常规结肠镜对男女性结直肠息肉检出情况分析

目的:了解不同性别、年龄者结直肠息肉发病情况。方法:2005-2006于我院接受常规结肠镜检查的2306例患者为研究对象,分析各年龄、性别组人群结直肠息肉发病情况。结果:(1)2306例患者中637例(27.6%)检出结直肠息肉,其中1160例男性中检出375例(32.3%),1146例女性中检出262例(22.9%),男性息肉检出率显著高于女性(P<0.001)。(2)以10年区分年龄段,男女性大肠息肉检出率均随年龄的增加而增长,女性40～50岁年龄段息肉检出率为15.6%,显著高于前一年龄段30～40岁息肉检出率(7.0%,P<0.05)。余男女相近年龄段息肉检出率差异无显著性(P>0.05)。(3)男女性50岁以上息肉检出率分别为44.7%及31.4%,均显著高于50岁以前息肉检出率(P<0.001)。(4)男女息肉均以左半结肠及直肠为主,腺瘤性息肉各占74.1%、67.9%(P>0.05),单发性息肉各占56.0%及52.7%(P>0.05)。结论:男性结直肠息肉检出率高于女性;男女性息肉检出率均随年龄增长而增加,女性40岁以上息肉检出率明显升高;男女性息肉在结直肠发生部位、病理及数量等方面无明显差异...     

不同年龄段结肠息肉的内镜及病理特征分析

目的 探讨不同年龄组结肠息肉的大小、生长方式及病理特点,为临床诊治提供客观依据.方法 回顾性分析同济大学附属东方医院2009年1月～2011年8月行电子结肠镜检查发现的1083例结肠息肉患者的资料.根据检查结果,比较不同年龄段患者的息肉检出率以及肠息肉的大小、数目、病理类型等特点.结果 结肠息肉检出率随年龄的增长逐渐增加,60岁以上人群,检出率为15.3％;结肠息肉大小以1 cm以下最为多见,各年龄组间息肉大小差异无显著性(P＞0.05);息肉的发生部位以直肠最多见(P ＜0.01),多部位息肉在50～79岁年龄组发生率显著高于20～49岁年龄组(P＜0.01);息肉生长方式20～40岁以亚蒂为主,40岁以上无蒂息肉发生率明显高于40岁以下年龄组(P ＜0.01);各年龄层息肉的病理分型均以腺瘤型息肉为主(P＜0.01);各年龄层均以单发息肉为主(P＜0.01),随年龄增加多发息肉发生率呈上升趋势.结论 结肠息肉的检出率、发生部位、生长方式、病理分型均与年龄呈一定的相关性,在行结肠镜检查和治疗时,应根据不同年龄层的息肉特点,有针对性的进行检查和治疗.     

单中心就诊中老年人群结肠癌结肠镜筛查结果研究

目的探讨于该院就诊的中老年人群结肠癌结肠镜筛查结果。方法研究对象为2015年1月-2017年12月在该院进行结肠癌筛查的40～74岁人群共96 352例,通过危险度评估与粪便免疫法粪便潜血试验进行结肠癌初步筛查,将初步筛查为高危人群的对象判定为初筛阳性,进行结肠镜进行精筛确诊,对有病变者取组织活检,组织活检结果作为判定金标准,分析筛查结果。结果 96 352例参与筛查的人群中,初步筛查阳性者5 078例,占5.3%;96 352例参与初筛的人群中,男47 153例(48.9%),女49 199例(51.1%),而1 212例肠镜检查的人群中,男668例,女544例,接受肠镜检查的男性与女性比较,差异无统计学意义(22.6%vs 25.7%,P0.05),其中40～49岁占15.0%,50～59岁占28.9%,60～69岁占40.8%,70～74岁占15.3%。5 078例初步筛查阳性者中,1 212例接受结肠镜检查,结肠镜顺应率23.9%。结肠镜筛查中,男性结肠息肉、结肠炎和结肠癌的发生率明显高于女性,差异均有统计学意义(P 0.05),结肠镜筛查中,不同年龄组结肠息肉、结肠炎和结肠癌的发生率比较,差异均有统计学意义(P 0.05),结肠息肉和结肠癌的发生率随着年龄的升高呈上升趋势,而结肠炎的发生率则呈下降的趋势。1 212例行结肠镜检查的人群中,共检出结肠癌30例,占2.5%,其中早期结肠癌14例(46.7%),中晚期结肠癌16例(53.3%);早期结肠癌中,男9例(64.3%),女5例(35.7%),不同性别之间差异无统计学意义(P0.05)。结论该院就诊中老年人群结肠镜筛查结果显示,男性结肠息肉、结肠炎、结肠癌的发生率明显高于女性,结肠息肉和结肠癌的发生率随着年龄的升高呈上升趋势。     

1853例结肠窟和结肠息肉的肠镜资料分析

目的研究不同年龄组结肠癌和结肠息肉的肠镜检查特点。方法回顾性对比分析1853例结肠癌和结肠息肉患者的发病年龄，性别、分布部位。结果（1）老年纽结肠癌和结肠息内的检出率均明显高于中年纽和青年组：（2）女性病例中，结肠癌发生比例以中年组最高：（3）同时共存结肠癌与息肉的病例有1．94％：（4）结肠癌和结肠息肉多好发于直，乙状结肠，但不同病理类型有一定的好友部位。结论对不同年龄组结肠癌和结肠息肉的肠镜特点的认识，有助于提高结肠癌和结肠息肉的诊断率。     

结肠良性肿瘤的病理特点与发病规律

目的探讨结肠良性肿瘤的病理特征及其发病规律，以提高结肠镜的使用效益和减少不必要的误诊和漏诊。方法对4943例有消化系统症状的病人行结肠镜检查时发现的结肠良性肿瘤，按性别、年龄、发生部位、病理学结果等因素进行分析。结果共检出结肠息肉1359例，占27．5％；男性为33.3％，高于女性的21．6％；检出率随年龄增长而逐渐增加，检出高峰在60岁年龄组；其发病规律和病理特征在不同性别间存在明显差异。结论结肠息肉是年龄相关性疾病；其发病规律和病理特征与性别有关；对息肉状病变应重视其病理学检查．逐个取活检，以减少不必要的误诊和漏诊。     

结肠黑变病的临床特点分析

目的 分析结肠黑变病（MC）的检出率及其与性别、伴发肠道疾病的相关性。方法 回顾性分析2013年1月－2020年10月该院378例行电子结肠镜检查并诊断为MC的患者的内镜资料及相关临床资料。采用SPSS 20.0统计软件分析MC的检出率及其与年龄、性别、伴发肠道疾病的相关性。结果 MC的检出率呈逐年升高趋势。年龄 ≤ 60岁的患者中,女性检出率高于男性;大于60岁且小于80岁的患者中,男性检出率及上升幅度大于女性。息肉是MC最常见的伴发疾病,约占28.31%。息肉大小和性别差异无统计学意义。结论 MC呈逐年上升趋势。80岁前,其检出率随着年龄的增长而增加。MC与结肠息肉、结肠癌关系密切,可合并炎症性肠病、结肠憩室、结直肠炎和脂肪瘤等。     

长春西部城区67504例健康体检者高尿酸血症调查分析

目的了解长春西部城区人群血尿酸水平及高尿酸血症(HUA)流行现状,为该地区HUA的防治提供参考。方法整理分析吉林大学第四医院2010年7月至2012年7月来自长春西部城区共67504例健康体检者的血尿酸资料,分析不同性别、不同年龄段血尿酸水平和HUA检出率。结果男性健康体检者平均血尿酸水平为(373.41±80.20)μmol/L,女性为(256.77±59.33)μmol/L,各年龄组男性血尿酸水平显著高于同龄组女性(P<0.05);HUA检出率男性为21.51%,女性为5.42%。除>56岁年龄组外,各年龄组HUA检出率男性均高于女性(P<0.05)。结论长春西部城区血尿酸水平男性高于女性,且男性HUA检出率显著高于女性,总体上看,男女HUA检出率的差异随着年龄增长有缩小趋势,在56岁之后男女HUA检出率几乎相当,男性尤其是45岁以下青中年男性及56岁以上的女性是本地区HUA的重点防治人群。     

健康体检中高脂血症发病情况与健康管理模式探讨

目的本文通过对我院2009年度健康体检人群中高脂血症的发病情况及伴发疾病的相关性研究,探讨了我院高脂血症人群健康管理的干预模式。方法在我院2009年度健康体检者中随机抽取5999例,使用横断面调查的方法对不同性别、年龄段高血脂分类检出率以及与体重指数（BMI）、血压、血糖的发病情况进行相关性研究。结果共5706例资料齐全者进入调查,检出高脂血症1633人,患病率为28.62%,男性患病率为33.14%,女性患病率为17.58%。年龄分布以50～69岁为主。男性组30岁起、女性组50岁起高脂血症检出率明显升高,男性高脂血症患病率除70岁以上年龄组外均高于女性,除60岁以上年龄组外差异均有统计学意义（P〈0.05）。BMI、空腹血糖、舒张压、性别、年龄与高脂血症的发生密切相关。结论健康体检中高脂血症与高BMI、高血压、高血糖的发生密切相关。采用中西医结合的健康管理模式,除了控制体质量外,还应同时对高血压、高血糖等进行综合干预以预防心脑血管疾病的发生。     

非寄生性肝囊肿的超声研究

目的对广州白云机场地勤人员进行非寄生性肝囊肿情况调查,探讨其检出率与年龄、性别的关系.方法对各年龄组人群共1 206人的肝脏行常规超声检查.结果非寄生性肝囊肿的检出率为7.88%.结论 40岁以上年龄组非寄生性肝囊肿检出率明显增高;50岁以上年龄组,男性检出率高于女性.     

经电子肠镜检查大肠病变的临床分析

目的探讨电子肠镜检查大肠病变的发生分布情况,为合理使用肠镜检查手段提供临床依据。方法回顾性分析我院2003年1月至2009年5月收治的1233例电子肠镜检查患者,其中检测出大肠疾病患者488例,并对发病年龄、性别、主要病变等差异进行统计。结果本组经肠镜检查的488例大肠疾病患者中老年组结肠癌的检出率均明显高于中年组和青年组。结肠癌和结肠息肉的检出率随年龄增长而逐渐增加。男性大肠患病率高于女性。结论电子肠镜对大肠病变的诊断有重要意义,有助于提高结肠癌和结肠息肉早期防治,从而提高了患者生活质量。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.