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《The aging male》2013,16(2):99-109
Male breast cancer (MBC) is a rare disease. However, as global populace ages, there is a trend to MBC increasing. Although aetiology is still unclear, constitutional, environmental, hormonal (abnormalities in estrogen/androgen balance) and genetic (positive family history, Klinefelter syndrome, mutations in BRCA1 and specially BRCA2) risk factors are already known. Clinic manifestation is painless hard and fixed nodule in the subareolar region in 75% of cases, with nipple commitment earlier than in women. Breast cancer has similar prognostic factors in males and females, among which axillary adenopathy (present in 40–55% cases) is the most important one. Although mammography, ultrasonography and scintigraphy can be useful tools in diagnosis; clinical assessment, along with a confirmatory biopsy, remains the main step in the evaluation of men with breast lesions. Infiltrating ductal carcinoma is the most frequent histological type. The established standard of care is modified radical mastectomy followed by tamoxifen for endocrine-responsive positive disease, although other options are being explored. While similarities between breast cancer in males and females exist, it is not appropriate to extrapolate data from female disease to the treatment of male. There is a need for specific multi-institutional trials to better understanding of clinicopathologic features and establishment of optimal therapy for this disease.  相似文献   
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Background and purpose. The number of octogenarians requiring surgery increases constantly. Data regarding perioperative morbidity and mortality in octogenarians is limited. Our aim was to assess surgery-related complications in octogenarians, undergoing urological surgery.

Patients and methods. We prospectively collected data from octogenarians and a control group of younger patients undergoing an elective urological surgery in our institution. Recorded data included: age, gender, American Society of Anesthesiologists (ASA) score, co-morbidities, number of medications, operation extent, anaesthesia type, surgery duration and perioperative morbidity and mortality.

Results. Forty-seven octogenarians and 80 patients with a median age of 59 years (range 19–75) enrolled prospectively. Gender ratio, surgeries extent and median operative time were similar among groups. General anaesthesia was more prevalent in the control group. ASA classification and duration of hospitalization were significantly higher in octogenarians. The rate of intra-operative complications was significantly higher in the octogenarians group 6.38% versus 3.75% (p = 0.007), there was no significant difference in immediate post-operative and post-discharge complications among groups. One octogenarian patient died 2 days post-surgery, no death occurred in the control group.

Conclusions. Octogenarians have higher rate of intra-operative morbidity, leading to longer hospital stay. More experienced surgeons and anaesthetists should be involved in the operation; and careful surgical technique, tapered anaesthesia and higher level of post-operative monitoring should be applied for patients in this age.  相似文献   
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文章总结了近年来将腔镜技术应用于泌尿外科教学的经验体会,发现相对于传统教学模式,将腔镜技术应用于教学可以显示泌尿系统更加形象真实的解剖结构和病理变化,使学生对教学内容更加容易理解和掌握,使教学更少受到时间、地点及医疗环境等的限制.腔镜教学展示的泌尿外科最新技术和诊疗效果,提高了学生的学习积极性,激发了他们从事外科学工作的意愿.将腔镜技术应用于泌尿外科教学,可提高教学质量和教学效率,是一种值得推广的教学方法.  相似文献   
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泌尿外科临床实习是医学生实习过程中的一个重要环节.课题组针对泌尿外科实习教学中存在的一些问题,开展了PBL教学模式改革.通过对实习生出科前进行考核及调查问卷,并对考核成绩进行比较分析,探讨其在泌尿外科实习教学中的优点及可行性.通过初步研究发现PBL教学模式可以提高泌尿外科实习质量,并有望在其他外科实习教学中推广.  相似文献   
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医学研究生是我国高层次医学人才。文章通过回顾分析南京医科大学第一附属医院泌尿外科近几年在研究生科研创新能力的培养和教育工作,体会到充分利用临床科室的优势,不断加强对研究生科研创新能力培养的管理,可以更好地培养高质量、高素质医学科研人才,以适应当前社会对医学人才的要求,同时对科室的发展也可以起到很好的促进作用。  相似文献   
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