内环处小切口精索静脉集束性结扎治疗精索静脉曲张临床效果的探讨

目的:探讨内环处小切口精索静脉集束性结扎治疗精索静脉曲张的临床效果。方法:局麻下经内环处小切口行精索静脉集束性结扎治疗178例精索静脉曲张患者。结果:178例患者手术疗效显著,所有患者切口I期愈合,术后3个月患者自觉症状消失,精液质量较治疗前明显改善,随访3年无复发,无睾丸萎缩、无睾丸鞘膜积液等并发症。结论:内环处小切口精索静脉集束性结扎治疗精索静脉曲张创伤小、疗效确切、设备投入少、病人费用低、手术安全易掌握,值得基层医院推广。     

疝环填充式和平片式无张力疝修补术治疗腹股沟疝的手术疗效研究

目的：对比分析疝环填充式和平片式无张力疝修补术治疗腹股沟疝的手术疗效及并发症情况。方法：回顾性分析80例腹股沟疝患者的临床资料,其中行疝环填充式无张力疝修补术患者42例,行平片式无张力疝修补术患者38例,对比分析两组的手术效果。结果：两组在手术时间、术中出血量及术后下床活动时间、住院时间方面比较,差异不显著,但B组行平片式无张力疝修补术的平均费用明显低于A组,两组比较,差异有显著统计学意义,P〈0．01。各组80％以上患者体温均小于38．5℃,两组均无一例出现切口感染。但两组患者术后尿潴留的发生率均较高,术后随访1年,两组均在术后不同时间出现1例复发病例,其余并发症如术后阴囊水肿及局部异物感等各组比较,差异不显著,P〉0．05。结论：疝环填充式和平片式无张力疝修补术治疗腹股沟疝手术效果相似,但平片式无张力疝修补术费用略低一些,更适合基层医院推广和应用。     

放射性脑损伤的MRI及灌注成像分析

目的探讨放射性脑损伤的影像特征。方法回顾分析我院环形强化放射性脑损伤病例31例,按环开闭情况、环的张力和形态演变、ASL-CBF灌注、DWI信号分析。结果 (1)4例呈闭环有张力;23例呈闭环无张力;4例呈开环。(2)低灌注26例;等灌注1例;边缘高灌注4例;(3)随时间延长:环缩小的17例,增大的11例,不变的3例;环形态不变的9例,变化的22例;(4)DWI信号:11例高信号位于环内,17例环形高信号,3例呈片状高信号。结论放射性脑损伤CBF多呈低灌注;脑外病变放疗导致的放射性脑损伤DWI高信号位于强化环内、强化环可逐渐增大但形态保持不变。     

Induction of labor and pain: a randomized trial between two vaginal preparations of dinoprostone in nulliparous women with an unfavorable cervix

Objective.?To compare pain associated with vaginal dinoprostone pessary vs. gel for induction of labor in women with an unfavorable cervix.

Study design.?A randomized controlled trial in a large academic public general hospital. A total of 52 nulliparous women of gestational age?≥38 weeks, with Bishop score?≤4 and intact membranes were allocated either to a controlled-release vaginal dinoprostone pessary or repeat doses of vaginal dinoprostone gel. Pain was recorded hourly from early induction until the onset of labor.

Results.?Mean pain experienced by women belonging to the two groups differed significantly (p?<?0.01). Women in the controlled-release device group were also significantly more often severe pain-free than women receiving gel (p?<?0.05). Both methods had similar rates of oxytocin infusion and vaginal deliveries.

Conclusions.?The two induction procedures should be considered equivalent as far as ripening the cervix and initiating labor. In view of this finding, the low Bishop score should be considered an indication to prefer the controlled-release device, since it reduces pain thereby improving the physical and emotional wellbeing of the parturient.     

The Association of Ring Chromosome 13 and Duodenal Obstruction

The antenatal diagnosis of ring chromosome 13 was made in a fetus at 30 weeks gestation. The pregnancy had progressed normally until this time, when polyhydramnios was suspected, and sonography demonstrated polyhydramnios, a growth delay of 4 weeks, and a double bubble sign, indicating duodenal obstruction or atresia. Cordocentesis was performed, and the karyotype was remarkable for a ring chromosome 13 in all fetal cells examined. Ring chromosome 13 is a rare chromosomal abnormality, usually associated with intrauterine growth delay and neural, cardiac, and renal malformations, but generally not associated with duodenal obstruction.     

对比内环外置法与内环内置法中国商环包皮环切术的临床效果

目的对比内环外置法与内环内置法中国商环包皮环切术的临床效果。方法将100例需行包皮环切术者随机分为内环外置组及内环内置组,每组50例,两组均采用中国商环行包皮环切术,内环内置组将内环置于包皮腔内,外环放置包皮外板外;内环外置组将内环置于包皮外板外,即标准化中国商环包皮环切术。对比两组手术时间、视觉模拟评分、切口愈合时间、术后并发症、切口愈合满意率。结果与内环外置组比较,内环内置组脱环时疼痛评分低,切口愈合时间短（P均〈0.05）,术后水肿、切口裂开发生率低,切口满意率高（P均〈0.05）。结论内环内置法中国商环包皮环切术具有效果好、脱环疼痛轻、术后并发症发生率低、愈合时间短、外观满意率高等优点。     

Ictal involvement of the nigrostriatal system in subtle seizures of ring chromosome 20 epilepsy

Studies in animal models and patients with epilepsy have suggested that basal ganglia circuits may control epileptic seizures and that striatal dopaminergic transmission may play a role in seizure modulation and interruption. Chromosome 20 [r(20)] syndrome is a well-defined chromosomal disorder characterized by epilepsy, mild-to-moderate mental retardation, and lack of recognizable dysmorphic features. Epilepsy is often the most important clinical manifestation of the syndrome, with prolonged episodes of nonconvulsive status epilepticus suggesting dysfunction in the seizure control system. We present the ictal blood oxygen level-dependent (BOLD) changes in brief seizures recorded by means of electroencephalography-functional magnetic resonance imaging (EEG-fMRI) coregistration in a patient with [r(20)] syndrome. We observed ictal BOLD increments in a cortical-subcortical network involving substantia nigrastriatum and frontal cortex. At present, this is the first functional neuroimaging evidence of the involvement of the nigrostriatal system during ictal EEG discharges in [r(20)] syndrome supporting a role of the basal ganglia circuits in human epileptic seizures.     

Functional polycarbonates and their self-assemblies as promising non-viral vectors

Polycarbonates are promising biomaterials due to their biocompatibility, degradability and low toxicity. In this study, a series of COOH-functionalized polycarbonates was synthesized via an organocatalytic ring opening polymerization pathway under mild conditions. The polymers displayed a range of molecular weights (M_w: 3.1, 5.5 and 9.7 kDa) and were very narrowly distributed (polydispersity index: 1.07, 1.07 and 1.15 respectively). Aliphatic amines with different chain lengths (triethylenetetramine, tetraethylenepentamine or pentaethylenehexamine) were then conjugated onto the polycarbonate backbone using DIC/NHS chemistry. These amine-functionalized polycarbonates could form nanoparticles upon simple dissolution in water and had CMC values ranging from 22 to 45 mg/L. It was found that a longer amine chain resulted in greater buffering capacity, more positive zeta potential and smaller hydrodynamic size of the polymeric nanoparticles. Results from gel retardation assays indicated that the polymers were able to condense DNA. In-vitro studies further demonstrated that selected amine-functionalized polycarbonates could mediate efficient luciferase expression in HEK293, HepG2 and 4T1 cell lines at levels that were comparable, or even superior, to the polyethylenimine (PEI) standard. Importantly, minimal cytotoxicty was induced in the cells. These functional polycarbonates therefore have the potential to be a useful non-viral vector for gene therapy.     

达克宁栓和制霉素素泡腾阴道片治疗80例阴道念珠菌病的疗效观察

目的：了解应用达克宁栓治疗阴道念珠菌病的效果。方法：达克宁栓组：将外阴洗净,每晚放一枚入阴道深处,连续用7天,7日为一个疗程,制霉菌素泡腾阴道片组;用法同达克宁栓,每日一次,共14天,结果：达克宁栓组：首次随访54例患中治愈36例,治愈率66．0％,有效15例,有效率27．0％,总有效率93．0％;第2次随访,治愈40例,治愈率74．0％,有效8例,有效率14．0％,总有效率88．0％,制霉菌素泡腾阴道片组：首次随访26例患中治愈15例,治愈率57．7％,有效8例,有效率30．0％,总有效率88．0％,第2次随访,治愈14例,治愈率53．4％,有效3例,有效率11．0％,总有效率65．4％。在远期随访中,两种药物治愈率,总有效率相比,均有显差异（P＜0．05）,结论：达克宁栓治疗阴道念珠菌病具有较好疗效,且外阴痉痒症状消退快。     

Ring chromosome 9 in a dysmorphic child

Ring chromosome is a rare genetic disorder observed in the children with variable clinical presentation and phenotype. Among several ring formation, individuals with r(9) generally have less distinct clinical features. An eight-mth-old boy, presenting with broad and dark eyebrows with protruding tongue, microcephaly, short stature and failure to thrive was found to have ring chromosome 9. 46,X,inv(Y),r(9)(p24q34). This shows that karyotype study is an essential integral investigation in the management of dysmorphic child.