超长段尿道狭窄术后勃起功能的评估

目的 探讨自体组织替代治疗超长段尿道狭窄对勃起功能的影响.方法 回顾性分析2007年1月至2009年1月采用不同自体组织补片(阴囊纵隔、包皮内板、口腔黏膜)Onlay术式替代治疗超长段男性尿道狭窄患者的临床资料,并随访患者ⅡEF-5评分、QOL评分及最大尿流率,并与术前相应情况进行分析.结果 根据研究标准收集23份有效数据.患者术前及术后3、6、12个月QOL评分分别为5.22±0.75、1.22±1.40、1.82±1.17、2.07±0.46,最大尿流率分别为(3.93±3.62)、(22.46±4.65)、(23.81±6.22)、(21.52±7.44)ml/s,术后不同时期均较术前明显改善(P＜0.01).术前及术后3、6、12个月ⅡEF-5评分分别为14.47±9.55、14.70±5.32、14.26±3.29和14.58±3.62,组间比较差异无统计学意义(P＞0.05).9例狭窄部位累及至后尿道者术后3、6、12个月ⅡEF-5评分分别为11.67±2.59、12.35±1.83、13.19±1.67,14例单纯前尿道狭窄者分别为17.79±6.42、16.57±4.78、16.01±3.85,2组间比较差异均有统计学意义(P＜0.05).狭窄累及后尿道患者多元线性回归分析中,年龄、受伤时间及尿道狭窄段长度与替代术后ⅡEF-5评分呈多元线性相关.结论 自体组织替代治疗男性超长段尿道狭窄对勃起功能影响不明显;狭窄段累及后尿道时可能对患者勃起功能产生一定影响.患者年龄和受伤时间对勃起功能有协同影响作用.

Abstract：

Objective To investigate the effect of substitutive reconstruction of long urethral stricture on male erectile function. Methods From January 2007 to January 2009, 23 patients with anterior or posterior long urethral stricture were accepted for a variety of onlay substitutive procedures, including lingual mucosa, perputial skin, and mid-scrotal skin. During the follow-up, data from the International Index of Erectile Function-5 (ⅡEF-5) questionnaire and the Quality of Life (QOL) questionnaire as well as maximal flow rate were recorded. All data were compared with those obtained before surgery. Results Significant improvement in QOL (1.22 ± 1.40, 1.82 ± 1. 17,2.07± 0.46) and maximal flow rate (22.46± 4.65, 23.81 ± 6.22, 21.52 ±7.44 ) could be observed 3, 6 and 12 months after surgery compared with those before surgery (5. 22 ± 0. 75, 3. 93 ± 3. 62)(P＜0.01). No significant differences in the responses to the ⅡEF-5 questionnaire were observed among all patients during the follow-up (P＞0. 05). At the 3, 6 and 12 months after procedure,scores of ⅡEF-5 in patients with anterior urethral stricture ( 17.79 ± 6.42, 16. 57 ± 4. 78, 16.01 ±3.85) were significantly higher than those with posterior urethral stricture (11.67 ± 2.59, 12.35 ±1.83,13. 19±1.67, P＜0.05). In patients with posterior urethral stricture, the multiple linear regression showed that age, time interval of injury and length of stricture were related to the ⅡEF-5score (P＜0.05). Conclusions Substitutive reconstruction for treating the long urethral stricture has little effect on male erectile function. But the location of stricture, especially extended to posterior urethra, may have impact on the erectile function.     

Detection of Chlamydia trachomatis in semen and urethral specimens from male members of infertile couples in Tunisia.

The sequelae to infection with Chlamydia trachomatis in women are an established cause of tubal infertility. However, little is known about chlamydial infection and male infertility. The main objective of this study was to evaluate the presence of asymptomatic C. trachomatis infections in urethral and semen specimens from the male members of infertile couples by means of four different methods: the direct fluorescence antibodies assay, cell culture, the Roche Cobas Amplicor polymerase chain reaction, and the presence of chlamydial local IgA antibodies by the recombinant antibody-enzyme-linked immunosorbent assay. One or more chlamydial infection markers were detected in 42 (45.7%) of the 92 examined urethral and semen specimens from the male partners of infertile couples. C. trachomatis was detected in 23.9% (22/92) of urethral specimens and in 35.9% (33/92) of semen specimens. Although there was a significant correlation between the detection of one or more chlamydial infection markers in urethral and semen specimens (p = 0.01), no significant correlation was found between the detection of C. trachomatis DNA in these samples. Furthermore, no significant association was found between the presence of chlamydial local IgA antibodies and the detection of C. trachomatis. The discrepancies in positive results found between some techniques for the detection of C. trachomatis in urethral and semen specimens might be explained by variations in the sensitivities and specificities of the tests carried out and the use of specimens from different anatomical locations. Our findings suggest that C. trachomatis seems to be widespread among the male partners of infertile couples in Tunisia. The detection of C. trachomatis in urethral or semen specimens can serve as a marker for the presence of this organism in the genital tract, which is not necessarily the cause of male infertility. The study of the correlation between the detection of chlamydial infection markers and the parameters of male fertility seems to be necessary in order to determine the direct link between chlamydial infection and male infertility and to choose the most efficient technique and most suitable specimen with which to diagnose C. trachomatis-associated male infertility.     

A longitudinal study of otitis media with effusion among 2- to 5-year-old African-American children in child care

OBJECTIVE: To prospectively document the prevalence of otitis media with effusion (OME) in 86 African-American children between ages 2 and 5 years. STUDY DESIGN: Eighty-six children in center-based child care whose ear status had been followed from infancy continued to be observed. Middle ear status was assessed by pneumatic otoscopy and tympanometry biweekly. RESULTS: The prevalence of OME decreased as children became older. The mean proportion of examinations demonstrating bilateral OME (BOME) ranged from 12% between 24 to 30 months to 4% between 54 to 60 months of age. The mean proportion of exams revealing bilateral normal ears increased from 77% at 24 to 30 months to 88% at 54 to 60 months of age. Although 60 children had experienced BOME that lasted 4 months or longer in the 6- to 24-month age period, only 8 of these children experienced at least 4 months of continuous BOME between 24 to 60 months. CONCLUSIONS: The proportion of time with BOME decreased progressively with increasing age in this population. Only 8 of 60 children who had experienced more than 4 consecutive months of BOME before 2 years of age continued to manifest persistent effusion or experience recurrences of prolonged BOME after 2 years of age.     

Extended spectrum of antibiotic susceptibility for tuberculosis,Djibouti

In the Horn of Africa, there is a high prevalence of tuberculosis that is reported to be partly driven by multidrug-resistant (MDR) Mycobacterium tuberculosis strictu sensu strains. We conducted a prospective study to investigate M. tuberculosis complex species causing tuberculosis in Djibouti, and their in vitro susceptibility to standard anti-tuberculous antibiotics in addition to clofazimine, minocycline, chloramphenicol and sulfadiazine. Among the 118 mycobacteria isolates from 118 successive patients with suspected pulmonary tuberculosis, 111 strains of M. tuberculosis, five Mycobacterium canettii, one ‘Mycobacterium simulans’ and one Mycobacterium kansasii were identified. Drug-susceptibility tests performed on the first 78 isolates yielded nine MDR M. tuberculosis isolates. All isolates were fully susceptible to clofazimine, minocycline and chloramphenicol, and 75 of 78 isolates were susceptible to sulfadiazine. In the Horn of Africa, patients with confirmed pulmonary tuberculosis caused by an in vitro susceptible strain may benefit from anti-leprosy drugs, sulfamides and phenicol antibiotics.     

我院2017-2019年深部抗真菌药物利用分析

目的:分析评价某三甲专科医院2017-2019深部抗真菌药物的临床使用情况,为深部抗真菌药物的合理规范使用提供参考.方法:利用信息系统,采用金额排序法和用药频度排序法对某三甲专科医院2017-2019年深部抗真菌药物进行统计分析.结果:2017-2019年该院深部抗真菌药物销售金额及所占比例有逐步下降趋势,使用频度排在...     

2015 - 2018年陕西省死因监测网报病例来源分析

目的 解陕西省死因监测病例来源分布,为提高死因监测数据的完整性和准确性提供依据。方法 从《中国疾病预防控制信息系统 - 死因报告信息系统》中导出的陕西省13个国家级死因监测点2015 - 2018年的网报数据进行分析。结果 2015 - 2018年陕西省13个国家级监测点共报告死亡病例129 740例,其中男性75 773例,女性53 688例。分别报告32 489例、33 212例、31 533例和32 227例死亡病例,各年性别比例均衡,趋势无统计学意义（趋势χ2 = 1.84,P = 0.17）。死亡病例主要来源于乡镇卫生院,占58.80%～61.51%,其次为社区卫生服务中心和县及县以上综合医院,二者分别报告占17.60%～19.81%和17.19%～18.69%（趋势χ2 = 27.79,P＜0.01）,在家中死亡的比例占绝大多数,73.06%～76.52%,死于医疗卫生机构的占17.67%～19.93%（趋势χ2 = 38.81,P＜0.01）。死亡病例生前最高诊断单位以二级医院（占46.36%～49.93%）和三级医院（占41.75%～45.63%）为主（趋势χ2 = 48.80,P＜0.01）,最高诊断依据以临床+理化为主（占60.74%～63.57%）。结论 陕西省死因监测中发现虽然大多数病人在二级或三级医院就诊,且这一比例逐年提高,但绝大多数死亡病例死于家中,主要由乡镇卫生院专干完成死亡病例卡网报。因此,在今后工作中应加强对乡镇卫生院及社区卫生服务中心的培训,定期开展数据查漏补报和质量核查工作。     

西安市50岁以上居民食物频率问卷准确性及重现性研究

目的对用于评价西安城区居民膳食营养状况的西安食物频率问卷(FFQ)的重现性和准确性进行食物组的研究。方法在西安城区随机抽取出125名50～80岁当地居民,共完成6轮的食物摄入情况的调查,其中4轮24小时膳食回顾调查(24HDRs)的结果作为参考,通过第一轮FFQ结果与第二轮FFQ以及4轮24HDRs结果之间的比较分别进行FFQ的重现性和准确性研究。结果各个食物组在两轮FFQ间的Spearman相关系数在0.38(糕点类)～0.74(茶类)。第二轮FFQ与4轮24HDRs均值间的相关系数在0.12～0.74之间,经过个体内方差校正后,相关系数均有所提高。结论西安食物频率问卷可以相对准确、可靠地评价西安城区50岁以上居民的膳食营养状况。