糖尿病性勃起功能障碍23例诊疗观察

糖尿病引发血管和神经病变是与勃起功能障碍（ED）关系最为密切的疾病之一。对我院1997-2004年糖尿病性ED诊治总结如下。     

阴茎勃起功能障碍的治疗

1引言 美国泌尿协会（AUA）、欧洲泌尿协会（EAU）及中国《勃起功能障碍诊治指南》（指南）均将ED的治疗分为一线、二线、三线治疗。中国《指南》指出在治疗ED的同时，还应去除ED的危险因素如吸烟、酗酒、肥胖、药物滥用等；积极治疗原发病如糖尿病、高血压、高血脂、内分泌疾病等；解除焦虑、抑郁等心理因素；加强性医学教育、夫妻共同参与等行为治疗。     

心脑血管病人群勃起功能障碍患病情况调查

目的:了解心脑血管病区及门诊人群勃起功能障碍(ED)的患病率及影响因素.方法:采用勃起功能国际问卷(IIEF-5),入选了532名25～89岁心脑血管病区及门诊就诊的男性患者进行问卷式调查.根据患者的自我评价诊断ED.结果:ED的总患病率为89.45%,其中轻、中、重度ED分别占59.79%、11.16%和29.05%.重度ED的患病率随年龄增长而上升,≥70岁年龄组重度ED患病率为60～69岁年龄组的4.4倍.ED除与年龄有关外,还与冠心病、高血压、泌尿系疾病、慢性阻塞性肺病、抑郁/焦虑这些老年男性共患疾病密切相关.长期服用降压药物及受教育程度对ED患病率也有影响.结论:ED是中老年男性心血管疾病及其相关人群中客观存在、不容忽视的严重问题,应引起广大临床医生的关注.     

儿童青少年情绪障碍患者治疗依从性研究进展

儿童青少年的情绪障碍（ED）是一组以焦虑、恐惧为主要临床特征的疾病。目前,关于儿童青少年ED患者治疗依从性的研究报道较少,该文通过对儿童青少年情绪障碍患者治疗依从性的研究进行综述,包括治疗依从性的概念、治疗依从性的评估工具、治疗依从性的影响因素、治疗依从性的干预措施等内容。     

多普勒联合口服Ⅴ型磷酸二酯酶抑制剂评价勃起功能障碍的研究进展

勃起功能障碍（ED）是临床常见的疾病。ED分为心理性、器质性和混合性;其中器质性ED中以血管性最为常见。多普勒超声技术作为血流动力学评价的无创技术已成为诊断血管性ED的首选方法,多普勒超声联合口服Ⅴ型磷酸二酯酶抑制剂（PDE5）是诊断血管性ED的一种新技术。本文旨在对口服PDE5联合彩色多普勒评价ED的技术和临床价值进行综述。     

探讨阴茎勃起功能障碍青年患者血中神经递质含量的变化

近年来阴茎勃起功能障碍（erectile dysfunction，ED）的发病率有增高趋势，是一种病因复杂的常见男科疾病。而有关对影响阴茎勃起的神经递质研究较少，在国内未见有关ED与儿茶酚胺类神经递质的实验报道，作者对35例青年ED患者血中泌乳素（prolactin，PRL）、睾酮（testosterone，T）及多巴胺（dopamine，DA）、去甲肾上腺素（NE）和肾上腺素（E）含量进行测定，期望对ED的成因了解及对治疗带来帮助。     

2012年第三届甲状腺疾病(上海)国际论坛通知

由上海市第六人民医院和上海交通大学甲状腺疾病诊治中心主办的第三届甲状腺疾病(上海)国际论坛将于2012年11月2～4日在上海市第六人民医院召开。大会将邀请国内外的知名专家前来授课和手术演示,紧紧围绕指南解读,诊治规范化,并发症防治,     

2012年第三届甲状腺疾病(上海)国际论坛通知

由上海市第六人民医院和上海交通大学甲状腺疾病诊治中心主办的第三届甲状腺疾病(上海)国际论坛将于2012年11月2～4日在上海市第六人民医院召开。大会将邀请国内外的知名专家前来授课和手术演示,紧紧围绕指南解读,诊治规范化,并发症防治,     

2012年第三届甲状腺疾病(上海)国际论坛通知

由上海市第六人民医院和上海交通大学甲状腺疾病诊治中心主办的第三届甲状腺疾病(上海)国际论坛将于2012年11月2～4日在上海市第六人民医院召开。大会将邀请国内外的知名专家前来授课和手术演示,紧紧围绕指南解读,诊治规范化,并发症防治,     

特纳综合征1例报告并文献复习

<正>特纳综合征(Turner syndrome,TS)又称先天性卵巢发育不全,其主要表现是患者染色体核型有一条完整的 X 染色体,而另外一条染色体完全或部分缺失,或者出现结构的异常^[1-2]。TS主要临床特征表现为身材矮小、卵巢功能衰竭、心血管系统异常、代谢功能异常和自身免疫功能异常等^[3-5]。已知国内外对 TS的心血管问题、代谢功能问题、自身免疫功能问题、骨质疏松问题等及 TS患者不同生长时期诊治问题均有报道。近几年关于 TS患者不孕与生殖评估等问题国内外相关报道更是在不断增加。现回顾分析本院收治的 1例TS患者的诊治过程并总结相应的文献复习,以期提高对 TS疾病的认识。     

门诊肠道寄生虫病感染状况的纵向观察

本文对 1981-2 0 0 0年门诊病人肠道寄生虫感染资料进行统计分析 ,总感染率为 30.89% ( 33607/ 10 8795 ) ;其中肠道蠕虫感染占 78.14% ,肠道原虫感染占 21.86 %。主要感染虫种为蛔虫、蓝氏贾第鞭毛虫、钩虫、肠滴虫、猪带绦虫和阿米巴。 2 0年间肠道寄生虫感染率呈明显下降趋势 ,由 1981年的 46.61%下降到 2000年的 12.82 % ;但近年来肠道蠕虫感染率下降速度变缓 ,而肠道原虫感染率呈现上升趋势 ,优势虫种亦由蛔虫、钩虫为主转为蓝氏贾第鞭毛虫、蛔虫居前。虽然肠道寄生虫感染 2 0年间变化较大 ,但每年的季节分布仍未打破 ,感染率以第三季度最高 ,第一季度最低。结果表明 ,目前人体肠道寄生虫病感染率还比较高 ,尤其是肠道原虫。因此 ,仍需根据季节、虫种、人群等具体情况 ,搞好肠道寄生虫病的防治工作.     

DURABILITY IN THE GENUS EUCALYPTUS

The durability of eucalypts is reviewed The causes of decay and termite resistance are discussed, and the effects of factors which result in variations in decay resistance such as genetic traits, environment, growth rate and ageing of heartwood in the standing tree are considered. It is shown that decay resistance in eucalypts is due to the presence of fungitoxic extractives, and termite resistance in the species investigated is due to repellent extractives. Decay resistance is not markedly affected by growth rate per se, but is strongly associated with it in the juvenile stage, as a result of which merchantable fast—grown trees have a greater percentage of relatively non-durable wood. It is shown that in one eucalypt, deterioration in decay resistance takes place in the growing tree, this being associated with the ageing of the heartwood.     

Current diagnosis and management of cardiac myxomas

Cardiac myxoma is the most common cardiac neoplasm. In the majority of cases, it is isolated (non-syndromic) and located in the left atrium. In up to 10% cases, it is seen in syndromic association with the Carney complex where it is encountered in younger patients, with atypical and multiple locations, such as the right atrium or ventricles, and carries a high risk of recurrence. Imaging is pivotal in the diagnosis, management guidance and surveillance. Surgical excision is the established definitive treatment. Further research should address management strategies in incidentally discovered small myxomas in asymptomatic patients and the role of genetic testing and screening in syndromic myxomas.     

Endobronchial tuberculosis

Endobronchial tuberculosis is defined as tuberculous infection of the tracheobronchial tree. Although clinical features differ between various types and stages of endobronchial tuberculosis, common symptoms are cough, hemoptysis, sputum production, wheezing, chest pain, fever and dyspnea. Endobronchial tuberculosis is difficult to diagnose, because the lesion is not evident in the chest radiograph. Computerized tomography is very useful in evaluating bronchial lesions such as stenosis or obstruction. The most important goal of treatment in active endobronchial tuberculosis is the eradication of tubercle bacilli. The second most important goal is prevention of bronchial stenosis. Corticosteroid therapy for prevention of bronchial stenosis in endobronchial tuberculosis remains controversial, but the best results are associated with minimal delay in the initiation of steroid treatment. In inactive disease, treatment to restore full patency is appropriate. As steroids or other medication are unable to reverse stenosis from fibrous disease, airway patency must be restored mechanically by surgery or endobronchial intervention. Aerosol therapy with streptomycin and corticosteroids is useful in treatment against active endobronchial tuberculosis. Time to healing of ulcerous lesions is shorter, and bronchial stenosis is less severe in patients on aerosol therapy. Progression to bronchial stenosis may be prevented if the therapy is initiated as soon as possible.     

Tradition and culture in Heidegger's Being and Time

In nursing literature, Heideggerian hermeneutics, as expounded in Being and Time , is taken well near unanimously to be an invitation to explore tradition and culture. Understanding, we are told in the name of Heidegger, is to be found in the realm of common meanings and shared practices. This interpretation of what Heidegger is about in Being and Time is neither unchallengeable nor unchallenged. While a number of scholars can be found to agree with it, there are many others who see it as an utter misreading of Heidegger. In their judgement, it is an interpretation diametrically opposed to what Heidegger sets forth in his treatise. For researchers interested in invoking Heidegger or following a Heideggerian approach, this is a frustrating impasse. The only valid starting point for resolving it, this article suggests, is a close reading of what Heidegger actually says in the pages of Being and Time .     

不同大小、形态动脉瘤的血流动力学差异

目的利用计算机模拟颅内动脉瘤及其载瘤动脉的血液流动,对不同大小的宽、窄颈动脉瘤进行血流动力学分析。方法根据动脉瘤大小分类,模拟典型侧方动脉瘤图像,联合应用Photoshop、Matlab、Ansys及Fluent软件,对动脉瘤进行血流动力学的计算机模拟。结果成功模拟出在一个完整的心动周期内动脉瘤及其载瘤动脉内血流的动态变化。宽颈动脉瘤内可见涡流现象,涡流流速随着瘤体体积的增大而增大,流速从小型动脉瘤的7.45E-05 m/s-2.32E-04 m/s增至巨大型动脉瘤的1.46E 00 m/s-4.21E 00 m/s。窄颈动脉瘤仅瘤颈处有低速血流而瘤体内无涡流。瘤颈处血流流速随着瘤体积的增大而减小,流速从小型动脉瘤的4.84E-05 m/s-2.26E-04 m/s降至大型动脉瘤的2.34E-10 m/s-5.38E-08 m/s,瘤体顶端部分的血流速度甚至接近于零。结论宽颈动脉瘤内涡流的形成造成了与窄颈动脉瘤在血流动力学方面的巨大差异。动脉瘤的血流动力学的研究为动脉瘤治疗方案制定及预后评估提供了理论依据。     

Altered body image: a fear-avoidance model of psycho-social difficulties following disfigurement

Altered body image is a potential and actual source of considerable distress, particularly following facial disfigurement, and social functioning is reported as a major area of difficulty by sufferers. However, the area of facial disfigurement has received comparatively little attention from researchers in health care. Two current models of disturbed body image are examined, and it is contended that both require development in order to be of use in responding to the difficulties experienced by disfigured people. A fear-avoidance model of exaggerated pain perception, which has clear treatment implications, is described, and it is shown how this model may be modified to offer a framework for the understanding and treatment of the psycho-social difficulties of disfigured people. In particular, it is suggested that the avoidance present following disfigurement is phobic in nature, and special attention is given to the roles of avoidance and confrontation in mediating these difficulties. Implications for intervention and the shortcomings of the model are described.     

Verapamil for Cluster Headache. Clinical Pharmacology and Possible Mode of Action

Verapamil is used mainly in cardiovascular diseases. High-dose verapamil (360-720 mg) is, however, currently the mainstay in the prophylactic treatment of cluster headache. The oral pharmacokinetics are variable. The pharmacodynamic effect of verapamil, the effect on blood pressure, also varies considerably among subjects. The dose of verapamil used for cluster headache is approximately double the dose used in cardiovascular disease, most likely because verapamil is a substrate for the efflux transporter P-glycoprotein in the blood–brain barrier. The access of verapamil to the central nervous system is therefore limited. The clinical use of verapamil in cluster headache is reviewed and several relevant drug interactions are mentioned. Finally, its possible mode of action in cluster headache is discussed. The effect of verapamil in cluster headache most likely takes place in the hypothalamus.Verapamil is an L-type calcium channel blocker but it is also a blocker of other calcium channels (T-, P-, and possibly N- and Q-type Ca²⁺ channels) and the human ether-a-go-go-related gene potassium channel. With so many different actions of verapamil, it is impossible at the present time to single out a certain mode of action of the drug in cluster headache.     

血脂异常的“痰瘀虚”中医病机内涵和临床应用

通过梳理古代文献,并结合临床实践,阐述“痰瘀虚”三种证候要素在血脂异常治疗中的应用原理与方法,提出以下观点:“痰、瘀、虚”为血脂异常的主要证候要素,痰证贯穿动脉粥样硬化病程的始终,瘀证继发于痰证从而痰瘀互结,脾肾亏虚为虚证内涵。另外,血脂异常在生理功能、发病机制方面均与痰湿有关,现代生物标志物的研究客观化地呈现了中医论治血脂异常的本虚标实内涵。标实应燥湿化痰、活血化瘀,本虚则分为两类:气虚阳虚治以参苓白术散、麻黄附子细辛汤,阴虚血虚治以养阴清肺丸和一贯煎。以“痰瘀虚”理论指导血脂异常调护,当以淡泊节欲、顾护脾胃、惜养肾精为要。