Application of noninvasive techniques to monitor reproductive function in a brown hyena(Hyena brunnea)

Estrus in a 10-yr-old brown hyena was described by monitoring urinary steroid metabolites. These studies were repeated the succeeding year and combined with ultrasonography, vaginal cytology, and laparoscopy to further aid in identifying natural and induced estrus. Collection of semen from a 14-yr-old male brown hyena was accomplished by electroejaculation. Use of frozen semen once during natural estrus and again during estrus induced with follicle stimulating hormone (FSH) did not result in pregnancy. Further studies with this animal indicate that stimulation with gonadotropin releasing hormone (GNRH), rather than FSH, may be the more appropriate treatment for stimulating ovulation in canids or related species. While this study did not result in conception, a significant step toward that end was realized by utilizing urinary estrogen to monitor the estrus cycle.     

Asymptomatic Hyperuricemia: Impact of Ultrasonography

Thirty-five patients (23 males) with asymptomatic hyperuricemia for at least two years underwent two-dimensioal ultrasonography of knees and ankles. Urate deposits (tophi) in tendons, synovium, and other soft tissues were detected in 12 patients (34%). Increased vascularity (inflammation) was evident in 8 of these patients (23%). Tophi were more frequently found in knees than in ankles and were especially prevalent in the distal patellar tendon. The presence of tophi was unrelated to the known duration of hyperuricemia (mean, 5 years). Ultrasonography allows detection of tophi and inflammation in a third and in a fourth, respectively, of asymptomatic hyperuricemic patients.     

Associations between feed efficiency,sexual maturity and fertility-related measures in young beef bulls

The beef industry has emphasized the improvement of feed utilization, as measured by modeling feed intake through performance traits to calculate residual feed intake (RFI). Evidence supports an inverse relationship between feed efficiency and reproductive function. The objective of this study was to determine the relationship of reproductive assessments and RFI unadjusted (RFI_Koch) or adjusted for body composition (RFI_us) and the relationship among fertility-related parameters. In total, 34 crossbred bulls were housed together for 112 days of performance evaluation, followed by assessment of scrotum IR imaging, scrotal circumference, testes ultrasonography and semen quality parameters at 377±33.4 days of age. Bulls were slaughtered at 389±34.0 days of age, and analyses of carcass composition, biometrics and histomorphometry of the testis and epididymis were conducted. Bulls were grouped into two subpopulations based on divergence of RFI, and within each RFI model either by including 50% of the population (Halves, high and low RFI, n=17) or 20.6% extremes of the population (Tails, high and low RFI, n=7). The means of productive performance and fertility-related measures were compared through these categories. Pearson’s correlation was calculated among fertility-related measures. In the Halves subpopulation of the RFI_us, sperm of low-RFI bulls had decreased progressive motility (47.30% v. 59.90%) and higher abundance of tail abnormalities (4.30% v. 1.80%) than that of high-RFI bulls. In the Tails subpopulation of the RFI_Koch, low RFI displayed less variation in the scrotum surface temperature (0.62°C v. 1.16°C), decreased testis echogenicity (175.50 v 198.00 pixels) and larger (60.90 v. 56.80 mm²) but less-developed seminiferous tubules than high-RFI bulls. The evaluation of fertility-related parameters indicated that a higher percentage of immature seminiferous tubules was correlated with occurrence of sperm with distal droplets (r=0.59), a larger temperature variation at the top of the scrotum was correlated with improved sperm progressive motility (r=0.38), a lower occurrence of sperm loose head abnormalities was correlated with larger temperature variation at the lower part of the scrotum (r=−0.43), and a lower minimum testis echogenicity (r=−0.59) and smaller scrotal circumference (r=0.72) were correlated with age. The adjustment for body composition (RFI determination) enabled distinct biological inferences about reproduction and feed efficiency when compared with the non-adjusted model. However, both RFI models and the correlation analysis supported the hypothesis that feed-efficient bulls have features of delayed sexual maturity. Overall, the assessment of fertility-related measurements is important to avoid the improvement of feed efficiency at the expense of reproductive function in young bulls.     

内镜黏膜下剥离术治疗消化系统早癌及癌前病变的临床疗效

目的:探讨内镜黏膜下剥离术(ESD)对消化道早癌及癌前病变的治疗效果。方法:选择2013年8月至2014年8月在我院接受治疗的消化道肿瘤患者79例作为研究对象,根据手术方法不同将所选患者分为ESD组(49例)和对照组(30例)。ESD组患者采用内镜黏膜下剥离术治疗,对照组采用传统手术治疗。观察并比较两组患者的手术时间、治愈性切除率、整块完整切除率、术后并发症的发生率及复发、转移情况。结果:ESD组患者的手术时间少于对照组,差异具有统计学意义(P0.05);两组患者手术治愈性切除率均为100%,差异无统计学意义(P0.05);ESD组手术整块完整切除率(63.27%)低于对照组(86.67%),差异具有统计学意义(P0.05)。ESD组患者术后并发症的发生率(4.08%)显著低于对照组(13.3%),差异具有统计学意义(P0.05)。两组患者术后一年内均未出现原发病灶转移及复发。结论:ESD治疗消化道早癌及癌前病变的临床疗效较好,与传统手术相比,ESD手术并发症较少、且安全性较高,更加适宜临床推广及应用。     

内镜黏膜下剥离术和挖除术治疗上消化道肿瘤的疗效及安全性分析

目的:分析内镜黏膜下剥离术(ESD)和黏膜下挖除术(ESE)治疗上消化道肿瘤的疗效及安全性。方法:回顾性分析2017年1月至2019年4月我院消化内科接受ESD或ESE治疗的68例上消化道肿瘤住院患者的临床资料,收集患者基础疾病、手术时间、病变部位大小、整块切除率、并发症等资料,同时采用Logistic回归分析对术中穿孔进行危险因素分析。结果:64例患者完整切除瘤体(94.12%),肿瘤平均直径(16.98±8.29)mm。食管病灶病理类型以高级别上皮内瘤变为主,有15例(22.06%);胃部病灶分布以胃体、胃底和胃窦居多,分别有18例(26.47%)、16例(23.53%)和12例(17.65%),病理类型以间质瘤最多,占36.76%;11例患者发生并发症(16.18%),4例患者出现术后出血(5.88%),经过内镜下止血后好转,8例患术中穿孔(11.76%),均行内镜下尼龙绳联合钛夹行荷包缝合,其中1例患者术中穿孔合并术后迟发性出血;病灶最大直径(≥25 mm,P=0.036)和病灶部位(胃底,P=0.015)是导致ESD或ESE术中穿孔的独立危险因素。结论:ESD和ESE治疗上消化道肿瘤安全有效,但需注意病灶大小和胃底病变,因其是导致术中穿孔的独立危险因素。     

超声内镜辅助下内镜黏膜下切除术对食管癌前病变患者肿瘤标志物及应激反应指标的影响

目的:探讨超声内镜(EUS)辅助下内镜黏膜下切除术(EMR)对食管癌前病变患者肿瘤标志物及应激反应指标的影响。方法:选择山东大学齐鲁医院青岛院区消化内科于2016年3月至2018年4月期间收治的食管癌前病变患者137例,采用随机数字表法将患者分为常规组(n=68,常规胃镜下行EMR)和EUS组(n=69,EUS辅助下行EMR),比较两组患者临床指标,比较两组术前、术后血清肿瘤标志物及应激反应指标水平,比较两组术前、术后1周相关遗传学分子水平。结果:EUS组手术时间、术后流质饮食时间均短于常规组(P0.05),并发食管黏膜小穿孔例数、使用钛夹止血例数均少于常规组(P0.05)。两组患者术后肿瘤特异性生长因子(TSGF)、细胞角蛋白19血清片段21-1(CYFRA21-1)、鳞状上皮细胞癌抗原(SCC-Ag)均较术前升高,但EUS组低于常规组(P0.05)。两组患者术后肾上腺素(E)、去甲肾上腺素(NE)、肾素(R)、血管紧张素Ⅱ(AngⅡ)、醛固酮均较术前升高,但EUS组低于常规组(P0.05)。两组患者术后1周细胞周期素E(Cyclin E)、转化生长因子-α(TGF-α)均较术前降低,且EUS组低于常规组(P0.05)。结论:相比于常规胃镜,经EUS辅助下EMR治疗食管癌前病变可有效改善患者的临床指标,减轻患者应激反应,有利于降低血清肿瘤标志物及遗传学分子水平。     

肺脏超声对新生儿呼吸窘迫综合征的诊断价值及肺超声评分的评估价值分析

目的:探讨肺脏超声对新生儿呼吸窘迫综合征(NRDS)的诊断价值,并分析肺超声评分的临床应用价值。方法:本研究选择2017年5月至2018年5月于我院确诊的NRDS患儿45例作为观察组,选择同期于我院就诊的非肺病患儿45例作为对照组,所有患儿均行肺脏超声检查。分析NRDS患儿肺脏超声特征性征象,比较肺脏超声对两组患儿各种征象的检出率,分析肺脏超声对NRDS的诊断价值,比较两组肺超声评分。结果:NRDS患儿全部存在肺实质征象,超声下肺组织回声呈肝样伴支气管充气征,轻度的NRDS患儿于肺脏超声下表现为局灶性的肺实质,且支气管充气征不明显;重度的NRDS患儿于肺脏超声下表现为肺实质范围的进一步扩大,且支气管充气征随病情的加重而愈发明显。观察组肺实质、胸膜线异常、A线消失、弥漫性肺水肿、支气管充气征等征象的检出率显著高于对照组(P0.05),两组B线存在征象的检出率比较无统计学差异(P0.05)。肺实质、胸膜线异常和A线消失三种特征征象同时存在时对NRDS诊断的灵敏度和特异性均为100.00%,肺实质、胸膜线异常和支气管充气征三种特征征象同时存在时对NRDS诊断的灵敏度为80.00%,特异性为100.00%。观察组双肺、左肺、右肺、双侧肺、双肺底肺超声评分均高于对照组(P0.05)。结论:肺脏超声对NRDS的诊断价值较高,且肺超声评分可以评估NRDS患儿的病情严重程度,有助于指导患儿的治疗。     

两种内镜手术对消化道神经内分泌肿瘤的切除效果及安全性评价

目的:探讨内镜下两种手术方法对消化道神经内分泌肿瘤的切除效果和安全性。方法:选取64例消化道神经内分泌肿瘤患者,随机分为A组和B组,每组各32例。A组接受内镜下黏膜切除术,B组接受内镜下黏膜剥离术。分析和比较两组所切除组织的病理学检查结果、手术时间、切除肿瘤的直径和厚度、治疗费用、住院时间、肿瘤完全切除率、垂直切缘阴性率以及并发症的发生率。结果:A组的手术时间为(8.95±1.63) min,治疗费用为(2127.70±468.31)元,均显著少于B组(P0.05);两组患者切除肿瘤直径和厚度、住院时间、垂直切缘阴性率对比差异均没有统计学意义(P0.05);B组的肿瘤完全切除率为93.75%,显著高于A组(P0.05);A组并发症发生率为3.13%,显著低于B组(P0.05)。结论:两种内镜下手术方式均可有效清除消化道神经内分泌肿瘤病灶。内镜下黏膜切除术的手术时间、费用及并发症的发生率更少低,而内镜下黏膜剥离术能够更彻底地清除肿瘤组织。     

胃炎性纤维性息肉的临床特征及内镜下诊治

摘要 目的：研究胃炎性纤维性息肉（IFP）的临床特征及内镜下诊断和治疗情况。方法：收集2010.1.1~2021.1.1陕西省人民医院确诊的11例IFP,重点分析其超声内镜表现及临床特征,探索其内镜下治疗价值。结果：IFP多发生在胃窦,均发生于40岁以上人群,男女比例无明显差别,平均直径1.2 cm,大部分临床无症状,有时可引起出血或腹痛。超声内镜示其为粘膜下隆起,孤立、界清,表面多光滑,均起源于粘膜下层,呈低回声,界清,类圆形;内镜下粘膜挖除术治疗IFP,手术时间短,恢复快,并获得完整的标本,术后病理有助确诊。结论：胃炎性纤维性息肉多发生40岁以上人群,多为胃窦孤立的粘膜下病变,多无症状,超声内镜有助于IFP的术前精确评估,内镜下粘膜挖除术是治疗IFP一项安全有效的方法,术后病理最终确诊。