评《WHO人类精液检查与处理实验室手册》(第5版)

2010年《WHO人类精液检查与处理实验室手册》(第5版)修订出版。本文就其贡献、修改和缺憾进行了评述。遗憾缺乏中国的数据与资料。正常精子形态4%难以置信和应用。笔者认为:手册不能视为"圣经",WHO的参考值是一个重要的历史记录,但绝对不是终点,而是一个新起点。创建中国特色精液分析是男科学工作者不可推卸的责任。     

阴部神经阻滞在痔手术中的应用

目的探讨阴部神经阻滞麻醉在痔切除手术中应用的临床效果。方法对两组各25例Ⅲ、Ⅳ度痔患者分别采用阴部神经阻滞麻醉及腰部麻醉,分别观察比较两组患者手术操作时间,术中麻醉效果,术后第一次疼痛的时间,最大疼痛分级,术后继发出血、尿潴留及恶心、呕吐情况。结果两组患者在手术操作时间及术中麻醉效果的比较上无显著性差异（P〉0.05）;阴部神经阻滞组术后第一次疼痛时间13.53±1.82 h相比腰部麻醉组6.15±2.60 h明显延长（P〈0.05）;阴部神经阻滞组在各时段最大疼痛分级明显优于腰部麻醉组（P〈0.05）;阴部神经阻滞组术后尿潴留及恶心、呕吐发生率比腰部麻醉组明显减少（P〈0.05）。结论阴部神经阻滞麻醉用于痔手术,麻醉效果好,镇痛时间长,降低了常规腰部麻醉带来的痔术后并发症的发生,并为门诊手术开展提供技术支持。     

铜离子多极治疗内痔出血537例的体会

目的探讨铜离子多极治疗内痔出血的临床疗效。方法对Ⅰ~Ⅲ度内痔出血患者采用铜离子多极一次性治疗的537例临床资料作回顾性分析。结果铜离子治疗后1个月内所有患者均不再便血。结论铜离子多极治疗对痔出血有止血迅速、缩短治疗时间的临床疗效。     

A comparative study of standard versus laparoendoscopic single-site surgery (LESS) totally extraperitoneal (TEP) inguinal hernia repair

Background  

Laparoscopic inguinal hernia repair has been around since the 1990s. A novel surgical approach known as laparoendoscopic single-site surgery (LESS) has been developed to reduce the port-related morbidities and improve the cosmetic outcomes of laparoscopic surgery, including totally extraperitoneal (TEP) inguinal hernia repair. The aim of the present study was to evaluate the safety and feasibility of the LESS TEP technique for inguinal hernia repair and compare the outcomes with the standard TEP approach.     

人羊膜间充质细胞向成骨细胞诱导分化的实验研究

目的 观察人羊膜间充质细胞(human amnion mesenchymal cells,hAMCs)体外诱导向成骨细胞分化,为骨组织工程提供种子细胞。方法 从剖宫产后废弃的人羊膜组织分离培养hAMCs,经成骨细胞诱导条件培养基诱导后,对细胞形态特征、碱性磷酸酶、骨桥素、骨钙素表达以及I型胶原分泌进行观察和检测。结果 原代培养的hAMCs形态呈长梭形或不规则形,呈均匀分布生长,传代后细胞体积略变大,约5～7d传代1次。经成骨细胞诱导培养15d后,hAMCs碱性磷酸酶、骨钙素、骨桥素的表达呈阳性,并且检测有I型胶原分泌。结论 hAMCs易于体外分离培养及扩增,体外成骨细胞定向诱导的hAMCs具有典型的成骨细胞的形态和功能性特征,是良好的骨组织工程种子细胞。     

活血通络凝胶对兔膝骨性关节炎IL-1β的影响

目的 观察活血通络凝胶对兔膝骨性关节炎IL-1β的影响.方法 40只75日龄日本大耳白兔,随机分为空白组、模型组、治疗组及对照组.除空白组外,其余30只家兔均采用改良的Hulth法造模.于造模后1周开始进行治疗,采用1兔1笼喂养.治疗组给予活血通络凝胶局部涂抹,0.1 g/次,覆盖患膝为度,1次/日,4周为1疗程,共3个疗程.疗程结束后,检测兔患膝软骨及滑膜中IL-1βmRNA表达与IL-1β含量.结果 治疗组IL-1βmRNA表达及IL～1β免疫组化灰度值表达均明显降低,与模型组、对照组比较,P＜0.05,差异有显著性意义.结论 活血通络凝胶可能通过降低软骨中IL-1βmRNA表达、降低关节局部IL-1β含量,阻止软骨组织进一步损伤,延缓病变发展.     

Hemi-arthroplasty performed in a 109-year-old patient with intertrochantericfracture: A case report

The mortality of conservative treatment and the risk resulting from operation for elderly patients with femoral intertrochanteric fractures are high. Safety in the perioperative period and quicker recovery should be placed at the top priority for elderly patients with hip fractures. We reported a case of 109-year-old female patient with intertrochanteric fracture who has undergone the hemiarthroplasty in our center recently. With sciatic nerve and lateral cutaneous nerve block anesthesia, she was offered the artificial femoral head replacement in the lumbar plexus block after sufficient preoperative preparation. The surgery went well with minimally invasive cut, and the patient''s recovery was satisfactory.     

Toll样受体2和低氧诱导因子-1α在胰腺癌中的表达及意义

目的 研究Toll样受体2(TLR2)和低氧诱导因子-1α(HIF-1α)在胰腺癌中的表达及其临床意义.方法 采用实时荧光定量PCR检测30例新鲜胰腺癌及相应癌旁组织标本中TLR2和HIF-1αmRNA水平,应用免疫组化检测TLR2、HIF-1α在65例胰腺癌及相应38例癌旁组织中的表达,分析其与临床病理特征间的关系以...     

Functional endothelial progenitor cells from cryopreserved umbilical cord blood

Umbilical cord blood (UCB) is recognized as an enriched source of endothelial progenitor cells (EPCs) with potential therapeutic value. Because cryopreservation is the only reliable method for long-term storage of UCB cells, the clinical application of EPCs depends on our ability to acquire them from cryopreserved samples; however, the feasibility of doing so remains unclear. In this study we demonstrate that EPCs can be isolated from cryopreserved UCB-derived mononuclear cells (MNCs). The number of outgrowth EPC colonies that emerged in culture from cryopreserved samples was similar to that obtained from fresh UCB. Furthermore, EPCs obtained from cryopreserved MNCs were phenotypically and functionally indistinguishable from freshly isolated ones, including the ability to form blood vessels in vivo. Our results eliminate the necessity of performing cell isolation procedures ahead of future clinical needs and suggest that EPCs derived from cryopreserved UCB may be suitable for EPC-related therapies.     

Comparison of the 6th and 7th Editions of the UICC TNM Staging System for Gastric Cancer: Results of a Chinese Single-Institution Study of 1,503 Patients

Aim

To evaluate the prognostic efficacy of the 7th edition tumor–node–metastasis (TNM) classification compared with the 6th edition in gastric cancer patients.

Methods

A total of 1,503 gastric cancer patients undergoing surgical resection were staged using the 6th and 7th edition staging systems. Homogeneity, discriminatory ability, and monotonicity of gradients of the two systems were compared using linear trend χ², likelihood ratio χ² statistics, and Akaike information criterion (AIC) calculations.

Results

Significant differences in 5-year survival rates were observed for the T, N, and M subgroups using the 7th edition system, except for stage N2 and N3 patients in the 6th edition system. There were no significant differences in survival between IB and IIA in the 7th edition system. Patients with stage IV disease due to T4/N3 in the 6th edition system who were downstaged to stage III in the 7th edition system had significantly better survival than those who remained at stage IV. The 7th edition system had higher linear trend and likelihood ratio χ² scores, and smaller AIC values compared with those for the 6th edition, which represented the optimum prognostic stratification.

Conclusions

Our study suggests that the 7th edition system performs better than the 6th edition in several aspects.