达营片治疗抗精神病药物所致男性高泌乳素血症的疗效观察

观察达营片对抗精神病药物所致男性高泌乳素血症的疗效。方法:采用随机对照研究方法,将男性精神分裂症患者中泌乳素高于正常者60例,随机分为2组。实验组在原治疗基础上加用达营片3次/天,8片/次;对照组按原方案治疗不做干预。采用化学发光法测定血清泌乳素浓度,采用阴性与阳性症状量表评估精神病性症状,将肝肾功能、甲状腺、骨密度作为安全性指标,分别于基线及12周末各测定1次。结果:治疗后达营片组泌乳素水平明显下降,差异有统计学意义,P<0.05。同时治疗后达营片组精神病性症状好转,差异有统计学意义,P<0.05。两组治疗后不良反应没有增加,肝肾功能、甲状腺、骨密度检查与治疗前没有变化。结论:中成药达营片联合服用治疗高泌乳素血症,具备抗精神药物(APS),有效治疗临床男性精神分裂症患者,坚持服药的依从性,同时也可改善精神病性症状,值得临床推广使用。

男性高泌乳素血症

高泌乳素血症（HPRL）是指由各种因素引起的，以血清泌乳素（PRL）持续升高，进而导致下丘脑一垂体一性腺轴功能紊乱的综合征。多见于女性，男性相对少见，主要表现为性功能障碍（性欲减退、勃起功能障碍、高潮障碍和射精障碍）、男性不育、男性乳房发育等，严重危害男性生殖健康。

吴深涛从浊毒论治男性高泌乳素血症溢乳治验浅析

男性高泌乳素血症(Hyperprolactinemia,HPRL)是指血清中泌乳素浓度异常升高,以乳房异常发育、溢乳等为临床表现的一组综合征,可归属中医学“乳泣”范畴。吴深涛教授认为HPRL病理演变在于少阳失和,升降失司,终致木郁土壅,酿生淤浊入血化毒,浊毒上蒸外溢,核心病机为“木郁土壅,淤浊酿毒”,临证治以化浊解毒之法,并强调木土同调、浊热分解、调复气机、随症加减,疗效显著,并附验案1则。

关于农村妇女素质与发展的思考

This article discusses the relationshipbetween women’s qualities and women’sdevelopment and analyses certain prejudicesand misunderstanding on the question ofwomen’s qualities. According to the author,only by directing women into the mainstreamof development can women play a mainstayrole and only in this way can women improvetheir qualities substantially.

男性健康的六种“硬伤”

男性素以大大咧咧、不拘小节为特征,然而在生活中,不拘小节的生活习惯有时却在无意中伤害了男性的生殖健康。性学专家与你一起探讨男性性健康问题,给男性朋友提出一些健康忠告。也许你觉得你什么都好,坚持锻炼身体,生活水平也不错,实在是没什么要讲究的啦,其实生活中的一些小细节虽然无伤大雅却不见得好,可能为你今后的健康埋下隐患,特别是涉及性健康的细节你可得留个心眼,避免以下六种伤害:

逍遥丸及补肾抑乳汤联合溴隐亭治疗男性高泌乳血症的疗效观察

【目的】观察逍遥丸及补肾抑乳汤联合溴隐亭治疗男性高泌乳素血症(肝郁肾虚证)患者的临床疗效。【方法】将72例高泌乳素血症(肝郁肾虚证)的男性患者随机分为试验组和对照组,每组各36例。对照组给予口服甲磺酸溴隐亭片治疗,试验组在对照组的基础上加服逍遥丸和补肾抑乳汤治疗。1个月为1个疗程,共治疗3个疗程。观察2组患者治疗前后中医证候评分(阳痿、性欲下降、焦虑和腰酸痛)及性激素水平[泌乳素(PRL)、促黄体生成素(LH)、卵泡生成素(FSH)和睾酮(T)]的变化情况,并评价2组的疗效及安全性。【结果】(1)治疗3个月后,试验组的总有效率为91.67%(33/36),对照组为83.33%(30/36),试验组的疗效明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的阳痿、性欲下降、焦虑和腰酸痛等各项中医证候评分均较治疗前明显改善(P<0.05),且试验组的改善作用均明显优于对照组,差异均有统计学意义(P<0.05)。(3)治疗后,2组患者的PRL水平均较治疗前降低(P<0.05),FSH、LH、T水平均较治疗前升高(P<0.05),且试验组对PRL水平的降低作用及对FSH、LH、T水平的升高作用均明显优于对照组,差异均有统计学意义(P<0.05)。(4)治疗过程中,2组患者的各项安全性指标均无明显异常变化。【结论】逍遥丸及补肾抑乳汤联合溴隐亭治疗男性高泌乳素血症疗效显著,不仅可恢复患者的各项性激素指标水平,还可有效缓解患者的性功能障碍、性欲减退、腰酸和焦虑等临床症状。

定经汤在男科病症中的应用

定经汤出自《傅青主女科》,具有疏肝补肾的功效,是治疗月经失调肝郁肾虚证的代表方剂之一。基于异病同治理论可知,妇科病症的病机与男科部分病症的病机相吻合,因此,在治疗男科病症时可以借鉴妇科的理论、方法和方药。肝郁肾虚证亦是男科病症的主要证型之一,也是定经汤治疗男科病症的辨证基础,将定经汤应用于阳痿、早泄以及高泌乳素血症等男科病症的治疗中,均可取得较好疗效。

印度北部麻风的社会——医学背景 Ⅲ麻风和饮食

在考察健康与疾病时,除了研究人的生理学外也不能忽略其社会和文化环境。作者于1984和1985两年的7～8月间在印度阿格拉郊区一所麻风院随机地对700名门诊病人做了调查,其中男563例,女137例,年龄均在9岁以上,以25～45岁者居多;印度教徒529人,回教徒171人,其间为3∶1,较之全印回教徒仅占11.2％,这里回教徒的比率较高。在调查时印度教徒中,男性素食者251人(59％),其中74人(17％)

Sex Hormones and Androgen Receptor:Risk Factors of Coronary Heart Disease in Elderly Men

Objective To investigate the variation of sex hormone and its receptor level in elderly male patients with coronary heart disease (CHD) and to evaluate the correlations between CHD and sex hormone as well as sex hormone receptor. Methods Altogether 139 male CHD patients (CHD group) aged 60-92 years and 400 healthy men (control group) aged 60-90 years were included in this cross sectional study. The plasma concentrations of dehydroepiandrosterone sulfate (DHEAS),total testosterone (TT),free testosterone (FT),estradiol (E2),sex hormone binding globulin (SHBG),luteinizing hormone (LH),and follicle-stimulating hormone (FSH) were measured. The androgen receptor (AR) was tested by flow cytometry. Correlations between CHD and levels of sex hormones and AR were analyzed. Results Compared with the control group,the levels of DHEAS,TT,FT,SHBG,and the fluorescence intensity of AR in the CHD group significantly reduced (P<0.05),while the levels of FSH and E2 significantly increased (P<0.01). Age was negatively correlated with TT (r=-0.28,P=0.00) and FT (r=-0.17,P=0.01),while it was positively correlated with SHBG (r=0.14,P=0.04) and E2 (r=0.33,P=0.00). AR fluorescence intensity was negatively correlated with systolic blood pressure (r=-0.12,P=0.01). Binary logistic regression analysis showed that TT,SHBG,and AR were all negatively correlated with CHD (P<0.05). Conclusions Elderly male patients with CHD are found to have low levels of DHEAS,TT,FT,SHBG,and AR,while high concentrations of E2 and FSH. Low levels of TT and SHBG may be the potential risk factors of CHD in elderly men.

Up-regulation of Bcl-2 is required for the progression of prostate cancer cells from an androgen-dependent to an androgen-independent growth stage

Bcl-2 is an anti-apoptotic oncoprotein and its protein levels are inversely correlated with prognosis in many cancers. However, the role of Bcl-2 in the progression of prostate cancer is not clear. Here we report that Bcl-2 is required for the progression of LNCaP prostate cancer cells from an androgen-dependent to an androgen-independent growth stage. The mRNA and protein levels of Bcl-2 are significantly increased in androgen-independent prostate cancer cells, shRNA-medi- ated gene silencing of Bcl-2 in androgen-independent prostate cancer cells promotes UV-induced apoptosis and suppresses the growth of prostate tumors in vivo. Growing androgen-dependent cells under androgen-deprivation conditions results in formation of androgen-independent colonies; and the transition from androgen-dependent to androgen-independent growth is blocked by ectopic expression of the Bcl-2 antagonist Bax or Bcl-2 shRNA. Thus, our results demonstrate that Bcl-2 is not only critical for the survival of androgen-independent prostate cancer cells, but is also required for the progression of prostate cancer cells from an androgen-dependent to an androgen-independent growth stage.

Prostate cancer and metastasis initiating stem cells

Androgen refractory prostate cancer metastasis is a major clinical challenge. Mechanism-based approaches to treating prostate cancer metastasis require an understanding of the developmental origin of the metastasis-initiating cell. Properties of prostate cancer metastases such as plasticity with respect to differentiated phenotype and androgen independence are consistent with the transformation of a prostate epithelial progenitor or stem cell leading to metastasis. This review focuses upon current evidence and concepts addressing the identification and properties of normal prostate stem or progenitor cells and their transformed counterparts.

Estrogen,male dominance and esophageal adenocarcinoma:Is there a link?

Esophageal adenocarcinoma is a cancer with poor prognosis, and its incidence has risen sharply over recent decades. Obesity is a major risk factor for developing this cancer and there is a clear male gender bias in the incidence that cannot be fully explained by known risk factors. It is possible that a difference in the expression of estrogen, or its signaling axes, may contribute to this gender bias. We undertook a com- prehensive literature search and analyzed the available data regarding estrogen and estrogen receptor expres- sion, and the possible sex-specific links with esopha- geal adenocarcinoma development. Potentially relevant associations between visceral vs subcutaneous fat deposition and estrogen expression, and the effect of crosstalk between estrogen and leptin signaling were identified. We also found limited studies suggesting a role for estrogen receptor 13 expression in esophageal adenocarcinoma development. The current literature supports speculation on an etiological role for estrogen in the male gender bias in esophageal adenocarcino- ma, but further studies are required.

Androgen deficiency in elderly men with systolic chronic heart failure

Objective Several previous studies have shown androgens deficiency in men with CHF, and 2 studies on the prognostic significance of serum levels of androgens in CHF patients have yielded conflicting results. The aim of this study was to examine the relationship between serum concentration of testosterone and mortality in men with systolic CHE Methods A total of 175 elderly （age ≥ 60 years） men with CHF were recruited. Total testosterone fiT） and sex hormone binding globulin （SHBG） were measured, and free serum testosterone （eFT） was calculated. The median follow-up time was 1262 days. Results During follow-up 54 （30.9%） patients died. TT and eFF deficiency was found in 21.7% （38/175） and 27.4% （48/175） patients, respectively. Both TT and eFT were inversely associated with LVEF and NT-proBNP （all P〈0.01）. Kaplan-Meier curves for patients in low, medium and high tertiles according to TF and eFT level showed significantly different cumulative survival rate （both P〈0.01 by log-rank test）. However, after adjustment for clinical variables, there were no significant associations between either Tr or eFT levels or survival time （OR=0.97, 95% CI, 0.84-1.12, P--0.28; and OR=0.92, 95% CI, 0.82-1.06,/＇=0.14, respectively）. Conclusion Our study showed that although levels of TT and eFT are commonly decreased in elderly patients with systolic CHF and related to disease severity, they are not independent predictors for mortality

Hepatocellular carcinoma in Egypt: A single center study over a decade

AIM： To identify the trend, possible risk factors and any pattern change of hepatocellular carcinoma （HCC） in Egypt over a decade. METHODS： All HCC patients attending Cairo Liver Center between January 1993 and December 2002, were enrolled in the study. Diagnosis of HCC was based on histopathological examination and/or detection of hepatic focal lesions by two imaging techniques plus α-fetoprotein level above 200 ng/mL. The duration of the study was divided into two periods of 5 years each; period Ⅰ （1993-1997） and period Ⅱ （1998-2002）. Trend, demographic features of patients （age, gender, and residence）, risk factors （HBsAg, HCV-Ab, schistosomiasis and others） and pattern of the focal lesions were compared between the two periods. Logistic regression model was fitted to calculate the adjusted odds ratios for the potential risk factors. The population attributable risk percentage was calculated to estimate the proportion of HCC attributed to hepatitis B and C viral infections. RESULTS： Over a decade, 1 328 HCC patients out of 22 450 chronic liver disease （CLD） patients were diagnosed with an overall proportion of 5.9%. The annual proportion of HCC showed a significant rising trend from 4.0% in 1993 to 7.2% in 2002 （P = 0.000）. A significant increase in male proportion from 82.5% to 87.6% （P = 0.009）; M/F from 5：1 to 7：1 and a slight increase of the predominant age group （40-59 years） from 62.6% to 66.8% （P = 0.387）in periods Ⅰ and Ⅱ respectively, reflecting a shift to younger age group. In the bivariate analysis, HCC was significantly higher in rural residents, patients with history of schistosomiasis and/or blood transfusion. Yet, after adjustment, these variables did not have a significant risk for development of HCC. There was a significant decline of HBsAg from 38.6% to 20.5% （P = 0.000）, and a slight increase of HCV-Ab from 85.6% to 87.9% in periods I and II respectively. HBV conferred a higher risk to develop HCC more than HCV in period Ⅰ （OR 1.9 vsl.6） and period Ⅱ （OR 2.7 vs 2.0）, but the relative contribution of HBV for development of HCC declined in period Ⅱ compared to period Ⅰ （PAR% 4.2%, 21.32%）. At presentation, diagnostic α-fetoprotein level （≥200 ng/mL） was demonstrated in 15.6% vs28.9% and small HCC （≤3 cm） represented 14,9% vs 22,7% （P = 0,0002） in periods Ⅰ and Ⅱ respectively. CONCLUSION： Over a decade, there was neady a twofold increase of the proportion of HCC among CLD patients in Egypt with a significant decline of HBV and slight increase of HCV as risk factors. α-Fetoprotein played a limited role in diagnosis of HCC, compared to imaging techniques. Increased detection of small lesions at presentation reflects increased awareness of the condition.

Andropause and the development of cardiovascular disease presentationmore than an epi-phenomenon

Andropause refers to a generalized decline of male hormones, including testosterone and dehydroepiandrosterone in middle-aged and aging men. This decline in hormones has been associated with changes such as depression, loss of libido, sexual dysfunction, and changes in body composition. Aging has been associated with an abundance of concomitant diseases, in particular cardiovascular diseases, and although andropause is correlated to aging, a causal relationship between reduction of androgens and the development of chronic diseases such as atherosclerosis and heart failure has not been convincingly established yet. On the other hand, increasing data has emerged that revealed the effects of low levels of androgens on cardiovascular disease progression. As an example, low levels of testosterone have been linked to a higher incidence of coronary artery disease. Whether hormone replacement therapy that is used for andropausal men to alleviate symptoms of ＂male menopause＂ can halt progression of cardiovascular disease, remains controversially discussed, primarily due to the lack of well-designed, randomized controlled trials. At least for symptom improvement, the use of androgen replacement therapy in andropausal men may be clinically indicated, and with the appropriate supervision and follow up may prove to be beneficial with regard to preservation of the integrity of cardiovascular health at higher ages.

Effect of Buyang Huanwu Decoction on Platelet Activating Factor Content in Arterial Blood Preand Post-Arterial Thrombosis in Rats

To explore the effect of Buyang Huanwu Decoction (BHD) on platelet activating factor (PAF) content in arterial blood pre- and post-arterial thrombosis in rats, male Wistar rats were randomly divided into 3 groups, the medicine group treated with BHD, the control group with dexamethasone liquid, and the blank group with distilled water. Oral administration was given for 14 consecutive days, once daily. Model of arterial thrombosis was established in the animals 2 hours after final medication, the blood content of PAF, dry weight (DW) and occlusion time (OT) of thrombus, and dry weight of thrombus/body weight (TW/BW) ratio were observed. Results indicated that BHD could markedly lower the arterial blood content of PAF after thrombosis, increase the OT of thrombus, reduce the dry weight of thrombus and the TW/BW ratio (P

Relationship of level of sex hormone and sex hormone receptor with development of metabolic syndrome in elderly men

Objective The sex hormone and the corresponding receptor may play some roles in the development of the metabolic syndrome （MS） in the elderly men. This study was designed to examine the relationship of level of the sex hormone and androgen receptor with MS in elderly men, thus to investigate the possible pathogenesis of MS. Methods This cross sectional study enrolled 587 elderly men, including 400 healthy controlls aged 62-92 years and 187 MS patients aged 60-87 years in Wan Shou Lu area of Beijing city. Dehydroepiandrosterone sulfate （DHAE-S）, total testosterone （TT）, sex hormone binding globulin （SHBG）, free testosterone （FT）, follicle-stimulating hormone （FSH）,Estradiol （E2）,luteinizing hormone（LH） and androgen receptor （AR） in blood were tested. Statistical analyses included the comparison analysis of variables and independent variables, correlation analysis using multi-factor linear regression, and multiple logistic regression analysis. Results DHAE-S, TT, SHBG, FT and AR fluorescence intensity in healthy control group were higher than those in MS group, however, FSH and E2 levels were lower in healthy group. Age was negatively correlated with diastolic blood pressure （DBP） and FT, but positively correlated with systolic blood pressure （SBP） and E2. AR fluorescence intensity was negatively correlated with SBP and LH. The logistic regression equation showed the negative correlation between DHEA-S, SHBG and the development of MS. Conclusions There are low levels of DHEA-S, TT, SHBG, FT and AR in the elderly patients with MS. On the contrary, FSH and E2 concentration are higher. It can be suggested that low levels of DHEA-S and SHBG may be the potential risk factors of MS in elderly men.

Bcl-2 expression is a poor predictor for hepatocellular carcinoma prognosis of andropause-age patients

Objective: The expression of B-cell lymphoma 2(Bcl-2) seems to be influenced by the endocrine environment. Numerous reports demonstrate the diverse expression of Bcl-2 family members under sex steroid regulation. With the exception of estrogen-related tumors, androgen-related tumors have shown their characteristics in Bcl-2 expression. In this study, the status of Bcl-2 expression in male hepatocellular carcinoma(HCC) patients was examined to verify the high incidence of HCC in males.Methods: Tumor tissue microarray was used to examine Bcl-2 expression levels in 374 HCC cases including 306 males and 68 females. Kaplan-Meier method, log-rank test, and Cox proportional hazards model were applied to investigate the predictive value of Bcl-2 in HCC patients.Results: Immunohistochemistry analysis showed that male patients with higher Bcl-2 levels had significantly longer median survival time and recurrence time than those with lower levels. However, no significant differences in outcomes were found between different Bcl-2 levels in female patients. When the male patients were stratified into several age points, the level of Bcl-2expression showed poorer predictive efficiency in the 45–49 and 55–60 age groups in andropause-age patients compared with other age groups. Bcl-2 was an independent prognostic factor for both overall survival(P < 0.0001) and recurrence time(P =0.0001) in male patients. After excluding male patients in the 45–60 age group, the predictive efficiency was enhanced(n = 147,OS, P = 0.0002, TTR, P < 0.0001).Conclusions: Bcl-2 expression is an independent predictor of survival and recurrence in male HCC. Bcl-2 levels may also be regulated by androgens or androgen receptors in male HCC patients. Bcl-2 levels change and exhibit poor predictive efficiency when androgen levels vary dramatically(andropause age).

Effect of Acupuncture on Plasmic Levels of Insulin,Glucagon and Hypercoagulability in NIDDM Complicated by Acute Cerebral Infarction

Twenty-one cases of acute cerebral infarction secondary to NIDDM were treated with acupuncture and conventional therapy, and compared with 16 cases treated with conventional therapy alone. The results showed that acupuncture was more effective in reducing insulin and glucagon levels (P