回顾性分析本中心1984年5月-2000年2月间收治的36例,经手术及术后病理证实的肝脏良性实质占位病变患者的诊断过程及外科治疗方式。结果：炎性假瘤23例,局灶性脂肪变性4例,脂肪瘤、局灶性结节性增生各3例,结核球2例,错构瘤1例。瘤变直径0.9-20.0cm,平均3.9cm。36例患者除病变外肝脏均无硬 变表现,AFP均为阴性,2例HBV标记物阳性。患者均接受病变切除术,4例炎性假瘤患者因误诊为肝癌在病变切除术后安置皮下植入式注药装置。29例患者获得随访0.84-14.3年（平均5.9年）,2例死于心肺疾患,1例错构瘤患儿术后1年死于肿瘤复发,26例患者无占位性病变复发。结论：AFP、HBV阴性、无肝硬变是肝脏良性实质占位病变与肝癌鉴别的重要依据,手术切除治疗肝脏良性实质占位病变有优良疗效。     

The benefits of hormone replacement therapy in pre-menopausal women with oestrogen deficiency on haemodialysis.

BACKGROUND: Impaired sexual function is an important cause of depression in uraemic females. Hyperprolactinaemia is frequent, and often associated with decreased serum oestradiol concentration, which can significantly contribute to accelerated bone loss. The aim of the study was to evaluate the effect of hormone replacement therapy (HRT) on sexual function, serum 17beta-oestradiol and prolactin, and bone mineral density (BMD) in pre-menopausal women undergoing haemodialysis. METHODS: Among 63 women on haemodialysis, aged 18-45 years, 23 with secondary amenorrhoea and serum oestradiol < 30 pg/ml were enrolled into the 1 year study. They were divided into: group I (n = 13) treated with transdermal oestradiol with cyclic addition of noretisterone acetate, and control group II (n = 10). BMD was measured with dual energy X-ray absorptiometry (DEXA). RESULTS: No important changes in sexual function and hormonal profile were observed in the control group, whereas in all women from group I the treatment induced regular menses and a marked improvement of libido and sexual activity. Serum 17beta-oestradiol increased after the first month from 20.5 +/- 11.7 to 46.8 +/- 13.6 pg/ml (P < 0.001) and remained at that level until the end of the study, accompanied by a decrease of serum prolactin (from 1457 +/- 1045 to 691 +/- 116 mIU/ml after 12 months; P < 0.001). In group I, the treatment induced an increase in BMD, although significant only in L2-L4 (P < 0.05), whereas in group II a mild insignificant decrease was observed. However, a comparison of BMD values after 12 months in both groups revealed marked (P < 0.01-P < 0.05) differences at all studied sites. CONCLUSIONS: Transdermal HRT allows sustained physiological serum oestradiol concentrations in pre-menopausal women with oestrogen deficiency on haemodialysis, with the restoration of regular menses and a marked improvement in their sexual function. The treatment inhibits bone demineralization and can play an important role in the prevention of early osteoporosis in this group of patients.     

The role of ultrasonography in the assessment of renal function in the elderly

BACKGROUND: Ageing is associated with a progressive loss of renal mass and kidney length and a decline in glomerular filtration rate (GFR). This study evaluated a possible correlation between renal function and kidney size measured by ultrasonography (US), and whether the latter helps estimate GFR in the elderly. METHODS: Twenty-five medically stable elderly patients (mean age 85 +/- 5 yrs) were examined in a geriatric ward at a university hospital. Blood samples were taken to determine serum creatinine (Cr) levels. On the same day, 51chromium ethylenediamine tetraacetic acid (51Cr-EDTA) clearance was performed as the gold standard of GFR. US measured kidney length, transverse and anteroposterior dimensions. RESULTS: Serum Cr (r=-0.67; p=0.0002), Cockcroft-Gault formula (r=0.82; p<0.0001), absolute length (r=0.51; p=0.008) and volume kidney (r=0.46; p=0.02) correlated significantly with GFR. After receiver operating curve (ROC) analysis, length was less specific than sensitive in detecting renal impairment. Adding length to the Cockcroft-Gault formula did not improve GFR estimation (p=0.44). In contrast, adding length to serum Cr levels improved GFR estimation (p=0.015). CONCLUSION: In the elderly, kidney length and volume significantly correlated with GFR. However, length has a low specificity in predicting renal impairment. Therefore, in clinical practice, serum Cr levels and calculated Cr clearance are more useful in predicting renal impairment. However, normal kidney length can help to exclude renal impairment in the elderly at risk of GFR underestimation by a calculated Cr clearance.     

Opposite effect of acute and subchronic treatments with Ferula hermonis on copulatory behavior of male rats

Sexually potent and sluggish/impotent male rats were orally treated with an extract of Ferula hermonis (30 and 60 mg/kg). The acute administration stimulated sexual motivation in potent rats and improved copulatory performance in sluggish/impotent rats. This last effect was elicited only by the higher dose, which, in parallel, increased serum testosterone levels in rats. On the contrary, when the extract was subchronically administered (10 days) a marked reduction in the percentage of rats achieving ejaculation was detected, together with a general impairment of the copulatory pattern. Furthermore, the repeated administration of the extract (6 mg/kg/day for 10 days) resulted in a significant reduction of testosterone levels in comparison with controls. The present results discourage a repeated assumption of F. hermonis, while suggesting its acute administration to improve the performance in sexual dysfunctions.     

Sexual function and satisfaction in men after laser treatment for penile carcinoma

PURPOSE: We evaluate sexual function, sexual satisfaction and cosmetic results after laser treatment of penile carcinoma. MATERIALS AND METHODS: A total of 67 patients were treated at our clinic for penile cancer using combined carbon dioxide and neodymium:YAG lasers from 1986 to 2000. At the time of this study 58 men, with a mean age of 64 years were alive, of whom 46 (79%) agreed to participate in a structured face-to-face interview addressing sexual function, sexual satisfaction and cosmetic results. The length of time that had elapsed since treatment ranged from 6 months to 15 years (median 3 years). RESULTS: Of 40 patients (87%) who had been sexually active before treatment 30 (75%) had resumed activities at the time of the interview. Unaltered erectile function after treatment was reported by 33 patients (72%), 10 patients (22%) reported decreased function and 3 (6%) reported improved function. Of the 46 patients 23 (50%) were satisfied/very satisfied with their sexual life. After treatment only 3 of 30 (10%) of the evaluable men had dyspareunia. The cosmetic results were considered satisfying/very satisfying by 36 (78%) men. CONCLUSIONS: Laser treatment of localized penile carcinoma preserves the penis and generally provides satisfactory sexual function and cosmetic results.     

A case report of idiopathic hypogonadotropic hypogonadism with particular reference to monitoring of prostate volume

A 23-year-old man visited our hospital, complaining of a lack of secondary sexual characteristics. Based on both clinical and endocrinological examinations, he was diagnosed as suffering from idiopathic hypogonadotropic hypogonadism (IHH). With human chorionic gonadotropin (hCG)/human menopausal gonadotropin (hMG) replacement therapy, clinical symptoms and serum testosterone levels improved to normal ranges. Interestingly, prostate volume as measured by transrectal ultrasonography increased considerably from 3.6 ml before treatment to 20.2 ml after treatment. The monitoring of prostate volume might be a parameter useful for evaluating the treatment effect of hCG/hMG replacement therapy in IHH.     

男性肝移植受者血清性激素水平及性功能的研究

目的 探讨男性肝移植受者术后血清性激素恢复过程及性生活质量.方法 采集69例原发病为良性肝病的已婚男性肝脏移植受者移植前后1～6个月血清标本,采用放射免疫法分析测定血清睾酮、雌二醇,采用酶联免疫吸附法性激素结合球蛋白的浓度,选择同期本院健康已婚体检男性23例为健康对照组.随访研究组69例肝移植术后存活半年以上的24～45岁患者的性功能状态.结果 患者肝移植术前血清雌二醇和性激素结合球蛋白明显高于健康对照组(雌二醇:87.56±31.21 vs.26.00±9.12,u=9.30,P＜0.0001,性激素结合球蛋白:134.50±30.68 vs.51.04±12.05,u=12.69,P＜O.0001)；睾酮明显低于健康对照组(睾酮:2.02±1.28 vs.4.82±1.48,u=-8.73,P＜0.0001)；与患者术前终末期肝病模型评分(model for end-stage liver disease,MELD)相关(分别r =0.80,r=-0.77,r =0.72,均P＜0.0001),术后2周时血清雌二醇与健康对照组相比差异无统计学意义,术后1个月时血清睾酮和性激素结合球蛋白与健康对照组相比差异无统计学意义.结论 男性肝移植术后1个月内血清雌二醇、血清睾酮和性激素结合球蛋白水平恢复正常,术后半年时性功能得到明显改善.     

Increased nitric oxide production during acute rejection in kidney transplantation: a useful marker to aid in the diagnosis of rejection

BACKGROUND: The diagnosis of acute rejection (AR) relies on biopsy (Bx), with all the noninvasive tests failing to show satisfactory predictive value. Nitric oxide (NO) has been shown to play a role in AR. The aim of this study is to analyze the relationship between NO and (1) biopsy-proven allograft rejection and (2) other reasons of allograft dysfunction. PATIENTS AND METHODS: Fifty consecutive renal allograft recipients ages 23-72 yrs who were transplanted were prospectively recruited. Blood samples were collected for 3 months. Endogenous serum nitrate (SNO(3)) levels were measured with Griess reagent in 1178 samples. Biopsies were performed as clinically indicated. Tacrolimus levels, urinary cultures, and renal function tests were done as per unit protocol. RESULTS: Fifty recipients (mean+/-SD age 45.2+/-2.18 yrs, 24 men and 6 women) underwent 68 biopsies. Forty-five Bx (66.2%) showed AR in 19 recipients (mean age 47+/-8) and 23 (33.8%) Bx in 13 recipients (mean age 43+/-12) showed no AR. SNO(3) in AR was (73+/-8.89 micromol/L) compared with negative Bx (45+/-4.5 micromol/L; P<0.05). There was also a significant difference in SNO(3) during AR and other causes of allograft dysfunction; delayed graft function (54+/-7.8 micromol/L), urinary tract infection (44+/-2.9 micromol/L), tacrolimus toxicity (51+/-2.86 micromol/L), and increase in serum creatinine (44+/-2.36 micromol/L). CONCLUSION: There is a significant increase of serum nitrate with episodes of acute rejection compared with other causes of renal dysfunction. SNO(3) can therefore aid in the diagnosis of acute rejection.