Prevalence of metabolic syndrome in patients with psoriasis: a cross-sectional study in Singapore

INTRODUCTIONPsoriasis is a chronic inflammatory condition that affects the skin and joints, and is associated with cardiovascular risk factors, including metabolic syndrome (MetS). We aimed to assess the prevalence of MetS in patients with psoriasis and determine whether there was a correlation between psoriasis severity and MetS in a Singapore population.METHODSThis was a cross-sectional study of patients with psoriasis, aged 18–69 years, who attended a tertiary dermatology referral centre in Singapore from October 2007 to February 2009. Fasting glucose, lipids, blood pressure, Psoriasis Area and Severity Index, and body mass index were measured. MetS was diagnosed in the presence of three or more criteria of the modified National Cholesterol Education Program Adult Treatment Panel III.RESULTSAmong 338 patients with psoriasis, there were 238 (70.4%) men and 100 (29.6%) women, who were Chinese (n = 228; 67.5%), Malay (n = 52; 15.4%) and Indian (n = 58; 17.2%). The prevalence of MetS was 45.1%. MetS was 44% more prevalent in patients older than 50 years (p = 0.02). Malay patients with psoriasis were significantly more likely to have hypertriglyceridaemia, elevated fasting plasma glucose and abdominal obesity. There was no significant correlation between psoriasis severity and risk of MetS.CONCLUSIONThe prevalence of MetS in patients with psoriasis in Singapore was 45.1%, or nearly threefold higher than the Singapore general population. Patients with psoriasis should be screened yearly for MetS and any modifiable cardiovascular risk factors should be actively controlled.     

基于医院信息系统的乳腺癌临床特征及中西医用药特征分析

目的 解析真实世界中乳腺恶性肿瘤患者的人群特征、诊断特征、中西医用药特征，为乳腺癌的临床防治提供参考。方法 采集2002年2月至2015年5月全国60家三级甲等医 院信息系统（Hospital Information System，HIS）中，出院诊断为“乳腺癌”的患者用药信息，采用SAS9.3统计软件，对人口学信息、诊断信息、医嘱用药信息等进行描述性分析。结果 39798例乳腺癌患者，平均年龄（50.93者，平均年龄）岁；多以门诊入院，入院病情以“一般”为主;合并疾病主要为高血压，骨肿瘤，联用西药以抑制肿瘤细胞增殖、治疗并发症、缓解放化疗不良反应为主；中医辨证以痰瘀互结证，气阴两虚证，肝气淤滞证，脾气亏虚证型最为常见，临床清热解毒剂、益气扶正剂，活血化瘀剂应用较多。结论 乳腺癌中西医结合治疗，联用药物广泛，临床治疗基本符合临床指南。     

IIEF-5与NEVA检测在阴茎勃起功能障碍诊断中的意义

目的探讨应用国际勃起功能评分5(IIEF-5)问卷表结合夜间阴茎勃起测定系统(NEVA)筛选勃起功能障碍(ED)的可行性及意义。方法148例门诊ED病人,应用IIEF-5问卷表评分,再通过NEVA测定仪监测夜间阴茎勃起情况,次日数据输入主机回放并分析。结果93例为心理性ED;在19~69岁的5个年龄组中,重度ED的比例由11.8%到55.0%,NEVA中度异常者IIEF积分(12.98±2.58)分,NEVA重度异常者IIEF积分(7.32±1.04)分。结论NEVA能有效地鉴别心理性与器质性ED,IIEF-5评分值与NEVA检测阴茎勃起时血容量变化值有相关性。IIEF-5与NEVA检测结合,能提高诊断和评估ED的可靠性。     

电针对狗血浆与胃黏膜组织中NO和NOS的影响及其意义

目的　观察电针对狗幽门压力、胃黏膜血流量的调控作用及其与血浆、胃黏膜组织中一氧化氮 (NO) ,一氧化氮合酶 (NOS)水平变化的关系 ,以探讨电针对胃黏膜保护作用的机制。方法　将 2 0只狗随机分为 4组 :空白对照组、非经非穴组、上巨虚组、足三里组 (每组 5只 )。采用胃压测量仪、激光多普勒血流仪监测幽门压力、频率及胃黏膜血流量的变化 ,同步测定血浆及胃黏膜组织中NO ,NOS含量 ,并观察变化规律。结果　电针后足三里组幽门括约肌总压力、基础压下降、频率下降 (P <0 .0 5 ) ,胃黏膜血流量显著升高 (4 .5 1± 0 .73→ 6.90± 1.0 1,P <0 .0 1) ,血浆及胃黏膜组织中NO ,NOS含量显著升高 (P <0 .0 5 ) ,上巨虚组仅幽门括约肌总压力下降 ,血浆NO含量上升。但足三里组各项监测指标变化趋势更明显 ,其他组变化无显著性。结论　电针可使狗幽门压力、频率下降 ,使胃黏膜血流量增加 ,与影响幽门压力、胃黏膜血流量的某些活性物质的含量改变有关 ,并具有一定的经络和穴位特异性。     

胃粘膜相关淋巴组织型淋巴瘤MAPK和Stat3磷酸化及cyclinD1蛋白表达的意义

目的:研究胃粘膜相关淋巴组织型(MALT)淋巴瘤MAPK和Stat3磷酸化与cyclinD1蛋白表达及其意义。方法:利用免疫组织化学方法检测了45例胃MALT淋巴瘤MAPK和Stat3磷酸化及cyclinD1蛋白的表达。结果:在胃MALT淋巴瘤中p-MAPK、p-Stat3及cyclinD1蛋白的阳性率分别为73.3%(33/45)、64.4%(29/45)和68.9%(31/45);低度恶性组p-MAPK和cyclinD1蛋白的阳性表达强度明显高于高度恶性组(P<0.01),而p-Stat3表达强度无明显差异(P>0.05);在低度和高度恶性胃MALT淋巴瘤中p-MAPK和cyclinD1蛋白的阳性信号强度均呈明显的正相关(r=0.6572和0.6823,P<0.01),而p-Stat3与cyclinD1蛋白表达未见明显相关性(r=0.1927,P>0.05)。结论:提示MAPK磷酸化在胃MALT淋巴瘤中发生及演进过程中起重要作用,但Stat3的磷酸化可能与该肿瘤的恶性演进关系不明显;在胃MALT淋巴瘤的发生与发展中,p-MAPK可诱导cyclinD1过度表达,从而促使该肿瘤细胞维持高增殖状态。     

An etiological and clinicopathological study of early syphilis in oropharynx]

OBJECTIVE: To investigate the characteristics of the early stage treponema pallidum infected tissue in ear, nose, oropharynx and larynx and to raise relevance ratio of syphilis in nose and oropharynx and enhance doctor's self-protection awareness. METHODS: The histopathologic characteristics were studied by using HE staining, Warthin-Starry (W-S) staining was adopted to examine the treponema pallidum(TP) in lesion issue and its exudates smear for 12 cases biopsy tissues of suspicious syphilis. The diagnosis was confirmed by venereal disease research laboratory (VDRL), rapid plasma reagin circle test(RPR), treponema pallidum hemagglutination test(TPHA) and fluorescent treponemal antibody-absorption test (FTA-ABS). Treat with curing syphilis methods which published by nation. RESULTS: In the 12 cases mucous membrane specimen, the squamous epithelium proliferated, neutrophilic granulocyte infiltrated, within inherent membrane generous plasmacyte and lymphocyte infiltrated. W-S staining: plenty of treponema pallidum were found inside mucous membrane epithelium and exudate smear. Serology examination: 11 cases VDRL(++++), 7 cases RPR (+), 11 cases TPHA(+), 1 case FTA-ABS(+). After systemic treatment, 11 cases are clinically recovered. All patients serology become negative. CONCLUSION: W-S staining method can directly demonstrate histopathologic characteristics in early syphilis, in intrinsic membrane numerous plasmacyte infiltration. Combining with specific syphilis serology examination could increase diagnosis rate of syphilis in nose and oropharynx.     

100例性病患者心理健康状况调查分析

目的：探讨性病患者的心理健康状况,为临床治疗和护理提供依据。方法：采用症状自评量表（SCL-90）对100例性病患者的心理健康状况进行测验。结果：100例性病患者SCL-90检测的阳性率为51%,阳性样本因子分居前的是敌对、强迫症状、抑郁、人际敏感。结论：性病患者广泛存在的心理问题,在药用治疗的同时应注意心理方面的治疗和疏导。     

"分段切开,多重挂线术"治疗高位复杂性肛瘘临床研究

目的:观察"分段切开,多重挂线术"治疗高位复杂性肛瘘的临床疗效。方法:将60例高位复杂性肛瘘随机分为治疗组40例,采用"分段切开,多重挂线术";对照组20例,采用传统切开挂线术进行对比观察。结果:显示治疗组与对照组显愈率分别为95%和90%,无明显差异(P>0.05),但两组间的术后疼痛程度、创口愈合时间、肛门功能情况存在显著差异(P<0.05)。结论:在治疗高位复杂性肛瘘时,"分段切开,多重挂线术"与传统切开挂线术相比,具有手术操作简单,对组织损伤小,痛苦小、疗程短、肛门功能保护好等优点,该术式的应用,使得高位复杂性肛瘘治疗更加安全、有效。     

应用前列腺素E1注射治疗勃起功能障碍8年经验

目的观察前列腺素E1(PGE1)注射治疗勃起功能障碍(ED)的长期疗效、副作用及预后。方法使用PGE1行阴茎海绵体注射,阴茎硬度检查仪(Rigiscan)连续记录1h,并根据观察结果,调查PGE1注射剂量,确定每例患者合适的注射量,掌握注射方法后回家自行注射。共筛选出ED患者410例,随访患者阴茎勃起情况、药量调整和副作用。结果410例ED患者中,心理性139例,静脉性83例,动脉性36例,神经性78例,混合性74例。对治疗满意的患者有256例(62.44%),其中21例(5.1%)在使用PGE15次后停用,并能达到满意的性生活而治愈。293例(71.46%)患者自述注射时有胀痛感。171例(43.17%)因疼痛(105例)、操作不便(25例)、副作用顾虑(37例)和其他原因(4例)而于6个月后放弃治疗。204例(49.76%)患者使用时间已超过1年,24例(5.85%)患者使用时间已超过5年,7例(1.7%)使用已有8年。未发现阴茎异常勃起和阴茎海绵体纤维化。注射损伤阴茎表面血管致瘀斑者有20例。有27例患者失访。结论PGE1是治疗ED的一种安全有效的药物,可以长期使用。其最常见的副作用是阴茎疼痛。Rigiscan能帮助确定PGE1的注射剂量。