Atrial functional mitral regurgitation (AFMR) is characterized by left atrial enlargement, without left ventricular dilation or systolic dysfunction, and with structurally normal leaflet tissue. It predominantly occurs in patients with atrial fibrillation and heart failure with preserved ejection fraction. The complex pathophysiological mechanisms involve mitral annular dilation, atriogenic leaflet tethering, and inadequate leaflet adaptation. Currently, standardized management protocols for AFMR remain lacking. Common approaches include pharmacotherapy, rhythm control, and surgical or percutaneous interventions, all requiring individualized therapeutic strategy based on etiology and clinical characteristics. This review discusses recent advances in the pathogenesis and treatment of AFMR, aiming to provide valuable insights for clinical practice and future research.
摘要:目的: 隨機對照研究、評估生物反饋訓練治療慢性功能性便秘的療效。 方法 : 60例慢性功能性便秘患者,隨機分為治療組30例和對照組30例。治療組接受1個療程(5周)生物反饋訓練治療(10次為一個療程、一次30～45分鐘、每周2次)。對照組患者接受聚乙二醇4000 10g BID 口服,療程5周。治療前后作便秘癥狀評分、結腸通過試驗檢測、直腸肛門壓力檢測。 結果 : 生物反饋訓練和聚乙二醇4000均可使多數慢性功能性便秘患者的大便次數、大便性狀及伴隨癥狀恢復正常或緩解,總有效率分別為667%和80%(P ＞005)。生物反饋訓練和聚乙二醇4000口服治療后,結腸通過試驗72小時標志物排出率分別為75%及73%,均較治療前明顯增加。生物反饋訓練治療后力排時肛門壓明顯下降。 結論 : 生物反饋訓練對出口梗阻型、慢傳輸型便秘均有效,是一種有效的、新興的治療慢性功能性便秘的方法,可作為功能性便秘的一線治療方法。Abstract: Objective: To assess the clinic effect of biofeedback therapy for functional constipation. Methods : Sixty cases of chronic functional constipation were randomly divided into treatment group (30 cases) and control group (30 cases). Cases in the treatment group were exposed to biofeedback for a fiveweeklong treatment course—individual treatment lasted for 3045 minutes and twice per week. Patients in the control group received PEG 4000 10g BID for five weeks. Data from constipation symptom score, colonic transit test, and anorectal manometry were done and compared before and after two kinds of treatments. Results : Biofeedback training and PEG 4000 could restore the stoolfrequency, stool characteristics and accompanying symptoms to normal or mitigation of the majority of patients with chronic functional constipation, with the total effective rates being 667% and 80% (P gt;005), respectively. After biofeedback training and PGE 4000 treatment, the discharge rate of 72hour markers of colonic transit test significantly increased to 75% and 73%, respectively. Additionally, anorectal pressure decreased dramatically after biofeedback training. Conclusion : Biofeedback training would play a positive role in outlet obstruction and slow transit constipation. Thus, it could be an effective firstline treatment of chronic functional constipation.
目的 探討在恥骨后前列腺癌根治術中尿控功能和性功能保護的手術技巧和療效。 方法 2001年8月-2010年1月，行恥骨后前列腺癌根治術21例，其中2例經腹腔鏡施行。均早期控制縫扎背靜脈復合體，并妥善處理前列腺尖和尿道。21例通過保護控尿神經、保護尿道橫紋括約肌等措施，保護尿控功能；17例通過保留神經血管束技術（12例保留雙側，5例僅保留一側）保護性功能。 結果 手術均成功完成，無圍術期嚴重并發癥。2周拔出尿管后，排尿通暢，無尿道狹窄。手術后3、12個月內恢復尿控能力分別為：6例、13例，持續性輕-中度尿失禁2例。21例中，手術前勃起功能正常，并于手術中保留神經血管束17例，手術后3、12個月內勃起功能恢復分別為：2、8例，4例勃起功能減弱，3例不能勃起。手術后病理報告均為前列腺腺癌，未侵及精囊．膀胱頸，雙側淋巴結陰性。后尿道切緣陽性1例。手術后6、24、54個月各有1例出現生化復發。 結論 精細解剖并注意手術技巧，可有效保護性功能和尿控功能，并達到腫瘤根治的療效。
ObjectiveTo investigate the effect of pelvic autonomic nerve preservation (PANP) with total mesorectal excision (TME) on sexual and urinary function in male rectal cancer patients. MethodsClinical data of eightyfour patients with rectal cancer from January 2008 to October 2010 in our hospital were analyzed. According to different operative techniques, all the patients were divided into two groups: PANP+TME group (n=41) and TME group (n=43). The sexual dysfunction, urination disorder rate, and local recurrence rate after operation of patients between two groups were compared. ResultsErectile dysfunction rate of patients in TME+PANP group and TME group was 29.3% (12/41) and 76.7% (33/43), ejaculation disorder rate was 26.8% (11/41) and 79.1% (34/43), and urination dysfunction rate was 24.4% (10/41) and 79.1% (34/43), respectively. The rate of sexual and urinary dysfunction of patients in TME+PANP group was significantly lower than that in TME group (Plt;0.05). Local recurrence rate of patients in TME+PANP group (9.8%, 4/41) was similar to that in TME group (11.6%, 5/43)， Pgt;0.05. ConclusionPANP based on TME can reduce effectively the rate of sexual and urinary dysfunction in male rectal cancer patients, which does not increase the local recurrence rate after operation.
Mitral regurgitation is one of the most common valvular heart diseases, with functional mitral regurgitation being the predominant type. Ventricular functional mitral regurgitation (VFMR) occurs due to impaired left ventricular systolic function combined with left ventricular dilation, leading to mitral annular enlargement and papillary muscle displacement, which cause relative tethering of the mitral leaflets despite structurally normal valve apparatus. Patients with VFMR often present with severe heart failure, face high surgical risks, and have a poor prognosis. In recent years, mitral valve transcatheter edge-to-edge repair (TEER) has emerged as a well-established interventional technique, offering a new treatment option for VFMR patients and significantly improving clinical outcomes. This review focuses on the advances in the pathogenesis, epidemiological characteristics, diagnosis, and management of VFMR, particularly the application and efficacy-influencing factors of TEER.
ObjectiveTo systematically review the association between 5α-reductase inhibitors (5ARIs) and risk of sexual dysfunction in subjects with benign prostatic hyperplasia (BPH).MethodsPubMed, Web of Science, The Cochrane Library, EMbase, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on the association between 5ARIs and risk of sexual dysfunction in subjects with BPH from inception to October 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by using Stata 12.0 software.ResultsA total of 15 studies involving 17 774 subjects were included. The results of the meta-analysis showed that compared with the placebo group, 5ARIs could significantly increase risk of erectile dysfunction (RR=1.52, 95%CI 1.36 to 1.69, P<0.000 1), while decrease libido (RR=1.79, 95%CI 1.37 to 2.32, P<0.000 1) and ejaculation disorder (RR=2.97, 95%CI 1.82 to 4.83, P<0.000 1) in subjects with BPH. Subgroup analysis of the type of 5ARIs, intervention period, publication year and sample size showed that the 5ARIs had a higher risk of sexual dysfunction than the placebo group.ConclusionsCurrent evidence shows that 5ARIs can increase risk of erectile dysfunction, decrease libido and ejaculation disorder in subjects with BPH. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
目的 探討腹腔鏡全直腸系膜切除術盆腔自主神經保留的可行性及對術后性功能的影響。方法 對我院2004年2月至2006年5月期間21例中低位直腸癌患者施行腹腔鏡全直腸系膜切除保留盆腔自主神經手術，調查了解患者術后性功能情況。結果 21例患者性功能均存在,絕大多數(18例)患者勃起功能良好。結論 腹腔鏡下全直腸系膜切除術保留盆腔自主神經是可行的，患者性功能恢復滿意。