fibulin-5基因在人脑胶质瘤中的表达

【目的】初步探讨fibulin-5基因在胶质瘤中的表达情况及其与胶质瘤发生、发展的关系。【方法】检测fibulin-5 mRNA在正常脑组织（7例）和低分级胶质瘤组（22例）和高分级胶质瘤组（15例）脑组织中的表达情况。【结果】fibulin-5 mRNA在对照组正常脑组织中,所有7例标本均检测到表达;在低分级胶质瘤组中,22例标本有14例检测到表达;在高分级组中,15例标本有3例检测到表达。正常脑组织标本的fibulin-5 mRNA表达阳性率以及平均IOD值和低分级组相比无统计学差异（P〉0．05）;高分级胶质瘤组的fibulin-5 mRNA表达阳性率以及平均IOD值均低于正常脑组织和低分级胶质瘤组的表达（P〈0．05）。【结论】fibulin-5在正常脑组织中表达。其在胶质瘤组织中表达的变化可能与胶质瘤的进展和血管生成存在联系。     

Fibulin-5和LOXL-1与女性盆底功能障碍性疾病

目的探讨阴道黏膜、子宫主韧带中Fibulin-5、LOXL-1表达变化与女性盆底功能障碍(PFD)发生的关系。方法选择因重度盆腔脏器脱垂行子宫全切术的绝经后患者30例为PFD组;以同期无盆腔脏器脱垂及尿失禁、因妇科良性疾病行子宫全切术的绝经后患者30例为对照组,于手术中取阴道黏膜、子宫主韧带。运用电子显微镜观察阴道黏膜、子宫主韧带结构的变化,采用免疫组化法检测两组阴道黏膜、子宫主韧带中Fibulin-5、LOXL-1表达变化。结果电子显微镜下PFD组阴道组织呈现大小不同空隙,弹性纤维排列紊乱,子宫主韧带组织中弹性纤维组织无序紊乱,纤维组织长度减短;免疫组化中发现,PFD组中阴道组织、子宫主韧带组织中Fibulin-5、LOXL-1者表达均减弱,但LOXL-1的表达减弱较为明显。结论 PFD患者阴道组织、主韧带组织弹性纤维组织排列紊乱,Fibulin-5、LOXL-1表达减弱,可能与PFD发生有关。     

Compliance with pelvic floor exercise program: maintaining bladder symptom relief

Urinary incontinence can cause social isolation and be a financial and hygienic burden to the individual. Pelvic floor muscle exercises can be effective in maintaining and improving urinary incontinence and associated bladder symptoms following a successful course of biofeedback and electrical stimulation.     

自发性盆腔内血肿1例

病例男,83岁,于2011年1月因咳嗽、咯痰入住当地医院,行CT检查发现盆腔占位病变,约7 cm×10 cm,体检:盆腔内可触及大小约10 cm×7 cm×7 cm的肿块,活动度可,无触痛;直肠指检肿块位于直肠膀胱间,与直肠关系不密切,质地     

Self-management of stress urinary incontinence: effectiveness of two treatment programmes focused on pelvic floor muscle training,one booklet and one Internet-based

Abstract

Objectives: In a previous study, self-management of stress urinary incontinence (SUI), via an Internet-based programme or a booklet improved symptoms and quality of life. We wanted to evaluate the effectiveness of these programmes when implemented for free use, as well as to characterize the users.

Design: Pragmatic prospective cohort study.

Setting and subjects: Information about the Internet programme and the booklet was provided at www.tät.nu and by nurse midwives. Both programmes included a three-month pelvic floor muscle training (PFMT) programme. Questionnaires were used at the start and after three months.

Main outcome measures: Characteristics of the participants regarding age and education. Reductions in symptom severity was measured using the validated ICIQ-UI SF.

Results: 109 women using the booklet, and 166 women using the Internet-based programme responded to the pre-treatment questionnaire. Of these, 53 (48.6%) in the booklet group and 27 (16.3%) in the Internet group responded to the follow-up. The mean age of booklet users was higher, 59.4 years vs. 54.5 years (p?=?.005). The proportion of women with post-secondary education was high, 59% in the booklet group and 67% in the Internet group. The mean reduction in the symptom score was 2.6 points (SD 3.4) in the booklet group, and 3.4 (SD 2.9) in the Internet group. These reductions were significant within both groups, with no difference between the groups, and in the same order of magnitude as in the previous randomised controlled study.

Conclusion: Two self-management programmes for SUI, one provided as a booklet and one as an Internet-based programme, also rendered clinically relevant improvements when made freely available.

• KEY POINTS

• Female stress urinary incontinence can be treated using self-management programmes focused on pelvic floor muscle training. This study evaluates the effect of two different programmes, one provided as a booklet and one Internet-based, when made freely available to the public.

• ?Both programmes rendered clinically relevant improvements, in the same order of magnitude as in the previous randomised controlled study.

• ?Self-management of stress urinary incontinence should be recommended to women that request treatment.

     

Emotional safety in the workplace: one hospice's response for effective support

Emotional support is important for health professionals working in the demanding area of hospice/palliative care. While physical safety practices and effective human resource support are generally available to staff, one New Zealand hospice has taken this a step further by developing an emotional safety policy that incorporates personal, professional, and organizational measures designed to protect and promote staff members' emotional safety and to minimize stress and fatigue. The aim of this paper is to provide the background and rationale for this work, to introduce a case study around best practice, and to describe the development of the emotional safety policy, which provides effective support for all staff working at the hospice.     

少见盆腔滑膜肉瘤1例

病例 女,11岁,缘于3d前无明显诱因出现腹痛症状,腹痛开始较剧烈,逐渐转为持续性钝痛,部位在下腹部,排尿及排便后可有所缓解,无腰背及会阴部放射痛,伴有发热,体温最高38.7℃,当地医院行腹部磁共振检查后提示"盆腔肿物".患者自发病以来精神差,饮食一般,睡眠差,大小便正常,近期体质量无明显减轻,随即于我院行手术治疗,术后患者家属拒绝行放疗及化疗等任何治疗,5月后行MR检查发现肿瘤复发.     

And two become one: unit integration

Time and space must take on a new dimension for nursing care as health systems evolve into expanded networks.     

Telehospice support for elder caregivers of hospice patients: two case studies

This project reports on the experience of two hospice caregivers using videophone technology to enhance communication with their care providers. The data show the overall satisfaction and technical feasibility with videophone technology in home hospice. The case studies have great implication for future research because they reveal many unexpected issues relevant for future large-scale interventions.     

新型定位持腿器在盆底重建术中的应用

恰当的手术体位能使手术野充分暴露,是手术成功的关键之一。截石位是盆底重建术的常用体位,体位的合理摆放是术者手术顺利进行的保证。我院于2009年8月—2009年12月在42例妇科手术中使用新型定位持腿器,现将使用情况介绍如下。     

Three-dimensional ultrasound imaging of the pelvic floor: the effect of parturition on paravaginal support structures.

OBJECTIVE: It is assumed that support of the female urethra and bladder is maintained by paraurethral and paravaginal fascial structures, with hypermobility resulting from delivery-related trauma. This study used three-dimensional translabial ultrasound to assess these structures and document peripartal changes. DESIGN: A clinical observational pilot study was performed on 26 nulliparous women recruited in the third trimester of pregnancy. They underwent translabial two- and three-dimensional ultrasound. Twenty-three women were again seen 2-5 months postpartum. The assessor was blinded against two-dimensional ultrasound and delivery data. Vaginal tenting was rated as being present, indeterminate or absent at each of three levels, and was correlated with bladder neck descent (BND) and urethral rotation on Valsalva maneuver. RESULTS: Tenting was visible at all levels in 21 of 26 women antepartally. In three women tenting was absent on one level; in two cases tenting was rated indeterminate. There was no significant difference in BND between women with visible tenting and those without. The BND range for women with intact tenting was 5.4-41.6 mm. Twenty-one of the 26 women were included in the postpartum analysis. Of these, obvious peripartal changes were documented in five. Loss of tenting did not correlate significantly with changes in BND. CONCLUSIONS: Most nulliparous women showed evidence of intact paravaginal support structures. Tenting occurred in women with widely varying BND, implying that excess bladder neck mobility may be due to increased fascial compliance. Postnatally, fascial disruption was suspected in a minority of patients only. In some women delivery-related changes may be due to attenuation rather than disruption of structures.     

Networks for research: the power of one plus one plus one.

Networks for emergency medicine research are both powerful and practical, and can be run on a very low budget. The keys to making them work are relevant questions, achievable goals, recognition of contributions, coordination, feedback and leadership. Many hands do really make the work light!     

直肠超声诊断罕见的膀胱盆底疝1例

病例 女,56岁.5年前发现右侧臀部一小硬结,余无不适,现包块逐渐增大,站立时臀部不等大,有坠胀感来院检查,门诊触诊拟诊为坐骨结节旁囊肿,应用Hitachi超声高频探头未发现皮下明显肿块,远场可见无回声区,改用直肠超声检查,发现右侧坐骨结节内侧一巨大无回声暗区,大小约129.8 mm×89.7 mm,壁较厚呈双边影,形态不规则,向左上方延伸,直肠、子宫推移至左侧,CDFI显示其内偶可见喷尿时彩色信号(图1),腹部探头对膀胱扫查,膀胱形态失常,呈腊肠样向右后下方脱垂(图2),嘱患者排尿后经直肠超声见肛常的或不正常的薄弱点或缺损、间隙进入另一部位.