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。     

Acute-phase response predicts erythropoietin resistance in hemodialysis and peritoneal dialysis patients

We defined erythropoietin (EPO) resistance by the ratio of the weekly EPO dose to hematocrit (Hct), yielding a continuously distributed variable (EPO/Hct). EPO resistance is usually attributed to iron or vitamin deficiency, hyperparathyroidism, aluminum toxicity, or inflammation. Activation of the acute-phase response, assessed by the level of the acute-phase C-reactive protein (CRP), correlates strongly with hypoalbuminemia and mortality in both hemodialysis (HD) and peritoneal dialysis (PD) patients. In this cross-sectional study of 92 HD and 36 PD patients, we examined the contribution of parathyroid hormone (PTH) levels, iron indices, aluminum levels, nutritional parameters (normalized protein catabolic rate [PCRn]), dialysis adequacy (Kt/V), and CRP to EPO/Hct. Albumin level serves as a measure of both nutrition and inflammation and was used as another independent variable. Serum albumin level (deltaR2 = 0.129; P < 0.001) and age (deltaR2 = 0.040; P = 0.040) were the best predictors of EPO/Hct in HD patients, and serum albumin (deltaR2 = 0.205; P = 0.002) and ferritin levels (deltaR2 = 0.132; P = 0.015) in PD patients. When albumin was excluded from the analysis, the best predictors of EPO/Hct were CRP (deltaR2 = 0.105; P = 0.003) and ferritin levels (deltaR2 = 0.051; P = 0.023) in HD patients and CRP level (deltaR2 = 0.141; P = 0.024) in PD patients. When both albumin and CRP were excluded from analysis in HD patients, low transferrin levels predicted high EPO/Hct (deltaR2 = 0.070; P = 0.011). EPO/Hct was independent of PTH and aluminum levels, PCRn, and Kt/V. High EPO/Hct occurred in the context of high ferritin and low transferrin levels, the pattern expected in the acute-phase response, not in iron deficiency. In well-dialyzed patients who were iron replete, the acute-phase response was the most important predictor of EPO resistance.     

肝郁痰凝型乳腺癌的钼靶X线表现及病理分析

目的：研究肝郁痰凝型乳腺癌的钼靶X线影像特点，探讨其病理基础。方法：观察41例中医证型为肝郁痰凝型、术后病理检查结果为乳腺癌患者的钼靶X线影像表现，对其病理学基础进行分析。结果：41例肝郁痰凝型乳腺癌中，乳腺类型以致密型及混合型居多（占78％）。异常血管征及透环征出现频率较高（占80％以上）。腋淋巴结转移出现频率偏低（占12％）。结论：（1）肝郁痰凝型乳腺癌患者，乳腺密度多偏高，可能与较多发生在绝经期前有关。（2）肿瘤周围透亮环征象及异常血管征象出现频率较高，表明此型患者肿块周围脂肪代谢异常较为普遍及血管生长刺激因子分泌较多。（3）腋窝淋巴结转移者所占比例较小，可能是由于此类患者多属于癌变早、中期，相对气血不足或脾肾虚弱等正虚表现不明显。     

中心静脉导管胸腔留置治疗胸腔积液

目的评价中心静脉导管留置治疗胸腔积液的疗效。方法257例胸腔积液患者分为两组，治疗组207例，应用胸腔留置中心静脉导管治疗；对照组50例，常规胸穿抽液治疗，观察并比较不同治疗方法的疗效、并发症等指标。结果两组对比多项指标差异有显著性（P〈0．05）。结论采用中心静脉导管治疗胸腔积液可减少胸穿次数、降低反应，提高治愈率。