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　　阳痿的危害表现在哪些方面?是很多阳痿患者比较关心的问题，北京中山男科医院专家介绍，阳痿是让男性朋友比较苦恼的疾病，一些患者对阳痿不能正确对待，更不了解患阳痿存在的风险因素。那么阳痿的危害表现在哪些方面?“BWT性功能障碍综合疗法”是目前临床治疗男性阳痿的新特效疗法。
&　　阳痿的危害表现在哪些方面?是很多阳痿患者比较关心的问题，北京中山男科专家介绍，阳痿是让男性朋友比较苦恼的疾病，一些患者对阳痿不能正确对待，更不了解患阳痿存在的风险因素。那么阳痿的危害表现在哪些方面?&BWT性功能障碍综合疗法&是目前临床治疗男性阳痿的新特效疗法。　　一、糖尿病　　糖尿病影响到血管系统和神经系统，是一种常见的阳痿的并发症，近一半的男性糖尿病病人患有阳痿，糖尿病患者阳痿发病年龄比普通人群提前10至15年。　　二、心理性阳痿　　在50岁以上的人群中，心理性阳痿约占10%，年轻人中这种类型的阳痿更为多见。　　三、肾疾病　　肾功能严重受损多伴有阳痿，在需要透析治疗的病人中有75%患有阳痿。　　四、严重的抑郁症　　有90%的抑郁症病人出现重度或中度阳痿。　　推荐疗法：北京中山医院BWT性功能障碍综合疗法　　北 京中山医院拥有国际领先的高精尖诊疗设备，由临床经验丰富的资深专家坐诊，全面诊治各种男性泌尿生殖系统常见疾病、多发病和疑难病。北京中山医院男性功能 障碍专科率先引进加拿大生物磁疗技术，并结合亚洲男性疾病特点，特推出&BWT性功能障碍综合疗法&，是轻、中度男性性功能障碍患者的临床科学诊疗的新模 式。　　BWT性功能障碍综合疗法，即以男科学、分子生物学、阴茎勃起解剖生理学、性心理学等多学科理论为基础，借助国际先进男科疾病诊疗设 备 工作站，运用新一代生物技术，通过调节大脑皮质功能,唤醒性神经及性腺轴，扩张阴茎动静脉血管，激活阴茎海绵体动力、促进性器官微循环等策略进行对症定 制、系统康复。同时辅以药精华进行益气升阳、整体调理，以达到标本兼治的目的。　　该疗法倡导 &科学精确分型、突出临床疗效、强调规范诊疗、注重愈后调理&，是世界卫生组织、美国泌尿外科协会临床指导小组和国内男科学权威组织极力推崇的治疗男性性功能障碍的最佳方法和最新模式。　　温馨提示：同时需要注意的是，治疗阳痿早泄的方法是多样的，谨慎选择，根据患者病情，对症治疗，会争取达到更好的效果。若你还有哪些疑问需要解答，可以在线咨询医院专家。
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　　富含硒的食物有鱼、虾、乳类、动物肝脏、肉类、坚果
　　◎ 瑞年国际董事局主席王福才与各位领导共同启
& 　　富含硒的食物有鱼、虾、乳类、动物肝脏、肉类、坚果类(如花生、瓜子)等。黄油、鱼粉、龙虾、蘑菇、猪肾、大蒜等食物虽然含有一定的硒元素，但吸收率不太理想。营养学...KeywordsDiabetes mellitus,Erectile dysfunction,Rats,Phenotype modulation,Tunica albuginea,Elastic fiber
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&&&&&&&&研究背景冷静等曾对上海市1582名40岁以上男性进行研究，发现勃起功能障碍(ED)的患病率为73.1％。流行病学调查发现大多数男性45岁以后患ED的风险性明显增高，当前在全世界约有15200万男性正遭受到ED的困扰，仅仅美国就有3000万人，据推测，到2025年全世界将有32200万人会经历ED。所以ED作为一种危害人们生活质量的疾病，已经引起了广泛的重视。而勃起功能障碍的男性患者中有35％～75％是糖尿病患者，而糖尿病是一组代谢性临床综合征，全球已确诊的有1.5亿人，预测2025年将增至3亿。因此，糖尿病性ED已成为男科学学者研究的热点。1实验动物的选择医学研究常常需要使用动物模型作为实验假说和临床假说的实验基础，男科学的相关研究，如ED更是如此，因为在人类身上直接进行的男科学相关研究会受到多种因素的限制，如伦理道德、组织取材的限制、不易控制共同背景受试条件等，因此男科学学者们设计了各种ED的动物模型用于ED的生理、病理生理、药理学等各方面的研究。为了保证动物实验的结果外推到人类这一最终过程的合理性及有效性，选用恰当的动物经行模型的构建是研究者首先应该考虑的问题。灵长类动物，如猴、大猩猩等是研究ED最好的动物，与人的实际情况也最为接近，但由于价格昂贵、动物缺乏、和伦理道德等的限制，国内尚无用灵长类动物经行研究的报道。大鼠是ED研究中应用最多的动物，其价格也是比较合适的，是用于ED研究中最便宜的，而且大鼠在盆腔、阴茎的血管和神经的解剖、受体的分布，性反应的感觉反射等方面都和人有较为一致的相似性，因此绝大多数的ED研究都可以用大鼠作为实验动物。因此，本研究所选动物为大鼠。2阴茎组织解剖学结构及勃起机制阴茎是由一对阴茎海绵体和一个尿道海绵体所形成的圆柱形器官，其中尿道海绵体包绕尿道，并形成远端的阴茎头。每个海绵体周围均有纤维鞘膜包绕，但两个阴茎海绵体间存在许多间隙，以利于海绵体间的血液交通。阴茎海绵体由平滑肌及纤维成分组成的小梁构成，小梁间有许多相互沟通的窦间隙，由内皮细胞衬附。阴茎的勃起是由于在多种因素作用下阴茎海绵体平滑肌松弛而引起。阴茎海绵体平滑肌的舒张使血流不断流入阴茎海绵窦，海绵窦间隙扩大，阴茎肿胀，白膜受压，导致沟通海绵窦与阴茎背静脉的沟通静脉受压，限制了阴茎海绵体内的血流流出，使血管内回流阻力上升，以至于静脉血不能外流，阴茎内血压上升，产生了坚硬的勃起。这种机制被称为静脉闭塞机制(Corporal Venooclusive mechanism)。而阴茎的疲软则是由阴茎海绵体平滑肌紧张收缩的结果，交感神经的兴奋使得平滑肌收缩，导致了动脉供血的减少，窦间隙缩小，海绵体内血压下降，白膜压迫减小，海绵窦静脉血外流增加，从而引起阴茎的疲软。3阴茎海绵体平滑肌表型转化的研究在正常人阴茎海绵体组织中平滑肌约占40％—52％，其余主要为胶原纤维。平滑肌主要分布在白膜下。研究表明，对于静脉闭塞机制障碍引起的勃起功能障碍的患者，阴茎海绵体平滑肌为19％—36％，而动脉供血不足引起勃起功能障碍的患者，阴茎海绵体平滑肌占10％—25％，并且随着年龄的增长，平滑肌的比例会进一步减少，因此可见，阴茎海绵体平滑肌是海绵窦间隙舒张及阴茎勃起的结构基础，当其功能及数量发生改变时，正常的勃起功能将会受到影响。近年来，对于心血管平滑肌在心血管疾病中所起的重要作用研究较多且深入，尤其是心血管平滑肌表型转化的研究，平滑肌的表型转化是指：机体发育的不同阶段或不同疾病状态下所发生的形态、结构和功能的改变。应当区别于化生的概念，化生是指：在病理状态或外界刺激作用下，同一胚胎来源的成熟组织细胞，可以一种向另一种成熟的细胞化生，如长期吸烟的人，气管的纤毛柱状上皮化生为复层鳞状上皮。而阴茎海绵体组织被认为是一种特殊的血管组织，其小梁中的平滑肌与心血管平滑肌在功能上具有相似性，因此阴茎海绵体平滑肌是否同样具有表型转化的特性，相关研究未见报道。所以，本研究的目的在于了解阴茎海绵体平滑肌是否存在表型转化，以及表型转化对勃起功能的影响。4白膜中弹性纤维改变对勃起功能的影响白膜的弹性功能是由于白膜中有显著的弹性纤维的分布，正是这种分布，使其能够在呈波浪状的胶原纤维中起到牵拉的作用，从而使白膜在勃起过程中抵抗强大的海绵窦内压，并且压迫白膜下及穿透白膜的流出静脉，维持较高的窦内压。从另一个角度说，如果白膜过度扩张，将会引起海绵体内的血管、神经受到过度拉伸，从而引起血流动力学的障碍。如果白膜中弹性纤维含量减少，将会引起白膜整体结构回弹能力的下降，从而降低了在对白膜下及穿越白膜的流出静脉的压迫，会出现阴茎勃起静脉闭塞机制的异常。5阿朴吗啡(APO)在男科学中的应用APO(apomorphine)是一种生物碱，是将吗啡分子上加以改变的半人工合成品，麻醉效果大为降低，而对中枢神经系统的兴奋作用有所加强。对位于延脑最后区的呕吐化学感受区的刺激作用特别显著，因此，其最主要的临床作用是催吐。但是，当大鼠给予每kg体重30μg时，可以显著增强阴茎的勃起。大鼠在正常情况下是很少出现自发的勃起的，但给予注射微量的APO后，会出现阴茎勃起、欠身、打哈欠(PE／SYS)的典型表现，一般从注射后10分钟开始，持续20～30分钟。因此，利用注射APO这种物质，可以将判断是否存在ED，被认为是一种行之有效的判定ED及其程度方法。目的1．探讨糖尿病性ED大鼠模型的建立：①APO致大鼠阴茎勃起的研究；②探讨APO致大鼠阴茎勃起及空腹血糖正常值的范围；③探讨利用链脲佐菌素(STZ)建立糖尿病性ED大鼠模型。2．对不同月龄大鼠阴茎组织形态学结构进行研究。3．探讨糖尿病性勃起功能障碍大鼠是否存在阴茎海绵体平滑肌表型转化，以及表型转化对勃起功能的影响。4．探讨糖尿病大鼠白膜中弹性纤维改变，以及对勃起功能的影响。5．探讨糖尿病对大鼠生精功能的影响。方法1．阿朴吗啡致大鼠阴茎勃起的研究：2月龄SD大鼠15只，在不同的5天，同一时间段内(早上9—11点)15只大鼠均给予相应处理，即第一天不给予注射APO观察勃起情况，第二天颈项皮肤松软处皮下注射APO60μg／kg观察勃起情况，第三天颈项皮肤松软处皮下注射APO80μg／kg观察勃起情况，第四天颈项皮肤松软处皮下注射APO100μg／kg观察勃起情况，第五天颈项皮肤松软处皮下注射APO120μg／kg观察勃起情况。记录并观察前30分钟内及后30分钟内的勃起次数。以龟头充血及阴茎体增长为阴茎勃起1次。2．探讨阿朴吗啡致大鼠阴茎勃起及空腹血糖正常值范围：APO 4mg溶解于0.5mg／kg的维生素C及生理盐水中，配制成浓度为40μg／ml的溶液，将30只大鼠全部按体质量注射100μg／kg的APO溶液，观察30分钟内的勃起次数，以龟头充血及阴茎体增长为阴茎勃起1次。并在大鼠空腹(大鼠禁食12小时)状态下取鼠尾血，利用血糖仪及配套血糖试纸测定空腹血糖。3．糖尿病勃起功能障碍大鼠模型的建立：30只SD大鼠，随机分为5组，分别为对照组、注射STZ40 mg／kg组、注射STZ60 mg／kg组、注射STZ80 mg／kg组、注射STZ100 mg／kg组，每组6只，分别记录4d、1周、2周、3周的空腹血糖、阿朴吗啡(APO)诱导阴茎的勃起次数及体质量。4．不同月龄大鼠阴茎组织形态学研究：不同月龄的SD大鼠，1月龄、2月龄、3月龄、4月龄各5只，麻醉后取阴茎组织，石蜡包埋并切片后，进行常规H.E染色，利用图像采集系统进行摄片，最后对采集的图片进行形态学描述。5．糖尿病勃起功能障碍大鼠阴茎海绵体平滑肌表型转化的研究：利用链脲佐菌素(STZ)制作糖尿病及糖尿病性勃起功能障碍模型，在大鼠注射STZ后两周，血糖＞7.2 mmol／L及APO诱导未出现阴茎勃起的，可以认为是糖尿病性勃起功能障碍模型(DM&ED group)，归为DM&ED组；血糖＞7.2 mmol／L但APO诱导出现阴茎勃起的大鼠，被认为是糖尿病性非勃起功能障碍模型(DM group)，应归为DM组，如果此后该组中有大鼠APO实验未出现勃起，该大鼠将从DM组中剔除，注射STZ后，未出现血糖升高且勃起功能正常的归为未成模组(None group)。40只SPF级SD雄性大鼠，先按时间随机分为两组(每组20只)，分别是注射STZ后7周组和4周组，再按处理因素即给予大鼠腹腔注射STZ(60mg／kg)是否成模，分为对照组(未注射STZ，5只)、成糖尿病性勃起功能障碍模型组、成糖尿病性非勃起功能障碍组、未成模组。根据α-actin是血管平滑肌表型转化过程中的收缩型的敏感标志，骨桥蛋白(OPN)是合成型的标志，其表达的改变将标志着细胞由收缩型向合成型转化。利用结蛋白(Desmin)的表达的改变间接反应平滑肌细胞数目的改变。利用免疫组化SP染色法对不同处理组的标本进行α-actin的研究，利用免疫组化SABC染色法对不同处理组的标本进行Desmin的研究，利用原位杂交技术检测不同组别OPN mRNA含量的改变。图像分析利用彩色图文分析系统，第三人进行图像分析及数据采集，测量随机每高倍镜视野下累积光密度(IOD)，以IOD的值反映组织切片中相应阳性物质的表达程度。6．糖尿病性大鼠白膜弹性纤维成分改变对勃起功能的影响：将上述第5项的阴茎组织切片，利用维多利亚蓝—丽春红染色法对不同处理组的标本进行弹性纤维的染色，利用彩色图文分析系统，第三人进行图像分析及数据采集，测量随机每高倍镜视野下染成蓝绿色的弹性纤维累积光密度(IOD)，以IOD的值反映组织切片中弹性纤维的含量。7．糖尿病对大鼠生精功能的影响：将上述第5项大鼠，按照实验要求，将大鼠麻醉后取出睾丸，4％多聚甲醛固定后，常规石蜡包埋，并连续切片，厚度5μm，进行常规H.E染色，利用图像采集系统进行摄片，最后对采集的图片进行形态学描述。结果：1．阿朴吗啡致大鼠阴茎勃起的研究：APO大鼠颈项部皮下注射后，前30分钟内勃起次数比后30分钟内的勃起次数显著较高(F=192.651，P=0.000)。对照组比其余各组的勃起次数均显著减少(P均小于0.001)。注射APO60μg／kg组与注射APO80μg／kg组间(P=0.336)及注射APO100μg／kg组与注射APO120μg／kg组间的勃起次数均无显著性差异(P=0.872)。注射APO60μg／kg组的勃起次数比注射APO100μg／kg组和注射APO120μg／kg组间的勃起次数均明显减少(P均小于0.05)。2．探讨阿朴吗啡致大鼠阴茎勃起及空腹血糖正常值范围：空腹血糖的95％正常参考值范围是4.0—7.2 mmol／L。APO给予大鼠皮下注射后，所有大鼠均出现勃起，在注射APO后的半小时内，最少勃起为1次，最多勃起为5次。3．糖尿病勃起功能障碍大鼠模型的建立：注射STZ后，4d、1周、2周、3周四个时间点间的空腹血糖有显著性差异(F=7.297，P=0.002)，第4d与第1、2、3周都有差异(O值分别是0.033，0.001，0.000)，且以第4d的空腹血糖较高，余两两间无显著性差异。不同组别间的空腹血糖存在显著性差异(F=16.508，P=0.000)，APO阴茎勃起实验的勃起次数在四个时间点间不存在显著性差异(F=1.236，P=0.306)，不同组别间的勃起次数不存在显著性差异(F=2.676，P=0.065)。体质量的改变在不回时间点间无显著性差异(F=0.584，P=0.628)。不同组别间的体质量改变有显著性差异(F=17.152，P=0.000)。4．不同月龄大鼠阴茎组织形态学研究：正常1月龄大鼠阴茎组织结构与其它组间有较大差异，1月龄大鼠阴茎海绵体只是含有一个圆柱状的海绵体柱，而且其中血窦小梁稀少，小梁中的平滑肌结构不是很清晰，且数量较少。其余3组间阴茎组织结构未见明显差别，阴茎海绵体有两个类圆柱型的海绵体构成，但两个海绵体间缺少明显的白膜间隔。5．α-actin免疫组化染色各处理组间IOD存在显著性差异(F=12.937，P=0.000)，糖尿病性勃起功能障碍组IOD均小于对照组、糖尿病非勃起功能障碍组及未成模组(P＜0.05)，糖尿病非勃起功能障碍组的IOD小于对照组和未成模组(P＜0.05)，不同时间点间的IOD不存在显著性差异(F=0.608，P=0.442)，交互效应不显著(F=2.130，P=0.120)。Desmin免疫组化染色不同时间点间的IOD不存在显著性差异(F=0.052，P=0.821)，各处理组间的IOD不存在显著性差异(F=0.045，P=0.987)，交互效应不显著(F=0.572，P=0.639)。OPN mRNA原位杂交染色不同时间点间的IOD不存在显著性差异(F=0.984，P=0.330)，各处理组间的IOD存在显著性差异(F=51.648，P=0.000)，交互效应不显著(F=0.246，P=0.864)。糖尿病性勃起功能障碍组的IOD均大于其余三组(P均小于0.001)。糖尿病非勃起功能障碍组的IOD大于对照组和未成模组(P均小于0.001)。对照组的IOD与未成模组未见显著差异(P=0.739)6．糖尿病性大鼠白膜弹性纤维成分改变对勃起功能的影响：各处理组间(即对照组，糖尿病性勃起功能障碍组，糖尿病非勃起功能障碍组，未成模组)白膜弹性纤维的含量存在显著性差异(F=10.433，P=0.000)，糖尿病性勃起功能障碍组均小于对照组、糖尿病非勃起功能障碍组及未成模组(P＜0.05)，糖尿病非勃起功能障碍组小于对照组(P＜0.05)，不同时间点间不存在显著性差异(F=0.685，P=0.415)，不存在交互效应(F=0.905，P=0.452)。7．糖尿病对大鼠生精功能的影响：对照组及未成模组大鼠睾丸生精上皮规则，排列紧密，结构清晰，层次分明，精原细胞增殖正常，规则地紧贴生精小管的基底膜，向内依次为初级精母细胞、次级精母细胞、精子细胞和精子，组成多种形态的生精上皮图像。糖尿病性勃起功能障碍组和糖尿病非勃起功能障碍组睾丸生精小管内，各级生精细胞排列紊乱，形成不规则的空隙，以精原细胞为主，可见少量的精母细胞、精子细胞和成熟的精子：严重者生精小管内生精细胞排列疏松，细胞层数减少，细胞形态不一，出现大量胞体增大的精原细胞，胞膜不清，核不规则，并出现多个核碎裂小体。睾丸生精上皮变薄、生精细胞脱落，睾丸内出现了多个核碎裂小体，生精功能定会受到严重的影响。结论：1．APO诱导大鼠勃起的最佳剂量应为100μg／kg，最佳观察时间应为注射APO之后的30分钟。2．APO只要能诱导大鼠勃起即可以认为勃起功能正常，空腹血糖超过7.2mmol／L即可以认为是高血糖。3．最佳成糖尿病模型的STZ注射剂量应为60 mg／kg，筛选糖尿病ED模型的APO勃起实验筛选时间应定在注射STZ后的2周左右。4．大鼠阴茎组织是发育变化的，与人类的阴茎组织存在一定的差异。5．阴茎海绵体平滑肌在收缩成分上与心血管平滑肌有相似性；糖尿病可以引起阴茎海绵体平滑肌的表型转化；阴茎海绵体平滑肌表型转化可以导致勃起功能障碍。6．糖尿病可以导致白膜弹性纤维的减少；白膜中的弹性纤维在勃起过程起到重要作用；白膜中弹性纤维的减少将导致勃起功能障碍。7．糖尿病对大鼠的生精组织有着明显的破坏作用，对大鼠的生精功能有严重的影响。
&&&&BACKGROUND After studied on one thousand five hundred and eighty twomen beyond forty years old in Shanghai, Len Jing found that the morbidity rate oferectile dysfunction(ED) was 73.1%. The possibility of men beyond forty years oldsuffering from ED is significant higher through epidemic research. There are onehundred and fifty two million men are disturbed by ED. It is supposed that there willbe three hundred and twenty two million men suffered from ED until 2025 in world.Therefore, ED which is bad to the quality of our life should be considered seriously.In all patients of ED, 35%—75% are diabetes mellitus patients. One hundred and fiftymillion people have been diagnosed by diabetes mellitus. It is predicted that thenumber of diabetes mellitus patients will be up to three hundred million. So thedisease of diabetes mellitus with erectile dysfunction has become a high light point toandrology researcher.1. Experimental animal to chooseExperimental animal is the base of medical research because of the definition ofmoral principles, especially in andrology area. So many andrology researchers design different kinds of animal model which are used for research on ED. To guarantee thesimilarity and consistency between animal models and human beings, which animalis suitable is the first problem we should consider. The primate such as monkeys andgorilla, which is the most similar to human beings, is the best experimental animal forandrology research. In our country, there is no report that the primate is used forandrology research, because of expense, lack of animal and moral principals. Rats arethe most common animal in andrology research because they are cheap and similar tohuman beings in anatomy of cavity of pelvis, blood vessel and nerve in penis,distribution of receptor and sensory reflex to sex reaction. Though, rats were chosento research on ED.2. Anatomy of penis and mechanism of erectile functionWithin the penis are two paired corpora cavernosa and a corpus spongiosum.The corpus spongiosum which surrounds the urethra forms the glans penis distally.The corpora cavernosa separate in the perineum to form the crura, which attachbilaterally to the inferior aspect of the ipsilateral ischiopubic ramus. More distally, thecorpora cavernosa communicate in the pendulous penis. Each corpus is surrounded bya thick fibrous sheath, the tunica albuginea, which encases the spongelike cavernosattissue with multiple interconnected lacunar spaces lined by vascular endothelium. Thetrabeculae form the walls of the lacunae and are composed of thick bundles of smoothmuscle and a fibroelasic framed consisting of fibroblasts, collagen, and elastin.Erection follows the relaxation of penile smooth muscle. Dilation of thecavernosal and helicine arteries increases blood flow to the lacunar spaces. Relaxationof the trabecutar smooth muscle dilates the lacunar spaces, causing engorgement ofthe penis. The systemic blood pressure, now transmitted through the dilated helicinearteries, expands the relaxed trabecular walls against the tunica albuginea. Thiscompresses the plexus of subtunical venules, reduces venous outflow in the lacunar space, and elevates lacunar space pressure, making the penis rigid. The pressure in thelacunar space during an erection is the result of the equilibrium between the perfusionpressure in the cavernosal artery and the resistance to blood outflow through thecompressed subtunical venules. The reduction of venous outflow by the mechanicalcompression of subtunical venules is known as the corporal venoocclusivemechanism.Detumescence is the result of the contraction of penile smooth muscle. Theactivation of sympathetic constrictor nerves causes an increase in the smooth muscletone of the helicine arteries and the trabeculae. This results in a reduction of arterialinflow and collapse of the lacunar spaces, with decompression of subtunical venulesand increased venous outflow from the lacunar spaces, returning the penis to theflaccid state.3. Research on phenotype modulation of smooth muscle in corpus cavernosumIn normal men, the content of smooth muscle in corpus cavernosum is 40%—52%. In ED caused by venoocclusive dysfunction, the content of smooth muscle incorpus cavernosum is 19%—36%. In ED caused by shortage of blood supply, thecontent of smooth muscle in corpus cavernosum is 10%—25%. The content ofsmooth muscle in corpus cavernosum will decrease with age.Recently, the research on the role played by smooth muscle on cardiovasculardisease is extensive and intensive. A classic view is that adult vascular smooth musclecells have the capacity to modulate their phenotype, or state of differentiation, in abidirectional manner. This concept was first hypothesized in 1967 by Wissler.Corpus cavernosum is considered as special vascular tissue. Smooth muscle cells intrabeculae have similar function to that in vessels. So whether there is possibility thatsmooth muscle can convert between noncontractile and contractile phenotypes, thereports concerned does not be found. 4. Changes of elastic fiber in tunica albuginea on erectile functionThe tunica albuginea is made up of almost completely of i itis able to expand during erection owing to the undulations of its collagenous fibers ina state of flaccidity. The fibers making up the intracavernosal fibrous framework willalso be stretched until the fibers become straight. The sparse elastic fibers may helpthe collagenous fibers of all fibrous elements to regain their undulations in flaccidity.Since the intracavernosal pressure during erection is highly elevated, the arteries andnerves would probably be unable to function if they were not surrounded by fibroussheaths to which the bundles of fibers of the fibrous framework are attached. Thisanatomical arrangement probably prevents the collapsing of arteries and thecompression of nerves during erection, when the elements of the fibrous frameworkstretch. In this latter condition the fibrous bundles of the intracavernsal frameworkpull on the fibrous sheaths around the arteries and the nerves from all directions whilebeing stretched by the distension of the tunica albuginea and its columns during thefilling of the vascular spaces of the corpora when erected. Without the parenchymalframework attached to all fibrous elements of the corpora, and especially to the deepsurface of the tunica albuginea, it is difficult to conceive how the corpora, relativelythin structures compared with their length, would resist flexing and frequent rupturesduring erection and intercourse.5. The contribution of apomorphine (APO) to andrology areaApomorphine is a kind of alkaloid, which is the semisynthesis of morphine andwhose anesthesia effect is lowed down. But its stimulation effect on central nervesystem is stronger, especially on receptor of vomiting in medulla oblongata. So APOis usually to make patients to vomit in clinic. But when rats are injected with APO 30μg per kilogram weight, the erectile function is strengthened obviously by APO. Innormal situation, spontaneous erection is rare in rats. But after injection of micro amount of APO, rats show penis erection, strength, and yawning syndromes. Thesesyndromes usually appear at about ten minutes after APO injection, and can lasttwenty to thirty minutes. Therefore, to inject APO to rats is an effective and good wayto judge rats whether are suffering from ED.Objective 1.how to build diabetes mellitus rats model with erectile dysfunction:①To investigate the best dose of apomorphine(APO) and observation time oferection induced by APO.②To supply erectile dysfunction rats model and (or)diabetes mellitus rats model with standards through research on penile erectionsinduced by apomorphine(APO) and fasting serum glucose.③To construct idealmodel of diabetes mellitus erectile dysfunction(ED) in rats throughstreptozotocin(STZ) injection. 2. To research on morphology of penis tissue in rats ofdifferent moon’s age. 3. To investigate phenotype modulation of smooth muscle ofcorpus cavernosum in diabetes mellitus rats with erectile dysfunction. 4. Toinvestigate the changes of elastic fiber in penis tunica albuginea in diabetes mellitusrats on erectile function. 5. To study on the effect of diabetes mellitus onspermatogenesis in rats.Methods1. To investigate the best dose of apomorphine(APO) and observation time oferection induced by APO: Fifteen male SD rats ,each rat was tested with each dose ofAPO in sequence(0μg/kg, 60μg/kg, 80μg/kg, 100μg/kg, 120μg/kg) at sameperiod(9 am to 11 am),one dose per day.2. To supply erectile dysfunction rats model and (or) diabetes mellitus rats modelwith standards through research on penile erections induced by apomorphine(APO)and fasting serum glucose: Thirty SD rats were observed erectile frequency after 100μg/kg APO injection and glucose was recorded after 12 hours fasting. 3. To construct ideal model of diabetes mellitus erectile dysfunction(ED) in ratsthrough streptozotocin(STZ) injection: Thirty male SD rates were randomly dividedinto five groups(control group、STZ 40 mg/kg group、STZ 60 mg/kg group、STZ 80mg/kg group、STZ 100 mg/kg group),6 rats each group. And all rats were observedfour days, one week, two weeks and three weeks after STZ injection. Fasting bloodglucose, erectile frequency induced by apomorphine and change of mass should berecorded.4. To research on morphology of penis tissue in rats of different moon’s age:There were four groups, each group had 5 rats. These groups were 1-month-old group,2-month-group group, 3-month-old group and 4-month-old group. All rats’ peniseswere cut off at the root of penis after anesthesia. Penises were embedded in paraffin.All slices were staininged by hematoxylin and eosin staining. After the pictures ofslices were collected through digital camera, morphology of penis tissue should bedescribed.5. To investigate phenotype modulation of smooth muscle of corpus cavernosumin diabetes mellitus rats with erectile dysfunction: Diabetes metlitus rats model andwith erectile dysfunction were made through streptozotocin (STZ) injection. 40 ratswere first divided into two groups randomly, 20 rats each that were 4 week group and7 week group. And then divided into four groups, that were control group(5 rats each,without STZ injection), diabetes mellitus rats with erectile dysfunctiongroup(DM&ED group), diabetes mellitus rats without erectile dysfunctiongroup(DM group) and rats without diabetes mellitus and erectile dysfunction groupafter STZ injection(None group). Immunohistochemical staining method and colorimage analysis were used to observe expression of a-actin and desmin in rats corpuscavernosum of different group on the basis of theory that the content of a-actin is akind of sensitive sign of phenotype modulation of smooth muscle in vascular tissue and its decrease accompanies with phenotype modulation of smooth muscle and thecontent of desmin is indirect sign of quantity of smooth muscle cells. Andnoncontractil phenotype is characterized by osteopontin (OPN). So content of OPNmRNA should be detected in situ hybridization.6. To investigate the changes of elastic fiber in penis tunica albuginea in diabetesmellitus rats on erectile function: Diabetes mellitus rats model and with erectiledysfunction were made through streptozotocin (STZ) injection. 40 rats were firstdivided into two groups randomly, 20 rats each that were 4 weeks group and 7 weeksgroup. And then divided into four groups, that were control group(5 rats each, withoutSTZ injection), diabetes mellitus rats with erectile dysfunction group(DM&EDgroup), diabetes mellitus rats without erectile dysfunction group(DM group) andrats without diabetes mellitus and erectile dysfunction group after STZinjection(None group). Victoria blue/Ponceau red staining and color image analysiswere used to observe the content of elastic fiber in tunica albuginea.7. To study on the effect of diabetes mellitus on spermatogenesis in rats: FortySPF rats were used for building diabetes mellitus model induced by treptozotocin(STZ). 40 rats were first divided into two groups randomly, 20 rats each that were 4week group and 7 week group. And then divided into four groups, that were controlgroup(5 rats each, without STZ injection), diabetes mellitus rats with erectiledysfunction group(DM&ED group), diabetes mellitus rats without erectiledysfunction group(DM group) and rats without diabetes mellitus and erectiledysfunction group after STZ injection(None group). Testes were got after anesthesia.And then testes were fixed in 4% paraformaldehyde. Embedded in paraffin, andsections were 5μm. All slices were staininged by hematoxylin and eosin staining.After the pictures of slices were collected through digital camera, morphology ofpenis tissue should be described. Results1. To investigate the best dose of apomorphine(APO) and observation time oferection induced by APO: Significant difference exists in erectile frequency amongfirst 30 minutes group via followed 30 minutes group (F=192.651, P＜0.001), 60μg/kg group via 100μg/kg group (P＜0.05), 60μg/kg group via 120μg/kg group (P＜0.05). There exists no significant difference in erectile frequency among 60μg/kggroup via 80μg/kg(P=0.336) and 100μg/kg group via 120μg/kg group(P=0.813).2. To supply erectile dysfunction rats model and (or)-diabetes mellitus rats modelwith standards through research on penile erections induced by apomorphine(APO)and fasting serum glucose: 95% reference range fasting serum glucose is 4.0 mmol/Lto 7.2 mmol/L.And all rats injected by APO showed penis erection in fist thirtyminutes.3. To construct ideal model of diabetes mellitus erectile dysfunction(ED) in ratsthrough streptozotocin(STZ) injection: Significant difference exists in fasting foodglucose among groups of different test time(F=7.297, P=0.002). There is significantdifference in fasting blood glucose and change of mass between groups of differentdose of STZ injection (P＜0.001).There is no significant difference in erectilefrequency induced by apomorphine and change of mass between groups of differenttest time(F=1.236, P=0.306 and F=0.584, P=0.628).4. To research on morphology of penis tissue in rats of different moon’s age:There was much difference between 1-month-old group rats and other 3 groups. In1-month-old group, within the penis were one corpora cavernosa (not two pairedcorpora cavernosa) and a corpus spongiosum. The trabecutae formed the walls of thelacunae and were composed of few bundles of smooth muscle and collagen. In otherthree groups, there was no difference in morphology between these three groups.Penis was formed by two paired corpora cavernosa and a corpus spongiosum, but albuginea septum between two paired corpora cavernosa did not exist.5. Expression of a-actin of smooth muscle in corpus cavernosum in DM&EDgroup is the lowest in all four groups (P＜0.05). No significant difference existsbetween 7 week group and 4 week group(F=0.608, P=0.442), and so doesinteraction(F=2.130, P=0.120). There is no significant difference in expression ofdesmin of smooth muscle in corpus cavernosum between four group( F=0.045, P=0.987) and so do that between 7 week group and 4 week group and interaction(F=-0.045, P=0.987; F=0.572, P=0.639). Expression of OPN mRNA ofsmooth muscle in corpus cavemosum in DM&ED group is the most in all four groups(F=51.648, P=0.000). No significant difference exists between 7 week group and 4week group(F=0.984, P=0.330), and so does interaction(F=0.246, P=0.864).6. To investigate the changes of elastic fiber in penis tunica albuginea in diabetesmellitus rats on erectile function: There exists significant difference between differenttest group (F=10.433, P=0.000). The content of elastic fiber in tunica albuginea inDM&ED group is the lowest in all four groups (P＜0.05). No significant differenceexists between 7 weeks group and 4 weeks group(F=0.685, P=0.415),and so doesinteraction(F=0.905, P=0.452).7. To study on the effect of diabetes mellitus on spermatogenesis in rats: Incontrol group and none group, the arrangement of seminiferous epithelium is regular.The alignment is compact. The architecture is lampros. Proliferation ofspermatogonium is normal, which is laid on the lamina of seminiferous tubuleregularly. But in DM and DM&ED group, the arrangement of spermatogenic cell ineach grade was in disorder. And few spermatocyte, spermatid and sperm can befounded.Conclusion1. The best dose of apomorphine (APO) is 100μg/kg and the best observation time of erection induced by APO is the first 30 minutes after APO injection.2. In rats, erectile dysfunction can not be considered if penile erection exists afterAPO injection, and diabetes mellitus can be considered if fasting serum glucoseexceeds 7.2 mmol/L.3. The best dose of STZ injection to construct ideal diabetes metlitus rats modelis 60 mg/kg and the best time to choose ED rats model is about two weeks after STZinjection.4. There exist difference in penis morphology between human and rat. And themorphology of penis in rats develops with age.5. The architecture of smooth muscle to contract in corpus cavernosum is similarwith that in vascular tissue. Phenotype modulation of smooth muscle in corpuscavernosum can be caused by diabetes mellitus disease. Erectile dysfunction can becaused by phenotype modulation of smooth muscle in corpus cavernosum.6. Decrease of elastic fiber in tunica albuginea can result from diabetes mellitusdisease. Elastic fiber in tunica albuginea plays an important role in the course oferection. Erectile dysfunction can be caused by the decrease of elastic fiber in tunicaalbuginea.7. Diabetes mellitus has a bad effect on spermatogenesis, also can destroy thestructure of seminiferous epithelium.
&&&&&&&&&&糖尿病性勃起功能障碍大鼠阴茎海绵体平滑肌表型转化及白膜纤维成分改变的研究摘要3-11ABSTRACT11-20第一章 糖尿病性勃起功能障碍大鼠模型的建立25-51&&&&第一节 阿朴吗啡致大鼠阴茎勃起的研究25-34&&&&&&&&第一小节 摘要25-26&&&&&&&&第二小节 ABSTRACT26-27&&&&&&&&第三小节 实验材料和方法27-29&&&&&&&&第四小节 实验结果29-31&&&&&&&&第五小节 讨论31-33&&&&&&&&第六小节 参考文献33-34&&&&第二节 探讨阿朴吗啡致大鼠阴茎勃起及空腹血糖正常值范围34-41&&&&&&&&第一小节 摘要34-35&&&&&&&&第二小节 ABSTRACT35-36&&&&&&&&第三小节 实验材料和方法36-37&&&&&&&&第四小节 实验结果37-38&&&&&&&&第五小节 讨论38-40&&&&&&&&第六小节 参考文献40-41&&&&第三节 糖尿病勃起功能障碍大鼠模型的建立41-51&&&&&&&&第一小节 摘要41-43&&&&&&&&第二小节 ABSTRACT43-44&&&&&&&&第三小节 实验材料和方法44-45&&&&&&&&第四小节 实验结果45-48&&&&&&&&第五小节 讨论48-50&&&&&&&&第六小节 参考文献50-51第二章 不同月龄大鼠阴茎组织形态学研究51-72&&&&第一节 摘要51-53&&&&第二节 ABSTRACT53-54&&&&第三节 实验材料和方法54-55&&&&第四节 实验结果55-59&&&&第五节 讨论59-61&&&&第六节 参考文献61-62&&&&第七节 附图62-72第三章 糖尿病勃起功能障碍大鼠阴茎海绵体平滑肌表型转化的研究72-100&&&&第一节 摘要72-74&&&&第二节 ABSTRACT74-76&&&&第三节 实验材料和方法76-80&&&&第四节 实验结果80-82&&&&第五节 讨论82-86&&&&第六节 参考文献86-88&&&&第七节 附图88-100第四章 糖尿病性大鼠白膜弹性纤维成分改变对勃起功能的影响100-113&&&&第一节 摘要100-101&&&&第二节 ABSTRACT101-102&&&&第三节 实验材料和方法102-104&&&&第四节 实验结果104-105&&&&第五节 讨论105-107&&&&第六节 参考文献107-108&&&&第七节 附图108-113第五章 糖尿病对大鼠生精功能的影响113-135&&&&第一节 摘要113-115&&&&第二节 ABSTRACT115-116&&&&第三节 实验材料和方法116-118&&&&第四节 实验结果118-120&&&&第五节 讨论120-121&&&&第六节 参考文献121-122&&&&第七节 附图122-135第六章 综述:阴茎海绵体平滑肌表型转化及白膜纤维成分改变对勃起的影响135-143攻读博士学位期间成果143-144致谢144-145
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