卵母细胞体外成熟技术在体外受精-胚胎移植中的补救应用

目的 对未成熟卵的体外成熟(IVM)技术在体外受精-胚胎移植(IVF-ET)中的补救性应用进行总结,探讨影响其治疗结果的因素.方法 在IVF-ET治疗中,对卵巢反应不良、卵泡发育迟缓和卵泡过多生长有发生过度刺激可能需要取消治疗周期的患者,在B超引导下经阴道卵泡穿刺术取卵后,对未成熟卵进行体外培养成熟后进行IVF或卵胞浆内单精子显微注射,良好胚胎进行移植.结果 取卵周期33个,共获未成熟卵214个,进行体外培养后126个成熟;32个周期进行常规胚胎移植,8例临床妊娠,移植周期临床妊娠率为25.00%(8/32);7例分娩8个健康婴儿.结论 未成熟卵IVM技术是IVF-ET治疗不孕不育中有效的补充方法,可以补救未成熟的卵,减少患者取消IVF-ET治疗周期的发生.     

原发性十二指肠恶性肿瘤的X 线诊断

目的　探讨X线诊断原发性十二指肠恶性肿瘤的价值。方法　回顾性分析 2 1例原发性十二指肠恶性肿瘤的X线所见并与手术病理对照。结果　X线表现包括充盈缺损、黏膜改变、肠腔狭窄和龛影。结论　根据临床及X线表现 ,术前可以正确诊断原发性十二指肠恶性肿瘤。     

Fatty acid-binding protein-4 as a biomarker predicting acromegaly-associated diabetes mellitus

Background/aimThe known pathogenesis of diabetes mellitus (DM) in acromegaly is mainly based on growth hormone (GH) and insulin-like growth factor-1 (IGF-1) excess. Fatty acid-binding protein 4 (FABP-4), a novel adipokine, is found to induce insulin resistance and type 2 DM. We aimed to investigate the possible effect of FABP-4 on glucose metabolism in patients with acromegaly.Materials and methodsThis case-control study included 28 patients newly diagnosed with acromegaly and 57 healthy volunteers. The patients with acromegaly were classified according to their glycemic status as with DM, prediabetes, and normal glucose tolerance. Anthropometric measurements, laboratory test results, and FABP-4 levels of the subjects were evaluated.ResultsAlthough no difference was observed in FABP-4 levels between acromegaly and control groups, the FABP-4 level was higher in the patients with acromegaly having DM compared to the patients with acromegaly having prediabetes and NGT, and the control group (p = 0.004, p = 0.001, p = 0.004, respectively). Logistic regression analysis suggested that the FABP-4 is an independent predictor of DM in acromegaly (β = 7.382, OR = 38.96, 95% CI: 1.52-5.76, p = 0.018).Conclusion The FABP-4 may be a helpful predictor of acromegaly-associated DM.     

Bacterial colonization of chronic leg ulcers: current results compared with data 5 years ago in a specialized dermatology department

Background In nearly every chronic wound different bacteria species can be detected. Nevertheless, the presence of such microorganisms is not necessarily obligatory associated with a delayed wound healing. But from this initially unproblematic colonization an infection up to a sepsis can arise in some patients. The aim of our clinical investigation was to analyse the spectrum of microbial colonization of patients with a chronic leg ulcer in our specialized dermatological outpatient wound clinic, and to compare them with the results of comparable data already collected 5 years ago. Objectives In our retrospective investigation the results of bacteriological swabs were documented in 100 patients with a total of 107 chronic leg ulcers. All patients visited the specialized wound outpatient clinic, Department of Dermatology, University of Essen in Germany. Methods A total of 60 patients were female, 40 were male. The mean age was 65 years. Altogether a total of 191 bacterial isolates and 25 different bacterial species could be identified. Results The most often detected species were Staphylococcus aureus (n = 60), Pseudomonas aeruginosa (n = 36) as well as Proteus mirabilis (n = 17). In 10 patients (10%) we identified a colonization with methicillin resistant S. aureus (MRSA). Merely in 6 patients the taken swabs were sterile. Five years ago a comparable investigation was already carried out in our wound outpatient clinic. At that time we could detect in particular more frequent MRSA (21.5% vs. 10%) and rarely P. aeruginosa (24.1% vs. 33.6%). Conclusion The results of our investigation demonstrate the current spectrum of the bacterial colonization in patients with chronic leg ulcers in a university dermatological wound centre in comparison to the last 5 years. In our institution we were able to demonstrate a shift of the detected bacterial species from gram‐positive in direction to gram‐negative germs. Beside the already known problems with MRSA, in future therapeutic strategies in patients with chronic leg ulcers the increasing amount of gram‐negative bacteria and especially of P. aeruginosa should considered.     

经腹超声和经会阴超声联用在孕中期前置胎盘诊断中的应用价值

目的:探究孕中期前置胎盘孕妇在使用经腹超声和经会阴超声联用后的诊断价值。方法:研究对象为2014年6月~2016年6月收入的80例疑似孕中期前置胎盘孕妇,对其展开回顾性分析,本院分别采用经腹超声及经腹+经会阴超声联合诊断两种方式对其进行诊断。诊断后经手术即实验室检查发现有72例发生孕中期前置胎盘,现比较两种诊断方式的实施对灵敏度、准确度、特异度的影响。结果:超声联合诊断的灵敏度(98.44%)、准确率(94.44%)及特异度(71.43%)显著比经腹超声诊断的(90.47%)、(84.72%)、(44.44%)高(χ^2=6.064、5.061、14.946,P<0.05)。结论:孕中期前置胎盘经过经腹超声和经会阴超声联用诊断后能够形成优势互补,灵敏度更高,诊断结果更为准确。     

微塑料生殖和胚胎发育毒性的研究进展

目的 研究发现微塑料（粒径小于5 μm的塑料颗粒）在低等生物和哺乳动物中均可诱导生殖毒性和胚胎发育毒性。本文对微塑料在生殖和胚胎中的毒性效应和作用机制进行综述,可为预防和控制微塑料所致生殖毒性提供理论基础和科学依据。方法 以微塑料、暴露途径、毒性机制、生殖毒性、胚胎毒性为关键词在中国知网、PubMed 等数据库检索相关文献,并对国内外相关文献进行归纳与总结。结果 综述微塑料暴露途径及其转运和代谢分布、全面系统地概述微塑料生殖和胚胎发育毒性效应及毒性机制。结论 研究发现微塑料在低等生物和哺乳动物中均可诱导生殖毒性和胚胎发育毒性,但微塑料所致生殖毒性主要局限在表型研究,目前仍缺乏针对微塑料生殖毒性作用机制的系统研究,同时需在人群层面进一步研究。     

2007-2014年细菌性食源性疾病病原菌检测结果分析

摘要:目的　分析厦门市思明区多年来细菌性食源性疾病病原菌种类、尤其是流行特征及实验室检测情况,为预防和控制食源性疾病提供科学依据。方法　对思明区2007-2014年细菌性食源性疾病实验室检测样品信息及结果进行统计分析。结果　8年共接到114起疑似细菌性食源性疾病送检样本,检测各类样本共857份,其中71起检出目标病原菌。依次以副溶血性弧菌（38.6%）、金黄色葡萄球菌（10.5%）、蜡样芽胞杆菌（5.3%）、致泻性大肠埃希菌（2.6%）和沙门菌（2.6%）为主要致病菌,第三季度发生率最高为49.1%（56/114）。结论　思明区细菌性食源性疾病以副溶血性弧菌为主要病原菌,且O3血清型为主;夏秋为高发季节。诺如病毒是非细菌性食源性感染的主要病毒。掌握食源性疾病的发生规律,加强食品卫生安全监督管理,制定针对性的预防措施,可有效预防和控制食源性疾病的发生。     

口服氨基葡萄糖联合关节腔内注射治疗膝骨性关节炎

目的 探讨口服氨基葡萄糖联合关节腔内注射治疗膝骨性关节炎的疗效.方法 门诊选取膝骨性关节炎患者402例,将患者按第1次关节腔内注射药物的不同分为透明质酸钠关节腔内注射组(214例)和三联针(透明质酸钠、醋酸曲安奈德、盐酸利多卡因)关节腔内注射组(188例),并在治疗后1、2、3、5周对患者按预先设定的疗效评价标准进行随访.结果 治疗后两组患者西安大略麦马斯特大学骨性关节炎指标可视化量表 (WOMAC) 疼痛指标和机体功能指标均明显下降,而且随观察时间延长,呈逐渐下降趋势,组间比较差异无统计学意义(P>0.05),但治疗后第1周随访,三联针关节腔内注射组疼痛指标下降趋势更明显,两组治疗期间塞来昔布用量比?差异有统计学意义(P<0.05).两组的不良反应发生率分别为8.9%(19/214)和8.5%(16/188),主要表现为轻中度的胃肠道不适和便秘.结论 口服氨基葡萄糖联合关节腔内注射在短期内能有效减轻膝骨性关节炎患者疼痛,改善关节功能,第1次关节腔内注射三联针能更快、更有效地缓解疼痛,减少了塞来昔布的用量.     

腰椎椎间融合术治疗脊柱不稳的临床观察

[目的]研究腰椎椎间融合术治疗脊柱不稳的重建方法和临床效果,为临床提供一种较为理想的椎间植骨选择.[方法]选择收治的腰椎段不稳患者78例,根据随机化原则分为对照组和实验组各39例,对照组行椎问自体髂骨块植骨,实验组行椎间自体棘突椎板连接处结构植骨.对两组患者术后融合率、融合所需时间以及疼痛改善和影像学诊断结果进行记录,应用统计学分析比较两组患者治疗的临床疗效.[结果]对照组和实验组在融合率、融合所需时间、疼痛缓解评分程度方面并无明显差异,但术后随访时(6个月,12个月),对照组患者的椎间隙高度明显低于实验组(P<0.05),而对照组患者椎体滑脱率明显高于实验组患者(P<0.05),在维持椎间隙高度及减少腰椎滑移危险方面差异有统计学意义.[结论]利用棘突根部与椎板连接处结构椎问植骨融合治疗脊柱不稳安全可行、疗效确切,临床应用前景广阔.