慢性盆腔疼痛综合征对精液参数的影响

目的 探讨慢性盆腔疼痛综合征(CPPS)对精液参数的影响.方法 检测46例慢性盆腔疼痛综合征病人,包括炎性慢性盆腔疼痛综合征(CPPSⅢA型)17例和非炎性慢性盆腔疼痛综合征(CPPSⅢB型)29例,以及30例正常男性的精液参数.结果 CPPSⅢA、CPPSⅢB型病人的精液量、液化时间及精子活动力与对照组相比,差异有显著性(F=3.899~6.309,P<0.05),而精液pH值、精子密度、精子存活率和精子畸形百分率的差异无显著性(P>0.05);CPPSⅢA型病人与CPPSⅢB型病人的精液参数差异无统计学意义(P>0.05).结论 CPPSⅢA、CPPSⅢB型病人的精液量增加,液化时间延长,精子活动力下降,两者对精液参数的影响相似.     

前列腺液免疫球蛋白、细胞因子及MIP-1α、MCP-1表达水平在慢性前列腺炎的临床意义

目的探析前列腺液免疫球蛋白(Ig)G、IgA、IgM、白介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)、巨噬细胞炎性蛋白-1α(MIP-1α)、单核细胞趋化蛋白-1(MCP-1)在慢性前列腺炎(CP)的表达意义。方法收集济南市莱芜人民医院2019年7月至2020年7月住院的CP患者126例,按照美国国立卫生研究院(NIH)分类法细化分为三组,慢性细菌性前列腺炎(CBP)组53例,慢性非细菌性前列腺慢性骨盆疼痛综合征(CPPS)ⅢA型组37例及CPPSⅢB型组36例;另收集35名体检健康男性作为正常对照组。检测各组前列腺液Ig G、Ig A、Ig M、IL-6、IL-8、TNF-α、MIP-1α、MCP-1水平变化,并根据前列腺症状指数(NIH-CPSI)评分法将CP患者划分为轻、中、重度,观察相关指标水平在CP不同严重程度的变化。结果 CBP组、CPPSⅢA型组、CPPSⅢB型组前列腺液Ig G、Ig A、Ig M、IL-6、IL-8、TNF-α、MIP-1α、MCP-1水平均明显高于正常对照组,差异有统计学意义(P0.05),其中CBP组、CPPSⅢA型组IL-6、IL-8、TNF-α、MIP-1α、MCP-1水平显著高于CPPSⅢB型组,差异有统计学意义(P0.05),CBP组、CPPSⅢA型组、CPPSⅢB型组Ig G、Ig A、Ig M比较差异无统计学意义(P0.05)。CP轻度组、中度组、重度组前列腺液Ig G、Ig A、Ig M、IL-6、IL-8、TNF-α、MIP-1α、MCP-1水平均高于正常对照组,差异有统计学意义(P0.05),且轻度、中度、重度组间两两比较,差异有统计学意义(P0.05)。结论 CP患者前列腺液Ig G、Ig A、Ig M、IL-6、IL-8、TNF-α、MIP-1α、MCP-1均明显升高,并与CP病理分型、病情严重程度相关,检测上述实验室指标有助于CP病理分型、病情进展评估。     

慢性前列腺炎与精液质量的相关性分析

目的 探讨慢性前列腺炎（CP）与精液延迟液化、精液量、精子活动力（a＋b）、精子密度的影响.方法 检测225例慢性前列腺炎患者及60例正常男性的精液参数（对照组）,比较慢性前列腺炎患者与对照组精液参数的差异.结果 液化时间、精液量、精子活动力（a＋b）、精子密度CP组与对照组差异存在显著性（P〈0.05）,精液pH值、精子活率及精子畸形率之间差异无统计学意义（P〉0.05）.结论 慢性前列腺炎影响患者精子密度、精液量、精子活动力（a＋b）、精液延迟液化、但与病程长短关系不明显,具体原因尚有待进一步研究.     

慢性前列腺炎与男性免疫性不育症的相关性分析

目的：分析慢性前列腺炎与男性免疫性不育症的相关性。方法：回顾性分析176例男性免疫性不育症患者的临床资料，根据是否合并慢性前列腺炎进行分组；对照组97例，未合并慢性前列腺炎；观察组79例，合并慢性前列腺炎；对比两组患者的精液质量，以精液液化时间、精子活率、精子浓度、正常形态率作为评价精液质量的观察指标，采取Spearman相关性分析慢性前列腺炎与男性免疫性不育症患者精液质量观察指标的关系。结果：观察组精液液化时间长于对照组，精子活率及正常形态率均小于对照组，精子浓度大于对照组，差异有统计学意义(P＜0.05)；经Spearman相关性分析，慢性前列腺炎与男性免疫性不育症患者的精液液化时间呈正相关，与精子活率、精子浓度、正常形态率均呈负相关，差异有统计学意义(P＜0.05)。结论：男性免疫性不育症的发生、发展可能与慢性前列腺炎有关，原因在于慢性前列腺炎可降低精液质量，这为临床治疗男性免疫性不育症提供了依据。     

慢性前列腺炎对精液质量的影响

目的观察慢性前列腺炎对精液质量的影响。方法分析72例慢性前列腺炎患者的精液参数及部分生化指标,并与30例健康正常生育男性进行对比。结果慢性前列腺炎患者精子存活率、活动力、正常形态百分率及精浆锌和果糖都较正常对照组低,液化时间较对照组长,精液量、精子密度及精液pH与对照组无差别。结论慢性前列腺炎可导致精液质量下降。     

酸性磷酸酶和锌在ⅢA型慢性前列腺炎合并不育男性精浆含量变化及意义

目的:探讨ⅢA型慢性前列腺炎(CPⅢA)男性精浆中酸性磷酸酶(PAP)和锌(Zn)水平与男性不育的关系. 方法:对30例正常生育男性、30例ⅢA型慢性前列腺炎可生育男性、105例ⅢA型慢性前列腺炎合并不育男性精浆酸性磷酸酶和锌分别进行检测.结果:①ⅢA型慢性前列腺炎可生育组酸性磷酸酶和锌含量均低于正常对照组,但差异无统计学意义(P>0.05);②ⅢA型慢性前列腺炎合并不育组酸性磷酸酶和锌含量明显低于正常对照组和ⅢA型慢性前列腺炎可生育组(P<0.05).结论:ⅢA型慢性前列腺炎可导致精浆中酸性磷酸酶和锌水平下降,从而使精子质量下降,影响男性生育能力.     

慢性前列腺炎患者EPS中IL-1βIL-2IL-10测定的意义

目的探讨前列腺液(EPS)中白细胞介素-1β(IL-1β)、白细胞介素-2(IL-2)、白细胞介素-10(IL-10)水平与不同类型慢性前列腺炎患者之间的关系。方法86例慢性前列腺炎患者按美国国立卫生研究院(NIH)分类法分为慢性细菌性前列腺炎(CBP)组,慢性非细菌性前列腺炎/慢性骨盆疼痛综合征(CPPSⅢA)组和慢性非细菌性前列腺炎/慢性骨盆疼痛综合征(CPPSⅢB)组3组。应用放射免疫分析(RIA)法分别对患者EPS中IL-1βI、L-2I、L-10含量进行了检测。结果慢性前列腺炎组IL-1βI、L-2浓度均明显高于对照组(P均<0.05或0.01),IL-10浓度明显低于对照组(P<0.01)。按CBP组、CPPSⅢA组、CPPSⅢB组的顺序,EPS中的IL-1β、IL-2浓度呈现明显的下降趋势,IL-10浓度呈现明显的升高趋势。其中IL-1βI、L-10在CBP组和CPPSⅢA组分别与CPPSⅢB组结果之间存在显著性差异(P均<0.05或0.01);CBP组与CPPSⅢA组IL-1β、IL-10结果之间差异无显著性(P>0.05)。IL-2在CBP组、CPPSⅢA组、CPPSⅢB组三组结果之间差异无显著性(P>0.05)。结论EPS中IL-1βI、L-2I、L-10在慢性前列腺炎的发病过程中起重要作用,检测EPS中的IL-1βI、L-2I、L-10水平是诊断慢性前列腺炎有价值的指标,EPS中的IL-1β、IL-10水平对于CPPSⅢ的诊断与分型亦具有重要价值。     

慢性前列腺炎对精液检验质量的影响

目的 探讨慢性前列腺炎(chronic prostatitis,CPT)对精液中各检验参数的影响.方法 检测46例慢性慢性前列腺炎患者,包括细菌性慢性前列腺炎患者(chronic bacterial prostatitis,CBP)17例和非细菌性慢性前列腺炎患者(chronic nonbacterial prostatitis,CNBP)29例,以及30例正常男性的精液作为对照组进行分析.结果 CBP、CNBP患者的精液量、液化时间及精子活动力与对照组相比,差异有显著性(F=3.899～6.309,P<0.05),而精液pH值、精子密度、精子存活率和精子畸形百分率的差异无显著性(P>0.05);CBP患者与CNBP患者的精液参数差异无统计学意义(P>0.05).结论 CBP、CNBP型患者的精液量增加,液化时间延长,精子活动力下降,两者对精液参数的影响相似.     

慢性前列腺炎与男性不育症的相关性研究

目的探讨慢性前列腺炎与男性不育症的相关性。方法选取本院2010年3月～2012年5月收治的男性不育症患者103例,均行前列腺液常规检测和精液支原体培养,根据检测结果分为两组,非慢性前列腺炎患者47例为对照组,慢性前列腺炎患者56例为观察组,分别检测患者的精液参数（液化时间）、精子活力及精子畸形情况,分析慢性前列腺炎与男性不育症相关因素的关系。结果观察组精子密度、精子a＋b活力、精子活动率均明显低于对照组,观察组精液液化时间、精子畸形率均明显高于对照组,差异有统计学意义（P〈0.05）。慢性前列腺炎与精子密度、精子a＋b活力、精子活动率均具有一定负相关性（P〈0.05）,慢性前列腺炎与精液液化时间、精子畸形率均具有一定正相关性（P〈0.05）。结论慢性前列腺炎可延长患者精液的液化时间,降低精子活力,对患者的精液质量产生影响,是男性不育症的诱发原因之一。     

抗生素治疗慢性前列腺炎/慢性骨盆疼痛综合征的疗效观察

目的 观察抗生素在慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)治疗中的作用.方法 将CP/CPPS患者分为A、B 2组,每组100例,对A组患者给予对症治疗,对B组患者在A组治疗方案基础上同时给予抗生素,观察治疗后2组患者美国国立卫生研究院慢性前列腺炎症状积分(NIH-CPSI)的变化情况,并进行统计学处理分析.结果 A、B 2组患者接受治疗后症状均有明显改善,且加用抗生素的B组患者的NIH-CPSI积分明显低于未用抗生素A组患者的NIH-CPSI积分(10.6±3.3 vs 4.2±3.0,P＜0.05).结论抗生素在CP/CPPS治疗中具有重要的作用,加用抗生素联合治疗更有利于CP/CPPS症状的改善.     

慢病管理对慢性乙型肝炎治疗效果的评价

目的观察慢病管理对慢性乙肝治疗的干预效果。方法将180例慢性乙肝患者随机分为观察组90例和对照组90例。对观察组进行慢痛管理干预,对照组未进行干预。采用疾病认知、依从性、生活方式测定量表对患者进行评价。结果观察组干预后疾病认知度、治疗依从性及生活方式积分较干预前明显提高,干预前后比较差异有统计学意义（P〈0．01）;干预后积分与对照组比较,差异有统计学意义（P〈0．05）。时照组干预前后治疗依从性评分比较,差异有统计学意义（P〈0．05）,疾病认知度及生活方式积分观察前后比较,差异无统计学意义（P〉0．05）。结论实施慢病管理干预可以提高乙肝患者对乙肝的认知度及治疗依从性,改善不良的生活方式。     

Prolonged chronic phase in chronic myelogenous leukemia after homoharringtonine therapy

Background Homoharringtonine （HHT） is effective in treating late stage chronic myelogenous leukaemia （CML）, but little is known about long term maintenance during complete cytogenetic response. Long term efficacy and toxicity profiles of low dose HHT were evaluated in this study. Methods One hundred and six patients with CML received 1.5 mg/m^2 of HHT alone by continuous daily infusion for seven to nine days every four weeks. Of 79 patients in the control group, 31 were treated with interferon α （IFN-α） and 48 with hydroxycarbamide. For 17 patients who failed to achieve cytogenetic response within 12 months＇ treatment of IFN-α, HHT was administered. Quantitative RT-PCR was used to detect the BCR-ABL mRNA expression in 36 Philadelphia positive CML patients enrolled after 2007. Haematological and cytogenetic responses were evaluated in all patients at the 12th month of follow-up. Long term efficacy was assessed in a follow-up with a median time of 54 months （12 months-98 months）. Results After 12 months of therapy, cytogenetic response rate of the HHT, IFN-α and hydroxycarbamide groups were 39/106, 14/31 and 3/48, and corresponding molecular cytogenetic response rates 6/18, 3/8 and 0. Of the 17 patients who received HHT as salvage treatment, 6 achieved cytogenetic response （3 major）. At the 48 months＇ follow-up, cytogenetic response was maintained in 32/39 patients treated with HHT. Patients who had cytogenetic response in HHT group or treated with IFN-α also showed longer median chronic durations, which were 45 months （12 months-98 months） and 49 months （12 months-92 months） respectively, indicating a longer survival time. Conclusions Low dose HHT alone showed considerable short term and long term efficacy in the treatment of late stage CML. It may also be a good choice for patients who have failed imatinib, IFN-α treatment or haematopoietic stem cell transplantation or cannot afford these treatments.     

四种方法治疗慢性淋巴水肿、淋巴管（结）炎的比较研究

目的应用四种常用方法,比较治疗慢性淋巴水肿和淋巴管（结）炎的疗效。方法采用音频电疗结合绑扎、桑叶注射液结合绑扎、香豆素、消肿乳糜清制剂分组治疗。结果音频电疗结合绑扎、桑叶注射液结合绑扎、香豆素、消肿乳糜清制剂组对慢性淋巴水肿疗后基本治愈和显效率分别为36．36％、68．75％、41．07％和61．78％,对慢性淋巴管结炎的治愈率分别为54．17％、83．33％、69．64％、95．85％。结论消肿乳糜清制剂是慢性淋巴水肿、淋巴管（结）炎患者最理想的天然治疗药物。     

Approaching chronic cough

Chronic cough is one of the most common reasons for referral to a respiratory physician. Although fatal complications are rare, it may cause considerable distress in the patient’s daily life. Western and local data shows that in patients with a normal chest radiograph, the most common causes are postnasal drip syndrome, postinfectious cough, gastro-oesophageal reflux disease and cough variant asthma. Less common causes are the use of angiotensin-converting enzyme inhibitors, smoker’s cough and nonasthmatic eosinophilic bronchitis. A detailed history-taking and physical examination will provide a diagnosis in most patients, even at the primary care level. Some cases may need further investigations or specialist referral for diagnosis.     

Tropical chronic pancreatitis

Tropical chronic pancreatitis (TCP) is a juvenile form of chronic calcific non-alcoholic pancreatitis, seen almost exclusively in the developing countries of the tropical world. The classical triad of TCP consists of abdominal pain, steatorrhoea, and diabetes. When diabetes is present, the condition is called fibrocalculous pancreatic diabetes (FCPD) which is thus a later stage of TCP. Some of the distinctive features of TCP are younger age at onset, presence of large intraductal calculi, more aggressive course of the disease, and a high susceptibility to pancreatic cancer. Pancreatic calculi are the hallmark for the diagnosis of TCP and in non-calcific cases ductal dilation on endoscopic retrograde cholangiopancreatography, computed tomography, or ultrasound helps to identify the disease. Diabetes is usually quite severe and of the insulin requiring type, but ketosis is rare. Microvascular complications of diabetes occur as frequently as in type 2 diabetes but macrovascular complications are uncommon. Pancreatic enzyme supplements are used for relief of abdominal pain and reducing the symptoms related to steatorrhoea. Early diagnosis and better control of the endocrine and exocrine dysfunction could help to ensure better survival and improve the prognosis and quality of life of TCP patients.     

慢性支气管炎患者慢性阻塞性肺疾病发病影响因素的研究

目的 研究慢性支气管炎患者慢性阻塞性肺疾病（COPD）发病的影响。方法 1992年对≥15岁的67251名农民普查发现1999例未发生COPD的慢性支气管炎患者,收集吸烟、COPD家族史、炉灶情况、粉尘接触、肺功能等基线资料。整群随机分为干预区和对照组,对干预区实施戒烟宣传等干预措施。2000年采用分层随机抽样方法抽取1114例进行复查。结果 应答且资料完整者869例（占1114例的78．0％）。吸烟、基线COPD家族史阳性使第1秒用力呼气量（FEV1）和／或第1秒用力呼气量百分比（FEV1／FVC）随年龄下降速度加快,戒烟者与不吸烟者下降速度无显著差异。COPD8年累积发病与基线年龄、吸烟、COPD家族史阳性呈独立的正相关,而与基线FEV1和FEV1／FVC呈独立的负相关,戒烟与不吸烟者发病危险差异无显著意义。结论 衰老、吸烟、COPD家族史、肺功能低下且慢性支气管炎患者COPD发病独立的危险因素,特别不是独立的危险因素,戒烟可使吸烟者发病危险降低至近似于不吸烟者的水平。     

Fluoxetine ameliorates symptoms of refractory chronic prostatitis/chronic pelvic pain syndrome

Background  Category III chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common syndrome of unclear etiology with significant impact on quality of life. Because the outcomes of multiple therapies for CP/CPPS have been far from approving, the possible psychological factors have been considered to play an important role in CP/CPPS. Based on this, we investigated the role of antidepressant drug (fluoxetine) in men with refractory CP/CPPS.

Methods  In this study, 42 men diagnosed with refractory CP/CPPS without response to standard therapy (include multiple antibiotic courses and α-blockers) were referred for fluoxetine therapy. All patients received fluoxetine (20 mg/d) for three months and were clinically evaluated before (baseline), and after 4, 8 and 12 weeks of therapy. The evaluation included a National Institutes of Health-chronic prostatitis symptom index (NIH-CPSI) and a Beck depression inventory (BDI) questionnaire. Moreover, the subjective global assessment (SGA) was assessed at the 4th, 8th and 12th week of therapy.

Results  Significant decreases were observed for total NIH-CPSI (28.55 to 9.29), NIH-CPSI pain (14.69 to 5.19), NIH-CPSI urinary (4.95 to 1.88 ), NIH-CPSI quality of life (8.83 to 2.20), and BDI (34.67 to 13.95) scores compared with baseline, all P values <0.05. Twenty-nine (69.05%) reported marked improvement on the subjective global assessment and 33 (78.57%) had a greater than 50% decrease in NIH-CPSI at the end of therapy (12th week). At the same time, the Pearson correlation coefficient analysis demonstrated a positive correlation between BDI score and each CPSI score. No adverse events were reported in this study.

Conclusions  Fluoxetine appears to be a safe and effective treatment in improving symptoms in, and the quality of life of, men with difficult CP/CPPS. Moreover, amelioration of difficult CP/CPPS-related symptoms could be related to a decrease in depressive symptoms.