下尿路症状患者排尿踌躇症状与尿动力学指标的相关性研究

下尿路(LUTS)症状在老年男性中较普遍,且多数LUTS症状继发于良性前列腺增生(BPH),但也可以由其他原因所致[1].国际尿控协会曾将下尿路(LUTS)症状分为3组:储尿期症状、排尿期症状和排尿后症状,每组均包括排尿踌躇症状[2].国际前列腺症状评分表(IPSS)被广泛的应用于LUTS症状的评估中,且可量化症状的严重程度[3].但最近有一些关于IPSS评分精确性的争论[4-5],有学者建议使用附加的频率量表[6-7].每一项IPSS评分均有相应的检测工具,如残余尿检测、排尿频率测定、最大尿流率等.虽然“踌躇”是经常描述症状之一[8],但目前尚缺乏一个经过证实的检测工具.尿动力学检查具有无创、经济、方便等优点,已经被广泛用于诊断LUTS疾病.现笔者对LUTS症状患者的排尿踌躇与尿动力学指标的相关性进行分析,报道如下.     

老年男性下尿路症状病因的尿动力学研究进展

下尿路症状（lowerurinarytractsymptoms，LUTS）是排尿障碍的总称，由wein等提出的一组症候群，是老年男性中最常见的症状之一。基于统计数据和各国老龄人口的增加，LUTS在未来社会中将不可避免的成为一种普遍的疾病，并成为专业人员面对的主要问题之一。随着尿动力学研究的进展，对LUTS的病因及常见疾病有了较深入的了解与认识，从而对LUTS的治疗起到了指导作用。     

Endoplasmic Reticulum Stress and Metabolic Syndrome: Mechanisms and Therapeutic Potential /内质网应激与代谢综合征的机制及治疗潜能

代谢综合征是指包括肥胖、脂质代谢紊乱、高血压和胰岛素抵抗在内的代谢异常症候群,是心血管和神经系统疾病的独立危险因素,发病过程中伴有脂肪因子（细胞因子和趋化因子）和瘦素的分泌失调。这些改变调节免疫、炎症反应,引起下丘脑饱食中枢的失衡。代谢综合征和神经系统疾病（如中风、抑郁症、阿兹海默病）存在相关性的分子机制目前尚不清楚。目前已知的联系代谢综合征和心血管疾病、神经疾病的分子和细胞机制包括：氧应激、糖、脂代谢的改变,胰岛素、瘦素分泌异常,凋亡和自噬等。最新研究表明,内质网应激反应（或未折叠蛋白反应）在代谢综合征患者的各个组织中被激活。下丘脑的内质网应激与炎症和瘦素、胰岛素抵抗有关。肝脏的内质网应激导致脂质沉积和胰岛素抵抗,而脂肪组织中的内质网应激触发炎症反应,调节脂肪因子的分泌。同时炎症反应可以进一步恶化内质网应激。另外,内质网应激直接导致自噬的发生而自噬可进一步加剧内质网应激。这些内质网应激与细胞损伤机制的相互作用可以影响胰岛素信号转导从而参与代谢综合征的发病。本文不仅综述了近期关于代谢综合征引起的心血管和神经系统疾病的发病机制,也分析了内质网应激在代谢综合征所致心血管和神经系统疾病中的作用。     

慢性前列腺炎和性功能障碍研究进展

慢性前列腺炎(chron ic prostatitis,CP)是男性青壮年常见病,大约50%的男性在一生的不同时期曾有过前列腺炎症状[1]。CP患者的症状主要包括下尿路症状(lower urinarytract symptom s,LUTS)和疼痛症状,LUTS症状表现排尿不畅、尿不尽、尿频、尿急和排尿困难等;疼痛症状为会阴部、     

胎儿炎症反应综合征诊疗进展

胎儿炎症反应综合征在医学范畴上属于全身炎症反应综合征，其临床表现在婴儿时期较为特殊。胎儿炎症反应综合征是指由于感染因素或非感染因素影响胎儿的自身免疫，致使大量炎症因子如白介素-6、肿瘤坏死因子等及体液出现过度释放，进而导致其处于亚临床状态。由于母体很少出现全身炎症的症状，绒毛膜羊膜炎无明显临床症状且病程较长。相反，胎儿炎症反应综合征却有独特的临床表现症状，包括脐带炎症和胎儿血清促炎细胞因子水平升高。胎儿炎症反应综合征作为因孕期宫内细菌或病毒感染引发的全身炎症反应，与罹患严重新生儿病如支气管肺发育不良、囊性脑室周围白质软化、颅内出血、脑性瘫痪、新生儿坏死性小肠结肠炎等有密切关系。现就胎儿炎症反应综合征的发病机制、诊断标准及相关疾病的关系展开综述。     

流感病毒对血清TNF–α、IL–6和SOD影响的研究进展

流行性感冒（简称流感）是由流感病毒引起的急性上呼吸道传染病,在儿童中发病率较高,且症状较严重。流感病毒可诱导宿主发生炎症反应,诱使炎症细胞聚集,释放大量炎症因子,如肿瘤坏死因子–α、白细胞介素–6等,还可诱导宿主细胞产生过量的活性氧,且抑制体内超氧化物歧化酶水平,导致氧化应激反应,从而引起疾病发生发展。本文就上述流感的发病机制进行综述,以便为临床治疗流感提供思路。     

肺衰老与呼吸系统疾病发病关系的研究进展?

呼吸系统有很多年龄相关性的病理变化,机体衰老导致的免疫、氧化应激、炎症以及端粒等方面的改变,可直接诱导并促进肺衰老的发生发展;与此同时,肺衰老的发生也进一步加重了呼吸系统疾病的免疫应激以及炎症反应,与呼吸系统疾病的发展是互为因果、相互促进。老年人发生呼吸系统损伤的可能性更高,并且病情通常比年轻患者更严重[1]。本文对肺衰老在呼吸系统疾病发病机制中作用的研究进展进行整理,有助于进一步了解年龄相关的呼吸系统疾病,也可为各种呼吸系统疾病的发病机制以及临床治疗的研究提供新的思路。     

前列腺疾病与下尿路症状

下尿路症状（lower urinary tract symptoms，LUTS）是排尿障碍的总称。良性前列腺增生症（benign prostatic hyperplasia，BPH）、良性前列腺肥大症（benign prostatic enlargement，BPE）或良性前列腺梗阻（benign prostatic obstruction，BPO）是老年男性中能引起LUTS最常见的疾病，多为缓慢进行性自然病程，而少数患者有病情加重的危险，如发生急性尿潴留或需进行手术治疗。基于统计数据和各国老龄人口的增加，LUTS在未来社会中将不可避免的成为一种普遍的疾病，并成为专业人员需面对的主要问题之一。LUTS表现在最常见的几种疾病，如压力性尿失禁、膀胱出口梗阻（bladder outlet obstruction，BOO）和神经系统的疾病及损伤。     

坎地沙坦在炎症过程中抑制氧化应激反应机制的研究

目的探讨坎地沙坦（Cande sartan,CAN）是否具有不依赖血管紧张素1型受体（anti-inflammation via independent,AT1R）的抗炎作用及其可能的机制。方法以人肾小管上皮细胞为研究对象，观察CAN对肿瘤坏死因子（TNF-α）诱导炎症趋化因子的影响及CAN对TNF-α所诱导ROS的作用。采用RT-PCR方法测定相关分子mRNA表达，Western blotting和ELISA方法测定相关分子蛋白含量。结果CAN能有效抑制TNF-α诱导炎症趋化因子MCP-1、RANTES mRNA和蛋白表达，且能抑制TNF-α诱导的NF-κB磷酸化。CAN具有类是抗氧化应激物N乙酰半胱氨酸（NCA）的作用．抑制TNF-α诱导的ROS产生。结论CAN能抑制TNF-α诱导肾小管上皮细胞发生炎症反应，其机制与CAN的直接抗氧化作用有关。     

脂质肾毒性机制的研究进展

血脂紊乱可损伤多种器官,肾脏是受累器官之一,脂质诱导产生肾脏损伤的机制包括自噬功能缺陷、氧化应激、内质网应激、炎症反应及表观遗传修饰等,本文就其研究进展做以综述。     

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.