雄激素替代治疗老年人雄激素缺乏的临床研究

老年人雄激素缺乏 (ＰＡＤＡＭ)疾病已受到关注 ,越来越多的证据表明雄激素对多种神经递质和脑部神经元受体的作用与老年男性的行为调节有关 ,雄激素替代治疗可能有助于延迟男性痴呆的发生和改善其认知功能。我们对我院1998年 2月至 1999年 6月 6 8例雄激素替代治疗的ＰＡＤＡＭ患者进行了追踪观察 ,现报道如下。　　一、材料与方法　　 1.对象 :6 8例ＰＡＤＡＭ患者 ,年龄 6 3～ 78岁 ,平均 6 8岁 ,丧偶 36例 (占 5 2 9% )。具有乏力、失眠、血管收缩、精神心理及性功能障碍等症状 ,患者病情持续 6个月至 2年 ,平均 10 5个月 ,血睾酮水平…     

尿道狭窄或闭锁的腔内治疗(附33例报告)

从 1995年 5月～ 1999年 12月我院共收治尿道狭窄或闭锁患者 61例 ,行腔内治疗 33例 ,疗效满意 ,现报告如下。1　资料与方法1.1　临床资料本组 33例均为男性 ,年龄 19～ 81岁 ,平均 53岁。病理 2周～ 1.5年。病因 :骨盆骨折致后尿道损伤 18例 ,骑跨伤致前尿道损伤 5例 ,前列腺术后9例 ,炎性尿道狭窄 1例。其中尿道闭锁 10例 ,尿道吻合术后 5例 ,尿道会师术后 3例 ,膀胱造瘘者2 8例。狭窄长度 0 .6～ 3.0ｃｍ ,平均 1.8ｃｍ ,其中狭窄长度 >2ｃｍ 19例。1.2　手术方法连续硬膜外麻醉或腰麻。患者取膀胱截石位 ,常规消毒铺巾 ,自尿道外口放入…     

前列腺癌与前列腺增生Ki-67／PCNA mRNA特异性表达比值的研究

目的以实时荧光定量RT-PCR技术研究良性前列腺增生（BPH）与前列腺癌（PCa）组织标本Ki-67蛋白和组织核增殖抗原（PCNA）mRNA的比值,探讨此比值在PCa诊断中的特异性意义。方法通过实时荧光定量RT-PCR检测63例PCa和37例BPH前列腺组织Ki-67／PCNA mRNA的表达,比较其在PCa与BPH组织中定量的差异。结果BPH与PCa组织Ki-67／PC—NA mRNA的定量表达值分别为2．264±0．460与5．905±0．780,差异有统计学意义（P〈0．05）。结论实时荧光定量RT-PCR检测Ki-67／PCNA mRNA为PCa的诊断提供了可靠的辅助指标。     

应用输尿管镜放置双J管早期治疗输尿管阴道瘘

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.     

应用输尿管镜放置双J管早期治疗输尿管阴道瘘

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.     

口服锌剂治疗慢性前列腺炎

慢性前列腺炎的病因复杂,症状多样化,病程漫长,呈反复性发作,难以根治.近年来成为泌尿外科的主要难题之一[1].有研究表明,慢性前列腺炎的发生发展与前列腺中微量元素锌(Zn)缺乏有关[2].我们用口服锌剂疗法,治疗慢性前列腺炎85例,取得较好疗效,现报告如下.     

雌激素与α1-受体阻滞剂联合治疗前列腺增生症的疗效-成本分析

目的探讨应用雌激素与α1-受体阻滞剂治疗前列腺增生症以降低医疗费用前景.1998年3月～1999年6月在9所医院采用已烯雌酚-哌唑嗪联合治疗80例BPH病人与数量相同的保列治-高特灵联合治疗及空白对照组进行比较,总结两组药物的疗效.结果使用安慰剂20周后的空白对照组病人国际前列腺症状评分(IPSS)评分及最大尿流率(MFR)无明显改善,雌激素试验组病人IPSS评分与MFR改善率分别为62%和34%,对照组与试验组相比对IPSS评分及MFR改善率较佳,为82%和53%,但对生活质量评分(QOL)及前列腺体积(v)改善差别不大,而在药物成本方面试验组费用仅为高值观察组的1/10.结论雌激素与α1-受体阻剂联合应用治疗BPH仍有一定的疗效,虽各改善指标不及高值药物对照组,但价格极低,副作用可以接受,为贫困地区的BPH病人提供一种有效、安全、廉价的治疗方案.     

后腹腔镜技术治疗肾上腺肿瘤53例报告

Objectives To summarize the clinical experience of retroperitoneal laparoscopic adrenalectomy for adrenal tumor and facilitate the clinical application.Methods From June 2002 to October 2009,S3 caws of adrenal tumor were treated with retroperitoneal laparoscopic adrenalectomy,including 19 cases of primary aldosteronism,8 cases of Cushings syndrome,9 cases of pheochromocytoma,14 cases of nonfunctional adrenal adenoma,2 cases of adrenal cyst,1 case of adrenal paraganglioma.B ultrasound and CT/MRI were used to diagnose all patients.33 tumors were on the left side and 20 on the right.The size of the tumors ranged from 1.2 to 7.0cm(mean,2.2cm).Results 49 surgeries were successfully completed.4 surgeries converted to open surgeries.The mean of operating time was 92(56～220) min.The mean of estimated blood loss was 55 (20～300 ) ml.The mean of postoperative hospitalization was 7(4～12) days.There was no serious complication during perioperative period.Conclusions Retroperitoneal laparoscopic adrenalectomy for adrenal tumor is safe and effective with the advantages of minimal invasion,quick recovery and few complications.It should be considered as the first choice for treating benign adrenal diseases.     

留置导尿管致尿路感染病原菌分布及耐药性分析

目的：了解导尿管伴随尿道感染（Utlc)的原菌谱及对常用抗菌药物的敏感性。方法：对1998年1月－2001年1月间，留置导尿管引起尿路感染患者尿液行细菌学培养，分离的病原菌以Kirby-Bauer琼脂扩散法药敏试验。结果：留置导尿管患者2071例尿液标本分离的病原菌535株，阳性率25．8％，其中以革兰阴性细菌为主，约占65％；大肠埃希菌、；痢疾杆菌、不动杆菌及克雷伯菌属占前4位；第三代头孢菌素对革兰阴性或阳性菌敏感率明显优于第一和二代头孢菌素，喹诺酮类也有较好的效果。结论：留置导尿管致尿道感染以革兰阴性菌为主，出现多重耐药，抗生素应交叉使用，必要时联合应用。     

全破壁灵芝孢子治疗中老年男性部分雄激素缺乏症的临床研究

探讨全破壁灵芝孢子治疗中老年男性部分雄激素缺乏症(PADAM)的疗效。【方法】采用随机数字表法将 138例诊断为PADAM患者随机分为2组。观察组(80例)给予口服全破壁灵芝孢子胶囊治疗,疗程3周;对照组给予外观相同的安慰剂治疗。观察两组的体能、血管舒缩症状、精神心理症状、性功能方面的PADAM自我评分情况,统计其总疗效,检测血睾酮(T)、红细胞超氧化物歧化酶(SOD)、丙二醛(MDA)含量,并观察不良反应情况。【结果】治疗3周后, 观察组患者的体能、血管舒缩症状、精神心理症状和性功能方面均较治疗前有改善(P<0．05或P<0．01),而对照组改善不明显(P>0．05),两组比较,均有显著性差异(P<0．01或P<0．05);观察组PADAM总疗效优于对照组(P<0．05)。治疗3周后,观察组患者的血T、SOD水平升高,MDA水平下降(与对照组比较,P<0．05)。治疗期间两组均未发现明显不良反应。【结论】全破壁灵芝孢子胶囊能有效治疗PADAM,可能与其调节自由基代谢和提高机体性激素水平有关。