The Risk of Erectile Dysfunction in Chronic Obstructive Pulmonary Disease: A Population-Based Cohort Study in Taiwan

The prevalence of erectile dysfunction (ED) in patients with chronic obstructive pulmonary disease (COPD) seemed high; however, large scale of population-based study was absent.We conducted a retrospective cohort study using data from the National Health Insurance system of Taiwan. The cohort included 29,042 male patients who were newly diagnosed with COPD. Patients were recruited between 2000 and 2011, and the date of diagnosis was defined as the index date. Each patient was randomly matched with 1 male person from the general population without COPD according to age and the index year. The occurrence of ED was followed up until the end of 2011. The hazard ratios of ED were estimated using the Cox proportional hazard model after adjusting for age, index year, comorbidities, and medications.The overall incidence of ED was 1.88-fold greater in the COPD cohort than in the non-COPD cohort (24.9 vs 13.3/1000 person-years, 95% confidence interval [CI] = 1.61–2.18). Compared with non-COPD patients, the hazard ratio increased with the number of emergency room visits and admissions for COPD from 1.51 (95% CI 1.29–1.77) to 5.46 (95% CI 3.03–9.84) and from 1.50 (95% CI 1.28–1.76) to 11.5 (95% CI 5.83–22.6), respectively.Patients with COPD are at a significantly higher risk of developing ED compared with the general population regardless of age and presence of comorbidity. The results also support that poor control of COPD status is a key factor affecting ED development.     

Statin use and breast cancer survival and risk: a systematic review and meta-analysis

The purpose of this study is to determine the associations between statin use and breast cancer survival and risk by performing a systematic review and meta-analysis. We searched PubMed, Embase and Web of Science up to August 2015 for identifying relevant prospective or case-control studies, or randomized clinical trials. Five prospective studies involving 60,911 patients reported the association between statin use and breast cancer mortality. Eleven prospective studies, 12 case-control studies and 9 randomized clinical trials involving 83,919 patients reported the association between statin use and breast cancer risk. After pooling estimates from all available studies, there was a significantly negative association between pre-diagnosis statin use and breast cancer mortality (for overall survival (OS): hazard ratio (HR) = 0.68, 95% confidence interval (CI) 0.54–0.84; for disease specific survival (DSS): HR = 0.72, 95% CI 0.53–0.99). There was also a significant inverse association between post-diagnosis statin use and breast cancer DSS (HR = 0.65, 95% CI 0.43–0.98), although the association with breast cancer OS did not reach statistical significance (HR = 0.71, 95% CI 0.48–1.07). Additionally, there was a non-linear relationship for the duration of post-diagnosis statin use with breast cancer specific mortality. On the other hand, with regards to the relationship between statin use and breast cancer risk, no significant association was detected. Our analyses suggest that although statin use may not influence breast cancer risk, the use of statin may be associated with decrease mortality of breast cancer patients. Further large-scale studies are warranted to validate our findings.     

棉酚纳米混悬剂在小鼠体内的药代动力学及组织分布

目的:考察棉酚纳米混悬剂在小鼠体内的药代动力学及组织分布特性。方法:采用HPLC测定生物样品中棉酚的含量,流动相甲醇-0.4%磷酸水(85∶15),检测波长238 nm。比较棉酚纳米混悬剂和棉酚溶液经尾静脉给药后体内药代动力学参数与组织分布特点的差异。结果:棉酚纳米混剂的血药浓度时间曲线面积、药物体内滞留时间、表观分布容积、消除速率和最大血药浓度分别为(18 792.56±2 304.43)μg·L-1·h-1,(21.82±1.60)h,(0.75±0.16)L·kg-1,(1.37±0.37)L·kg-1·h-1,(17 589.81±3 034.14)μg·L-1。棉酚纳米混悬剂在肝、心、脾、肺及肾中的相对摄取率分别为1.44,3.21,12.19,1.88,6.54。结论:棉酚纳米混悬剂能显著提高药物在各组织中的浓度水平,且延长了药物在体内组织的滞留时间,提高药物生物利用度,并在一定程度上延长药物在动物体内的循环时间。纳米混悬剂很有可能成为棉酚的一种新型药物传递系统。     

芦丁对糖尿病肾病大鼠肾功能及肾组织病理变化的影响

目的:观察芦丁对糖尿病肾病大鼠肾功能及肾组织病理变化的影响。方法:SD大鼠ip四氧嘧啶70 mg·kg-1,连续3次,每天1次,建立糖尿病大鼠模型。将成模大鼠随机分为模型组,芦丁低、高剂量组(100,200 mg·kg-1)及厄贝沙坦组(20 mg·kg-1),另设正常组。造模后各组大鼠ig给药每天1次,连续12周。给药后测定大鼠血清空腹血糖(FBG),血肌酐(SCr),尿素氮(BUN)及24 h尿蛋白含量,并计算肾指数。分别采用HE染色,Masson染色及电镜观察各组大鼠肾组织形态。结果:与正常组比较,模型组大鼠FBG,SCr,BUN,24 h尿蛋白及肾指数明显增加(P0.01),且肾组织损伤严重,肾小球萎缩,囊腔增大,肾间质区可见大量清晰的蓝色胶原纤维增生,基底膜弥漫性增厚,足突增宽、融合甚至消失。给药后,与模型组比较,芦丁各剂量组可不同程度降低FBG,SCr,BUN,24 h尿蛋白及肾指数值(P0.05,P0.01),且高剂量组作用更为明显。结论:芦丁可改善糖尿病大鼠肾功能,并可减轻肾组织病变损害程度。     

基于中医证候与危险分层关系的高脂血症神经网络预警模型研究

目的：探讨基于高脂血症中医证候与危险分层的神经网络预警模型。方法：在Matlab R2010a环境下,以高脂血症中医证候为输入,高脂血症危险分层为输出,建立反向传播（BP）神经网络预警模型。随机选取286例作为神经网络学习训练样本,剩余的30例作为测试样本。为了提高模型精度,建模前先对输入自变量进行降维处理。结果：降维前后的结果对比显示,经过降维处理后的神经网络预测准确率有所提高,平均误差为10%左右,说明建立的神经网络模型能够较好地预测高脂血症的风险等级。结论：研究结果表明,所建立的模型能够较好地提取中医证候与高脂血症危险分层的内在关系,将神经网络技术用于高脂血症中医证候与危险分层的研究是可行的。     

髋臼骨折术后残留移位与髋关节功能的相关性分析

目的通过术后CT评价髋臼骨折复位质量,探讨累及负重区和非负重区的残留移位(台阶移位和间隙移位)与术后髋关节功能的相关性。方法回顾分析2004年6月-2009年6月48例髋臼骨折患者术后CT检查和临床随访结果。患者均行切开复位内固定。术后均获随访,随访时间24～72个月,平均36个月;骨折均愈合。根据关节面残留移位是否累及负重顶,将患者分为负重区组(30例)和非负重区组(18例)。髋关节功能按Merled’Aubigné-Postel标准评定;术后关节面复位质量采用CT评价,于CT片上测量残留移位的两个指标(台阶移位和间隙移位)最大值。所得数据均采用Spearman秩相关检验分析。结果负重区组残留移位值与髋关节功能成强负相关性(rs=—0.722,P=0.001);非负重区组残留移位值与髋关节功能无相关性(rs=0.481,P=0.059)。临床随访结果与相关性分析一致。负重区组台阶移位值与髋关节功能成极强负相关(rs=—0.825,P=0.002),而间隙移位值与髋关节功能无相关性(rs=0.577,P=0.134)。结论髋臼骨折患者术后髋关节功能不仅与关节面残留移位大小相关,还与残留移位部位相关。与非负重区相比,累及负重区的残留移位是影响术后髋关节功能的关键因素;在负重区台阶移位值越大,髋关节功能越差。     

Radiographic and clinical results of posterior dynamic stabilization for the treatment of multisegment degenerative disc disease with a minimum follow-up of 3 years

Background  

This study aims to compare radiographic and clinical outcomes of Dynesys and posterior lumbar interbody fusion (PLIF) for the treatment of multisegment disease.     

Survival outcomes for men with mediastinal germ-cell tumors: The University of Texas M. D. Anderson Cancer Center experience

ObjectivePrimary mediastinal germ-cell tumors are rare, and the effect of newer drugs and treatment strategies in this disease on overall survival is not known. We retrospectively assessed treatment outcomes at a single institution.Materials and methodsWe identified men seen at our institution from 1998 through 2005 for mediastinal germ-cell tumors. Medical records were reviewed for patient characteristics, histology, tumor markers, treatment, and survival outcome.ResultsThirty-four patients met study criteria, of whom 27 had nonseminomatous germ-cell tumor (NSGCT) and 7 had pure seminoma. Eleven patients (41%) with NSGCT were alive at last contact with a median overall survival time of 33.5 months. Among 13 patients with NSGCT referred to us at initial diagnosis, 7 (54%) were alive and recurrence-free at a median follow-up of 56.5 months. Progression-free survival was associated with absence of risk factors (any histology other than endodermal sinus tumor, β-hCG > 1000 mIU/mL, or disease outside the mediastinum). For the patients whose disease progressed (n = 5) or who had been referred to us for salvage treatment (n = 14), the 3-year overall survival from the date of first progression was 23%. Conversely, patients with seminoma did uniformly well with platinum-based chemotherapy; most did not undergo radiation or surgery.ConclusionChemotherapy given to maximum effect followed by surgical consolidation resulted in long-term progression-free survival for 54% of patients with mediastinal NSGCT. The number of risk factors present at diagnosis may be associated with survival outcome and should be studied in a larger test group.     

Recurrent seminomas: Clinical features and biologic implications

ObjectivesCertain patients with seminoma and clinically atypical phenotypes—visceral metastases, elevated levels of β human chorionic gonadotropin (βHCG), and/or recurrent disease—have a poor prognosis. The primary goal of this pilot study was to characterize the clinical characteristics and treatment profile of these rare patients. We also wished to test whether these tumors expressed any specific biomarkers that might distinguish them as a unique subtype of seminoma.Materials and methodsWe retrospectively identified 25 patients with a history of seminoma plus visceral metastases, βHCG levels >200 mU/ml, and/or recurrent disease. We reviewed these patients' histories for treatment efficacy and clinical outcome. Tissue samples were available from 6 of those patients, and we studied them for expression of the markers OCT 3/4, PLAP, CD30, TRA-1-60, c-kit, and gp200. We compared our results with the expression of those markers in tissue samples from mixed seminoma/embryonal carcinomas and classic seminomas.ResultsOur analysis suggested that certain chemotherapeutic regimens (such as ifosfamide, paclitaxel, and cisplatin) are efficacious for the treatment of patients with these atypical seminomas. Further, specimens from the atypical seminomas generally had staining profiles that resembled those of classic seminomas and the seminoma components in mixed germ-cell tumors, but the profiles differed from those of the embryonal carcinoma components in the same mixed germ-cell tumors.ConclusionsAlthough these atypical seminomas tend to be resistant to chemotherapy, they may still respond to certain chemotherapeutic regimens. Our pilot immunohistochemical study also suggested that the unique phenotypes associated with these atypical seminomas do not result from any relationship with embryonal carcinomas. More study is needed to confirm these initial findings.