先天性生殖器官异常孕妇的围生结局分析

目的探讨先天性生殖器官异常孕妇的围生结局。方法选择2009年1月至2019年12月,于四川大学华西第二医院活产分娩的99779例单胎妊娠孕妇为研究对象。根据是否合并先天性生殖器官异常,将其分为观察组(n=324,合并)及对照组(n=99455,未合并)。回顾性分析2组孕妇的临床病例资料,总结观察组不同类型先天性生殖器官异常孕妇的围生结局特点。采用χ^(2)检验及独立样本t检验,对2组孕妇妊娠期各并发症发生率、剖宫产率及新生儿出生体重等,进行统计学分析。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求。结果①观察组孕妇最常见先天性生殖器官异常前3位依次为纵隔子宫、单角/残角子宫及弓形子宫,分别占35.2%(114/324)、26.2%(85/324)及13.9%(45/324)。包括既往妊娠次数在内,观察组孕妇共计妊娠571次,其中弓形子宫、纵隔子宫孕妇的自然流产率位列前2位,分别为38.5%(35/91)、28.6%(61/213);阴道畸形孕妇足月产率(70.0%),高于子宫畸形者(52.8%),并且差异有统计学意义(χ^(2)=4.432、P=0.035)。②观察组孕妇早产、胎膜早破、胎位异常、胎盘早剥、胎儿生长受限(FGR)、胎盘黏连/植入、子宫破裂及剖宫产率分别为29.6%、29.3%、36.1%、5.9%、2.5%、21.0%、3.4%、78.7%,均分别高于对照组孕妇的9.8%、22.3%、5.7%、1.2%、1.0%、11.5%、1.5%、62.0%;而羊水过少率(0.9%)及新生儿出生体重[(2913±652)g],则显著低于对照组的2.9%、(3254±445)g,并且上述差异均有统计学意义(均为P<0.05)。2组孕妇前置胎盘、妊娠期高血压疾病(HDCP)、产后出血(PPH)及子宫切除率比较,差异均无统计学意义(P>0.05)。结论先天性生殖器官异常孕妇的母、胎围生期并发症发生风险高。提高该病孕妇的孕前及早孕期诊断率,加强围生期保健及处理,可改善其围生结局。     

蒙药毛勒日—达布斯—4汤中微量元素及氨基酸含量的测定

目的：测定蒙药毛勒日-达布斯-4汤中微量元素和氨基酸的含量。方法：用原子吸收分光光度计,测定蒙药毛勒日-达布斯-4汤中几种重要的微量元素含量;用氨基酸自动分析仪测定氨基酸的含量。结果与结论：蒙药毛勒日-达布斯-4汤中含有较高的Mn、Fe、Zn和Mg;含有17种氨基酸,包括7种人体必需氨基酸,氨基酸总量为4.615%（mg/g）。     

丙型肝炎病毒母婴传播研究

目的：探讨HCV母婴传播的可能性及其在流行病学中的意义。方法：应用ELISA方法对2136名产前检查的孕妇进行了抗－HCV检测,抗－HCV阳性者进一步应用PCR检测其HCV－RNA并收集其婴儿脐血进行抗－HCV和HCV－RNA检测。结果：孕妇的抗－HCV阳性率为1.59%(34/2136),抗－HCV阳性母亲的HCV－RNA阳性率为47.06%(16/34),母亲HCV－RNA阳性者发生垂直传播率为53.3%。结论 ：应用抗－HCV评价母婴传播并不合和达,只有通过检测HCV－RNA方能证实感染的存在。HCV确实存在母婴传播,但在人群HCV流行中并非主要传播途径。母新肝功能异常是影响HCV母婴传播的一个重要因素。     

86例痤疮患者血清性激素水平分析

目的 研究痤疮患者血清性激素水平与痤疮的关系。方法 对86例痤疮患者以放免法检测患者血清睾酮、卵泡刺激素（男性称精子生成素）、黄体生成素（男性称间质细胞刺激素）、孕酮和雌二醇;并对其中20例患者检测了泌乳素。结果 男性寻常痤疮、男和女聚合性痤疮和痤疮伴四肢或乳晕多毛（女性）63．89％患者血清睾酮增高,75％患者雌二醇增高;男性疮疮90．91％患者精子生成素低于正常。结论 血清性激素水平与痤疮类型有关,在痤疮的发生、发展和持续状态中起重要作用。     

丝素蛋白用于生物材料的研究进展

阐述了丝素蛋白用于固定化酶载体、生物酶防护剂、生物传感器、药物缓释载体、功能性细胞培养基质、抗血凝物质、人工器官等生物材料的研究进展。丝素蛋白在生物材料方面有非常广阔的应用前景。     

冠状静脉逆灌注对犬缺血心肌的保护作用

【目的】探索一种简便的冠状静脉逆灌注方法,了解其有效性和安全性。【方法】健康成年犬13条,随机分为逆灌注组（n=7）和对照组（n=6）。开胸结扎左冠状动脉前降支（LADA）,逆灌注导管经右颈外静脉送入冠状静脉窦并进一步插至心大静脉（GCV）远端,动脉血由左颈总动脉引出,以自身动脉血压为动力进行持续逆灌注。逆灌注组于LADA结扎后5min开始持续逆灌注,共6h;对照组同样进行插管但不灌注。观察血流动力学、心电图、血清生化及形态学改变。【结果】逆灌注组血流动力学较稳定（P＜0.05～0.01）。LADA结扎后两组缺血中心区心外膜心电图ST段均明显抬高,30min后逐渐回降,逆灌注组回降速度较快（P＜0.01）。与逆灌注组相比,对照组血清肌酸激酶-MB（CK-MB）明显升高,一氧化氮（NO）水平明显下降（P＜0.05～0.01）。对照组和逆灌注组缺血心肌发生梗死的面积分别占（76.2±4.7）%和（38.8±7.3）%（P＜0.01）。光镜下,逆灌注组前室间静脉（LADV）及其小属支内膜结构完整,无明显损伤;两组均未见到出血性梗死。【结论】采用简便的冠状静脉逆灌注方法可明显减轻心肌的缺血性损伤,减小心肌梗死面积,稳定血流动力学,且对冠状静脉系统及心肌组织无明显损伤。     

HPV在小儿喉乳头状瘤中的表达及临床意义

目的：探讨HPV与小儿喉乳状瘤发病及发展的相关性。方法：采用免疫组化方法检测46例小儿喉乳头状瘤96次手术的肿瘤组织及其HPV表达,另取8例正常小儿及成人的喉黏膜,10例成人喉乳头状瘤作对照,结果：小和和成人的正常喉黏膜无HPV表达,成人喉乳头状瘤2例有HPV表达,46例96人次小儿喉乳头状瘤,其中33例61人次肿瘤组织中有HPV表达,且与肿瘤的复发频率呈正相关。结论HPV在小儿喉乳头状瘤的发生发展过程中起重要作用。     

Efficacy of testosterone replacement therapy for treating metabolic disturbances in late-onset hypogonadism: a systematic review and meta-analysis

International Urology and Nephrology - Late onset hypogonadism (LOH) is an age-dependent reduction of testosterone associated with alterations of metabolic profile, including glucose control,...     

Supratentorial pediatric cortical ependymomas: a comprehensive retrospective study

Neurosurgical Review - Pediatric cortical ependymomas (CEs) are rare; the clinical features and optimal treatment remain ill-defined. We aimed to clarify the clinical characteristics and outcome of...     

Clinicopathological characteristics,prognosis, and chemosensitivity in patients with metastatic upper tract urothelial carcinoma

PurposeTo investigate the clinical characteristics, chemosensitivity, and outcome of metastatic upper tract urothelial carcinoma (UTUC).Patients and MethodsRecords of patients with metastatic UTUC since January 2005 were retrieved from a database that included clinical and survival data. Statistical analyses including survival and multivariate analyses of factors were respectively performed by the Kaplan-Meier method and Cox proportional hazard model.ResultsA total of 250 consecutive UTUC cases were evaluated. There were 56 patients (22.4%) with initially diagnosed stage IV disease. The most common metastatic sites were lung (39.6%), distant lymph nodes (39.2%), bone (19.6%), liver (18.0%), and adrenal gland (7.2%), respectively, and the local recurrence rate was 10.4%. Two hundred thirteen patients received first-line chemotherapy. The overall response rate was only 28.7% and the median progression-free survival time was only 5.0 months. The overall survival time of the cohort was 18.0 months. Multivariate analyses showed that initially diagnosed stage IV disease, number of metastatic organs ≥3, no response to chemotherapy and cycles of chemotherapy ≤2 were adverse prognosticators for overall survival.ConclusionUTUC presented to be more prone to metastasize than locally recur and thought to have low chemosensitivity. Stage IV disease at initial diagnosis, number of metastatic organs, response and cycles of chemotherapy were independent prognosticators for metastatic UTUC.