参芪降糖颗粒治疗2型糖尿病患者阴茎勃起功能障碍的研究

目的探讨参芪降糖颗粒治疗2型糖尿病阴茎勃起功能障碍(erectile dysfunction,ED)的疗效。方法将100例2型糖尿病ED患者随机分为2组,参芪降糖颗粒组、西药组,疗程6个月,治疗前后分别进行勃起功能国际问卷(ⅡEF-5)评分。结果治疗后两组比较,参芪降糖颗粒组ⅡEF-5评分显著升高(P<0.01)。结论参芪降糖颗粒能改善2型糖尿病ED患者的阴茎勃起功能。     

西地那非治疗经尿道前列腺电切术后勃起功能障碍临床观察

目的研究西地那非对前列腺电切术(TURP)后勃起功能障碍(ED)的治疗效果。方法将26例TURP术后ED患者随机分为实验组和对照组,每组13人,分别口服西地那非和安慰剂,治疗前和治疗后4个月分别行国际勃起功能指数(IIEF)评估。结果 26例患者中,2例失访。治疗4个月后,实验组12例患者中10例(83.3%)勃起功能得到改善,IIEF评分中勃起功能、性交满意度、性高潮、总体满意度评分都显著高于治疗前(P<0.01);对照组只有2例(16.7%)勃起功能改善,IIEF评分治疗前后无显著差异。两组比较,上述各项指标均有显著性差异(P<0.05)。结论口服西地那非能显著改善TURP术后患者勃起功能障碍。     

中老年男性高血压患者勃起功能障碍相关因素分析

目的探讨中老年男性高血压患者勃起功能障碍(ED)的相关因素。方法选择257例40~70岁男性原发性高血压患者,记录其年龄、高血压病程、血压、有无靶器官损伤、体质量指数和腰围等情况,采用国际勃起功能指数-5评估勃起功能,抑郁自评量表(SDS)评估抑郁状态及严重程度,单因素和多因素Logistic回归分析ED与相关因素的关系。结果 257例原发性高血压患者中ED 188例(73.15%),ED患者SDS评分(47.49±10.74)显著高于国内常模(41.88±10.57)(P<0.01)。Logistic回归分析显示:中年男性(40~59岁)高血压患者病程、脉压、靶器官损伤、抑郁程度与ED的关联有统计学意义(P<0.05);老年男性(60~70岁)高血压患者病程、脉压与ED的关联有统计学意义(P=0.00)。结论高血压病程长、脉压大且伴有靶器官损伤和抑郁的中老年男性需考虑ED的可能性。     

伴勃起功能障碍男性抑郁症患者的自尊及应对方式研究

目的 探讨男性抑郁症勃起功能障碍(ED)患者的自尊及应对方式.方法 对60例26～50岁的男性抑郁症患者采用国际勃起功能指数问卷(IIEF-5)、汉米尔顿抑郁量表(HAMD)、自尊量表(SES)、特质应对方式问卷(TCSQ)等进行评估.结果 男性抑郁症ED组HAMD评分[(18.79±2.40)分]显著高于非ED组[(17.00±1.96)分],P ＜0.05,二者SES、TCSQ积极应对及消极应对分均差异无显著性;男性抑郁症ED患者中复发抑郁症组TCSQ积极应对分[(27.07±4.94)分]显著低于首发抑郁症组[(31.59±8.10)分],P ＜0.05,IIEF-5、HAMD、SES及TCSQ消极应对分首发与复发抑郁症组比较均差异无显著性;男性抑郁症患者IIEF-5及TCSQ积极应对分与HAMD评分显著负相关,TCSQ消极应对分与HAMD评分显著正相关;多元回归分析表明影响男性抑郁症患者勃起功能的因素为HAMD评分、TCSQ消极应对分以及体质量指数.结论 男性抑郁症患者自尊较低,应对消极,患有ED对男性抑郁症患者自尊及应对方式均无明显影响.     

奥美沙坦酯对男性高血压患者性功能的影响

目的 探讨奥美沙坦酯及苯磺酸氨氯地平对男性高血压患者性功能的影响。方法 选取2012年1月-2014年6月在江阴市中医院门诊就诊的男性高血压患者160例（高血压分级为1～2级）,采用随机数字表法将患者分为奥美沙坦酯组和苯磺酸氨氯地平组,各80例。奥美沙坦酯组给予奥美沙坦酯20 mg/d口服,苯磺酸氨氯地平组给予苯磺酸氨氯地平5 mg/d口服,疗程均为24周。观察两组治疗前后性功能和血清睾酮、雌二醇水平的变化。性功能评定按照勃起功能国际问卷-5（IIEF-5）进行问卷调查,主要通过勃起功能、性交满意度、达到高潮能力、性欲、总体满意度分值评价男性性功能。结果 奥美沙坦酯组和苯磺酸氨氯地平组各有5例患者因血压持续不达标而退出。两组患者治疗后收缩压、舒张压比较,差异均无统计学意义（t=0.802、0.811,P＞0.05）。治疗前两组勃起功能、性交满意度、达到高潮能力、性欲、总体满意度分值比较,差异均无统计学意义（P＞0.05）;治疗后两组性交满意度、达到高潮能力、总体满意度分值比较,差异均无统计学意义（P＞0.05）;奥美沙坦酯组勃起功能、性欲评分均高于苯磺酸氨氯地平组,差异有统计学意义（P＜0.05）;奥美沙坦酯组治疗后勃起功能、性欲评分高于治疗前,差异均有统计学意义（P＜0.05）。两组治疗前勃起功能障碍（ED）发生率比较,差异无统计学意义（χ2=0.027,P=0.870）;两组治疗后ED发生率比较,差异无统计学意义（χ2=2.807,P=0.094）。奥美沙坦酯组治疗后ED发生率低于治疗前,差异有统计学意义（χ2=4.120,P＜0.05）;苯磺酸氨氯地平组治疗后ED发生率与治疗前比较,差异无统计学意义（χ2=2.811,P=0.094）。治疗前两组睾酮、雌二醇水平比较,差异均无统计学意义（P＞0.05）;治疗后两组雌二醇水平比较,差异无统计学意义（P＞0.05）;奥美沙坦酯组睾酮水平高于苯磺酸氨氯地平组,差异有统计学意义（P＜0.05）。奥美沙坦酯组治疗后睾酮水平高于治疗前,差异有统计学意义（P＜0.05）。结论 奥美沙坦酯能提高男性高血压患者睾酮水平,改善性功能。     

重庆城区男子性功能状况的初步调查

目的：研究重庆城区男子性功能状况，即勃起功能障碍和早泄的患病率、危险因素及性交频率。方法： 2001年7月～10月在重庆市某城区的社区进行随机抽样男子健康问卷调查，共访问18～69岁的男子990人。量表由北京大学人民医院设计，它包括一般情况和中国人勃起功能指数问卷（Chinese Index of Erectile Function ,CIEF）、性交频率及早泄。CIEF<22分为评分ED；受调查者自我评分的勃起功能障碍为自评ED。问卷调查表的结果用SPSS10.0统计学软件处理。结果：本调查评分ED的患病率为44.8%，自评ED为21.5%；大于40岁男子评分ED的患病率为 69.7%，自评ED为 37.4%；在高龄组的患病率高于低年龄组。早泄的患病率为8.1%。随着年龄增大，性交频率下降。影响ED患病的危险因素有躯体疾病和社会因素。结论： ED和早泄的患病率随年龄增高而增加，但性交频率随年龄增高而降低；躯体疾病和社会因素等是ED的危险因素。     

复方仙灵脾汤合用伐地那非治疗勃起功能障碍临床研究

目的 观察复方仙灵脾汤合用伐地那非治疗勃起功能障碍(ED)与单用伐地那非的疗效区别.方法 120例肾阳虚兼气滞血瘀勃起功能障碍患者随机平均分为试验组和对照组.试验组服用复方仙灵脾汤颗粒24g/次,2次/d,性生活前30min服用伐地那非10 mg,疗程6周.对照组性生活前30 min服用伐地那非10 mg,疗程6周.以国际勃起功能问卷表(IIEF-5)评分、性欲评分、性交满足感评分、中医证候评分为评价指标.结果 治疗6周后,2组的IIEF-5评分、性欲评分、性交满足感评分较治疗前有显著提高(P＜0.05),中医证候评分较治疗前有显著降低(P＜0.05).试验组性欲评分、性交满足感评分评分较对照组有显著提高(P＜0.05),中医证候评分较对照组有显著降低(P＜0.05).结论 复方仙灵脾汤合用伐地那非治疗勃起功能障碍在提高性欲、增加性交满足感、减轻全身症状方面优于单用伐地那非.PDE5-抑制剂联合中药治疗ED值得推广.     

曲唑酮治疗抑郁症伴发勃起功能障碍的临床研究

目的:观察曲唑酮对抑郁症患者伴发勃起功能障碍(ED)的疗效及安全性。方法:选择91例抑郁症伴发勃起功能障碍的患者,在原有抗抑郁药物不变的情况下,随机分为实验组46例(合并曲唑酮治疗),对照组45例,疗程6周,于治疗前及治疗后第1、2、4、6周采用勃起功能国际指数评分问卷(IIEF-5)及副反应量表(TESS)评定疗效及不良反应。结果:实验组抑郁症患者勃起功能障碍用曲唑酮治疗的显效率为58.60%,对照组为21.14%,差异具有显著性(P<0.01),实验组IIEF-5评分于第4周末即显著高于对照组,TESS两组比较无显著差异。结论:曲唑酮可显著改善抑郁症患者的勃起功能,安全性高,值得临床应用。     

补肾降压方对男性轻中度高血压患者勃起功能障碍及内皮舒张功能的影响

目的：探讨补肾降压方对轻中度高血压患者勃起功能障碍的改善作用及对血管内皮舒张功能的影响。方法：86例诊断为1级或2级高血压病同时伴勃起功能障碍且符合中医肾虚型患者随机分为药物组（补肾降压方与盐酸贝那普利片联合用药组）43例,对照组（盐酸贝那普利片对照组）43例,两组患者均服用盐酸贝那普利片10mg,1次/d,4周后血压仍高于140/90mmHg者加用氨氯地平片5mg,1次/d,药物组在上述治疗基础上加服＂补肾降压方＂水煎剂,1剂/d,4周为1个疗程,两组均治疗3个疗程,分别于治疗前、治疗后应用IIEF-5评分量表进行勃起功能障碍评分及无创超声行血管内皮舒张功能检测。结果：药物组血压控制总有效率明显高于对照组（95.30%vs89.50%,P〈0.01）;勃起功能障碍评分显著高于对照组（16.9±5.49vs13.6±4.99,P〈0.01）;治疗后两组FMD、NMD均有增高,而药物组FMD、NMD升高更为明显（FMD：13.6±2.58vs10.4±2.06,NMD：16.9±2.82vs12.6±2.12,P〈0.01）。结论：补肾降压方具有良好的降压效果,能够改善高血压合并ED患者勃起功能,显著提高ED患者勃起动能障碍评分,其可能机制考虑与其能够显著改善高血压合并ED患者血管内皮舒张功能有关。     

复方玄驹胶囊改善ED患者勃起功能及心理和人际关系情况研究

目的研究复方玄驹胶囊改善ED(勃起功能障碍)患者勃起功能及心理和人际关系改善情况,探讨其改善ED患者勃起功能及心理和人际关系的可能机制。方法选取IIEF(国际勃起功能评分)评分8-21分的ED患者,随机分入实验组和对照组,应用问卷调查IIEF评分和SEAR问卷(心理和人际关系问卷)对性自信、性自然指数和时间顾虑等方面进行评价,和复方玄驹胶囊服药三周后IIEF,SEAR评分改善情况。结果轻度ED组和中度ED组的IIEF、SEAR评分显著好于治疗前(P0.05)。与万艾可对照组相比,轻度ED组和中度ED组的IIEF、SEAR评分无统计学差别(P0.05)。结论中高IIEF评分ED患者服用复方玄驹胶囊产生相应勃起功能改善和心理和人际关系改善。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.