Psychological functioning across stages of treatment for infertility

Psychological functioning was examined for a cross section of 104 couples in different stages of medical investigation for infertility. Couples were separated into three stages based upon the length of time they had been pursuing medical treatment for infertility: year 1, year 2, and year 3 and beyond. Emotional strain was moderately elevated during the first year, returned to more normal levels during the second year, and showed marked increases beyond year 3. Indices of marital adjustment and sexual satisfaction were stable across the first two stages but deteriorated after the third year. These data suggest that the stage of treatment may exert a major influence upon psychological functioning for infertile couples pursuing medical assistance. The results are consistent with a model of psychological strain that reflects an acute stress reaction to the initial diagnosis and treatment overlaid with a chronic strain response to longer-term treatment.Research was aided by a grant-in-aid of research from Sigma Xi, The Scientific Research Society, a research fellowship from the University of South Carolina, and NIMH Institutional Training Grant MH-15930.     

Live human germ cells in the context of their spermatogenic stages

BACKGROUND: Various types of live, dispersed, human testicular cells in vitro were previously compared with the morphologic characteristics of human spermatogenic germ cells in situ within seminiferous tubules. The current study extends those observations by placing live human germ cells in the context of their developmental steps and stages of the spermatogenic cycle. METHODS: Live human testicular tissue was obtained from an organ-donating, brain-dead person. A cell suspension was obtained by enzymatic digestion, and dispersed cells were observed live with Nomarski optics. Testes from 10 men were obtained at autopsy within ten hours of death, fixed in glutaraldehyde, further fixed in osmium, embedded in Epon, sectioned at 20 microm, and observed unstained by Nomarski optics. RESULTS: In both live and fixed preparations, Sertoli cells have oval to pear-shaped nuclei with indented nuclear envelopes and large nucleoli, which makes their appearance distinctly different from germ cells. For germ cells, size, shape, and chromatic pattern of nuclei, the presence of meiotic metaphase figures, acrosomic vesicles/structures, tails, and/or mitochondria in the middle piece are characteristically seen in live dispersed cells and those in the fixed seminiferous tubules. These lead to identification of live germ cells in man and placement of each in the context of their developmental steps of spermatogenesis at corresponding stages of the spermatogenic cycle. CONCLUSIONS: This comparative approach allows verification of the identity of individual germ cells seen in vitro and provides a checklist of distinguishing characteristics of live human germ cells to be used in clinical procedures or by scientists interested in studying live cells at known steps in spermatogenic development characteristic of germ cells in specific stages of the spermatogenic cycle.     

Microvasculature of regular and irregular areolae of the areola-gland subunit of the porcine placenta: structural and functional aspects

To examine the vasculature of the areola-gland subunit of advanced pig placenta, tissues from ten animals between 43 and 112 days of gestation were prepared for histology and for scanning electron microscopy of vascular corrosion casts from both maternal and fetal sides. Regular areolae, tributary to one gland only, are round with a wide-meshed and smooth subepithelial capillary network on the maternal side, which is similar to the pre-implantative stage and bordered by an abrupt rim towards the interareolar maternal capillary network. On the fetal side, the capillary network follows papillae which protrude into the areolar cavity or converge to form a ring towards the areolar periphery. Irregular areolae, in contrast, have indistinct boundaries and are characterized by two or more gland openings. The maternal capillary network has moderate density and follows the corrugations, whereas the fetal capillary network is basically two-dimensional with some blunt sinusoidal protrusions. Vessel architecture of both areolar types implies facilitated external inflow of blood into the areola on arteriolar as well as on capillary levels, whereas the outflow from the areolar capillaries comprises venules converging into one or two areolar stem veins, and therefore conducts venous blood in a manner different from that of the interareolar region. It is suggested that this arrangement could favour vascular control mechanisms in uterus, placenta and fetus. On the basis of these observations and the discussion, it is suggested that these areolaspecific vessel systems are important for sustaining the characteristic substance transfers in the areola, the secretion, metabolism and absorption, which according to the literature are not the same in the regular as in the irregular areolar type of the porcine areola-gland subunit of the placenta.     

降低终末期肾病患者动静脉内瘘成熟不良率

目的降低终末期肾病患者动静脉内瘘成熟不良率。方法成立品管圈圈组,通过现状调查、原因解析明确问题真因,从制定动静脉内瘘院前指导规范,建立多学科协作模式;实施“VAP”评估模式,制定围手术期标准化管理流程;构建“互联网 +”智能宣教模式,优化院外延伸服务三方面进行改进。结果终末期肾病患者动静脉内瘘成熟不良率由10.6%降低至3.3%。结论开展品管圈活动降低了终末期肾病患者动静脉内瘘成熟不良率。     

互动式头针结合镜像疗法对脑卒中软瘫期上肢功能障碍的康复疗效

目的：探索脑卒中患者促进上肢运动功能恢复中头针与镜像疗法联合应用的临床价值。方法：选取株洲市中心医院2021年8月至2022年11月期间收治的60例脑卒中后上肢功能障碍患者,以随机分组的方式分为两组,每组30例。其中常规康复训练联合镜像治疗纳入对照组,在对照组基础上增加头针治疗纳入观察组。在治疗4周后,比较两组患者临床治疗有效性、Fugl–meyer运动功能评定量表（FMA）上肢部分评分以及Brunnstrom分期。结果：两组患者治疗后FMA评分均高于治疗前,且观察组患者治疗后FMA评分高于对照组,差异具有统计学意义（P<0.05）。观察组患者治疗后上肢Brunnstrom运动功能分期结果优于对照组,差异具有统计学意义（Z=–2.101,P <0.05）。观察组患者治疗后手Brunnstrom运动功能分期结果优于对照组,差异具有统计学意义（Z=–2.152,P <0.05）。结论：在恢复早期,头针、镜像疗法与常规康复训练有效结合,对脑卒中患者软瘫期上肢运动功能恢复具有积极作用。     

The Spectrum of Malnutrition/Cachexia/Sarcopenia in Oncology According to Different Cancer Types and Settings: A Narrative Review

Nutritional status in oncological patients may differ according to several modifiable and non-modifiable factors. Knowledge of the epidemiology of malnutrition/cachexia/sarcopenia may help to manage these complications early in the course of treatment, potentially impacting patient quality of life, treatment intensity, and disease outcome. Therefore, this narrative review aimed to critically evaluate the current evidence on the combined impact of tumor- and treatment-related factors on nutritional status and to draw some practical conclusions to support the multidisciplinary management of malnutrition in cancer patients. A comprehensive literature search was performed from January 2010 to December 2020 using different combinations of pertinent keywords and a critical evaluation of retrieved literature papers was conducted. The results show that the prevalence of weight loss and associated symptoms is quite heterogeneous and needs to be assessed with recognized criteria, thus allowing a clear classification and standardization of therapeutic interventions. There is a large range of variability influenced by age and social factors, comorbidities, and setting of cures (community-dwelling versus hospitalized patients). Tumor subsite is one of the major determinants of malnutrition, with pancreatic, esophageal, and other gastroenteric cancers, head and neck, and lung cancers having the highest prevalence. The advanced stage is also linked to a higher risk of developing malnutrition, as an expression of the relationship between tumor burden, inflammatory status, reduced caloric intake, and malabsorption. Finally, treatment type influences the risk of nutritional issues, both for locoregional approaches (surgery and radiotherapy) and for systemic treatment. Interestingly, personalized approaches based on the selection of the most predictive malnutrition definitions for postoperative complications according to cancer type and knowledge of specific nutritional problems associated with some new agents may positively impact disease course. Sharing common knowledge between oncologists and nutritionists may help to better address and treat malnutrition in this population.     

早期股骨头缺血坏死介入治疗的探讨（附15例报告）

目的：探索早期股骨头缺血性坏死的介入治疗方法及效果。方法：采用seldinger穿刺方法超选择插管至患侧旋股内,外动脉,注入治疗药物（溶栓,扩血管,改善微循环等）。介入前后分别血管造影,以观察血管数及近期疗效。结果：介入治疗后患髋股头颈区血管数较治疗前增多（P＜0．001）,髋关节疼痛缓解,功能改善。结论：对早期股骨头缺血性坏死实施介入治疗,能够改善患髋的血液循环,减轻临床症状,改善关节功能,是一种微创安全有效的新方法,对远期疗效和治疗机理尚有待进一步观察和研究。     

维生素D缺乏性晚发性佝偻病的骨密度研究

目的：探讨维生素D缺乏性晚发性佝偻病的骨密度变化;方法：采用病例对照研究方法。对640名学生进行问诊及体验,测定非优势侧尺挠骨中1／3交界处骨密度（BMD）,病例组检测骨碱性磷酸酶,拍摄腕部X光片,病例组与对照组同测血250HD3;结果：病例组骨密度显著低于对照组,病例组250HD3异常者显著低于对照组;结论：晚佝病是由于维生素D缺乏所至的骨量减少性疾病,日后影响峰值骨量的形成,并与成人期骨质疏松有密切的关系,骨密度检查对晚佝病有重要诊断价值。     

脑出血急性期血肿扩大的临床分析

目的：探讨脑出血急性期血肿扩大的发生率、原因、临床表现、预后及采取的相应措施。方法：回顾性分析1994-2000年间诊治的867例脑出血病人的临床和CT资料。结果：脑出血急性期血肿扩大的发生率为20.1%,其主要与血压增高的程度、凝血功能、出血部位、血肿形态及早期过度脱水有关,血肿扩大增加了病人的死亡率。结论：血肿扩大的发生影响病人预后,应尽早确诊,采取积极防治措施,改善病人预后。     

皮肤撕脱伤39例Ⅰ期治愈分析

目的 总结皮肤撕脱伤修复后Ⅰ期愈合的治疗效果。方法 早期彻底创面清创,清除所有失去活力的皮肤组织、异物、积血和死腔;根据创面部位、受伤程度选择缝合、皮片、皮瓣移位等不同修复方法修复;早期足量的抗生素应用。结果 1例失败38例成活。Ⅰ期愈合率达97.5%,术后效果满意。结论 本组治疗方法治疗时间短致残率低,Ⅰ期愈合率高,效果满意。