胰岛素对糖尿病大鼠阴茎内nNOS神经纤维的影响

目的探讨糖尿病性阴茎勃起功能障碍（ED）的发病机制及胰岛素的治疗作用。方法注射链脲佐菌素建立糖尿病（DM）大鼠模型，胰岛素治疗组于成模后注射胰岛素。7周和12周后注射阿扑吗啡（APO）进行大鼠阴茎勃起功能实验，取大鼠阴茎和血浆，用ABC免疫组织化学法观察nNOS神经纤维的变化。测定血浆NOS活性。结果（1）与对照组相比，DM组大鼠阴茎勃起次数明显减少;胰岛素治疗后症状缓解;（2）与对照组相比，DM组血浆NOS活性明显增高;DM组血浆NOS活性与病程延长呈负相关;与DM组比较，胰岛素治疗组血浆NOS活性明显降低;（3）与对照组相比，DM组阴茎内nNOS阳性神经纤维明显减少;与DM组比较，胰岛素治疗组nNOS阳性神经纤维表达增加。结论糖尿病性ED阴茎内nNOS阳性纤维的数量及光密度随DM病程的延长而下降;早期给予胰岛素治疗可预防糖尿病大鼠ED的出现及阴茎内nNOS含量的下降。     

Urethral dysfunction in diabetic rats

PURPOSE: We investigated the effects of diabetes mellitus (DM) on urethral relaxation mechanisms during reflex bladder contractions in rats. MATERIALS AND METHODS: Five weeks after streptozotocin injection (65 mg/kg intraperitoneally) the effects of DM on urethral relaxation mechanisms were evaluated by simultaneous recordings of intravesical pressure under isovolumetric conditions and urethral perfusion pressure (UPP) using urethane anesthesia. RESULTS: In diabetic rats the UPP nadir during urethral relaxation and intravesical pressure thresholds for inducing urethral relaxation were significantly higher (199% and 92%, respectively) than in normal rats, while baseline UPPs were not significantly different. The mean rate and amplitude of high frequency oscillations of urethral striated muscle in diabetic rats were also significantly lower (17% and 64%, respectively) compared with normal rats. Following alpha-bungarotoxin treatment to eliminate striated muscle sphincter contractions intravenous administration of L-arginine (200 mg/kg) [corrected] , the substrate of nitric oxide (NO) synthase, decreased the UPP nadir (36% and 22%, in diabetic and normal rats) as well as intravesical pressure thresholds (49% and 22%, respectively). The effect was greater (61% to 126%) in diabetic rats than in normal rats. In each group of rats the effect of L-arginine was inhibited by Nomega-nitro-L-arginine (100 mg/kg intravenously) [corrected], a NO synthase inhibitor. CONCLUSIONS: During reflex bladder contractions streptozotocin induced diabetic rats exhibited smooth and striated muscle dysfunctions of the urethral outlet. L-arginine therapy, which could augment urethral smooth muscle relaxation by increasing NO production, may be useful for partially restoring the urethral relaxation mechanism in DM.     

还原型谷胱甘肽在预防糖尿病大鼠勃起功能障碍中的研究

目的探讨还原型谷胱甘肽(GSH)在预防糖尿病大鼠勃起功能障碍中的作用。方法通过腹腔注射链脲佐菌素65mg/kg建立糖尿病大鼠模型,然后随机分成DM组和DM+GSH组,DM+GSH组每天肌肉注射GSH200mg/kg。10周后观察大鼠勃起功能,并获取海绵体组织检测其谷胱甘肽、一氧化氮合酶(NOS)与丙二醛(MDA)水平,用TUNEL法检测细胞凋亡。结果成功建立糖尿病大鼠模型。与未注射GSH的DM组相比,DM+GSH组和正常对照组(C组)勃起功能更好,勃起率分别是20%,62.5%和100%。GSH水平DM+GSH组和C组明显比DM组高,其3组含量每克蛋白分别是(75.83±15.62)、(61.47±8.65)和(35.03±12.29)mg(P<0.05);NOS水平在DM+GSH组每毫克蛋白为(133.9±31.9)U,与正常对照组每毫克蛋白为(142.2±31.2)U相当,但较DM组每毫克蛋白为(58.4±18.9)U高(P<0.05);MDA含量在DM组每毫克蛋白为(3.71±0.62)nmol,明显高于正常对照组和DM+GSH组(P<0.05),这两组每毫克蛋白为(2.08±0.34)nmol和(2.44±0.28)nmol;细胞凋亡率在DM组、DM+GSH组和C组的分别是(22.6±3.6)%、(10.8±1.7)%和(7.2±2.1)%(P<0.05)。结论还原型谷胱甘肽对糖尿病大鼠阴茎组织有较好的抗氧化作用,能减少细胞凋亡,对延缓糖尿病性ED的发生有一定的作用。     

滋阴壮阳胶囊对糖尿病性勃起功能障碍大鼠血清NO、ET-1的影响*

目的通过研究滋阴壮阳胶囊对糖尿病性勃起功能障碍(DED)大鼠血清中NO和ET-1的影响,探讨该药治疗DED的作用机制.方法雄性SD大鼠70只,60只以STZ诱导建立糖尿病(DM)模型后,通过阿朴吗啡(APO)进行阴茎勃起实验筛选DED模型,余10只为空白对照组.造模后的DED大鼠随机分成滋阴壮阳胶囊治疗组、六味地黄软胶囊对照组和模型组,在灌胃2周后,腹主动脉取血检测各组大鼠NO和ET-1.结果各组间ET-1和NO差异均有统计学意义(P<0.01);与空白对照组比较,模型组ET-1水平显著升高、NO显著下降(P<0.01);与模型组比较,治疗组和对照组均可降低ET-1水平,升高NO水平(P<0.01、P<0.05),且在降低ET-1方面治疗组优于对照组(P<0.05).结论滋阴壮阳胶囊可通过升高NO的浓度,降低ET-1的水平,重新调整ET-1与NO之间的平衡,这可能是该药治DED的机理之一.     

Genetic and environmental effects on the continuity of ejaculatory dysfunction

Study Type – Symptom prevalence (retrospective cohort)
Level of Evidence 2b

OBJECTIVES

To investigate temporal continuity in ejaculatory dysfunction by comparing self‐reported experiences of premature ejaculation (PE) at first intercourse with self‐reported PE and delayed ejaculation at present, and to clarify whether and to what extent genetic or environmental factors affect continuity in ejaculatory dysfunction, as previous studies indicate moderate heritability for PE at first intercourse.

SUBJECTS AND METHODS

The study comprised retrospective self‐reported data on ejaculatory performance at first sexual intercourse and a concurrent self‐report of the same at the time of data collection in a population‐based sample of 2633 Finnish twins and their siblings aged 18–48 years (mean 26.63, sd 4.68). The continuity of ejaculatory function was assessed by correlation and multiple regression. Reasons for continuity were separated into genetic and environmental sources using twin‐model fitting.

RESULTS

Ejaculatory function, particularly PE, was stable over time. Genetic effects accounted for ≈30% of the variance in PE both at first intercourse and when measured at data collection. Unshared environmental effects accounted for most of the variance (≈70%). Genetic effects were almost identical between the sample occasions, but there was a substantial discrepancy between unshared environmental effects affecting PE at first intercourse and unshared environmental effects affecting PE later in life. Age effects were generally negligible. Data were self‐reported and retrospective, and thus vulnerable to response bias.

CONCLUSIONS

Ejaculatory dysfunction seems to be temporally stable both in the short and long term. Genes that contribute to the variance in PE at first intercourse are similar to those that contribute to the variance in PE later in life, whereas there are, in this regard, substantial differences in the unshared environmental factors that are a cause of PE.     

射精管部分梗阻致大鼠血精模型的建立

目的:建立射精管部分梗阻致大鼠血精模型,探讨血精症发病机制。方法:成年雄性SD大鼠50只,分为A组(30只)和B组(20只)。将A组大鼠行右侧射精管部分结扎,B组仅行开关腹(假手术)。于手术后1周行电刺激诱导射精,从A组中选出产生肉眼血精者设为A1组(实验组),从B组中选出射精功能完好者设为B1组(对照组),比较两组间精液常规及精囊内压力。结果:A1组精液量[(0.46±0.12ml]较B1组[(0.91±0.12)ml]减少,差异有显著性(P<0.01);两组精液中白细胞数[(0.83±0.75)/HPvs(0.89±0.78)/HP]及精子密度[(29.85±1.68)×106/mlvs(30.58±1.64)×106/ml]均无统计学差异(P>0.05)。A1组精子活动力[(36.35±3.52)%]较B1组[(61.02±5.35)%]明显减小,有显著性差异(P<0.01)。A1组精囊内压较B1组[(6.73±1.50)cmH2Ovs(1.39±0.56)cmH2O]明显增大,有显著性差异(P<0.01)。结论:射精管部分梗阻可引发血精,且伴随有精液指标的变化,其发生与精囊内压力增高密切相关。     

糖尿病女性性功能障碍研究进展

糖尿病是一种常见病、多发病,而女性性功能障碍是其并发症之一。研究显示糖尿病血管病变、神经病变、内分泌失常和心理因素是女性性功能障碍的主要发病原因。本文就近年来糖尿病女性性功能障碍研究进展做一综述。     

Practical application of color Doppler ultrasonography in patients with ejaculatory dysfunction

We describe two cases in which dynamic analysis of ejaculation using color Doppler ultrasonography was useful in diagnosis of ejaculatory dysfunction and planning of therapy. The first patient was a 32‐year‐old man with a diagnosis of retrograde ejaculation. A bladder neck collagen injection was carried out, as the main cause was thought to be the bladder neck remaining open during ejaculation. The patient had antegrade ejaculation 1 week later. The second patient was a 48‐year‐old man with a diagnosis of anorgasmia accompanied by decreased seminal emission and insufficient function of the rhythmic pelvic striated muscles. The patient was prescribed etilefrine hydrochloride 15 mg/day. The symptom improved 2 weeks after starting this drug. These cases suggest that the use of color Doppler ultrasonography during ejaculation can improve the understanding of ejaculatory dysfunction and therapy for this condition.     

负压吸引对糖尿病性ED大鼠阴茎海绵体组织一氧化氮合酶表达的影响

目的研究负压吸引对糖尿病性勃起功能障碍（ED）大鼠阴茎组织一氧化氮合酶（NOS）表达水平的影响。方法25只实验鼠中随机选取5只为正常对照组（A组）,其余火鼠用链脲左菌素和阿朴吗啡诱导建立Ⅰ型糖尿病性ED大鼠模型。之后把造模成功的糖尿病性ED大鼠随机分成糖尿病ED吸引组（B组）和糖尿病ED非吸引组（C组）。在B组大鼠负压吸引治疗结束后将A、B、C3组大鼠处死并取阴茎组织进行石蜡包埋。采用免疫组织化学方法检测各组大鼠阴茎组织中三种一氧化氮合酶亚型（nNOS、eNOS、iNOS）的表达情况。结果A组大鼠阴茎组织中nNOS蛋白表达水平高于B组和C组（均P〈0.001）;A组和B组大鼠阴茎组织中eNOS蛋白表达水平高于C组（均P〈0.01）;A组iNOS蛋白表达水平低于B组和C组（P〈0.01,P〈0.001）,同时B组iNOS蛋白表达水平低于C组（P〈0.01）;剩余其他各组间的比较差异无统计学意义（P〉0.05）。结论负压吸引可以通过升高阴茎组织中的eNOS和降低iNOS的表达来改善勃起功能。     

Melatonin prevents deterioration of erectile function in streptozotocin-induced diabetic rats via sirtuin-1 expression

A review of the literature indicated that sirtuin-1 expression, a regulator of nitric oxide bioavailability in erectile dysfunction (ED) after melatonin therapy, has not yet been investigated. The objective of this study was to evaluate the protective effects of melatonin for erectile function with sirtuin-1 protein expression in type 1 diabetic rat models. Fifty male Sprague Dawley rats were placed into five groups. Except for those in the control group (C), each animal received a single dose (60 mg/kg) of streptozotocin to induce diabetes. The animals were placed into the diabetes (D) group, insulin (I) group (6 U/kg/day), melatonin (Mel) group (10 mg kg⁻¹ day⁻¹) and combined treatment (I + Mel) group. Ten weeks later, the serum testosterone levels, intracavernosal pressure (ICP), mean arterial pressure (MAP), malondialdehyde (MDA), cyclic guanosine monophosphate (c-GMP), 8-hydroxydeoxyguanosine (8-OHdG), nitric oxide synthase (NOS), caspase-3 activity, sirtuin-1 and endothelial nitric oxide synthase (eNOS) protein expression and histological findings were assessed. The mean ICP/MAP ratio for the D group was lower than the mean ratios for the other groups. The treatment groups, particularly the I + Mel group, exhibited lower 8-OHdG and MDA levels and caspase-3 activity than the D group. The sirtuin-1 and eNOS expression and cavernosal tissue (CT) histology seemed to have been preserved by the melatonin and/or insulin therapy. These results were indicative of a profound protective effect of melatonin by the activation of sirtuin-1 protein expression against hyperglycemia-induced oxidative CT injury.     

糖尿病性勃起功能障碍相关因素分析

目的 研究糖尿病性勃起功能障碍(ED)的发病情况及其影响ED程度的相关因素。 方法 调查90例男性2型糖尿病病人的性功能状态、年龄、糖尿病病程、测量血压,同时测定其糖化血红蛋白(HbA1C)血脂等指标。结果 糖尿病病人中ED患病率为75.6%(68/90),患病率随年龄的增加而增加,在非ED组与不同程度ED组之间,年龄存在非常显著差异(P<0.01),DM病程、HbA1C存在显著差异(P<0.05)结论 糖尿病病人ED患病率高,糖尿病性ED的程度随年龄、DM病程、HbA1C的增加而加重,长期良好的血糖控制有助于延缓糖尿病性ED的加重。     

糖尿病大鼠血糖波动对肝脏功能及超微结构的影响

目的 建立糖尿病(diabetes mellitus,DM)大鼠血糖渡动模型,观察血糖波动对DM大鼠肝脏损伤的作用.方法 SD 大鼠24只均分为3组,A组为正常对照组,B组为稳定高血糖组,C组为波动血糖组,B组、C组大鼠均一次性腹腔内注射链脲佐菌素(STZ)65 mg/kg,建立DM模型.C组每天错时给予胰岛素和50%...     

The relationship between serum irisin levels and erectile dysfunction in diabetic men (irisin and erectile dysfunction in diabetic patients)

Irisin is an exercise-induced myokine that alleviates endothelial dysfunction and reduces insulin resistance in type 2 diabetes mellitus. We conducted this cross-sectional prospective study to determine the association of serum irisin levels and erectile dysfunction in type 2 diabetic patients. We compared 34 diabetic patients with erectile dysfunction with 30 diabetic patients without erectile dysfunction. In our study, serum irisin levels were found to be statistically significantly higher in diabetic patients without erectile dysfunction compared to those with erectile dysfunction (p = .016) and according to correlation analysis, irisin levels had a significantly negative correlation with the serum HbA1C value (r = −.294, p = .018). Based on the results of our study, we think that this molecule can be used in the diagnosis or treatment of erectile dysfunction in diabetic patients, if these findings are supported by larger studies.     

糖尿病性勃起功能障碍兔模型的建立

目的 用新西兰兔建立糖尿病性勃起功能障碍(ED)动物模型,为ED的基因治疗提供实验基础。方法 雄性新西兰白兔(2.4~2.6)kg30只,实验兔15只采用四氧嘧啶耳缘静脉注射(150mg/kg)诱发糖尿病,对照组兔15只耳缘静脉注射等量生理盐水。在相同条件下饲养,6月后比较试验组兔和对照组兔阴茎勃起功能的改变:方法是测量两组兔基础海绵体内压(ICP)和电刺激盆神经后检测ICP的变化,同时检测颈动脉血压(SAP),鉴定ED兔的建立。结果 用四氧嘧啶诱导的糖尿病兔的血糖值明显高于对照组兔,血糖均大于20mmol/L,体重增加小于对照组兔,两组数值有显著性差异。两组兔基础ICP无明显差异,P>0.05;电刺激盆神经时,糖尿病组兔的平均ICP为(11.651.40)mmHg;而对照组兔为(33.613.20)mmHg,P<0.01,差异有显著性。结论 用四氧嘧啶可诱导新西兰雄兔建立糖尿病动物模型,进一步建立ED的动物模型,为研究ED的基因治疗奠定实验基础。     

评价经直肠彩色多普勒超声在男性不育症精囊和射精管病变诊断中的价值

目的探讨经直肠超声在男性不育症患者精囊和射精管病变诊断中的价值.方法应用经直肠彩色多普勒超声技术对50例男性不育症患者进行精囊和射精管检查.结果男性不育症患者经直肠超声表现呈现多样性特点,其中包括精囊先天性缺如和发育不良、慢性精囊炎如精囊肿大或精囊壁增厚伴钙化,射精管梗阻性病变如射精管扩张以及射精管囊肿,射精管壁钙化等.部分病例未发现明显精囊和射精管病变.结论经直肠彩色多普勒超声可用于射精管梗阻性病变和精囊先天性改变的诊断.对于精囊炎症性表现具有一定诊断意义,它是男性不育症患者精囊和射精管病变诊断的理想手段.     

Bladder dysfunction in type 2 diabetic patients

AIMS: To reevaluate urodynamic findings of bladder dysfunction (BD) in type 2 diabetic patients with patient characteristics and concommittant chronic complications. METHODS: Patients (M/F:27/27) with lower urinary tract symptoms (LUTS) underwent a detailed urodynamic investigation. Urodynamic findings were classified as diabetic cystopathy [DC, characterized by impaired bladder sensation, increased post-void residual urine (PVR) and increased bladder capacity and decreased bladder contractility], detrusor overactivity, bladder outlet obstruction (BOO), urge and stress urinary incontinence or BD in which one of the alterations was included. Glycated hemoglobin (HbA1C), diabetic retinopathy, nephropathy, sensorimotor, and autonomic neuropathies were evaluated. RESULTS: BD was present in 74.07% of men (DC, 50%; BOO, 25%; detrusor overactivity, 25%) and in 59.26% of diabetic women (DC, 43.75%; detrusor overactivity, 31%; urge incontinence, 12.5%; stress urinary incontinence 12.5%). In men, age, duration of diabetes and HbA1C threshold values predicting BD were >64 years, >9 year, >7.9%, while in women, they were >56 years, >8 years, >7%, respectively. Prolongation of QTc, abnormal esophageal transit and gastric emptying times, diabetic retinopathy, and microalbuminuria were associated with an increased risk of PVR >or= 100 ml. CONCLUSIONS: DC was the most frequent finding in patients. Ageing, duration of diabetes, worse metabolic control, PVR 100 ml, cardiac, esophageal and gastric parasympathetic autonomic neuropathies, retinopathy, and microalbuminuria provided a means to predict BD in patients in order to investigate by urodynamics. The establishment of DC in at least 8-9 years after the diagnosis of type 2 DM was an important parameter to inform our diabetic patients.     

糖尿病大鼠精囊组织中神经生长因子和胆碱能M3受体的变化

目的:观察糖尿病大鼠精囊组织中神经生长因子(NGF)和胆碱能毒蕈碱M3受体含量的变化,以探讨糖尿病自主神经病变对精囊的影响,为糖尿病不育的临床防治提供理论依据。方法:成年雄性普通级SD大鼠15只,随机分为正常对照组5只和糖尿病模型组10只。链脲佐菌素(STZ)制备糖尿病模型成功后饲养8周,取精囊组织进行苏木精-伊红(HE)染色和免疫组化染色。结果:与正常对照组相比,糖尿病模型组HE染色可见大鼠精囊平滑肌细胞减少,腺上皮胞质变薄,结构紊乱。免疫组织化学染色显示,糖尿病模型组NGF阳性强度明显增强,而M3受体则明显减弱,糖尿病模型组与正常对照两组间NGF和M3平均累积光密度(IA)[0.018 7±0.002 4 vs 0.010 0±0.001 5和0.020 9±0.008 5 vs 0.041 2±0.011 7]的差异均具有统计学意义(P均<0.01)。结论:NGF和M3受体在糖尿病鼠精囊中表达改变,提示糖尿病可致精囊自主神经病变。     

Exogenously administered adenosine attenuates renal damage in streptozotocin-induced diabetic rats

Background: Diabetic nephropathy (DNP) is one of the most serious complications of diabetes mellitus (DM). In the present study, we investigated the potential of adenosine as a therapeutic candidate for preventing DNP.

Methods: Twenty-one adult male rats were included in the study. Fourteen rats were administered a single dose of 60?mg/kg streptozotocin (STZ) to induce diabetes. Seven rats served as normal control group. Diabetic rats were randomly divided into two groups: one group was treated with 1?mL/kg saline/day (DM?+?saline) and the other group was treated with 5?mg/kg/day adenosine (DM?+?adenosine) for 6?weeks. After 6?weeks, biochemical parameters including urea, creatinine, blood urea nitrogen (BUN), kidney injury molecule-1 (KIM-1) and tumor necrosis factor-α (TNF-α) were measured in plasma samples. Also, kidneys were removed for histopathological assessment.

Results: Both of plasma KIM-1 and TNF-α levels were significantly higher in DM?+?saline group compared to controls. However, treatment of diabetic rats with adenosine significantly decreased the plasma KIM-1 and TNF-α levels compared to DM?+?saline group. Significant histopathological changes were observed in diabetic rats whereas adenosine treatment effectively prevented these changes.

Conclusions: The findings of the present study suggest that adenosine may be a useful therapeutic agent for preventing DNP.     

糖尿病性阴茎勃起功能障碍动物模型血清雄激素测定

ＳＤ大鼠注射链脲佐菌素制造溏尿病（ＤＭ）动物模型后,注射阿朴吗啡观察不同时期大鼠阴茎勃起情况,筛选ＤＭ性阴茎勃起功能障碍（ＥＤ）大鼠模型,测定其血清ＬＨ、ＦＳＨ及睾酮的浓度,并观察睾丸组织的显微结构,研究ＤＭ性ＥＤ的发病机理。结果ＤＭ性ＥＤ大鼠血清睾酮浓度显著降低,睾丸组织显微结构发生明显病理性改变,且上述变化与ＤＭ病程密切相关;ＬＨ在ＤＭ早期无改变、晚期明显降低;ＦＳＨ无明显改变。提示ＤＭ严重影阴茎勃起功能及雄激素的合成分泌,雄激素降低可能是其主要发病机理之一。     

褪黑素抗氧化治疗糖尿病大鼠阴茎勃起功能障碍的研究

目的 观察褪黑素对糖尿病大鼠阴茎勃起功能的影响,探讨氧化应激在糖尿病性勃起功能障碍发病机制中的作用.方法 一次性腹腔注射STZ建立糖尿病大鼠模型,随机分为糖尿病组、褪黑素(MT)治疗组以及对照组.8周后通过电刺激各组大鼠勃起神经来检测海绵体内压,评价勃起功能;采用硫代芭比妥酸法检测阴茎海绵体组织中丙二醛(MDA)含量,黄嘌呤氧化酶法测超氧化物氧化酶(SOD)活性;免疫组化染色半定量分析各组大鼠阴茎海绵体中平滑肌及内皮的含量.结果 与正常对照组相比,阴茎海绵体组织中MDA含量显著增加(P＜0.01),SOD活性降低(P＜0.05),最大海绵体内压(ICP)亦显著降低(P＜0.05);与糖尿病组相比,MT组大鼠海绵体MDA含量明显降低(P＜0.05),其SOD活性和ICP显著升高(P＜0.05);且其海绵体平滑肌及海绵窦内皮细胞含量明显提高.结论 MT可通过改善组织中氧化应激水平,促进阴茎海绵体平滑肌和内皮组织修复,提高勃起功能;抗氧化治疗可能为糖尿病性勃起功能障碍的防治提供新的策略.