300例慢性前列腺炎患者病原菌检测及复合药敏试验

目的分析慢性前列腺炎(chronicprostatitis,CP)致病菌及复合药敏试验规律,探索治疗方法.方法对300例无菌采集的前列腺液(EPS)标本同时接种需氧菌,厌氧菌、L型菌培养基鉴定并做药敏试验.结果表皮葡萄球菌(58.3%)、丙酸杆菌(29.3%)为CP致病的两大优势菌;二者在致病过程中具有协同作用;表皮葡萄菌随年龄增大而感染率降低,三组间有显著性差异(P＜0.05),L型菌是疾病复发、难以治愈的原因之一;治疗首选利福平、氟哌酸而青霉素、洁霉素几乎是无效的.结论多种形式的细菌检测和复合药敏试验是非常必要的,目前尚无他法替代.     

尿胰蛋白酶原—2测定对急性胰腺炎的早期诊断价值

目的 探讨尿胰蛋白酶原－2测定在急腹症中筛选急性胰腺炎的价值。方法 对346例连续就诊的急腹症病人同时测定尿胰蛋白酶原－2及血、尿淀粉酶。结果 41例急性胰腺炎中有38例尿胰蛋白酶原－2阳性,敏感性为92．7％,305例非胰腺炎的急腹症病人有15例假阳性,特异性为95．1％。5例重症急性胰腺炎中尿胰蛋白酶原－2全部阳性。结论 尿胰蛋白酶原－2是急腹症病人筛选急性胰腺炎快而简便的方法,具有较高的特异性和敏感性。     

表皮生长因子及染料木黄酮对垂体瘤细胞增殖的调节

12例垂体瘤做原代细胞培养 ,检测了表皮生长因子 ( EGF)及染料木黄酮 ( Genistein)对肿瘤细胞 3H- Td R掺入率及酪氨酸激酶产物表达的影响。研究表明 EGF使大部分功能性腺瘤及所有非功能性腺瘤细胞的 3H- Td R掺入率明显增加 ,酪氨酸激酶活性增强 ,而 Genistein能抑制 EGF的作用使所有瘤细胞的 3H- Td R掺入率下降。提示表皮生长因子对垂体瘤细胞有明显的增殖刺激作用 ;Genistein能消除表皮生长因子的细胞增殖刺激作用 ,抑制肿瘤细胞增生 ,对垂体瘤治疗有重大意义。     

nm23—H1基因表达与乳腺癌侵袭转移的关系

目的：探讨肿瘤抑制基因（nm23-H1）的表达与乳腺癌浸润转移的关系,方法：采用免疫组织化学及反转录一多聚酶链反应（RT－PCR）方法对30例乳腺癌及10例乳腺良性肿瘤中nm23-H1基因产物的表达进行研究,结果：nm23-H1在乳腺癌组织中的表达明显高于良性组织,早期乳腺癌（Ⅰ-Ⅱ期）nm23-H1阳性表达率明显高于中晚期乳腺癌（Ⅲ-Ⅳ）,有淋巴结转移的乳腺癌组织中nm23-H1阳性表达率显著低于无淋巴结转移者;nm23-H1的表达与乳腺癌的病理类型无关,结论：nm23-H1异常表达可能是乳腺癌浸润转移的重要分子学标志,检测乳腺癌组织nm23-H1的表达,有助于预测其进展程度和对淋巴结转移的判断。     

口腔修复科进修医师接诊前培训探析

为了提高进修医师的教学质量和医疗水平,我们在2006届进修医师教学工作中加强和细化了进修医师接诊前的培训,取得了良好的效果.实践证明,实施接诊前培训对于提高进修医师的医疗水平和自信心,实施规范化操作,克服诊疗中的盲目性,减少或避免医疗纠纷,进而提高进修医师的教学质量具有重要意义,值得推广和借签.     

Fractionated carbon dioxide (CO2) laser treatment contributes to trans-nail penetration of rhodamine B and changes of cytokine microenvironment

Lasers in Medical Science - This study is to determine the role of the fractional CO2 laser in topical drug delivery and the impact of local immune responses. Experimental rabbit nails were treated...     

Development a nomogram to predict fertilisation rate of infertile males with borderline semen by using semen parameters combined with AMH and INHB

The sperm quality of some males is in a critical state, making it hard for clinicians to choose the suitable fertilisation methods. This study aimed to develop an intelligent nomogram for predicting fertilisation rate of infertile males with borderline semen. 160 males underwent in vitro fertilisation (IVF), 58 of whom received rescue ICSI (R-ICSI) due to fertilisation failure (fertilisation rate of IVF ≤30%). A least absolute shrinkage and selection operator (LASSO) regression analysis identified sperm concentration, progressively motile spermatozoa (PMS), seminal plasma anti-Müllerian hormone (spAMH), seminal plasma inhibin (spINHB), serum AMH (serAMH) and serum INHB (serINHB) as significant predictors. The nomogram was plotted by multivariable logistic regression. This nomogram-illustrated model showed good discrimination, calibration and clinical value. The area under the receiver operating characteristic curve (AUC) of the nomogram was 0.762 (p < .001). Calibration curve and Hosmer–Lemeshow test (p = .5261) showed good consistency between the predictions of the nomogram and the actual observations, and decision curve analysis showed that the nomogram was clinically useful. This nomogram may be useful in predicting fertilisation rate, mainly focused on new biomarkers, INHB and AMH. It could assist clinicians and laboratory technicians select appropriate fertilisation methods (IVF or ICSI) for male patients with borderline semen.     

多西他赛+卡铂联合曲妥珠单抗方案对早期人表皮生长因子受体2阳性乳腺癌的新辅助治疗效果

目的探讨多西他赛+卡铂联合曲妥珠单抗(TCH)方案对早期人表皮生长因子受体2(HER2)阳性乳腺癌的新辅助治疗效果。方法回顾性分析2013年1月至2018年12月北京大学第一医院乳腺疾病中心经治的522例早期HER2阳性乳腺癌患者的临床资料,占同期收治早期浸润性乳腺癌患者的21.80%(522/2 394)。其中113例接受TCH方案进行新辅助治疗,年龄[M(QR)]52(13)岁(范围:23~69岁)。记录TCH方案新辅助治疗后病理完全缓解(pCR,ypT0N0M0期)的例数,采用Miller-Payne标准进行病理学评价。采用Kaplan-Meier法计算无病生存率和总体生存率,采用Log-rank检验比较组间生存差异。结果接受曲妥珠单抗规范治疗患者(294例)的无病生存率优于未规范治疗患者(177例)(84.4%比72.4%,χ²=4.095,P=0.046)。发生3~4级不良反应的患者占全部患者的15.9%(18/113),包括3~4级中性粒细胞减少12例,腹泻6例。31例患者获得pCR(ypT0N0M0),pCR率为27.4%(31/113)。pCR患者与非pCR患者的无病生存率和总体生存率无差异(91.8%比85.0%,92.5%比90.5%,P值均>0.05)。病理学评价为G4~5的患者无病生存率优于G1~3患者(89.6%比81.5%,χ²=5.340,P=0.021),而总体生存率的差异无统计学意义(91.4%比89.1%,χ²=1.008,P=0.315)。结论早期HER2阳性乳腺癌采用TCH方案行新辅助治疗的效果较好,新辅助治疗后病理学评价为G4~5的患者的无病生存率更高。     

Early bioprosthesis failure in mitral valve replacement

The causes of early bioprosthesis failure include infective endocarditis, pannus formation, and structural valve deterioration. We reported a patient who suffered from early mitral bioprosthesis failure due to leaflets restricted by the subvalvular apparatus and early pannus formation. In patients with symptoms relapse and mitral regurgitation recurrence early after mitral valve replacement, early pannus formation needs to be anticipated, and surgical intervention should be performed if symptoms persist after medical treatment.