Long-term oestrogen therapy is associated with improved endothelium-dependent vasodilation in the forearm resistance circulation of biological males

1. The aim of the present study was to determine the effects of long-term oestrogen on resistance vessel reactivity in biological males. 2. Recent studies have demonstrated that long-term oestrogen therapy favourably alters the lipid profile and improves vasodilator function in the conduit arteries of biological males. Whether a similar benefit is exerted on the resistance circulation is not known. Therefore, we examined the effects of long-term oestrogen therapy on skeletal muscle resistance vessel function in biological males and the potential mechanisms by which it may exert its effects. 3. Forearm blood flow (FBF) and resistance were compared in 15 male-to-female transsexuals being prescribed oestrogen, with 14 age-matched healthy males, at rest and in response to the endothelium-dependent nitric oxide (NO) vasodilator acetylcholine (ACh), the endothelium-independent but NO-mediated vasodilator sodium nitroprusside (SNP), the endothelium-independent and non-NO-mediated vasodilator verapamil (VER) and the endothelium-independent vasoconstrictor phenylephrine (PE). 4. Basal blood flows were similar in the two groups. However, the male-to-female transsexuals had a significant upward and leftward shift in FBF responses to ACh compared with males, with a 52% increase in FBF responses at the highest dose of ACh used. Forearm blood flow in transsexuals rose from a mean (+/- SEM) baseline level of 3.02 +/- 0.25 to a maximum of 19.5 +/- 2.59 mL/min per 100 mL forearm tissue (compared with 3.24 +/- 0.41 and 9.43 +/- 1.97 mL/min per 100 mL forearm tissue, respectively, in males) with the highest dose of ACh (+2.73 micrograms/min per 100 mL; P < 0.0005). Forearm vascular resistance was also significantly reduced in transsexuals compared with males (P < 0.05). Vasodilator responses to SNP, VER and PE were similar in both groups. 5. There were no differences observed in total cholesterol and low-density lipoprotein-cholesterol levels. However, male-to-female transsexuals had 20% higher high-density lipoprotein-cholesterol levels compared with males (1.57 +/- 0.11 vs 1.26 +/- 0.08 mmol/L, respectively; P < 0.05) and 47% higher triglyceride levels (P < 0.005). Serum testosterone levels (an index of oestrogen therapy) was a predictor of responses to endothelium-dependent vasodilation (rs = -0.50; P < 0.01). 6. Long-term oestrogen therapy enhances endothelium-dependent vasodilation in the skeletal muscle microcirculation of biological males. The effects appear to be selective because endothelium-independent vasodilation and vasoconstriction are not altered.     

肝肾囊肿硬化疗法的改良

目的　对Bean肝肾囊肿治疗方法加以改良 ,并比较两种方法的临床疗效。方法　采用Bean法治疗 75例 ,改良法治疗 77例 ,改良法在Bean法基础上穿刺囊肿内插管 ,用 5 0 %葡萄糖代替无水酒精作硬化剂。结果　Bean法有 5 2例一次完成治疗 (6 9.33% ) ,随访治愈率 72 % ,有 43例治疗时出现中度以上疼痛 (5 3.33% )。改良法 76例一次完成治疗 (98.70 % ) ,治愈率 10 0 % ,病人无任何不适感及并发症。改良组一次治疗成功率和治愈率均显著高于Bean法 (P <0 .0 0 1)。结论　改良法明显优于Bean法。     

心理护理干预对乳腺癌患者生存质量的改善

目的观察心理护理干预对乳腺癌患者生存质量的改善。方法将100例乳腺癌患者随机分为试验组和对照组各50例。对照组行常规护理;试验组同时给予常规护理和心理护理干预。比较两组患者的生存质量。结果试验组患者的生存质量与对照组比较,得到显著提高。结论心理护理干预能有效提高乳腺癌患者的信心,使其正确认识乳腺癌,调整积极心态,改变行为模式,生存质量得到明显改善。     

维持性血液透析患者的心理健康状态调查与心理干预

目的:了解维持性血液透析患者的心理健康状态,为其患者进行及时有效的心理干预提供科学依据。方法:采用量表(SCL-90,HAMA,HAMD,SSPS)对100例维持性血液透析患者进行心理问卷调查研究,检出患者的不同心理障碍程度,根据存在的不同心理问题,给予有针对性的人性化的心理干预。结果:经过1个月透析后问卷调查显示84%的患者存在不同程度的心理障碍。心理干预前,患者SCL-90评分与全国常模进行比较,差异有显著性(P<0.01);干预后,患者SCL-90评分与全国常模进行相比,差异无统计学意义(P>0.1)。结论:根据不同程度的心理问题,有针对性的进行心理干预,能使维持性血液透析患者对生活态度明显改善,提高血液透析的治疗效果及生活质量。     

改良的PBL教学法在骨外科专业教学中的应用

目的探讨改良的PBL教学法在骨外科专业临床理论与临床见习应用的主要作用。方法本研究选取了2013年度来我科见习的100例本科临床医学专业以及七年制专业学生,随机分为实验组与对照组两组,每组50例。实验组采用改良的PBL教学模式;对照组采用传统的教学方式进行见习代教。学期结束进行理论考试以评价学生的学习效果与教学效果,并对教学情况进行问卷调查。结果学期结束考试中,实验组总成绩为(82.24±4.57)分,明显高于对照组的(65.35±3.59)分,差异有统计学意义(P0.05)。其中两组基础理论成绩差异无统计学意义(P0.05),而实验组学生的病案分析成绩为(48.04±4.81)分,明显高于对照组(34.45±3.52)分,差异有统计学意义(P0.05)。调查问卷结果表明,实验组学生满意度96%,明显高于对照组88%,差异有统计学意义(P0.05)。结论改良的PBL教学法可以培养和发展学生的创造性思维,使学生尽可能地利用临床思维思考与解决临床问题,大大地提高了教学效果。     

炎症性肠病患者的心理健康与生活质量状况调查分析

目的 研究炎症性肠病(IBD)患者的生活质量(quality of life,QOL)及主要影响因素.方法 应用中文炎症性肠病问卷(IBDQ)、SF-36、焦虑、抑郁自评量表,对广州市4所医院的71例炎症性肠病患者的QOL进行横断面调查,通过相关分析,探讨焦虑、抑郁与患者生活质量的关系.结果 IBD患者的生活质量得分明显下降,低于肠易激综合征(IBS)组患者(P＜0.05),亦显著低于健康对照组的生活质量(P＜0.05).相关分析表明,IBD患者的焦虑、抑郁水平与生活质量呈负相关.结论 (1)我国IBD患者的生活质量水平低;(2)焦虑、抑郁水平高的IBD患者生活质量低.