158例胸部手术患者抗菌药物应用调查与分析

本文采用回顾性调查方法,将2002年1月～2003年9月胸部手术病历调出,对其使用抗菌药物的品种,用药频度,相关费用,联合用药,手术类型,切口愈合等情况进行分析评价.结果表明,158例胸部手术患者抗菌药物使用率达100%,涉及7个类别35种;联用抗菌药物达138例,人均使用抗菌药费为2587.75元,总药费与抗菌药费之比为1:0.38;平均疗程为32.28天;术后抗菌药物疗程明显偏长,联用比率偏高,有必要规范抗菌药物的应用.     

氟罗沙星治疗细菌性感染的药物经济学研究

目的:评价氟罗沙星和氧氟沙星治疗细菌性感染的经济性.方法:治疗组患者35例,使用氟罗沙星0.3 g,静脉滴注,1次/d共10.5 d;对照组患者32例,使用氧氟沙星0.3 g,静脉滴注,2次/d,共10.5 d.运用药物经济学的成本-效果分析方法进行评价.结果:2种方案的成本-效果比(C/E)分别为22.87,20.43,效果(以有效率表示)分别为91%,84%(P＞0.05).结论:氧氟沙星经济性最佳,氟罗沙星市场价格太贵,建议厂商重新考虑市场的药品定价策略.     

脓毒症心肌损害新生大鼠模型的建立

【摘要】 目的 建立一种具有良好稳定性及重复性的能模拟新生儿脓毒症（NS）心肌损害的新生大鼠动物模型,为研究NS致病机制及防治提供模型动物。方法 选取出生10天的健康雄性SD新生大鼠54只,随机分为正常对照组、假手术组（Sham组）、盲肠结扎穿孔术组（CLP组）,每组各18只。通过观察血培养菌落生长,采用酶联免疫吸附法（ELISA）对血清肌钙蛋白I（cTNI）浓度、心肌组织肿瘤坏死因子α（TNF α）和白细胞介素1β（IL 1β）含量进行检测,光镜下观察HE染色后心肌组织的病理变化。结果 正常对照组和Sham组新生大鼠的血培养结果均为阴性,CLP组新生大鼠的血培养中检出以大肠杆菌为主的菌落。正常对照组新生大鼠的血清cTNI浓度、心肌组织TNF α和IL 1β含量和Sham组比较差异无统计学意义（P＞0.05）;CLP组新生大鼠的血清cTNI浓度、心肌组织TNF α和IL 1β含量较Sham组明显增加（P＜0.05）。正常对照组和Sham组的心肌组织HE染色示心肌细胞均未出现炎性改变,但CLP组心肌细胞周围出现了炎性细胞浸润等病理改变。结论 通过盲肠结扎穿孔可建立较为理想的脓毒症心肌损害新生大鼠模型。     

Establishment of a formal program for retinoblastoma: Feasibility of clinical coordination across borders and impact on outcome

Retinoblastoma is an ocular tumor that occurs in young children, in either heritable or sporadic manner. The relative rarity of retinoblastoma, and the need for expensive equipment, anesthesia, and pediatric ophthalmologic expertise, are barriers for effective treatment in developing countries. Also, with an average age‐adjusted incidence of two to five cases per million children, patient number limits development of local expertise in countries with small populations. Lebanon is a small country with a population of approximately 4.5 million. In 2012, a comprehensive retinoblastoma program was formalized at the Children's Cancer Institute (CCI) at the American University of Beirut Medical Center, and resources were allocated for efficient interdisciplinary coordination to attract patients from neighboring countries such as Syria and Iraq, where such specialized therapy is also lacking. Through this program, care was coordinated across hospitals and borders such that patients would receive scheduled chemotherapy at their institution, and monthly retinal examinations and focal laser therapy at the CCI in Lebanon. Our results show the feasibility of successful collaboration across borders, with excellent patient and physician adherence to treatment plans. This was accompanied by an increase in patient referrals, which enables continued expertise development. However, the majority of patients presented with advanced intraocular disease, necessitating enucleation in 90% of eyes in unilateral cases, and more than 50% of eyes in bilateral cases. Future efforts need to focus on expanding the program that reaches to additional hospitals in both countries, and promoting early diagnosis, for further improvement of globe salvage rates.     

Mutations of the TP53 gene in adenocarcinoma and squamous cell carcinoma of the cervix: A systematic review

ObjectiveMutations of the tumor suppressor gene TP53 are the most significant events in several human cancers. Few studies have analyzed the frequency of TP53 alterations in squamous cell carcinoma and adenocarcinoma of the cervix with controversial results. This study provides a detailed analysis of TP53 mutation spectra in cervical squamous cell carcinoma and adenocarcinoma from different geographical regions.MethodsThe analysis of TP53 mutational profiles was performed in 1353 cervical cancers retrieved from the IARC p53 mutation database (R15, 2010) and the COSMIC data along with the literature review of related studies identified by PubMed searching.ResultsThis analysis showed a significant higher mutation frequency of TP53 gene in cervical adenocarcinoma (32 of 241; 13.3%) compared to squamous cell carcinoma (39 of 657; 5.9%; P = 0.0003, χ² test). The proportion of adenocarcinoma with mutated TP53 varied from 4% in North America to 19% in Asia. Among the six hot-spot codons of TP53 gene, three codons (175, 248 and 273) were the most commonly mutated in both types of cervical cancer, one codon (249) mainly in squamous cell carcinoma and one codon (282) only in adenocarcinoma. The G to A and C to T transitions were the prevalent type of mutations in both squamous cell carcinoma and adenocarcinoma (48.7% and 53.5% of all mutations, respectively). The frequency of C to A transversion was relatively high only in adenocarcinoma (25%), while the mirror mutation G to T was comparatively frequent in squamous cell carcinoma (14.6%).ConclusionsDifferent patterns of TP53 mutations occur in squamous cell carcinoma and adenocarcinoma of the cervix in different regions of the world. The highest frequency of mutated TP53 has been observed in cervical adenocarcinoma from Asia. Further studies are needed to better define the role of TP53 alterations in cervical cancer and possibly to understand the impact of mutations on cancer prognosis and outcomes.     

冠脉造影联合动态心电图监测在老年冠心病患者诊断中的应用分析

目的分析冠脉造影联合动态心电图监测在老年冠心病患者患者诊断中的应用价值。方法本次研究选取我院2013年3月至2014年3月治疗的82例冠心病老年患者为例,患者均使用冠脉造影联合12导联动态心电图监测进行诊断。结果 82例患者中,共有63例患者为阳性冠结果,19例患者为阴性结果 ;59例患者12导联动态心电图结果为阳性,23例患者12导联动态心电图结果为阴性。患者冠状动脉病变程度与12导联动态心电图ST低压阳性率差异并不明显,不存在统计学意义(P0.05)。结论只使用12导联动态心电图监测诊断老年冠心病的应用效果较差,可以使用冠脉造影配合诊断,提高老年冠心病的诊断准确率,适合进行临床推广。