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1. Immediate Effects of Aerobic Exercise on Arterial Stiffness in a Male Population with Different Blood Glucose Levels
HE Rong, ZHANG Li, LI Peng, ZHANG Xiaoling, ZHANG Guo, ZANG Yiran, WU Shouling, SUN Lixia
Chinese General Practice    2023, 26 (24): 2997-3004.   DOI: 10.12114/j.issn.1007-9572.2023.0029
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Background

Previous studies on the benefits of aerobic exercise mainly focus on the impact of aerobic exercise on long-term cardiovascular health and outcomes, namely regular aerobic exercise can improve arterial stiffness, while some studies point out that high blood sugar increases arterial stiffness.

Objective

To investigate the immediate effect of aerobic exercise on arterial stiffness in people with different blood glucose levels.

Methods

This study selected individuals who had participated in the 6th follow-up physical examination of the Kailuan Study during 2018—2020 and participated in the 5th national physical fitness surveillance in 2020 and completed their brachial-ankle pulse wave conduction velocity (baPWV) measured before and after the secondary load test of the power vehicle bicycle in four subordinate enterprises of Kailuan Group. Epidemiological survey result were collected: general information (age, hypertension, hyperlipidemia, history of antihypertensive drugs, etc.) , anthropometric indicators〔systolic blood pressure (SBP) , diastolic blood pressure (DBP) , etc.〕and biochemical indicators (fasting blood glucose, etc.) . baPWV measured in the secondary load test of the power vehicle bicycle (used as the aerobic exercise) was used as an indicator of upper and lower limb arterial stiffness. baPWV-related indicators〔SBP, DBP, mean arterial pressure (MAP) , heart rate (HR) , baPWV, metabolic equivalent (MET) , maximal oxygen uptake (VO2max) , etc.〕before and after the test were expressed using a unified form, for example, pre- and post-test baPWV were recorded as baPWV1 and baPWV2, respectively, and its pre- and post-test difference was denoted as ?baPWV. The epidemiological survey result and BAPWV-related data were compared between fasting blood glucose (FBG) quartile groups〔Q1 (n=220) : <5.00 mmol/L; Q2 (n=240) : 5.00-<5.40 mmol/L; Q3 (n=230) : 5.40-<5.81 mmol/L; Q4 (n=234) : ≥5.81 mmol/L〕. Generalized linear regression model was used to evaluate the association of FBG with pre- and post-test baPWV.

Results

A total of 924 eligible cases were enrolled, with an average age of (36.9±7.7) years. FBG quartile groups had statistically significant differences in mean age, hyperlipidemia and hypertension, history of using antihypertensive drugs, mean SBP, DBP, FBG, high sensitivity C-reactive protein, triglyceride, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol (P<0.01) . HR2 was found to be statistically significant higher than HR1 in groups Q1, Q2 and Q3 (P<0.01) . The baPWV2 was found to be statistically significant higher than baPWV1 in Q1, Q2, Q3 and Q4 groups (P<0.01) . SBP1, DBP1, MAP1 and baPWV1 significantly differed across the groups, and so did SBP2, DBP2, MAP2 and baPWV2 (P<0.01) . Compared with baPWV1, baPWV2 decreased by an average of 36.0 cm/s in people with different blood glucose levels. The generalized linear regression model showed that after adjusting for confounding factors, the ?baPWV level in group Q1 was lower than that in group Q4〔B (95%CI) =-18.96 (-36.96, -0.96) , P=0.04) 〕.

Conclusion

Aerobic exercise can immediately improve the degree of arterial stiffness, but the effect can be weakened by high blood sugar. Clinicians should design aerobic exercise programs according to the personal features of populations to improve arteriosclerosis and delay vascular aging.

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2. Relationship between Time in Range and Long-term HbA1c Glycemic Variability in Elderly Male Patients with Type 2 Diabetes
FANG Fusheng, LIU Xingyu, YAN Shuangtong, WANG Ning, LI Chunlin, TIAN Hui
Chinese General Practice    2023, 26 (16): 1979-1983.   DOI: 10.12114/j.issn.1007-9572.2022.0547
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Background

As a new indicator of glycemic management, time in range (TIR) is significantly related to short-term glycemic variability, but whether it is also associated with long-term glycemic variability is still unclear.

Objective

To investigate the relationship of TIR with coefficient of variability (CV) of HbA1c and HbA1c variability score (HVS) during a long-term follow-up in elderly male patients with type 2 diabetes.

Methods

Two hundred elderly male type 2 diabetic inpatients from the Second Medical Center of PLA General Hospital were enrolled from January 2007 to January 2011. All of them underwent continuous glucose monitoring (CGM) during hospitalization, and by the baseline TIR derived from CGM, they were divided into TIR≥85% group (n=141) and TIR<85% group (n=59), and followed up for (12.5±1.1) years. The CV of HbA1c and HVS in the follow-up were compared between the groups. The relationships of TIR with the CV of HbA1c and HVS were analyzed using Pearson correlation analysis and multivariate linear regression analysis.

Results

The long-term CV of HbA1c〔 (9.7±3.8) % vs (8.2±4.5) %, P=0.028〕 and HVS〔 (48.7±20.4) vs (32.5±20.8), P<0.001〕 in TIR<85% group were both significantly higher than those in TIR≥85% group. Pearson correlation analysis suggested that TIR showed a significant linear negative correlation with CV of HbA1c (r=-0.239, P<0.001) or HVS (r=-0.400, P<0.001). Multiple linear regression analysis indicated that TIR had an impact on long-term CV of HbA1cb (95%CI) =-0.07 (-0.12, -0.03), P<0.05〕or HVS〔b (95%CI) =-0.44 (-0.67, -0.21), P<0.05〕after adjusting for confounding factors.

Conclusion

TIR was independently associated with long-term CV of HbA1c or HVS in elderly male patients with type 2 diabetes. With the decrease of TIR, the long-term HbA1c glycemic variability increased gradually during follow-up.

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3. Association of Oxidative Stress and Energy Metabolism with Sperm Quality in Chinese Male Adults
ZHAO Xiaolong, NIU Zhiping, TAN Jidong, HAN Donghui, YANG Fa, WEN Weihong, WANG Anhui, QIN Weijun
Chinese General Practice    2023, 26 (11): 1318-1324.   DOI: 10.12114/j.issn.1007-9572.2022.0779
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Background

Oxidative stress and energy metabolism are important factors that affect sperm quality in male individuals. However, the majority of available studies are based on animal models, and evidence from human studies is still inadequate. Besides, most previous studies have paid more attention to the effects of oxidative stress and energy metabolism on sperm concentration and motility, with a little focus on their impact on sperm motility velocity and trajectory and other specific objective indicators evaluating the state of male infertility.

Objective

To investigate the effects of biological indicators related to oxidative stress and energy metabolism on sperm concentration, motility, movement velocity and trajectory in male adults, thus to provide epidemiological evidence for precise intervention of male reproductive health problems.

Methods

One hundred and nine volunteers were recruited as subjects from the Center of Reproductive Medicine in Xijing Hospital, Air Force Medical University from June to December 2021. Their semen samples were collected. The computer-assisted sperm analysis system was applied to detect sperm concentration parameters (sperm concentration, linear motion sperm concentration), sperm motility〔total sperm motility, progressive motility (PR), non-progressive motility (NP) 〕, sperm motility velocity parameters〔curvilinear velocity (VCL), straight-line velocity (VSL), average path velocity (VAP) 〕 and sperm motility trajectory parameters 〔mean amplitude of lateral head displacement (ALH), mean beat-cross frequency (BCF), mean angular displacement (MAD), linearity coefficient (LIN), wobble coefficient (WOB), straightness coefficient (STR) 〕. Besides that, the levels of malondialdehyde (MDA) and reduced glutathione (GSH) in semen samples were measured as oxidative stress markers, and the level of sperm adenosine triphosphate (ATP) was measured to assess the level of energy metabolism. General linear model (GLM) was used to evaluate the correlation of MDA and GSH and ATP with sperm quality parameters.

Results

A total of 67 sperm samples were used to examine oxidative stress level, and 42 sperm samples were employed to assess the level of energy metabolism. The analysis using the GLM demonstrated that in terms of oxidative stress level, MDA level was negatively correlated with linear motion sperm concentration, total sperm motility, PR, NP, VCL, VSL, VAP, ALH, BCF, MAD, LIN, WOB, and STR (P<0.05) ; the level of GSH was positively correlated with linear motion sperm concentration, total sperm motility, PR, VSL, VAP, ALH, BCF, MAD, LIN, WOB, and STR (P<0.05). In terms of energy metabolism, the level of ATP was positively correlated with linear motion sperm concentration, total sperm motility, PR, NP, VCL, VSL, VAP, ALH, BCF, MAD, LIN, WOB, and STR (P<0.05) .

Conclusion

Higher level of oxidative stress is associated with lower sperm motility, lower velocity of sperm movements, and the adverse change in sperm trajectory. While higher ATP level is related to higher sperm motility, higher sperm movement velocity, and the favorable change of sperm trajectory.

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4. Phenotypically Male Congenital Adrenal Hyperplasia Patient with Huge Space-occupying Adrenal Masses: a Case Report and Literature Review
RAO Yufeng, MENG Liheng, ZHOU Jia, LIANG Xinghuan, HUANG Zhenxing, QIN Yingfen
Chinese General Practice    2023, 26 (21): 2690-2694.   DOI: 10.12114/j.issn.1007-9572.2022.0723
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Congenital adrenal hyperplasia (CAH) is an autosomal recessive genetic disease encompassing enzyme deficiencies in the process of adrenal steroidogenesis, which leads to adrenal cortex dysfunction. Hypersecretion of corticotrophin-releasing hormone and insufficient cortisol production often lead to enlarged adrenal glands. Existing studies have reported that most of space-occupying adrenal masses in CAH are benign, only very few are malignant. It is difficult for clinicians to distinguish the nature of space-occupying adrenal masses, and physicians have insufficient experiences in treating the disease. We reported a phenotypically male case of CAH with huge space-occupying adrenal masses and reviewed relevant literature, aiming to provide evidence on the diagnosis and treatment of this disease for clinicians. The space-occupying adrenal masses in CAH often show tumor-like hyperplasia before diagnosis and treatment or effective hormone replacement therapy, but most of them will be significantly reduced or disappear after glucocorticoid replacement therapy. But a follow-up of several years showed that space-occupying adrenal masses in the CAH patient encountered by us had no significant changes and no significant impact on the patient's body, even without effective drug intervention.

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5. Influence of HIV-related Knowledge and Anticipated Stigma on Depression of Men Who Have Sex with Men: a Latent Class Analysis
Zhenwei DAI, Mingyu SI, Yijin WU, Xu CHEN, Jiaqi FU, Yiman HUANG, Hao WANG, Weijun XIAO, Fei YU, Guodong MI, Xiaoyou SU
Chinese General Practice    2022, 25 (30): 3803-3809.   DOI: 10.12114/j.issn.1007-9572.2022.0360
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Background

Chinese men who have sex with men (MSM) have a higher prevalence of depression than the general population. Long-term depression symptoms could increase the risk of having physical harm, self-harm and suicide. Therefore, depression issues among MSM need to be solved urgently.

Objective

To explore the latent classes of depression, and the influence of HIV-related knowledge and anticipated stigma on depression among MSM.

Methods

Usingthe General Information Questionnaire, HIV Knowledge Questionnaire, Anticipated HIV Stigma Scale and 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) , an online questionnaire survey was conducted from December 2020 to March 2021 via the same-sex social network of Blued7.5. A total of 1396 MSM with HIVinfection or unclear status of HIVinfection were sampled by use of convenience sampling to attend the survey. The latent classes of depressive symptoms were analyzed by latent class analysis. Multinomial Logistic regression analysis was used to explore the correlation of the latent class of depression with HIV-related knowledge or anticipated HIV stigma.

Results

Finally, 1 394 cases (99.9%.) who returned responsive questionnaires were included. The 10 items of CES-D-10 were taken as observed indicators, and exploratory latent class analysis was employed to identify the latent classes of depression based on model from 1 to 5 classes. The 4-class model was finally selected, and the probabilities of each class were 40.1% (no obvious depression) , 21.6% (possible risk of depression) , 28.0% (possible mild depression) , and 10.3% (possible moderate to severe depression) . The accuracy of the classification was assessed by test for homogeneity according to the cut-off value of CES-D-10 (0=no depression, 1=depression) and the results of latent class analysis (0= no obvious depression and possible risk of depression, 1= possible mild depression and possible moderate to severe depression) , and the result showed that Kappa=0.735 (P<0.001) . Multinomial Logistic regression analysis indicated that a high level of HIV-related knowledge (OR=0.926, P=0.001) , undergraduate attainment or above (OR=0.642, P=0.003) were related to possible risk of depression. The anticipated HIV stigma (OR=1.594, P<0.001) and being married (OR=0.593, P=0.026) were related to possible mild depression. A high level of HIV-related knowledge (OR=0.935, P=0.026) , anticipated HIV stigma (OR=2.239, P<0.001) and no long-term employment (OR=1.518, P=0.045) were related to possible moderate to severe depression.

Conclusion

The depression in MSM population presented obvious category characteristics, which may be a new idea for tailoring interventions to depression in MSM. Relevant authorities may cooperate with social media to deliver interventions incorporated with HIV-related knowledge and anticipated HIV stigma to prevent and control the development of depression in MSM.

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6. Associated Factors of Osteoporosis and Physical Fitness in Elderly Chinese Men
Shufang WANG, Xiuyan WANG, Yuwei YAN, Risu NA, Yuyu HENG, Ruhong WU, Ling JIN, Juan AN, Yan MEI, Xiaochun WU, Zhenqing LIU
Chinese General Practice    2022, 25 (18): 2188-2193.   DOI: 10.12114/j.issn.1007-9572.2022.02.002
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Background

As life expectancy increases, the number of elderly patients with osteoporosis rises as well. Many factors affect the development of osteoporosis, and good physical fitness may contribute to having better social adaptability in older people. So it is very important to pay attention to osteoporosis and ensure physical fitness in this group.

Objective

To explore the factors associated with osteoporosis, and analyze physical fitness in elderly men, providing a theoretical basis for preventing osteoporosis, improving physical fitness and developing health management programs for this group.

Methods

This study was conducted from January 2018 to December 2020. A total of 250 elderly men who underwent bone mineral density (BMD) examination were selected from Health Management Center, Inner Mongolia People's Hospital, and divided into normal BMD, osteopenia and osteoporosis groups by BMD examination results. Data were collected, including baseline information, laboratory results, physical fitness test results〔 including muscular strength (number of elbow bending within 30 seconds, 30-second sit-to-stand test results) , flexibility (shoulder and arm stretches, sitting flexion test) , balance (stand on one foot with eyes closed) , aerobic capacity (2-minute step test) , agility/mobility (timed up go test with a minimal space of 2.5 meters) 〕.

Results

Of the 250 subjects, 76 (30.4%) had normal BMD, 123 (49.2%) had osteopenia, and 51 (20.4%) had osteoporosis. Multivariate Logistic regression analysis demonstrated that abdomen circumference〔OR=0.710, 95%CI (0.566, 0.891) 〕, body mass index 〔OR=0.685, 95%CI (0.474, 0.990) 〕, high-density lipoprotein cholesterol〔OR=74.182, 95%CI (3.738, 1 472.125) 〕, 25 (OH) D3OR=0.745, 95%CI (0.619, 0.897) 〕, and estradiol〔OR=0.784, 95%CI (0.665, 0.924) 〕were associated with osteoporosis in elderly men (P<0.05) . All the subjects successfully completed physical fitness tests, without adverse events. The number of repetitions of sit-to-stands within 30 seconds, results of shoulder and arm stretches, sitting flexion test, and 2-minute step test, duration for stand on one foot with eyes closed, as well as time used for timed up go test with a minimal space of 2.5 meters differed significantly across normal BMD, osteopenia and osteoporosis groups (P<0.05) . The number of elbow bending within 30 seconds showed no significant differences across the three groups (P>0.05) .

Conclusion

In elderly men, abdomen circumference, body mass index, high-density lipoprotein cholesterol, 25 (OH) D3, and estradiol may independently associated with osteoporosis. Physical fitness indices varied significantly by BMD, especially flexibility, balance, aerobic capacity and agility/mobility.

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7. Efficacy and Safety of Combination Therapy with Tadalafil and Tamsulosin in Treating Lower Urinary Tract Symptoms and Erectile Dysfunction in Men:a Meta-analysis 
LI Jinze,PENG Lei,LI Yunxiang,WEI Tangqiang,XIONG Wei,NIU Chao,ZHANG Zongping
Chinese General Practice    2021, 24 (14): 1813-1819.   DOI: 10.12114/j.issn.1007-9572.2021.00.461
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Background Tamsulosin and tadalafil(TAD)have been widely used for the treatment of lower urinary tract symptoms(LUTS)and erectile dysfunction(ED).However,the efficacy and safety of the combination therapy of these two medicines for LUTS and ED in men is still controversial.Objective To systematically investigate the efficacy and safety of TAD plus tamsulosin compared with TAD monotherapy in treating men with LUTS and ED.Methods PubMed,EMBase,Cochrane Central Register of Controlled Trials,SinoMed,CNKI,WanFang Data Service Platform,and CQVIP databases were searched extensively from inception to February 29,2020 to obtain eligible studies comparing the efficacy and safety of TAD plus tamsulosin and TAD monotherapy in treating men with LUTS and ED.Data were extracted,such as the name(s)of the first author(s),year of publication,geographical location(country)of the research setting,types of research,sample size,age and BMI of the subjects,interventions,dosage,follow-up time and outcome indicators 〔total International Prostate Symptom Score(IPSS)score,IPSS storage subscore,IPSS voiding subscore,quality of life score,maximum urinary flow rate,post-void residual urine volume and International Index of Erectile Function-5(IIEF-5)score〕,incidence of adverse events(including total incidence of adverse events,incidence of headache,myalgia,back pain,dizziness,nasopharyngitis and ejaculation dysfunction),and rate of treatment discontinuation due to adverse events.Revman 5.3.0 was used for data evaluation and statistical analysis.Results Six studies were included,all were assessed with high methodological quality,involving 776 cases,394 in the combination group and 382 in the TAD group.The results of the meta-analysis indicated that compared with the TAD group,the combination group obtained more benefits from treatment in aspects of total IPSS score 〔MD=-2.67,95%CI(-3.82,-1.50),P<0.001〕,IPSS storage subscore 〔MD=-0.55,95%CI(-0.85,-0.26),P=0.000 2〕,IPSS voiding subscore 〔MD=-0.97,95%CI(-1.43,-0.51),P<0.001〕,quality of life score 〔MD=-0.37,95%CI(-0.51,-0.23),P<0.001〕,and maximum urinary flow rate 〔MD=1.45,95%CI(0.90,1.99),P<0.000 01〕.However,there were no significant differences in post-void residual urine volume 〔MD=-4.22,95%CI(-12.82,4.39),P=0.34〕,IIEF-5 score 〔MD=0.44,95%CI(-0.23,1.11),P=0.19〕,the incidence of adverse events 〔OR=1.43,95%CI(0.98,2.08),P=0.06〕,the incidence of headache 〔OR=1.34,95%CI(0.66,2.72),P=0.42〕,myalgia 〔OR=1.56,95%CI(0.64,3.82),P=0.33〕,back pain 〔OR=1.45,95%CI(0.40,5.22),P=0.57〕,dizziness 〔OR=1.14,95%CI(0.27,4.76),P=0.86〕,nasopharyngitis 〔OR=0.47,95%CI(0.10,2.21),P=0.34〕,ejaculatory dysfunction 〔OR=3.81,95%CI(0.44,32.97),P=0.22〕,and the rate of treatment discontinuation due to adverse events 〔OR=1.44,95%CI(0.88,2.35),P=0.15〕 between the two groups.Conclusion Both therapies have similar beneficial effects on ED and similar safety,but the combination of TAD plus tamsulosin is more effective for the improvement of the LUTS.Hence,the combination therapy may be recommended as a suitable option for men with both LUTS and ED.However,due to limited evidence,high-quality randomized controlled trials are required to further confirm these findings.
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8. Glucose Variability and Osteoporosis in Newly Diagnosed Male Patients with Type 2 Diabetes Mellitus 
HU Jing
Chinese General Practice    2021, 24 (9): 1057-1060.   DOI: 10.12114/j.issn.1007-9572.2020.00.630
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Background Diabetic patients have high risk of osteoporosis.There have been many reports on the adverse effects of persistent hyperglycemia on bone mineral density(BMD),but there are few reports on the relationship between glucose variability and osteoporosis.Objective To explore the relationship between glucose variability and osteoporosis in newly diagnosed male T2DM patients.Methods 115 newly diagnosed male T2DM patients were prospectively selected from Department of Endocrinology,People's Hospital of Ningxia Hui Autonomous Region from January 2018 to January 2019.Clinical data were collected,including calculated BMI,fasting plasma glucose,serum calcium,phosphorus,and lipid profile indicators(total cholesterol,triacylglycerol,high-density lipoprotein and low-density lipoprotein) in the sample collected from the median cubital vein in the early morning after fasting for more than 8 hours,and 2-hour postprandial glucose,fasting insulin,fasting C-peptide(FC-P),2-hour postprandial insulin,2-hour postprandial C-peptide(2 hC-P),homeostasis model assessment-insulin resistance(HOMA-IR),and glycosylated hemoglobin(HbA1c),L1-L4 BMD,glucose variability evaluated based on plasma glucose measured at 7 time points(before and after three meals,and at 2:00),and calculated standard deviation of blood glucose(SDBG),postprandial glucose excursion(PPGE),largest amplitude of glycemic excursion(LAGE),coefficient of variation for fasting plasma glucose(CV-FPG),and mean plasma glucose.The above-mentioned indicators were compared between those who were detected with osteoporosis(n=60) and those without(n=55).Correlation of glucose variability with BMD was analyzed by Pearson correlation analysis.Results T2DM patients with osteoporosis were found with higher mean HOMA-IR,HbA1c,SDBG,PPGE,LAGE,CV-FPG and mean plasma glucose,and lower mean high-density lipoprotein,FC-P,2 hC-P and BMD compared to those without(P<0.05).BMD was negatively correlated with age,SDBG,PPGE,LAGE,2 hPG,low-density lipoprotein,HOMA-IR and HbA1c(r=-0.501,-0.325,-0.436,-0.111,-0.603,-0.506,-0.324,-0.712,P<0.05),and positively correlated with serum calcium and 2 hC-P (r=0.029,0.015,P<0.05).After adjusting for age and BMI,BMD was positively correlated with 2 hC-P(r=0.008,P<0.05) and negatively correlated with HbA1c,SDBG and LAGE(r=0.519,0.285,0.399,P<0.05).Conclusion BMD was positively correlated with 2 hC-P and negatively correlated with HbA1c,SDBG and LAGE,indicating that glucose variability may be closely related to BMD in newly diagnosed male patients with T2DM,and controlling glucose variability may have a positive effect on the prevention and treatment of osteoporosis.
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9. The Clinical Characteristics of Epilepsy Caused by a New Mosaicism Mutation of PCDH19 Gene in a Man were Analyzed and the Literature was Reviewed 
WU Wenjuan,HU Jintong,TANG Hongxia,ZHANG Xiaoqing,LI Aixia,LI Baoguang,SUN Suzhen
Chinese General Practice    2020, 23 (29): 3751-3756.   DOI: 10.12114/j.issn.1007-9572.2020.00.466
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PCDH19 gene mutations mainly cause epilepsy confined to women with mental retardation.Because of its special inheritance,it mainly leads to female heterozygosity.At present,more than 200 cases of PCDH19 mutation female cases have been reported,and their clinical characteristics have been more clear.There are still few reports of male patients with PCDH19 gene mutation.The clinical features of its onset are not yet clear,and further research is urgently needed.This article reports the clinical data of a case of male Mosaicism with pathogenic mutation of PCDH19 gene.The results of genetic testing suggest that PCDH19 c.1078 (exon 1) G> A (p.Glu360Lys) mutation is a new mutation and broadens the mutation of PCDH19 gene.Pathogenic gene phenotype profile.After literature search and analysis,the clinical data of 13 cases of male Mosaicism with pathogenic mutation of PCDH19 gene in males with sex chromosome karyotype of XY type reported in the past.The incidence characteristics of 14 male chimeras were:(1)all had seizures,100% had cluster seizures,78.6% had heat sensitivity,the onset age was 5 to 31 months,and the median age was 9 months.The first seizure was usually a generalized seizure.Tonic clonic seizures were common.Focal seizures are common,with a status epilepticus in 35.7% of the course of the disease.(2)Most of the intelligence is normal before the seizure,and about 76.9% after the seizure have intellectual disability and mental symptoms.Provide a theoretical basis for clinical diagnosis and treatment of children with PCDH19 gene mutation.
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10. Association between Serum 25-hydroxy Vitamin D and Microalbuminuria in Overweight or Obese Male Patients with Type 2 Diabetes 
GUO Jiuchang,ZHANG Lin,YANG Dan,YANG Xiaoxia,LI Mingze,LIAO Xin,GAO Lin
Chinese General Practice    2020, 23 (15): 1884-1888.   DOI: 10.12114/j.issn.1007-9572.2020.00.229
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Background The associations of vitamin D with obesity,obesity-related complications,diabetes and diabetes-related complications have become a new study field and a hot topic.However,there are few reports on the association of vitamin D with early diabetic kidney disease(EDKD) in overweight or obese populations.Objective To explore the association between serum 25-hydroxy vitamin D〔25(OH)D〕 level and microalbuminuria(MAU) in overweight or obese male patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods A total of 261 newly diagnosed male T2DM patients from the Affiliated Hospital of Zunyi Medical University were enrolled from January to December 2018.They were divided into DM group(82 with DM),microalbuminuria(MAU) group(47 with normal body weight complicated by MAU),OWB-DM group(65 with overweight or obesity),and OWB-MAU group(67 with overweight or obesity complicated by MAU) according to 24 hour urinary albumin excretion rate(UAER) and body mass index(BMI).By serum 25(OH)D level,overweight or obese patients were divided into quartiles 1,2,3,4 groups〔Q1 group,serum 25(OH)D<18.13 μg/L,n=33;Q2 group,18.13 μg/L≤serum 25(OH)D<21.22 μg/L,n=33;Q3 group,21.22≤μg/Lserum 25(OH)D<24.32 μg/L,n=32;Q4 group,serum 25(OH)D≥24.32 μg/L,n=34〕.The clinical data of male T2DM patients were collected,the correlation between 24 h UAER and other indicators in overweight or obese male T2DM patients,and the relationship between serum 25(OH)D level and MAU were analyzed.Results There were significant differences in mean levels of BMI,systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),2-hour postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA1c),total cholesterol (TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),homeostasis model assessment of insulin resistance index(HOMA-IR),estimated glomerular filtration rate(eGFR)and serum 25(OH)D among DM,MAU,OWB-DM and OWB-MAU groups (P<0.05).The mean level of serum 25(OH)D in MAU group〔(20.84±4.12)μg/L〕,OWB-DM group〔(23.46±3.35)μg/L〕 or OWB-MAU group〔(18.00±4.46)μg/L〕 was significantly decreased compared with that of DM group〔(26.14±3.40)μg/L〕(P<0.05).The mean serum 25(OH)D level in OWB-MAU group was significantly lower than that of MAU and OWB-DM groups(P<0.05).Q1 group〔72.80(54.70,133.20)mg/24 h〕 had much higher mean 24 hUAER level than Q2〔38.50(18.25,78.85)mg/24 h〕,Q3〔27.90(19.95,69.80)mg/24 h〕,Q4〔20.0(13.20,24.50)mg/24 h〕groups(P<0.05).The mean 24 hUAER level in Q4 group was much lower than that of Q2 and Q3 groups(P<0.05).Spearman correlation analysis showed that 24 hUAER was negatively correlated with serum HDL-C and 25(OH)D levels(rs=-0.199,-0.405,P<0.05),and was positively correlated with BMI,SBP,DBP,2 hPG and TG(rs=0.257,0.350,0.282,0.421,0.202,P<0.05) in overweight or obese patients.Binary Logistic regression analysis showed that 25(OH)D,SBP and 2 hPG were independent influencing factors for MAU in overweight or obese male patients(OR=0.717,1.173,1.327,P<0.05).Conclusion The level of serum 25(OH)D in overweight or obese T2DM male patients was lower than those with normal weight.24 hUAER was closely related to decreased serum 25(OH)D,disorders of glucose and lipid metabolism,and increased blood pressure.Decreased serum 25(OH)D and increased SBP and 2hPG may be involved in the progression of EDKD in overweight or obese male patients.
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11. Study on Related Factors for Male Psychiatric Patients with Violent Behavior 
ZHEN Wenfeng,MA Xin,LIN Xiangji,WANG Hongxing
Chinese General Practice    2020, 23 (14): 1790-1795.   DOI: 10.12114/j.issn.1007-9572.2019.00.812
Abstract566)      PDF(pc) (1097KB)(322)    Save
Background Some psychiatric patients,mainly male patients,may have violent behavior,often causing accidents and misconduct,but there is a lack of analytical research on the factors on related factors of violent behavior in this type of patients.Objective To explore the related factors of violent behavior of male psychiatric patients,and help to prevent the occurrence of violent behavior.Methods From March 2014 to January 2016,96 male patients who were judged by the Judicial Appraisal Center of Beijing Ankang Hospital and met the criteria were included in the study group,and 65 patients with mental illness admitted to Beijing Anding Hospital were included in the control group.This study was a case-control study.we used a self-made questionnaire to investigate the patient's general information,including age,years of schooling,marital status,ethnicity,education,place of residence,occupation;history of the disease,including the age of first onset,treatment,history of craniocerebral disease,history of alcohol consumption,history of smoking and suicide,number of past hospitalizations;overview of personal growth history,including whether you lived in poor family environment in childhood,whether you were abused by parents,whether you were abandoned by parents,parental health status,parental marriage status,mental illness hospitalization records,whether your parents had a criminal record,whether your parents had alcohol or substance abuse history,the way of living,whether the family was harmonious,and family monthly income;family history,including family crime history,family psychosis history.The Psychological Correction Scale Revision(PCL-R) was used to evaluate the personality characteristics of patients.The Concise Psychiatric Rating Scale(BPRS) was used to evaluate the psychiatric symptoms of patients.The Modified Explicit Attack Behavior Scale(MOAS) was used to evaluate patient's attacks behavior.The questionnaire was filled out after two investigators who were trained in the consistency of the questionnaire asked the patients who was identified or on the day of admission or their family members.Results Judicial identification results showed that most of the psychiatric patients with violent behaviors were schizophrenia(82 cases,accounting for 85.4%).The study group and the control group had statistically significant in education level,place of residence,occupation,treatment status,number of previous hospitalizations,and monthly household income per capita(P<0.05).Compared with the control group,the study group had higher anti-social factor score of PCL-R,higher thinking disorder score,hostile factor score and the total score of BPRS,and property attack weighted score,physical attack weighted score and total weighted score of MOAS(P<0.05).Multivariate Logistic regression analysis showed that the educational level 〔OR=8.732,95%CI(1.268,60.123)〕,treatment 〔OR=45.846,95%CI(4.254,494.149)〕,property attack weighted score 〔OR=0.044,95%CI(0.006,0.321)〕,physical attack weighted score 〔OR=0.035,95%CI(0.005,0.246)〕 was the influencing factor of the occurrence of violent behaviors in male psychiatric patients(P<0.05).Conclusion Male psychiatric patients with violent behaviors were mostly schizophrenia patients.Low levels of education,lack of active treatment,property attacks tendency,and physical attack tendency are the risk factors for the occurrence of violent behaviors in male psychiatric patients.To strengthen cultural education and active treatments may help to reduce the occurrence of accidents in such patients.
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12. Use of Geosocial Networking Smartphone Applications and Associated Sexual Behaviors and Sexually Transmitted Infections among Men Who Have Sex with Men:a Systematic Review 
WANG Haidong,ZHANG Lu,ZHOU Ying,WANG Guoli,WU Jianhui
Chinese General Practice    2019, 22 (32): 3969-3974.   DOI: 10.12114/j.issn.1007-9572.2019.00.161
Abstract1703)      PDF(pc) (1114KB)(787)    Save
Background In recent years,a number of global positioning system(GPS)-equipped smartphone applications(App) designed to serve men who have sex with men(MSM) have been developed and achieved great popularity in this population.Increased use of these App may facilitate finding casual sexual partners,resulting in unsafe sexual practices.Objective The purpose of this systematic review was to summarize the evidence of the use of MSM App and associated sexual behaviors and sexually transmitted infections(STI) in MSM population.Methods Databases of PubMed,Wanfang Data Knowledge Service Platform and CNKI were searched for articles included between 2005 and 2017 about the use of App and associated sexual health or behaviors in MSM population,and studies concerning sexual behaviors and STI in MSM who use App and those do not.Data about number of male sexual partners,group and unprotected sexual practices,as well as testing and definite diagnosis of STI were extracted from the eligible studies.Results Twenty-three articles concerning 21 studies were included.App-users were more likely to have more than 5 male sex partners in the past 12 months than non-users.Compared with non-users(8.5%),App-users(10.9% to 13.2%) reported engaging in more group sexual practices in the last 6 months.However,one study found that App-users were less likely to have group sexual practices than non-users in the past 12 months(the prevalence was 8.8% and 10.3%,respectively).The prevalence of unprotected sexual practices in the past 6 months among App-users ranged from 31.9% to 50.5%,while that of non-users ranged from 26.3% to 35.6%.Compared with non-users(32.6%),App-users(29.9% to 88.6%) were more likely to have lifetime STI testing.The self-reported prevalence of prior diagnosis of STI among App-users ranged from 11.9% to 51.1%,while that of non-users was 23.2%.Conclusion The increase in MSM using these App may produce more adverse effects on sexual health.
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13. Risk of HPV-16/18 Infections in MSM Population:a Latent Class Analysis 
GONG Zheng,ZHANG Zhanlin,YELEDAN?Mahan,TUO Xiaoqing,CHEN Zhen,GULISIYA?Hailili,DAI Jianghong
Chinese General Practice    2019, 22 (29): 3549-3553.   DOI: 10.12114/j.issn.1007-9572.2019.00.057
Abstract707)      PDF(pc) (1056KB)(836)    Save
Background In recent years,men who have sex with men (MSM) become a group with a high incidence of sexually transmitted diseases(STDs),especially HPV 16/18 infection incidence remains high.HPV infection will develop into STDs if it is not effectively controlled.So it is important to research the main influencing factors for high incidence of HPV 16/18 infection in MSM.Objective To explore the risk of HPV 16/18 infection in MSM in Urumqi with latent class analysis (LCA),providing a scientific basis for the delivery of targeted interventions for this population.Methods From March 2016 to August 2017,a survey was conducted in a snowball sample of 884 MSM in Urumqi.Participants' general demographic characteristics,sexual behavior characteristics and HPV infection-related factors were collected.HPV 16/18 genotypes were detected.Class of risk of HPV16/18 infection was identified by LCA.Results Nine variables including sex,sexual intercourse pattern,commercial sexual behavior,use of drugs,history of sexually transmitted infections,condom use,anal intercourse,sexual orientation and circumcision were included.The AIC and BIC models with 3 potential categories are the lowest and the best models.According to the characteristics of sexual behavior and the related factors of HPV infection,the patients were divided into low risk group (520 cases),medium risk group (290 cases) and high risk group (74 cases). The infection rates for these groups were 9.2%,14.5% and 24.3%,respectively,and high risk group showed much higher infection rate than low risk group(P<0.05). Conclusion LCA can be used to stratify the risk of HPV-16/18 infections in MSM.
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14. The Dilemma of Breast Cancer in Males and Research Progress 
YE Zengjie,LIANG Muzi
Chinese General Practice    2019, 22 (26): 3260-3264.   DOI: 10.12114/j.issn.1007-9572.2019.00.084
Abstract421)      PDF(pc) (2773KB)(537)    Save
Breast cancer in men (BCM) is rare and accounts for appropriately 1% of breast cancer(BC).Compared with breast cancer in women (BCW) BCM is often neglected by clinicians because of its low incidence.Men patients are routinely excluded in most clinical trials of breast cancer treatments,resulting in the dilemma where no clinical guideline could be used to the diagnosis and treatment of BCM.What's more,influenced by Chinese cultural issues,patients with BCM are not willing to talk about breast cancer with their clinicians and it will surely affect the prognosis of BCM.Thus,this study is performed to report updated information about epidemiological characteristics and potential risk factors,clinical manifestations and assessment,pathological features,prognostic factors,treatment and detection,follow-up and prospects after treatment by searching literatures,providing physicians some suggestions and research direction of BCM treatment.
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15. Relationship of Lipid Accumulation Product and Alcohol Consumption with Risk of Hypertension in Men 
SUN Liangliang,XIE Hong,ZHANG Yanfang,WANG Lihua
Chinese General Practice    2019, 22 (25): 3094-3098.   DOI: 10.12114/j.issn.1007-9572.2019.00.438
Abstract518)      PDF(pc) (1004KB)(313)    Save
Background Heavy alcohol consumption and obesity are two important modifiable risk factors for hypertension,and the mechanisms of the two risk factors leading to hypertension are similar.Lipid accumulation product(LAP),a new obesity index,is more closely related to metabolic diseases.There may be interactions between high LAP and heavy alcohol consumption on the risk of hypertension in men.Objective To explore the relationship of LAP and alcohol consumption with the risk of hypertension in men,and to analyze whether there is additive interaction between high LAP and heavy alcohol consumption.Methods Stratified random sampling method was used to select 1 822 permanent male residents over 18 years in Longzihu District of Bengbu from July to August 2015,and 1 306 of them were eligible for the final analysis.Participants were divided into non-hypertension groups(n=673) and hypertension(n=633),and intergroup comparison of the demographic characteristics,results of the physical examination,laboratory examination results.The Youden's index was used to determine the optimal cut-off point of LAP screening for hypertension.High LAP was defined as equal to or higher than the optimal cut-off point.Multivariate Logistic regression was used to analyze the relationship of high LAP and/or heavy alcohol consumption with the risk of hypertension,and to further assess the impact of interaction between high LAP and heavy alcohol consumption on hypertension.Synergy index(SI),relative excess risk due to interaction(RERI),and the attributable proportion due to interaction(AP)were calculated.Results There were significant differences in age,alcohol consumption,physical activity and family history of hypertension between hypertension and non-hypertension groups(P<0.05).The total cholesterol,triglyceride,fasting blood glucose,glycosylated hemoglobin,waist circumference,body mass index and LAP in hypertension group were significantly higher than those in non-hypertension group(P<0.05).The optimal cut-off point of LAP in the screening of hypertension was 29.69 cm•mmol/L(sensitivity and specificity were 0.64,0.59,respectively).After adjusting for age,smoking,physical activity and family history of hypertension,participants with high LAP〔OR=2.79,95%CI(2.19,3.55)〕or heavy alcohol consumption〔OR=1.60,95%CI(1.15,2.21)〕had a higher risk of hypertension.And the risk was even higher for those with both high LAP and heavy alcohol consumption〔OR=4.75,95%CI(3.10,7.27),SI=1.64,95%CI(0.91,2.98),RERI=1.47,95%CI(-0.47,3.40),and AP=0.31,95%CI(<0.01,0.62)〕.Conclusion High LAP or heavy alcohol consumption increased the risk of hypertension in men.And the risk would be higher if both high LAP and heavy alcohol consumption coexist.But no significant additive interaction was found between the two factors on the risk of hypertension.
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16. Age-specific Cut-off Point for the Determination of Populations  of Late-onset Hypogonadism:a Study Conducted in Community-dwelling Middle-aged and Older Males in Chengdu 
YANG Fan,JIANG Xiaobo,CAO Hongyi,TANG Yi,YANG Jing,REN Xin,KANG Jun,WAN Haiyan
Chinese General Practice    2019, 22 (24): 2996-2999.   DOI: 10.12114/j.issn.1007-9572.2018.00.318
Abstract533)      PDF(pc) (1124KB)(580)    Save
Background Male late-onset hypogonadism (LOH)is a clinical and biochemical syndrome associated with aging.It will severely affect the quality of life and bring adverse effects on multiple organs .At present,there is no unified diagnostic criteria at home and abroad,and the incidence of LOH varies in different regions.Objective To investigate the prevalence of LOH and identify age-specific cut-off point for the determination of LOH among community-dwelling middle-aged and older males in Chengdu.Methods By use of stratified sampling,we selected 800 males aged 30-70 from the fixed populations living in Chengdu Banknote Printing Company Community in Chengdu's Wenjiang District during May to August 2017,and 709 of them including 231(32.6%) aged 30-39,168(23.7%) aged 40-49,178(25.1%) aged 50-59,and 132(18.6%) aged 60-69 were finally enrolled according to the exclusion criteria.The Androgen Deficiency in Aging Males(ADAM) questionnaire was used to screen LOH.Serum total testosterone was measured to identify LOH.Chi-square test was used to compare the prevalence of LOH among different age groups.Spearman rank correlation analysis was used to explorethe relationship between age and the prevalence of LOH.ROC curve analysis was performed to determine the age-specific cut-off point for the determination of high risk population of LOH.Results The prevalence of LOH in all participants assessed by ADAM score,serum TT level,and ADAM score combined with serum TT level was 67.1%,19.0%,17.9%,respectively.The prevalence of LOH assessed by ADAM score,serum TT level,and ADAM score combined with serum TT level differed significantly between the four age groups(P<0.05).The prevalence of LOH in all participants assessed by ADAM score,or ADAM score combined with serum TT level increased with age(rs=0.238,0.231,P<0.05).The optimal age-specific cut-off points for the identification of LOH by ADAM score,serum TT level,and ADAM score combined with serum TT level were 42.5,50.5,53.5,respectively.Conclusion The prevalence of LOH in community-dwelling middle-aged and older males in Chengdu is high,and it correlates with age.The age-specific cut-off point  of LOH is 40-55 years old,but it needs to be further verified.
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17. Relationship of Nutritional Status with Urine Gonadotropin and Sex Hormones in Preschool Boys 
WANG Yong,CHEN Chunmei,MA Yaping,HANG Biao,HANG Yin,RUI Fang,YAO Min,QIN Liqin,BEN Ze,NIE Shuang,XU Zhuangjian
Chinese General Practice    2019, 22 (20): 2416-2421.   DOI: 10.12114/j.issn.1007-9572.2019.00.031
Abstract571)      PDF(pc) (1088KB)(869)    Save
Background Nutritional status may affect gonadotropin(Gn)and sex hormone levels in children.Currently,related studies mainly focus on the effect of nutritional status on the above hormones in blood of children over 7 years old,with relatively small sample sizes.Objective To explore the levels of urine Gn and sex hormones in normal preschool boys with different nutritional status,providing a reference for epidemiological study and clinical application of urine Gn and sex hormones using non-invasive approaches.Methods Preschool boys at least 3 years of age but less than 7 were selected from Mashan Street and Hudai communities,Jiangsu's Wuxi from May 2015 to December 2016.Height and weight were measured,and height-for-age Z-score(HAZ),weight-for-age Z-score(WAZ)and BMI-for-age Z-score(BAZ)were calculated.According to HAZ,WAZ and BAZ,they were divided into 6 groups,respectively.The first morning urine samples were collected.The urinary luteinizing hormone(ULH),urinary follicle-stimulating hormone(UFSH),urinary estriol (UE3),urinary estradiol(UE2),and urinary testosterone(UT)were determined by immunochemiluminometric assay.Kruskal-wallis H test was used to compare the differences among HAZ,WAZ and BAZ groups,respectively.Kruskal-wallis one-way ANOVA was conducted to compare the differences between HAZ,WAZ and BAZ groups,respectively.Spearman rank correlation was performed to analyze the correlations of urine Gn and sex hormones with HAZ,height,WAZ,weight,BAZ and BMI.Results A total of 871 boys who met the inclusion criteria with successful urine specimen collection were included.The detection rates of ULH,UFSH,UE3,UE2 and UT were 6.7%(58/871),99.4%(866/871),99.7%(868/871),99.8%(869/871)and 98.0%(854/871),respectively.UE3 showed significant differences among HAZ groups(P<0.05),in particular,UE3 in Hc group was much lower than that of He and Hf groups,and UE3 in He group was much higher than that of Hd group(P<0.05).UE2 differed significantly among HAZ groups(P<0.05),to be specific,UE2 in Hb group was much higher than that of Ha,Hc and Hd groups,and UE2 in Hc group was much lower than that of He and Hf groups(P<0.05).UT varied significantly among HAZ groups(P<0.05),to be specific,UT in Hc group was much lower than that of He and Hf groups,and UT in Hd group was obviously lower than that of He group (P<0.05).UFSH,UE3,UE2 and UT differed significantly among WAZ groups(P<0.05).In particular,Wf group had much higher UFSH than Wc,Wd and We groups(P<0.05);Wf group showed obviously higher UE3 than Wc,Wd and We groups(P<0.05);Wc group had much lower UE2 than Wb group,and Wf group demonstrated significantly higher UE2 than Wc,Wd and We groups (P<0.05);Wf group presented significantly higher UT than Wc,Wd and We groups(P<0.05).UFSH,UE3,UE2 and UT varied significantly among BAZ groups(P<0.05).Specifically,Bf group had much higher UFSH than Bb,Bc and Bd groups(P<0.05);Bd group had much lower UE3 than Bb group,and Bf group showed obviously higher UE3 than Bc,Bd and Be groups (P<0.05);Bd group had much lower UE2 than Bb group,and Bf group demonstrated much higher UE2 compared with Bc,Bd and Be groups (P<0.05);Bf group demonstrated much higher UT compared with Bb,Bc,Bd and Be groups(P<0.05).The correlation analysis showed that UFSH was positively correlated with height(rs=0.095,P<0.05).UE3 was positively correlated with HAZ(rs=0.106),height(rs=0.231),WAZ(rs=0.082),BAZ(rs=0.106)and BMI(rs=0.084,P<0.05).UE2 was positively correlated with HAZ(rs=0.081),height(rs=0.164)and BAZ(rs=0.081,P<0.05).UT was positively correlated with HAZ(rs=0.102),height(rs=0.217),WAZ(rs=0.074),weight(rs=0.070),BAZ(rs=0.102) and BMI(rs=0.080,P<0.05).Conclusion In normal preschool boys,the ULH content is low,and urine Gn and sex hormones differ by nutritional status.UE3,UE2 and UT tend to be increased with the improvement of nutritional status in a short period of time.Therefore,the nutritional status in this population should be concerned in order to ensure their healthy growth.
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18. Interpretation of the Adult Well-male Examination by American Academy of Family Physician 
WANG Yang,XU Yanli
Chinese General Practice    2019, 22 (14): 1637-1640.   DOI: 10.12114/j.issn.1007-9572.2019.00.144
Abstract906)      PDF(pc) (1360KB)(782)    Save
Health examination is a basic ways and effective mean for disease prevention and health management.In December 2018,the American Family Physician published the latest guidelines for adult well-male examination.There is still no universally accepted guideline in this field in the United States.Therefore,it is the first evidence-based guideline for to men's health examination in primary care published by American Academy of Family Physician (AAFP).This article refines and summarizes the core content of the guideline,and compares it with Expert Consensus about Basic Project in Physical Examination,to provide external reference for general practitioners and patients in China.
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19. Prevalence of Benign Prostatic Hyperplasia with Fatty Liver Disease and Its Influencing Factors among Male University Teachers 
HUANG Zhijie,HU Yiping,LIU Fengqin,WANG Haoxiang,ZHOU Zhiheng,CHEN Baoxin,OU Wensen,WU Wenlin,YANG Zhipeng,ZHANG Man,ZHONG Yongyi,WANG Jiaji
Chinese General Practice    2019, 22 (3): 292-295.   DOI: 10.12114/j.issn.1007-9572.2018.00.177
Abstract558)      PDF(pc) (1077KB)(515)    Save
Background The incidence of benign prostatic hyperplasia(BPH) or fatty liver disease(FLD) in male university teachers is high,and both diseases are often accompanied.At present,the pathogenesis of the two diseases and the causes of their concomitant diseases are not clear yet.Objective To explore the prevalence rate of BPH with FLD and its influencing factors among male university teachers,providing a basis for the formulation of targeted prevention and control strategies.Methods The enrolled 2 136 male university teachers were sampled from individuals undergoing physical examination in the physical examination center of a university hospital in Guangzhou between January 2016 and January 2017,including 500 with BHP(BHP group) and 311 with BHP and FLD (combination group).Clinical data of these two groups were analyzed comparatively.Influencing factors of BHP combined with FLD were analyzed by using multivariate Logistic regression.Results Totaled 811 cases(38.0%) were found with BHP,311 of whom (38.4%) were identified with FLD.Those with BHP and FLD demonstrated significantly increased mean levels of BMI,urine protein,fasting blood glucose(FBG),urine specific gravity(USG),uric acid(UA),low-density lipoprotein,triacylglycerol(TG),diastolic blood pressure compared with those with BHP (P<0.05).Multivariate Logistic regression analysis showed that increased BMI〔OR=1.447(1.306,1.603),P<0.001〕,FBG〔OR=1.694 (1.365,2.103),P<0.001〕,UA〔OR=1.003(1.000,1.006),P<0.05〕and TG〔OR=1.590 (1.186,2.132),P<0.05〕were risk factors for BHP combined with FLD,while increased high-density lipoprotein was the protective factor for BHP combined with FLD〔OR=0.389(0.162,0.931),P<0.05〕.Conclusion The prevalence rate of BHP combined with FLD is higher than that of BHP among male university teachers.BMI,FBG,TG,UA and high-density lipoprotein are the influencing factors of BHP combined with FLD.
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20. Value of Serum Uric Acid in Predicting Metabolic Syndrome in Obese Male Children 
XU Xiao-hua,DONG Guan-ping,WU Wei,HUANG Ke,JIN Wei,YAO Qi-hong,WANG Ling,FU Jun-fen
Chinese General Practice    2018, 21 (22): 2707-2711.   DOI: 10.12114/j.issn.1007-9572.2018.00.012
Abstract435)      PDF(pc) (1090KB)(399)    Save
Objective To evaluate the value of serum uric acid (SUA) in predicting metabolic syndrome (MS) in obese male children.Methods We enrolled 256 obese male children from Department of Endocrinology,The Children's Hospital,Zhejiang University School of Medicine,Department of Pediatrics,The First Affiliated Hospital of Huzhou University,Department of Pediatrics,Huzhou Maternal & Child Care Hospital between June 2008 and October 2015,including 118 with MS and 138 without.We collected and compared their data about physical examination and laboratory findings.Performance analysis of different combinations of markers for the prediction of MS was conducted using area under the ROC curve (AUC),sensitivity,specificity and Cohen's Kappa coefficient(κ).Results For the prediction of MS,the AUC of SUA 〔0.631,95%CI(0.562,0.970)〕was significantly different from that of triglycerol(TG)〔0.878,95%CI(0.833,0.932),Z=5.898,P<0.001〕and high-density lipoprotein cholesterol (HDL-C)〔0.787,95%CI(0.730,0.844),Z=3.432,P<0.001〕,but similar to that of systolic blood pressure (SBP)〔0.688,95%CI(0.621,0.754),Z= 1.168,P= 0.243〕,diastolic blood pressure (DBP)〔0.592,95%CI(0.251,0.667),Z=0.777,P=0.437〕,low-density lipoprotein cholesterol(LDL-C)〔0.664,95%CI(0.598,0.731),Z=0.676,P= 0.449〕,fasting plasma glucose(FPG) 〔0.642,95%CI(0.571,0.713),Z=0.219,P=0.827〕,2 h-postprandial plasma glucose(2 h PG)〔0.647,95%CI(0.576,0.718),Z=0.319,P=0.750〕.The sensitivity of TG in serial combination with SUA was significantly different from that of TG in serial combination with FPG or 2 h PG,TG in serial combination with HDL-C or LDL-C and TG in serial combination with hypertension(P<0.001);TG in serial combination with SUA showed obviously different specificity compared with TG in serial combination with FPG or 2 h PG(P=0.001) as well as TG in serial combination with hypertension(P<0.001),but was similar to that of TG in serial combination with HDL-C or LDL-C(P=0.324).The κ of TG in serial combination with SUA did not significantly differ from that of TG in serial combination with FPG or 2 h PG,TG in serial combination with HDL-C or LDL-C,TG in serial combination with hypertension(Z=1.913,0.389,1.057;P=0.056,0.697,0.291).The κ for measuring the extent of agreement was 0.357 between TG in serial combination with SUA and TG in serial combination with FPG or 2 h PG,0.554 between TG in serial combination with SUA and TG in serial combination with HDL-C or LDL-C,0.459 between TG in serial combination with SUA and TG in serial combination with hypertension.Conclusion SUA can be used as a predictor of MS,and the prediction effect will be better if it is used in combination with TG.
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21. Evaluation of the Value of Transrectal Ultrasonography in Diagnosing Male Infertility #br#
LIU Gui-mei1,2,GE Hui-yu1*,RAN Wei-qiang1,CHEN Wen1,MENG Xiu-feng2
Chinese General Practice    2018, 21 (20): 2506-2510.   DOI: 10.3969/j.issn.1007-9572.2018.00.175
Abstract390)      PDF(pc) (1685KB)(1149)    Save
Objective To explore the value of transrectal ultrasound in diagnosing male infertility.Methods We summarized and analyzed the sonographic features of the ejaculatory duct,the seminal vesicles,and the terminal part of the vas deferens in patients with non-sexual dysfunction infertility who were treated at the Peking University Third Hospital between January 2014 and February 2016.Results Ultrasound examination revealed an abnormality rate of 49.29% (836/1 696) in the ejaculatory duct,seminal vesicle,and terminal vas deferens.The incidence of abnormalities in the ejaculatory duct was 31.72% (538 cases),including 458 cases(27.00%) of ejaculatory duct cysts,35 cases(2.06%) of ejaculatory duct calcification or stones,28 cases(1.65%) of ejaculatory duct cysts accompanied by stones,8 cases(0.47%) of ejaculatory duct expansion accompanied by stones,7 cases(0.41%) of ejaculatory duct expansion,and 2 cases(0.12%) of ejaculatory duct wall thickening.The incidence of seminal vesicle abnormalities was 32.02%(543/1 696),including 290 cases(17.10%) of congenital deficiency of the seminal vesicle,127 cases(7.49%) of congenital dysplasia of the seminal vesicle,81 cases(4.78%) of seminal vesicle expansion,25 cases(1.47%) of seminal vesicle stones,11 cases(0.65%) of seminal vesicle cysts,and 9 cases(0.53%) of seminal vesicle wall thickening.The rate of abnormalities in the terminal vas deferens was 8.20% (139/1 696),of which 109 cases(6.43%) had congenital deficiency or dysplasia of the vas deferens,11 cases (0.65%) had expansion of the terminal vas deferens,11 cases (0.65%) had vas deferens calcification or stones,8 cases(0.47%) had vas deferens wall thickened.Conclusion Transrectal ultrasound examination of male infertility can be used to diagnose patients with congenital and acquired lesions of the ejaculatory duct,seminal vesicles,and terminal vas deferens,thus providing clear diagnostic value and a basis for disease treatment.
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22. Localization of Upper Airway Obstruction in Male OSAHS Patients:a Comparative Study of Fibre Nasopharyngoscopy and Magnetic Resonance Imaging #br#
FENG Guo-fei,WANG Han-qing*,ZHUGE Pan,YOU Hui-hua
Chinese General Practice    2018, 21 (17): 2072-2076.   DOI: 10.3969/j.issn.1007-9572.2017.00.188
Abstract467)      PDF(pc) (1140KB)(664)    Save
Objective To investigate the results of upper airway parameters and localization of upper airway obstruction in males with varying degrees of obstructive sleep apnea hypopnea syndrome(OSAHS) detected by fibre nasopharyngoscopy(FN) versus magnetic resonance imaging(MRI),and based on this,to analyze the correlation and consistency of the two methods for the localization of upper airway obstruction in these patients.Methods We enrolled 93 OSAHS patients who received treatment in Department of Otolaryngology,Head and Neck Surgery,Jinhua Central Hospital from May 2014 to December 2015,including 32 with mild OSAHS(mild group),31 with moderate OSAHS(moderate group),and 30 with severe OSAHS(severe group).The collapse degree of the hinder parts of the soft palate,the tongue and epiglottis was measured with FN.The cross-sectional area,left-right dimension and front-back dimension of the hinder part and thickness of pharyngeal wall of the soft palate,the tongue and the epiglottis were measured by MRI.SPSS 15.0 statistical software was applied to analyze the measurement results of the two methods.Results The collapse degree,cross-sectional area,left-right dimension and front-back dimension of the hinder part of the soft palate,the tongue and epiglottis,and the lateral wall thickness of the epiglottis differed significantly between the three groups(P<0.05).Pearson correlation analysis found that,the collapse degree and the cross-sectional area of hinder part of epiglottis were positively correlated in the mild group(r=0.53,P=0.002),while they were negatively correlated in the moderate group(r=-0.53,P=0.002).The results of localization of upper airway obstruction by FN were consistency with MRI(Kappa=0.390,P=0.007).Conclusion Both FN and MRI can detect the airway soft tissue compliance and anatomical features in patients with varying degrees of OSAHS,but for the localization of upper airway obstruction,they have no correlation and consistency.Therefore,in order to comprehensively assess the upper airway obstruction in these patients,these two methods can be used together.
 
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23. 老年男性症状量表评分预测社区中老年男性血清睾酮相关指标异常的价值研究
熊世敏1,刘方苇1,史勇军1,余琴1,余纳2,申旭波3,李红钢4,熊承良4,周远忠1*
Chinese General Practice    2017, 20 (33): 4130-4135.   DOI: 10.3969/j.issn.1007-9572.2017.00.061
Abstract407)      PDF(pc) (740KB)(587)    Save
目的  探讨老年男性症状量表(AMS)评分预测社区中老年男性血清睾酮相关指标〔总睾酮(TT)、性激素结合球蛋白(SHBG)、黄体生成素(LH)、游离睾酮(cFT)、游离睾酮指数(FTI)、睾酮分泌指数(TSI)〕异常的价值,以期为临床筛查和诊断迟发性性腺功能减退症(LOH)提供参考依据。方法  根据遵义市的经济特征和生活方式,将社区分为城市、城镇、乡村3个层次,于2013年8-9月,采用分层整群抽样方法以1∶10的比例从每层中随机抽取7个社区/居委会/村作为抽样点。选取抽样点20岁及以上男性为调查对象,共收集到1 166份合格数据。以227例20~39岁居民的血清睾酮相关指标水平来确立男性血清睾酮相关指标异常切点值,采用939例40岁及以上居民的数据评价AMS评分预测血清睾酮相关指标异常的价值。采用自制调查问卷对居民进行调查,调查内容包括基本情况、家族史、既往史、AMS评分(设定AMS评分<27分为无LOH症状,≥27分为有LOH症状)。检测居民血清TT、SHBG、LH,计算cFT、FTI、TSI。结果  939例40岁及以上居民中,有LOH症状628例(66.9%),TT异常36例(3.8%,其中有LOH症状25例),SHBG异常203例(21.6%,其中有LOH症状155例),LH异常57例(6.1%,其中有LOH症状53例),cFT异常136例(14.5%,其中有LOH症状110例),FTI异常271例(28.9%,其中有LOH症状213例),TSI异常249例(26.5%,其中有LOH症状200例)。有LOH症状与无LOH症状居民TT比较,差异无统计学意义(P>0.05);有LOH症状居民SHBG、LH高于无LOH症状居民,cFT、FTI、TSI低于无LOH症状居民(P<0.05)。有LOH症状与无LOH症状居民TT异常率比较,差异无统计学意义(P>0.05);有LOH症状居民SHBG、LH、cFT、FTI、TSI异常率大于无LOH症状居民(P<0.05)。以AMS评分27分为临界值,AMS评分预测TT异常的总符合率较低,为34.61%,预测FTI、TSI异常的总符合率较高,分别为49.63%、49.20%。AMS评分预测TT异常的Kappa值为0.003,P=0.739;AMS评分预测SHBG、LH、cFT、FTI、TSI异常的Kappa值分别为0.069、0.049、0.065、0.118、0.123,P值均<0.01。结论  AMS评分预测TT异常的价值较差,预测FTI、TSI异常的价值较好。
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24. 高频超声对非性功能障碍男性不育患者阴囊疾病的诊断价值分析
刘桂梅1,葛辉玉1*,冉维强1,陈文1,方南宁1,孟秀峰2
Chinese General Practice    2017, 20 (30): 3791-3795.   DOI: 10.3969/j.issn.1007-9572.2017.06.y09
Abstract388)      PDF(pc) (1011KB)(575)    Save
目的  探讨高频超声对非性功能障碍男性不育患者阴囊疾病的诊断价值。方法  回顾性分析2014年1月-2016年1月北京大学第三医院的非性功能障碍男性不育症患者阴囊高频超声检查结果及图像特点,主要包括睾丸、附睾、输精管阴囊部、睾丸鞘膜腔及精索静脉的形态结构、内部回声及血流动力学等信息。结果  共选择男性不育症患者1 645例,高频超声检查显示阴囊异常发生率为76.8%(1 264/1 645)。睾丸异常发生率为35.0%(575/1 645),包括睾丸体积小249例(15.1%)、睾丸实质回声不均匀9;5例(5.8%)等;附睾异常发生率为59.9%(986/1 645),包括附睾囊肿582例(35.4%)、附睾体积增大153例(9.3%)等;输精管阴囊部异常发生率为1.8%(29/1 645),包括输精管阴囊部增粗、扩张、狭窄、闭塞;睾丸鞘膜腔异常发生率为4.4%(73/1 645),包括睾丸鞘膜腔积液52例(3.2%)和睾丸鞘膜腔结石21例(1.3%);精索静脉曲张发生率为34.5%(567/1 645),包括左侧396例(24.1%)、双侧147例(8.9%)、右侧24例(1.5%)。结论  高频超声可以清晰显示睾丸、附睾、输精管阴囊部、睾丸鞘膜腔和精索静脉正常及异常声像图,对男性不育者进行阴囊高频超声检查,有助于临床获得部分先天及后天影响男性不育的诊断和治疗依据。
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25. 绘画治疗对中年男性冠心病患者康复作用的研究
周月英1*,吕兰竹1,梁叶青1,李景珊2,曾汇庆1,黄新金1,伍焕平1
Chinese General Practice    2017, 20 (22): 2806-2810.   DOI: 10.3969/j.issn.1007-9572.2017.22.024
Abstract461)      PDF(pc) (801KB)(405)    Save
目的  了解绘画治疗对中年男性冠心病患者的康复作用。方法  选取2015年1月-2016年1月在佛山市顺德区桂洲医院门诊就诊和住院、年龄40~59岁的男性冠心病患者78例。采用随机数字表法将所有患者分成对照组(n=39)和观察组(n=39)。对照组仅接受规范药物治疗,观察组在对照组的治疗基础上进行团体和/或一对一绘画治疗,干预时间为6个月。所有患者康复治疗前后均接受心脏彩超、颈动脉彩超检查及生活质量评估。彩超检查的观察指标为左心室舒张末期内径(LVDD)、左心室射血分数(LVEF)及颈动脉内中膜厚度(IMT);生活质量评估量表包括简明36项健康问卷(SF-36)、西雅图心绞痛量表(SAQ)及心肌梗死后生活质量问卷(QLMI)。结果  两组患者治疗前SF-36生理健康、心理健康评分及健康总分比较,差异无统计学意义(P>0.05);治疗后观察组SF-36各项评分和总分高于对照组,差异均有统计学意义(P<0.05)。两组患者治疗前SAQ躯体活动受限程度、心绞痛稳定状态、心绞痛发作情况、治疗满意程度、疾病认识程度评分及总分比较,差异无统计学意义(P>0.05);治疗后观察组SAQ各项评分和总分高于对照组,差异均有统计学意义(P<0.05)。两组患者治疗前QLMI症状、活动受限程度、信心、自尊、情感评分及总分比较,差异无统计学意义(P>0.05);治疗后QLMI各项评分和总分高于对照组,差异均有统计学意义(P<0.05)。两组患者治疗前后LVDD、LVEF及IMT比较,差异均无统计学意义(P>0.05)。结论  在规范药物治疗的基础上,联合绘画治疗可以明显改善患者的总体健康水平,提高心绞痛的稳定状态和改善心绞痛发作情况,提高患者对疾病的认识程度和治疗满意程度,增加患者的信心、自尊等。
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26. 臭氧自血疗法辅助治疗男性原发性高血压病的疗效和安全性研究
曹国庆1,戴欣钰1,赵娜1,左欣鹭2,倪家骧1*
Chinese General Practice    2017, 20 (10): 1200-1203.   DOI: 10.3969/j.issn.1007-9572.2017.10.012
Abstract444)      PDF(pc) (558KB)(684)    Save
目的  观察评估臭氧自血疗法(O3-AHT)辅助治疗男性原发性高血压病的疗效和安全性。方法  选取2014年1月-2015年1月在首都医科大学宣武医院就诊的男性原发性高血压病患者60例,采用随机数字表法分为试验组和对照组,各30例。对照组给予口服左旋氨氯地平,5 mg/次,1次/d。试验组在对照组基础上,给予O3-AHT(浓度为20 mg/L、1次/2 d、10次/疗程)辅助治疗。记录治疗前(T0)、首次疗程结束后3个月(T1)、二次疗程结束后3个月(T2)、三次疗程结束后3个月(T3)的收缩压(SBP)和心率(HR);记录T3的药物口服情况和满意度指数(PSI)评分等级;记录治疗期间不良反应发生情况。结果  两组年龄、病程间差异无统计学意义(P>0.05)。两组SBP间差异有统计学意义(P<0.05),不同时间点SBP间差异有统计学意义(P<0.05),治疗方法和时间在SBP上存在交互作用(P<0.05)。两组HR间差异无统计学意义(P>0.05),不同时间点HR间差异无统计学意义(P>0.05);治疗方法和时间在HR上不存在交互作用(P>0.05)。试验组药物口服情况和PSI评分等级均优于对照组,差异有统计学意义(P<0.05)。两组患者均无一例出现严重低血压、心脑血管意外、溶血、过敏等不良反应。结论  O3-AHT辅助治疗男性原发性高血压病的疗效确切,安全性高。
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27. 吸烟及其相关因素对中国男性单纯吸烟人群颈总动脉弹性影响的研究
马琳1,阚艳敏1,李治安2*,郭瑞君3,肖丹4,黄品同5
Chinese General Practice    2017, 20 (6): 661-667.  
Abstract402)      PDF(pc) (800KB)(405)    Save
背景  吸烟是引起动脉硬化的主要危险因素,动脉弹性减低是动脉硬化的早期改变,分析吸烟及其相关危险因素对动脉弹性的影响有重要意义。血管回声跟踪(ET)技术可以在血管发生明显的形态学改变之前检测到动脉弹性的减低。目的  探讨吸烟及其相关因素对中国男性单纯吸烟人群颈总动脉(CCA)弹性的影响。方法  2009年8月-2011年8月从全国各地46所医院的国人吸烟人群调查数据中,选取符合纳入标准的男性单纯吸烟者915例为吸烟组。同时选取国人正常值手册中的1 920例中国男性正常人群为正常组。记录两组年龄,吸烟组吸烟相关因素,即平均每日吸烟量、吸烟年数、开始吸烟年龄、尼古丁依赖程度评分。记录吸烟组左右侧CCA的内膜中膜厚度(IMT),两组CCA的弹性参数〔硬度指数(β)、弹性系数(Ep)、顺应性(AC)、膨大指数(AI)及脉搏波传导速度(PWVβ)〕。结果  吸烟组左、右侧CCA的β、Ep、PWVβ均大于正常组,AC、AI均小于正常组(P<0.05);吸烟组20~29岁、30~39岁、40~49岁、50~59岁、≥60岁左、右侧CCA的β大于正常组(P<0.05)。吸烟组10~19岁左侧CCA,20~29岁、30~39岁、40~49岁、50~59岁、≥60岁左、右侧CCA的Ep大于正常组(P<0.05)。吸烟组20~29岁、≥60岁左、右侧CCA,30~39岁左侧CCA,50~59岁右侧CCA的AC小于正常组(P<0.05)。吸烟组10~19岁、20~29岁左、右侧CCA,30~39岁、50~59岁右侧CCA的AI小于正常组(P<0.05)。吸烟组10~19岁、≥60岁右侧CCA,20~29岁左、右侧CCA,30~39岁、40~49岁左侧CCA的PWVβ大于正常组(P<0.05)。吸烟组平均每日吸烟量与CCA的IMT、β、Ep、PWVβ呈正相关,与CCA的AC呈负相关(P<0.05);吸烟年数、开始吸烟年龄、尼古丁依赖程度评分与CCA的IMT、β、Ep、AI、PWVβ呈正相关,与CCA的AC呈负相关(P<0.05)。多元逐步线性回归分析结果显示,平均每日吸烟量、吸烟年数是CCA的IMT的影响因素(P<0.05);平均每日吸烟量、吸烟年数、尼古丁依赖程度评分是CCA的β、Ep、AC、PWVβ的影响因素(P<0.05);吸烟年数是CCA的AI的影响因素(P<0.05)。结论  吸烟人群CCA弹性明显减低,平均每日吸烟量、吸烟年数、尼古丁依赖程度的增加均是吸烟人群CCA弹性减低的危险因素。
颈总动脉|弹性|吸烟|男人|中国
10.3969/j.issn.1007-9572.2017.06.006
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28. 青年男性冠心病患者首次发病前缺血性心血管病风险评估研究
范书英,罗荷,吴文静,徐曼曼,王勇
Chinese General Practice    2016, 19 (11): 1263-1266.   DOI: 10.3969/j.issn.1007-9572.2016.11.007
Abstract422)      PDF(pc) (585KB)(513)    Save
目的  采用国人缺血性心血管病(ICVD)10年发病风险评估表对134例年龄≤45岁、首次经冠状动脉造影诊断为冠心病的男性患者进行回顾性ICVD风险评估,以明确现行ICVD风险评估方法对青年男性患者ICVD风险评估的有效性。方法  入选2011年1月-2013年12月在中日友好医院心内科住院,年龄≤45岁,首次经冠状动脉造影诊断为冠心病的男性患者134例。收集其发病前临床资料,根据传统ICVD风险因素(包括年龄、血压、体质量、吸烟史、糖尿病和血脂水平),按照国人ICVD 10年发病风险评估表对其本次发病前的ICVD风险进行回顾性评估。结果  青年男性冠心病患者中,检出的前3位风险因素为超重和肥胖、吸烟及高脂血症,高血压和糖尿病的检出率占20.0%~30.0%。根据传统风险因素,按照国人ICVD 10年发病风险评估表对患者发病前的ICVD风险进行评估,发现ICVD 10年发病绝对风险仅为2.09%,属于低风险患者。与同年龄段人群ICVD 10年发病平均风险相比,该组青年男性患者ICVD 10年发病风险增加1.66倍;与ICVD 10年发病最低风险相比,该组青年男性患者ICVD 10年发病风险平均增加5.70倍。冠状动脉造影结果显示,青年男性冠心病患者中,单支血管病变者占44.0%,双支及三支血管病变者占56.0%;梗死相关血管以前降支为主,其次是右冠状动脉。结论  青年男性是冠心病的易患人群,但我国现行的ICVD 10年发病风险评估表明显低估年龄≤45岁的男性ICVD风险,不能很好地预测其ICVD发生的风险。
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29. 奥美沙坦酯对男性高血压患者性功能的影响
袁彬,何胜虎,冯凯,沈巍,江武,邱炜炜,季小波,蒋敏勇,祝兴超,黄辉,高永兴
Chinese General Practice    2016, 19 (06): 648-651.   DOI: 10.3969/j.issn.1007-9572.2016.06.006
Abstract2280)      PDF(pc) (518KB)(1019)    Save
目的  探讨奥美沙坦酯及苯磺酸氨氯地平对男性高血压患者性功能的影响。方法  选取2012年1月-2014年6月在江阴市中医院门诊就诊的男性高血压患者160例(高血压分级为1~2级),采用随机数字表法将患者分为奥美沙坦酯组和苯磺酸氨氯地平组,各80例。奥美沙坦酯组给予奥美沙坦酯20 mg/d口服,苯磺酸氨氯地平组给予苯磺酸氨氯地平5 mg/d口服,疗程均为24周。观察两组治疗前后性功能和血清睾酮、雌二醇水平的变化。性功能评定按照勃起功能国际问卷-5(IIEF-5)进行问卷调查,主要通过勃起功能、性交满意度、达到高潮能力、性欲、总体满意度分值评价男性性功能。结果  奥美沙坦酯组和苯磺酸氨氯地平组各有5例患者因血压持续不达标而退出。两组患者治疗后收缩压、舒张压比较,差异均无统计学意义(t=0.802、0.811,P>0.05)。治疗前两组勃起功能、性交满意度、达到高潮能力、性欲、总体满意度分值比较,差异均无统计学意义(P>0.05);治疗后两组性交满意度、达到高潮能力、总体满意度分值比较,差异均无统计学意义(P>0.05);奥美沙坦酯组勃起功能、性欲评分均高于苯磺酸氨氯地平组,差异有统计学意义(P<0.05);奥美沙坦酯组治疗后勃起功能、性欲评分高于治疗前,差异均有统计学意义(P<0.05)。两组治疗前勃起功能障碍(ED)发生率比较,差异无统计学意义(χ2=0.027,P=0.870);两组治疗后ED发生率比较,差异无统计学意义(χ2=2.807,P=0.094)。奥美沙坦酯组治疗后ED发生率低于治疗前,差异有统计学意义(χ2=4.120,P<0.05);苯磺酸氨氯地平组治疗后ED发生率与治疗前比较,差异无统计学意义(χ2=2.811,P=0.094)。治疗前两组睾酮、雌二醇水平比较,差异均无统计学意义(P>0.05);治疗后两组雌二醇水平比较,差异无统计学意义(P>0.05);奥美沙坦酯组睾酮水平高于苯磺酸氨氯地平组,差异有统计学意义(P<0.05)。奥美沙坦酯组治疗后睾酮水平高于治疗前,差异有统计学意义(P<0.05)。结论  奥美沙坦酯能提高男性高血压患者睾酮水平,改善性功能。
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30. 北京市方庄社区70岁以上男性骨质疏松症患病率及其临床危险因素调查
费琦,张效栋,林吉生,王炳强,孔慜,杨雍,马钊,王奇,吴浩,贾鸿雁,赵新颖,刘新颖,王丽,刘晓辉,彭伟,张晓蕾,杨京香
Chinese General Practice    2015, 18 (35): 4344-4348.   DOI: 10.3969/j.issn.1007-9572.2015.35.018
Abstract329)      PDF(pc) (936KB)(510)    Save
目的  调查北京市丰台区方庄社区70岁以上老年男性原发性骨质疏松症(OP)患病率及其相关的临床危险因素。方法  根据入选和排除标准于2014年1-10月在北京市丰台区方庄社区采用广告招募的抽样方法,收集接受双能X线骨密度仪骨密度检查并完成《北京市老年男性原发性骨质疏松症高危人群临床危险因素调查问卷》调查的北京地区70岁以上老年男性人群150例。测量并记录所有患者的腰椎总(L1~4)、左侧股骨颈和左侧髋部总的骨密度值。根据WHO诊断标准诊断OP患者,将研究对象分为OP组和非OP组,分析各临床危险因素与OP发生的相关性。结果  150例老年男性OP患病率为20.7%(31/150),骨量减少者占55.3%(83/150),骨量正常者占24.0%(36/150)。150例老年男性腰椎总骨密度、左侧股骨颈骨密度、左侧髋部总骨密度比较,差异有统计学意义(F=96.106,P<0.001);其中腰椎总骨密度高于左侧股骨颈骨密度和左侧髋部总骨密度,左侧股骨颈骨密度高于左侧髋部总骨密度,差异均有统计学意义(P<0.001)。OP组和非OP组吸烟史、饮酒史、既往骨折病史、糖尿病史、饮茶、饮咖啡、饮碳酸饮料、食用醋情况比较,差异均无统计学意义(P>0.05);OP组和非OP组体质指数和体质量比较,差异有统计学意义(P<0.05)。以体质量评价OP时,AUC值为0.701,最佳诊断截断值为70.0 kg,灵敏度为48.7%,特异度为83.9%;以体质指数评价OP时,AUC值为0.661,最佳诊断截断值为23.8 kg/m2,灵敏度为62.2%,特异度为74.2%。结论  方庄社区70岁以上老年男性OP患病情况不容忽视,低体质指数和低体质量是OP相关的临床危险因素,其中体质量因素有中度预测价值,但有待进一步深入研究。
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31. 男性配偶产后抑郁症的相关因素及防治措施
丁金锋,孙玫,唐四元
Chinese General Practice    2015, 18 (31): 3856-3859.   DOI: 10.3969/j.issn.1007-9572.2015.31.020
Abstract419)      PDF(pc) (607KB)(729)    Save
目前对产后抑郁症的研究大多数局限于产妇,然而男性配偶的产后抑郁症也不容忽视。本文从生理、遗传、社会心理等方面对男性配偶产后抑郁症发生的相关因素进行了综述,并从医院、家庭、政府、社会四个角度探讨男性配偶产后抑郁症的防治措施。提示各方应提高对男性配偶产后抑郁症的重视,并积极探索适合我国国情的防治措施。
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32. 症状自评量表、艾森克人格问卷及中国服刑人员个性分测验三个量表在男性服刑人员心理健康状况测量中的关联性分析
林兆楠,董杰
Chinese General Practice    2015, 18 (25): 3104-3108.   DOI: 10.3969/j.issn.1007-9572.2015.25.024
Abstract514)      PDF(pc) (698KB)(995)    Save
目的 探讨症状自评量表(SCL-90)、艾森克人格问卷(EPQ)、中国服刑人员个性分测验(COPA-PI)三个量表在男性服刑人员心理健康状况测量中的关联性。方法 采用便利抽样方法,于2014年4-5月抽取辽宁省锦州监狱男性服刑人员542例,采用SCL-90、EPQ、COPA-PI三个量表同时对其进行心理健康状况测量,量表的信度采用Cronbach′s α,量表间的相关性采用Pearson相关分析,量表的结构效度采用探索性因子(EFA)分析与验证性因子(CFA)分析。结果 SCL-90、EPQ、COPA-PI三个量表的Cronbach′s α系数分别为0.97、0.87、0.84。SCL-90总分及各因子得分与EPQ神经质、精神质因子得分呈正相关,与内外向、掩饰虚假因子得分呈负相关(P<0.05)。SCL-90总分及各因子得分与COPA-PI内外倾因子得分呈负相关,与除聪慧性因子外的其余因子得分呈正相关(P<0.05);SCL-90抑郁、恐怖因子得分与COPA-PI聪慧性因子得分呈正相关(P<0.05)。EPQ精神质因子得分与COPA-PI内外倾、同众性、攻击性因子得分呈正相关,与情绪稳定性、信任感、同情心、自信心、焦虑感、聪慧性因子得分呈负相关(P<0.05);EPQ内外向因子得分与COPA-PI情绪稳定性、同众性、冲动性、攻击性、报复性、信任感、自信心、焦虑感、心理变态倾向、犯罪思维模式因子得分呈正相关,与同情心因子得分呈负相关(P<0.05);EPQ神经质因子与COPA-PI聪慧性因子得分呈正相关,与除同情心外的其余因子得分呈负相关(P<0.05);EPQ掩饰虚假因子得分与COPA-PI内外倾因子得分呈负相关,与其余因子得分呈正相关(P<0.05)。经EFA分析得到三因子结构方程模型,各条目共同度为0.51~0.94,累计方差贡献率为76.42%,对模型进行CFA分析得到拟合优度指数(GFI)、调整的拟合优度指数(AGFI)均>0.90,近似误差均方根(RMSEA)<0.08,均达到适配标准。结构方程模型中非标准化与标准化回归系数分别为0.70~1.35、0.64~0.97。结论 SCL-90、EPQ、COPA-PI三个量表之间存在一定的内在关联性,在对服刑人员进行心理健康状况测量时,应联合使用。
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33. 实时剪切波弹性成像对不同类型男性乳腺发育症的诊断价值
韩秀梅,张维维,马灵芝
Chinese General Practice    2015, 18 (24): 2983-2985.   DOI: 10.3969/j.issn.1007-9572.2015.24.023
Abstract462)      PDF(pc) (494KB)(346)    Save
目的 探讨实时剪切波弹性成像(SWE)对不同类型男性乳腺发育症的诊断价值。方法 收集2014年1-12月中国医科大学附属第四医院门诊及住院经手术或临床随访观察诊断为男性乳腺发育症的患者78例为研究对象。应用实时SWE对患者进行检查,记录其弹性模量值最大值、弹性模量值最小值和平均弹性模量值。根据超声图像特征将78例男性乳腺发育症患者的乳腺病灶(97个)分为3组,即结节型组(A组,33例,40个)、类女性乳腺型组(B组,34例,43个)和树根型组(C组,11例,14个)。比较各组弹性模量值的差异。结果 各组弹性模量值最大值、平均弹性模量值比较,差异有统计学意义(P<0.05);各组弹性模量值最小值比较,差异无统计学意义(P>0.05)。B组弹性模量值最大值低于A组(P<0.05);B组、C组平均弹性模量值低于A组(P<0.05)。结论 实时SWE对不同类型男性乳腺发育症有一定诊断价值,尤其是平均弹性模量值和弹性模量值最大值。
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34. 男性特发性低促性腺激素性性腺功能减退症患者心理健康状况研究
李晨曦,张小倩,章秋,代芳,何勇,胡红琳,陈明卫,邓大同,左春林,王长江
Chinese General Practice    2015, 18 (23): 2787-2791.   DOI: 10.3969/j.issn.1007-9572.2015.23.010
Abstract403)      PDF(pc) (516KB)(735)    Save
目的 了解男性特发性低促性腺激素性性腺功能减退症(IHH)患者的心理健康状况。方法 选取2012年1月-2015年1月在安徽医科大学第一附属医院内分泌科住院诊治的男性IHH患者38例(IHH组),另选取同期在本院体检的健康男性青年20例为对照组。测定两组双侧睾丸容积、阴茎长度、性激素〔卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)〕、血脂〔总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)〕、空腹血糖、空腹胰岛素、25羟维生素D等水平,并运用艾森克个性问卷(EPQ)、自卑感量表(FIS)、症状自评量表(SCL-90)评定两组心理健康状况。结果 两组年龄、BMI、TC、LDL-C、HDL-C、空腹血糖和25羟维生素D比较,差异均无统计学意义(P>0.05);IHH组睾丸左侧容积、睾丸右侧容积、阴茎长度、FSH、LH、T均低于对照组;TG、空腹胰岛素和胰岛素抵抗指数(HOMA-IR)均高于对照组(P<0.05)。EPQ:两组内外向(E)、精神质(P)和掩饰性(L)评分比较,差异无统计学意义(P>0.05);IHH组神经质(N)评分高于对照组(P<0.05)。FIS:两组学习能力评分比较,差异无统计学意义(P>0.05);IHH组自我价值、社交自信、外貌自信、体能自信和FIS量表总分均高于对照组(P<0.05)。SCL-90:IHH组躯体化、强迫、人际关系敏感、抑郁、焦虑、敌对、恐惧、偏执、精神病性、其他因子评分及总分均高于对照组(P<0.05)。SCL-90总分与N(r=0.844,P<0.001)、P(r=0.733,P=0.003)、自我价值(r=0.748,P=0.002)、社交自信(r=0.551,P=0.041)、外貌自信(r=0.687,P=0.007)呈正相关。多元线性回归分析结果显示,N和自我价值是影响IHH患者心理健康的因素(P<0.05)。结论 男性IHH患者心理健康水平低于正常人群,伴有N、自我价值因子评分较高的患者更容易发生心理问题。
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35. 乌鲁木齐市男男性行为者HIV感染状况及其影响因素
王森路,郭妮娅,胡晓敏,陈学玲,胡晓远,马媛媛,倪明健
Chinese General Practice    2015, 18 (11): 1260-1264.   DOI: 10.3969/j.issn.1007-9572.2015.11.008
Abstract1725)      PDF(pc) (2314KB)(538)    Save
目的  探讨乌鲁木齐市男男性行为者(MSM)HIV感染状况及其影响因素,为针对性开展MSM高危性行为干预提供依据。方法  2013年5—8月在乌鲁木齐市天山区和沙依巴克区通过现场、网络和社会小组方式招募年龄>18周岁、自述有同性性行为、自愿接受调查的MSM进行问卷调查、采血和检测。结果  共调查857例MSM,维吾尔族HIV阳性检出率为13.1%(14/107),高于汉族的7.2%(32/445)(χ2=3.922,P=0.048)。近6个月内发生同性性行为者804例(93.8%)、仅与固定同性发生性行为者173例(20.2%)、与同性和异性发生性行为者107例(12.5%),发生以上3种性行为时安全套使用率分别为38.3%(308/804)、77.5%(134/173)、28.0%(30/107);近6个月内购买、提供同性商业性行为者分别占3.9%(33/857)、1.8%(15/857),性交时安全套使用率分别为84.8%(28/33)、66.7%(10/15);HIV抗体检出率为8.3%(71/857)。多因素Logistic回归分析显示,近6个月内发生同性性行为〔OR=5.820,95%CI(1.302,26.015)〕、近6个月内与非固定同性性伴发生无保护性性行为〔OR=2.475,95%CI(1.255,4.879)〕、梅毒感染阳性〔OR=4.208,95%CI(1.979,8.947)〕是乌鲁木齐市MSM HIV感染的影响因素。结论  乌鲁木齐市MSM高危性行为普遍,不同民族MSM中HIV感染率、性行为方式有差异,人群活动隐蔽、高危性行为频繁和艾滋病预防服务缺乏是MSM HIV感染的主要原因。
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36. 中国男男性行为者高危性行为结构性影响因素及干预模式的研究现状
雷云霄,李现红,王红红
Chinese General Practice    2015, 18 (5): 573-576.   DOI: 10.3969/j.issn.1007-9572.2015.05.020
Abstract595)      PDF(pc) (1997KB)(640)    Save
近年来,男男性行为者(MSM)随着我国艾滋病(AIDS)流行特点的转变而备受关注,该人群的HIV感染率呈现迅猛上升的趋势。以往从公共卫生视角开展的AIDS干预措施虽取得了一定成效,但“AIDS知识与高危性行为”分离的现象成为了干预措施的瓶颈。越来越多的学者已认识到社会、亚文化、制度等结构性因素对该群体高危性行为的影响。鉴于此,本文总结了中国MSM高危性行为的结构性因素以及干预模式的研究现状,以期为我国MSM高危性行为干预、预防AIDS的传播提供策略支持。
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