层面递进法激光腔内剜除高危前列腺增生的治疗体会

目的探讨1 470 nm激光剜除治疗高危前列腺增生的手术技巧及临床效果。 方法回顾分析2018年6月至2018年9月中山大学附属第三医院泌尿外科采用1 470 nm激光治疗共89例高危前列腺增生患者的临床资料，年龄平均（68±3）岁，前列腺体积（57.4±2.6）ml。所有患者均采用"寻找层面，先易后难，剜切结合"的层面递进法思路行激光腔内前列腺剜除术，比较患者术中及术后情况。 结果89例均顺利完成手术，与术前相比，术后3个月患者最大尿流率明显增加，[（6.9±2.1） ml/s vs（19.8±3.6） ml/s]。国际前列腺症状评分显著好转，[（24.6±1.7） vs（8.0±1.2）]。术中无输血、无电切综合征、无直肠和膀胱穿孔病例，无输尿管损伤、大出血、心脑血管意外等严重并发症发生。 结论层面递进法激光剜除技术构想对于高危前列腺增生外科包膜层面的寻找、减少术后并发症有独到优势，且易于掌握，或可为业界同行提供一个新的思路。     

3M无痛保护膜联合造口袋治疗大便失禁相关性皮炎的临床观察

目的探讨用3M无痛保护膜联合造口袋治疗大便失禁相关性皮炎(Incontinent dermatitis,IAD)的疗效。方法选择我院2014年12月至2015年6月收治的50例IAD患者为研究对象,按照随机数表法将其分为对照组与实验组,每组25例。对照组患者予以传统皮肤护理方法;实验组的患者除传统皮肤护理外加用3M无痛保护膜联合造口袋治疗。并比较两组患者治疗后的皮炎改善情况、皮炎愈合时间及皮炎复发率。结果实验组患者治疗效果明显优于对照组,实验组皮炎愈合短于对照组,实验组皮炎复发率明显低于对照组,差异均有统计学意义(P<0.05)。结论 3M无痛保护膜联合造口袋治疗IAD,临床效果显著,且愈合快,复发低。     

经胫骨隧道前交叉韧带双束八股解剖重建的临床研究

目的观察关节镜下采用自体腘绳肌腱经胫骨隧道前交叉韧带（anterior cruciate ligament, ACL）双束八股解剖重建的临床效果。方法随访上海交通大学附属第六人民医院运动医学科2018年12月—2020年1月收治的103例ACL断裂患者资料，其中男78例，女25例，年龄18~45岁，平均（26.8±5.86）岁；左侧47例，右侧56例，均采用关节镜下自体腘绳肌腱经胫骨隧道打股骨骨隧道，ACL双束八股解剖重建。按照Lysholm评分、国际膝关节评分委员会（IKDC）膝关节评分、Tegner膝关节评分标准和膝关节自我效能量表K-SES评价疗效。结果所有患者术后获随访12～42个月，平均（24±8.18）个月；手术前、末次随访评分比较，Lysholm评分分别为（48.41±4.44）分和（95.34±1.91）分，2组比较差异有统计学意义（P<0.001)；IKDC评分分别为（44.05±4.36）分和（95.66±1.89）分，2组比较差异有统计学意义（P<0.001)；Tegner评分分别为（2.84±0.95）分和（6.15±0.89）分，2组比较差异有统计学意义（P<0.001)；膝关节自我效能量表K-SES量表（3.10±0.83）分和（7.12±1.10）分，2组比较差异有统计学意义（P<0.001)。末次随访103例患者前抽屉试验阴性，轴移试验阴性。98例（95.1%）Lachman试验阴性，5例（4.9%）Lachman试验1°阳性。结论关节镜下采用自体腘绳肌腱经胫骨隧道双束八股解剖重建前交叉韧带是一种恢复膝关节稳定性，恢复伤前活动水平的有效方法。     

Identification of key genes and pathways in discoid lupus skin via bioinformatics analysis

Discoid lupus erythematosus (DLE) is the most common skin manifestation of lupus; however, the molecular mechanisms underlying DLE remain unknown. Therefore, we aimed to identify key differentially expressed genes (DEGs) in discoid lupus skin and investigate their potential pathways.To identify candidate genes involved in the occurrence and development of the disease, we downloaded the microarray datasets {"type":"entrez-geo","attrs":{"text":"GSE52471","term_id":"52471"}}GSE52471 and {"type":"entrez-geo","attrs":{"text":"GSE72535","term_id":"72535"}}GSE72535 from the Gene Expression Database (GEO). DEGs between discoid lupus skin and normal controls were selected using the GEO2R tool and Venn diagram software (http://bioinformatics.psb.ugent.be/webtools/Venn/). The Database for Annotation, Visualization, and Integrated Discovery (DAVID), Enrichr, and Cytoscape ClueGo were used to analyze the Kyoto Encyclopedia of Gene and Genome pathways and gene ontology. Protein-protein interactions (PPIs) of these DEGs were further assessed using the Search Tool for the Retrieval Interacting Genes version 10.0.Seventy three DEGs were co-expressed in both datasets. DEGs were predominantly upregulated in receptor signaling pathways of the immune response. In the PPI network, 69 upregulated genes were selected. Furthermore, 4 genes (CXCL10, ISG15, IFIH1, and IRF7) were found to be significantly upregulated in the RIG-I-like receptor signaling pathway, from analysis of Enrichr and Cytoscape ClueGo.The results of this study may provide new insights into the potential molecular mechanisms of DLE. However, further experimentation is required to confirm these findings.