COMPARISON OF FOUR METHODS FOR SPERM PREPARATION FOR IUI

We compared the pregnancy rates and sperm characteristics of semen prepared by the albumin, Percoll, Puresperm, and swim-up methods. Semen analysis was performed by a computer-assisted system (CASA). The overall pregnancy rate was 14% per patient and 11% per cycle. The albumin and Percoll methods had the highest pregnancy rates, up to 12% per cycle. We then compared each method with the albumin method. The swim-up technique yielded the highest percentage of motile sperm. The Percoll method yielded statistically significant changes in average path velocity and straight-line velocity, while the Puresperm method revealed the same statistical changes in total concentration and hyperactive motile sperm percentage. After adjusting for age, methods, and CASA estimates, only straight-line velocity was significantly correlated with pregnancy. Although the Percoll method was associated with the best pregnancy rate, this product has been withdrawn from the market because of toxic contamination. Puresperm had replaced it in our laboratory but showed an unsatisfactory pregnancy rate. The swim-up method is the best choice for IUI.     

舒康博敷贴缓解老年患者肌内注射部位硬结的效果

目的 探讨舒康博敷贴缓解注射部位硬结的疗效.方法 对40例患者肌内注射硬结进行处理,随机分为实验组和对照组各20例,实验组采用舒康博敷贴外敷,对照组采用50%硫酸镁湿热敷,比较两组疗效.结果 两组在有效率和患者满意率上差异均有统计学意义（P＜0.05或P＜0.01）.结论 舒康博敷贴对老年患者注射部位硬结疗效明显,满意率高,是舒康博敷贴在临床应用上的新发现.     

经皮空心加压螺钉内固定治疗股骨颈骨折

目的：探讨经皮空心加压螺钉内固定治疗股骨颈骨折的方法及疗效。方法：对58例股骨颈骨折患者在C型臂监测下于牵引床上复位后采用经皮加压空心螺钉内固定。结果：58例随访6～24个月,骨折愈合51例,不愈合4例,股骨头坏死3例。结论：经皮空心加压螺钉内固定术治疗股骨颈骨折具有创伤小、方法简便、固定牢靠、可早期功能锻炼、并发症少的优点。     

Perforating plate-like osteoma cutis in a man with solitary morphoea profunda

Summary Solitary morphoea profunda is an unusual form of scleroderma. characterized by marked fibrosis, hyalinization of collagen fibres, and inflammatory cell infiltration in the deep dermal and subcutaneous layers. We describe a 58-year-old man showing solitary morphoea profunda. Plate-like osteoma cutis, with transepidermal elimination of bony material. within the morphoea profunda, was present.     

高龄髋部术后足踝运动方法对下肢静脉回流 影响的临床观察

目的：观察高龄髋关节置换术后足踝屈伸运动时不同的运动角度与持续时间对小腿肌群挤压深静脉增加血流速度的效果,探讨最佳的足踝屈伸运动角度与持续时间。方法：选择2009年10月至2010年8月收治的高龄髋部外伤行择期全髋或半髋关节置换术的患者17例。其中股骨颈骨折8例,股骨粗隆骨折9例;年龄80～96岁,平均87岁;男11例,女6例。用彩色超声多普勒检测患者术后第2天患侧股静脉在足踝屈伸不同角度与不同持续时间状态下的血流动力学指标（血流峰速度）,并进行统计学分析。结果：不同角度的血流峰速度与静息状态[（29.2±3.4）cm/s]比较,足踝跖屈30°背伸20°持续时间2秒/次[（38.1±6.2）cm/s]、3秒/次[（37.9±6.4）cm/s]及足踝跖屈45°背伸30°5个持续时间[持续时间1～5秒/次分别为（40.6±7.9）、（52.6±7.0）、（48.8±7.1）、（42.1±6.3）、（39.3±5.7）cm/s]差异有统计学意义（P〈0.01）;足踝跖屈30°背伸20°持续时间2秒/次与3秒/次比较无统计学意义（P〉0.05）;足踝跖屈45°背伸30°各持续时间与足踝跖屈30°背伸20°持续时间2秒/次比较：足踝跖屈45°背伸30°持续时间2、3秒/次时差异有统计学意义（P〈0.01）;持续时间为4秒/次也有统计学意义（P〈0.05）。结论：高龄髋外伤围手术期卧床期间足踝运动角度以跖屈45°背伸30°,运动持续时间以2秒/次和3秒/次最佳,可显著地增加股静脉血流速度。     

MicroRNA expression profiling in prostate cancer

MicroRNAs (miRNA) are small, endogenously expressed noncoding RNAs that negatively regulate expression of protein-coding genes at the translational level. Accumulating evidence, such as aberrant expression of miRNAs, suggests that they are involved in the development of cancer. They have been identified in various tumor types, showing that different sets of miRNAs are usually deregulated in different cancers. To identify the miRNA signature specific for prostate cancer, miRNA expression profiling of 6 prostate cancer cell lines, 9 prostate cancer xenografts samples, 4 benign prostatic hyperplasia (BPH), and 9 prostate carcinoma samples was carried out by using an oligonucleotide array hybridization method. Differential expression of 51 individual miRNAs between benign tumors and carcinoma tumors was detected, 37 of them showing down-regulation and 14 up-regulation in carcinoma samples, thus identifying those miRNAs that could be significant in prostate cancer development and/or growth. There was a significant trend (P=0.029) between the expression of miRNAs and miRNA locus copy number determined by array comparative genomic hybridization, indicating that genetic aberrations may target miRNAs. Hierarchical clustering of the tumor samples by their miRNA expression accurately separated the carcinomas from the BPH samples and also further classified the carcinoma tumors according to their androgen dependence (hormone naive versus hormone refractory), indicating the potential of miRNAs as a novel diagnostic and prognostic tool for prostate cancer.     

苯扎氯铵进行膀胱冲洗对导尿管相关下尿路感染的防治

目的：探讨使用苯扎氯铵溶液进行膀胱冲洗对长期留置尿管患者下尿路感染的防治效果：方法：30例需要留置尿管超过3d的患者,按住院号单双号分为对照组和观察组,分别采用0．02％呋喃西林溶液和0．0025％苯扎氯铵溶液进行膀胱冲洗,在不同时问点留取中段尿标本进行尿常规及细菌学检测。结果：膀胱冲洗后第5、9天对照组尿白细胞计数明显高于观察组,对照组尿液细菌培养的阳性率明显高于观察组（P〈0．01）。结论：用苯扎氯铵溶液进行膀胱冲洗,患者表现出较好的耐受性,能够有效预防和治疗与留置尿管相关的下尿路感染。     

Chemical castration and anti-androgens induce differential gene expression in prostate cancer

Endocrine therapy by castration or anti-androgens is the gold standard treatment for advanced prostate cancer. Although it has been used for decades, the molecular consequences of androgen deprivation are incompletely known and biomarkers of its resistance are lacking. In this study, we studied the molecular mechanisms of hormonal therapy by comparing the effect of bicalutamide (anti-androgen), goserelin (GnRH agonist) and no therapy, followed by radical prostatectomy. For this purpose, 28 men were randomly assigned to treatment groups. Freshly frozen specimens were used for gene expression profiling for all known protein-coding genes. An in silico Bayesian modelling tool was used to assess cancer-specific gene expression from heterogeneous tissue specimens. The expression of 128 genes was > two-fold reduced by the treatments. Only 16% of the altered genes were common in both treatment groups. Of the 128 genes, only 24 were directly androgen-regulated genes, according to re-analysis of previous data on gene expression, androgen receptor-binding sites and histone modifications in prostate cancer cell line models. The tumours containing TMPRSS2-ERG fusion showed higher gene expression of genes related to proliferation compared to the fusion-negative tumours in untreated cases. Interestingly, endocrine therapy reduced the expression of one-half of these genes and thus diminished the differences between the fusion-positive and -negative samples. This study reports the significantly different effects of an anti-androgen and a GnRH agonist on gene expression in prostate cancer cells. TMPRSS2-ERG fusion seems to bring many proliferation-related genes under androgen regulation.     

Overexpression of androgen receptor enhances the binding of the receptor to the chromatin in prostate cancer

Androgen receptor (AR) is overexpressed in the majority of castration-resistant prostate cancers (CRPCs). Our goal was to study the effect of AR overexpression on the chromatin binding of the receptor and to identify AR target genes that may be important in the emergence of CRPC. We have established two sublines of LNCaP prostate cancer (PC) cell line, one overexpressing AR 2-3-fold and the other 4-5-fold compared with the control cells. We used chromatin immunoprecipitation (ChIP) and deep-sequencing (seq) to identify AR-binding sites (ARBSs). We found that the number of ARBSs and the AR-binding strength were positively associated with the level of AR when cells were stimulated with low concentrations of androgens. In cells overexpressing AR, the chromatin binding of the receptor took place in 100-fold lower concentration of the ligand than in control cells. We confirmed the association of AR level and chromatin binding in two PC xenografts, one containing AR gene amplification with high AR expression, and the other with low expression. By combining the ChIP-seq and expression profiling, we identified AR target genes that are upregulated in PC. Of them, the expression of ZWINT, SKP2 (S-phase kinase-associated protein 2 (p45)) and FEN1 (flap structure-specific endonuclease 1) was demonstrated to be increased in CRPC, while the expression of SNAI2 was decreased in both PC and CRPC. FEN1 protein expression was also associated with poor prognosis in prostatectomy-treated patients. Finally, the knock-down of FEN1 with small interfering RNA inhibited the growth of LNCaP cells. Our data demonstrate that the overexpression of AR sensitizes the receptor binding to chromatin, thus, explaining how AR signaling pathway is reactivated in CRPC cells.     

柴胡加龙骨牡蛎汤加减联合耳部刮痧治疗围绝经期综合征临床研究

目的：观察柴胡加龙骨牡蛎汤加减联合耳部刮痧治疗围绝经综合征（肝郁肾虚证）的效果。方法：选取120例围绝经期综合征（肝郁肾虚证）患者,采用随机数字表法分为常规组、汤剂组、刮痧组、联合组4组,每组30例。常规组实施常规西医治疗,汤剂组给予常规西医+柴胡加龙骨牡蛎汤加减治疗,刮痧组给予常规西医+耳部刮痧治疗,联合组给予常规西医+柴胡加龙骨牡蛎汤加减+耳部刮痧治疗,均治疗3个月。评价4组临床疗效,比较4组治疗前后中医证候评分、血清卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E2）水平,观察不良反应发生情况。结果：4组总有效率比较,差异有统计学意义（P<0.05）;联合组总有效率高于刮痧组和常规组（P<0.05）。治疗后,4组主症、次症评分与总分均较治疗前下降（P<0.05）;且治疗后联合组主症、次症评分与总分均低于其他3组（P<0.05）,汤剂组均低于刮痧组和常规组（P<0.05）,刮痧组低于刮痧组和常规组（P<0.05）。治疗后,4组血清FSH、LH水平均较治疗前下降（P<0.05）,联合组血清FSH、LH水平均低于其他3组（P<0.05...