Original immunophenotype of blood endothelial progenitor cells and microparticles in patients with isolated arterial erectile dysfunction and late onset hypogonadism: effects of androgen replacement therapy

Objective.?Blood endothelial progenitor cells (EPCs) and endothelial microparticles (EMPs) have been proposed as markers of endothelial dysfunction. Aim of this study was to evaluate an original immunophenotype of EPCs and EMPs in patients with isolated arterial erectile dysfunction (ED) and late onset hypogonadism (LOH) before and after androgen replacement therapy.

Materials and methods.?Fifty patients (50–64 years) with ED and LOH were selected. EPC (CD45_neg/CD34_pos/CD144_pos) and EMP (CD45_neg/CD34_neg/CD144_pos) blood concentrations were evaluated by flow cytometry. Thirty patients received androgen replacement therapy (Tostrex® ProStrakan) for 6 months (group A), other 20 patients not received androgen therapy for the contraindications in their clinical history (group B).

Results.?After 6 months, group B showed IIEF-5 score, peak systolic velocity and acceleration time significantly worse than group A; in addition EPCs and EMPs were significantly higher in group B compared to group A.

Conclusions.?Patients with isolated arterial ED and LOH not treated with androgen therapy showed worst vascular parameters measured by penile Doppler and higher EPCs and EMPs compared to treated hypogonadal patients, hence, LOH appears to be an additional vascular risk factor, and these markers may be considered as predictors of cavernous artery disease. Finally, androgen therapy improves endothelial dysfunction.     

Acquired immune deficiency syndrome projections in England and Wales: interplay of methodology and data

Since the late 1980s, regular monitoring of the human immunodeficiency virus epidemic in England and Wales has been carried out through the work of successive national working groups. One of their tasks has been to provide short-term projections of the incidence of acquired immune deficiency syndrome. In this paper the data and methods used in this projection work are reviewed and results critically assessed with the aim of highlighting the strong interaction between methodological developments and data acquisition.     

Validation of an Arabic ADAM questionnaire for androgen deficiency screening in the Arab community

Background.?It is well documented that testosterone levels decline with age, this decline is associated with symptoms which could be assessed denoting androgen deficiency. We investigated the validity of an Arabic version of the Saint Louis University androgen deficiency in ageing men (ADAM) questionnaire to screen for androgen deficiency in Saudi and non Saudi Arabic speaking men.

Methods.?It was a cross sectional study of ambulatory community-based Arabic Saudi men recruited from Volunteers in Riyadh city, Capital of Saudi Arabia, aged 18–80 years. Seven hundred thirty men agreed to fill the Arabic ADAM questionnaire, they were invited to a morning blood sample for total testosterone and sex hormone binding globulin and those who agreed to complete the whole study were only 407 men. Low serum bioavailable testosterone (BT) levels (androgen deficiency) were defined as <10th percentile of serum BT levels in young healthy Saudi men (18–30 years).

Results.?Cronbach's Alpha of 0.71 (n?=?730) showed a good internal consistency of the Arabic ADAM questionnaire. Among participants, 18.2% and 77.6% had low serum BT levels and a positive ADAM questionnaire, respectively. The prevalence of positive ADAM and low serum BT is increasing with age. The Arabic ADAM questionnaire had a high sensitivity of 86.5%, a low specificity of 24.3%, and positive predictive values (+PVs) and negative (?PVs) of 20.3% and 89%, respectively.

Conclusion.?The Arabic ADAM questionnaire has a very good sensitivity but very low specificity for screening of androgen deficiency in Saudi men, therefore biological confirmation is needed especially when clinical symptoms of androgen deficiency are present.     

Adding to the controversy: Pitfalls in the diagnosis of testosterone deficiency syndromes with questionnaires and biochemistry

Purpose. To determine the value of available questionnaires used for the diagnosis of testosterone deficiency syndromes (TDS) by correlating their ratings with a panel of hormonal determinations in a male population.

Materials and methods. Participants completed the ADAM questionnaire and underwent biochemical evaluation at the local site. Assessments determined entry into Group A (symptomatic) or Group B (non-symptomatic). After stratification, subjects provided a morning sample of blood, completed the Aging Male Survey (AMS) and the newly developed Canadian Society for the Study of the Aging Male (CSAM-Q) questionnaires. Serum aliquots were analysed at a central lab for 8 putative markers commonly associated with symptomatic testosterone deficiency associated with aging: total testosterone (T); bioavailable T (BT); dehydroepiandrosterone sulphate (DHEA-S); sex-hormone binding globulin (SHBG); luteinizing hormone (LH), prolactin (PRL); thyroid-stimulating hormone (TSH) and insulin-like growth factor-1 (IGF-1).

Results. 92 men were screened; of these 59 (mean age of 58 ± 11 years) completed the study, 30 (51%) scored positively (mean 61.5 years) to the ADAM while 29 (49%) did not (mean 54.1 years). For the AMS the weight of the three domains (psychological, somato-vegetative and sexual) was significantly greater in Group A (p < 0.001) than in Group B. Equally, for the CAS questionnaire, the scores for the variables energy, global performance, frequency of intercourse, mood and quality of sleep were lower in Group A than in their asymptomatic counterparts (p < 0.001). The domain of memory assessment within the CSSAM-Q was not discriminatory. ADAM and AMS are self-administered and completed within 10 minutes. CSSAM-Q is more time consuming, requires an investigator to administer, and memory domain is biased in favour of specific professional training.

No difference was found between the two groups in 6 of 8 biochemical tests. However, significant lower values (p < 0.001) were found for DHEA-S and IGF-1 in the symptomatic group as compared with the non-symptomatic cohort.

Conclusions. This study confirms that newer, more complex tools perform similarly to the simpler ADAM questionnaire. The lack of correlation between the clinical picture and the most commonly used biochemical confirmatory tests, again, clearly points to the paramount importance of the clinical evaluation. An emphasis and reliance on serum T alone hinders the clinician's ability to manage testosterone deficiency syndromes (TDS).     

转机并非转折——中国经济摆脱“疲软”的制度经济学分析

本文认为 ,我国处于市场化改革的进程中 ,既不存在比较发达和完善的市场制度 ,也不存在严重的市场失效 ,市场机制难以有效发挥作用 ,因此采用西方凯恩斯主义和货币主义的措施难以启动经济 ,应利用新制度经济学方法研究我国现实问题。文章指出 ,我国在制度上的主要矛盾是改革变形 ,改革变形的深层原因在于中国经济自身有不少不健康因素 ,对此应有清醒的理性认识     

大学生母语文化的英语表达能力调查与思考

对大学生母语文化的英语表达能力的调查,反映出大学生母语文化的表达能力严重不足的问题,其原因包括大学生母语文化素养有待提高,大学英语教材中母语文化的输入不够等多种因素。     

Comprehensive evaluation of androgen replacement therapy in aging Japanese men with late-onset hypogonadism

Abstract

Objective: This study assessed the efficacy and safety of testosterone replacement therapy (TRT) in aging Japanese men with late-onset hypogonadism (LOH).

Methods: This study included 50 (median age: 57.7 years) Japanese men with LOH, who were consecutively enrolled and treated with TRT for at least six months at our institution. We evaluated the following measurements before and after six months of treatment with TRT as follows: blood tests, prostate volume, residual urine volume, self-ratings for International Index of Erectile Function 5 (IIEF-5), International Prostate Symptom Score (IPSS), Self-Rating Depression Scale (SDS), Aging Male Symptom (AMS) and the Medical Outcomes Study 8-item Short-Form health survey (SF-8).

Results: Following six months of TRT, the levels of testosterone, red blood cells, hemoglobin and hematocrit were significantly increased from baseline, while total cholesterol level was significantly decreased from baseline. Furthermore, TRT led to a significant increase in IIEF-5 score and a significant decrease in IPSS score. Of 30 men who were diagnosed with depression at baseline, only 11 men (36.7%) were still suffering from depression after TRT, and SDS scores were significantly decreased from baseline at month six. Treatment with TRT led to a significant decrease in all scores of the AMS scale as well as a significant improvement in all scores of the SF-8 survey, with the exception of the bodily pain score.

Conclusion: These findings suggest that TRT is an effective and safe treatment for aging Japanese men with LOH. TRT improved depressive symptoms as well as health-related quality of life.     

行政立法的正当性初探

行政立法是社会发展的产物,它的产生和扩张有其经济、政治、科技等外在原因以及法制发展需要的内在原因。我们无法否定或取消行政立法的存在,但是行政立法确实存在种种弊端,这些弊端是由其自身的性质和特点决定的。我们必须加强对行政立法的监督控制,包括规则控制、程序控制、立法监督和司法监督,促进行政立法权的正当行使。     

身体-主体的缺席与实践美学和后实践美学的共同欠缺

作为实在的活动,实践的承担者只能是身体-主体。离开身体-主体来谈论实践,就无法敞开其实在品格,以实践为原初范畴的美学建构便会处于悬空状态。从这个角度看,实践美学的最大欠缺是对身体-主体的忽略。忽略身体而又强调实践的意义这种自我矛盾的做法不但造就了一系列逻辑悖论,而且使实践美学无法回答许多根本性的美学问题。后实践美学的倡导者虽然力图超越实践美学,但同样未意识到身体-主体的意义,因而也将实践美学的逻辑欠缺带到自身的理论建构中。只有敞开了实践、生存、生命对身体-主体的原始归属关系,我们才能超越实践美学和后实践美学的共同欠缺,建构出圆融的、具有独创性的、富有解释力的汉语美学体系。     

中医古代脾阴学说源流和脾阴学说内涵

通过对自秦汉时期开始至明清时期的中医古籍中关于脾阴学说的文献进行挖掘与梳理,厘清脾阴学说的源流脉络,从而清楚地认识脾阴学说的发展规律,全面地总结了脾阴学说的实质内涵,以期对现代脾阴理论研究和临床实践有所裨益。