结直肠癌的社区筛查及早期诊治

目前虽然结直肠癌诊断及外科治疗已取得长足的进步,但近10年来其5年生存率仍徘徊于50%左右。结直肠癌的社区筛查及其早期诊治成为了提高患者生存率、改善患者生活质量的关键。本文汇总了结直肠癌社区筛查及早期治疗的策略和相关治疗技术的最新进展。期待能提高对结直肠癌筛查及早期治疗的认识,进一步降低结直肠癌的发病率及病死率。     

吴茱萸热敷在结直肠癌术后胃肠功能恢复中的应用进展

结直肠癌是最常见的肠道恶性肿瘤之一,其发病率和致死率呈逐年上升趋势.手术治疗是本病主要的治疗手段.然而,胃肠功能障碍是结直肠癌术后常见并发症.本文对影响结直肠癌术后患者胃肠功能恢复的因素及吴茱萸热敷对结直肠癌术后胃肠功能恢复中的应用作一综述,为其临床康复提供理论依据.     

基质金属蛋白酶及其抑制剂在结直肠癌中的作用研究进展

结直肠癌是最常见的消化道恶性肿瘤之一。在世界范围内其发病率和死亡率分别位于恶性肿瘤的第3位和第4位。结直肠癌的发病是环境、饮食、生活习惯及遗传等多因素协同作用的结果,目前对结直肠癌发病的具体机制还不明确。结直肠癌发病有关的危险因素有吸烟、缺乏身体锻炼、肥胖、红肉和肉制品食用过多以及酒精摄入过多等。在结直肠癌患者的治疗中影响生存和预后的重要因素是肿瘤的侵袭和转移。     

结直肠癌化疗药物的选择及治疗进展

癌症一直威胁人类的身体健康，其中，结直肠癌是最常见的恶性肿瘤之一。2001年美国结直肠癌的发病率为51．8／10万，死亡率为20．0／10万。国内结直肠癌的发病率也呈逐年上升趋势。据上海市2000年恶性肿瘤的发病率统计，男性结直肠癌发病率为43．4／10万，女性为39．3／10万，男女性结直肠癌发病率均位居第三。尽管结直肠癌有40％～50％的患者可通过手术治愈，但其余的患者会发生转移或复发并最终死亡。化疗是转移复发或局部晚期结直肠癌的主要治疗手段之一，本文主要介绍结直肠癌化疗药物的选择及防治进展。     

^18F-FDG PET/CT显像在结直肠癌临床诊疗中的应用

结直肠癌是消化系统常见的恶性肿瘤,在我国,结直肠癌的发病率在消化道肿瘤中仅次于胃癌和食管癌,居第三位。随着人们生活条件和饮食习惯的改变,结直肠癌的发病率和死亡率呈明显上升趋势。因此,结直肠癌的早期诊断、治疗对于提高病人的生存质量、延长生命有重要意义。^18F-FDGPET／CT显像在检出结直肠癌原发病变、发现区域淋巴结和远处转移灶、判断综合治疗后局部肿瘤复发或残留等方面有较大临床价值。     

kras基因突变检测对结直肠癌靶向治疗的临床指导意义

结直肠癌是最常见的恶性肿瘤之一,目前世界范围内其发病率已居所有恶性肿瘤的第三位[1].2011年中国肿瘤登记年报公布的我国结直肠癌的发病率也位居全部恶性肿瘤第三位[2].尽管40％～50％的结直肠癌患者可通过手术治愈,但大部分患者会发生转移或复发,并最终导致死亡.近年来,随着靶向治疗的兴起,2种针对表皮生长因子受体(epidermal growth factor receptor,EGFR)的单克隆抗体类药物——西妥昔单抗和帕尼单抗在结直肠癌的治疗中显示出了很好的疗效,明显改善了患者的生存.最近研究显示,除EGFR本身因素外,其下游信号转导通路中的其他成员与这2种靶向药物疗效也密切相关;同时多项临床研究发现,EGFR靶向治疗不受益的结直肠癌患者中,kras基因的突变率较治疗受益者高.因此,临床上将结直肠癌靶向治疗的失败归因于kras基因突变,并提出了应将结直肠癌患者kras 基因状态作为是否进行EGFR靶向治疗的筛选标准.     

结直肠癌肿瘤干细胞研究进展

结直肠癌为人类消化道常见恶性肿瘤,在西方国家发病率较亚、非洲高,但在我国的流行病调查研究发现,结直肠癌的发病率呈逐年上升趋势,其中男性较女性发病率高[1]。肿瘤干细胞是一群具有自我更新和多向分化潜力的细胞,与肿瘤的复发、转移密切相关;而结直肠癌患者的癌细胞转移和术后复发是威胁生命的主要原因,因此,从肿瘤干细胞的角度深入研究结直肠癌的生物学特征,可为结直肠癌患者的防治指引方向。现将其相关研究作一综述。     

青年人结直肠癌的诊治进展

结直肠癌是常见消化道恶性肿瘤，发病率平均居全部恶性肿瘤的第4位，结直肠癌死亡居癌症死因第3位。在我国近年来发病率有上升趋势，尤其青年人较为明显。青年人结直肠癌由于其临床症状隐匿，表现缺乏特异性，浸润转移早，恶性程度高等临床特点，故其误诊率高，预后差。因此了解我国青年人结直肠癌的诊治现状，进一步提高对青年人结直肠癌的治疗效果，有着十分重要的意义。     

结直肠癌中医治疗研究进展

近年来,我国结直肠癌的发病率逐年上升,且有年轻化的趋势,居恶性肿瘤发病的第3位,严重影响人们健康[1].在我国,中医治疗已成为结直肠癌综合治疗中的组成部分.大量的临床表明,中医治疗能提高患者对手术的耐受性,增加放化疗的完成率,减轻放化疗的不良反应,在结直肠癌的根治术后预防复发和转移以及在提高晚期患者生存质量、延长生存期的治疗中发挥着举足轻重的作用.     

老年结直肠癌的外科治疗和围手术期处理

结直肠癌的发病率随年龄增长而迅速上升,随着人口的老龄化和医疗水平的提高,老年结直肠癌患者手术日益增多.作者自2000年6月至2004年5月对70岁以上结直肠癌患者66例的临床资料,进行回顾性分析,以探讨老年结直肠癌的临床特点和治疗方法.     

Diagnosis and management of positional head deformity

In children with positional head deformity (posterior plagiocephaly), the occiput is flattened with corresponding facial asymmetry. The incidence of positional head deformity increased dramatically between 1992 and 1999, and now occurs in one of every 60 live births. One proposed cause of the increased incidence of positional head deformity is the initiative to place infants on their backs during sleep to prevent sudden infant death syndrome. With early detection and intervention, most positional head deformities can be treated conservatively with physical therapy or a head orthosis ("helmet").     

Educational approaches to management of low back pain

With the high incidence of low back pain in adults, especially in the work place, industrial and health care professionals must work together to reduce the physical, emotional, and monetary cost of back pain. Conservative management can be effective when it includes therapy and patient education. This article discusses back schools and work hardening programs, two methods used to return employees to productive levels.     

Candida and severe acute pancreatitis: We won't be fooled again

Several studies have suggested a role of candida in infected cases of severe acute pancreatitis. This commentary reports high incidence and mortality rates of candida infection in this setting and demonstrates the value of the colonization index to detect patients at risk for fungal infection. These findings indicate the need to review the place of antifungal therapy and prophylaxis.     

A method of comparing the toxicities of disease suppressive agents: possible application to a comparison between D-penicillamine and chloroquine

A general method for calculating incidences of the more common adverse reactions during long-term therapy with disease suppressive agents is presented. With D-penicillamine treatment, the incidence of proteinuria rises during 6-12 months and then declines, but with aurothiomalate treatment the incidence of proteinuria and rash progressively decline. Low-dose chloroquine treatment was associated with a much lower withdrawal rate due to adverse reactions compared to D-penicillamine. However, the efficacy at mean doses of chloroquine less than 250 mg day-1 has not been formally evaluated. A formal, well-controlled trial comparing D-penicillamine, at current dosage, and of chloroquine, at low dosage, seems warranted in order to place the usefulness of D-penicillamine in perspective.     

早产儿视网膜病变的筛查及临床分析

【目的】对早产儿视网膜病变（ROP）进行筛查和临床分析,了解ROP的高危因素和发病情况。【方法】对2008年7月至2009年7月在本院门诊筛查视网膜病变的350例早产儿进行回顾性分析。【结果】孕周小于32周、体重低于2000g及氧疗时间长的患儿ROP的发病率显著增高;ROP组与正常眼底组的出生体重、胎龄、吸氧时间差异均有显著性。【结论】不规范吸氧、出生体重低及胎龄小是ROP形成的高危因素,临床上早期诊断、早期治疗是降低ROP危害的关键。     

Neonatal Infusion Therapy: Preventing Complications and Improving Outcomes

Infusion therapy is one of the most common procedures performed in the hospitalized patient. Particularly in the neonatal intensive care unit, almost 100% of the patients receive infusion therapy. The process becomes very routine and many patients do not suffer obvious complications. However, some complications are very common and often accepted as part of the treatment. There are measures that can help to decrease the incidence or seriousness of these complications. This article will focus on the process of initiation and maintenance of short peripheral infusion therapy, the most common type administered. Common complications and how they may be prevented or minimized in the neonatal patient are presented. Standards and guidelines currently in place are discussed as they apply to the neonatal population.     

Evidence-based recommendations for older adults with Helicobacter pylori or those using nonsteroidal anti-inflammatory drugs.

Currently, about half the world's population is infected with Helicobacter pylori. This organism is known to cause peptic ulcers and places patients at higher risk for gastric cancer. Older adults are more susceptible to the negative effects of Helicobacter pylori infection. In addition, this population consumes large amounts of nonsteroidal anti-inflammatory drugs and typically demonstrates a high incidence of atrophic gastritis, both of which place them at even higher risk for gastrointestinal disease. Consequently, older adults should be carefully assessed for gastrointestinal irritation, peptic ulcer, and gastric cancer. Age-specific therapy can result in improved outcomes related to a lower incidence of nonadherence with medications, decreasing hospital admissions, lowering costs of care, and increasing quality of life.     

早产儿视网膜病危险因素分析

目的调查瑞安市人民医院早产儿视网膜病（ROP）的发生率和高危因素。方法2005年8月1日至2008年8月1日对瑞安市人民医院新生儿监护病房（NICU）住院并符合筛查标准的540例新生儿进行了ROP筛查。结果在接受筛查的540例新生儿中,44例发生了ROP,发生率为8.1%。Ⅰ～Ⅲ期病变分别为35、7、和2例;其中2例需激光治疗,无失明病例。结论ROP相关因素的logistic回归分析结果表明,孕周、出生体重、吸氧时间、呼吸窘迫综合征是ROP形成的高危因素。     

全胃切除术后空肠造口肠内营养治疗的护理

目的：探讨全胃切除术后空肠造口肠内营养治疗的护理方法。方法：对12例全胃切除术后空肠造口肠内营养治疗的患者进行针对性的心理护理，输注过程中的精心护理，加强并发症的观察及处理。结果：治疗效果满意，无严重并发症发生。结论：空肠造口肠内营养治疗对护理要求高，但严密的观察和精心的护理可减少并发症的发生，提高肠内营养治疗效果。     

2009-2013年辽宁省手足口病重症病例流行特征分析

目的全面掌握辽宁省2009-2013年手足口病重症病例的流行特征及病原分布,为防治手足口病提供科学依据。方法应用描述流行病学方法对2009-2013年辽宁省手足口病重症病例进行分析。结果 2010年报告手足口病重症病例最多,重症病死率逐年下降,流行高峰集中在7、8月;病例以1~5岁年龄组儿童为主;病原构成主要是肠道病毒71型(EV71),但各地区分布存在差异,临床特征以发热、皮疹为主,多伴有神经系统症状。结论辽宁省手足口病重症病例的发病呈减缓态势,但检出阳性病例病原以EV71为主,进一步加强监测是深入研究该省手足口病的重要措施。