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。     

Sensitive skin evaluation in the Japanese population

Sensitive skin syndrome was first described in 1977; however, no robust study has been carried out to evaluate its prevalence in Japan. A national representative sample of the Japanese population over the age of 18 years was taken. Individuals were questioned by telephone and selected according to the quota method. When asked “Do you have a sensitive skin?”, 52.84% of men and 55.98% of women answered “rather sensitive” or “very sensitive”. There was no significant difference (P = 0.22) between the two sexes. The non‐response rate among respondents was zero, suggesting that the term “sensitive skin” held a meaning for the majority of the population. Concerning questions about the onset of a rash, tingling or irritation in the presence of various factors, such as emotional issues, cold, heat, sun, dry air, air‐conditioning, water, air pollution and temperature variations, respondents with rather sensitive or very sensitive skin responded “yes” more often than others: approximately three‐times more often for water (18.97%/6.15%), air pollution (39.29%/12.45%) and warm climatic conditions (29.74%/9.8%). To our knowledge, this epidemiological study is the first to focus on sensitive skin among Japanese people of this century. It is of particular interest for two reasons: (i) it was conducted on a representative sample of the Japanese population; and (ii) the methodology used was identical to that used for sensitive skin assessment studies conducted in Europe and the USA, making it possible to draw certain comparisons.     

Family Quality of Life of South African Families Raising Children with Autism Spectrum Disorder

This article describes the family quality of life among families who are raising a young child with autism spectrum disorder. Survey research was conducted with 180 families of children with autism spectrum disorder who were receiving disability-related services in the Gauteng province of South Africa. The principle measure used was the Beach Center Family Quality of Life Scale to assess five subdomains: family interaction, parenting, emotional well-being, material/physical well-being, and disability-related support. Results indicated that families felt the most satisfied with disability-related support and the least satisfied with the family’s emotional well-being. Family income, family type, and the severity level of autism were significantly associated with how satisfied families felt about their quality of life.     

Cardiac ventricular support. Considerations for psychiatry.

Cardiac ventricular support is fostering additional roles for psychiatric consultation with this vulnerable end-of-life cardiac group. Incidence of premorbid and postsurgical psychiatric disorders (Axis I), psychotropic use, neurologic events, and mortality was obtained for 21 Novacor left-ventricular assist system patients prospectively and 13 Abiomed left/right ventricular-assist device patients retrospectively. This fragile patient population and their families warrant involvement for psychiatry because of the extreme conditions and consequences associated with mechanical cardiac assistance. The authors address psychiatric morbidity and neurobehavioral modifications associated with ventricular support.     

Paediatric experiences with work‐hour limitations

Objectives To evaluate the perceived impact of work‐hour limitations on paediatric residency training programmes and to determine the various strategies used to accommodate these restrictions. Methods A three‐page pre‐tested survey was administered to programme directors at the 2004 Association of Paediatric Programme Directors meeting. The impact of work‐hours was evaluated with Likert‐type questions and the methods used to meet work‐hour requirements were compared between large programmes (≥30 residents) and small programmes. Results Surveys were received from 53 programme directors. The majority responded that work‐hour limitations negatively impacted inpatient continuity, time for education, schedule flexibility and attending staff satisfaction. Supervision by attending staff was the only aspect to significantly improve. Perceived resident satisfaction was neutral. To accommodate work‐hour limitations, 64% of programmes increased clinical responsibility to existing non‐resident staff, 36% hired more non‐resident staff and 17% increased the number of residents. Only one programme hired additional non‐clinical staff. Large programmes were more likely to use more total methods on the inpatient wards (P < 0.01) and in the intensive care units (P < 0.05) to accommodate work‐hour limitations. Conclusions Programme directors perceived a negative impact of work‐hours on most aspects of training without a perceived difference in resident satisfaction. While a variety of methods are used to accommodate work‐hour limitations, programmes are not widely utilizing non‐clinical staff to alleviate clerical burdens.     

Intensity of antianginal therapy in patients referred for coronary angiography: a comparison of fee-for-service and health maintenance organization therapeutic strategies

BACKGROUND: No formal criteria have been developed to guide medical therapy for angina prior to revascularization, and no comparisons have been made between health maintenance organization (HMO) and fee-for-service (FFS) hospitals with respect to angina treatment. HYPOTHESIS: Using a literature-based measure of medical intensity, we tested the hypothesis that there is no difference in anginal medical therapeutic intensity between HMO and FFS systems. METHODS: For each antianginal drug, we developed a model from which an intensity score between 0 and 100 could be calculated. Average and maximal daily doses of drug were fit to a sigmoid curve such that they represented scores of 50 and 99, respectively. Overall intensity scores were obtained by weighted and unweighted averaging of three scores from nitrates, calcium-channel blockers, and beta blockers. This model was applied to 199 patients undergoing angiography at an FFS and an HMO hospital. RESULTS: HMO patients were taking more classes of antianginal drug (1.9 vs. 1.0, p < 0.001). Overall unweighted (17.7 vs. 11.7, p = 0.02) and weighted (27.3 vs. 16.9, p = 0.003) intensity scores for both HMO and FFS patients were low. HMO intensity scores for the use of beta blockers were greater than FFS scores (19.2 vs. 9.6, p = 0.002). The intensity scores for the use of nitrates and calcium blockers were similar. CONCLUSIONS: Models for the measurement of anginal medical therapy intensity can provide important information regarding medical therapy prior to revascularization. The overall intensity of medical therapy was low in both health care systems. These findings have important implications for patient management, guideline development, and national healthcare policy.     

耳穴贴压治疗单纯性肥胖症临床研究

目的探讨耳穴贴压治疗单纯性肥胖症的临床效应。方法应用耳穴贴压治疗单纯性肥胖症，观察治疗前后患者肥胖指标、血脂指标等的变化，评测耳穴贴压减肥的效果。结果各项指标在治疗前后差异均有显著性。结论耳穴贴压治疗单纯性肥胖，疗效确切，对患者各项生理指标有良性调节作用。