农村妇儿肺通气功能免疫水平的配对分析

用配对比较的方法,探讨厨房位置和燃料不同对农村妇儿肺通气功能免疫水平的影响规律,结果是家庭月耗煤多的妇儿FEV1.0％、儿童唾液溶菌酶、血清IgG含量偏低;炉灶置宅内耗煤多的家庭儿童IgA含量偏高。说明合理布局厨房位置、设置排烟道及精选燃料,可大大改善室内空气质量,保护妇儿健康。     

成人喉乳头状瘤恶变17例临床分析

目的 探讨成人喉乳头状瘤恶变的临床特征、病理特点及远期治疗效果.方法 对62例成人喉乳头状瘤患者手术前后的临床及病理资料进行分析.结果 62例成人喉乳头状瘤中发生恶变17例,其中术前经1次病理检查确诊者5例(29.4%),经2～7次病理检查确诊8例(47.1%),术后确诊4例(23.5%);其早期病理特征是部分区域恶变,而其他部位还保持着喉乳头状瘤的特点.其中声门型14例(T1N0M06例,T2N0M05例,T3N0M0 2例,T3N1M0 1例),声门上型3例(T4N0M01例,T4N1M02例).行全喉切除术4例,喉部分切除术13例,术后1年内全部拔管,拔管率100%.3年、5年生存率分别为88.2%(15/17)、76.5%(13/17).结论 必要时反复活检是术前确诊成人喉乳头状瘤恶变的重要方法,彻底的手术切除是其治疗的重要手段. Abstract： Objective To explore the malignant change of laryngeal papilloma in adults, especially its pathological figures, clinical characters and long -term results.Methods Analysis was made for the pre - and post - operated clinical and pathological dates of 62 laryngeal papilloma cases.Results Malignant changes had been found in 17 cases.Among these cases, 5 were diagnosed after 1 biopsy, 8were diagnosed after 2 up to 7 biopsies, 4 were diagnosed after surgeon.It was the character of earlier pathological changes that there were malignant changes in part areas, whereas normal papilloma in the other areas of the laryngeal neoplasm.There were 14 of 17 cases whose malignant changes were in glottis (T1N0M0 6 cases, T2N0M0 5 cases, T3N0M0 2 cases, T3N1M0 1 case).Malignant changes of the other 3cases were in supraglottic area(T4N0M0 1 case, T4N1M0 2 cases).Total laryngectomy was performed for 4 cases, and partial laryngectomy was selected for other 13 cases.The decannulation rate was 100% after 1 - year' s follow - up.The overall 3 - years and 5 - years survival rates were 88.2%(15/17)and 76.5%(13/17)respectively.Conclusions It is important to repeat biopsies if necessary to avoid fail to report the malignant change before surgeon.The key to cure it is completely removal of the tumor.     

构建成人高等医学教育教学质量管理与监控体系

本文在分析全面质量管理(total quality management,TQM)内涵的基础上,借鉴TQM的质量第一、系统管理、过程控制、预防为主和不断改进的核心理念与工作思路,提出了构建南华大学成人高等医学教育教学质量管理与监控体系研究方案.同时,对该质量管理体系的研究任务与目标、基本构建框架与管理要素以及运行该质量管理体系的保障机制等问题进行了初步研究与实践.     

脑卒中女性患者的盆底结构及盆底肌电特征

目的 探讨脑卒中对女性患者盆底结构和功能的影响。方法 2020年6月至12月,东南大学附属中大医院住院的脑卒中女性患者21例(卒中组)分为尿失禁组(n=6)和非尿失禁组(n=15),另选取同龄健康女性志愿者20例作为对照组。所有受试者行经会阴盆底超声和盆底表面肌电检查。结果 尿失禁组和非尿失禁组平均肌电值、积分肌电值、均方根值、平均功率频率和中位频率均低于对照组(P <0.05),尿失禁组与非尿失禁组间无显著性差异(P> 0.05)。三组间膀胱颈位置,膀胱尿道后角,膀胱颈移动度,尿道旋转角,以及Valsalva动作后肛提肌裂孔前后径、左右径和面积均无显著性差异(F <2.484, P> 0.05)。结论 无论是否存在尿失禁,脑卒中女性患者盆底肌活动均有不同程度下降,盆底支持组织的结构尚未发生明显改变。     

子宫内膜干细胞研究进展

子宫内膜干细胞是一种成体干细胞,具有自我更新、多向分化和高度增殖的潜能。目前大量研究已证实子宫内膜中存在干细胞样细胞,从而使子宫内膜具有很强的再生能力;同时,研究还显示子宫内膜干细胞的功能和生存环境异常可能与子宫内膜异位症、子宫内膜癌等妇科疾病有关。虽然子宫内膜干细胞的生物学特性和功能仍需进一步的研究来阐述和证实,但其子宫内膜再生和分化为其他组织的潜能已得到越来越多的关注,并可能成为子宫内膜过薄和内膜病变患者进行内膜修复替代治疗的手段;同时可为子宫内膜异位症、子宫内膜癌等提供新的研究思路。     

Factors Provoking Lower Urinary Tract Infection in Women

Our aim was to evaluate possible risk factors, other than sexual activity, for urinary tract infection (UTI) in women. A case-control study was designed. 50 cases and 50 controls were included.

A larger fraction of cases than controls reported that episodes of the following preceded the UTI: voluntary deferred voiding (Odds ratio 5.0, 95% confidence interval 1.7; 20.1), cold hands (4.7, 1.3; 25.3), cold feet (5.8, 2.0; 22.8), and cold buttocks (5.5, 1.2; 51.0).

Cold body parts should be further evaluated as a possible risk factor for UTI in UTI-prone women.     

New neurons in old brains

The brain was traditionally viewed as a static organ, without turnover of neurons or significant capacity for self‐repair after insults. Research in the last years has established that neurons are renewed in certain areas throughout life. The prospect of stimulation of endogenous neurogenesis as well as cell transplantation has raised hope for new therapies for neurological diseases.     

Approach and treatment of the adult acquired flatfoot deformity

Adult acquired flatfoot deformity (AAFD), embraces a wide spectrum of deformities. AAFD is a complex pathology consisting both of posterior tibial tendon insufficiency and failure of the capsular and ligamentous structures of the foot. Each patient presents with characteristic deformities across the involved joints, requiring individualized treatment. Early stages may respond well to aggressive conservative management, yet more severe AAFD necessitates prompt surgical therapy to halt the progression of the disease to stages requiring more complex procedures. We present the most current diagnostic and therapeutic approaches to AAFD, based on the most pertinent literature and our own experience and investigations.     

Exercise intensity. An important factor in the etiology of menstrual dysfunction?

The objective of this case control study was to compare training activity in female long distance runners with irregular (IR, n =13) and regular (R, n =16) menstrual function, especially with regard to exercise intensity. Serum estradiol concentration during the follicular phase was considered normal in the R subjects (31±6 pg/1). In contrast, the IR runners were clearly hypoestrogenic (11±1.6 pg/1). The two groups had similar V o_2max' anaerobic threshold (AT) and maximal heart frequency (HF_max). In both groups AT was found at 88% of HF_max' The two groups had similar mean race results in half marathons during the previous year. The number of running contests was, however, twice as high in the IR group. A light portable pulse recorder was used to monitor heart rate during 1 week of regular training activity, and during a controlled high intensity work-out. During a week with normal training activity, an equal amount of training at high intensity levels (>85% HF_max) was performed by the two groups. The amount of training at lower intensities (<85% HF_max) was, however, more extensive in the group with irregular menstrual function. During the controlled self-administered, high intensity work-out, the amounts of training at and above AT were equal in the two groups. In conclusion: no difference in extent of high intensity training between long distance runners with regular and irregular menstrual function could be found in the present study group. The IR runners did, however, have significantly more training activity at lower intensity levels, and more frequent race participation.