聚合酶链反应顺序特异性寡聚核苷酸探针反向杂交法在HLA—DRBl分型中的应用

目的：探讨聚合酶链反应顺序特异性寡聚核苷酸探针(polymerase chain reaction-sequence specific oligonucleotide probes,PCR-SSOP)反向杂交法应用于人类白细胞抗原(human leukocyte antigen,HLA)—DRBl配型的可行性。方法：随机选取25例已行聚合酶链反应顺序特异性引物(polymerase chain reaction-sequence specific primers,PCR-SSP)法HLA—DRB1配型的肾移植受者的血标本，采用PCR—SSOP反向杂交法再次配型，并与PCR—SSP法的结果比较。结果：两法的一致性达92％。2例不一致的患者经再次PCR—SSOP反向杂交法配型后，其中1例与PCR—SSP结果一致，PCR—SSOP反向杂交法的平均操作时间为4小时30分。结论：PCR—SSOP反向杂交法是一种能以中等分辨度进行等位基因分型的方法，操作较简单，结果解读客观，适用于临床肾移植配型。     

Shorter recurrence-free survival time, higher risk of multiple recurrences: a retrospective study of non-muscle invasive bladder cancer after transurethral resection

Background  Multiple recurrences are common in non-muscle invasive bladder cancer, but the risk of multiple recurrences has not been fully described. Identifying patients at high risk of multiple recurrences will help to select an optimal therapeutic strategy and to improve prognosis. This study was conducted to identify the risk factors for multiple recurrences of non-muscle invasive bladder cancer.

Methods  We reviewed the clinical data of all patients with non-muscle invasive bladder cancer in our hospital between January 2003 and February 2010. Patients with at least one recurrence were included. Multivariate analysis was performed for theorized risk factors (age, gender, tumor stage, grade, size, location, number of lesions, adjuvant intra-vesical chemotherapy after transurethral resection, and recurrence-free survival after each resection) to clarify risk factors for multiple recurrences of non-muscle invasive bladder cancer.

Results  Of the 278 patients with non-muscle invasive bladder cancer, 84 were with at least one recurrence and a total of 222 recurrences among them were followed up for 6–70 months (mean, 36.1 months). Recurrence-free survival after initial resection predicted the overall frequency of bladder cancer recurrence (risk ratio (RR) = 37.83, 95% confidence interval (CI)=3.45–396.13, P=0.001) and second recurrence (RR=6.15, 95% CI=1.28–29.57, P=0.023). Similarly, recurrence-free survival after a second resection was the only significant risk factor for third recurrence (RR=31.08, 95% CI=2.53–381.47, P=0.007). Moreover, recurrence-free survival after initial resection was the only significant factor to predict later progression to muscle invasive bladder cancer (RR=8.62, 95% CI=1.47–58.34, P=0.001).

Conclusions  Recurrence-free survival after resection is an independent predictor of multiple recurrences of non-muscle invasive bladder cancer. The shorter the period between resection and recurrence is, the higher the risk of multiple recurrences.

     

阴茎异常勃起的诊治

目的提高阴茎异常勃起的诊治水平。方法回顾性分析15例阴茎异常勃起病例资料，结合文献复习进行讨论。结果 将病例分成低流量型和高流量型两组。低流量组中白血病6例，予全身化疗，随访5例，4例死亡，1例发生勃起功能障碍(ED)；药物性2例，原因不明5例，均行海绵体灌洗及分流术，随访中5例出现ED，2例恢复性生活。高流量组中，外伤1例，反复予海绵体注射阿拉明及挤压排空，术后性生活正常；另1例行阴茎海绵体动脉造影发现动脉灌注比例失调，行单侧海绵体栓塞，术后半年恢复勃起。结论阴茎海绵体动脉灌注比例失调可引起高流量型异常勃起，选择性海绵体动脉栓塞是其有效安全的治疗方法，高流量型疗效优于低流量型。