Progress in studies on pathological changes and future treatment strategies of obesity-associated female stress urinary incontinence: a narrative review

With the increasing prevalence of obesity worldwide, obesity-related female stress urinary incontinence (FSUI) has become a key health problem. Recent studies indicated that FSUI is primarily caused by obesity-related pathological changes, such as fat droplet deposition, and results in pelvic floor nerve, vascular, and urethral striated muscle injury. Meanwhile, treatments for obesity-associated FSUI (OA-FSUI) have garnered much attention. Although existing OA-FSUI management strategies, including weight loss, pelvic floor muscle exercise, and urethral sling operation, could play a role in symptomatic relief; they cannot reverse the pathological changes in OA-FSUI. The continued exploration of safe and reliable treatments has led to regenerative therapy becoming a particularly promising area of researches. Specifically, micro-energy, such as low-intensity pulsed ultrasound (LIPUS), low-intensity extracorporeal shock wave therapy (Li-ESWT), and pulsed electromagnetic field (PEMF), have been shown to restore the underlying pathological changes of OA-FSUI, which might be related by regulation endogenous stem cells (ESCs) to restore urine control function ultimately in animal experiments. Therefore, ESCs may be a target for repairing pathological changes of OA-FSUI. The aim of this review was to summarize the OA-FSUI-related pathogenesis, current treatments, and to discuss potential therapeutic options. In particular, this review is focused on the effects and related mechanisms of micro-energy therapy for OA-FSUI to provide a reference for future basically and clinical researches.     

双气囊小肠镜诊断不明原因消化道出血的临床研究

背景:双气囊小肠镜(DBE)是诊断不明原因消化道出血(OGIB)的常用方法,不同地区OGIB病因有所差异。目的:评价DBE诊断OGIB的有效性和安全性,分析湖北地区OGIB患者的病因特点。方法:收集2006年12月～2012年1月武汉大学人民医院诊断为OGIB的216例患者,并接受DBE检查,对诊断结果、治疗、随访、并发症等进行回顾性分析。结果:DBE的诊断率为80.6%(174/216),并发症发生率为1.9%(4/216),DBE对76.8%(166/216)患者的治疗策略产生影响。湖北地区常见的OGIB病因依次为憩室/重复畸形(23.1%)、肿瘤(21.8%)、溃疡/糜烂(21.8%)、息肉(5.6%)等。结论:DBE是一种安全、有效的OGIB诊断方法。湖北地区OGIB病因以憩室/重复畸形、肿瘤、溃疡/糜烂较为常见。     

丙泊酚合用氯胺酮在小儿腹部以下手术麻醉中的疗效观察

目的探讨丙泊酚单独使用及与氯胺酮合用在小儿椎管内麻醉中的疗效。方法选取我科40名腹部以下手术的患儿,随机分为两组(Ⅰ组和Ⅱ组),分别以单独使用丙泊酚及联合氯胺酮给药的方式,记录术中生命体征及不良事件情况。术后记录恶心、呕吐等不适及疼痛评分。结果两组术中均无呼吸暂停等严重事件发生,手术开始及手术开始后各时段Ⅰ组的生命体征均有显著差异(P<0.05),Ⅱ组手术开始时的收缩压与手术前有显著差异(P<0.05)。两组术后恢复时间与不适发生无显著差异(P>0.05),Ⅱ组术后镇痛效果优于Ⅰ组(P<0.05)。结论丙泊酚合用氯胺酮能够提供更平稳的镇静效果,减轻不良反应的发生,同时不影响苏醒时间,术后不良反应及疼痛发生率较低,是一种理想的小儿椎管内麻醉方法。     

加强医疗设备安全使用管理应把握的几个环节

针对临床科室人员在使用仪器设备时普遍存在的重使用、轻管理的现象,阐述了应从建立健全组织机构、明确安全管理重点以及严格落实制度措施等方面加强医疗设备安全使用管理,切实提高医疗设备安全使用管理水平,促进医院综合水平和社会效益的双提高。     

Invasive ductal carcinoma of the breast associated with extensive melanin melanosis: a case report and review of the literature

Extensive melanosis of breast tissue due to melanin in the absence of involvement by melanoma either primary or secondary has been rarely encountered. Herein we report a first and unique case of extensive macroscopic and microscopic melanosis of mammary parenchyma between carcinoma cells due to melanin in a patient with a poorly differentiated invasive ductal carcinoma of the breast with no evidence of melanocytic differentiation or melanoma. In contrast to previously reported cases in the literature, there is no breach of dermal-epidermal junction and there is no dermal infiltrate in the skin overlying the carcinoma, or Pagetoid disease in the nipple.     

CIP2A is a poor prognostic factor and can be a diagnostic marker in papillary thyroid carcinoma

Papillary thyroid carcinoma (PTC) is the most common type of thyroid carcinoma. CIP2A has recently been described as a prognostic marker in many cancers. In this study, we assessed the value of this novel prognostic marker in PTC. A total of 178 surgical specimens of both benign and malignant thyroid tumors were collected. Immunohistochemical staining for CIP2A, HBME‐1, galectin‐3, and CK19 was performed. Western blotting for CIP2A was also performed. CIP2A was expressed in 85.3% of malignant tumors and 12.1% of benign tumors. ROC analysis showed that the AUC for CIP2A was higher than those for other tumor markers. Western blotting showed that CIP2A expression was higher in PTC than in other tumors. Poor progression‐free survival was observed in the high‐CIP2A expression group. High CIP2A expression is a poor prognostic factor and can be a diagnostic marker in PTC. The presence of any two of the three indicated makers (CIP2A, galectin‐3, and HBME‐1) is strongly correlated with the diagnosis of PTC.     

血管内支架成形材料在脑供血动脉狭窄治疗中的应用

目的:总结近年来血管内支架成形材料在脑供血动脉狭窄治疗中的应用情况.方法:由作者应用计算机检索维普数据库中与血管内支架置入治疗脑供血动脉狭窄有关的文章,检索时限2000-01/2010-10.检索关键词:血管内支架成形术;脑供血动脉狭窄;缺血性脑卒中;并发症.纳入标准:血管内支架置入治疗脑供血动脉狭窄的文章.排除标准:重复研究或较陈旧文献.结果:金属内支架进入临床治疗后取得了令人瞩目的效果,但具有一定的致血栓形成性、永久性存留体内、再狭窄仍较高、金属表面难以附载药物等缺点.针对以上不足,近些年对支架材料、构形设计、制作工艺等均作了不少改进,更引人注目的是20世纪80年代末和90年代初覆膜支架的出现和生物学支架概念的提出,使血管内支架又进入了一个新的阶段.结论:随着血管内技术的发展,脑保护装置下血管内支架置入已成为治疗颅内外动脉狭窄的主要方法之一,支架技术的安全性和有效性已显著提高,但仍存在如血栓形成、脑出血、再狭窄以及过度灌注等问题.     

早期声门型喉癌累及前连合的处理及预后

早期声门型喉癌治疗方法主要包括放射治疗、经口微创手术及开放性手术等。本文通过复习相关研究资料,对累及前连合的声门型喉癌的各种治疗方法及预后做一综述。