口腔医学专业硕士研究生对艾滋病认知状况及态度的调查研究

为了探寻艾滋病的教育模式,帮助口腔医学专业硕士研究生形成对待艾滋病患者的正确态度,武汉大学口腔医学院对本院硕士研究生进行了问卷调查.调查结果显示,研究生对艾滋病相关知识及防护措施的认知水平总体较高,但仍然需要加强;对艾滋病患者和艾滋病病毒携带者持积极救助态度,但同时心存恐惧.因此,规范、系统的临床操作习惯亟需培养,无菌观念和“普遍预防”的意识亟需建立.     

度洛西汀联合硫辛酸治疗糖尿病痛性神经病变的临床研究

目的 探讨度洛西汀联合硫辛酸治疗糖尿病痛性神经病变的临床效果.方法 将62例糖尿病痛性神经病变患者按照随机数字表法分为三组:A组22例用度洛西汀联合硫辛酸治疗,B、C组各20例分别用度洛西汀和硫辛酸治疗;其他治疗方案相同.疗程均为6周.比较三组患者治疗前后疼痛缓解程度及神经传导速度的变化.结果 A、B、C组患者治疗后疼痛均有明显改善(P＜0.01);总有效率分别为86.4%(19/22)、70.0%(14/20)、50.0%(10/20),差异有统计学意义(P＜0.05);从治疗后2周开始A组视觉模拟评分(VAS)明显低于B组和C组(P＜0.05);A、C组神经传导速度均有改善,与治疗前比较差异有统计学意义(P＜0.01);但治疗后A、C组神经传导速度比较差异无统计学意义(P＞0.05);B组治疗前后神经传导速度比较差异无统计学意义(P＞0.05).结论 度洛西汀联合硫辛酸可提高治疗糖尿病痛性神经病变的临床效果.

Abstract：

Objective To investigate the clinical curative effects of duloxetine combined with thioctic acid on diabetic painful peripheral neuropathy. Methods Sixty-two patients with diabetic painful peripheral neuropathy were divided into three groups by random digits table: group A(22 patients, duloxetine combined with thioctic acid group), group B (20 patients,duloxetine group) and group C (20 patients,thioctic acid group). The other treatments were same. All patients were treated for six weeks. The pain remission level and nerve conductive velocity were compared among three groups. Results The pain level in three groups was significantly alleviated after treatment (P ＜ 0.01 ). The general effective rate was 86.4%(19/22),70.0% (14/20) and 50.0% (10/20) in group A,group B and group C,respectively (P ＜ 0.05). Visual analogue scales (VAS) in group A was significantly lower than that in group B and group C from the second week after treatment (P ＜ 0.05 ). Nerve conductive velocity was improved in both group A and group C after treatment (P＜0.01),but there was no significant difference between two groups (P＞0.05). In group B,compared with that before treatment,nerve conductive velocity had no significantly improved after treatment (P＞ 0.05). Conclusion Duloxetine combined with thioctic acid can enhance the clinical curative effects on diabetic painful peripheral neuropathy.     

Treatment of urethral strictures using lingual mucosas urethroplasty: experience of 92 cases

Background Urethroplasty of complex urethral stricture is a difficult procedure, and there is no widely accepted standard approach described in the published literature. We evaluated the efficacy and safety of urethroplasty using lingual mucosa grafts （LMGs） for the repair of urethral strictures. Methods Between August 2006 and April 2009, 92 cases of urethral strictures （length ranging from 2.5 cm to 18 cm, mean 6.5 cm） were treated using LMGs. Of the 92 patients, 38 with long-segment urethral strictures （9-18 cm） underwent dual LMG or LMG combined with foreskin flap or buccal mucosal graft urethroplasty. Results Follow-up was obtained for 3-33 months （mean 17.2 months） postoperatively. Complications occurred in 8 patients, including urinary fistulas in 4 patients; recurrent strictures developed in 4 patients at 3-4 months post-operatively. The remaining patients voided well postoperatively, with peak flows between 14.3 ml/s and 54.6 ml/s （mean 28.4 ml/s）. Conclusions The tongue is an excellent source of graft material for the repair of anterior mucosal strictures. Dual LMG substitution urethroplasty can successfully treat longer, more complex urethral strictures.     

耐甲氧西林金黄色葡萄球菌在动物流行病学中的研究进展

葡萄球菌是动物中重要的机会性病原体,耐甲氧西林金黄色葡萄球菌(MRSA)因其多药耐药的特征日益成为动物和公众健康的主要威胁。由于动物与动物及人畜间存在相互传染的风险,在控制MRSA感染的整个体系中,分析MRSA在动物中的流行显得尤为重要。     

A comparitive study of buccal mucosa graft and penile pedical flap for reconstruction of anterior urethral strictures

Anterior urethral strictures, where the length is more than 2 cm, are best treated by substitution urethroplasy with either preputial/penile skin flaps or free grafts.~1 The use of dartos pedicled flaps has many advantages in terms of increased survival thanks to its own vascularization. Recently, buccal mucosa has become increasingly popular among urologists for urethral replacement when local penile skin is unavailable.~2 Both penile skin flaps and buccal mucosa grafts have emerged as reliable urethral substitutes with comparable long-term results.~(3,4) These urethral substitutes are traditionally placed on the ventral aspect of the stricture and have a success rate of about 85%.~5 Recently, dorsal placement of the free graft has been described, allowing the skin patch/buccal mucosa to be spread and fixed on the tunica albuginea of the corporal bodies overlying the strictured segment of the urethra.~6 This location offers a better outcome. We reviewed our experience with dorsal and ventral onlay substitution urethroplasty using free buccal mucosa and pedicled penile/preputial flaps to determine the outcome and particular problems associated with each technique.     

链脲佐菌素诱导长爪沙鼠I型糖尿病模型的实验研究

目的 探讨链脲佐菌素(STZ)诱导长爪沙鼠I型糖尿病模型的可能性,并观察模型动物早期肾脏损害情况.方法 雄性长爪沙鼠96只,随机分为正常对照组(NC组)、模型组1(DM1组)、模型组2(DM2组),DM1及DM2组沙鼠分别一次性腹腔注射100 mg/kg、200 mg/kg STZ,NC组注射等量柠檬酸盐缓冲溶液.注射STZ后1、2、4、6周末,分别监测沙鼠一般情况,血糖、胰岛素等血清学指标和尿液指标,并处死沙鼠进行胰腺和肾脏组织的病理学检查.结果 注射STZ 24 h后,DM2组及DM1组部分沙鼠逐渐出现典型的"三多一少"症状,随着病程的发展,DM2组沙鼠持续高血糖,DM1组沙鼠血糖值与NC组差异有显著性(P<0.05),但有下降趋势;DM2组沙鼠胰岛素显著性降低(P<0.05),其他血清学指标及尿液指标均显著性升高(P<0.05),DM1组沙鼠各指标差异无显著性.DM2组沙鼠及DM1组少数沙鼠胰腺组织中可见胰岛β细胞减少、空泡样变性等变化,DM2组沙鼠肾脏组织中出现肾小球基质增多,毛细血管襻扩张等病变,DM1组沙鼠肾脏组织未见明显变化.结论 STZ 200 mg/kg可成功诱导长爪沙鼠I型糖尿病模型,在病程早期沙鼠肾脏结构和功能已经发生改变.     

江苏省扬州市社区矫正人员心理健康状况调查

目的了解社区矫正人员心理健康状况。方法对67名社区矫正人员进行症状自评量表(SCL-90),艾森克人格问卷(EPQ),生活事件量表(LES)以及家庭环境量表中文版(FES-CV)测定并进行评估。结果社区矫正人员症状自评量表(SCL-9O)的总分(141.84±58.49)以及躯体化(1.70±0.80)、抑郁(1.65±0.79)、焦虑(1.53±0.72)、恐怖(1.34±0.63)、精神病因子(1.44±0.60)比全国常模高(P<0.05);艾森克人格问卷(EPQ)精神质(p)均分(52.54±13.61)高于全国常模均值(50±10)(P<0.05);在生活事件量表(LES)评分中,所有67名社区矫正人员中总分超过20分的达到12人(17.9%),而95%正常人1年内中LES总分不超过20分;在家庭环境量表中文版(FES-CV)亲密度的均分(7.03±2.07)较常模(7.70±1.9)偏低(P<0.05);在矛盾性方面均分(3.58±2.12)较常模(2.20±1.9)高(P<0.01)。结论社区矫正人员存在较多的心理问题,家庭成员之间的亲密度不够,而且家庭成员之间很容易产生矛盾冲突,他们需要心理干预和社会支持。     

护理干预对风湿性心脏病患者焦虑心理的影响

目的探讨护理干预对风湿性心脏病(风心病)患者焦虑心理的影响。方法将68例风心病患者随机分为观察组和对照组各34例。对照组采用常规护理,观察组给予护理干预。采用汉密尔顿焦虑量表(HAMA)对焦虑情况进行评价,并对2组护理前、后的HAMA评分及护理后焦虑情况进行比较。结果观察组护理后HAMA评分低于对照组,焦虑情况优于对照组,差异均有统计学意义(P<0.05和P<0.01)。结论护理干预可缓解风心病患者的焦虑心理。     

Pandemic influenza is a strong motivator for participation in vaccine clinical trials among HIV-positive Canadian adults

BACKGROUND:

HIV-positive patients represent an immunosuppressed population at risk for severe influenza. In the event of a pandemic, such as 2009 H1N1, rapid implementation of vaccine clinical trials in target populations will be critical. In the present paper, knowledge and attitudes of HIV-positive adults regarding seasonal/pandemic influenza vaccination were evaluated, and facilitators and barriers to participation in vaccine clinical trials were explored.

METHODS:

A validated, 70-item, self-administered questionnaire was distributed to all HIV patients presenting for routine follow-up at eight Canadian Institutes of Health Research Canadian HIV Trials Network (CTN) sites from October 2008 to February 2009, as well as all participants in CTN trial 237. This study has representation from all Canadian provinces.

RESULTS:

In total, 610 HIV-positive adults responded (298 CTN 237 participants; 312 non-CTN 237 participants). Most reported receiving influenza vaccine last season (83% of CTN 237 participants versus 83% non-CTN 237 participants; P not significant) and most would receive a pandemic influenza vaccine if offered (76% versus 73%; P not significant). A majority believed that it was important to include HIV patients in vaccine clinical trials (65% versus 53%; P<0.001) and would agree to participate in trials of a pandemic vaccine if invited (86% versus 51%; P≤0.0001). Predictors of willingness to participate in a pandemic vaccine trial were ‘desire to be protected from pandemic flu’, OR 4.5 (95% CI 2 to 8) and ‘desire to help others’, OR 2.3 (95% CI 1.3 to 4.5). ‘Fear of needles’, OR 0.49 (95% CI 0.1 to 1.5) and ‘need for extra blood tests’, OR 0.49 (95% CI 0.2 to 1.4) were key barriers to participation.

CONCLUSION:

Most HIV-positive Canadian adults surveyed receive influenza vaccination. Protection from pandemic influenza is considered important and is a motivator for receiving influenza vaccine and future trial participation. Modifiable barriers to these objectives identified in the present study should be the focus of efforts to increase influenza immunization in this population.