Fresh Osteochondral Allograft Transplantation for Treatment of Large Cartilage Defects of the Femoral Head: A Minimum Two-Year Follow-Up Study of Twenty-Two Patients

Background

Controversy remains over the surgical management of large osteochondral lesions of the femoral head in young, active patients. The purpose of this study is to assess midterm clinical and radiographic outcomes after fresh osteochondral allograft transplantation (OAT) for large femoral head lesions at minimum 2-year follow-up.

Quantitative assessment of fascia preservation improves the prediction of membranous urethral length and inner levator distance on continence outcome after robot‐assisted radical prostatectomy

Aims

To determine whether preoperative prostate/pelvic anatomical structures and intraoperative fascia preservation (FP) predict continence recovery after robot‐assisted radical prostatectomy (RARP).

Methods

Between January 2012 and March 2016, 439 prostate cancer (PCa) patients with normal preoperative continence were retrospectively included. FP score was defined as the extent of FP from base to apex of the prostate, quantitatively assessed by the surgeon. Anatomical prostate structures were measured on endorectal preoperative Magnetic Resonance Imaging. The International Consultation on Incontinence Questionnaire‐Short Form (ICIQ‐SF) was used to assess urinary incontinence (UI). Cox analysis was used to determine predictive factors for early continence recovery. Finally a binary logistic regression analysis was performed to develop a risk calculator.

Results

At a median follow up of 12.1 months 50.8% of men reported UI. In the Cox multivariate analysis longer membranous urethral length (MUL; P < 0.0001; OR 1.309; CI 1.211, 1.415) and shorter inner levator distance (ILD; P < 0.0001; OR 0.904; CI 0.85, 0.961) were predictors of earlier continence recovery. In the multivariate binary logistic regression analysis longer MUL (P < 0.0001; OR 1.565, CI 1.362, 1.798), shorter ILD (P < 0.0001; OR 0.819, CI 0.742, 0.904) and higher FP score (P = 0.024; OR 1.089, CI 1.011, 1.172) were independent predictors of continence outcome. The risk calculator predicted continence recovery between 1.3% and 99%.

Conclusions

Preoperative longer MUL and shorter ILD, but also intraoperative FP independently improve continence recovery after RARP. The risk calculator could be used to identify patients at high risk of UI.     

男护生对中医护理本科课程设置的看法及教学对策

目的 了解中医护理本科男生（男护生）对现行课程体系的看法，为制定符合男护生特点的课程体系研究提供依据。方法 使用自制的调查问卷，调查某校47名男护生对中医护理本科现行课程设置的看法。结果 男护生对中医护理本科课堂教学项目的满意率为11％-40％，83％的男护生认为目前护理操作含量低，琐碎，不屑学习，分别有51％和77％的男护生认为应加强特色专科课程及人文课程的学习。结论 要适应男护生的特点，全面提升男护生的知识、能力、素质，学校应该适当调整课程结构，加强男护生特色专科课程的理论教学和实践活动，编写适合男护生的教材，拓展男护生知识结构，加强专科护理技术教学，注重基础护理培训，缩减医学基础课，增加实践课、人文课程等。     

利多卡因加液体石蜡用于男性导尿的观察

目的 观察利多卡因加液体石蜡在男性导尿中的效果。方法 将90例接受导尿的清醒男病人随机分为两组，观察组48例，在常规插尿管前自尿道外口注入利多卡因液体石蜡混合液，对照组42例，按常规导尿法插尿管。两组均以插尿管时患疼痛的主诉及插管时所遇阻力为判断指标。结果 两组在导尿时疼痛及插管阻力经x^2检验分别x^2=8.62,x^2=5.59,均P＜0．05,有显性差异。结论 利用卡因加液体石蜡用于男性导尿明显减轻插管时的疼痛，显提高导尿的成功率。     

Endocrine effects of breast cancer treatment

OBJECTIVES: To discuss long-term physical effects of treatment for breast cancer including effects on reproductive, bone, sexual health, and related women's issues. DATA SOURCES: Research articles, abstracts, literature reviews. CONCLUSION: Long-term effects of treatment have become increasingly prevalent in breast cancer survivors. The most common are effects on reproductive, bone, and sexual health. IMPLICATIONS FOR NURSING PRACTICE: Long-term effects of treatment can have a significant negative impact on the long-term health and QOL of women with breast cancer. Oncology nurses are well-positioned to anticipate and address the reproductive and endocrine consequences of breast cancer treatment.     

血小板冻干保存的研究进展

冻干是保存血小板最理想的方法，能常温保存、占用空间小、重量轻和便于运输等，可解决目前血小板保存和运输方面存在的局限性问题。然而冻干除引起血小板膜结构损伤、蛋白质变性甚至死亡之外．还可致血小板激活损伤，冻干所致的血小板激活与膜通道脂质发生相变有关。针对损伤机制应用各种保护剂可减少冻干损伤．目前已有研究通过海藻糖的载入，在实验室成功地进行了血小板的冻干保存，冻干再水化后血小板仍具有正常生理功能和存活能力。这些研究结果表明血小板的冻干保存可应用于将来的血库和临床输血。本文综述了冷冻干燥对血小板损伤作用、保护剂在血小板冷干研究中的应用及血小板冻干保存的实验研究。