改良性治疗法联合西地那非治疗勃起功能障碍维吾尔族患者2505例回顾性分析

目的:性治疗法目前尚未普及,本研究旨在评价性治疗法联合西地那非治疗勃起功能障碍(ED)的疗效。方法:根据治疗方法的不同将在本院治疗随访过的3130例维吾尔族ED患者分成2组。对照组625例,单纯口服西地那非3个月;试验组2505例,采用性治疗法联合西地那非治疗3个月。采用国际勃起功能问卷表(IIEF-5)在各组治疗前、后进行疗效评估,并随访12个月。结果:对照组治疗前、后及在6个月、12个月随访的IIEF-5评分分别为12.80±3.76、18.10±2.61、17.35±2.73和16.64±2.63;试验组治疗前、后及在6个月、12个月随访的IIEF-5评分分别为12.73±3.52、19.06±4.07、19.86±2.42和20.47±2.38。两组治疗前后IIEF-5评分自身对比差异均有显著性(P<0.05)。组间比较,试验组较对照组6个月和12个月随访IIEF-5评分均有显著性差异(P<0.05)。结论:性治疗法联合西地那非治疗ED的效果优于单纯西地那非治疗,并在12个月的随访中稳定性良好。     

Evaluation of drugs for elimination of leukemic cells from the bone marrow of patients with acute leukemia

Relatively nonmyelotoxic drugs and drug combinations were investigated for their ability to eliminate malignant cells from human bone marrow. In vitro 90% inhibitory concentration (IC90) doses were established on granulocyte macrophage colony-forming units (GM-CFU) in culture of bone marrow by using the GM-CFU assay for the following drugs: 4- hydroperoxycyclophosphamide (4-HC), Adriamycin, L-asparaginase, bleomycin, hydrocortisone, VP-16, spirogermanium, Taxol, and vincristine. The leukemic cell kill efficiency of these drugs at IC90 doses was compared with that of 4-HC on acute lymphoid leukemia (ALL) cell lines by using the limiting-dilution assay. Under these conditions, no single drug was superior to 4-HC. To increase the in vitro effect in leukemic cell kill, combinations of vincristine with hydrocortisone, Adriamycin, VP-16, and 4-HC were investigated. Vincristine at 1 to 5 micrograms/mL increased the marrow cytotoxicity of hydrocortisone, Adriamycin, and VP-16, but it was protective (subadditive) with 4-HC. Vincristine and 4-HC in combination was additive to supraadditive on ALL cell lines, increased the leukemic cell kill by one to two logs above 4-HC alone at IC90 doses (P less than .05), and was not affected by the addition of excess marrow cells. The recommended doses for chemopurging in clinical studies are vincristine, 1 to 5 micrograms/mL, plus 4-HC, 5 micrograms/mL.     

Differences in clinical presentation between depressed outpatients wanting versus not wanting treatment for comorbid social anxiety disorder

Patients with comorbid major depressive disorder (MDD) and social anxiety disorder (SAD) demonstrate greater severity of symptoms and functional impairment compared with patients with either disorder alone. However, no known studies have examined what differentiates patients who do and do not want treatment for comorbid SAD in addition to MDD. The aim of the current study was to examine clinical characteristics (e.g., variables related to depression and social anxiety severity) of patients who did versus did not desire treatment for comorbid SAD. Results showed that patients who desired treatment for comorbid SAD reported a greater number of social fears and poorer work and current social functioning compared with patients who did not desire treatment for SAD. Work functioning and number of social fears remained significant after controlling for depression and overall illness severity. Results suggest that future treatments adapted for comorbid MDD and SAD perhaps should target work functioning and a broad range of social fears.     

Anterior thalamic lesions reduce spine density in both hippocampal CA1 and retrosplenial cortex,but enrichment rescues CA1 spines only

Injury to the anterior thalamic nuclei (ATN) may affect both hippocampus and retrosplenial cortex thus explaining some parallels between diencephalic and medial temporal lobe amnesias. We found that standard‐housed rats with ATN lesions, compared with standard‐housed controls, showed reduced spine density in hippocampal CA1 neurons (basal dendrites, ?11.2%; apical dendrites, ?9.6%) and in retrospenial granular b cortex (Rgb) neurons (apical dendrites, ?20.1%) together with spatial memory deficits on cross maze and radial‐arm maze tasks. Additional rats with ATN lesions were also shown to display a severe deficit on spatial working memory in the cross‐maze, but subsequent enriched housing ameliorated their performance on both this task and the radial‐arm maze. These enriched rats with ATN lesions also showed recovery of both basal and apical CA1 spine density to levels comparable to that of the standard‐housed controls, but no recovery of Rgb spine density. Inspection of spine types in the CA1 neurons showed that ATN lesions reduced the density of thin spines and mushroom spines, but not stubby spines; while enrichment promoted recovery of thin spines. Comparison with enriched rats that received pseudo‐training, which provided comparable task‐related experience, but no explicit spatial memory training, suggested that basal CA1 spine density in particular was associated with spatial learning and memory performance. Distal pathology in terms of reduced integrity of hippocampal and retrosplenial microstructure provides clear support for the influence of the ATN lesions on the extended hippocampal system. The reversal by postoperative enrichment of this deficit in the hippocampus but not the retrosplenial cortex may indicate region‐specific mechanisms of recovery after ATN injury. © 2014 Wiley Periodicals, Inc.     

甘草泻心汤治疗溃疡性结肠炎机制及临床研究进展

溃疡性结肠炎（UC）是一种慢性、非特异性炎症性肠病,病因与环境、遗传、感染和肠道微生物等多种因素相关。甘草泻心汤出自《伤寒论》,由炙甘草、黄芩、黄连、干姜、人参、半夏、大枣组成,具有调和寒热,消痞止利的功效。现代研究发现,甘草泻心汤单独或联合西药治疗UC具有显著疗效,其作用机制包括调节炎症因子、保护肠道黏膜和改善肠道菌群。通过查阅相关文献,对近年来甘草泻心汤及其单体治疗UC的相关机制与临床研究进行梳理与总结,以期为中医及中西医结合治疗UC提供理论依据并拓展治疗思路。     

Global perception in simultanagnosia is not as simple as a game of connect-the-dots

Simultanagnosia is a neuropsychological disorder characterized by a restriction of visuospatial attention. In addition, patients are able to identify local elements of a scene, but not the global whole. This may be due to a failure to scan and assemble local elements into a global whole (i.e. connect-the-dots). We monitored the eye movements of a simultanagnosic patient while she identified local and global elements of hierarchical letters. Scanning each local element was not necessary, nor sufficient, for successful global level identification. Our results argue against a connect-the-dots strategy of global identification and suggest that residual global processing may be occurring.