感染指标CD64与慢性细菌性前列腺炎其他相关检测指标的关系

目的:探讨慢性细菌性前列腺炎前列腺液(EPS)中炎性反应相关指标CD64与其他指标,即白细胞和外周血中C-反应蛋白(CRP)、降钙素原(PCT)与慢性前列腺炎症状评分表(CPSI)的关系。方法:采用免疫比浊法检测50例慢性细菌性前列腺炎(CBP)患者和30例健康体检者外周血CRP、PCT,流式细胞仪定量检测前列腺液中CD64表达,前列腺液白细胞镜检,专业技术人员指导下填写CPSI表。结果:健康对照组和感染组CD64与EPS、CPSI-1、CPSI总分在三组中比较,差异有统计学意义(r=0.231、0.258、0.254,P<0.05),与CRP、PCT无相关性(P>0.05)。结论:CD64优于CPSI等方法,可在前列腺慢性炎临床检验中作为一项炎性反应检测指标。     

慢性前列腺炎患者SDS、SAS与NIH-CPSI评分的相关性分析及综合治疗评价

目的探讨慢性前列腺炎患者焦虑及抑郁自评量表(SAS、SDS)与NIH-CPSI评分间的相关性,及综合治疗在慢性前列腺炎(CP)患者中的疗效观察。方法治疗前对42例慢性前列腺炎患者行SDS、SAS及CPSI评分及相关性分析,以健康人群为对照。慢性前列腺炎患者给予综合治疗(药物、物理治疗+心理干预+生活指导),比较治疗前后患者SDS、SAS与CPSI评分间差异。结果 CP患者与健康人群SDS、SAS及CPSI评分差异有统计学意义(P0.001)、且SDS、SAS与CPSI评分呈正相关(r1=0.628,r2=0.512,P0.001),42例CP患者综合治疗前后SDS、SAS与CPSI评分差异有统计学意义(P0.01)。结论综合治疗是目前慢性前列腺炎(CP)治疗较为全面、有效的方法,能有效缓解症状及焦虑抑郁情绪,改善患者生活质量。     

慢性前列腺炎的综合治疗分析

目的:探讨慢性前列腺炎的有效治疗方法.方法:分析455例慢性前列腺炎(CP)患者的病史和实验室检查结果,依据美国国立卫生研究院(NIH)前列腺炎的诊断标准进行分类,综合治疗4～6周.根据慢性前列腺炎症状指数评分(CPSI)、症状及体征判断疗效.结果:治疗4～6周后显效359例(78.9%),有效71例(15.6%),无效25例(5.5%).结论:综合性治疗是CP的有效治疗方法.     

基于规律排精的综合疗法治疗ⅢA型前列腺炎

目的 探讨基于规律排精而辅以特拉唑嗪的综合疗法对ⅢA型前列腺炎的治疗效果.方法 33例ⅢA型前列腺炎患者(其中15例已经接受过其他方案的治疗),均被建议规律排精每周2次,同时口服盐酸特拉唑嗪2 mg 1日1次.观察慢性前列腺炎症状指数(NIH-CPSI)及前列腺液中白细胞计数的改善情况.结果 患者经过1～3个月的随访,治疗前后CPSI评分分别为(27.91±5.79)和(12.42±7.23)(t=11.749,P＜0.001).前列腺液白细胞计数分别为(34.39±23.04)和(17.27±10.57)(t=5.877,P＜0.001).总有效率84.8%.结论 基于规律排精的综合疗法治疗ⅢA型前列腺炎患者容易接受,安全有效.即使在常规疗法失败后也可试用.     

血清前列腺特异性抗原水平与慢性前列腺炎相关性的临床探讨

目的 探讨血清前列腺特异性抗原(PSA)水平与慢性前列腺炎(CP)的临床相关性.方法 选择CP患者60例,根据前列腺按摩液中白细胞计数将患者分为轻度组、中度组和重度组,探讨各组患者血清游离前列腺特异抗原(fPSA)、总前列腺特异抗原(tPSA)和fPSA/tPSA水平与病变严重程度的相关性,并观察血清fPSA、tPSA和fPSA/tPSA水平在治疗过程中的变化情况.结果 血清fPSA和tPSA与疾病严重程度呈正相关(r=0.712,r=0.774,均P＜0.01);fPSA/tPSA与疾病严重程度呈负相关(r=-0.417,P＜0.05);经治疗后血清fPSA和tPSA水平降低,fPSA/tPSA值增加,就诊时与治疗8周后相比(t=6.104,t=7.235和t=2.013),治疗4周后与治疗8周后相比(t=2.461,t=2.512和t=1.975),差异均有统计学意义(均P＜0.01或P＜0.05).结论 在CP的治疗过程中,应动态检查血清fPSA、tPSA和fPSA/tPSA,可提示疾病的严重程度及临床治疗情况.     

慢性前列腺炎病人前列腺液中IL-1β、IL-8、TNF-α和PGE2的变化及意义

目的探讨慢性前列腺炎病人前列腺液中细胞因子IL-1β、IL-8、TNF-α和PGE2的变化与慢性前列腺炎类型、发病机制、症状和前列腺液白细胞计数的关系。方法以Meares-Stamey法对100例前列腺炎病人行尿液、前列腺按摩液细菌培养,结合前列腺液常规检查和NIH-CPSI评分,将其分为慢性细菌组（Ⅱ型,11例）、慢性非细菌组（Ⅲa型,66例）、前列腺痛组（Ⅲb型,23例）。应用放射免疫法测定各组病人前列腺液中IL-1β、IL-8、TNF-α和PGE2含量,并与20例正常人进行对照。结果Ⅱ型前列腺炎病人前列腺液中IL-1β、IL-8、TNF-α、PGE2水平明显高于Ⅲa型、Ⅲb型及对照组,Ⅲa型明显高于Ⅲb型及对照组,差异有显著性（F=27.001～59.541,q=3.70～4.50,P〈0.01）;Ⅲb型与对照组相比无明显差异（P〉0.05）。前列腺炎病人前列腺液IL-1β水平与TNF-α、PGE2水平呈正相关（r=0.563、0.826,P〈0.01）,白细胞计数与IL-8水平呈正相关（r=0.547,P〈0.01）,IL-1β、PGE2水平与NIH-CPSI疼痛不适症状评分呈正相关（r=0.506,P〈0.01）。结论慢性前列腺炎病人前列腺液IL-1β、IL-8、TNF-α、PGE2表达增高可作为慢性前列腺炎的诊断依据之一,对慢性前列腺炎分型可能有一定临床意义。     

前列腺增生合并前列腺炎的临床分析及MMP-9的表达与意义

目的 通过检测良性前列腺增生(BPH)合并前列腺炎(CP)患者基质金属蛋白酶(MMP-9)蛋白的表达,结合临床特点,探讨MMP-9在BPH中的作用与意义.方法 选择BPH患者68例,根据是否合并CP将其分为,单纯组(21例)和合并组(47例).观察并记录两组患者年龄、前列腺体积、国际前列腺症状评分(IPSS)和生活质量评分(QOL);ELISA检测患者血清中前列腺特异抗原(PSA)浓度;ELISA和Western blot法检测前列腺组织中MMP-9蛋白的表达水平.结果 单纯组患者年龄、前列腺体积、IPSS和QOL均明显低于合并组(P＜0.05).ELISA结果显示血清中PSA与组织中MMP-9浓度成正相关,合并组高于单纯组为(P＜0.05).Western blot结果表明合并组中MMP-9蛋白表达水平较高(P＜0.05).结论 BPH合并CP患者MMP-9蛋白表达水平与各项临床指标呈正相关,有利于BPH患者和BPH合并CP患者的鉴别诊断.     

金黄散治疗慢性前列腺炎疗效分析

目的:观察金黄散治疗慢性前列腺炎的临床疗效,并与单用抗生素治疗进行疗效对比.方法:慢性前列腺炎患者97例随机分为治疗组(金黄散熏洗)和对照组(氟嗪酸口服)进行观察,疗程3个月,治疗前后分别进行前列腺液(EPS)常规、慢性前列腺症状指数(CPSI)及不良反应观察.结果:治疗后治疗组EPS的WBC改善率、卵磷脂小体的恢复率和CPSI改善率等均优于对照组,两组比较差异有显著性意义(P<0.05).结论:金黄散是治疗慢性前列腺炎的有效药物.     

不同症状慢性前列腺炎患者前列腺按摩液pH值、卵磷脂小体与白细胞数比较

目的:探讨前列腺按摩液(EPS)pH值、白细胞和卵磷脂小体计数与慢性前列腺炎症状之间的关系.方法:按症状将151例慢性前列腺炎患者分为3组,即排尿症状组52例,疼痛或不适组74例,混合组25例.正常对照组23例.通过直肠按摩取得EPS标本后立即用pH试纸测定pH值,高倍镜下计数白细胞和卵磷脂小体.结果:排尿症状组EPS的pH值显著高于其他3组(P＜0.01).3组慢性前列腺炎患者的EPS中白细胞计数均高于正常对照组,卵磷脂小体计数均低于正常对照组(P＜0.01),而3组间差异均无统计学意义(P＞0.05).4组EPS标本中pH值与白细胞计数均呈正相关(r=0.334,P＜0.001),与卵磷脂小体计数呈负相关(r=-0.447,P＜0.01),白细胞计数与卵磷脂小体计数呈负相关(r=-0.443,P＜0.01).结论:慢性前列腺炎患者排尿症状组EPS中pH值升高,而疼痛或不适组与混合组患者pH升高不明显,可能与EPS中高浓度的尿酸影响有关;EPS中白细胞和卵磷脂小体计数与症状类型无关,提示除了炎症反应外尚有其他因素影响慢性前列腺炎症状.     

翁沥通治疗慢性前列腺炎

目的：观察翁沥通对慢性前列腺炎的治疗效果。方法：将慢性前列腺炎患者60例分为翁沥通组和对照组,对比观察翁沥通治疗2个月后慢性前列腺炎症状评分（NIH—CPSI）及前列腺液的变化。结果：翁沥通组患者NIH—CPSI评分明显降低（P〈0．01）,检查前列腺液自细胞明显改善（P〈0．01）。结论：中药翁沥通治疗慢性前列腺炎有显著疗效。     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.     

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.