良性前列腺增生术后症状无改善的原因分析并文献复习

目的探讨良性前列腺增生（BPH）切除术后症状无改善的原因。方法对BPH切除术后37例症状无改善患者的临床资料进行分析。结果膀胱功能异常16例。尿道狭窄14例，腺体残留5例。膀胱结石2例。结论膀胱功能异常、尿道狭窄是引起术后症状无改善的主要原因。尿流动力学检查对术前合理选择病例，术后分析症状原因具有重要价值。小体积前列腺增生或前列腺增生伴有慢性炎症者，宜采用经尿道前列腺电切术（TURP）治疗，可减少术后尿道狭窄的发生。     

良性前列腺增生术后症状无改善的原因分析并文献复习

目的 探讨良性前列腺增生(BPH)切除术后症状无改善的原因.方法 对BPH切除术后37例症状无改善患者的临床资料进行分析.结果 膀胱功能异常16例,尿道狭窄14例,腺体残留5例,膀胱结石2例.结论 膀胱功能异常、尿道狭窄是引起术后症状无改善的主要原因.尿流动力学检查对术前合理选择病例,术后分析症状原因具有重要价值.小体积前列腺增生或前列腺增生伴有慢性炎症者,宜采用经尿道前列腺电切术(TURP)治疗,可减少术后尿道狭窄的发生.     

不同手术方式治疗前列腺增生的护理比较

目的:比较两种不同手术方式治疗前列腺增生(BPH)的护理效果。方法:回顾性分析前列腺增生患者206例,其中采用经尿道前列腺电切术(TURP)145例,经腹腔镜耻骨后保留尿道前列腺切除术(MMPC)治疗61例。比较两组病人在手术时间、持续膀胱冲洗时间、拔管时间、术后住院天数等方面的差异。结果:两组病人在手术时间、持续膀胱冲洗时间、拔管时间、术后住院天数等方面差异有统计学意义。结论:MMPC组与TURP组比较具有患者痛苦小、膀胱冲洗时间及带导尿管时间短、并发症少、护理工作量轻等优点。     

266例良性前列腺增生术后膀胱痉挛相关因素分析及预防

目的探讨良性前列腺增生(BPH)术后膀胱痉挛(BS)发生的相关因素,以便采取针对性的预防措施。方法根据理论研究,从患者的年龄、病史、症状、前列腺增生程度、手术方式、膀胱冲洗液温度、术后是否发生膀胱痉挛等方面进行回顾性调查。结果纳入的研究对象266例,BPH术后出现BS患者107例,发生率为40.23%。在年龄、病史以及前列腺增生程度等因素方面,术后发生BS与未发生BS者比较,差异无统计学意义(t=-0.182,P﹥0.05;t=-0.700,P﹥0.05;χ2=0.875,P﹥0.05)。开放性前列腺切除术与经尿道前列腺电切术(TURP)术后膀胱痉挛发生率比较,差异有统计学意义,χ2=6.372,P﹤0.05。结论 BS是BPH手术后常见的并发症。BPH术后发生膀胱痉挛与年龄、病史以及前列腺增生程度没有相关性,与手术方式有关。采用TURP能减少膀胱痉挛的发生。     

长托宁复合静脉止痛泵治疗良性前列腺增生术后不稳定膀胱的疗效观察

目的探讨长托宁复合静脉止痛泵治疗良性前列腺增生（既IH）术后不稳定膀胱的疗效观察。方法对52例BPH患者在行经尿道前列腺电切手术（TURP）后随机分成长托宁组和对照组各26例，长托宁组采用长托宁注射液1mg加入静脉止痛泵内行术后镇痛，对照组在发生膀胱痉挛性疼痛时酌情肌注度冷丁或其他解痉镇痛药。结果长托宁组患者的膀胱痉挛每日次数及每次持续时间明显减少（P〈0．01），术后出现膀胱痉挛的持续天数及冲洗液转清时间明显缩短（P〈0．05）。结论长托宁复合静脉止痛泵能缓解不稳定膀胱的临床症状，减少BPH术后不稳定膀胱的发生。     

高海拔地区老年高危患者良性前列腺增生合并膀胱肿瘤的电切治疗

目的 探讨对高海拔地区老年高危患者患有良性前列腺增生(BPH)合并浅表性膀胱肿瘤(SBT)采用经尿道等离子束刀快速电切术,并采用术中、术后膀胱化疗的有效性及安全性分析.方法 对44例老年BPH合并SBT,同时合并心肺功能异常的患者,采用等离子束刀电切肿瘤后立即用20 mg丝裂霉素注入膀胱,保留10 min后电切前列腺,术后再予正规膀胱灌注化疗.结果 BPH合并SBT、同时合并心肺功能异常的患者采用等离子束刀电切治疗,手术顺利,电切时间30～ 110 min,无异常并发症,术后经常规膀胱化疗后,患者排尿顺畅,膀胱肿瘤复发率低.结论 对高海拔地区高危老年患者患有BPH合并SBT、同时合并心肺功能异常的采用等离子束刀快速电切手术治疗,术后经常规膀胱化疗,是一种安全有效的治疗方法.     

腔镜和传统Madigan耻骨后保留尿道前列腺切除术对比研究

目的评价两种不同的手术方法治疗良性前列腺增生的疗效和术后并发症。方法 45例患者作为治疗组接受腔镜耻骨后保留尿道前列腺切除术,50例患者作为对照组接受传统耻骨后保留前列腺切除术,观察两组的手术效果和术后并发症。结果除手术时间较长外,在切口长度、尿管停留时间、出血量和住院时间方面治疗组与对照组比较具有明显差异(P<0.05)。治疗组在膀胱颈尿道损伤、切口感染和排尿困难并发症上和对照组相比统计学上都有显著性差异(P<0.05)。结论腔镜耻骨后保留尿道前列腺切除术具有微创、安全有效、并发症少特点,而且手术简单易学。     

腹膜外腹腔镜保留尿道前列腺切除术加疝修补术一期治疗良性前列腺增生合并腹股沟疝

目的 探讨腹膜外腹腔镜保留尿道前列腺切除术加疝修补术治疗良性前列腺增生(BPH)合并腹股沟疝的临床效果及可行性.方法 28例BPH合并腹股沟疝患者,均采用腹膜外腹腔镜保留尿道前列腺切除术加疝修补术一期治疗,对其临床资料及随访情况进行回顾性分析.结果 28例手术均获成功,无中转开腹及术中输血者,手术时间85～188(130.2±37.5)min;术中出血量60～305(185.3±102.5)ml;术后均未膀胱冲洗,术后次日即下床活动;术后住院时间3～8(5.2±2.2)d;术后3个月复查最大尿流率、国际前列腺症状评分、残余尿量、生活质量评分均较术前明显改善(P＜0.01);术后随访3～24个月,无尿路感染、血尿、尿失禁、尿道狭窄等并发症发生,无性功能降低及逆向射精,无疝气复发.结论 同期采用腹膜外腹腔镜保留尿道前列腺切除术加疝修补术安全可行,手术创伤小,术后恢复快,是治疗BPH合并腹股沟疝的有效方法.     

保留部分尿道黏膜改良经尿道钬激光前列腺剜除术治疗良性前列腺增生病人的疗效观察

目的:研究保留部分尿道黏膜改良经尿道钬激光前列腺剜除术(HoLEP)治疗良性前列腺增生(BPH)病人的效果。方法:选取2017-06～2019-06期间我院BPH病人145例,根据手术方式不同分为B组、A组。B组(n=72)行经尿道前列腺电切术(TURP),A组(n=73)行保留部分尿道黏膜改良HoLEP,比较两组手术基本情况、并发症发生率及手术前后前列腺症状(IPSS)评分、最大尿流率(Qmax)评分。结果:与B组比较,A组术中出血量、手术用时、导尿管置留时间、住院天数、术后6个月IPSS评分、Qmax、QOL评分、并发症发生率较优(P0.05)。结论:BPH病人采用保留部分尿道黏膜改良HoLEP治疗,能减轻症状,减少并发症发生,提高生活质量,促进病人康复。     

经尿道钬激光前列腺剜除术在良性前列腺增生外科治疗中的应用进展

近年来,经尿道前列腺电切术(TURP)一直是良性前列腺增生(BPH)外科治疗的金标准,对于体积较小的BPH患者手术效果确切,但对于体积较大的BPH患者手术效果不佳.既往大体积BPH患者多采用开放性前列腺切除术(OP),但术中及术后失血量均较多.经尿道钬激光前列腺剜除术(HoLEP)是一种新的技术,该研究从HoLEP技术...     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.