1型糖尿病患者勃起功能障碍的患病情况及相关因素分析

目的探讨1型糖尿病（T1DM）患者勃起功能障碍（ED）的患病情况及相关影响因素。方法收集182例已婚男性T1DM患者，用无记名问卷形式根据国际勃起功能指数问卷进行自我评分。并对年龄、病程、糖化血红蛋白（HbA1c）、睾酮、尿微量白蛋白排泄量、肾功能、血压、吸烟史、饮酒史、应用药物等因素进行调查，分析其与ED的关系。结果T1DM患者ED患病率为37．36％（68／182）。Logistic逐步回归分析结果显示，病程、年龄、HbA1c、收缩压、尿微量白蛋白排泄量与T1DM患者ED发生独立相关，病程增加5年、年龄增加10岁、HbA1c增加2％、收缩压增加4kPa及尿微量白蛋白排泄量的OR值分别为1．6275、1．1613、2．4211、2．3715、1．5234，P均〈0．01。结论加强对T1DM患者ED高危因素的关注和定期检测，有助于早期发现ED。     

MODS患儿血清磷酯酶A2的变化及意义

目的：探讨磷酯酶A2（PLA2）在多脏器功能障碍综合征（MODS）患儿中的作用及意义。方法：结合危重病例评分，采用ELISA法检测26例MODS患儿血清PLA2含量，并与健康体检儿童20例对照。结果：多脏器功能障碍综合征患儿血清PLA2含量明显高于正常对照组，P＜0．01，并与危重病例评分成正相关。结论：PLA2参与MODS的病理生理过程，与危重病的病情有关，并可作为早期预警多脏器功能障碍综合征的实验参数。     

Prophylaxis and treatment of bladder dysfunction after Wertheim-Meigs operation: the positive effect of early postoperative detrusor stimulation using the cholinergic drug betanecholchloride

The efficacy of betanecholchloride in the postoperative treatment of bladder dysfunction is controversial. We therefore performed a comparative study on the effect of this therapy for the prophylaxis of detrusor hypotonia after Wertheim-Meigs operation. Forty patients with cervical cancer FIGO stage Ib/IIa were divided into two study groups. The control group (24 patients) only received betanecholchloride if the residual urine persisted above 50 ml after the 10th postoperative day. The study group (16 patients) received 50 mg betanecholchloride three times a day from the 3rd postoperative day onward. In this group postoperative catheter treatment, and consequently hospital stay, were significantly shorter (9.6 versus 13.3 days and 15.5 versus 18.6 days). The residual urinary volume normalized faster (8.0 versus 13.0 days) and the rate of cystitis was lower (18.8 versus 25%). According to our study, a prophylactic application of the parasympathomimetic drug betanecholchloride diminishes postoperative complications associated with bladder dysfunction after Wertheim-Meigs operation. EDITORIAL COMMENT: Bladder dysfunction plays an important role after radical hysterectomy. The authors present data indicating improved and quicker resumption of bladder function following radical hysterectomy with early administration of betanecholchloride, versus use of the medication only when indicated by elevated postvoid residual. Although the study is not a double-blinded placebo-controlled trial, the patients who received beta-necholchloride from postoperative day 3 had significantly decreased postoperative catheter treatment, earlier resumption of adequate bladder emptying defined as a postvoid residual of less than 50 ml, decreased incidence of bladder infection and shorter hospital stay. This information is encouraging for this subset of patients, who characteristically are at high risk for long-term bladder dysfunction. Further studies in this area are needed to clarify therapeutic options to improve patients’ quality of life, specifically in regard to bladder function following treatment of their cancer.     

Purification of rabbit, rat and mouse protein C with the use of monoclonal antibody to human protein C, PC01

Ca(++)-dependent monoclonal antibody specific to gamma-carboxyglutamic acid (Gla) domain of protein C was produced. It did not cross-react to the other vitamin K-dependent plasma proteins but to protein C of the other species. Using this monoclonal antibody, PC01, rabbit (170 micrograms), rat (60 micrograms) and mouse (40 micrograms) protein Cs were isolated from 100 ml of their plasma by affinity chromatography. All of these protein Cs were two chain form linked by disulfide bond as well as human protein C and activated by thrombin-thrombomodulin complex. Rat and mouse protein Cs showed similar characters to human protein C. On the other hand rabbit protein C had different M(r) of heavy and light chains and showed lower anticoagulant activity compared with human protein C.     

DTPA renal scan assessment of renal allograft dysfunction in rats

The precise cause of allograft dysfunction after renal transplantation often cannot be established by non-invasive means. In clinical practice, radionuclide scans form an integral part of the clinician's armamentarium in the assessment of these patients [1, 2]. Unfortunately, in the clinical setting more than one pathological process may be responsible for the impaired function, making it difficult to correlate the scan appearances with the pathology. In this study in rats we compared the renal DTPA scan appearances of the various pathological processes which may cause renal allograft dysfunction in the immediate post-transplant period.     

Normothermic cardiopulmonary bypass: effect on the incidence of persistent postoperative neurological dysfunction following coronary artery bypass graft surgery

We retrospectively reviewed the records of 250 consecutive patients undergoing coronary artery bypass graft surgery (CABG) from January 1994 through January 1996 to determine the incidence of persistent postoperative neurological dysfunction after CABG and to compare normothermic and moderate hypothermic cardiopulmonary bypass (CPB). Normothermic CPB was used in 128 patients (36°–37°C) and hypothermic CPB (27°–28°C) in 122 patients. Postoperative neurological dysfunction included focal motor deficits, delayed recovery of consciousness (>24h) after surgery, and seizures within 1 week postoperatively. Persistent neurological dysfunction was diagnosed if complete resolution had not occurred within 10 days of surgery. The incidence of persistent postoperative neurological dysfunction was 4.1% in the hypothermic CPB group and 2.3% in the normothermic CPB group. There were no statistically significant differences between the two groups (P=NS). These results suggest that normothermic CPB did not increase the incidence of persistent postoperative neurological dysfunction compared to hypothermic CPB.     

糖尿病血管内皮损害标志物的检测及其与尿白蛋白的关系

目的　对比观察2型糖尿病(DM)及糖尿病肾病(DN)患者血管内皮损害标志物,分析其与白蛋白尿相关性。方法　6 8例2型糖尿病患者根据尿白蛋白排泄率分为正常白蛋白尿组(Ⅰ组)和微量白蛋白尿组(Ⅱ组) ,同时以健康成人作为对照组(Ⅲ组) ,分别检测其循环内皮细胞(CEC)、vonWillebrand因子(vWF)、内皮素- 1 (ET - 1 )的变化,并分析其相关性。结果　DM患者CEC、vWF和ET - 1明显增高,尤其是DN组(P <0 .0 5 ) ,各指标间以及与尿白蛋白排泄呈正相关。结论　2型DM患者在出现白蛋白尿前已存在血管内皮功能异常,其白蛋白排泄与血管内皮功能障碍程度有一定相关性。     

镇痛灵对雄性1型糖尿病大鼠性功能的影响

目的 :本实验以成年雄性大鼠为研究对象 ,观察和探讨中药镇痛灵对糖尿病大鼠性功能的影响。　方法 :3～ 5月龄雄性Wistar大鼠 32只 ,随机分为糖尿病组 2 2只 ,正常对照组 10只。 72h后 ,将造模成功的糖尿病大鼠随机分为 2组 :未治疗组 ;镇痛灵治疗组。第 5周测血糖 ,阿朴吗啡勃起实验后 ,乙醚麻醉下断头取血 ,分离血清 ,取一侧睾丸组织制成匀浆液 ,测定血清及组织匀浆中NO及NOS水平。　结果 :糖尿病大鼠与正常对照组比较 ,血清NO、NOS明显降低 ,差异有高度显著性 (P <0 .0 0 1) ;镇痛灵治疗组血清NO、NOS值与未治疗组比较明显升高 ,差异有显著性 (P <0 .0 1) ;阿朴吗啡勃起实验证实 ,镇痛灵治疗组大鼠阴茎勃起次数明显多于未治疗组 ,差异有显著性(P <0 .0 1) ,而与正常对照组比较 ,差异无显著性 (P >0 .0 5 )。　结论 :复方中药合剂镇痛灵有降血糖作用 ,对糖尿病并发的性功能障碍有一定治疗作用。     

山楂结块体外凝结、离解的实验研究

目的:探讨山楂结块形成的机制,以指导预防和治疗。方法:配制以胃蛋白酶为基本液的模拟胃液,对60个山楂糊团和500g山楂糊进行酸凝实验。使用6％和8％浓度的碳酸氢钠溶液对酸凝后的山楂糊团、山楂糊做碱离解试验。设搅拌、非搅拌组和清水对照组作对比。结果:酸凝实验:山楂团硬度增加。清水对照组山楂团硬度明显低于酸凝组。散放入模拟胃液中的山楂糊相互接触处发生凝结,形态仍呈不规则片块状。碱离解实验:6h后碳酸氢钠溶液中均出现酸碱中和现象。非搅拌组:结块表面有碎屑脱落,至第10天碳酸氢钠溶液和清水中的结块均未自行碎解。搅拌组:搅拌时有较多碎屑脱落。第3天,1个结块碎解。至第10天,20个结块全部碎解。清水对照组:仅1个结块在第8天碎解。结论:山楂团酸凝后硬度增大。散放入的山楂糊酸凝后形态仍呈不规则片块状。碱溶液通过酸碱中和可使山楂结块表面松解,无外力作用时不能使结块碎解。     

周围神经损伤后勃起功能障碍的治疗进展

外伤、手术可因盆神经丛和 (或 )海绵体神经损伤而造成勃起功能障碍。较理想的治疗方法是使损伤神经自我再生修复 ,完全恢复勃起功能。本文综述近年来勃起神经损伤后再生修复方面的研究进展 ,试图寻找出一种促进损伤的勃起神经再生的最佳方法