麒麟丸联合维参锌胶囊治疗复发性流产史男性精子DNA损伤的临床观察

目的:探讨麒麟丸在男性不育患者精子DNA损伤中的保护作用。方法:选择66例合并有精子DNA完整性异常(DFI15%)的复发性流产史男性不育症患者,随机分为治疗组33例和对照组33例。治疗组口服麒麟丸联合维参锌胶囊;对照组单独服用维参锌胶囊,共3个月。于治疗前及治疗3个月末采用计算机辅助精子分析(CASA)系统与流式细胞仪分别检测精液常规参数和DFI。使用SPSS19.0统计软件对治疗前后各项精液参数及DFI进行数据分析。结果:治疗前治疗组与对照组的精子密度、精子活动率、前向运动精子百分比和DFI差异无统计学意义(P0.05)。治疗3个月后,治疗组精子活动率与对照组及治疗前相比有显著提高(P0.01);前向运动精子百分比与对照组及治疗前相比有显著提高(P0.01);精子密度比对照组及治疗前有显著提高(P0.05);DFI较对照组及治疗前显著下降(P0.05)。结论:应用麒麟丸联合维参锌胶囊治疗复发性流产史男性不育症患者,可以显著改善其精子活力与精子DNA完整性。     

苁蓉益肾颗粒联合左卡尼汀治疗少弱精子症的临床观察

目的:观察苁蓉益肾颗粒联合左卡尼汀治疗少弱精症的临床疗效及对精子参数水平的影响。方法:将400例本病患者随机分为治疗组与对照组各200例,对照组采用左卡尼汀治疗,治疗组服苁蓉益肾颗粒和左卡尼汀治疗,疗程3个月。观察临床疗效和治疗前后精液各参数(精子密度、活动率、活力)的变化。结果:治疗组总有效率为92.00%,显著高于对照组的65.00%(P0.01);两组治疗前各精液指标比较,差异均无统计学意义(P0.05);两组治疗后各精液指标均较治疗前显著改善(P0.01),且治疗组治疗后精子计数、精子成活率、a级及a+b级指标依次为(33.1±13.4)×10~6/mL、(67.9±19.8)%、(24.7±5.9)%、(52.6±17.9)%,改善程度均更优于对照组(P0.05)。结论:苁蓉益肾颗粒联合左卡尼汀可明显改善少弱精子症不育患者的精液质量,提高临床疗效。     

麒麟丸联合枸橼酸他莫昔芬片治疗特发性少弱畸精子症的临床疗效观察

目的:评估麒麟丸联合枸橼酸他莫昔芬片治疗特发性少弱畸精子症的临床疗效。方法:选取2014年3月至2016年8月湖北省十堰市人民医院就诊的符合条件患者122例,随机分为试验组(麒麟丸+他莫西芬,n=60与对照组(他莫西芬,n=62),按照麒麟丸每次6 g,3次/d;枸橼酸他莫西芬片10 mg,2次/d,连续服用3个月为1个疗程。对比分析治疗前后精液体积,精子浓度,前向运动精子百分率,正常精子形态率及外周血清性激素(FSH,LH,T)水平,评估其临床疗效。结果:所有患者均完成本试验性治疗,治疗前后两组精液体积无明显改善(P>0.05),与治疗前相比,两组精液精子浓度,前向运动精子百分率,正常精子形态率及外周血清性激素水平均有明显提高(P<0.05),与对照组相比,试验组显著优于对照组(P<0.05),均未见明显不良反应。结论:麒麟丸联合枸橼酸他莫昔芬片能够显著改善特发性少弱畸精子症患者的精液质量和性激素水平,值得临床推广。     

左卡尼汀对梗阻性无精子症患者睾丸内精子质量的影响

目的:观察左卡尼汀对梗阻性无精子症患者睾丸内精子活力的改善作用。方法:2014年12月至2015年12月来成都中医药大学第二附属医院就诊的不育患者中筛选出30例附睾管梗阻的无精子症患者,治疗前至少3个月未服用任何生精药物,采用微创性睾丸活检取曲细精管数段送生殖检验室,实验员按照卵胞浆内单精子显微注射(intracytoplasmic sperm injection,ICSI)要求,撕碎曲细精管,提取精子悬液,在显微镜下随机数取200个精子,找出其中活动精子数量及活力等级并给以记录。同一患者给与左卡尼汀10m L,3次/d,连续服用3个月后,再次采用同样方法取精,记录活动精子数量及等级。观察临床疗效。结果:经治疗睾丸内活动精子数量及活力等级有了明显提高,差异具有统计学意义(P0.05)。结论:左卡尼汀可有效改善梗阻性无精子症患者睾丸内精子的质量。     

五子衍宗丸与麒麟丸治疗男性特发性少弱精子症的临床疗效和安全性

目的探析五子衍宗丸与麒麟丸治疗男性特发性少弱精子症的临床疗效和安全性。方法选取2017年5月至2018年9月成都市妇女儿童中心医院诊治的109例男性特发性少弱精子症(IO)患者作为研究对象。按照平行对照研究标准行双盲法随机分组,观察组55例,采取麒麟丸治疗;对照组54例,给予五子衍宗丸治疗。比较两组用药1个月、2个月和3个月后精液参数水平变化,检测T、LH、FSH等性激素指标,统计IO患者女方妊娠率。结果两组IO患者随用药治疗时间延长,精子浓度、向前运动(PR)、精子活动率均明显提高,与治疗前比较差异具有统计学意义(P0.05);且观察组治疗后精子浓度、PR、精子活动率与同一时段对照组比较差异具有统计学意义(P0.05)。观察组LH降低幅度及T升高水平明显优于对照组,差异具有统计学意义(P0.05)。观察组患者女方妊娠率明显高于对照组,差异具有统计学意义(P0.05)。两组用药期间未见明显副作用反应。结论五子衍宗丸与麒麟丸可显著提高精子质量,其中麒麟丸治疗IO效果更为明显,调节性激素水平,疗效呈时间-效应提升,且用药安全,无不良反应。     

联用生精胶囊治疗少、弱精子症的临床观察

目的：观察生精胶囊治疗男性少弱精子症的疗效。方法：分三组共治疗255例由少弱精子症引起的男性不育患者。A组（n=32）、B组（n=96）和C组（n=127）的患者都服用维生素E、复合维生素B和知柏地黄丸,B组和C组的患者在此基础上再联用生精胶囊治疗。疗程为3～6个月。结果：B组和C组的精液检查参数明显改善,妊娠率显著高于A组,P〈0.01。结论：联用生精胶囊可以显著地提高少弱精子症患者的精子密度、精子活动力和活动率,并显著地提高妊娠率。     

二仙补肾益精解毒方改善无症状性弱精子症患者精子活力临床研究

目的:评价二仙补肾益精解毒方改善无症状性弱精子症患者精子活力的临床疗效和安全性。方法:将72例无症状性弱精子症患者按随机对照的试验方法分成试验组和对照组,试验组用二仙补肾益精解毒方免煎颗粒每日1剂、早晚各半剂进行治疗,对照组用左卡尼汀口服液每次1支、每日2次进行治疗,疗程11周。整个疗程中治疗不中断,采用治疗前、治疗后对照研究的方法客观评价二仙补肾益精解毒方对无症状性弱精子症患者的疗效。重点观察无症状性弱精子症患者精液精子总活力(PR+NP)、前向运动精子百分率(PR)变化,同时注意对药物毒副作用的观察。结果:试验组精子总活力、前向运动精子百分率治疗前后比较采用配对t检验,差异均有显著统计学意义(P0.01);对照组精子总活力、前向运动精子百分率治疗前后比较采用配对t检验,精子总活力的差异无统计学意义(P0.05),前向运动精子百分率的差异有统计学意义(P0.05);两组治疗后精子总活力、前向运动精子百分率,两组比较采用成组t检验,差异均有统计学意义(P0.05);治疗前后精子总活力差值及前向运动精子百分率差值,两组比较采用成组t检验,其中精子总活力差值的差异均有统计学意义(P0.05),前向运动精子百分率差值的差异具有显著统计学意义(P0.01)。试验组显效、有效、无效例数分别为17、10、3例;对照组显效、有效、无效例数分别为10、9、10例。两组精子活力总体疗效比较采用Mann-Whitney U检验,差异具有统计学意义(P0.05)。除对照组1例患者药物过敏,试验组1例患者失访外,两组患者在治疗过程中均未出现头晕、头痛、腹痛、腹泻、恶心、呕吐等明显的局部和全身不良反应。结论:采用二仙补肾益精解毒方治疗无症状性弱精子症安全有效。     

左卡尼汀联合黄精赞育胶囊治疗雷达作业人员少弱精症的临床观察

目的:本文旨在探讨应用左卡尼汀联合黄精赞育胶囊治疗雷达作业人员少弱精症的临床疗效。方法:选取60名服役2年以上的雷达作业官兵,随机分为治疗组和对照组,每组各30例。治疗组采用左卡尼汀联合黄精赞育胶囊治疗,对照组单纯采用黄精赞育胶囊治疗。分别对治疗前和治疗后3个月的精液参数进行分析。结果:治疗组的总有效率为86.7%,对照组的总有效率为60%,两组差异具有统计学意义(P0.05)。治疗组和对照组在治疗后精子密度、精子活力均较治疗前明显改善,差异具有统计学意义(P0.05);治疗组治疗后和对照组治疗后比较,精子密度没有显著差异(P0.05);但是精子活力治疗组显著高于对照组,差异具有统计学意义(P0.05)。结论:左卡尼汀联合黄精赞育胶囊治疗雷达作业人员少弱精症临床疗效显著。     

补肾衍精汤联合左卡尼汀治疗少弱精症的临床观察

目的:观察中药补肾衍精汤联合左卡尼汀口服液治疗少弱精症的临床疗效。方法:选取符合标准的68例少弱精症患者给予补肾衍精汤配合左卡尼汀口服液内服。结果:68例患者治疗后痊愈21例,显效26例,有效11例,无效6例,脱落4例,总有效率为85.29%。与治疗前相比,治疗3个月后患者的精液量、精子密度、精子活动率、精子活力均有显著变化,其差异均有统计学意义(均P0.05)。结论:补肾衍精汤联合左卡尼汀口服液可以明显改善少弱精症患者的精液质量,提高临床疗效。     

维生素E联合他莫昔芬治疗特发性少弱精症患者的前瞻性随机对照研究

目的:评估维生素E作为抗氧化剂和他莫昔芬作为抗雌激素组合治疗对精子浓度和活力的可能效果,并与只用一种药物的特发性少弱精子症患者进行对比。方法:90例特发性少弱精子症患者随机平均分为三组,A组:服用维生素E(300mg/d)6个月;B组:服用他莫昔芬(20mg/d)6个月;C组:服用相同剂量的两种药物组合6个月。所有患者均接受了以下内容:询问病史、全身和生殖器检查、精液分析、血清促卵泡激素、总睾酮、阴囊超声。精液检查在治疗开始时、治疗结束后3个月和结束后6个月分别进行。结果:与治疗前相比,服用维生素E的小组,6个月的治疗后平均精子浓度没有显著增加。另一方面,在6个月的治疗后,其他两个小组的平均精子浓度显著改善,且联合治疗组更明显(P0.01)。在前向运动精子比例方面,所有患者群体中都有所改善,且在联合治疗组更明显。对于服用维生素E组,这一数字是(28.07±9.65)%(P0.01)。对于服用他莫昔芬组,这一数字为(33.33±14.10)%(P0.01),在联合治疗组,是(40.50±17.54)%(P0.01)。结论:结合抗氧化和抗雌激素疗法对于我们选定的患有不明原因的少弱精子症患者治疗有效。     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Multiple New-Onset Subcutaneous Nodules of the Upper Extremity Digits: Giant Cell Tumor of Tendon Sheath and Lipoma

A black woman with the concurrent onset of two subcutaneous nodules located on the digits of her upper extremities is described. Initially, a single systemic disorder was considered; yet, the lesions differed in morphology and consistency. Microscopic examination of the nodules showed a giant cell tumor of tendon sheath and a lipoma. Although Occam's “razor” suggests that multiple lesions in the same person are more likely to represent variable manifestations of a single disorder than several different diseases in that individual, the simultaneously appearing lesions in this patient represented two different conditions.