基于西医病机学说论硬皮病的“肾虚血瘀”

通过探讨硬皮病的病机学说与"肾虚血瘀"的相关性,提出肾虚证对应的免疫异常与血瘀证对应的血管病变,贯穿硬皮病的全程,而硬皮病胶原合成异常所致组织器官纤维化,乃继发于肾虚与血瘀。由此,为中医辨证论治硬皮病提供一个新的思路。     

李曰庆从肝肾论治阳痿经验

介绍李曰庆教授从肝肾论治阳痿经验,认为阳痿的病机是肾虚为本、肝郁为标,本虚标实,治疗时应肝肾同治,以补肾疏肝作为基本治疗原则,兼顾他脏,并善用虫药.     

穴位埋线联合泻肝益肾汤治疗肝郁肾虚型阳痿的临床疗效观察

目的:探讨穴位埋线联合泻肝益肾汤口服治疗肝郁肾虚型阳痿的临床疗效。方法:将60例明确诊断为肝郁肾虚型阳痿的患者,以随机的方式分为治疗组与对照组。治疗组30例,给予泻肝益肾汤口服;对照组30例,口服泻肝益肾汤,同时联合穴位埋线治疗。观察治疗前后国际勃起功能指数(IIEF-5)评分、中医症候评分阳痿肝郁肾虚型积分变化情况以及阴茎多普勒血流图变化情况。结果:按国际勃起功能指数评分(IIEF-5评分)的变化评定疗效后,治疗组与对照组总有效率分别为为86. 7%、60. 0%,两组患者疗效间差异具有统计学意义(χ~2=4. 265,P=0. 032)。中医症候评分(肝郁肾虚型)积分变化评定疗效后,治疗与对照组总有效率分别为为90. 0%、63. 3%,两组患者疗效间差异具有统计学意义(χ~2=3. 392,P=0. 041)。治疗后阴茎多普勒血流图阴茎血流变化方面有两组均有明显改善,差异具有统计学意义(P 0. 05),且治疗组优于对照组。结论:穴位埋线联合泻肝益肾汤口服治疗肝郁肾虚型阳痿的临床疗效显著,值得临床推广。     

银屑病血瘀证的思考

银屑病防治尚存诸多难点,本文从中医角度探讨了中医病因病机、证候群及治疗效果,从西医角度探讨了本病组织结构、血液流变学、甲皱微循环、血浆内皮素的改变,发现银屑病存在血瘀证,为寻求治疗银屑病的新思路和新方法提供理论根据。     

从古今医学文献探析青年男性阳痿的病因病机

阳痿这一疾病困扰广大男性,青年阶段频发,严重影响患者的生活质量。本文从现代医学研究和中医古籍医论2个方面对青年男性阳痿的病因病机进行归纳与总结。现代医学将青年男性发生阳痿的病因病机概括为性生活频繁、心理压力增加、饮食谱的改变等因素;中医学将青年男性阳痿的病因病机概括为房事不节、饮食不节、情志不畅等导致的肾阴亏虚,命门火衰,肝气郁结、肝经湿热下注、心气不足、心火闭塞、脾胃不振等。无论是现代医学还是传统中医理论都认为,青年男性阳痿的病因病机与生活习惯、情志因素密切相关。     

勃起功能障碍中医病因病机探析

勃起功能障碍又称为阳痿,是指阴茎持续不能达到或者维持勃起以满足性生活。约5%-10%的成年男子患有不同程度的阳痿。过去,认为阳痿大多由精神和心理因素造成,近年来由于医学的发展,检查和诊断水平不断提高,器质性阳痿所占比例明显上升。由于人们在对阳痿的病因、发病机理、诊断和治疗等方面的认识上存在诸多问题,虽然中西医学的研究取得了很多成果,但尚有许多不尽人意之处。近年来,中医诊治阳痿思维活跃, 思路宽阔,师古不泥古,大胆创新,病因认识更加深入, 病机思路更加拓展,从而极大地提高了阳痿病因病机认识水平。     

论肾虚血瘀是糖尿病性勃起功能障碍的基本病机

本文旨在从中医基本理论,现代医学的分子生物学、神经、血管等方面,论述糖尿病性勃起功能障碍的中医基本病机——肾虚血瘀。在肾虚血瘀基本病机的基础上提出补肾活血法的可行性的理论探讨。     

阳痿从肝肾同源论治探讨

本文介绍了肝肾同源理论的内涵及外延,阳痿的发病与肝、肾两脏的关系。重点从肝肾同源的角度探讨了中医对阳痿发病的认识以及现代医学对阳痿发病的认识,把肝肾同治作为阳痿的基本治疗法则指导临床治疗。旨在将阳痿的肾虚观和肝郁论两主流观点结合,更深入地认识阳痿的发病,提高临床疗效。     

勃起功能障碍的中医病因病机分析和综合个体疗法

进入21世纪,人类的疾病谱正在发生潜在的变化,威胁男性健康的许多男性病正在引起人们广泛的关注,特别是日渐严重影响人们生活质量且发病率逐渐上升的男性勃起功能障碍(ED)。1病因病机分析中医学对勃起功能障碍俗称阳痿的认识有着悠久的历史,积累了丰富的临床经验,历代医学家对阳痿的病因病机的认识各有侧重,见仁见智。但依旧房事过度,命门火衰,肾气亏虚为主,治疗大法基本囿于补肾壮阳,据文献调研从汉朝至明清的39部相关中医著作中的400首治疗阳痿的方剂中壮阳药占80%以上。据有关专家对当今市场销售的60多种治疗阳痿的中成药及性保健品进行…     

多囊卵巢综合征中医证型分布特点的现代文献研究

目的：了解多囊卵巢综合征的中医证型分布情况,进一步探讨多囊卵巢综合征的内在规律,为中医辨证治疗提供循证依据.方法：对1993年至2013年内从中医角度研究多囊卵巢综合征的文献进行梳理,统计明确提出中医辨证分型的文献的证候频数,并提取病位和病性类证候要素.结果：在符合纳入标准的66篇文献中,多囊卵巢综合征一病最常见的证型为痰湿证,病位主要在肾、肝、脾三脏,病性类证候要素主要为痰湿和血瘀.结论：多囊卵巢综合征的病机复杂,应重视肾在其中的作用,以及痰湿和血瘀丽种因素.     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Multiple New-Onset Subcutaneous Nodules of the Upper Extremity Digits: Giant Cell Tumor of Tendon Sheath and Lipoma

A black woman with the concurrent onset of two subcutaneous nodules located on the digits of her upper extremities is described. Initially, a single systemic disorder was considered; yet, the lesions differed in morphology and consistency. Microscopic examination of the nodules showed a giant cell tumor of tendon sheath and a lipoma. Although Occam's “razor” suggests that multiple lesions in the same person are more likely to represent variable manifestations of a single disorder than several different diseases in that individual, the simultaneously appearing lesions in this patient represented two different conditions.