Objective To study the effectiveness, safety and tolerance of testosterone undecanoate （TU） in improving exhaustion and quality of life （QOL） of the elderly male patients with chronic disease in advanced stage. Methods Using a simple randomized controlled trial design, eighty patients were randomized into two groups. The treatment group took routine therapy and TU and the control group with routine therapy alone. Results 1. Baseline characteristics in both groups were similar. 2. The PADAM grade decreased, and the QOL scale increased in the treatment group （P〈0.05 ）. 3. Serum total testosterone in the treatment group rose, upper arm circumference and right hand grip improved （P〈0.05 ）. 4. There were no significant differences in adverse effects between both groups. Conclusions TU can improve the clinical health status in the elderly male patients with chronic disease in advanced stage and increase serum testosterone level, there is a satisfactory tolerances and few adverse reactions.
Objective To explore the sonographic features of testicular torsion in adult males (≥25 years). Method We retrospectively analyzed the clinical, pathological and sonographic data of 79 adult male patients with testicular torsion, in whom 20 underwent resection of testis and 59 retained testis in West China Hospital from September 2006 to March 2017. Results There were 56 patients with spermatic cord nodules or mass with the largest mass of about 36 mm ×31 mm; the scrotal wall thickened in 48 patients with the thickness of 5–10 mm; axial changes of the affected testis were found in 24 patients; there were 61 patients with testicular growth in the affected side, while the affected testis was reduced in 7; there were 67 patients with asymmetric echo in the affected side, and the maximum hypoechoic area was about 36 mm×26 mm; the epididymis of the affected side in 35 patients with were unclear, and the epididymis of the affected side was enlarged in 19; 25 patients had hydrocele of testis; there was no blood flow in 49, blood flow reduced in 25, and blood flow increased in 5. Four patients were diagnosed by contrast-enhanced ultrasound, and there was no enhancement in 3 and partial enhancement in 1. Conclusion The sonographic features of testicular torsion in adult males are obvious, and the early diagnosis of testicular torsion can be confirmed by contrast-enhanced ultrasonography.
目的探讨乳腔镜手术治疗男性乳腺发育症的手术方法和安全性问题。 方法对我院自2010年2月至2011年3月期间收治的11例男性乳腺发育症患者用乳腔镜行单纯皮下腺体切除术。 结果11例手术均获成功，术后3～6 d拔除引流管，术后平均住院时间12.5 d； 术后发生皮下气肿3例，乳头部浅层缺血3例，无其他并发症。 结论乳腔镜手术治疗男性乳腺发育症能达到常规手术无法取得的美容效果，且较为安全。乳腔镜应用前景广阔。
目的 对19例男性乳腺癌的发病情况及诊治过程和结果进行回顾性总结。方法 选择我院1973年至1997年收治的19例男性乳腺癌患者，并对其发病特点及诊治情况、预后进行分析。结果 男性乳腺癌发病率低(1.2%)，发病年龄高，平均55岁，病程长，平均3.75年，病理类型均为浸润型。治疗均采用手术切除，加术后放、化疗及内分泌治疗。结论 男性乳腺癌较少见，病程长，恶性程度高，预后差。由于其在临床表现上无特异性，故极易被忽视或误诊。由于上述特点，要提高男性乳腺癌的存活率，早期诊断及治疗就显得尤为重要。
①供体授精:我们发现,在供体授精的效果方面,尚缺乏高质量证据.②胞浆内精子注射+体外授精:1篇系统评价发现,尚无足够的证据说明胞浆内精子注射+体外授精与单独使用体外授精何者效果更好.③宫腔内人工授精:两篇系统评价发现,宫腔内人工授精较宫颈内授精或自然性交,能明显增加每个周期的妊娠率.④体外授精与配子输卵管内移植:1个RCT显示,尚无足够证据证明体外授精与配子输卵管内移植何者效果更好.
Objective To systematically review the efficacy and adverse events of alendronate on bone mineral density and fractures in men with osteoporosis. Methods We electronically searched MEDLINE (1990 to 2005), EMBASE (1990 to 2005), The Cochrane Library (Issue 3, 2005), Controlled Trials Register and The National Research Register, CBM disc, VIP, and CNKI. We also handsearched some related journals. The search was conducted in Nov., 2005. The quality of included randomized controlled trials (RCTs) was evaluated and meta-analysis was conducted by RevMan 4.2.8. Results We identified 7 studies including 817 patients. Sufficient evidence showed that alendronate plus calcium was superior as preventive treatment to calcium in increasing the bone mineral density (SMD 0.59, 95% CI 0.15 to 1.03, P=0.009) of the lumbar spine. The incidence of withdrawal and lost to follow-up due to adverse events of the alendronate plus calcium was lower than that of calcium (RR 0.32, 95% CI 0.11 to 0.87). Two studies showed that alendronate was superior to placebo in increasing the bone mineral density in men with osteoporosis but with no significantly statistical difference in reducing fractures. Two studies showed alendronate was superior to alfacalcidol in increasing the bone mineral density and reducing the vertebral fractures in men with osteoporosis. One study showed alendronate was not superior to calcitonin or alfacalcidol in increasing the bone mineral density in men at high risk of osteoporosis. One study comparing anledronate or parathyroid hormone with combination of these drugs in men with osteoporosis suggested that anledronate wasn’t superior to parathyroid hormone in increasing the bone mineral density, and the combination did not show any difference compared to parathyroid hormone alone. Conclusions Alendronate is more effective in prevention and treatment of men with osteoporosis compared to placebo. Alendronate is more effective than alfacalcidol in increasing bone mineral density and reducingvertebral fractures in men with osteoporosis. Alendronate is not superior to alfacalcidol or calcitonin in increasing the bone mineral density in preventing men osteoporosis. Alendronate compared to combination of parathyroid hormone does not show more effectiveness in increasing the bone mineral density in men with osteoporosis. More RCTs of high quality, especially multiple center trials are needed to generate ber evidence.
ObjectiveTo explore the suitable division of male genitalia subunits and the effectiveness of large-area perineum defect repair under its guidance.MethodsAccording to the anatomical and functional characteristics of male genitalia, the subunit division scheme was proposed: area Ⅰ, glans penis; area Ⅱ, body of penis; area Ⅲ, scrotum; area Ⅳ, scrotum. Between April 2017 and July 2019, 12 patients with large genitalia defects were treated, with an average age of 60.9 years (range, 57-66 years) and an average disease duration of 2.7 years (range, 2-5 years). The defect area involved area Ⅰ in 1 case, area Ⅱ in 7 cases, area Ⅲ in 5 cases, and area Ⅳ in 8 cases; the size of area ranged from 6 cm×4 cm to 23 cm×16 cm. The causes of defect included 3 cases of trauma, 6 cases of Paget disease, 2 cases of squamous cell carcinoma, 1 case of spindle cell tumor. According to the design of the corresponding repair scheme, the main repair methods were to rotate and advance the skin flap and pedicled skin flap in the same area. When the defect was large, the free skin flap transplantation, free skin grafting, and free mucosa transplantation were used to repair the defect.ResultsAll the patients were followed up 6-13 months with an average of 8.6 months. Skin flap, skin graft, and mucosa survived in one stage in 10 patients; infection occurred in 1 case after the scrotal flap of area Ⅲ was transferred to repair the defect in area Ⅱ, 1 case had distal venous crisis at 2 days after repair area Ⅲ defect used free anterolateral thigh flap, and after active treatment, the condition improved. The appearance of the receiving area and the supplying area was good, and the local feeling was recovered satisfactorily. The range of motion of hip joint was good in 10 cases, and 2 cases were slightly stretched but did not affect normal life. All patients had normal urination and defecation function, and were satisfied with the treatment effectiveness.ConclusionThe subunits of male genitalia can be used to guide the repair of the defect, which can better restore the physiological appearance and function, and has positive clinical significance.
Microsurgical varicocelectomy (MVC) is the current gold standard for the treatment of varicocele. Studies have shown that MVC can bring certain clinical benefits to patients with varicocele and male infertility. In today’s era of assisted reproduction, MVC is clinical used usually to improve ART outcomes before treatment with assisted reproductive technology (ART). This article summarizes the efficacy evaluation and cost-effectiveness of MVC combined with ART. Although there is a lack of prospective evidence supporting MVC before ART, many large retrospective studies have shown that operating MVC before using ART may improve ART outcomes. However, large-scale and standardized clinical trials are still needed to further verify the effectiveness and feasibility of MVC before ART.