东革阿里治疗更年期男性勃起功能障碍的临床研究

目的 探讨东革阿里治疗更年期男性勃起功能障碍的(ED)的疗效和安全性.方法 将134例更年期男性ED患者分为观察组与对照组,每组67例,观察组予东革阿里治疗,对照组用十一酸睾酮治疗.治疗3个月后,比较两组患者治疗前后勃起硬度分级量表(EHS)、男性性健康量表(SHIM)评分、老年男性症状量表(AMS)、勃起功能障碍治疗满意度问卷(EDITS)评分和血清总睾酮(TT)、血清游离睾酮(FT)、黄体生成激素(LH)、促卵泡激素(FSH)和性激素结合球蛋白(SHGB)变化情况及并发症的发生率.结果 经3个月治疗后,两组患者的 EHS、SHIM、AMS评分和血清 TT、FT 水平与治疗前比较均明显改善(P<0.05),观察组的结果明显优于对照组(P<0.05);观察组患者血清L H、FSH水平较治疗前无明显变化(P>0.05),而对照组患者血清LH、FSH水平较治疗前明显降低(P<0.05);观察组患者血清SHGB水平较治疗前降低(P<0.05),对照组患者血清SHGB水平较治疗前升高(P<0.05);观察组患者EDITS评分较对照组高(P<0.01);观察组患者并发症发生率为2.99%,明显低于对照组(16.41%),差异有统计学意义(P<0.05).结论 东革阿里能明显提高更年期男性ED患者的性欲和性功能.     

苁蓉益肾颗粒辅助地红霉素和萘哌地尔治疗慢性前列腺炎伴性功能障碍140例临床观察

了解联合使用苁蓉益肾颗粒等药物治疗慢性前列腺炎伴性功能障碍的临床疗效。方法将140例符合前列腺炎伴性功能障碍患者随机纳入治疗组(75例)对照组(65例)。对照组给予地红霉素胶囊口服,500mg/日,萘哌地尔片25mg qn。治疗组在对照组用药的基础上加用苁蓉益肾颗粒2g,tid,po,均连续治疗8周。采用慢性前列腺炎相关性功能治疗指数(CPSFI)评分标准和国际勃起功能指数-5(IIEF-5)问卷调查表评估治疗前后性功能变化。结果 CPSI评分标准分析显示,治疗组和对照组有效率分别为84%,53.8%;IIEF-5评分标准分析显示,治疗组和对照组有效率分别为74.6%,55.3%。均有统计学意义。结论苁蓉益肾颗粒辅助治疗慢性前列腺炎伴性功能障碍有一定疗效。     

十三味滋阴壮阳胶囊联合他达那非治疗勃起功能障碍的疗效观察

目的观察十三味滋阴壮阳胶囊联合他达那非治疗勃起功能障碍(ED)的临床疗效。方法 90例ED患者随机分为十三味滋阴壮阳胶囊组(A组)、他达那非组(B组)、十三味滋阴壮阳胶囊联合他达那非组(C组),分别给予十三味滋阴壮阳胶囊、他达拉非、十三味滋阴壮阳胶囊和他达那非药物治疗。三组患者于治疗12周后观察国际勃起功能问卷评分(IIEF-5)、血清睾酮水平、性活动日志情况。结果三组治疗12周后IIEF-5评分分别均较治疗前均明显改善(P0.05),C组IIEF-5评分较A组和B组改善显著(P0.05)。A组和C组血清睾酮水平较治疗前均升高(P0.05),且C组血清睾酮升高水平优于A组(P0.05)。三组对于SEP的阳性回答率均较高,C组性活动日志阳性率优于其他两组(P0.05)。结论十三味滋阴壮阳胶囊联合他达那非不仅较好的改善ED患者的勃起功能,还能够显著提高性自信,降低性交时间顾虑,提高患者的性生活质量,联合用药优于单用十三味滋阴壮阳胶囊、他达那非。     

针药结合治疗勃起功能障碍的临床研究

目的观察针药结合治疗勃起功能障碍(ED)的临床疗效和安全性。方法将80例符合纳入标准的ED患者,按随机数字表法随机分为两组,每组40例,对照组给予口服复方玄驹胶囊的同时口服西地那非片,治疗组在对照组的治疗基础上给予针刺治疗。观察两组患者治疗前、治疗3个月后的IIEF-5评分以及不良反应发生情况。结果两组病例治疗后愈显率比较,治疗组明显优于对照组(P0.05);治疗后两组IIEF-5评分均明显升高,差异有统计学意义(P0.01);两组治疗后IIEF-5评分和差值比较,治疗组明显高于对照组,差异有统计学意义(P0.01)。结论针药结合治疗ED的临床疗效明显,可改善患者的伴随症状及自信心,减少西地那非片的用量。     

益肾活血汤联合硫辛酸对2型糖尿病勃起功能障碍患者血清Hcy、NO、ET-1及氧化应激的影响

目的 :研究益肾活血汤联合硫辛酸对2型糖尿病勃起功能障碍患者血清Hcy、NO、ET-1及氧化应激的影响。方法 :选择2015年9月—2017年2月在我院进行治疗的2型糖尿病勃起功能障碍患者116例,根据治疗方案不同分为观察组和对照组,对照组给予硫辛酸治疗,观察组以对照组为基础联合益肾活血汤治疗,两组患者均治疗3个月。治疗后观察两组临床疗效,检测分析两组治疗前后血清Hcy、NO、ET-1水平,应激反应水平,IIEF-5,EQS评分以及性生活满意度。结果 :治疗后,观察组总有效率(82.3%)明显高于对照组(63.8%)(P0.05);与对照组相比,观察组Hcy、ET-1水平显著较低[(10.04±1.75)μmol/L vs(8.54±1.04)μmol/L,(73.21±12.42)ng/L vs(68.64±11.87)ng/L],NO较高[(28.94±4.85)μmol/L vs(35.64±5.86)μmol/L(P0.05)];观察组MDA水平显著低于对照组[(6.36±1.33)μmol/L vs(7.46±1.04)μmol/L],SOD、GSH-Px显著高于对照组[(79.25±12.86)KU/L vs(72.86±13.71)KU/L,(101.14±16.64)U vs(93.86±15.86)U](P0.05);观察组IIEF-5、EQS均明显高于对照组[(21.42±3.71)分vs(17.43±3.81)分,(77.14±12.43)分vs(68.96±11.18)分](P0.05);观察组性生活总满意度(93.10%)明显高于对照组(79.31%),两组比较差异显著(P0.05)。结论 :益肾活血汤联合硫辛酸治疗2型糖尿病勃起功能障碍可显著提高其临床疗效,降低血清Hcy、ET-1水平,增高NO水平,显著减少患者氧化应激。     

通癃启闭汤对良性前列腺增生症患者血清性激素水平及IPSS和IIEF-5评分的影响

【目的】观察通癃启闭汤对良性前列腺增生症(BPH)患者血清性激素水平及国际前列腺症状评分(IPSS)和国际勃起功能评分(IIEF-5)的影响。【方法】将65例BPH患者随机分为中药组33例和对照组32例。中药组给予口服通癃启闭汤治疗,对照组给予口服非那雄胺片治疗。2组均以30 d为1个疗程,共治疗2个疗程。观察2组患者治疗前后中医证候积分、血清睾酮(T)、雌二醇(E2)水平、IPSS和IIEF-5评分的变化情况,并评价2组临床疗效及安全性。【结果】(1)中药组脱落2例,对照组脱落1例,无剔除及终止病例。(2)经2个疗程治疗后,中药组的总有效率为87.1%,对照组为67.7%,中药组的中医证候疗效优于对照组(P0.05)。(3)治疗后,2组患者的中医证候积分均较治疗前明显降低(P0.05),且中药组的降低作用明显优于对照组(P0.05)。(4)治疗后,2组患者血清T水平均无显著性变化(P0.05),而中药组患者血清E2水平较治疗前明显下降(P0.05),中药组对血清E2水平的改善作用明显优于对照组(P0.05)。(5)治疗后,2组患者IPSS评分均较治疗前明显下降(P0.05),中药组患者IIEF-5评分较治疗前提高(P0.05),对照组患者IIEF-5评分较治疗前下降(P0.05),中药组在改善IIEF-5评分方面的作用优于对照组(P0.05)。(6)试验过程中,2组患者均未见明显不良反应和肝肾功能损害。【结论】通癃启闭汤能改善肾虚血瘀型BPH患者的中医临床证候,且在减少患者勃起功能障碍的副作用方面具有明显优势,其作用机理可能与抑制血清雌激素水平有关。     

自拟补肾生精汤联合负压吸引结合中药灌洗对肾虚型糖尿病勃起功能障碍患者血清睾酮水平的影响

目的 探讨自拟补肾生精汤联合负压吸引结合中药灌洗对肾虚型糖尿病勃起功能障碍患者血清睾酮水平的影响.方法 研究对象选取2013年5月-2015年8月收治的66例2型糖尿病勃起功能障碍患者,随机分成2组,每组33例.2组均接受原降糖方案,对照组予金匮肾气丸口服,研究组予自拟补肾生精汤口服加上负压吸引结合阳痿方中药灌洗,治疗前后进行IIEF-5量表、mSLQQ-Qol量表评估,NPT试验,检测血清性激素水平,并比较临床疗效.结果 与治疗前比较,2组IIEF-5、mSLQQ-Qol评分升高(P<0.01),血清FSH、LH、E2水平降低(P<0.01),T水平升高(P<0.01),阴茎勃起时间及阴茎头、跟部平均硬度升高(P<0.05);与对照组比较,研究组IIEF-5、mSLQQ-Qol评分较高(P<0.01),血清FSH、LH、E2水平较低(P<0.01),T水平较高(P<0.01),阴茎勃起时间及阴茎头、跟部平均硬度较高(P<0.05),治疗有效率较高(P<0.01).结论 自拟补肾生精汤联合负压吸引结合中药灌洗治疗肾虚型糖尿病勃起功能障碍疗效显著,能促进血清性激素水平恢复.     

雄蚕益肾方联合小剂量睾酮补充治疗男性迟发性性腺功能减退症临床观察

目的观察雄蚕益肾方联合小剂量睾酮补充治疗男性迟发性性腺功能减退症(late-onset hypogonadism,LOH)的临床疗效。方法将符合LOH诊断标准的106例患者按随机数字表法分为对照组和试验组各53例,对照组采用常规睾酮补充治疗,试验组服用雄蚕益肾方联合小剂量睾酮补充治疗,疗程均为3个月。比较两组治疗前后的老年男性症状量表(AMS)评分、血清性激素水平及中医证候评分。结果 (1)两组治疗后较治疗前AMS各项症状评分和总分均有显著下降(P0.05),总睾酮(TT)水平及睾酮分泌指数(TSI)值均显著提高(P0.05),促黄体生成素(LH)、卵泡刺激素(FSH)水平均下降(P0.05),且试验组改善效果优于对照组(P0.05)。(2)两组治疗后较治疗前中医症状分级量化评分均显著下降(P0.05),且试验组下降更为明显(P0.05);试验组的中医证候改善总有效率达81.1%,明显高于对照组的54.7%(P0.05)。结论雄蚕益肾方联合小剂量睾酮补充治疗LOH疗效确切。     

胰岛素强化治疗2型糖尿病性勃起功能障碍的临床疗效观察

目的观察胰岛素强化治疗对2型糖尿病性勃起功能障碍的临床疗效。方法选择2010年6月至2011年6月来我院就诊的2型糖尿病(DM)合并勃起功能障碍(ED)的108例患者为研究对象,随机分为两组,治疗组给予胰岛素强化治疗,对照组给予口服降血糖药治疗,比较两组治疗后勃起功能障碍的临床疗效。结果治疗组:显效29例,有效24例,无效3例,总有效率为94.64%;对照组:显效14例,有效30例,无效8例,总有效率为84.62%。两组临床疗效差异有统计学意义(χ2=8.035,P=0.018)。两组治疗后HbAlc、FBG、血清睾酮及IIEF-5评分与治疗前比较差异有统计学意义,均P<0.05。治疗组治疗后HbAlc、FBG及IIEF-5评分与对照组比较差异有统计学意义,均P<0.05。结论胰岛素强化治疗对糖尿病性勃起功能障碍具有良好的临床疗效,值得临床推广运用。     

自拟强精健龙方治疗中老年男性勃起功能障碍疗效观察

目的:评估自拟强精健龙方治疗中老年男性勃起功能障碍的临床疗效。方法:选择80例确诊为勃起功能障碍的中老年患者,随机分为强精健龙方组(治疗组)40例和复方玄驹胶囊组(对照组)40例,均进行2个月的治疗,停药后随访3个月。采用勃起功能障碍症状评分(international index of erectilefunction-5,IIEF-5)评估治疗前后及随访3个月后两组的疗效。结果:治疗前两组IIEF-5评分无显著差异(P0.05),治疗后两组评分分别为(19.23±5.22)、(18.87±4.39)分,与本组治疗前均有显著差异(P0.05),组间比较无显著差异(P0.05)。治疗组显效18例(45.00%),有效13例(32.5%),总有效率77.5%;对照组显效16例(40.0%),有效12例(30.0%),总有效率70.0%,两组比较无统计学意义。停药3个月后两组随访IIEF-5评分分别为(17.01±2.33)、(12.01±1.98)分,差异有统计学意义(P0.01)。结论:自拟强精健龙方和复方玄驹胶囊均能明显改善治疗中老年勃起功能障碍患者的IIEF-5评分,而强精健龙方长期疗效优势更为显著。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.