经乳晕切口治疗男性乳房肥大症

目的 探讨经乳晕切口治疗男性乳房肥大症的临床效果.方法 经乳晕弧形切口切除,必要时配合使用肿胀吸脂法去除肥大乳腺组织,保留乳头乳晕区下方的部分乳腺组织垫.结果 20例患者40侧乳腺组织切除彻底,术后患者胸部平坦,外形满意,切口瘢痕隐蔽.结论 采用乳晕小切口能完整、彻底去除肥大乳腺组织,并发症少,是治疗男性房肥大症的良好手术方法.     

乳晕下小切口加肿胀吸脂治疗男性乳房发育症

目的评价肿胀麻醉下通过乳晕下小切口配合脂肪抽吸治疗男性乳房发育症的手术方法的临床效果。方法对23例男性乳房发育患者,17例单纯腺体增生的患者采用乳晕下小切口切除术,6例腺体脂肪混合增生的患者采用脂肪抽吸配合腺体切除术。结果术后全部患者无乳头乳晕坏死及感觉减退,胸部平坦,外形满意,切口瘢痕隐蔽。结论根据腺体增生类型采用乳晕下小切口或配合脂肪抽吸术能完整、彻底去除肥大乳腺组织和脂肪组织;该手术方式具有出血少,损伤轻,安全,恢复快,切口瘢痕不明显,乳头乳晕无变形,疗效确切,患者满意度高等优点。     

双环法中央蒂真皮帽乳房缩小成形术的临床实践

目的总结双环法中央蒂真皮帽乳房缩小成形术在巨乳治疗中的临床应用经验。方法对32例64侧乳房肥大伴或不伴乳房松垂者,采用以乳头为中心的中央蒂真皮帽双环法乳房缩小成形术,保留第4肋间神经径路的乳腺组织的完整性,切除多余的腺体组织,环形荷包缩拢外环口缝合。结果切除腺体组织量150～920 g/侧。3例术后9～12 d拆线时切口部分裂开;1例乳头表面部分坏死,经换药后痊愈。余均无伤口感染、血肿等并发症。随访0.5～5年,5例切口处瘢痕增生;4例乳晕形态不佳再次修复后满意;1例乳房肥大复发伴松垂。其余患者双侧乳房大小和乳头乳晕对称,形态自然,乳房上极较饱满,瘢痕隐蔽,乳头乳晕感觉正常,效果满意。结论双环法中央蒂真皮帽乳房缩小成形及悬吊术设计操作简单、灵活,瘢痕隐蔽,手术后可确保乳头乳晕的血供、感觉与哺乳功能。     

体表标记乳晕切口治疗男性乳房发育症17例临床分析

目的探讨采取在体表标记下乳晕切口手术治疗Ⅰ～Ⅱ度男性乳房发育症的临床疗效。方法对2010年3月-2013年3月该院乳腺外科17例Ⅰ～Ⅱ度男性乳房发育症患者采用体表标记下乳晕弧形切口进行手术治疗的临床资料进行回顾性分析,分析其临床优势及效果。结果所有患者术后均获得平整的胸廓外观,胸部平坦,外形满意,无乳头乳晕凹陷畸形;切口愈合良好,瘢痕轻微、隐蔽,手术效果满意;2例患者术后皮瓣下有积液,经穿刺抽液及加压包扎后均皮瓣黏合良好。结论体表标记下采取乳晕弧形切口治疗男性乳房发育症取得较好的临床疗效,值得推广应用。     

小切口腺体切除联合吸脂术与单纯开放手术切除法治疗轻中度男性乳房发育症的疗效比较

目的 探讨小切口腺体切除联合吸脂术与单纯开放手术切除治疗轻中度男性乳房发育症的临床疗效。方法 回顾性分析2012年3月至2018年6月在安徽省立医院行手术治疗的男性乳房发育症患者132例临床资料。根据手术方式不同分为小切口腺体切除联合吸脂组（微创组）62例，单纯开放手术切除组（开放组）70例，比较两组患者的治疗效果，住院时间、术后即刻疼痛评分（VSS评分）、并发症、切口瘢痕情况及整体满意度等指标。结果 两组患者术后乳房体积均减小。微创组均在局麻下完成手术，门诊手术室即可进行；微创组患者住院时间较开放组短、术后即刻疼痛评分（VSS评分）较开放组低，差异有统计学意义（P<0.05）。微创组的手术时间、术后并发症发生率与开放组比较，差异无统计学意义（P>0.05）。微创组切口瘢痕评分及整体满意度明显优于开放组，差异有统计学意义（P<0.05）。结论 小切口腺体切除联合吸脂术治疗轻中度男性乳房发育症具有切口小、出血少、疼痛轻，住院时间短及瘢痕不明显等优点，值得推广应用。     

环乳晕切口切除术治疗乳腺纤维瘤的临床疗效分析

目的探讨环乳晕切口切除术治疗乳腺纤维瘤的临床疗效。方法对本院近两年收治的乳腺纤维瘤43例患者环乳晕切口切除术,术后观察切口愈合情况。结果 43例患者手术均取得了良好的效果,且无明显瘢痕,双侧乳房对称,乳头乳晕感觉良好。结论环乳晕切口乳腺纤维瘤切除术既可彻底切除病灶,又可以保持乳房外形美观,隐匿手术疤痕。     

肿胀麻醉微创治疗青春期男性乳腺增生症

目的探讨应用肿胀麻醉乳晕切口微创治疗青春期男性乳腺增生症的临床经验。方法采取肿胀麻醉乳晕切口微创治疗39例青春期男性乳腺增生症患者。结果39例患者均手术顺利，术后无一例出现血肿、感染、乳头乳晕坏死，胸部平整对称。随访28例，时间为6～12个月，术区瘢痕不明显，胸部平坦，无复发。结论肿胀麻醉乳晕切口微创治疗青春期男性乳腺增生症是一种操作简单、安全性高、彻底的治疗方法。     

麦默通微创旋切术治疗男性乳腺发育症的临床研究

目的探讨麦默通(Mammotome)微创旋切手术治疗男性乳腺发育症的疗效评价和美容效果。方法回顾性分析96例双侧男性乳腺发育症的患者,实验组50例采用Mammotome手术治疗,对照组46例采用开放式手术治疗,对术后外形、切口瘢痕及乳头乳晕等方面进行术后效果的综合评价。结果术后随访6~12个月,与开放式手术治疗男性乳腺发育症患者相比,Mammotome手术治疗切口愈合时间快,瘢痕不明显,乳头、乳晕无明显内陷,乳头感觉无异常可正常勃起,所有患者对手术效果表示满意。两组相比较,差异具有统计学意义(P<0.05)。结论 Mammotome手术治疗男性乳腺发育症,术后胸部外观及功能等方面疗效较好,患者满意率高。     

麦默通微创旋切手术治疗良性乳腺肿物效果分析

目的 分析麦默通微创旋切手术治疗良性乳腺肿物的效果.方法 选取2011年6月至2016年3月我院收治的370例良性乳腺肿物患者,依据手术方式分为研究组和对照组各185例,对照组行传统乳腺肿物切除术治疗,研究组行麦默通微创旋切术治疗,比较两组乳房美容效果评分、相关临床指标以及术后并发症情况.结果 研究组乳房形状、乳头感觉等乳房美容效果评分优于对照组,差异有统计学意义(P＜0.05);研究组出血量、瘢痕大小等关临床指标少于对照组,局部血肿、切口感染等术后并发症情况少于对照组,差异有统计学意义(P＜0.05).结论 良性乳腺肿瘤患者行麦默通微创旋切术治疗可提高其乳房美容效果,并缩短手术时间与住院时间,减少并发症与术中出血量,值得推广.     

经乳晕切口手术治疗男性乳房发育症

目的探讨经乳晕小切口治疗男性乳房发育症的疗效及术后的美容效果。方法回顾性分析42例男性乳房发育症的患者经乳晕小切111行手术治疗的临床资料。结果42例患者手术均获成功,术后随访3个月至2年,手术切口瘢痕不明显,乳头、乳晕感觉正常,无并发症发生。结论经乳晕小切口治疗男性乳房发育症的手术疗效确切,术后术区胸部外观良好,值得临床推广应用。     

不同配比的芍药甘草方对利培酮所致女性精神分裂症高催乳素血症的影响

目的：观察不同配比的芍药甘草方治疗抗精神病药利培酮所致女性精神分裂症患者高催乳素血症的临床疗效。方法收集2013年7月－2014年1月河北省第六人民医院门诊及住院的患者120例,按随机数字表法将患者随机分为对照组、芍甘组A、芍甘组B,每组均为40例,观察治疗前、治疗12周后3组患者血清催乳素、雌激素（雌二醇、睾酮、促卵泡刺激素、促黄体生成素、孕酮）表达水平,采用阳性及阴性症状量表（ PANSS）评价精神分裂症患者精神症状,药物副作用量表（TESS）评价药物不良反应。结果治疗前3组患者血清催乳素、雌激素水平及 PANSS 评分比较差异无统计学意义（ P＞0．05）。治疗12周后,3组患者血清雌激素水平比较差异无统计学意义（ P＞0．05）;A组、B组与对照组比较,血清催乳素水平均明显下降（P＜0．05）,B组与A组比较,血清催乳素水平明显下降（P＜0．05）。疗效方面：治疗12周后,3组患者PANSS评分比较差异无统计学意义（P＞0．05）,3组患者分别与同组治疗前比较,PANSS评分均明显下降（P＜0．05）。安全性方面：3组患者治疗前后TESS 评分比较差异无统计学意义（ P＞0．05）。结论不同配比的芍药甘草方能明显降低利培酮所致女性精神分裂症患者血清催乳素水平,尤以2∶1的芍药甘草方能降低催乳素水平,并且不影响抗精神病药利培酮的临床疗效。     

乳晕边缘小切口切除乳腺纤维腺瘤

目的探讨手术治疗乳腺纤维腺瘤的最佳切口选择。方法回顾性分析5年间采用乳晕小切口治疗乳腺纤维腺瘤148例的临床资料。结果全部患者通过手术切除了乳房纤维腺瘤,对手术切口的选择均表示满意。结论乳晕小切口乳房肿块切除术不仅能切除纤维腺瘤,而且无明显瘢痕。     

温针刺结合健脾祛痰法治疗体重正常型多囊卵巢综合征效果及对性激素、胰岛素抵抗的影响

目的 探究温针刺结合健脾祛痰法对体重正常型多囊卵巢综合征治疗疗效及分子生物学指标变化.方法 选取2015年2月-2016年2月收治的多囊卵巢综合征患者90例,随机分为对照组与观察组,各45例.对照组采用苍附导痰汤治疗,观察组采用温针刺结合苍附导痰汤治疗,共治疗3个月.比较两组治疗前后子宫内膜及卵泡情况,空腹血糖(FPG)、空腹胰岛素(FINS)、餐后2h血糖,餐后2h胰岛素、胰岛素抵抗指数(HOMA-IR),性激素变化,血清肿瘤坏死因子-α(TNF-α)、抵抗素、脂联素水平及胰岛素受体底物-l(IRS-1)和细胞外信号调节激酶-2(ERK-2)基因相对表达情况.结果 治疗后对照组子宫内膜厚度、成熟卵泡数量、促卵泡生成素和脂联素水平高于治疗前,而FPG、FINS、HOMA-IR、睾酮、黄体酮、泌乳素、TNF-α及抵抗素水平低于治疗前(P＜0.05).治疗后观察组子宫内膜厚度、卵泡数量、促卵泡生成素、脂联素和IRS-1相对表达量均高于治疗前和对照组,而FPG、FINS、餐后2h血糖、餐后2h胰岛素、HOMA-1R、睾酮、黄体酮、泌乳素、TNF-α、抵抗素和ERK-2相对表达量均低于治疗前和对照组(P＜0.05).结论 温针刺结合健脾祛痰法治疗体重正常型多囊卵巢综合征患者疗效明显,能够调节体内性激素水平,增强胰岛素敏感性,推测其机制可能引血清TNF-α及抵抗素水平降低、脂联素水平升高有关,同时还可能与抑制MAPK/ERK通路激活,抑制IRS-1丝氨酸磷酸化有关.     

The effects of propranolol and acebutolol on the overnight plasma levels of anterior pituitary and related hormones

1 The effects of single evening doses of the beta-adrenoceptor blocking agents propranolol (80 mg orally) and acebutolol (200 mg orally) on plasma levels throughout the night of prolactin, growth hormone, luteinising hormone, follicle stimulating hormone, cortisol and testosterone have been studied in seven healthy male volunteers. 2 Three way analysis of variance showed that acebutolol significantly reduced circulating levels of prolactin and follicle stimulating hormone, but did not alter the levels of the other hormones studied. 3 Propranolol significantly reduced follicle stimulating hormone and testosterone, and significantly increased circulating levels of cortisol, but caused no change in the other hormones studied. 4 Prolactin, luteinising hormone, testosterone and cortisol showed a significant variation with time indicating the existence of a diurnal rhythm in the pattern of their secretion. 5 There was a significant inter-subject variability in all the hormones studied. 6 There was a significant between-subject variation in response to both propranolol and acebutolol. 7 Different subjects showed significant variations with respect to time in prolactin, growth hormone and cortisol levels. 8 Neither propranolol nor acebutolol significantly altered the time course of secretion of any of the hormones studied. 9 Possible relationships of these beta-adrenoceptor blocker-induced changes in anterior pituitary and related hormones to the antihypertensive mechanism of acebutolol and propranolol are discussed.     

Imatinib-associated bilateral gynecomastia and unilateral testicular hydrocele in male patient with metastatic gastrointestinal stromal tumor: a literature review

Imatinib mesylate is a drug that has been approved for treatment of advanced gastrointestinal stromal tumors (GISTs) and patients with leukemia such as chronic myeloid or Philadelphia chromosome-positive acute lymphoblastic. Although it has been described only in one patient with testicular hydrocele and gynecomastia in the literature, several cases of male gynecomastia have been reported with the use of imatinib mesylate in chronic myeloid leukemia (GML). Generally, male mastoplasia resolves after discontinuation of imatinib treatment. We report a 73-year-old male with metastatic GISTs who developed gynecomastia and unilateral testicular hydrocele while receiving imatinib mesylate. Nine months after commencing imatinib treatment, gynecomastia and testicular hydrocele were determined. Hormone analyses requested showed serum testosterone levels below and serum estrogen levels above normal limits. During the first month after discontinuing imatinib mesylate treatment, serum testosterone level was normal and there was a partial regression in gynecomastia and testicular hydrocele. To our knowledge, this is the second report of male gynecomastia following imatinib mesylate treatment of a patient with GIST. In conclusion, male patients who are to receive treatment with imatinib mesylate may be monitored for serum testosterone levels and for other reproductive hormone profiles before initiation of the treatment and their breasts may be examined during follow-up visits.     

A comparative study of the effects of ranitidine and cimetidine on carbohydrate tolerance, growth hormone secretion and the hypothalamic-pituitary-gonadal axis in man

The effect of chronic oral administration of cimetidine (1 g per day) and ranitidine (300 mg per day) on plasma levels of prolactin (PRL), testosterone, dihydrotestosterone (DHT), luteinizing hormone (LH), follicle stimulating hormone (FSH), sex hormone binding globulin (SHBG) and human growth hormone was compared in 2 groups of male patients who presented with dyspeptic symptoms. Eight were treated with ranitidine and 9 with cimetidine for 4 weeks. The glucose and insulin response to a 100 g oral glucose load was also assessed. Cimetidine treatment resulted in a significant increase in plasma testosterone levels which was not found in the ranitidine group. No significant change occurred in PRL, LH, FSH, SHBG, DHT and growth hormone. There was no evidence of a significant alteration in carbohydrate metabolism.