男性泌尿生殖系急性创伤对性功能影响及急诊措施的临床研究

目的:探讨男性泌尿生殖系急性创伤对性功能影响性,寻找出最佳的方法,以提高临床诊治水平。方法:随机选取2010年2月至2013年2月35例男性泌尿生殖系急性创伤患者为研究组;另外选取35例健康男性为对照组,观察两组在性功能上的变化情况,且对研究组及时采取有效的措施进行整治,观察治疗后的效果。结果:两组在性激素E2、PRL、FSH、T水平和性欲频度、性交频度、阴茎勃起力度、勃起持续状态、性生活满意度、国际勃起功能指数上比较差异有统计学意义(P0.05),且治疗前和治疗后、治疗1个月后和治疗1年后在国际勃起功能指数上比较差异也有统计学意义(P0.05)。结论:男性泌尿生殖系急性创伤可降低性功能,早期规范治疗后可使性功能恢复。     

炔诺酮治疗无排卵性功能失调性子宫出血的临床效果分析

目的:探讨炔诺酮治疗无排卵性功能失调性子宫出血的临床效果分析。方法:通过分析2013年1月至2014年11月医院收治的146例无排卵性功能失调性子宫出血患者的临床资料,随机分为观察组和对照组,对照组患者给予决雌醇环丙孕酮片治疗,观察组患者给予炔诺酮进行治疗,治疗结束后观察两组患者临床疗效。结果:治疗结束后观察组临床有效率为98.63%,对照组临床有效率为79.45%,两组临床有效率组间差异有统计学意义(P0.05)。两组患者治疗前经期天数、周期和血红蛋白水平组间差异无统计学意义(P0.05),治疗后比较差异有统计学意义(P0.05)。统计两组患者血性激素水平,结果显示治疗前血性激素水平指标组间差异无统计学意义(P0.05),治疗后观察组E2、FSH、P和LH四项指标比较组间差异有统计学意义(P0.05)。结论:使用炔诺酮治疗无排卵性功能失调性子宫出血患者可显著改善患者月经周期、血清性激素指标和血红蛋白指标,临床指导意义重大。     

男性2型糖尿病患者性激素水平变化及其相关因素探讨

目的:探讨2型糖尿病(T2DM)男性患者性激素水平变化及其相关影响因素。方法:选取我院2012年1月至2014年8月收治的96例T2DM患者进行研究,根据年龄、BMI、病程、ED严重程度、血糖水平进行分组,比较各组性激素水平变化情况,探讨相关影响因素。结果:T2DM患者IIEF-5评分发病后较发病前降低,差异有统计学意义(P0.05)。不同年龄、病程、BMI的T2DM患者性激素水平对比差异无统计学意义(P0.05)。不同程度ED患者E2、P和PRL对比差异无统计学意义(P0.05)。从无ED到ED严重程度加重FSH、T和LH水平逐渐增高,总体比较差异有统计学意义(P0.05)。不同血糖患者FSH、T、E2、P和PRL对比差异无统计学意义(P0.05)。而血糖低于6.5%的患者LH较另外两组高,整体比较差异有统计学意义(P0.05)。结论:2型糖尿病的发生可能加重勃起功能障碍病情,卵泡刺激素、黄体生成素和睾酮水平与患者血糖及性功能障碍程度相关。     

寻常痤疮患者血清P物质的检测分析

目的 探讨P物质（SP）在寻常痤疮发病机制中的作用.方法 对50例寻常痤疮患者及35例正常人血清中的SP浓度进行检测分析.结果 寻常痤疮患者组血清P物质浓度高于健康对照组,差异有统计学意义（P＜0.05）.其中Ⅰ级痤疮患者组与对照组血清P物质浓度比较差异无统计学意义（P＞0.05）,Ⅱ级痤疮患者组与对照组血清P物质浓度比较差异有统计学意义（P＜0.05）,Ⅲ级及Ⅳ级痤疮患者组与对照组血清P物质浓度比较差异有统计学意义（P＜0.01）.组间比较：Ⅱ级、Ⅲ级及Ⅳ级痤疮患者组分别与Ⅰ级痤疮患者组血清P物质浓度比较差异有统计学意义（P＜0.05）.Ⅱ级、Ⅲ级及Ⅳ级痤疮患者组血清P物质浓度组间两两比较差异无统计学意义（P＞0.05）.结论 SP可能在寻常痤疮发病中起重要作用,且与寻常痤疮的病情轻重程度密切相关.     

腹腔镜下全子宫切除对患者性激素水平及术后生活质量的影响

目的探讨腹腔镜下全子宫切除对患者性激素水平及术后生活质量的影响。方法选取2015年1月至2017年5月渭南市妇幼保健院诊治的140例子宫肌瘤患者作为研究对象。按随机数字表法将其分为研究组与对照组,每组70例。对照组患者采用常规开腹子宫切除术治疗,研究组患者采用腹腔镜下全子宫切除术治疗,治疗后比较两组患者一般指标、性激素水平、生活质量与性生活质量。结果研究组患者手术时间、术中出血量、住院时间及肛门排气时间均较对照组短,差异均具有统计学意义(均P0.05)。术前两组患者性激素水平较差异无统计学意义(P0.05)。术后研究组患者FSH和LH水平均低于对照组,E2水平较对照组高,但差异均无统计学意义(均P0.05)。术前两组患者生活质量比较差异无统计学意义(均P0.05)。术后研究组患者躯体疼痛评分较对照组低,其他维度评分均高于对照组,差异均具有统计学意义(均P0.05)。术前两组患者性生活质量评分比较差异无统计学意义(P0.05)。术后研究组性生活质量各维度评分均较对照组高,差异均具有统计学意义(均P0.05)。结论与开腹子宫切除术相比,腹腔镜下全子宫切除术对患者性激素水平影响相似,但对生活质量及性生活质量改善效果更好,且具有创伤小、术后恢复快的特点。     

免疫抑制剂对系统性红斑狼疮患者性激素水平及性功能影响的临床研究

目的:探讨免疫抑制剂对系统性红斑狼疮(SLE)患者性激素水平及性功能影响性,以期提高临床诊治水平。方法:选取2010年2月至2013年4月65例SLE患者为研究对象,均为女性,均采用电化学法检测血中性激素雌二醇(E2)、催乳素(PRL)、促卵泡素(FSH)、睾酮(T)水平情况,且将以上病例分成两组,对照组31例,予雷公藤多甙治疗;观察组34例,予免疫抑制剂治疗,观察其和病情活动情况之间的关系。结果:两组患者在性激素E2、PRL、FSH、T水平和性功能指标性欲、性唤起、阴道润滑、性高潮、性满意度和性交疼痛比较差异有统计学意义(P0.05)。结论:免疫抑制剂可促使SLE患者性激素水平下降,性功能减退,在临床上应用时要加强监测。     

美托洛尔对男性高血压患者性功能的影响研究

目的研究美托洛尔对男性高血压患者性功能的影响,为临床治疗提供参考。方法选取2016年10月至2017年10月云南省第三人民医院诊治的160例男性高血压患者作为研究对象。按照随机表法平均分为两组。其中观察组80例给予美托洛尔治疗,对照组80例给予缬沙坦治疗。两组患者均治疗2个月,对比临床疗效、性激素水平及性功能指标变化。结果治疗后,两组患者的FSH、PRL及E2血清性激素水平均降低,且观察组低于对照组,差异均具有统计学意义(均P0.05)。治疗后,观察组患者总有效率为82.5%,高于对照组的75.0%,差异具有统计学意义(P0.05)。治疗后,两组患者的性高潮、性欲及性满意度评分均降低,且观察组均低于对照组,差异均具有统计学意义(均P0.05)。结论美托洛尔治疗男性高血压,疗效相对缬沙坦更好,但其可降低患者性激素水平,影响患者患者性功能指标,建议综合参考。     

盆腔炎对女性性激素的影响及其与不孕症的关系

目的:探讨盆腔炎对女性性激素水平的影响,研究盆腔炎与不孕不育的关系。方法:76例女性不孕症合并盆腔炎患者设为观察组1,50例单纯女性不孕症设为观察组2,并以同期有生育史健康女性62例为对照组,比较三组性激素水平及炎性因子差异。结果:三组性激素水平FSH、T差异无统计学意义(P0.05),观察组1与观察组2及对照组比较,观察组1 LH、PRL、E2、P出现升高差异有统计学意义(P0.05),观察组2与对照组比较性激素6项差异均无统计学意义(P0.05);三组炎性因子比较,观察组1TNF、IL-2均出现升高,与观察组2及对照组差异有统计学意义(P0.05),观察组2与对照组TNF、IL-2差异无统计学意义(P0.05);合并盆腔炎不孕症患者炎性因子TNF、IL-2与LH、PRL、E2、P均呈正相关,均有统计学意义(P0.05)。结论:盆腔炎与不孕症关系密切。     

宫腔镜子宫肌瘤电切术治疗子宫粘膜下肌瘤对患者卵巢储备功能及性功能的影响

目的探讨宫腔镜子宫肌瘤电切术治疗子宫粘膜下肌瘤对患者卵巢储备功能及性功能的影响。方法选取2015年1月至2017年5月十堰市妇幼保健院诊治的170例子宫粘膜下肌瘤患者作为研究对象。按随机数字表法将其分为研究组与对照组,每组各85例。对照组患者采用腹腔镜下子宫肌瘤剜除术治疗,研究组采用宫腔镜子宫肌瘤电切术治疗,术后3个月时比较两组患者手术相关指标、卵巢储备功能及性功能改变情况。结果研究组手术时间、术中出血量及术后镇痛率高于对照组,但差异无统计学意义(P0.05)。研究组术后排气时间及出院时间较对照组短,差异具有统计学意义(P0.05)。术前两组患者卵巢储备功能指标比较差异无统计学意义(P0.05)。术后研究组患者FSH、LH、AFC及E2均低于对照组,但差异无统计学意义(P0.05)。两组患者卵巢储备功能术前与术后比较差异无统计学意义(P0.05)。两组患者性功能指标术前与术后比较差异无统计学意义(P0.05)。术前及术后两组患者性欲望、性唤起、阴道润滑、性高潮、性交疼痛及性生活满意度比较差异均无统计学意义(均P0.05)。结论宫腔镜子宫肌瘤电切术与腹腔镜下子宫肌瘤剜除术对子宫粘膜下肌瘤患者卵巢储备功能及性功能均无明显影响,但宫腔镜子宫肌瘤电切术造成的创伤较小,术后恢复快。     

不同术式处理对无妊娠需求子宫肌瘤患者卵巢功能及性功能的影响

目的:探讨不同术式处理对无妊娠需求子宫肌瘤患者卵巢功能及性功能的影响差异。方法:92例无妊娠需求子宫肌瘤患者按手术方式不同分为A组(n=46)、B组(n=46),分别行次全子宫全切除术、子宫肌瘤剔除术。观察两组手术效果,术前、术后6个月测定两组血清卵巢功能指标,并以国际女性性功能评价量表评估性功能情况。结果:两组手术时间、并发症比较无统计学差异(P0.05),出血量、术后排气时间比较有统计学差异(P0.05)。两组术前促卵泡生长激素(FSH)、促黄体生长素(LH)、雌二醇(E_2)激素水平比较无统计学差异(P0.05);A组术后FSH、LH水平显著升高,E_2水平显著下降(P0.05),而B组术后FSH、LH、E_2水平与术前相比无统计学差异(P0.05);A组、B组术后FSH、LH、E_2水平比较有统计学差异(P0.05)。两组术前性功能各项评分比较无统计学差异(P0.05);两组术后性欲、性唤起和阴道性交达兴奋、性高潮评分均显著升高(P0.05),A组术后性行为中异常症状、射精时间评分较术前明显下降,且B组评分高于A组(P0.05)。结论:与次全子宫全切除术相比,子宫肌瘤剔除术对无妊娠需求子宫肌瘤患者卵巢功能及性功能的影响较小,因而更具有临床应用价值。     

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.     

Pathogenic role of IL-17 in psoriasis and psoriatic arthritis

Psoriasis is a chronic inflammatory skin disorder resulting from a complex network of cytokines and chemokines produced by various immune cell types and tissue cells. Emerging evidence suggests a central role of IL-17 and IL-23/T17 axis in the pathogenesis of psoriasis, giving a rationale for using IL-17-blocking agents as therapeutics.Three agents targeting IL-17 signaling are being studied in Phase III clinical trials: secukinumab and ixekizumab (IL-17 neutralizing agents), and brodalumab (IL-17 receptor antagonist). Preliminary results are highly promising for all anti-IL17 agents, creating fair expectations on this class of agents as the new effective therapeutic approach for the treatment of psoriasis.