Seminoma With Bronchial Involvement and Superior Vena Cava Syndrome: A Rare Combination

We describe the case of a 45-year-old male who was admitted with clinical signs of superior vena cava syndrome (SVCS). Physical examination showed collar of Stokes and extensive collateral circulation in the neck and anterosuperior thoracic region, as well as a large testicular mass. Fibrobronchoscopy revealed an endobronchial tumor, histopathologically diagnosed as seminoma, with the same characteristics as the testicular biopsy. Treatment was initiated with surgery, chemotherapy and radiotherapy, resulting in a major clinical improvement. We indicate the importance of considering SVCS as an entity related with less common neoplasms such as germ cell tumors.     

天狼星红苦味酸染色法和MASSON染色法在显示大鼠肾脏胶原纤维的比较应用

目的比较天狼星红苦味酸染色法和MASSON三色染色法用于大鼠肾脏标本胶原纤维染色的效果。方法建立大鼠单侧输尿管梗阻肾间质纤维化模型,取梗阻侧肾脏标本,行天狼星红染色和MASSON三色染色,图像分析软件测定肾间质胶原面积。结果天狼星红染色和MASSON三色染色都能显示出胶原纤维,两种方法测定胶原面积无显著差异。天狼星红染色标本在偏光显微镜观察能分辨胶原类型。结论天狼星红苦味酸染色法比MASSON三色染色法操作步骤简单．是显示胶原的优良方法。     

Repeat HIV Testing and Incident Rates among Individuals Attending Voluntary Counseling and Testing Clinics in Wuxi,China: A Retrospective Study

Objective We aimed to elucidate the rates of repeat HIV testing and incident HIV diagnosis,and baseline CD~(4+) T cell count among individuals attending HIV voluntary counseling and testing(VCT) clinics in Wuxi,China.Methods A repeat HIV testing within 12 months was recorded if individuals had their first test with negative results,during 2013-2014 and retested within 12 months.An incident HIV diagnosis was recorded if individuals had their first test with negative results,during 2013-2015 and had a subsequent positive result at any point by the end of 2015.Data on HIV testing and diagnosis among individuals attending 32 VCT clinics from 2013 to 2015 and HIV diagnosis from other clinical services in Wuxi,China,were retrieved.A multivariate logistic regression model was used to analyze factors associated with repeat HIV testing.Cox regression was used to evaluate factors associated with incident HIV diagnosis.Results From 2013 to 2014,11,504 individuals tested HIV negative at their first recorded test,with 655(5.7%) retesting within 12 months.Higher repeat HIV testing within 12 months was associated with male gender [adjusted odds ratio(a OR) = 1.7,95% confidence interval(CI): 1.4-2.2],risk behaviors [commercial heterosexual behaviors(a OR = 1.4,CI: 1.1-1.6),male-male sexual behaviors(a OR = 3.7,CI: 2.7-4.9)],injection drug use(a OR = 9.9,CI: 6.5-15.1),and having taken HIV tests previously(a OR = 2.0,CI: 1.6-2.4).From 2013 to 2015,1,088 individuals tested negative on HIV test at their visit and at ≥ 2 subsequent tests; of them 30 had incident HIV diagnosis.The overall rate of incident HIV diagnosis among all VCT individuals was 1.6(95% CI: 1.1-2.1) per 100 person-years.Incident HIV diagnosis was associated with male gender [adjusted hazard ratio(a HR) = 8.5,95% CI: 1.9-38.1],attending hospital-based VCT clinics(a HR = 7.8,95% CI: 1.1-58.3),and male-male sexual behavior(a HR = 8.4,95% CI: 1.5-46.7).Individuals diagnosed at VCT clinics had higher CD~(4+) T cell count compared with those diagnosed at other clinical services(median 407 vs.326 copies/mm~3,P = 0.003).Conclusion VCT individuals in Wuxi,China,had a low repeat HIV testing rate and high HIV incidence.VCT-clinic-based interventions aimed at increasing repeat HIV testing are needed to detect more cases at an earlier stage,especially among individuals at high risk for HIV infection such as men who have sex with men.     

螺旋CT在乳腺疾病的应用

目的 评价CT在乳腺疾病诊断和鉴别诊断的价值。方法 52例病理证实的乳腺疾病先作全乳腺的平扫,其中38例平扫后加增强扫描,47例同时进行钼钯照片。结果 肿块边缘的毛刺、尖角及细小的簇状钙化为乳腺癌较特征性的表现。病灶明显强化、皮肤增厚、皮下索条状增粗影也是重要的征明。结论 CT在乳腺疾病的诊断和鉴别诊断,判断预后有重要价值。     

周剂量多西紫杉醇联合顺铂和氟尿嘧啶治疗晚期胃癌

目的 观察周剂量多西紫杉醇联合顺铂和氟尿嘧啶方案治疗晚期胃癌的临床疗效和毒性反应.方法 晚期胃癌患者31例,给予多西紫杉醇35 mg/m2,静脉滴注1 h,第1、8、15天;顺铂20 mg/m2,静脉滴注4 h,第2～6天;5-氟尿嘧啶750 mg/m2,持续静脉滴注24 h,第2～6天;28 d为一周期,至少治疗2个周期,按标准评价疗效和毒性反应.结果 全组31例均可评价疗效,总有效率为48.4%,其中17例初治患者有效率为64.7%,CR 2例;14例复治患者有效率为28.6%.中位肿瘤进展时间6个月,中位生存期11个月,1年生存率41.9%.主要毒性反应为骨髓抑制、消化道反应和脱发,多数为1～2 度.结论 周剂量多西紫杉醇联合顺铂和氟尿嘧啶治疗晚期胃癌疗效较好,毒性反应较轻,耐受性好.     

产业工人中男男性行为HIV感染者确证前后的高危性行为变化及相关因素研究

目的了解产业工人中男男性行为HIV感染者(MSM感染者)在确证前后的高危性行为变化及相关因素, 为制定针对HIV感染者的行为干预措施提供依据。方法 2021年8-9月在深圳市开展横断面调查, 通过方便抽样选取产业工人中MSM感染者为研究对象, 估计样本量为530人。问卷调查结合日常随访收集研究对象社会人口学、高危性行为、性伴告知、病毒载量检测和性病患病史等信息。采用χ2检验比较确证前后的高危性行为的差异, 采用多因素logistic回归分析研究对象确证后12个月内高危性行为的相关因素。结果产业工人中MSM感染者560例, 确证后12个月内发生无保护肛交(UAI)的比例为32.1%(180/560)。确证前12个月内与同性临时、商业和固定性伴发生UAI的比例分别为73.4%(381/519)、75.1%(187/249)和69.5%(207/298), 确证后12个月内分别降低到36.2%(146/403)、40.2%(86/214)和34.2%(67/196), 差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示, 研究对象确证后12个月内发生UAI的保护...     

强化健康教育对预防耳科眩晕患者跌倒的研究

目的：对耳科眩晕患者强化健康教育，提高护理质量，避免患者的意外跌倒，减少医疗纠纷的发生。方法：对2007年6月至2008年6月在耳专科住院的103名眩晕患者进行强化入院、心理、活动、药物治疗、平衡康复等健康教育。结果：所有眩晕患者在位院期间无一例意外跌到。结论：强化健康教育，使眩晕患者树立防跌倒的意识，掌握防跌倒的方法，能有效地防止意外跌倒，提高护理质量。     

益肾汤对实验性IgA肾病模型小鼠肾组织转化生长因子β_1表达的影响

[目的]观察益肾汤对实验性IgA肾病(IgAN)模型小鼠肾组织转化生长因子β1(TGF-β1)表达的影响.[方法]选用BALB/c小鼠,采用口服牛血清白蛋白联合尾静脉注射葡萄球菌肠毒素B方法复制小鼠IgAN模型,抽样检测造模小鼠24 h尿蛋白定量、肾组织过碘酸雪夫反应(PAS)染色及免疫荧光检查,确定造模成功后随机分为模型组,益肾汤高、低剂量组(剂量分别为0.1、0.05 g·kg-1·d-1),并设正常对照组;采用荧光定量聚合酶链反应(FQ-PCR)法检测各组小鼠肾组织TGF-β1mRNA表达,免疫组化法检测各组肾组织TGF-β1含量.[结果]模型组肾组织TGF-β1mRNA表达及TGF-β1含量均显著升高(P<0.05);益肾汤高、低剂量组肾组织TGF-β1mRNA表达及TGF-β1含量均显著降低(P<0.05).[结论]益肾汤治疗IgAN的作用与抑制肾组织中TGF-β1的分泌及其mRNA表达有关.     

Bacillus subtilis inhibits growth of Cladophialophora carrionii in vitro

The antifungal activity of Bacillus subtilis against a strain of Cladophialophora carrionii was evaluated using plate diffusion (PD) and sealed plate (SP) methods. For the PD test, the inoculum was obtained by homogenizing the log-phase fungus, adjusted to 0.5 McFarland and seeded (0.5 ml) on Sabouraud dextrose agar (SDA) plates; the B. subtilis extract was prepared from an 8-day culture, whose supernatant was lyophilized, concentrated 10 × and distributed (40 μl) in 4-mm holes previously punched in the seeded SDA plates. The plates were incubated at 30 °C for 72 hours. For the SP method, the inoculum was obtained from a 3-day fungal culture, seeded in the center of a SDA plate and placed over a SDA plate which had been inoculated with 0.2 ml of B. subtilis suspension. The two plates were sealed together and incubated for 7 days, either at room temperature or at 30 °C. With the PD method, a 20-mm diameter halo was observed after 72 h of incubation and the SP method showed 25% of fungal inhibition at both temperatures assayed. The results obtained with either method suggest the presence of metabolites from the bacterium that effectively inhibit the growth of C. carrionii. Although a single strain of C. carrionii was used here, these preliminary results provide grounds for further work to confirm the antifungal potential of B. subtilis against agents of chromoblastomycosis or to further characterize the chemical nature of the inhibitory substances involved.     

The loss of αSNAP downregulates the expression of occludin in the intestinal epithelial cell of acute pancreatitis model

Background and objectiveIntestinal barrier damage is an important event during the occurrence and progression of severe acute pancreatitis. The expression of occludin, one of the main components of the intestinal barrier proteins, is regulated by various factors related to intestinal barrier formation and the remodeling process. The αSNAP, as a novel membrane protein, is ubiquitously expressed in intestinal epithelial cells. This study aimed to investigate the role of αSNAP in acute pancreatitis and the relationship between occludin and αSNAP.MethodsMild and severe acute pancreatitis models were established by retrograde injections of 0.5% and 3.8% sodium taurocholate solutions, respectively, into rat pancreaticobiliary ducts. The animals were killed at 1, 2, and 3 days after the injection, and the pathological changes of the pancreas and intestinal mucosa, the changes in intestinal permeability, and the protein expression of occludin and αSNAP were assessed. Cultured epithelial IEC-6 cells were further infected with lentiviral αSNAP shRNA, cell apoptosis was determined with flow cytometry (FCM), and any changes in occludin expression were detected by Western blotting and immunofluorescent staining.ResultsThis pathologic study of a rat acute pancreatitis model indicated pancreatic tissue necrosis and inflammatory cell infiltration; the intestinal villi in the severe acute pancreatitis (SAP) group demonstrated edema, lodging, atrophy, and intestinal epithelial cell necrosis, and shedding. The intestinal permeability in rats with pancreatitis increased significantly. The SAP group showed significantly increased levels of serum TNF-α and endotoxins. The results of immunofluorescent staining and Western blotting revealed that compared with the SO (sham operation) and MAP (mild acute pancreatitis) groups, the SAP group displayed significantly downregulated protein expressions of αSNAP and occludin in the intestinal epithelial cells. After the lentiviral transduction of αSNAP shRNA, apoptosis in IEC-6 cells was drastically increased, whereas the expression of occludin was decreased significantly.ConclusionThe downregulated expression of αSNAP in intestinal epithelial cells leads to reduced occludin expression and enhanced apoptosis of intestinal epithelial cells. Hence, the permeability of the intestinal barrier may be increased in a severe acute pancreatitis model.