摘要：Varicocele repair in adolescent remains controversial. Our aim is to identify and combine clinical trials results published thus far to ascertain the efficacy of varicocelectomy in improving testis volume and semen parameters compared with nontreatment control. A literature search was performed using Medline, Embase and Web of Science, which included results obtained from meta-analysis, randomized and nonrandomized controlled studies. The study population was adolescents with clinically palpable varicocele with or without the testicular asymmetry or abnormal semen parameters. Cases were allocated to treatment and observation groups, and testis volume or semen parameters were adopted as outcome measures. As a result, seven randomized controlled trials （RCTs） and nonrandomized controlled trials studying bilateral testis volume or semen parameters in both treatment and observation groups were identified. Using a random effect model, mean difference of testis volume between the treatment group and the observation group was 2.9 ml （95% confidence interval [CI]： 0.6, 5.2; P 〈 0.05） for the varicocele side and 1.5 ml （95% CI- 0.3, 2.7; P 〈 0.05） for the healthy side. The random effect model analysis demonstrated that the mean difference of semen concentration, total semen motility, and normal morphology between the two groups was 13.7 x 106 ml-1 （95% CI： -1.4, 28.8; P= 0.075）, 2.5% （95% CI：-3.6, 8.6; P= 0.424）, and 2.9% （95% CI： -3.0, 8.7; P= 0.336） respectively. In conclusion, although varicocelectomy significantly improved bilateral testis volume in adolescents with varicocele compared with observation cases, semen parameters did not have any statistically significant difference between two groups. Well-planned, properly conducted RCTs are needed in order to confirm the above-mentioned conclusion further and to explore whether varicocele repair in adolescents could improve subsequently spontaneous pregnancy rates.

摘要：目的探讨全身低能量光疗(LLLT)对重度烧伤大鼠全身炎症反应的影响。方法将50只SD大鼠随机分为空白对照组、单纯烧伤组、烧伤后单次短时光照组、烧伤后单次长时光照组和烧伤后多次短时光照组,每组10只。单次短时光照组、烧伤后单次长时光照组、烧伤后多次短时光照组大鼠在烧伤后均给予低强度LED光(640nm)照射全身,分别照射5min/d、15min/d、5min×3次/d。各组大鼠分别于造模前1d,造模后即刻,造模后第1、3、7、14天取尾静脉血检测血清肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-1β、IL-6的含量,计数静脉血白细胞;并于造模后第3、7、14天测量创面面积,计算创面愈合率。结果与空白对照组相比,造模后第1天时单纯烧伤组及烧伤后单次短时光照组大鼠血清TNF-α含量升高(P<0.05),而烧伤后单次长时光照组及烧伤后多次短时光照组分别于造模后第1、7天时升高(P<0.05);各组大鼠血清IL-1β含量均在造模后第1天时下降(P<0.05),后逐渐恢复,但恢复速度不一;单纯烧伤组及烧伤后多次短时光照组大鼠血清IL-6含量均在造模后第1天时升高(P<0.05),后下降,但单纯烧伤组下降幅度大于烧伤后多次短时光照组,而烧伤后单次短时光照组于造模后第3天升高后下降,烧伤后单次长时光照组呈持续升高态势(P<0.05)。单纯烧伤组及烧伤后单次长时光照组大鼠静脉血白细胞计数均于造模后第1天时升高并维持(P<0.05),其余各组白细胞计数无明显改变。烧伤后单次短时光照组、烧伤后单次长时光照组和烧伤后多次短时光照组大鼠创面愈合率均高于单纯烧伤组(P<0.05)。结论全身LLLT可改善严重烧伤大鼠血清炎症因子TNF-α、IL-1β、IL-6的含量及静脉血白细胞计数,促进创面愈合,且不同照射模式所产生的效果不一。

摘要：目前国内缺乏对医学生批判性思维能力正式的评价标准。结合军医大学临床八年制医学生自身特点,利用改良的CCTDI量表评价PBL教学模式下学生批判性思维能力的训练效果是一种新的尝试和探索。研究表明,PBL教学模式有助于军校医学生批判性思维能力的培养,改良CCTDI量表可以全面有效地评价不同教学模式下学生批判性思维能力的差异,对军校医学生批判性思维评价方法的建立及临床教学课程设计具有一定的参考价值。