恶性滋养叶细胞肿瘤综合治疗的疗效观察

目的:观察分析滋养叶细胞肿瘤的临床特点、治疗及预后。方法:回顾性分析安顺市人民医院2006～2011年收治的86例恶性滋养叶细胞肿瘤患者的临床资料。对诊断恶性滋养叶细胞肿瘤的患者进行解剖分期及预后评分,并按评分选择化疗方案:低危患者(≤6分)予单药化疗,高危患者(>7分)予联合化疗+子宫切除术。结果:1年生存率为100.00%,5年生存率为97.67%(不包括失访的2例患者)。单药化疗组治愈率为88.46%(46/52),联合化疗组子宫切除率为67.65%(23/34)。结论:对诊断恶性滋养叶细胞肿瘤的患者需进行正确的解剖分期及预后评分,及早给予化疗及手术的综合治疗。     

恶性滋养叶细胞肿瘤综合治疗预后分析

目的：探讨恶性滋养叶细胞肿瘤综合治疗预后效果。方法选取2010年6月-2012年5月我院收治的恶性滋养叶细胞肿瘤72例进行分析，按照随机数字表法分成观察组和对照组两组，每组36例，观察组采用综合治疗，对照组采用单纯化疗，观察两组近期临床疗效、3年内患者生存率和复发率。结果观察组治疗总有效率为94.5%，明显高于对照组的80.6%（P＜0.05）；观察组3年内生存率分别为97.2%、94.4%、88.9%，对照组分别为94.4%、86.1%、77.8%，两组在1年内生存率无明显差异（P＞0.05），观察组1年以上生存率明显高于对照组（P＜0.05）；观察组3年内复发率为11.1%，明显低于对照组的25.0%（P＜0.05）。结论对于恶性滋养叶细胞肿瘤低危患者可采用单纯化疗，对于高危和耐药患者应采用化疗＋手术的综合治疗，能够有效改善患者的预后，提高生存率，降低复发率，效果显著。     

两种化疗方案治疗恶性滋养细胞肿瘤的临床疗效对比分析

目的讨论两种化疗方案治疗恶性滋养细胞肿瘤的临床疗效。方法选取2013年1月-2014年12月在该院进行恶性滋养细胞肿瘤治疗患者63例进行回顾性分析,按照化疗方案分为EP组38例和5-FU+KSM组25例。观察患者经过治疗完全缓解的例数,及手术切除子宫患者所占比例。观察两组患者副作用发生情况。结果两组患者疗效比较,EP组患者完全缓解比例略高28例,占73.68%;5-FU+KSM组完全缓解18例,占72%。5-FU+KSM组手术比例略高,手术切除子宫8例,占32%;EP组手术切除12例,占31.58%,但两组数据差异均无统计学意义(均P0.05)。胃肠反应、口腔溃疡、肝肾毒性、腹泻等副作用EP组明显低于5-FU+KSM组,差异有统计学意义(P0.05)。白细胞减少、脱发、血红蛋白下降、血小板减少等副作用两组数据差异无统计学意义(P0.05)。结论两种化疗方案在临床疗效上差异无统计学意义,但EP组在部分化疗副作用方面明显小于5-FU+KSM组。     

EP方案与FK方案治疗恶性滋养细胞肿瘤的临床比较

目的 研究EP方案与5-Fu＋KSM方案治疗恶性滋养细胞肿瘤的疗效及化疗副反应.方法 采用EP方案治疗恶性滋养细胞肿瘤27例与5-Fu＋KSM方案治疗恶性滋养细胞肿瘤45例.结果 EP方案治疗恶性滋养细胞肿瘤完全缓解率为85.2%,5-Fu＋KSM方案总完全缓解率为84.4%;EP方案化疗副反应主要为Ⅰ～Ⅱ级恶心、呕吐和白细胞稍有下降.5-Fu＋KSM方案治疗恶性滋养细胞肿瘤化疗副反应主要为Ⅰ～Ⅱ级恶心、呕吐和骨髓抑制明显,消化道反应重,有时会发生严重的口腔溃疡及腹泻.结论 采用EP方案治疗妊娠恶性滋养细胞肿瘤疗效满意,化疗副反应轻,患者易接受,可作为临床一线用药.     

时辰化疗治疗滋养细胞肿瘤的临床观察

目的:观察时辰化疗与普通化疗方法治疗滋养细胞肿瘤的疗效及副作用比较。方法:将62例滋养细胞肿瘤病人随机分为观察组及对照组,观察组采用时辰化疗,即每晚12时开始化疗。对照组采用一般化疗方法,即每日上午9时开始化疗,方案、药物剂量、疗程及滴注速度一样。结果:观察组32例,治愈所用疗程为103个,对照组30例,用疗程为109个。两组比较(P<0.05)观察组所用疗程少于对照组,观察组发生的化疗副反应如白细胞下降、呕吐、腹泻、口腔溃疡、肝脏损害等均少于对照组,差异分别为P<0.01及P<0.05。结论:时辰化疗用于治疗滋养细胞肿瘤具有所需的疗程少、副反应低、病人容易接受等优点,值得推广应用。     

吉西他滨单药维持治疗晚期非小细胞肺癌的疗效及安全性评估

目的评价吉西他滨单药维持治疗晚期非小细胞肺癌的疗效及安全性。方法选择秦皇岛市第二医院2006-2010年确诊的ⅢB~Ⅳ期非小细胞肺癌患者,经4周期标准紫杉醇、顺铂化疗方案治疗病情未进展的患者86例,随机分为治疗组和对照组,治疗组43例给予吉西他滨单药维持及最佳支持治疗,对照组43例给予最佳支持治疗,观察比较两组患者的疗效、生活质量及药物毒副作用。结果观察组治疗疗效和生活质量方面的总有效率分别为88.4%、95.3%,均明显高于对照组的69.8%、79.1%,组间差异均有统计学意义（P〈0.05）;治疗组的毒副作用发生情况明显低于对照组,两组间差异有统计学意义（P〈0.05）。结论吉西他滨单药维持治疗晚期非小细胞肺癌临床疗效满意,安全性高,是最佳的治疗方案之一。     

恶性滋养细胞肿瘤101例分析

目的:探讨恶性滋养细胞肿瘤的临床特点、治疗方法及疗效。方法:回顾分析1993年1月-2002年5月收治的恶性滋养细胞肿瘤患者101例的临床资料。其中绒癌36例(35.6％),侵蚀性葡萄胎65例(64.4％)。结果:101例患者行化疗或化疗联合手术治疗,除2例脑转移患者死亡外,71例完全缓解,28例部分缓解。结论:恶性滋养细胞肿瘤的治疗以化疗为主,手术为辅,多药联合全身化疗是治疗的主要方法。早期诊断,及时有效的化疗是改善预后的关键。     

恶性滋养细胞肿瘤101例分析

目的探讨恶性滋养细胞肿瘤的临床特点、治疗方法及疗效.方法回顾分析1993年1月～2002年5月收治的恶性滋养细胞肿瘤患者101例的临床资料,其中绒癌36例(35.6%),侵蚀性葡萄胎65例(64.4%).结果101例患者行化疗或化疗联合手术治疗,除2例脑转移患者死亡外,71例完全缓解,28例部分缓解.结论恶性滋养细胞肿瘤的治疗以化疗为主,手术为辅,多药联合全身化疗是治疗的主要方法.早期诊断,及时有效的化疗是改善预后的关键.     

康艾注射液联合单药化疗治疗老年晚期非小细胞肺癌临床观察

目的 观察康艾注射液联合单药吉西他滨化疗治疗老年晚期非小细胞肺癌患者的疗效.方法 将56例晚期非小细胞肺癌患者随机分为治疗组和对照组.治疗组(29例)用康艾注射液加化疗,对照组(27例)行单纯化疗.结果 治疗组有效率为34.5％ (10/29),对照组有效率为33.3％ (9/27),差异无统计学意义(P＞ 0.05),治疗组血液及非血液毒性均低于对照组(P＜0.05),治疗组生活质量明显改善(P＜0.05).结论 康艾注射液联合吉西他滨单药治疗老年晚期非小细胞肺癌有提高临床获益率,减轻毒性反应,提高生活质量的作用.     

恶性滋养细胞肿瘤101例分析

目的：探讨恶性滋养细胞肿瘤的临床特点、治疗方法及疗效。方法：回顾分析1993年1月～2002年5月收治的恶性滋养细胞肿瘤患者101例的临床资料，其中绒癌36例(35．6％)，侵蚀性葡萄胎65例(64．4％)。结果：101例患者行化疗或化疗联合手术治疗，除2例脑转移患者死亡外，71例完全缓解，28例部分缓解。结论：恶性滋养细胞肿瘤的治疗以化疗为主，手术为辅，多药联合全身化疗是治疗的主要方法。早期诊断，及时有效的化疗是改善预后的关键。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.