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1.
本文对164例10-14岁中学生进行两年纵向随访,调查晨尿中出现精子的阳性率,及连续6天精尿的阳性频数。又以放射免疫法测定同期晨尿中睾酮含量,结果其浓度与相同个体同日的血清睾酮浓度呈正相关。 相似文献
2.
多聚酶链反应检测尿中结核杆菌的临床意义 总被引:1,自引:0,他引:1
应用多聚酶链反应(PCR)对86例患者(10例经病理诊断为肾结核,69例可疑肾结核,7例单纯附睾结核)和30例健康对照者进行连续2日晨尿结核菌检测。10例肾结核患者检出均阳性;可疑肾结核者第一次检出9例,第二次为6例;7例附睾结核者两次无一阳性;对照组有1例二次检查均为阳性。认为PCR对尿中结核杆菌检出率高、准确、快速,值得在临床上推广应用。 相似文献
3.
中老年男性下尿路症状的流行病学调查 总被引:8,自引:3,他引:5
为了了解下尿路症状在中、老年男性中的流行情况,用附加了二个症状问题的SL问卷对871名52~74岁的男子作回顾性调查,对调查结果作了年龄分组分析。结果发现:平均IPSS总分为4.93分,无症状者为12.2%,轻症者为64.7%,中度症状者为19.6%,重症者为3.5%。夜尿者占72.3%,尿终滴沥占54.4%,而症状中分值>3分者尿终滴沥占25.6%,夜尿占14.6%,平均QOL为1.74,QOL为0~2、3、4~6的比例分别为52.7%、46.0%、1.3%。QOL与IPSS的相关性较好(r=0.62),与梗阻症状群的相关性(r=0.57)优于与刺激症状的相关性(r=0.44)。中重度症状者中有72.0%的人未进行治疗。 相似文献
4.
肾病综合征出血热(HFRS)并发肾破裂临床少见,易误诊。我院1985年4月~1997年11月收治HFRS并发肾破裂5例,现报告如下。1 临床资料本组5例,男4例,女1例,年龄27~53岁,平均40.5岁。均因发热、头痛、少尿等症状以HFRS收住传染科。免疫荧光测定均为阳性。住院6~11d(发病后8~15d)突然腰痛加重,伴腹痛、大汗淋漓、面色苍白或昏厥,血压下降〔64/33mmHg~78/48mmHg(1mmHg=0.133kPa)〕,经外科急会诊作腹腔穿刺抽出不凝固淡血性液4例,凝固血性液1例… 相似文献
5.
王刚 《中华泌尿外科杂志》2000,(1)
为了研究勃起功能障碍患者的血浆睾酮水平与性欲之间的关系,作者回顾性研究了1997年4月~1998年1月间180例勃起功能障碍患者的临床资料。性欲状况用《简要性功能调查问卷》进行评价,同时测定了血浆总睾酮及游离睾酮水平。其中,资料完整者108例,年龄33~79岁,平均(59-5±10.2)岁。按性欲强弱分为3组:性欲减退者55例(50-9%),性欲适中者38例(35-2%),性欲高亢者13例(13-9%)。3组间的平均性欲、性焦虑及总性功能评分差异有显著性(P<0-001)。3组平均血浆总睾酮水平… 相似文献
6.
7.
肾移植术后尿漏成因及防治:附39例报告 总被引:20,自引:0,他引:20
我院自1978年4月至1994年7月共行肾移植手术638例次,39例(6.0%)出现不同程度尿漏,我们对尿漏的成因及防治进行分析:与手术直接相关者21例,占53%(3.3%);感染所致者13例,占33%(2.0%);其它原因所致者5例,占13%(0.7%)。手术是引起尿漏的主要原因,随着手术方法的改进和提高,以及预防性应用抗感染治疗。尿漏的发生率明显下降(P〈0.01),尿漏的治疗主要根据尿漏程度 相似文献
8.
鲁藤巴赫综合征的外科治疗 总被引:1,自引:0,他引:1
鲁藤巴赫综合征的外科治疗赵希武,杨耀晨,张显清1984.4~1992.1我们手术治疗7例鲁藤巴赫综合征(Lutembacher'ssyndrome)病人。现报道并讨论如下:临床资料本组病人中男1例,女6例。年龄6~36岁。其中心功能II级者1例,II... 相似文献
9.
为了探讨女性酒渣鼻患者血清睾酮、雌二醇水平及月经周期改变情况,作者用放射免疫分析法测定了25例患者及20例正常对照者血清睾酮及雌二醇水平,并调查了250例患者及100例正常对照者月经周期变化情况。结果显示,患者血清中睾酮的平均值为5.27nmol/L,明显于对照组(t=2.91,p<0.01)。雌二醇平均值为574.6nmol/L,与对照组无明显差异(t=0.11,p>0.05)。患者月经紊乱率为69.6%,明显高于对照组(χ2=35.55,p<0.01)。可见,女性酒渣鼻患者血清睾酮升高,雌二醇正常,且多伴月经周期紊乱。 相似文献
10.
切除颌下腺对大鼠睾酮和精子顶体酶活力的影响 总被引:4,自引:1,他引:4
本实验对大鼠切除颌下腺30和48天时,睾丸和附睾重量、血清睾酮水平及精子顶体酶活力进行了观察。结果显示:(1)切除颌下腺的实验组,睾丸和附睾重量明显低于对照组(P<0.05,P<0.01),睾丸脏器系数也明显降低(P<0.01),但附睾脏器系数无明显降低(P>0.05);(2)血清睾酮水平30天时实验组略低于对照组,48天时为2.41nmol/L,明显低于对照组的4.49nmol/L(P<0.01);(3)实验组的精子顶体酶活力分别为7.19和6.00mU/ml明显低于对照组(P<0.01)分别降低了55.1%和61.1%。结果表明表皮生长因子(EGF)参与了调节睾酮的分泌,并能影响精子顶体酶活力以及睾丸和附睾的重量。 相似文献
11.
Vasopressor hormone response following mesenteric traction during major abdominal surgery 总被引:1,自引:0,他引:1
A. Brinkmann W. Seeling C. F. Wolf E. Kneitinger C. Schonberger N. Vogt K. H. Orend M. Buchler P. Radermacher M. Georgieff 《Acta anaesthesiologica Scandinavica》1998,42(8):948-956
Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI2) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI2), TXB2 (stabile metabolite of thromboxane A2) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI2 release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB2 (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI2 release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A2, presumably contributing to hemodynamic stability within 30 min after MT. 相似文献
12.
Don Dame 《Artificial organs》1996,20(5):613-617
Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required. 相似文献
13.
Kai von Appen Christoph Weber Udo Losert† Heinrich Schima† Hans-Jürgen Gurland Dieter Falkenhagen 《Artificial organs》1996,20(6):420-425
Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal. 相似文献
14.
T. Tateishi M. Watanabe H. Nakura M. Tanaka T. Kumai T. Aoki S. Kobayashi 《Acta anaesthesiologica Scandinavica》1998,42(9):1028-1032
Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably. 相似文献
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably. 相似文献
15.
Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H2 O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg−1 followed by 0.15 mg · kg−1 · h−1 , n=8) or verapamil (0.1 mg · kg−1 followed by 0.3 mg · kg−1 · h−1 , n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO. 相似文献
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO. 相似文献
16.
Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made
of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300
million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly
obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries
were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However,
health-care awareness of obesity and bariatric surgeons are slowly increasing. 相似文献
17.
Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts 总被引:3,自引:0,他引:3
B. Heindl B. F. Becker S. Zahler P. F. Conzen 《Acta anaesthesiologica Scandinavica》1998,42(8):995-1003
Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress. 相似文献
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress. 相似文献
18.
D. Ma S. M. Sapsed-Byrne M. K. Chakrabarti J. G. Whitwam 《Acta anaesthesiologica Scandinavica》1998,42(6):670-677
Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg?1 i. v. or midazolam 0.05 mg · kg?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg?1 i. v. and 32 μg · kg?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg?1. The mean ED50s, calculated from dose-response curves, were 5.4 mg · kg?1, 3.9 μg · kg?1 and 0.4 mg · kg?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg?1 i. v. or midazolam 0.05 mg · kg?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg?1 and 8 μg · kg?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration. 相似文献
19.
Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery 总被引:1,自引:0,他引:1
J. Boldt M. Papsdorf S. Piper W. Padberg G. Hempelmann 《Acta anaesthesiologica Scandinavica》1998,42(8):941-947
Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg?1 · min?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min?1 · m?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO2I) and oxygen consumption index (VO2I) were also significantly increased in the dopexamine group (DO2I: from 416±91 to 717±110 ml/m2 · m2; VO2I: from 98±25 to 157±22 ml/m2 · m2), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow. 相似文献
20.
A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions. 相似文献