α受体激动剂盐酸米多君治疗女性压力性尿失禁的临床研究

目的　评价盐酸米多君 (管通 )治疗女性压力性尿失禁的有效性和安全性。　方法　采用多中心、随机、双盲、安慰剂平行对照方法对 136例女性压力性尿失禁患者进行管通与安慰剂的对比研究。试验组 6 8例 ,服管通 2 .5mg/次 ,3次 /d ,疗程 4周 ;对照组 6 8例 ,以安慰剂替代管通。 　结果　完成试验 12 9例 ,,管通组 (6 6例 )平均尿失禁量减少 9.9g ,安慰剂组 (6 3例 )减少 3.1g ;管通组尿失禁等级评分减少 1.0 2分 ,安慰剂组减少 0 .35分 ;管通组的客观有效率和主观有效率分别为 6 6 .7%和 80 .3% ,安慰剂组分别为 31.7%和 33.3% ,两组比较 ,差异均有显著性意义 (P均 <0 .0 0 1)。管通组患者副作用发生率 15 .0 % ,安慰剂组 17.1% ,两组间差异无显著性意义 (P >0 .0 5 )。　结论　盐酸米多君治疗女性压力性尿失禁疗效明显 ,优于安慰剂 ,安全性和耐受性与安慰剂相似。     

舍尼通~和抗生素联合用药治疗慢性非细菌性前列腺炎临床研究

目的:评价舍尼通与抗生素联合用药治疗慢性非细菌性前列腺炎的有效性及耐受性。方法:采用双盲、平行对照、多中心临床试验研究方法,通过Stam ey试验、前列腺按摩液(EPS)常规及美国国立卫生院慢性前列腺炎症状评分(NIH-CPSI),筛选出160例慢性非细菌性前列腺炎患者,随机分为试验组(80例,脱落1例)和对照组(80例)。试验组前4周合用舍尼通和左氧氟沙星,后4周单用舍尼通,服用剂量为舍尼通2次/d,1片/次,左氧氟沙星2次/d,0.1 g/次;对照组方法同上,仅将舍尼通换为安慰剂。所有患者均行入组前、治疗第4周和第8周随访并行NIH-CPSI评分、EPS等检查及药物不良反应的评估。结果:治疗后4周和8周,试验组疼痛评分降低分别为3.34±2.45,4.33±3.13,排尿评分降低分别为2.22±1.79,2.77±2.04;对照组疼痛评分降低分别为2.28±2.42,3.30±3.29,排尿评分降低分别为1.24±1.67,1.83±2.25。两组治疗前后的自身对比均差异有显著性(P<0.01),生活质量影响评分差异也有显著性(P<0.05)。组间比较,试验组较对照组第4周和第8周疼痛和排尿评分差异均有显著性(P<0.01或P<0.05)。两组治疗前后白细胞、卵磷脂小体差异无显著性(P>0.05),对药物的耐受性差异无显著性(P>0.05),无严重不良反应事件发生。结论:舍尼通与抗生素联合用药方案能更有效地缓解慢性非细菌性前列腺炎患者的疼痛不适症状和排尿症状,耐受性好,值得在临床上推广应用。     

雄激素剥夺条件下阻断自噬增加LNCaP细胞凋亡

目的 探讨雄激素剥夺条件下阻断自噬后LNCaP细胞凋亡变化与半胱天冬酶(caspase)激活的关系.方法 应用激光共聚焦显微镜、RT-PCR方法观察雄激素剥夺致细胞自噬增加后,利用DAPI染色观察细胞凋亡变化及药物抑制caspase后对凋亡的影响.结果 ①雄激素去除后LNCaP细胞自噬体增加,标准培养基(CM)培养下LNCaP细胞自噬体数量为1.90分;无血清培养基(SF)中细胞自噬体数量增高为2.64分;加入双氧睾酮(SFA组)后细胞自噬体下降至1.85分(P<0.01).CM中LNCaP细胞LC3 mRNA表达率为23%,血清饥饿12 h后,LC3表达量上调至100%,而SFA组LC3 mRNA表达量为86%;血清饥饿24 h后,SF组LC3 mRNA表达量为62%,SFA组为35%.②SF组和SFA组LNCaP细胞基础凋亡率分别为(3.19±1.09)0A和(3.01±0.33)%,加入3-甲基腺嘌呤(3-MA)阻断自噬24 h后,SF组凋亡率为(10.90±2.91)%,SFA组为(4.63±1.69)%.SF+3-MA组中加入Z-VAD-FMK后,细胞凋亡减至(1.16±0.52)%.组间差异有统计学意义(P<0.01).结论 剥夺雄激素后LNCaP细胞中自噬明显增加,阻断自噬后凋亡发生率增加.     

无张力疝修补术治疗腹股沟嵌顿疝85例分析

目的探讨无张力疝修补术治疗腹股沟嵌顿疝的临床效果。方法对83例腹股沟嵌顿疝患者选择性施行无张力疝修补术，分析其术后效果。结果83例患者中围手术期死亡2例，伤口感染1例，其余恢复良好．平均住院时间5．1d。结论应用无张力疝修补术治疗腹股沟嵌顿疝安全可靠，效果较为满意。     

全玻璃体切割治疗玻璃体积血疗效分析

目的 探索全玻璃体切割在玻璃体积血中的应用.方法 回顾51只眼手术病例,视网膜静脉阻塞23只眼,糖尿病视网膜病变9只眼,视网膜静脉周围炎2只眼,视网膜孔源性玻璃体积2只眼.眼外伤性玻璃体积血15只眼.采用睫状体平坦部三通闭合式全玻璃体切割术,并通过巩膜压陷结合高斜镜切割基底部玻璃体.结果 术后随诊5～12月,51只眼视力均有不同程度提高,其中视力在4.5者19只眼、4.6～5.0者9只眼4.0～4.4者19只眼、指数4只眼.结论 对玻璃体积血患者掌握好适应证及手术时机,行全玻璃体切割切实有效的减少玻璃体积血残留所致的并发症提高手术效果.     

Inhibition of thrombin generation by the oral direct thrombin inhibitor ximelagatran in shed blood from healthy male subjects

Ximelagatran, an oral direct thrombin inhibitor, whose active form is melagatran, was studied using a model of thrombin generation in humans. Healthy male volunteers (18 per group) received ximelagatran (60 mg p.o.), dalteparin (120 IU/kg s.c.) or a control (water p.o.). Shed blood, collected after incision of the forearm with standardised bleeding time devices at pre-dose, and at 2, 4 and 10 h post-dosing, was analysed for markers of thrombin generation. Statistically significant reductions (p < 0.05) in levels of prothrombin fragment 1+2 (F1+2) and thrombin-antithrombin complex (TAT) in shed blood were detected at 2 and 4 h post-dosing in both the ximelagatran and dalteparin groups. Shed blood F1+2 and TAT levels had returned to pre-dose levels at 10 h post-dosing. Using a shed blood model, we demonstrate that the reversible thrombin inhibitor melagatran and, therefore, oral administration of ximelagatran, inhibits thrombin generation in humans after acute activation of coagulation.     

凯西莱联用复方丹参注射液治疗酒精性肝病临床观察

目的探讨凯西莱联用复方丹参注射液治疗酒精性肝病(ALD)的临床效果。方法将160例ALD患者随机分为治疗组和对照组,每组80例,对患者治疗前后进行临床评估和检测肝功能、AFP、肝纤维化等指标变化情况。结果治疗组治疗28天后临床症状和体征除肝区疼痛明显改善外(P<0.05),其余症状与对照组比较差异无显著性(P>0.05);两组治疗后肝功能、肝纤维化四项及AFP均有明显改善,但治疗组A/G、AST以及肝纤维化四项指标改善程度均优于对照组(P<0.01)。无明显毒副作用。结论凯西莱能有效改善ALD患者的临床症状、体征及肝功能、AFP,联合应用复方丹参注射液疗效更佳,尤其是抗肝纤维化效果更为明显,且毒副作用少,具有临床应用价值。     

Extracts of Monascusus Purpureus beyond Statins——Profile of Efficacy and Safety of the Use of Extracts of Monascus Purpureus

Monascus purpureus is a fungus that has been tradi-tionally used in China for thousands of years to produce ricewine . Traditionally the fungus is used to ferment non-gluti-nous cooking of rice ,to produce a kind of famous red ricewine .Its main traditional indications consist of disordersdue to the accumulation of fats (nosologically linked withthe problems of stasis of circulation in traditional Chinesemedicine) ,liver disorders and some forms of tumor as ithelps i mprove the circulation of …     

Sexual precocity: sex incidence and aetiology

The aetiology of 197 girls and 16 boys presenting with sexual precocity was reviewed. Ninety one girls and four boys had central precocious puberty (M:F 23:1); a cause was identified in all the boys but in only six girls. All boys with precocious puberty need detailed investigation; in girls investigation should be based on clinical findings, particularly the consonance of puberty.