86例痤疮患者血清性激素水平分析

目的 研究痤疮患者血清性激素水平与痤疮的关系。方法 对86例痤疮患者以放免法检测患者血清睾酮、卵泡刺激素（男性称精子生成素）、黄体生成素（男性称间质细胞刺激素）、孕酮和雌二醇;并对其中20例患者检测了泌乳素。结果 男性寻常痤疮、男和女聚合性痤疮和痤疮伴四肢或乳晕多毛（女性）63．89％患者血清睾酮增高,75％患者雌二醇增高;男性疮疮90．91％患者精子生成素低于正常。结论 血清性激素水平与痤疮类型有关,在痤疮的发生、发展和持续状态中起重要作用。     

广东省绿头鸭场鸭乙肝病毒自然携带状况调查

目的　调查两个鸭场携带乙肝病毒(DHBV)状况。方法　在对广东省家养绿头鸭分布状况进行系统调查的基础上,对南海市和顺镇、里水镇两个绿头鸭场作了随机抽样调查,采集了雏鸭、青年鸭和种鸭的血标本共519份,应用斑点分子杂交(DotBlot)测定法观察绿头鸭乙型肝炎病毒(DHBV)自然携带率。结果　两鸭场绿头鸭的DHBV自然携带率为36.0%(187/519),其95%可信限为31.0%～44.0%。不同鸭龄组绿头鸭DHBV自然携带比较,两鸭场同日龄绿头鸭DHBV自然携带率比较,绿头鸭DHBV自然携带率的性别比较,差异均无显著意义。不同鸭龄的绿头鸭DHBV-DNA含量定量分析(A值),差异有非常显著性(P＜0.01),其含量由高到低顺序为雏鸭＞种鸭＞青年鸭,和顺鸭场的绿头鸭DHBV-DNA含量高于里水鸭场。结论　两鸭场绿头鸭携带的DHBV可能源于不同的亚株。     

Diagnostic value of routine semen analysis in clinical andrology

Infertility is a major health issue affecting over 48.5 million couples around the world, with the male factor accounting for about 50% of the cases. The conventional semen analysis recommended by the World Health Organization (WHO) is the cornerstone in the evaluation of male fertility status. It includes macroscopic and microscopic evaluation of the ejaculate, which reflects the production of spermatozoa in the testes, the patency of the duct system and the glandular secretory activity. Evaluation of seminal fructose, sperm vitality and leucocytes (Endtz test) are useful adjuncts to semen analysis that provide information on specific clinical conditions. Though several computer-assisted sperm analysis (CASA) systems have been developed, conventional methods for semen analysis are still widely accepted in clinical practice. This review summarises the conventional techniques used in routine semen analysis and their diagnostic value in clinical andrology.     

Diagnostic Utility of Platelet Count/Lymphocyte Count Ratio and Platelet Count/Mean Platelet Volume Ratio in Periprosthetic Joint Infection Following Total Knee Arthroplasty

BackgroundDiagnosing a periprosthetic joint infection (PJI) can be challenging and often requires a combination of clinical and laboratory findings. Monocyte/lymphocyte ratio, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio (PLR), and platelet/mean platelet volume ratio (PVR) are simple predictors for inflammation that can be readily obtained from complete blood count. The aim of this study is to evaluate the diagnostic utility of these markers in predicting PJI in total knee arthroplasty (TKA) patients.MethodsA total of 538 patients who underwent revision TKA with calculable marker ratios prerevision in 2 groups were evaluated: (1) 206 patients with a preoperative diagnosis of PJI (group I) and (2) 332 patients treated for revision TKA for aseptic failures (group II). The diagnostic abilities of the markers were assessed via receiver operator characteristic curve analysis.ResultsThe optimal threshold of PVR at 30.82 had the highest sensitivity of 87.7%, while the optimal threshold of PLR at 234.13 had the highest specificity of 82.5%. Both PLR and PVR, when combined with Musculoskeletal Infection Society thresholds for erythrocyte sedimentation rate, C-reactive protein, synovial WBC, and PMN%, achieve significantly higher sensitivity and specificity rates for PJI at or above 97% (PLR: 99.03%; 98.80%; PVR: 98.54%;97.89%).ConclusionOur study demonstrates that PVR and PLR, which are readily available and inexpensive to obtain from complete blood counts, when combined with serum and synovial fluid markers have increased sensitivity and specificity comparable to that of alpha defensin. This suggests that PVR and PLR can be used together with other hematologic and aspirate markers to increase the accuracy of PJI diagnosis in TKA patients.     

Utility and Prognostic Ability of a Diagnostic Injection Before Revision Total Knee Arthroplasty

BackgroundDiagnostic injections are commonly utilized in the workup of painful total knee arthroplasties (TKA), particularly when the diagnosis remains unclear. However, current literature provides limited evidence regarding the utility and prognostic capability of anesthetic injections in this scenario. This study sought to establish the role of diagnostic injections in predicting successful revision TKA.MethodsA retrospective review was conducted on 144 consecutive aseptic revision TKAs receiving diagnostic anesthetic injections. Instability (57.6%) and aseptic loosening (33.3%) comprised most revision etiologies. Patient-reported percentage pain relief after the injection was statistically correlated with KOOS JR, Knee Society Score, UCLA Activity Level, and satisfaction scores.ResultsAbout 74.3% (107/144) of revision TKAs reported >50% pain relief after injection. There were no differences in pain relief based on revision indication (P = .841). Improvement from preoperative activity level was greater in the >50% pain relief group (P = .024). Four-month patient satisfaction did not differ between patients who reported >50% and ≤50% pain relief (67% vs. 66%, P = .130). About 64% of patients who reported >50% pain relief were satisfied at minimum 1-year follow-up, compared with only 47% of those who reported ≤50% pain relief after diagnostic injection (P < .001).ConclusionStudy results show that patients reporting >50% pain relief after diagnostic injection have improvements in activity level and maintain greater satisfaction at minimum 1-year than those reporting ≤50% pain relief. Expectations for improvement after revision TKA should be tempered if diagnostic anesthetic injection yields minimal subjective pain relief.     

9种试点食药物质的安全性评价及试点风险监测现况

按照传统既是食品又是中药材的物质简称为食药物质,传统中医药常使用食药物质来防治疾病或养生保健。随着我国大健康产业的迅速发展,食药物质成为健康领域关注的热点。近年来,随着食药物质品种的增加,研发产品的创新种类和应用增多,拟新增食药物质的安全性问题成为关注重点。现综述国家卫生健康委员会和市场监督管理总局开展的按照传统既是食品又是中药材物质管理试点工作的9种试点食药物质的食用与药用价值、安全性和不良反应、国内部分省份风险监测内容和方案,以期为9种试点食药物质的食品安全风险监测工作的开展提供参考,为食药物质的合理应用和资源开发提供一定的依据。     

经典名方甘草泻心汤基准样品的量值传递研究

目的 建立经典名方甘草泻心汤（Gancao Xiexin Decoction,GXD）基准样品的HPLC图谱及指标性成分含量测定方法,研究GXD基准样品量值传递规律。方法 制备15批GXD基准样品,建立特征图谱并选用《中药色谱指纹图谱相似度评价》软件进行相似度评价,明确特征峰并对其进行归属。测定指标性成分甘草苷、甘草酸、黄芩苷、盐酸小檗碱、表小檗碱、黄连碱、巴马汀的含量,计算指标成分转移率,分析指标成分在饮片-基准样品中量值传递的规律。结果 15批GXD基准样品指纹图谱相似度均大于0.90,共指认22个共有峰,甘草5个、黄芩5个、甘草和黄芩共有3个、黄连6个、黄芩和黄连共有2个、干姜1个;各指标成分从药材-饮片平均转移率分别为98.69%、98.13%、96.94%、94.59%、91.76%、88.08%、94.16%;饮片-基准样品平均转移率为49.08%、42.24%、28.34%、26.72%、29.32%、33.62%、47.93%。结论 特征图谱与多指标成分含量测定方法相结合,对GXD药材-饮片-基准样品的量值传递过程进行分析研究,为经典名方GXD制剂开发提供参考。     

Diagnostic and prognostic biomarkers in salivary gland tumours

Salivary glands are a heterogeneous group of neoplasms and are diagnostically challenging with overlapping microscopic features between tumours as well as intra-tumour morphological diversity. Correct diagnosis is essential to ensure appropriate management and follow-up. Morphological and cytological analysis of haematoxylin and eosin stained tissue sections is supplemented by a large number of immunohistochemical and special stains as well as molecular rearrangements. A broad literature search was performed to provide an overview of all biomarkers used for diagnosis and prognosis prediction of salivary gland tumours. The wide range of biomarkers reported in the literature can be overwhelming but used in the correct context can aid diagnosis and predict the behaviour of these challenging tumours. They can also help identify recently described new entities.     

不同b值条件下心脏体素内不相干运动成像相关参数的一致性

目的观察不同b值条件下心脏体素内不相干运动(IVIM)成像相关参数的一致性。方法对30名健康志愿者行左心室中间部IVIM扫描,以双指数模型获取IVIM参数值慢速表观弥散系数(ADCslow)、快速ADC(ADCfast)及灌注分数f。比较9个b值(0、20、50、80、100、120、200、300、500 s/mm^2)与7个b值(0、20、80、100、200、300、500 s/mm^2)条件下所测参数值的差异,采用组内相关系数(ICC)分析2名医师测量参数结果的一致性,以Bland-Altman检验分析不同b值条件下所测参数的一致性。结果9个与7个b值条件下ADCslow、ADCfast及f差异均无统计学意义(P均>0.05),且2名医师测量IVIM参数的组内及组间一致性均较好(ICC均≥0.66,P均<0.05)。Bland-Altman图显示,9个与7个b值时ADCslow的平均偏差为-0.07×10-3 mm^2/s,一致性界限(-1.87,1.73);ADCfast的平均偏差1.57×10-3 mm^2/s,一致性界限(-72.64,75.77);f的平均偏差1.17%,一致性界限(-13.45,15.79)。结论9个与7个b值条件下心脏IVIM成像各参数值的一致性较好。