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.     

未净化Z:ZCLA长爪沙鼠封闭群繁育及遗传稳定性分析

目的 分析未净化Z:ZCLA长爪沙鼠封闭群繁育和生长指标,并利用直接测序法分析其遗传稳定性.方法 随机选择40对Z:ZCLA长爪沙鼠,记录其繁殖胎次、产子数等指标,分析其仔鼠的生长发育情况.遗传稳定性分析选择Z:ZCLA长爪沙鼠非同胞、非亲代个体33只,提取肝脏基因组DNA,PCR扩增D-Loop序列,产物纯化后双向测序,测序结果与Z:ZCLA长爪沙鼠标准序列比对.结果 Z:ZCLA长爪沙鼠每胎产仔7只,胎间隔多在20～60d间,雄性体重高于雌性.遗传稳定性分析检测发现33只Z:ZCLA长爪沙鼠序列与标准序列完全一致.结论 Z:ZCLA长爪沙鼠群体内未发现遗传多态性,说明该群体具有较好的遗传稳定性.     

复杂性尿道狭窄及并发症诊治的实验研究与临床运用

复杂性尿道狭窄或闭锁的处理一直是泌尿外科最棘手的难题之一,尤其是对初次或再次治疗失败后的复杂性超长段尿道狭窄或闭锁(＞ 14 cm)患者的治疗,作者在治疗复杂性尿道狭窄及其并发症中取得了一系列的原创性成果.与国内外的同类研究比较,主要有以下发现和创新点.①在国际上首次提出并证实结肠黏膜可作为尿道替代物;临床治疗55例超长段尿道狭窄(平均15.2 cm)的结果提示结肠黏膜具有材源丰富、易于剥离、抗感染力强、皱缩率低等优点,适于14 cm以上尿道的重建,尤其是多次治疗失败的复杂性超长段尿道狭窄.②在国际上首次建立新型分期手术治疗复杂性超长段狭窄或闭锁,临床应用11例,疗效显著,为难治性前后尿道间长段狭窄或闭锁提供了一个新的思路.③在国际上首次阐述舌黏膜尿道重建的病理学特征及转归,建立大面积舌黏膜取材新技术;在国内率先开展舌黏膜尿道成形术,样本量为国内外最大.④在国际上首次建立了尿道压客观量化指标(90 cmH2O或较基础压提高40 ～50 cmH2O),用于评估球部尿道悬吊术中尿道压力.从而提高了手术成功率,减少了并发症,取得了显著治疗效果.该系列研究成果先后获省部科技进步一等奖和多项二等奖.     

肾交感神经刺激对全身交感神经系统的影响

目的：评价肾交感神经刺激(Renal sympathetic nerves stimulation,RSNS)对全身交感神经系统的影响。方法12只成年杂种犬随机分为两组：假手术组(Sham组,n=6)和肾交感神经刺激组(RSNS组,n=6)。RSNS组经左肾动脉外膜给予持续2 h高频电刺激,刺激参数：频率20 Hz,脉宽0.1 ms,刺激强度随血压进行调整,以保持血压较刺激前升高10%;假手术组在左肾动脉附近寻找一处体表皮肤给予以同样2 h高频电刺激。分别于基础状态和2 h刺激末检测血压(BP)、心率(HR)、心率变异性(HRV)和血清去甲肾上腺素（NE）浓度。结果与基础状态比较,Sham组成年杂种犬2 h末BR、HR、交感神经活性和血清去甲肾上腺素浓度比较差异均无统计学意义(P>0.05)。与基础状态比较,RSNS可以明显提高成年杂种犬BR、交感神经活性和血清去甲肾上腺素浓度,差异有统计学意义(P<0.05)。结论肾交感神经刺激可以明显提高全身交感神经系统活性。     

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...     

Cardiorespiratory fitness and body mass index values in 9-year-old rural Norwegian children

Aim: To describe cardiorespiratory fitness and body mass index (BMI) values in a representative population of 9-year-old Norwegian children in two rural communities and compare present values with previous findings.
Methods: Two hundred and fifty-nine 9-year-old children were invited, and 256 participated in this study. Maximal oxygen uptake was directly measured during a continuous progressive treadmill protocol. Body mass and height were also measured.
Results: The mean ± SD relative maximal oxygen uptake was 52.8 ± 6.5 for boys and 46.9 ± 7.2 mL/kg/min for girls. Eight percent of the boys and 16.8% of the girls were classified as overweight, and 1.6% of the boys and 6.9% of the girls as obese. Mean age, body mass, height and Ponderal index were not significantly different between sexes. Girls had a higher BMI than boys (p = 0.05).
Conclusion: Compared to earlier Norwegian studies, children's BMI values seem to have increased substantially. This increase is most pronounced in girls. When assessing these differences using the PI, this increase is less marked. Comparing maximal oxygen uptake data with that in earlier Nordic studies, there is no evidence that fitness has declined among 9-year olds. However, the limitations of the few earlier studies make reliable comparisons difficult.     

Three children with congenital toxoplasmosis: early report from a Swedish prospective screening study

The aim of this prospective study was to define the incidence of congenital toxoplasmosis in Sweden. Blood eluates collected on filter papers, Guthrie cards, from 40978 newborn babies were analysed for specific immunoglobulin M (IgM) and IgG antitoxoplasma antibodies. This is a preliminary report of three children with congenital toxoplasmosis, defined by the occurrence of antitoxoplasma-specific IgM antibodies. Two children were asymptomatic at birth. They were both normally developed at the age of 12 and 15 months, respectively. The third child had unidentified but uncomplicated symptoms of infection in the neonatal period. As a result of the screening congenital toxoplasmosis was confirmed and treatment instituted. Microphthalmus and peripheral chorioretinitis were detected in one eye. In spite of the chemotherapeutic treatment he developed hydrocephalus needing neurosurgical intervention at the age of 3 months. His development at 14 months was normal. The incidence in Sweden of congenital toxoplasmosis detected by specific IgM antitoxoplasma antibodies in blood from filter papers is less than 1:10000.     

Usefulness of muscle denervation as an MRI sign of peripheral nerve pathology

Peripheral nerve disorders may be classified into compressive or entrapment neuropathies and non‐compressive neuropathies. Muscle denervation recognized on MRI may be a useful sign in the diagnosis of peripheral nerve disorders. Acute or subacute denervation results in prolonged T2 relaxation time, producing increased signal in skeletal muscle on short tau inversion‐recovery and fat‐suppressed T2‐weighted images. Chronic denervation produces fatty atrophy of skeletal muscles, resulting in increased muscle signal on T1‐weighted images. This review will outline and illustrate the various ways that muscle denervation as seen on MRI may assist in the diagnosis and localization of peripheral nerve disorders.     

丁香水溶性化学成分的研究

目的：研究丁香水溶性化学成分。方法：利用HP-20大孔吸附树脂、反相硅胶柱色谱、反相制备薄层色谱、制备型反相高效液相色谱进行分离,NMR和MS等方法进行结构鉴定。结果：从丁香干燥花蕾的水提物中分离鉴定了5个化合物,分别为槲皮素-3-O-葡萄糖醛酸苷（1）,槲皮素-3-O-葡萄糖醛酸苷6″-甲酯（2）,槲皮素-3-O-葡萄糖苷（3）,丁香酚-β-芸香糖苷（4）,杨梅酮（5）。结论：化合物1～4为首次从丁香属植物中分离得到。