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.     

内镜下全腹膜外Sublay修补在腹壁疝中的应用

目的评价腹壁疝内镜下全腹膜外Sublay(TES)手术的效果并总结经验。方法回顾性总结国内10所医院自2016年3月至2019年7月115例腹壁疝内镜下TES手术的患者资料。分析患者情况、疝的特点、手术经过和结果。结果115例计划实施TES的患者中,因严重腹膜破损中转为IPOM修补患者1例,其余均成功手术。可以缝合缺损患者108例(94.74%),需要永久补片固定患者15例(13.16%)。放置引流患者76例(66.67%),中位手术时间为144 min,术中无严重并发症发生。随访时间3~45个月,总并发症发生率为20例(17.54%),其中出现血清肿患者5例(4.38%)。绝大多数患者术后仅出现轻微疼痛,未出现慢性疼痛。结论在腹壁疝的治疗中,对熟悉腹壁解剖的外科医师而言,TES是一种有效、安全的修复手段。在熟悉手术的基础上适应症可逐步拓展。     

Insulin Dependence Increases the Risk of Complications and Death in Total Joint Arthroplasty: A Systematic Review and Meta‐(Regression) Analysis

ObjectivesTo investigate the proportion of insulin‐dependent diabetes mellitus (IDDM) patients among diabetic patients undergoing total joint arthroplasty (TJA) and whether insulin dependence is associated with postoperative complications.MethodsA systematic literature search was performed in EMBASE, PubMed, Ovid, Medline, the Cochrane Library, Web of Science, the China Science and Technology Journal Database, and China National Knowledge Infrastructure from the inception dates to 10 September 2019. Observational studies reporting adverse events with IDDM following TJA were included. Primary outcomes were cardiovascular complications, pulmonary complications, kidney complications, wound complications, infection, and other complications within 30 days of surgery. Secondary outcomes were the proportion of IDDM patients among diabetic patients undergoing TJA and its time trend.ResultsA total of 19 studies involving 85,689 participants were included. Among patients undergoing TJA, 26% of diabetic patients had IDDM. Compared with non‐insulin‐dependent diabetes (NIDDM), the incidences of cardiac arrest (risk ratio [RR], 2.346; 95% confidence interval [CI], 1.553 to 3.546), renal failure (relative risk [RR], 2.758; 95% CI, 1.830 to 4.156), deep incisional surgical site infection (RR, 1.968; 95% CI, 1.107 to 3.533), wound dehiscence (RR, 2.209; 95% CI, 1.830 to 4.156), and death (RR, 2.292; 95% CI, 1.568 to 3.349) were all significantly increased in IDDM. A significant time trend was witnessed for the prevalence of IDDM (P = 0.014). There was no statistical significance for organ/space surgical site infection, thrombotic events (deep venous thrombosis/ pulmonary embolism), and revision rates.ConclusionInsulin‐dependent diabetes is an independent high‐risk factor for increased adverse outcomes relative to NIDDM, suggesting that hierarchical and optimal blood glucose management may contribute to reducing the adverse complications after surgery for these patients. In addition, because the risk of sepsis, deep wound infection, organ/space surgical site infection, urinary tract infection, renal insufficiency, and renal failure significantly increase after TJA in IDDM patients, more active postoperative antimicrobial prophylaxis may be needed on the premise of protecting renal function.     

Influences of Heavy Metals and Salt on Seed Germination and Seedling Characteristics of Halophyte Halogeton glomeratus

Bulletin of Environmental Contamination and Toxicology - Heavy metals pollution and salinization of soils are widely distributed in agricultural soils. This study investigated the effects of five...