改良Devine术与传统Shiraki治疗小儿隐匿性阴茎的临床探讨

目的：对小儿隐匿性阴茎患者进行改良Devine术与传统Shiraki术,做好临床效果的探究。方法：选取2020年1月至2021年1月本院收治的隐匿性阴茎患儿60例,采用随机分组方式,每组人数为30例。常规组采用Shiraki手术治疗,试验组采用改良Devine手术治疗,做好治疗效果、术后阴茎延长情况比较、并发症效果的比较。结果：试验组患者临床疗效比常规组显著要更好（P<0.05）,试验组采用治疗中有效、显效、无效人数分别为21例、7例、2例,.所占比例分别为93.3%。试验组患者中术前阴茎长度、术后阴茎长度分别为（1.78±0.63）cm、（4.47±0.57）cm,常规组患者中术前阴茎长度、术后阴茎长度分别为（1.85±0.27）cm、（2.92±0.10）cm,经比较,术后情况明显改善,两组患者具有一定差异（P<0.05）。通过对患者进行并发症情况比较,其中常规组患者出现术后包皮严重水肿、阴茎回缩人数分别为6例、1例,试验组患者人数分别为1例、0例,经比较,试验组效果较优（P<0.05）。试验组治疗后生活质量整体效果较好（P<0.05）。治疗后试验组的生活质...     

Devine术治疗儿童隐匿阴茎26例分析

2004年6月～2008年12月,作者应用Devine术治疗儿童隐匿阴茎26例。疗效满意,现报告如下。     

改良Brisson术与传统手术对隐匿性阴茎患儿阴茎指数的影响

目的 探究改良Brisson术与传统手术对隐匿性阴茎患儿阴茎指数的影响,以供临床参考。方法 238例隐匿性阴茎患儿分为观察组120例和对照组118例,分别接受改良Brisson术治疗和传统手术治疗,比较2组围手术期指标、术后并发症情况。术后随访半年,分别从阴茎增加长度、阴茎外观、术后皮肤外观3个方面评估患儿阴茎指数,调查患者对手术的满意度。结果 观察组手术时间为(42.36±2.26)min、术中出血量为(8.41±1.36)mL,均低于对照组,差异有统计学意义(P<0.05);观察组术后并发症总发生率(3.33%)与对照组(7.63%)差异无统计学意义(χ²=2.124,P=0.145)。术后半年,观察组的阴茎指数总评分及各方面评分均高于对照组,差异有统计学意义(P<0.05);观察组手术总满意度(90.83%)高于对照组(80.51%),差异有统计学意义(χ²=5.180,P=0.023)。结论 与传统术式相比,改良Brisson术有助于缩短手术时间,降低术中出血量及术后并发症发生率,改善患儿术后的阴茎指数。     

阴囊推进式皮瓣治疗儿童隐匿性阴茎临床分析

目的探讨儿童隐匿性阴茎的手术治疗方式,提高对该疾病的认识及临床治疗的效果。方法对18例隐匿性阴茎患儿采用阴囊推进式皮瓣手术矫正,术中将阴茎包皮脱套至阴茎根部,切除多余包皮内板,识别并剔除阴茎体部发育不良的条索状组织,阴囊皮瓣向阴茎推进,术后对所有患者进行随访。结果本组患者术后随访3-12个月,手术均获得成功,无一例复发,无皮肤长期水肿、坏死、勃起疼痛等并发症,术后阴茎显露及外观满意,发育良好,排尿及勃起功能正常。结论本术式纠正了隐匿性阴茎的病理改变,术后阴茎功能和形态良好,是治疗隐匿性阴茎的理想术式。     

隐匿性阴茎不是小阴茎

有些人自认为是小阴茎，其实他们的阴茎并不小，发育也正常，只是阴茎的大部分隐匿在皮肤或脂肪组织中。以致从外表看来阴茎短小，甚至只看到一些包皮皱褶，尿液也就从这些皱褶中射出。这种情况，医学上称为隐匿性阴茎。     

隐匿性阴茎矫形术围术期的护理

目的 总结隐匿性阴茎矫形术围手术期患儿的护理经验,为临床护理提供理论指导.方法 对我院近年来收治的56例隐匿性阴茎患儿围手术期护理进行回顾性总结.结果 56例患儿切口均一期愈合,无并发症发生.术后阴茎长度3.0～5.0(4.0±0.5)cm,随访6个月～2年,52例患儿阴茎显露满意,包皮每次能完全上翻,无狭窄环;4例术后阴茎显露不满意,经治疗后明显改善.结论 良好的基础护理,有效的心理护理能促使家属的积极配合,并能提高儿童的心理承受力,利于患儿的早日康复.     

阴茎脱套固定术治疗隐匿阴茎效果探究

目的：探讨分析对隐匿阴茎患儿,分别采用脱套固定术与Devine术,哪种手术方式治疗效果更好。方法回顾分析76例患儿的治疗,其中采用阴茎脱套固定术与Devine术进行隐匿阴茎治疗的患儿各38例,前者归入A组,后者归入B组,对比两组疗效。结果术后两组患儿阴茎状况均良好,均无包皮坏死等并发症出现,然而A组患者手术疗效更好,总有效率为97．4％,高于B组患者78．9％的数据,差异显著,具备统计学意义（P＜0．05）。结论在治疗隐匿阴茎患者时,脱套固定术的临床效果明显优于Devine术,更值得采用。     

认识隐匿性阴茎

隐匿阴茎指原本正常的阴茎被埋藏于皮下,外观阴茎短小,包皮似一鸟嘴包住阴茎,是阴茎肉膜发育异常所致的先天性畸形,多数患者会合并包茎,或伴有尿道下裂畸形,若不及时治疗,可影响患儿的排尿与成人患者的性生活。现阶段,临床中针对该病患者的治疗以手术为首选方案,术后患者能够获得理想恢复效果。本文将重点探究隐匿性阴茎的诊断与治疗,及该病对正常性生活的影响。     

儿童隐匿性阴茎的围手术期护理

目的 探讨隐匿性阴茎围手术期的护理要点.方法 通过对本院107例患儿针对性的护理,使其在心理和生理上的得到全面护理.结论 精心有效的围手术期护理有效减少手术并发症.     

不同手术方法治疗小儿隐匿性阴茎的临床效果分析

目的研究分析改良Brisson术与传统Shiraki术治疗小儿隐匿性阴茎的临床疗效。方法选取2018年6月-2019年6月该院收治的隐匿性阴茎患儿68例为研究对象,根据随机数字表法分为A组和B组,每组各34例。A组行改良Brisson术治疗,B组行常规Shiraki术治疗。观察并记录两组患儿手术治疗时间、术后的阴茎长度(与术前阴茎长度比较)、手术后阴茎的延长长度,术后并发症情况。结果两组患儿手术治疗时间比较,差异无统计学意义(P>0. 05)。术后两组患儿的阴茎长度均较术前明显增长,且A组患儿明显长于B组,差异均有统计学意义(均P<0. 05)。A组患儿手术后阴茎的延长长度明显大于B组,差异有统计学意义(P<0. 05)。A组患儿手术治疗后的并发症率略低于B组,差异有统计学意义(P<0. 05)。结论对小儿隐匿性阴茎患儿行改良Brisson术式治疗,术后整体疗效更好,外形更符合生理特点,患儿家属满意度较高,对于淋巴回流重建效果更好,并可有效降低术后阴茎水肿度,适合临床选择应用。     

临床路径应用于护理教学的效果研究及探讨

目的探讨在护理带教中应用临床路径指引的成效及优点。方法选取在中山大学附属第三医院心胸外科实习的护生共六十名分为两组,对照组采用临床传统的教学方法,实验组采用临床路径指引,对比两组学生理论、操作及对带教方式满意度。结果实验组学生较对照组成绩优异,且对带教方式满意度更高,差异有统计学意义(P<0.05)。结论通过对两年教学的实践效果对比,临床路径为教学确定了标准化、规范化、程序化的临床带教计划,收到了原计划的效果,采用临床路径进行临床教学确是一种促进护理教学进步的好方式,值得推广。     

Recombinant Modified Vaccinia Ankara (MVA) effectively boosts DNA-primed HIV-specific immune responses in humans despite pre-existing vaccinia immunity

The presence of vector-specific immune responses may hamper the induction of responses to a foreign antigen encoded by the vector. We evaluated the impact of pre-existing immunity to vaccinia virus on the induction of HIV-specific responses after immunization of healthy volunteers with a HIV-1 DNA prime-MVA boost vaccine. Following three priming immunizations with HIV-1 DNA plasmids, the volunteers were boosted with a single injection of recombinant MVA encoding HIV-1 proteins. Pre-existing immunity to vaccinia virus did not reduce the proportion of individuals who responded to HIV-1, but did lower the magnitude of responses. Our results suggest that vaccinia-based vectors can be used to efficiently induce immune responses to vectored HIV-1 antigens, even in individuals with pre-existing immunity to vaccinia virus.     

Modified live marker vaccine candidate CP7_E2alf provides early onset of protection against lethal challenge infection with classical swine fever virus after both intramuscular and oral immunization

Due to the vast economic consequences of classical swine fever (CSF) outbreaks, emergency vaccination plans are under discussion in European Union Member States. However, animals vaccinated with the conventional C-strain vaccine are subject to trade restrictions. To ease these restrictions, potent marker vaccines are required. One promising candidate is the chimeric pestivirus CP7_E2alf. For emergency vaccination in a CSF outbreak scenario, early onset of immunity is required. Here, the studies performed with a CP7_E2alf virus stock produced under good manufacturing conditions (GMP) are reported. In challenge experiments, CP7_E2alf induced full clinical protection 1 week after intramuscular vaccination, and 2 weeks after oral immunization. Furthermore, even after application of diluted vaccine preparations complete protection could be achieved if challenge infection was carried out 4 weeks after vaccination. In conclusion, GMP-produced CP7_E2alf proved to be a suitable marker vaccine candidate – also for emergency vaccination – both after intramuscular and oral application.     

老年房颤患者行非心脏手术的麻醉处理体会

目的分析老年房颤患者施行非心脏手术的麻醉处理过程,探讨围手术期的监测手段和治疗措施。方法 28例老年房颤患者中,9例采用全身麻醉,14例采用椎管内阻滞,5例采用臂丛神经阻滞。其中23例患者术前接受抗心律失常药物治疗。结果 28例患者均安全度过围手术期。结论积极处理原发病,改善心功能,选择适当的麻醉方式以及药物,严密监测,及时纠正心律失常以及血流动力学紊乱,尽可能消除加重房颤的诱因,是病人安全度过围术期的重要保证。     

Efficacy of marker vaccine candidate CP7_E2alf in piglets with maternally derived C-strain antibodies

Marker vaccines offer the possibility to differentiate classical swine fever (CSF) infected from CSF vaccinated animals based on serology and their implementation will ensure free trade with pigs. Therefore, new generations of promising marker vaccines have been developed, among them the chimeric vaccine CP7_E2alf. However, in populations previously vaccinated with live attenuated vaccines like the C-strain, passive immunity through maternal antibodies can interfere with efficacy of CP7_E2alf vaccination. Therefore, the efficacy of CP7_E2alf was examined in piglets from sows vaccinated once intramuscularly with C-strain vaccine 4 weeks before farrowing. Thus, these piglets were vaccinated intramuscularly with CP7_E2alf at the age of 5 or 8 weeks. Subsequently, the piglets and their mock-vaccinated littermate controls were challenged 2 weeks post vaccination with highly virulent Classical swine fever virus (CSFV) strain “Koslov”.     

Modified Early Warning System: Quality Improvement with the Help of Healthcare Failure Modes and Effect Analysis

Abstract

Introduction: Hospitals struggle to implement MEWS. This study aims to improve MEWS implementation in the studied hospital.

Objective: Improve the implementation of MEWS with the help of HFMEA.

Materials: HFMEA together with training is used to improve the implementation.

Results: The pre-intervention RPN got reduced from 1558 to 516 in the post-implementation phase.

Application: This demonstrates improvement in the implementation of MEWS with the help of HFMEA, this study design can be widely used.

Conclusion: The HFMEA is an effective tool to use for the improvement of MEWS implementation by the hospital nurses.     

麦胚提取物对免疫和抗氧化功能的影响

目的探讨面粉加工副产品麦胚的脂溶性提取物对机体免疫和抗氧化等多种功能的影响。方法实验动物分为对照组、环磷酰胺组、麦胚提取物组、麦胚提取物+环磷酰胺组。15天后观察各组腹腔巨噬细胞吞噬率、吞噬指数、消化程度、血清半数溶血值、肝脏SOD的变化。另设对照组、实验1组,每日1次给予麦胚提取物0.025ml,实验2组隔日1次给予麦胚提取物0.025ml,观察受试动物游泳开始至死亡的时间。结果小鼠腹腔巨噬细胞吞噬率、血清半数溶血值、肝脏超氧化物歧化酶、游泳时间4项指标,实验组与对照组相比,均有显着性差异(P<0.01、P<0.05、P<0.05、P<0.05)。结论麦胚提取物在免疫调节、抗氧化、抗疲劳等方面均有较强的生理活性,可能与其富含多不饱和脂肪酸、维生素E等营养素有关。     

单侧与双侧PKP治疗OVCF的疗效分析

目的比较单侧与双侧经椎弓根穿刺椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩性骨折(OVCF)的疗效。方法选择2009年12月至2010年12月间采用经皮球囊扩张椎体后凸成形术治疗骨质疏松性椎体压缩性骨折患者34例。其中19例经单侧椎弓根穿刺,15例经双侧椎弓根穿刺。按照VAS疼痛评分、影像学资料分别对患者疼痛、椎体高度和Cobb’s角进行疗效比较。结果所有手术均顺利完成,无严重手术并发症。术后10～12个月随访,两种穿刺方法VAS疼痛评分、影像学资料较术前均有改善(P<0.05)。术后1年单侧组与双侧组比较,伤椎前缘的高度、椎体后凸Cobb’s角有显著性差异(P<0.05),VAS疼痛评分无显著性差异(P>0.05)。结论①单侧与双侧经椎弓根穿刺椎体后凸成形术治疗骨质疏松性椎体压缩性骨折均是有效的。②双侧穿刺在伤椎前缘高度的恢复、椎体后凸Cobb’s角的改善方面优于单侧穿刺。     

保乳手术联合化疗治疗乳腺癌的临床疗效分析

目的观察保乳手术联合化疗药物治疗乳腺癌的疗效。方法收集100例乳腺癌患者,随机分为两组,A组50例,行乳腺癌根治手术治疗;B组50例,行保乳手术联合化疗药物治疗,比较两组患者临床疗效、生存质量评分、IL-17和IL-10水平变化。结果治疗后A组与B组临床总有效率比较差异无统计学意义(P>0.05);B组的术后美容评价效果优于A组,差异有统计学意义(P<0.05);两组治疗后IL-17、IL-10水平降低明显(P<0.05),B组IL-17、IL-10水平低于A组(P<0.05)。两组治疗后生存质量评分明显升高(P<0.05),B组高于A组(P<0.05)。结论保乳手术联合化疗治疗乳腺癌患者的临床美容效果更优,能够提高患者生存质量,能够显著下调IL-17和IL-10水平,起到治疗作用。     

Harnessing the unique local immunostimulatory properties of modified vaccinia Ankara (MVA) virus to generate superior tumor-specific immune responses and antitumor activity in a diversified prime and boost vaccine regimen

Recombinant poxviruses expressing tumor-associated antigens (TAAs) are currently being evaluated in clinical trials as an approach to treat various cancers. We have previously generated poxviral vectors expressing a TAA and a TRIad of COstimulatory Molecules (B7-1, ICAM-1, and LFA-3; TRICOM) as transgenes, including replication competent recombinant vaccinia (rV) or replication-defective modified vaccinia Ankara (MVA), to prime tumor-specific immune responses, and a replication-defective recombinant fowlpox (rF) to boost these responses. MVA is a potentially safer, replication-defective form of vaccinia virus with unique immunostimulatory properties that could make it a superior priming vaccine. Here, an MVA vector encoding a tumor antigen (CEA) and TRICOM was utilized (rMVA). A single rMVA-CEA/TRICOM vaccination induced greater expression of several serum cytokines associated with enhanced T-cell immunity than that seen with vaccinia. We hypothesized that this effect might “precondition” the vaccination site for a more effective boost. An rMVA-CEA/TRICOM prime followed 7 days later (but not 30 days later) by an rF-CEA/TRICOM boost at the same injection site (but not at a distal site) induced more potent CEA-specific T-cell responses, and superior CEA-specific immunity and antitumor activity, than rV-CEA/TRICOM followed by rF-CEA/TRICOM. This preconditioning effect was also observed using a heterologous antigen model, where priming with rMVA-CEA/TRICOM followed 7 days later by rF-LacZ/TRICOM enhanced β-gal-specific immunity compared to rF-LacZ/TRICOM only. The studies reported here show for the first time that priming with rMVA followed 7 days later by an rF boost at the same injection site, versus a distal site, generates superior tumor-specific immunity and antitumor activity.