性自慰导致膀胱尿道异物4例分析

目的 探讨性自慰导致的膀胱尿道异物的临床诊治和预防措施。方法 回顾性分析广东医科大学附属医院2019年4月至2022年2月收治的4例因性自慰导致膀胱尿道异物患者的临床资料,其中3例通过膀胱镜取出异物,1例通过开放手术取出异物。结果 所有患者均痊愈出院。经电话随访,1例尿道异物(牙签合并塑料管)患者术后反复出现尿频、尿急症状,拒绝返院进一步诊治;1例膀胱异物合并慢性肾功能衰竭的患者随访至术后1个月,肾功能较前明显改善;其余2例患者术后1个月排尿通畅。结论 应该提高对膀胱尿道异物的认识,通过详细的病史询问和必要的辅助检查明确诊断,避免因患者隐瞒病史导致漏诊和误诊。同时积极开展性教育,避免膀胱尿道异物的发生。     

性自慰致直肠异物6例报告

性自慰常用异物来刺激泌尿生殖器,放人膀胱、尿道或阴道内的异物屡有报道,但异物放入直肠少见。我院痔瘘科自1986年1月至1999年11月共收治因性自慰放入直肠内异物6例,报告如下:     

6岁男孩尿道异物1例报告

成人因性自慰,用异物刺激生殖器发生膀胱或尿道异物的病例屡有报道,但在儿童则少见发生,我们在1996年9月收治1例,现报告如下。患儿,男,6岁。入院前半日独自一人在后院中玩耍,将一草杆插入尿道中不能取出,直至排尿不畅、尿痛,才送当地医院就诊,因用镊子未取出且排尿呈滴状转入我院。患儿发育营养好,合作;外生殖器无畸形;尿道外口轻度红肿,阴茎及会阴部触诊尿道无异物感,会阴部触诊尿道有局限压痛。消毒后经尿道外口注入的卡因及石蜡油,用小血管钳试取异物仍未成功,遂用     

经尿道前列腺等离子电切术与传统电切术对前列腺增生患者性功能的影响

目的比较分析经尿道前列腺等离子电切术与传统经尿道前列腺电切术治疗前列腺增生对患者性功能的影响。方法根据手术方式的不同,将80例患者分为治疗组和对照组,每组40例患者。治疗组患者采用经尿道前列腺等离子电切术,对照组患者采用传统经尿道前列腺电切术。比较两组患者术前、术后各项指标和术后性功能情况,分析两组患者差异。结果两组患者基本情况无显著差异,治疗组患者术中、术后出血量少于对照组患者;治疗组患者留置尿管时间和住院时间小于对照组患者,术后性功能障碍发生率低于对照组患者。结论经尿道等离子前列腺电切术治疗前列腺增生比传统经尿道前列腺电切术安全,并发症少,术后恢复快,对性功能影响小。     

偏离性手淫异物症的病因分析和防治措施

收治11例偏离性手淫异物症患者,采取去除异物治疗,并进行性健康教育。结果显示11例患者均取出异物,无明显并发症发生,成功戒掉了偏离性手淫习惯,说明长期科学的性健康教育,对防治偏离性手淫异物症是必要的。     

沙利度胺治愈铁异物肉芽肿一例北大核心CSCD

异物肉芽肿是异物进入人体引起的一种过敏反应。手术切除治疗异物肉芽肿最为有效。我们用沙利度胺成功治愈l例铁异物肉芽肿患者,现报告如下。     

钬激光治疗尿道内尖锐湿疣5例报告

目的　观察钬激光经尿道治疗尿道内尖锐湿疣的疗效。方法　对 5例尿道内尖锐湿疣患者采用钬激光经尿道切除术 ,尿道镜检后用钬激光光纤对准疣体汽化切除。结果　手术时间 10～ 3 0min ,术中出血少 ,随访半年无复发。结论　钬激光经尿道治疗尿道内尖锐湿疣疗效好 ,痛苦小。     

经尿道前列腺等离子电切术与经尿道前列腺电切术对良性前列腺增生患者治疗效果及预后性生活质量观察

目的探讨经尿道前列腺电切术和经尿道前列腺等离子电切术对治疗良性前列腺增生的近期临床疗效,以及术后对患者的性生活质量带来的影响。方法选取2016年8月至2017年8月天门市第一人民医院诊治的60例良性前列腺增生患者作为研究对象。根据手术类型分为两组,观察组应用经尿道前列腺等离子电切术进行治疗,对照组应用经尿道前列腺电切术进行治疗。结果观察组患者的各项手术指标显著优于对照组,差异具有统计学意义(P0.05);观察组并发症发生率显著低于对照组,差异具有统计学意义(P0.05);治疗前两组患者前列腺症状评分方无明显区别,差异无统计学意义(P0.05),治疗后观察组显著低于对照组,差异具有统计学意义(P0.05);治疗前两组患者勃起功能无明显区别(P0.05),治疗后观察组显著低于对照组,差异具有统计学意义(P0.05)。结论良性前列腺增生的治疗过程中,观察组采用的经尿道等离子电切术的治疗效果理想,较对照组的经尿道前列腺电切术来说,观察组的治疗方法对人体产生的伤害较小,应该在临床上进一步推广经尿道前列腺等离子电切术使用。     

氨基酮戊酸光动力疗法治疗男性尿道多发性尖锐湿疣临床观察

目的:观察氨基酮戊酸-光动力疗法(ALA-PDT)治疗男性尿道多发性尖锐湿疣的疗效及安全性.方法:采用ALA-PDT治疗10例男性尿道多发性尖锐湿疣.结果:经3次治疗后,10例患者疣体完全脱落,未出现瘢痕及尿道狭窄.随访3个月,1例在治疗结束后50 d复发,1例56 d复发.结论:ALA-PDT治疗男性尿道多发性尖锐湿疣安全、有效.     

经尿道输尿管镜光动力疗法治疗男性尿道内尖锐湿疣临床观察

目的比较经尿道输尿管镜光动力疗法和钬激光治疗男性尿道内尖锐湿疣的疗效和安全性。方法 126例男性尿道内尖锐湿疣患者随机分为试验组和对照组,每组63例。试验组采用光动力治疗,对照组采用钬激光治疗。治疗后观察疗效、复发率及不良反应。结果试验组患者痊愈率和有效率分别为80.95%(51/63)和95.24%(60/63);对照组患者痊愈率和有效率分别为58.73%(37/63)和82.54%(52/63),两组痊愈率和有效率比较,差异有统计学意义(P0.01P0.05)。所有患者均随访6个月,试验组复发率为12.70%(8/63),明显低于对照组的复发率26.98%(17/63),两组比较差异有统计学意义(P0.05)。试验组患者治疗后无尿道出血、尿道狭窄和瘢痕,而对照组分别有3例(4.8%)和5例(7.9%)患者出现尿道狭窄和瘢痕。结论经尿道输尿管镜光动力治疗尿道内尖锐湿疣临床有效、不良反应小、复发率低。     

不孕患者子宫内膜病变的临床病理分析

目的：探讨不孕患者子宫内膜病变的病理类型以及对治疗效果的影响。方法：选取不孕患者104例，于月经来潮后12h内行诊断性刮宫并进行病理分析。分泌反应类患者给予活血补肾为主的中医治疗，增生反应类患者给予克罗米芬口服。结果：子宫内膜病变中以分泌类反应较多，其中尤其以分泌欠佳所占比例最大，而增生类反应中以增生反应较多见。不同程度分泌异常患者随着病变严重程度增加，治疗效果也越来越差，组间比较差异明显，具有统计学意义（P＜0.05）。不同类型增生异常患者治疗效果差别不大，无统计学意义（P＞0.05）。结论：分泌类反应患者的病理诊断有助于对患者预后作出判断；增生类反应者虽然不同类型预后差别不大，但是治疗手段却不同，因此病理诊断也十分必要。     

Assessing the viability of Mycobacterium leprae by the fluorescein diacetate/ethidium bromide staining technique.

In the present study we have evaluated the Fluorescein Diacetate/Ethidium Bromide (FDA/EB) staining technique to assess the viability of Mycobacterium leprae obtained from biopsies of leprosy patients under different periods of treatment. Bacillary suspensions were obtained from skin punch biopsies and stained with the FDA/EB solution. The average percentage of green cells seen which were deemed to be viable were: 67.2% of green cells in patients without previous treatment; 45.6% in patients with 1 to 6 months of treatment; 25.9% for patients with 7 to 12 months of treatment and 10.5% in patients with 13 to 24 months of treatment. All the patients studied were on multidrug therapy. The differences obtained in the percentages of green cells in the different groups of patients were statistically significant as determined by the Wilcoxon's test. The decrease in the percentage of green cells observed with increasing periods of treatment suggests that the FDA/EB technique correlates with the actual viability of M. leprae. The application of this technique in the routine procedures performed with Hansen's disease patients could be very useful for monitoring the effectiveness of treatment in leprosy patients.     

Psoriasis treatment with etanercept and efalizumab: clinical strategies influencing treatment outcome

BACKGROUND: Multiple trials have been conducted in which the safety and efficacy of different biological therapies for psoriasis have been studied. However, the treatment course in clinical practice is different from the setting in which trials are conducted. OBJECTIVES: The evaluation of the efficacy, safety and adverse events of etanercept and efalizumab treatment in daily practice and the investigation of interfering clinical strategies that could be of influence on treatment outcome. METHODS: A prospective cohort consisting of 101 patients with high-need psoriasis was followed for 2 years and analysed. Patients were treated with etanercept or efalizumab between February 2005 and May 2007. Efficacy, safety and adverse events were investigated. Furthermore, all accompanying factors of which an influence on treatment efficacy outcome was suspected were registered, including treatment interruptions, dosage adjustments and combinations of therapies. RESULTS: Etanercept and efalizumab treatment was effective and safe in most patients. However, in many cases the treatment course was characterized by unsatisfactory efficacy (83%), necessitating combination therapies or dosage adjustments. Treatment interruptions occurred in 56% (etanercept 2x50 mg group), 84% (etanercept 2x25 mg group) and 10% (efalizumab-treated patients). CONCLUSIONS: Treatment of high-need psoriasis patients in daily practice is highly different from treatment courses in clinical trials. Frequently applied clinical strategies such as treatment interruptions, dosage adjustments and combinations of treatments influence treatment outcome in routine treatment in comparison with randomized controlled trials. Information about treatment with these new drugs in daily clinical practice is important for adjusting treatment schedules and guidelines.     

复方玄驹胶囊治疗Ⅲ型前列腺炎相关性功能障碍的临床研究

目的：研究复方玄驹胶囊治疗Ⅲ型前列腺炎相关性功能障碍的临床效果。方法：选取我院收治的Ⅲ型前列腺炎相关性功能障碍患者90例,对照组采取左氧氟沙星胶囊常规治疗,观察组在此基础上加用复方玄驹胶囊治疗。对两组患者不同PSFI评分分级患者的治疗效果进行比较,对两组患者不同CPSI评分分级患者的治疗效果进行比较,对两组患者治疗前后的焦虑评分进行比较。综合评价复方玄驹胶囊在治疗前列腺炎相关性功能障碍患者的疗效。结果：治疗后两组PSFI和CPSI轻度、中度和重度患者组间疗效比较,观察组均明显优于对照组,组间比较差异均有显著性,有统计学意义（P均〈0.05）。观察组治疗后SAS评分改善程度明显大于对照组,差异有显著性,有统计学意义（P〈0.05）。结论：复方玄驹胶囊联合西医抗生素治疗Ⅲ型前列腺炎相关性功能障碍临床效果显著,并可有效减轻患者的焦虑。     

盛水汤三种不同剂型治疗特发性弱精症的临床研究

目的：观察盛水汤三种不同剂型（汤剂、酒剂、酒水剂）治疗特发性弱精症的临床疗效。方法：105例患者采用随机数字表法分为汤卉13组（甲组）、酒剂组（乙组）、酒水剂组（雨组）,分别按设计的治疗方法进行治疗。其中甲组35例,采用盛水汤汤剂治疗;乙组32例,采用盛水汤酒剂治疗;丙组38例,采用盛水汤酒水剂治疗,疗程3个月,分别于治疗前后观察病人的精子活力。结果：三组均可显著提高特发性弱精症患者的精子活力（P〈0．05）,而三组之间疗效差异无显著性（P〉0．05）。结论：盛水汤三种不同剂型治疗特发性弱精症疗效明显,酒剂、酒水剂与汤剂疗效接近。     

A personalized treatment approach of frontalis muscle with botulinum toxin A (Bont-A) related to functional anatomy: case studies

ABSTRACT

Background: The forehead is one of the most frequent sites of botulinum toxin (Bont-A) application. To date, few data are available about the anatomy of the frontalis muscle. Its anatomy is highly heterogeneous in Caucasian people. Consequently, personalized treatments with botulinum toxin-A (Bont-A) are needed to obtain good esthetic results and to reduce side effects. Recently, a study on cadavers found four anatomical shapes of the frontalis muscle, corresponding to four horizontal wrinkle patterns in live patients.

Objective: To perform a personalized, reproducible, and safer treatment with Bont-A of the forehead, by classifying patients according to four specific anatomical shapes of the frontalis muscle related to skin wrinkle patterns during contraction.

Methods: We treated four patients classified according to the four anatomic types (I, II, III, and IV). The patients’ forehead was divided into 21 areas and matched with 4 horizontal wrinkle patterns. Detecting different activities of the muscle in the different areas of the forehead, treatment injections were performed with a different dose, dilution, and at different anatomical layers (intramuscular or intradermal) per point.

Conclusions: We confirmed four different wrinkle patterns after forehead contraction according to the anatomical shape of the frontalis muscle. This allows us to perform a tailored treatment with Bont-A. Nevertheless, some patients with atypical patterns still need “ad hoc” treatment.     

Patient preference study for different characteristics of systemic psoriasis treatments (Protimisis)

“The Protimisis” study was a multicenter, cross‐sectional study investigating the relative importance and economic value that patients assign to different characteristics of systemic psoriasis treatments. Treatment preferences were investigated with the DCE methodology and patients had to decide over the most important aspects of different psoriasis treatments. A questionnaire regarding demographic data/medical history and the DLQI and EQ‐5D‐3L questionnaires were also completed. A total of 310 patients were included. Out of those, 37.4% reported using oral medications for psoriasis as their most recent treatment, while the remaining patients reported treatment with injections once per week (14.8%), injections twice per week (7.4%), injections once every three months (29.4%) and intravenous injections every two months (8.4%) as their most recent treatment. Mean DLQI score was 6.6 (SD 6.5), and in the EQ‐5D‐3L index, 71.0% of patients reported having problems with anxiety or depression. DCE analysis showed a clear preference for treatments with longer dosing intervals, rapid onset of action, lasting clinical response, low risk of SAEs and lower cost. The risk of SAEs was the most important treatment characteristic (54% of patients). Older patients showed less concern for safety matters than younger patients. The highest willingness‐to‐pay was recorded for treatments with longer dosing intervals and for safer treatment options.     

治疗滴虫性阴道炎的新体会

目的:探讨个体化治疗滴虫性阴道炎的体会。方法:研究对象38例,妊娠者8例,绝经者7例,月经正常者23例,既往患滴虫性阴道炎者11例。根据个体情况采用常规治疗、复发者的治疗、妊娠者的治疗。结果:患者停药3～5天后复查,临床症状消失、妇科检查正常及分泌物化验滴虫为阴性。结论:个体化治疗滴虫性阴道炎能有效治愈,降低复发率。     

尖锐湿疣患者外周血淋巴细胞表型及治疗后的变化

采用ＩＩＦ技术对３５例ＣＡ病人治疗前后外周血Ｔ淋巴细胞亚群进行检测。结果表明：ＣＡ病人外周血中细胞百分比升高，细胞百分率、比率下降；治疗后３个月内未复发的７名患者，Ｔ细胞亚群恢复到正常范围，而１６名复发者，治疗前后比较各群细胞均无明显变化。提示病人机体内存在细胞免疫缺陷，检测外周血Ｔ细胞亚群对疗效的预测有帮助。     

Evaluation of port wine stain perfusion by laser Doppler imaging and thermography before and after argon laser treatment.

Thirteen patients with port wine stains (PWS) were treated with argon laser therapy. Before and at different points in time following treatment, skin blood perfusion and temperature were mapped with laser Doppler imaging and thermography. In nine patients no elevation in blood perfusion was observed in the PWS in comparison with the surrounding normal skin before treatment. In the remaining four patients a significantly (p less than 0.01) higher blood flow was recorded within the PWS. Immediately after treatment nine patients showed elevated perfusion within the PWS. During the first two days following treatment, all patients showed a gradually decreasing hyperperfusion in the borderline between the PWS lesion and surrounding skin. Immediately after treatment 10 patients had a significantly (p less than 0.01) higher temperature in the PWS than in normal skin. During the first 24 h following treatment, an elevated perfusion was in general accompanied by a tissue temperature increase. Three and a half months after argon laser treatment, three patients showed excellent clinical results with no remaining PWS spots or scarring. Two of these patients had had both elevated perfusion and temperature in the PWS prior to treatment.