目的 探讨男性人乳头瘤病毒（HPV）基因分型感染情况。方法 收集采用聚合酶链式反应反向斑点杂交法进行28种HPV基因分型检测的1 137例男性检查结果,进行回顾性分析。结果 1 137例男性患者中阳性441例,阳性率为38.79%,感染率居前5位的亚型依次为HPV6（11.35%）、HPV11（7.92%）、HPV16（5.10%）、HPV52（3.52%）、HPV43（2.64%）;就诊人群以20~39岁为主,感染人数也最多,各年龄组间阳性率比较差异无统计学意义（P>0.05）,≥50岁组HPV52型阳性率高于20~29岁组（P<0.05）和30~39岁组（P<0.05）。单一感染占67.35%,多重感染占32.65%,单一感染中低危型占比最多（41.27%）,多重感染中,二重感染占比最多（19.50%）,高低危混合感染为各种类型感染之首（15.87%）。结论 1 137例样本中HPV阳性率为38.79%,感染亚型以HPV6、HPV11、HPV16、HPV52、HPV43为主,单一低危型感染较为常见,各年龄组间阳性率相近。

Objective To investigate the genotypes of human papillomavirus（HPV）infection．Methods A total of 1 137 male patients’ diagnoses were collected and analyzed retrospectively,which came from the detections using polymerase chain reaction reverse dot blot hybridization to genotype 28 HPV．Results Among 1 137 male patients,441 were HPV positive,with a positive rate of 38.79%,the infections of top five HPV types were HPV6（11.35%）,HPV11（7.92%）,HPV16（5.10%）,HPV52（3.52%）,HPV43（2.64%）．The majority of the patients were the 20-39 age group,and the number of infections was also the highest．There was no statistical significance on the difference in the positive rate among different age groups（P>0.05）．The positive rate of HPV52 in ≥50 years old group was higher than the groups of aged 20~29（P<0.05）and 30~39（P<0.05）．The single and multiple infections accounted for 67.35% and 32.65%．The low-risk HPV accounted for the highest proportion（41.27%）in single infections,while in patients with multiple infections,the proportion of dual infections was the largest（19.50%）and the high- and low-risk HPV mixed infections was the maximum of the infection types（15.87%）．Conclusions The detection rate of positive HPV in 1 137 male patients was 38.79%,mainly were type 6,type 11,type 16,type 52 and type 43,and the single low-risk HPV infected was common．Positive rates were similar among different age groups．

目的 了解并分析白云区不同年龄段男性精液质量现状。方法 选取2020年1月—2021年12月在我中心就诊的已婚孕前体检男性为研究对象,开展常规精液检测,采集精液标本进行分析。结果 白云区育龄男性精液各项指标均在正常范围仅有3 176例（占比57.52%）,随年龄的增加,精液指标总活力、存活率和精子前向运动指标逐渐降低（P<0.05）。结论 26~30岁年龄段男性的精液质量各项指标正常率较其他年龄组更好（P<0.05）,是男性生育的黄金年龄。

Objective To understand and analyze the status of semen quality in men of different ages in Baiyun District of Guangzhou. Methods From January 2020 to December 2021,married men who received pre-pregnant physical examination in our center were selected as the research subjects．Routine semen testing was conducted,and samples were collected for semen analysis. Results Only 3176 cases（57.52%）of male semen data of childbearing age in Baiyun District were within the normal range．With the increase of age,total semen motility,survival rate and sperm forward motility decreased gradually（P < 0.05）. Conclusions Men in the age group of 26-30 years had higher normal rates of all indicators of semen quality than other age groups（P < 0.05）,which is the golden age of male fertility.

目的 分析子宫癌肉瘤的临床诊疗过程及其特征,以期提高对该病的认识。方法 回顾性分析我院收治的1例藏族女性子宫癌肉瘤患者的临床资料。并检索中国万方、中华医学期刊、PubMed等数据库,对相关文献进行系统性分析,归纳其临床、病理特点。结果 本例患者术后一般情况良好,切口痊愈出院,电话随访了解到患者术后9月均未按期进行复查,亦未行术后辅助治疗,无法获得辅助治疗和随访复诊的情况。结论 子宫癌肉瘤在临床上较为少见,无特异性临床表现,确诊依靠病理,病理上有特殊性,含有癌和肉瘤两种组织成分,治疗上参考子宫内膜癌的高危特殊组织类型处理,但缺少有效的治疗手段,需要采用各种综合治疗,预后较差。

Objective To analyze the clinical diagnosis and treatment of uterine carcinosarcoma and its characteristics,in order to improve the understanding of the disease．Methods The clinical data of a Tibetan woman with uterine carcinosarcoma treated in our hospital was analyzed retrospectively．The databases of China Wanfang,Chinese Medical Journal and PubMed were searched,and the relevant literatures were systematically analyzed to summarize the clinical and pathological characteristics．Results This patient was generally in good condition after operation．The incision was healed and she was discharged．The telephone follow-up found that the patient did not receive re-examination as scheduled in 9 months after the operation,and did not receive postoperative adjuvant treatment．The follow-up situation was unable to obtain．Conclusions Uterine carcinosarcoma is relatively rare in clinic and has no specific clinical manifestations．The diagnosis depends on pathology．It has particularity in pathology and contains two kinds of tissue components：cancer and sarcoma．Treatment refers to high-risk special tissue types of endometrial cancer,but there is a lack of effective treatment means,a variety of comprehensive treatment is needed,and the prognosis is poor．

目的 探索2型糖尿病(T2DM)男性患者血尿酸水平与骨密度(BMD)、临床骨折患病率的相关性。方法 选取广州市第一人民医院住院的T2DM男性患者192例,采用双能X线骨密度仪测定各部位BMD,记录年龄、糖尿病病程、BMI,检测血尿酸、空腹血糖、糖化血红蛋白、血脂、碱性磷酸酶等,并分析BMD与其余指标的相关性。结果 骨质疏松组血尿酸、各部位BMD均低于骨量正常组及低骨量组(P＜0.05)。血尿酸与各部位BMD正相关(P＜0.01)。右股骨颈BMD与年龄负相关,与空腹血糖正相关(P＜0.05)。多元Logistic回归分析显示,血尿酸与临床骨折呈负相关。调整年龄、空腹血糖、ALP等混杂因素后,血尿酸水平与临床骨折仍有关联。当进一步调整各部位BMD时,结果无统计学意义。结论 维持正常稍高的血尿酸水平可能有利于减少T2DM男性患者骨质疏松及脆性骨折的发生。

Objective To explore the correlation in serum uric acid level and bone mineral density (BMD) and fracture rate in male patients with type 2 diabetes mellitus (T2DM). Methods 192 cases of male patients with T2DM in Guangzhou First People's Hospital were selected in this study.BMD was measured by bone density machine. The patient's age, diabetes course and BMI were recorded. Fasting blood glucose, glycated hemoglobin (HbA1c), liver and kidney function, blood uric acid, blood lipid, alkaline phosphatase, 25 hydroxyvitamin D3 levels were measured, and the correlation between BMD and other indicators was analyzed. Results The serum uric acid level,lumbar and right femoral neck BMD in the osteoporosis group were lower than those in the normal and low bone mass groups (P<0.05). Serum uric acid was positively correlated with BMD values of lumbar spine and right femoral neck in male patients with type 2 diabetes (P<0.01). BMD value of right femoral neck was negatively correlated with age and positively correlated with fasting blood glucose (P<0.05). Multivariate logistic regression analysis showed a significant negative correlation between serum uric acid and clinical fractures in male patients with type 2 diabetes (model 1). When the model was adjusted for age, fasting blood glucose, ALP and other factors, serum uric acid levels were still associated with clinical fractures (model 2). When the BMD values of the lumbar spine and the right femoral neck were further included (model 3), the results were not statistically significant. Conclusion Slightly higher blood uric acid levels may help to reduce the incidence of OP and fracture rate in male patients with T2DM.

目的 我们探讨2019年6月—2020年1月复发性流产夫妇男性患者精浆弹性蛋白酶同精液参数及DNA碎片率的可能关系。方法 研究对象纳入80例复发性流产的男性患者及25例因女方输卵管因素行IVF-ET正常生育的男性患者。精液标本用来进行精浆弹性蛋白酶、精液常规分析、精子核染色质分析及精子形态学等参数分析。结果 结果表明同正常生育男性相比,复发性流产的弹性蛋白酶是增高(P=0.010)。我们将复发性流产男性患者分为正常组(<600 ng/mL)及异常组(≥600 ng/mL)。结果表明异常组患者的精子前向运动比例(P=0.002)及正常形态百分率(P=0.009)均降低,而精子DNA碎片率(P=0.002)增高。Spearman相关性分析发现精浆弹性蛋白酶同精子前向运动比例(r=-0.43,P<0.001)及正常形态百分率(r=-0.39,P<0.001)负相关,而同精子DNA碎片率(r=0.36,P=0.001)正相关。结论 精浆弹性蛋白酶可能影响复发性流产男性患者的精子活力、形态及DNA碎片率。复发性流产男性患者的生殖道隐性感染值得重视,其相关临床探讨性值得深入研究。

Objective Our study is aim to investigate the possible relationship of seminal elastase, on semen parameters and DNA fragmentation in male patients of recurrent pregnancy loss (RPL) between June 2019 and January 2020. Methods The patients included 80 male patients of RPL couple and 25 male patients from couples with clinical pregnancy through in vitro fertilization due to the female tubal factor. The semen samples were used to determine the seminal elastase, computed assisted semen analysis, sperm dispersion test and sperm morphology analysis. Results Compared to the control group, the levels of seminal elastase was increased in the RPL group. The RPL group was divided into the normal group (Elastase<600 ng/mL) and abnormal group (Elastase ≤ 600 ng/mL).The abnormal group exhibited the lower percentage of progressive sperm (P=0.002) and normal morphology (P=0.009),but higher precentage of DNA fragmentation (P=0.002). Meanwhile, the seminal elastase was positively associated with DNA fragmentation (r=0.36,P=0.001), but was inversely associated with the sperm motility (r=-0.43,P<0.001) and normal morphology (r=-0.39,P<0.001). Conclusion Our study may unveil the possible effects of the seminal elastase on the semen parameters and DNA fragmentation in the male patients of RPL couples. Further studies should put more emphasis on the silent genital tract inflammation of the patients.

目的 初步探讨D-二聚体对判断女性恶性肿瘤病情和疗效观察的应用价值与诊断效能。方法 选取2016年3月—2017年12月间在佛山第一人民医院乳腺肿瘤内科住院治疗的女性恶性肿瘤患者149例,早期术后患者(术后组)58例,晚期复发转移患者(晚期组)91例,测定其接受化疗前后的血浆D-二聚体水平(分别记作D1、D2),分析D-二聚体浓度变化(ΔD=D2-D1)与疗效的相关性。D-二聚体浓度(ng/mL)用中位数(四分位间距)表示,治疗前后配对样本比较用Wilcoxon秩和检验,两组间独立+样本比较用Mann-Whitney U检验,以Spearman法分析两组资料的相关性是否有统计学意义。结果 术后组患者化疗后D-二聚体水平低于化疗前(ΔD=-184.8,P<0.0001),D1、D2均与年龄正相关(P<0.01),r²分别为0.356,0.389。晚期组患者中,化疗后有33例出现病情进展(progressive disease, PD组),58例获得疾病缓解或稳定(非PD组)。PD组化疗前基线水平高于非PD组(1 586 vs 754.2,P<0.01),接受化疗后PD组D-二聚体较基线水平升高(ΔD=1 124,P<0.0001),非PD组较基线水平下降(ΔD=-153.3,P=0.004 5),PD组化疗后D-二聚体水平高于非PD组(2 511 vs 525.8,P<0.01)。以ΔD、D1、D2诊断是否PD分别进行受试者工作特征曲线(receiver operating characteristic curve,ROC)分析,结果显示ROC曲线下面积分别为0.8 603(95% CI:0.768 5~0.952 0)、0.674 0(95% CI:0.558 2~0.759 7)、0.895 6(95%CI:0.829 1~0.962 1),对诊断PD有一定准确性。当ΔD＜-145.4 ng/mL、D1>1 375 ng/mL、D2>1 033 ng/mL时,Youden指数最大,诊断PD的准确性较高。结论 血浆D-二聚体的变化与肿瘤负荷密切相关,有助于女性恶性肿瘤病情的判断和疗效观察及评价预后,对辅助判断病情进展上的具有较高的诊断效能。

Objective To investigate the clinical significance and diagnostic value of plasma D-dimer measurement in response evaluation of female patients with tumor. Methods 149 female cancer patients were enrolled, in which there were 58 post-operative early staged cases(post-operative group), 91 metastatic cases(metastatic group). D-dimer levels before chemotherapy (D1) and after the last cycle of chemotherapy (D2) were assessed and analyzed to examine whether they are correlated to response of therapy. D-dimer levels were presented as median(25^th percentile,75^th percentile) and compared using Wilcoxon signed-rank test(for paired samples) and Mann-Whitney U test(for independent samples). Spearman rank tests were conducted to show the correlation of two variables. Results In post-operative group,D2 was lower than D1(ΔD=-184.8,P<0.0001),and both of D1 and D2 were positively correlated with age(r²= 0.356,0.389,respectively,P<0.01). In metastatic group, after chemotherapy,33 cases had progressive diseases(PD group), while 58 cases gained response or stable diseases(non-PD group). Baseline D-dimer level of PD group was higher than that of non-PD group(1586 vs 754.2,P<0.01),and after chemotherapy the case was similar(2511 vs 525.8,P<0.01). After chemotherapy, D-dimer level increased in PD group(ΔD=1124,P<0.0001), and decreased in non-PD group(ΔD=-153.3,P=0.0045).We compared the abilities of the ΔD(ΔD=D2-D1), D1and D2 to discriminate between responders and non-responders using receiver operating characteristic curves(ROC). The areas under the curve (AUC) of the ΔD, D1and D2, were 0.8603(95%CI:0.7685-0.9520)、0.6740(95%CI:0.5582-0.7597)、0.8956(95%CI:0.8291-0.9621), respectively. The appropriate cut-off values with biggest Youden index of D-dimer for non-responders were as follows: ΔD＜-145.4 ng/mL,D1>1375ng/mL,D2>1033ng/mL. Conclusion Plasma D-dimer level is strongly associated with tumor burden. D-dimer could be used to predict prognosis and treatment response in female patients with tumor.

目的 在糖尿病尿失禁女性患者中使用盆底肌功能训练手册,了解该手册对改善糖尿病女性尿失禁的作用。方法 将260例糖尿病尿失禁患者随机分为观察组、对照组,2组均进行常规盆底肌功能训练,每月提醒患者坚持训练,观察组在此基础上发放盆底肌功能训练手册,指导患者及家属填写方法, 每月检查填写记录情况;在治疗前、后评价2组患者尿失禁改善、观察心理健康改善情况。结果 观察组患者在干预后尿失禁改善、心理健康改善优于对照组。盆底肌功能训练手册准确真实反映患者治疗的落实情况,可督促患者落实治疗,从而提高治疗效果,提高患者生活质量。结论 盆底肌功能训练手册对糖尿病尿失禁患者实用性高,尤其对于记忆力下降的糖尿病患者实用性高。

目的 分析25羟维生素D[25(OH)D]在新疆汉族及维吾尔族老年男性2型糖尿病(T2DM)合并骨质疏松(OP)患者中的水平及与骨密度(BMD)的相关性。方法 收集住院的汉族、维吾尔族老年男性T2DM患者281例,根据民族及骨密度值将其分为汉族非骨质疏松(NOP)组127人(A组)、汉族骨质疏松(OP)组21人(B组)、维族NOP组103人(C组)、维族OP组30人(D组),记录四组患者的25(OH)D水平并进行比较,分析25(OH)D与BMD的相关性。结果 同一民族中,B组的25(OH)D低于A组(P<0.05),D组的25(OH)D低于C组(P<0.05); T2DM合并OP患者中,D组的25(OH)D低于B组(P<0.05); 相关性分析显示,25(OH)D与BMD呈正相关。结论 维吾尔族老年男性T2DM合并OP患者较汉族患者的25(OH)D水平低,25(OH)D水平低的T2DM患者更易合并OP,25(OH)D检测有助于识别T2DM患者合并OP的风险。

Objective To analysis the level of 25 hydroxy vitamin D[25(OH)D] in Xinjiang Han and Uyghur elderly male patients with T2DM and osteoporosis, and the correlation between 25(OH)D levels and bone mineral density(BMD). Methods We collected 281 cases of T2DM patients from Hans and Uyghurs, divided them into four groups according to the nationality and BMD: Han non-osteoporosis(NOP) group including 127 cases(group A), Han osteoporosis(OP) group 21 cases(group B), Uyghur NOP group 103 cases(group C), Uyghur OP group 30 cases(group D). Recorded and compared their 25(OH)D levels, and analyzed the correlation between 25(OH)D levels and BMD. Results In the same nationality,the level of 25(OH)D in group B were lower than those in group A(P<0.05), and group D were lower than those in group C(P<0.05); In T2DM patients combined with OP, the levels of 25(OH)D in group D were lower than those in group B(P<0.05); Correlation analysis showed that 25(OH)D was positively correlated with BMD. Conclusion The level of 25(OH)D in elderly male patients with T2DM combined with osteoporosis, those of Uyghurs are lower than those of Hans. T2DM patients with lower 25(OH)D level are more likely to combine OP. The 25(OH)D level test may help to identify the risk of combining OP in T2DM patients.

目的 研究益精汤对改善男性不育症患者精子质量和提高生育率的临床疗效。方法 将符合纳入标准的100例男性不育症患者随机分为益精汤组和五子衍宗片组进行治疗,治疗后采用ZKPACS-E彩色精子质量分析系统检测精子各项参数标指和调查孕育人数,进行分析对比。结果 通过治疗前后对比,益精汤组的治愈率及临床治愈率较五子衍宗片组高,益精汤组、五子衍宗片组总有效率依次是82%、64%,差异有统计学意义(P<0.05)。益精汤组对患者的精液液化时间、精子活力等指标方面的恢复和改善优于对照组。结论 益精汤能显著提高精子的质量,在治疗男性不育症方面效果显著,值得进一步临床研究和推广。

目的 探讨女性宫内节育器使用年限及类型与生殖道感染的关系,以降低生殖道感染率。方法 2013年1月—2015年1月于我院门诊检查使用宫内节育器360名女性的临床资料进行回顾性分析,研究节育器使用年限、类型、患者年龄、孕次、是否绝经与生殖道感染的关系。结果 带尾丝组患者的生殖道感染率比不带尾丝组高(P<0.05),无尾丝组生殖道感染率与置器年限无关,差异无统计学意义(P>0.05),带尾丝组生殖道感染率与置器年限有关,差异有统计学意义(P<0.05)。生殖道感染率与与女性年龄及妊娠次数无关,与是否绝经有关,未绝经女性的生殖道感染率较高(P<0.05)。结论 带尾丝的宫内节育器的使用可使生殖道感染率增加,使用年限越长,生殖道感染的发生率越高。

Objective To investigate the associations between different time and types of intrauterine device with female reproductive tract infection in order to provide evidence for reducing infection rate. Methods 360 females using intrauterine device were continually recruited during Jan 2013-Jan 2015 in our hospital, and their clinical data was also collected in the same period. The associations between reproductive track infection and clinical characteristics including service time, types, age, gravidity and menopause status were further analyzed. Results We found that the female using intrauterine device with tail wire, as well as with non-menopause had higher infection risk than those did not have(P<0.05). In addition, service time of intrauterine device was significantly associated with infection risk in those patients using intrauterine device with tail wire. However, there was no any remarkable relevance for age and gravidity with risk of reproductive track infection. Conclusion The use of intrauterine device with tail wire, as well as longer service time, could cause the increased risk of reproductive track infection for females.