半导体激光并超短波治疗慢性前列腺炎的临床观察

目的:观察半导体激光治慢性前列腺炎的临床疗效。方法:将患者140例随机分为2组,治疗组76例,采用半导体激光并体外短波对会阴部治疗;对照组64例,单纯采用体外短波治疗。结果:治疗组有效率为89.2%;对照组有效率为76.5%。两组比较差异显著(p<0.05)。结论:半导体激光照射治疗慢性前列腺炎可明显提高疗效。

司帕沙星与逍遥丸内服联合吲哚美辛栓肛门外塞治疗ⅢA型前列腺炎的临床观察

目的:观察司帕沙星与逍遥丸内服联合吲哚美辛栓肛门外塞治疗ⅢA型前列腺炎中西医结合的疗效。方法:司帕沙星与逍遥丸内服配合吲哚美辛栓肛门外塞对ⅢA型前列腺炎进行治疗,并对临床症状及全列腺液进行治疗前后比较。结果:治疗后8周实验组的临床症状、前列腺液常规明显改善,疗效差异有显著性(P<0.01)。结论:司帕沙星内服联合吲哚美辛栓肛门外塞治疗ⅢA型前列腺炎疗效显著,对全列腺炎临床症状及全列腺液有明显的改善作用。

Clinical Application of Double-hand Needling Manipulation

Double-hand manipulation is a needling technique, with which No. 30 filiform needles of various lengths are selected and inserted into the affected part of the body in opposite directions or symmetrically upward-downward, rightward- leftward, anteriorly-posteriorly to the point, followed by needle twirling with both hands. When the two opposite needle tips are twirled to a certain degree, the soreness, warm, numbness, and distending needling sensation tends be connected in a line, forming a rather strong needling sensation. After such manipulation for some time, the needles are retained for 30 min., during which the needle manipulation is given 3-5 times at intervals. This needling treatment is given once daily. The author of this article has adopted this manipulation method in the acupuncture treatment of various diseases with quite satisfactory results. Some of the sample cases are listed as follows.

Management of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS):an evidence-based approach

Objective：To evaluate the efficacy and safety of the treatment of chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）. Methods- The randomized controlled trials （RCTs） about the treatment for CP/CPPS all over the world were searched. MEDLINE （January 1966 to June 2007）, EMBASE （January 1988 to June 2007）, and 4 Chinese databases were electronically searched. The studies included in the refer- ences of eligible studies were additionally searched. Two reviewers independently screened the studies for eli- gibility, evaluated the quality and extracted the data from the eligible studies, with confirmation by cross- checking. Divergences of opinion were settled by discussion or consulted by the experts. Meta-analysis was performed by using RevMan 4.2 software. Results： Twelve original studies involving 1 003 participants met inclusion criteria. Compared with placebo, alpha-blockers could improve the symptoms of CP/CPPS obvious- ly with WMD of NIH-CPSI, total score and pain score were -4.10 （95%CI： -6. 92 to -1.28） and -1.68 （95 %CI： -2.54 to -0. 82）. Antibiotics could not improve the symptoms obviously with WMD of NIH-CP- SI; total score and pain score were -2.71 （95%CI： -4. 78 to -0. 64） and -0.86 （95%CI： -2.07 to 0.36）. Flavoxate could not improve the NIH-CPSI total score obviously, but could relieve the pain, with WMD of NIH-CPSI total score and pain score being -2.96 （95%CI： -5.17 to -0. 74） and --2.31 （95%CI.. -4.05 to 0.03）. Prostat could improve the NIH-CPSI total score obviously, but could not relieve the pain, with WMD of NIH-CPSI total score and pain score being --7. 60 （95%CI.. -9. 97 to -5.23） and -2. 02 （95%CI： -4.07 to 0. 04）. Conclusion： Drug intervention could improve total symptoms of CP/CPPS in some degree, but no universally effective treatment is available that can prove significant lasting benefit for all the symptoms of CP/CPPS. Future RCT must use an appropriate sample size and optimal duration and fol- low-up of participants. It is important to improve the quality of internal original studies.

Serum testosterone suppression and potential for agonistic stimulation during chronic treatment with monthly depot formulation of domestic substitute of leuprorelin acetate microspheres for metastatic prostate cancer

Objective： We aimed to evaluate the efficiency of serum testosterone suppression as well as the potential for agonistic stimulation of serum testosterone during chronic treatment with monthly （3.75 mg） depot formulation of domestic substitute of leuprorelin acetate microspheres for patients with metastatic prostate cancer. Methods： A total of 23 patients with metastatic prostate cancer were enrolled in the prospective study and received 6 monthly intramuscular depot injections of domestic substitute of leuprorelin acetate microspheres. Their levels and patterns of serum testosterone suppression and the potential for agonistic stimulation of serum testosterone were monitored following injection monthly （3.75 rag） depot formulation of domestic substitute of leuprorelin acetate microspheres for 24 weeks. Results： Mean testosterone was 431.4 ng/dL, 119.3 ng/dL, 28.2 ng/dL by week 1, 2, 3 and decreased to less than 15.6 ng/dL by week 4 where it remained throughout the treatment period. Median time to suppression of serum testosterone was 20.7 days. No transient minor ＂escape＂ from suppression occurred in all patients which was defined as a single testosterone value greater than 50 ng/dL once suppression was achieved. Assessment of agonistic stimulation following the second depot injection revealed no pattern of stimulation. Conclusion： We concluded that monthly （3.75 mg） depot formulation of domestic substitute of leuprorelin acetate microspheres could provide persistent, stable suppression of serum testosterone throughout the dosing intervals, and that the initial depot injection of this formulation also could provide sufficient pituitary desensitization to prevent agnostic stimulation of serum testosterone during chronic treatment.

Role of bile acids, prostag landins and COX inhibitors in chronic esophagitis in a mouse model

AIM. To develop a new experimental model of esophagitis that serves a complementary tool to clinical investigation in an insight into the mechanism of the damage to the esophagus mucosa by aggressive factors, and role of COX inhibitors in this process. METHODS： The study was conducted in 56 male mice. Animals were divided into seven groups： （1） perfused with HCI, （2） perfused with HCI and physiologic concentration of pepsin （HCI/P）, （3） perfused with similar HCI/P solution enriched with conjugated bile acids （glycho- and tauro-sodium salts） designated esophageal infusion catheter under the general anesthesia, （4） perfused as in group 2 treated with indometacin, （5） perfused as in group 2 treated with NS-398, （6） perfused as in group 3 treated with indometacin, and （7） perfused as in group 3 treated with NS-398. The esophagus was divided into 3 parts： upper, middle and lower. The PGE2 concentration was measured in all parts of esophagus using RIA method. Esophagus of sacrificed animals was macroscopically evaluated using a low power dissecting microscope （20x）. Specimeris, representing the most frequently seen changes were fixed, stained with H＆E and assessed microscopically using the damage score, and inflammatory score. RESULTS： The macroscopic changes were significantly severer in HCI/P than those in HCI animals （77%） and in HCI/P/BA group （43%）. In HCI/P NS-398 group we noticed significantly less changes than those in not treated group （42%） and in analogical group treated with indometacine （45%）. In HCI/P/BA INDO group we observed significantly severer changes than that in not treated group （52%）. We noticed less changes in HCI/P NS-398 than that in group with indometacine （46%）. In HCI/P/BA NS-398 group we had less changes than that in indometacin group （34%）. The microscopic changes observed in HCI/P/BA INDO group were severer than that in not treated group （48%）. Esophagitis index in HCI group was significantly lower than in HCI/P and also HCI/P/BA group （32% and 33 %）. In HCI/P/BA/INDO group the esophagitis surface was larger than that in not treated group （33%）. In HCL/P group the surface of esophagus with ulceration was significantly larger （10-fold） than that in HCI/P/BA group. The PGE2 concentration was significantly higher in HCI/P group than in HCI/P/BA group. The PGE2 concentration in lower part of esophagus was also significantly higher in middle than those in HCI and HCI/P/BA groups. In upper part of esophagus the PGE2 concentration was significantly higher in HCI/P/BA group than that in group treated with indometacine （46%）. We also observed higher PGE2 concentration in middle part of esophagus in HCI/P/BA group than those in group treated with indometadne and in group treated with indometacin and NS-398 （by 52% and 43% respectively）. CONCLUSION： Pepsin is the pivotal factor in the development of chronic esophageal injury. Bile acids diminish chronic esophageal injury induced by HCI/P, indicating its potential negative impact on pepsin proteolytic potential, pivotal for mucosal injury in low pH. The role of selective COX inhibitors is still unclear, and needs more investigations. This novel chronic experimental esophagitis is an excellent model for further study on the role of cytokines in genetically modified animals.

Observation of therapeutic effect on chronic non-bacterial prostatitis treated with warm needling moxibustion

Objective To observe the clinical effects of chronic non-bacterial prostatitis treated with warm needling moxibustion. Methods One hundred and twenty-five cases were randomly divided into warm needling moxibustion group （42 cases）, acupuncture group （41 cases） and western medicine group （42 cases）. Of which, in warm needling moxibustion group, acupuncture combined with warming acupuncture were provided①puncture on Shènshū（肾俞 BL 23）, Gānshū （肝俞BL 18） and Zhìbiān （秩边BL 54） without retention of needles,②Guānyuán （关元CV 4）, Zhō ngjí （ 中极CV 3）, Yīnlíngquán （ 阴陵 GB 34） and Sānyīnjiāo （三阴交 SP 6） ,with warming acupuncture, once a day; in acupuncture group, the prescriptions and needling technique were the same as those in warm needling moxibustion group, without moxibustion; in western medicine group, Cernilton was applied twice a day, one pill for each time. After one course treatment, the therapeutic effects and NIH-Chronic Prostatitis Symptom Index （NIH-CPSI） of 3 groups were compared. Results The total effective rate was 88. 10% in warm needling moxibustion group, 63.41% in acupuncture group, and 66.67% in western medicine group. The clinical effect in warm needling moxibustion group was superior to that in either acupuncture group or western medicine group （both P〈0.05）. The score of NIH-CPSI was 11.92 ±7.11 in warm needling moxibustion group, 16.08±6.83 in acupuncture group, and 15.66±5.88 in western medicine group. The score of each group was obviously reduced （both P〈0.01 ） after treatments, in which, the reduction in warm needling moxibustion group was most obvious （both P〈0.0t）. Conclusion A good therapeutic effect of chronic non-bacterial prostatitis was received by warm needling moxibustion.

Effects of different Chinese herbal prescriptions on cytokines in autoimmune prostatitis rats

OBJECTIVE:To observe and compare the effects of Chinese herbal prescriptions for promoting blood circulation,clearing heat,removing toxicity,and dispersing stagnated liver-Qi on cytokines in model rats with experimental autoimmune prostatitis(EAP) to provide an experimental basis for the use of Chinese herbal prescriptions in the treatment of chronic prostatitis.METHODS:One-hundred and ten male Wistar rats were randomly divided into 11 groups:blank group;model group;Huoxuehuayu(promoting blood circulation to remove blood stasis) high,middle,and low dose groups;Qingrejiedu(clearing heat and removing toxicity) high,middle,and low dose groups;and Shuganliqi(dispersing stagnated liver-Qi) high,middle,and low dose groups.Except the blank group,rats in all groups were injected subcutaneously in multiple points on days 0 and 30 with prostatic protein extractive solution(60 mg/ml_),and intraperitoneally injected with diphtheria-pertussis and tetanus vaccine(DPT vaccine) to establish the EAP model.Model rats were administrated high,middle,and low doses of Chinese herbal prescriptions and were sacrificed after 4 weeks.Pathological changes in the prostate gland were observed with HE staining and changes in serum interleukin-6(IL-6),interleukin-8(IL-8),and prostaglandin E_2(PGE_2) levels were detected with enzyme-linked immunosorbent assay.RESULTS:Compared with the blank group,serum PGE_2,IL-6,and IL-8 levels in the model group were significantly higher(P < 0.05).Compared with the model group,serum PGE_2,IL-6,and IL-8 levels in the Qingrejiedu low dose and middle dose groups were significantly lower(P < 0.05),with the lower dose having a more obvious effect.Serum PGE_2,IL-6,and IL-8 levels in the Huoxuehuayu high dose group(P < 0.05),IL-6 and IL-8 levels in the Huoxuehuayu middle dose group(P < 0.05),and the IL-8level in the Huoxuehuayu low dose group were significantly lower than those in the model group(P < 0.05).There were significant differences in PGE_2 and IL-6 levels among the different dose groups of Shuganliqi drugs(P < 0.05).Compared with the model group,serum PGE_(2/) IL-6,and IL-8levels in the Shuganliqi high dose group(P <0.05) and IL-8 level in the Shuganliqi low dose group were significantly lower(P < 0.05),while the Shuganliqi middle dose group did not change significantly(P > 0.05).CONCLUSION:Therefore,in TCM treatment of autoimmune prostatitis,different treatment methods should select different doses.For prescriptions that clear heat and remove toxicity,low doses should be used.For prescriptions that promote blood circulation to remove blood stasis and for prescriptions that disperse stagnated liver-Qi,high doses should be used.