开县三峡库区传染病传播的影响因素分析

目的通过分析开县三峡库区传染病传播的影响因素,为三峡库区疾病防治提供科学依据。方法搜集开县气象和地理及植被资料,搜集开县2004～2008年疫情资料,采用人工小时法和鼠夹法开展蚊种及蚊密度、鼠种及鼠密度调查;采用鼠笼法捕活鼠收集鼠体蚤,进行分类并计算总蚤指数;采用系统抽样和环境抽样相结合的方法查找钉螺。结果开县属中亚热带湿润季风气候区,开县三峡库区未发现钉螺,三峡水库建成后将出现大面积洲滩、沟渠等消落带区,适合钉螺生长;开县2004～2008年流行性乙型脑炎平均发病率为1.81/10万,钩体病、流行性出血热和疟疾处于低发病水平;开县三峡库区平均鼠密度为0.97%,存在鼠疫、钩体病、流行性出血热等疾病传播宿主及媒介;开县三峡库区平均蚊密度为113.90只/人工小时,其中传播流行性乙型脑炎和疟疾的库蚊和按蚊分别占2.29%和8.88%。结论开县三峡库区疾病监测及防治工作有待进一步加强。     

开县医疗机构2007～2008年消毒灭菌效果监测分析

目的了解医疗机构消毒灭菌质量情况，为加强医疗机构医源性感染提供科学依据。方法采取现场抽样和检测方法，对医疗机构消毒灭菌质量进行检测。结果开县医疗机构2007～2008年监测总合格牢为87．74％，其中使用中消毒剂为89.69％，使用中灭菌剂合格率为73．08％，医务人员手合格术为62．50％，灭菌器械合格牢为53．85％，物体表面合格率为50．00％．手术室空气合格率为30％。县级、乡镇级医疗机构使用中消毒剂的合格牢高于村级．结论开县医疗机构消毒灭菌总体合格率不高，消毒灭菌质量有待提高。     

营养风险与伊立替康导致延迟性腹泻的关系

目的探讨营养风险与伊立替康导致延迟性腹泻的关系。方法对302例次伊立替康化疗的胃肠癌患者采用NRS2002（Nutritional risk screening 2002）评分筛查,分为存在营养风险组与无营养风险组,比较两组患者Ⅱ～Ⅳ度延迟性腹泻及Ⅲ～Ⅳ度以上腹泻的发生率。结果 NRS2002评分筛查存在营养风险组发生Ⅱ～Ⅳ度延迟性腹泻及Ⅲ～Ⅳ度以上腹泻的概率明显大于无营养风险组（P〈0.05）。结论存在营养风险的患者应用伊立替康化疗发生延迟性腹泻的风险较大。     

多西他赛或奥沙利铂联合卡培他滨治疗老年晚期胃癌疗效及并发症比较

Objective To compare the short-term efficacy and adverse effects of docetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients. Methods Eighty-two aged patients with late-staged gastric cancer were randomly divided into two groups,of which 38 patients were treated group) ,and 44 patients were treated with oxaliplatin (100 mg/m2 ivgtt on 1st day) and eapecitabine (2000 mg/1 cycle). Results There is no failure of follow-up. In the docetaxe group,the effective rate was 52.63% (20/38) and 54.55 % (24/44) for the docetaxe and oxaliplatin group,respectively (P>0.05). The median progression-free survival(PFS) in the docetaxe group (6.1 months) was similar to that in the oxaliplatin group (6.3 months) (P>0.05). Gastrointestinal response,myelosuppression and neurotoxicity (Ⅰ or Ⅱ level) were the most common ad-verse effects observed in both groups (P>0.05). No chemotherapy-related death was observed. Conclusions The short-term efficacy of decetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients is similar,and the adverse effects are all within tolerance limits.     

多西他赛或奥沙利铂联合卡培他滨治疗老年晚期胃癌疗效及并发症比较

Objective To compare the short-term efficacy and adverse effects of docetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients. Methods Eighty-two aged patients with late-staged gastric cancer were randomly divided into two groups,of which 38 patients were treated group) ,and 44 patients were treated with oxaliplatin (100 mg/m2 ivgtt on 1st day) and eapecitabine (2000 mg/1 cycle). Results There is no failure of follow-up. In the docetaxe group,the effective rate was 52.63% (20/38) and 54.55 % (24/44) for the docetaxe and oxaliplatin group,respectively (P>0.05). The median progression-free survival(PFS) in the docetaxe group (6.1 months) was similar to that in the oxaliplatin group (6.3 months) (P>0.05). Gastrointestinal response,myelosuppression and neurotoxicity (Ⅰ or Ⅱ level) were the most common ad-verse effects observed in both groups (P>0.05). No chemotherapy-related death was observed. Conclusions The short-term efficacy of decetaxe or oxaliplatin combined with capecitabine in the treatment of late-staged gastric cancer in aged patients is similar,and the adverse effects are all within tolerance limits.     

奥沙利铂神经毒性机制及防治研究进展

奥沙利铂是第3代铂类抗癌药物,抗癌谱广、毒副反应轻微是其主要特点。但该药的外周神经毒性发生率却高达90%,是其剂量限制性毒性。现对奥沙利铂(乐沙定)神经毒性表现、分级、发生机制及防治策略进行综述,以便为奥沙利铂疗程持续和达到更好疗效、更小毒性提供依据。     

慢性阻塞性肺疾病急性加重期心肌损伤血清生物学指标变化及其临床意义

目的探讨慢性阻塞性肺疾病（COPD）急性加重期患者低氧血症对心肌损伤血清生物学指标的影响及临床意义。方法对72例COPD急性加重期患者的动脉血氧分压（PaO2）和心肌损伤的血清生物学指标进行检测。根据PaO2的水平分成3组,观察心肌损伤血清生物学指标的变化,并分析PaO2和各种心肌损伤血清生物学指标的关系。结果三个低氧血糖组CK—MB、Mb任意两组比较均不同,轻度与中度CTnI、LDH均相近,其余任意两组比较均不同。结论低氧血症可导致血清CK—MB、LDH、Mb水平增高,且随着缺氧程度加重而加重。重度低氧血症可出现cTnI水平增高,提示患者病情危重。     

腓骨长肌转位修复陈旧性跟腱断裂

陈旧性跟腱断裂手术修复较困难，术后效果与新鲜断裂相比较差，且重建的跟腱由于瘢痕增生而粗大，踝关节活动受限。作者于2000年8月-2003年11月利用腓骨长肌转位重建跟腱术19例，取得满意效果。     

靛玉红甲肟对奈达铂抗人食管癌EC-1细胞的化疗增效作用

 目的 探讨靛玉红甲肟(Indirubin-3′-monoxime,IRO)与奈达铂联合应用对人食管癌细胞株EC-1的影响及其作用机制。方法 经不同浓度的IRO和(或)奈达铂处理EC-1细胞后,用MTT法测定细胞增殖抑制效应;流式细胞术观察细胞周期变化;免疫组织化学法观察凋亡相关基因表达变化。结果与IRO或奈达铂单药作用相比,IRO与奈达铂联合应用可显著增强人食管癌细胞增殖抑制作用,联合用药后细胞周期分布发生改变,G₀/G₁期细胞比例下降,G₂/M期细胞比例上升,癌细胞Bcl-2基因表达下降,Bax表达增强。结论 IRO与奈达铂联合应用具有协同抗食管癌作用,其机制可能与细胞周期调控及凋亡相关基因表达调控有关。