治肾虚就是治ED？

过去在中国，ED的治疗方法是中药和西药结合，还有就是补充雄激素。万艾可上市之后，对男科界是一个里程碑。万艾可的上市可以解决大部分的ED患者，但是使用一段时间之后发现，治疗ED不光是解决一个勃起的问题，这可以说是“治标”，运用中西医结合的方法，利用中药调理患者整体机能，是一个“治本”的问题。虽然万艾可起效比较快，     

胰岛素强化治疗对糖尿病性勃起功能障碍的疗效观察

目的 探讨胰岛素强化治疗对糖尿病性勃起功能障碍（ED）的治疗效果.方法 使用勃起功能国际问卷（IIEF-5）诊断ED,将116例糖尿病性ED患者分为胰岛素组和口服药组,分别予胰岛素和口服药治疗6个月,治疗前后测定血糖、血清睾酮,并进行IIEF-5评分.结果 治疗后胰岛素组患者的空腹血糖（FBG）和糖化血红蛋白（HbAlc）较治疗前明显降低,IIEF-5评分明显升高.治疗后胰岛素组患者的FBG和HbAlc较口服药组降低,IIEF-5评分较口服药组明显升高.结论 胰岛素强化治疗能明显提高糖尿病性ED患者的勃起功能,其疗效优于口服药.     

老年心脏病及糖尿病病人勃起功能障碍的临床影响因子及早期干预

目的分析老年心脏病及糖尿病勃起功能障碍(ED)病人的临床影响因子并进行干预。方法以问卷调查方法,根据患者的自我评价诊断ED,根据国际勃起功能指数(IIEF)评分,将患者分为功能正常组(IIEF≥12)及勃起功能轻、中、重度异常组(IIEF<12)。100例60岁以上ED病人,同期40岁以下ED病人40例作为对照,分别比较两组患者的ED患病率、认知率、治疗率及对整体生活满意的比例,以及年龄、吸烟、疾病、治疗对ED患病率及严重程度的影响。两组患者常见危险因子、体质指数及勃起功能(EF)积分的差异。结果60岁以上组与对照组相比,以器质性ED为主81%对54%,病程为(13.28±0.77)年对(382±0.46)年,伴常见危险因子者为91%对12%,体重质指数为(28.56±0.46)对(23.38±0.45),IIEF积分为(9.98±0.48)分对(12.56±0.46)分。两组病因组成、病程、常见危险因子伴随者比例及EF积分有显著差异(P<0.01)。结论老年ED病人以器质性ED为主,伴随常见危险因子增多,病程延长,ED加重。干预适于早期。     

饮酒量与男性2型糖尿病患者勃起功能障碍的相关性研究

目的探讨饮酒量与男性2型糖尿病患者勃起功能障碍(ED)的相关性。方法对2007年4月至2010年1月在沈阳军区总医院内分泌科住院的400例男性2型糖尿病患者进行问卷调查,采用勃起功能国际指数(IIEF-5)评分问卷对其勃起功能进行评分,按照患者饮酒量进行分组。比较大量饮酒组、适量饮酒组、不饮酒组的基础信息和勃起功能。结果三组糖尿病患者中年龄、空腹血糖、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、体重指数(BMI)、血压、雌激素、睾酮比较差异无统计学意义,三组糖尿病患者糖尿病病程、血管和神经并发症方面比较差异亦无统计学意义。大量饮酒组中ED患病率为83.42%,适量饮酒组中ED患病率为51.11%,不饮酒组中ED患病率为53.70%;大量饮酒组与适量饮酒组比较差异有统计学意义,大量饮酒组与不饮酒组比较差异有统计学意义,而适量饮酒组与不饮酒组比较差异无统计学意义。结论酒精的大量摄入可能是男性2型糖尿病患者ED患病率增加的一个重要因素。     

注射用胰激肽原酶治疗糖尿病性勃起功能障碍的疗效观察

50例糖尿病性勃起功能障碍患者均采取注射用胰激肽原酶治疗,40U/天,15至20天。采用国际勃起功能指数表(IIEF-5)对治疗前后的疗效进行评价。结果本组50例患者经注射用胰激肽原酶治疗后,IIEF-5评分较治疗前有显著改善,差异有统计学意义(P0.05)。所有患者在治疗过程中均未出现明显的不良反应。结论采用注射用胰激肽原酶治疗糖尿病性勃起功能障碍,临床疗效确切,安全性高,值得临床推广。     

糖尿病勃起功能障碍的口服药物治疗

勃起功能障碍(ED)是糖尿病常见并发症之一,是指不能达到或维持勃起以进行满意的性生活(阳萎-NIH协调大会)[1].国外报道40～70岁的男性糖尿病患者完全性ED,患病率是普通人的群的3倍以上[2].我院内分泌糖尿病门诊,对此类患者23例,进行以控制代谢为基础,以改善勃起功能为目的综合治疗,效果较满意,现报告如下.     

糖尿病勃起功能障碍的口服药物治疗

勃起功能障碍（ED）是糖尿病常见并发症之一。是指不能达到或维持勃起以进行满意的性生活（阳萎-NIH协调大会）。国外报道40～70岁的男性糖尿病患者完全性ED。患病率是普通人的群的3倍以上。我院内分泌糖尿病门诊，对此类患者23例，进行以控制代谢为基础，以改善勃起功能为目的综合治疗，效果较满意，现报告如下。     

硫辛酸对老年2型糖尿病勃起功能障碍患者的疗效及对其氧化应激的影响

目的观察硫辛酸对老年2型糖尿病(T2DM)勃起功能障碍(ED)患者的疗效及对其氧化应激的影响。方法选取老年男性T2DM合并ED患者60例(B组),老年男性T2DM无ED患者60例(A组)。两组患者均进行国际勃起功能指数问卷-5评分,比较两组患者的氧化应激水平:超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH)、SOD/MDA比值。B组应用硫辛酸干预治疗3 w,观察干预前后氧化应激水平的变化及临床疗效。结果干预前B组患者的氧化应激水平较A组升高(均P0.05)。硫辛酸干预后,B组的氧化应激水平较治疗前降低国际勃起功能指数问卷-5评分升高(均P0.05)。结论硫辛酸可降低老年男性T2DM并ED患者的氧化应激水平,疗效肯定。     

一平苏治疗伴有勃起功能障碍的高血压病人的疗效

目的　观察一平苏对伴有勃起功能障碍 (ED)的高血压病人降压及改善ED的疗效。方法　 77例高血压伴器质性血管性阳萎病人随机分成 2组 :一平苏组 (39例 ) ,接受一平苏片 2 .5mg～ 5mgqd .× 12w ;络活喜组 (2 8例 )则作为对照接受络活喜片 5mg～ 10mgqd .× 12w。根据治疗前后的BP改变情况评定降压疗效 ;根据治疗前后 2组病人对国际勃起功能指数 (IIEF 5 )问卷自报评分变化和多普勒血流仪上阴茎 肱动脉收缩压指数 (PBI)变化评定 2组治疗前后的变化。结果　 2组治疗后不论SBP或DBP均有显著下降 (P <0 0 1) ,在降低SBP上络活喜略优于一平苏 (P <0 0 5 ) ;而在降低DBP上则一平苏略优于络活喜 (P <0 0 5 ) .。治疗后患者IIEF 5答卷评分显示一平苏明显高于络活喜 (P <0 0 1) ,治疗后多普勒血流仪的PBI比较 ,一平苏明显高于络活喜 (P <0 0 1)。结论　一平苏能在降低血压的同时 ,改善阴茎动脉血供 ,改善阳蒌症状 ,适用于治疗伴有ED的男性高血压病人     

糖尿病视网膜病变与勃起功能障碍的关系

目的探讨糖尿病视网膜病变（DR）与勃起功能障碍（ED）的关系。方法对2型糖尿病（T2DM）合并视网膜病变组（DR组）22例、T2DM无视网膜病变组（非DR组）92例用国际勃起功能指数（IIEF）评分,比较两组间的评分情况。结果DR组的评分明显低于非DR组（P〈0．05）,DR组的ED发生率明显高于非DR组（P〈0．05）。结论糖尿病视网膜病变与ED的发生密切相关。     

妊娠时间与肺结核复发的相关性研究及诊治对策

目的 分析肺结核史患者妊娠时间和肺结核复发间相关性.方法 选取我院收治的有肺结核史的妊娠妇女576例作为研究对象,对其妊娠前肺结核治疗、治愈后妊娠时间、妊娠后复发肺结核等进行分析,总结有肺结核史育龄女性的妊娠时间和肺结核复发之间的关系.结果 肺结核治愈后不同时间段妊娠者的结核复发率比较,差异具有显著性（P＜0.05）,停药后间隔时间越久妊娠,肺结核复发的几率越小.结论 加强孕期痰菌检查,及早发现复发肺结核,提高母婴安全.     

我国骨关节结核诊治的回顾与展望

骨关节结核是危害人们健康的严重感染性疾病,近95％由他处结核病继发而来.罹患骨关节结核疾病后几乎均将致残,严重影响人们的健康、工作和生活.建国以来在党和国家的关心和支持下,骨关节结核的诊治水平取得了长足进步.时至今日,由于多种原因,学科发展和被重视程度受到一定的制约,同整个医疗行业的发展不相适应.回顾过去,展望未来,我们需要重新审视骨关节结核的诊治方法,努力推进骨关节结核诊疗技术的科学发展.     

Effect of phosphorylation of MAPK and Stat3 and expression of c-fos and c-jun proteins on hepatocarcinogenesis and their clinical significance

AIM To study the effect of phosphorylation ofMAPK and Stat3 and the expression of c-fos andc-jun proteins on hepatocellular carcinogenesisand their clinical significance.METHODS SP immunohistochemistry was usedto detect the expression of p42/44~(MAPK), p-Stat3,c-fos and c-jun proteins in 55 hepatocellularcarcinomas (HCC) and their surrounding livertissues.RESULTS The positive rates and expressionlevels of p42/44~(MAPK), p-Stat3, c-fos and c-junproteins in HCCs were significantly higher thanthose in pericarcinomatous liver tissues (PCLT).A positive correlation was observed between theexpression of p42/44~(MAPK) and c-fos proteins, andbetween p-Stat3 and c-jun, but there was nosignificant correlation between P42/44~(MAPK) and p-Stat3 in HCCs and their surrounding livertissues.CONCLUSION The abnormalities of Ras/Raf/MAPK and JAKs/ Stat3 cascade reaction maycontribute to malignant transformation ofhepatocytes. Hepatocytes which are positive forp42/ 44~(MAPK), c-fos or c-jun proteins may bepotential malignant pre-cancerous cells.Activation of MAPK and Stat3 proteins may be anearly event in hepatocellular carcinogenesis.     

Overweight and Obesity and Progression of ADPKD

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Effect of phosphorylation of MAPK and Stat3 and expression of c-fas and c-jun proteins on hepatocarcinogenesis and their clinical significance

AIM To study the effect of phosphorylation ofMAPK and Stat3 and the expression of c-fos andc-jun proteins on hepatocellular carcinogenesisand their clinical significance.METHODS SP immunohistochemistry was usedto detect the expression of p42/44MAPK, p-Stat3,c-fos and c-jun proteins in 55 hepatocellularcarcinomas (HCC) and their surrounding livertissues.RESULTS The positive rates and expressionlevels of p42/44MAPK, p-Stat3, c-fos and c-junproteins in HCCs were significantly higher thanthose in pericarcinomatous liver tissues (PCLT).A positive correlation was observed between theexpression of p42/44MAPK and c-fos proteins, andbetween p-Stat3 and c-jun, but there was nosignificant correlation between p42/44MAPK and p-Stat3 in HCCs and their surrounding livertissues.CONCLUSION The abnormalities of Ras/Rat/MAPK and JAKs/ Stat3 cascade reaction maycontribute to malignant transformation ofhepatocytes. Hepatocytes which are positive forp42/ 44MAPK, c-fos or c-jun proteins may bepotential malignant pre-cancerous cells.Activation of MAPK and Stat3 proteins may be anearly event in hepatocellular carcinogenesis.     

Replication and Inhibitors of Enteroviruses and Parechoviruses

The Enterovirus (EV) and Parechovirus genera of the picornavirus family include many important human pathogens, including poliovirus, rhinovirus, EV-A71, EV-D68, and human parechoviruses (HPeV). They cause a wide variety of diseases, ranging from a simple common cold to life-threatening diseases such as encephalitis and myocarditis. At the moment, no antiviral therapy is available against these viruses and it is not feasible to develop vaccines against all EVs and HPeVs due to the great number of serotypes. Therefore, a lot of effort is being invested in the development of antiviral drugs. Both viral proteins and host proteins essential for virus replication can be used as targets for virus inhibitors. As such, a good understanding of the complex process of virus replication is pivotal in the design of antiviral strategies goes hand in hand with a good understanding of the complex process of virus replication. In this review, we will give an overview of the current state of knowledge of EV and HPeV replication and how this can be inhibited by small-molecule inhibitors.     

Effects of sex and time of day on metabolism and excretion of corticosterone in urine and feces of mice

Non-invasive techniques to monitor stress hormones in small animals like mice offer several advantages and are highly demanded in laboratory as well as in field research. Since knowledge about the species-specific metabolism and excretion of glucocorticoids is essential to develop such a technique, we conducted radiometabolism studies in mice (Mus musculus f. domesticus, strain C57BL/6J). Each mouse was injected intraperitoneally with 740 kBq of 3H-labelled corticosterone and all voided urine and fecal samples were collected for five days. In a first experiment 16 animals (eight of each sex) received the injection at 9 a.m., while eight mice (four of each sex) were injected at 9 p.m. in a second experiment. In both experiments radioactive metabolites were recovered predominantly in the feces, although males excreted significantly higher proportions via the feces (about 73%) than females (about 53%). Peak radioactivity in the urine was detected within about 2h after injection, while in the feces peak concentrations were observed later (depending on the time of injection: about 10h postinjection in experiment 1 and about 4h postinjection in experiment 2, thus proving an effect of the time of day). The number and relative abundance of fecal [3H]corticosterone metabolites was determined by high performance liquid chromatography (HPLC). The HPLC separations revealed that corticosterone was extensively metabolized mainly to more polar substances. Regarding the types of metabolites formed, significant differences were found between males and females, but not between the experiments. Additionally, the immunoreactivity of these metabolites was assessed by screening the HPLC fractions with four enzyme immunoassays (EIA). However, only a newly established EIA for 5alpha-pregnane-3beta,11beta,21-triol-20-one (measuring corticosterone metabolites with a 5alpha-3beta,11beta-diol structure) detected several peaks of radioactive metabolites with high intensity in both sexes, while the other EIAs showed only minor immunoreactivity. Thus, our study for the first time provides substantial information about metabolism and excretion of corticosterone in urine and feces of mice and is the first demonstrating a significant impact of the animals' sex and the time of day. Based on these data it should be possible to monitor adrenocortical activity non-invasively in this species by measuring fecal corticosterone metabolites with the newly developed EIA. Since mice are extensively used in research world-wide, this could open new perspectives in various fields from ecology to behavioral endocrinology.     

心电图、心电向量图与冠状动脉造影结果对比分析

目的:通过分析心电图(Electrocardiogram,ECG)和心电向量图(Vectorcardiogram,VCG)的改变与冠脉造影（CAG）结果进行对比,探讨ECG、VCG在冠状动脉病变中的诊断价值。方法: 选择2008年1月~2009年12月临床拟诊断为冠心病患者108例,行常规ECG、VCG检查,并于1周内进行CAG,对检查结果依据各自的诊断标准进行判定,以CAG为标准诊断法,利用四格表法,计算相关评价真实性的指标并进行比较。结果: ①VCG检测的灵敏度、特异度、准确度显著高于ECG(P<0.05,P<0．01)。②ECG、VCG阳性率与冠脉病变支数组间比较:在单支病变、双支病变中,VCG阳性率明显高于ECG(P<0.05),左主干或三支病变无统计学意义;组内比较:ECG组左主干或三支病变组较单支病变、双支病变阳性率高(P<0.05,P<0.01);VCG组左主干或三支病变组较单支病变阳性率高(P<0.05);与双支病变阳性率比较无统计学意义;③ECG、VCG阳性率与冠脉病变程度组间比较:冠脉病变狭窄50%～69%的VCG阳性率明显高于ECG (P<0.05),其他两组阳性率比较无统计学意义;组内比较:ECG组冠脉病变狭窄≥90%较50%～69%、70%～89%的阳性率高(P<0.05,P<0.01); VCG组狭窄≥90%较50%～69%阳性率高（P<0.01),其他无统计学意义。结论: VCG对冠心病检测价值显著高于ECG。     

Detection and characterization of the product of hydroethidine and intracellular superoxide by HPLC and limitations of fluorescence

Here we report the structural characterization of the product formed from the reaction between hydroethidine (HE) and superoxide (O(2)(.-)). By using mass spectral and NMR techniques, the chemical structure of this product was determined as 2-hydroxyethidium (2-OH-E(+)). By using an authentic standard, we developed an HPLC approach to detect and quantitate the reaction product of HE and O(2)(.-) formed in bovine aortic endothelial cells after treatment with menadione or antimycin A to induce intracellular reactive oxygen species. Concomitantly, we used a spin trap, 5-tert-butoxycarbonyl-5-methyl-1-pyrroline N-oxide (BMPO), to detect and identify the structure of reactive oxygen species formed. BMPO trapped the O(2)(.-) that formed extracellularly and was detected as the BMPO-OH adduct during use of the EPR technique. BMPO, being cell-permeable, inhibited the intracellular formation of 2-OH-E(+). However, the intracellular BMPO spin adduct was not detected. The definitive characterization of the reaction product of O(2)(.-) with HE described here forms the basis of an unambiguous assay for intracellular detection and quantitation of O(2)(.-). Analysis of the fluorescence characteristics of ethidium (E(+)) and 2-OH-E(+) strongly suggests that the currently available fluorescence methodology is not suitable for quantitating intracellular O(2)(.-). We conclude that the HPLC/fluorescence assay using HE as a probe is more suitable [corrected] for detecting intracellular O(2)(.-).     

荣宝和氯硝柳胺灭螺效果比较及成本分析

目的 评价新型灭螺药物荣宝杀灭钉螺的效果,探讨其推广应用价值.方法 按目前推荐的荣宝灭螺剂量,喷洒法为30 g/m2,浸杀法为50 g/m3;氯硝柳胺喷洒法和浸杀法分别采用2 g/m2和2 g/m3杀螺剂量,分别在室内和现场进行灭螺试验,观察两种药物的灭螺效果并初步分析评估其成本.结果 在现场气温22～30℃条件下,荣宝50 g/m3浸杀3、5、7 d后,螺袋内钉螺校正死亡率均达到100.0%,与氯硝柳胺2 g/m3灭螺效果相似;荣宝30 g/m2剂量喷洒3、5、7、15 d后,钉螺校正死亡率分别为54.5%、58.0%、69.0%、79.1%,氯硝柳胺喷洒组钉螺校正死亡率分别为61.0%、69.4%、76.7%、77.9%.在室温18℃条件下,荣宝以30 g/m2喷洒3、5、7、15 d后,钉螺校正死亡率分别为72.9%、87.2%、91.5%、76.1%;而相应2 g/m2氯硝柳胺喷洒后的钉螺校正死亡率分别为81.3%、95.7%、97.9%、80.4%.同样完成1000 m2的喷洒灭螺任务,荣宝所需灭螺药物和人力资费成本比氯硝柳胺多支出0.114元/m2;完成72 m3的浸杀灭螺任务,荣宝所需灭螺药物和人力资费成本比氯硝柳胺多支出0.127元/m3.50 g/m3荣宝浸杀灭螺剂量,对成鱼(＞250 g)的活力不会造成影响,但对鱼类幼苗仍具较强毒性.结论 荣宝与氯硝柳胺灭螺效果相似,由于其成本较高,氯硝柳胺仍然是目前首选灭螺药物,但荣宝的鱼类毒性低,可作为氯硝柳胺之外有益的补充灭螺药物.