How antepartum and postpartum acute urinary retention affects the function and structure of the rat bladder

Introduction and hypothesis

To examine the effect of acute urinary retention (AUR) on the urodynamic function and molecular structure of rat bladders in pregnancy and after parturition.

Methods

Forty-eight nulliparous rats were distributed into AUR and non-AUR groups. AUR was induced by clamping the distal urethra of each rat after infusing 3 ml of saline for 60 min. Plasma progesterone levels and cystometric data were evaluated on the 14th day of gestation, 3 and 10 days postpartum, and in virgin rats. The immunoreactivity of caveolins and nerve growth factor (NGF) was analyzed. The number of caveolae in bladder muscle cells was evaluated by electron microscopy.

Results

Progesterone levels significantly increased during pregnancy and 3 days postpartum. In cystometric results, the AUR group has significantly shorter intercontraction interval, lower void volume and greater residual volume compared with the non-AUR. AUR rats exhibited higher NGF immunoreactivity, lower caveolin-1 immunoreactivity, and less caveolae in the bladder compared with the non-AUR. The caveolin-1 and NGF immunoreactivity and the number of caveolae in the bladder decreased during pregnancy and 3 days postpartum compared with virgin rats. By using Pearson correlations, we found significant correlations between urodynamic variables (residual volumes and intercontraction intervals) and the expressions of caveolin-1, caveolae and NGF in the AUR rats on the 14th day of gestation and 3 days postpartum.

Conclusions

Bladder dysfunction in pregnancy and immediately postpartum in a rat model caused by AUR is associated with the plasma progesterone level change and the expressions of caveolin, caveolae, and NGF in bladder muscle cells.     

单卵裂期胚胎移植在体外受精-胚胎移植中的临床结局

目的探讨体外受精第3天(D3)单卵裂期胚胎移植在体外受精-胚胎移植中的临床应用前景。方法回顾性分析我院体外受精D3单卵裂期胚胎移植临床结局,收集172个新鲜胚胎移植周期,观察原发不育组和继发不育组、D3移植胚胎细胞数及评级、主动性单卵裂期胚胎移植及被动性单卵裂期胚胎移植与临床妊娠的关系。结果继发不育组女方年龄高于原发不育组,临床妊娠率(胚胎种植率)分别为33.63%、23.73%。D3移植胚胎的细胞数在8细胞以上者妊娠率与细胞数不足7细胞者相比有统计学差异(P0.01)。主动性单卵裂期胚胎移植组虽然年龄和不育年限高于被动性单卵裂期胚胎移植组,但移植胚胎质量及妊娠率明显高于后者(P0.01)。被动性单卵裂期胚胎移植组中各年龄段患者的移植胚胎质量没有显著性差异,但年龄低于35岁者有较好的妊娠结局。结论体外受精D3单卵裂期胚胎移植能获得良好的妊娠结果,临床妊娠结局主要与移植胚胎所含细胞数及评分密切相关。其次,年龄不足35岁,不育年限短的不育患者有更好的妊娠结局。     

Long-Term toxicity studies in Canine of E10A, an adenoviral vector for human endostatin gene

E10A, a recombinant adenovirus type 5 vector carrying the human endostatin gene, may be a promising gene therapy drug in the treatment of solid tumors by antiangiogenesis, but a preclinical safety evaluation of E10A has not yet been performed. With high and low doses equivalent to 30 and 7.5 times the human curative dose, respectively, intramuscular injections of E10A were given once daily, 6 days/week, for 3 months, followed by a 1-month recovery period. As of 4 months, all experimental animals appeared generally healthy: normal behavior and eating habits, no nausea, vomiting, or salivation, no abnormal changes in urination or defecation, and increased body weight with the time of experiment. Urinalysis, hemogram, blood biochemistry, electrocardiogram, macroscopic and microscopic studies of organs and tissues were done before treatment, at month 3 of treatment, and 1 month posttreatment. At all time points, no significant abnormal toxic effects were noted. Preliminary investigation of E10A immunotoxicity in dogs indicated that anti-adenoviral antibodies were generated, in a dose- and time-independent manner, after E10A injection. Our data demonstrated that, long term, high-dose intramuscular administration of recombinant human endostatin-carrying adenovirus (E10A) was not notably toxic and might be safe for clinical therapeutic use, although additional long-term toxicity studies by other administration routes are still necessary.     

急诊护士对医护合作的认知状况调查

医疗和护理虽然有着独立的体系，但两者是密不可分的，且在卫生工作中发挥着同等重要的作用，缺一不可。尤其在急诊科，抢救中默契的医护配合是提高病人救治水平、消除病患、维系病人生命的重要保证。医护合作的态度是指医生与护士对医护合作的评价和所持有的具有持久性而又有一致性的心理倾向，积极的医护合作态度具有指导双方的职业行为的功能。     

OPN sesame

Osteopontin (OPN) is a growth regulatory protein for hepatocellular carcinoma (HCC) and a potent chemoattractant for macrophages. Zhu and colleagues recently reported significant clinical associations between poor postoperative prognosis and the concurrent detection of tumoral OPN expression and peritumoral macrophage (PTM) infiltration. An in-depth understanding on the complex interaction between tumoral OPN and macrophage-infiltrated microenvironment opens new doors to novel anticancer treatments.     

儿童腹股沟疝快速康复临床路径的应用价值

目的：观察快速康复临床路径治疗儿童腹股沟疝的安全性及应用价值。方法回顾性分析2013年1月至2014年2月,南方医科大学附属南海医院入院的腹股沟疝患儿170例,按照是否进入快速康复临床路径分为快速康复路径组（观察组）和普通临床路径组（对照组）。观察组患儿（86例）采用快速康复临床路径,对照组患儿（84例）采用普通腹股沟疝临床路径。比较二组患儿的复苏时间、术后不良反应、并发症、住院时间、住院费用。结果二组患儿均无并发症出现。观察组复苏时间为（9±4）min,对照组复苏时间（18±9）min,二组比较差异有统计学意义（t＝－23．686,P＝0．00）;观察组术后不良反应发生率为9．3％,对照组为23．8％,二组比较差异有统计学意义（χ2＝6．501,P＝0．11）;观察组住院时间（1．2±0．2）d,对照组住院时间（2．9±0．7）d,二组比较差异有统计学意义（t＝－25．646,P＝0．00）;观察组住院费用（4864±360）元,对照组住院费用（5311±463）元,二组比较差异有统计学意义（t＝－7．340,P＝0．00）。结论快速康复临床路径应用于儿童腹股沟疝治疗是安全可行的,利于患儿的快速康复并减少住院时间,减轻患者家属的经济负担。     

幼龄成骨细胞移植促进骨质疏松性骨折愈合中不同类型一氧化氮合酶的动态表达

目的:追踪观察移植细胞在骨折愈合不同时间点的神经型一氧化氮合酶、诱导型一氧化氮合酶与内皮型一氧化氮合酶动态表达的生物学意义。方法:实验于1999-01/2004-02在中山大学动物试验中心、中山大学病理教研室完成、中山大学肿瘤防治中心完成。选择SD清洁级大鼠96只,按配对原则分为实验组48只,对照组48只;SD清洁级乳鼠20只进行成骨细胞原代培养。建立SD大鼠老龄骨质疏松骨折的动物模型,实验组将SD乳鼠颅骨体外培养的成骨细胞移植到SD雌性大鼠骨质疏松性骨折部位,对照组注入等量无血清培养液。手术后3,7,10,14,21,28,56,84d处死,每组每个时间点6只。用免疫组化检测骨折愈合不同时相的标本诱导型一氧化氮合酶、内皮型一氧化氮合酶和神经元型一氧化氮合酶的动态表达情况。结果:96只大鼠均进入结果分析。实验组:诱导型一氧化氮合酶在3d左右可见较多阳性表达的细胞,7d有表达高峰。内皮型一氧化氮合酶在3d左右可见少量阳性细胞,14d有表达高峰。神经元型一氧化氮合酶在10d左右可见少量阳性细胞,14～21d表达稍有增高,整个实验过程中神经元型一氧化氮合酶表达较弱,表达高峰不明显。而对照组诱导型一氧化氮合酶、内皮型一氧化氮合酶均有较弱表达,表达峰低平,而神经元型一氧化氮合酶表达很弱,未见明显表达高峰。结论:诱导型一氧化氮合酶、内皮型一氧化氮合酶在成骨细胞移植促进老年骨质疏松性骨折愈合的表达具有时效性,且表达的定位细胞不同,表达的量有差别,提示骨折部位一氧化氮合酶的释放可能对促进骨质疏松性骨折愈合有意义。神经元型一氧化氮合酶在成骨细胞移植促进老年骨质疏松性骨折愈合过程中的作用不明显。     

Neuroendocrine carcinoma of the stomach: clinical features and CT findings

Purpose

The purpose of the study is to investigate the computed tomographic characteristic and clinical findings of gastric neuroendocrine carcinoma (G-NEC) to increase awareness of this disease.

Methods

Twenty-two patients with a diagnosis of G-NEC were identified through the PACS of our hospital from August 2010 to November 2014. The clinical data, computed tomography (CT) features, and pathology records were analyzed.

Results

Among the 22 patients, 21 were male (95.45%), and 1 was female (4.55%). The mean age was 63.5 years old. Positive rates of neuroendocrine markers were 77.28% for chromogranin A staining, 86.36% for synaptophysin staining. All cases were single lesions including 16 (72.73%) in the gastric fundus, 3 (13.64%) in the gastric body and 1 (4.55%) in the gastric angle. Additionally 2 (9.09%) were found in the gastric antrum. Gastric wall was local thickening in 15 cases, and mass formation in 7 cases, with the stenosis and deformation of the adjacent gastric cavity. The long-axis diameter of the lesions ranged from 1.2 to7.4 cm (mean diameter, 2.47 cm), and the long-axis diameter was <2 cm in 12 case, 2–7.4 cm in 10 cases. The radiodensity values of the lesions were homogeneous density in 15 cases ranging from 22 to 47 HU (mean 34 HU). An ulcer with an irregular base and slightly raised borders located in the stomach was seen in 19 cases. The CT images showed homogeneous enhancement in 15 cases and heterogeneous enhancement in 7 cases. Obvious enhancement was seen in two cases, moderate enhancement was seen in sixteen cases, and mildly enhancement was seen in four cases. The peak value occurred in the arterial phase in 5 cases and the peak value was seen in 17 cases in the portal phase. Eleven lesions invaded the gastric serosa, and lymphatic metastasis was observed in 21 cases, 8 of which were combined with liver metastasis. CT images revealed 2 cases of the liver metastasis had obvious enhancement.

Conclusion

The CT features regarding location, incidence rates of ulcer and enhancement pattern described in our findings are common in all malignant gastric tumors. Therefore, the diagnosis of G-NEC must be confirmed with pathological test.

     

脑卒中病人的康复护理

脑血管病是一类严重危害中老年人生命的疾病。近年来 ,随着医学科学的进步 ,脑卒中病人抢救成活率不断提高 ,但常留有神经系统后遗症。脑卒中病人及早实施康复护理可提高病人的生活质量。如果早期的医疗方案缺乏康复措施 ,容易引起肌肉萎缩和关节孪缩变形 ,造成不可逆的继发性残疾。我们对 80例脑血管病人实施了综合康复护理 ,取得了较满意的效果。现介绍如下。1　资料和方法1.1　临床资料　 80例病人经CT扫描均确诊为脑血管病 ,其中男 68例 ,女 12例 ,年龄 42岁～ 70岁 ,平均 5 6岁。在常规治疗护理的同时进行康复护理。1.2　康复护理方法…