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1.
Surgical therapy for ulcerative colitis(UC) depends on the medical therapy administered for the patient’s condition. UC is a benign disease. However, it has been reported that the rare cases of cancer in UC patients are increasing, and such cases have a worse prognosis. Recently, surgical therapy has greatly changed, there has been quite an increase in the number of UC patients with high-grade dysplasia and/or cancer. These lesions are known as colitis-associated cancer(CAC). The relationship between inflammation and tumorigenesis is well-established, and in the last decade, a great deal of supporting evidence has been obtained from genetic, pharmacological, and epidemiological studies. Inflammatory bowel disease, especially UC, is an important risk factor for the development of colon cancer. We should determine the risk factors for UC patients with cancer based on a large body of data, and we should attempt to prevent the increase in the number of such patients using these newly identified risk factors in the near future. Actively introducing the surgical treatment in addition to medical treatment should be considered. Several physicians should analyze UC from their unique perspectives in order to establish new clinically relevant diagnostic and treatment methods in the future. This article discusses CAC, including its etiology, mechanism, diagnosis, and treatment in UC patients.  相似文献   

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Objective:To investigate the status of diagnosis and treatment of primary breast cancer in Beijing,2008.Methods:All the patients who were diagnosed as primary breast cancer in Beijing in 2008 were enrolled in this study.Information of these patients,including the features of tumors,clinical diagnosis and treatment was collected,and filled in the well-designed questionnaire forms by trained surveyors.The missing data were partly complemented through telephone interviews.Results:A total of 3473 Beijing cit...  相似文献   

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《癌症》2017,(11):548-559
Background: Esophageal cancer is associated with substantial disease burden in China, and data on the economic burden are fundamental for setting priorities in cancer interventions. The medical expenditure for the diagnosis and treatment of esophageal cancer in China has not been fully quantified. This study aimed to examine the medical expenditure of Chinese patients with esophageal cancer and the associated trends. Methods: From 2012 to 2014, a hospital-based multicenter retrospective survey was conducted in 37 hospitals in 13 provinces/municipalities across China as a part of the Cancer Screening Program of Urban China. For each esophageal cancer patient diagnosed between 2002 and 2011, clinical information and expense data were extracted by using structured questionnaires. All expense data were reported in Chinese Yuan (CNY; 1 CNY= 0.155 USD) based on the 2011 value and inflated using the year-specific health care consumer price index for China. Results: A total of 14,967 esophageal cancer patients were included in the analysis. It was estimated that the overall average expenditure per patient was 38,666 CNY, and an average annual increase of 6.27% was observed from 2002 (25,111 CNY) to 2011 (46,124 CNY). The average expenditures were 34,460 CNY for stage Ⅰ, 39,302 CNY for stage Ⅱ, 40,353 CNY for stage Ⅲ, and 37,432 CNY for stage IV diseases (P < 0.01). The expenditure also differed by the therapy type, which was 38,492 CNY for surgery, 27,933 CNY for radiotherapy, and 27,805 CNY for chemotherapy (P < 0.05). Drugs contributed to 45.02% of the overall expenditure. Conclusions: These conservative estimates suggested that medical expenditures for esophageal cancer in China substantially increased in the last 10 years, treatment for early-stage esophageal cancer costs less than that for advanced cases, and spending on drugs continued to account for a considerable proportion of the overall expenditure.  相似文献   

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Digestive endoscopy is currently the main diagnostic procedure for investigation of the digestive tract when a digestive disease is suspected.The use of computers and electronic medical records for the management of endoscopic data are an important key to improving endoscopy unit efficiency and productivity.This technology supports optimal program operation,monitoring and evaluation colorectal cancer screening.This article is a comprehensive survey of endoscopic electronic medical records and information systems.Computerized clinical records have the capability of identifying patients due for screening and to calculate baseline rates of colorectal cancer screening by patient characteristics and by primary care physician and practice group.This paper describes data flow in the endoscopy unit,the minimum data set of colorectal cancer and key features of endoscopic electronic medical record.In addition,the researchers state standards in different aspects,especially terminology standards and interoperability standards for image and text.  相似文献   

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There are notable differences in the incidence and mortality rates for prostate cancer between Asia and Western countries. It is also recognized that there are differences in thinking with regard to treatment options. Recently it is also the case that opinions have been reported concerning the differences between Asian and Western patients with regard to their reaction to androgen depletion therapy (ADT). Given that ADT is a method of treatment that focuses on the elimination of testosterone, an inevitable symptom of its administration is testosterone losing syndrome. It is for this reason that in Western countries ADT has only been recommended in cases of advanced or metastatic cancer. On the other hand, in Asia, ADT is used in relatively many cases, including non-metastatic localized cancer and invasive localized cancer. To date, however, there has been little substantive discussion concerning this difference in utilization ofADT. ADT-related drugs for prostate cancer and the development of new drugs for castration resistant prostate cancer (CRPC) have been actively tested in recent years. It could be the case that analyzing the differences in concepts about ADT between Asia and the West could contribute to the effective use of ADT-related drugs and also help to build new treatment strategies for prostate cancer.  相似文献   

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Objective: Although a new matrix formulation fentanyl has been used throughout the world for cancer pain management, few data about its efficacy and clinical outcomes associated with its use in Chinese patients have been obtained. This study aimed to assess the efficacy and safety of the new system in Chinese patients with moderate to severe cancer pain. Methods: A total of 474 patients with moderate to severe cancer pain were enrolled in this study and were treated with the new transdermal fentanyl matrix...  相似文献   

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Objective: To evaluate the analgesic efficacy as well as adverse effects of OxyContin for the treatment of moderate to severe cancer pain. Methods: OxyContin was administered at an initial dose of 10 mg every 12 h and titrated upwards according to the extent of pain relief. The analgesic effect, Karnofsky performance status (KPS) scale as well as adverse effects were investigated. Results: The mean onset time and duration of analgesic effect was 41 min and 12.6 h, respectively, with the daily average dose of 69.03 mg. Among all the 31 patients who had suffered moderate to severe pain, slight pain relief was achieved in one patient (3.23 %). Moderate, obvious and complete pain relief were achieved in 4 (12.90 %), 20 (64.52 %) and 6 (19.53%), respectively. KPS was elevated in 19 (61.29%) and stable in 9 (29.03%) patients after administration of OxyContin. 3 (9.68%) patients were died of disease deterioration. Main adverse effect was constipation in 10 cases (32.26%). Conclusion: OxyContin was effective in the treatment of moderate to severe cancer pain, with rapid onset, good analgesic performance, mild adverse effect and safety profile.  相似文献   

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Heʼnan Medical Team has stationed in Lin county(now Linzhou City) of Heʼnan Province for 60 years since November 1959 to carry out prevention and treatment research on high incidence of esophageal cancer. In the past 60 years, three generations of medical experts in Heʼnan Province have made a series of remarkable scientific research achievements in the molecular mechanism and early detection of esophageal cancer, intervention and prevention methods of precancerous lesions, and benefited thousands of patients. Based on the 34-year research of esophageal cancer prevention and treatment in our research group, this paper focuses on the understanding and thinking about the epidemic characteristics, key scientific issues and important research directions of esophageal cancer in China, so as to provide a reference for the prevention and treatment of esophageal cancer. © 2020, CHINA RESEARCH ON PREVENTION AND TREATMENT. All rights reserved.  相似文献   

9.
Breast cancer is defined as a chronic disease. Increasing amounts of attention have been paid to the health management of breast cancer survivors. An important issue is how to find the most appropriate method of follow-up in order to detect long-term complications of treatment, local recurrence and distant metastasis and to administer appropriate treatment to the survivors with recurrence in a timely fashion. Different oncology organizations have published guidelines for following up breast cancer survivors. However, there are few articles on this issue in China. Using the published follow-up guidelines, we analyzed their main limitations and discussed the content, follow-up interval and economic benefits of following up breast cancer survivors in an effort to provide suggestions to physicians. Based on a large number of clinical trials, we discussed the role of physical examination, mammography, liver echograph, chest radiography, bone scan and so on. We evaluated the effects of the above factors on detection of distant disease, survival time, improvement in quality of life and time to diagnosis of recurrence. The results of follow-up carried out by oncologists and primary health care physicians were compared. We also analyzed the correlation factors for the cost of such follow-up. It appears that follow-up for breast cancer survivors can be carried out effectively by trained primary health care physicians. If anything unusual arises, the patients should be transferred to specialists.  相似文献   

10.
The overall survival of patients with cervical cancer has improved due to detection at an early stage and availability of comprehensive treatments in China. As patients' lives prolonged, it is important to understand their healthrelated quality of life (QoL) during and after treatment. We used the EQ-5D questionnaire to assess QoL of 194 patients with cervical lesions at Sichuan University West China Second Hospital between May 2010 and January 2011. Patients were surveyed before primary treatment and at 1, 3, and 6 months after primary treatment. Results showed a consistent decline in EQ-5D scores in the spectrum of cervical lesions at each time point after treatment (all P 〈 0.05). For patients with precursor lesions, there was an increasing trend along the timeline of treatment (P 〈 0.01). For patients with earlystage cervical cancer, EQ-5D scores declined in the first month (P = 0.01) and gradually increased to higher levels at 6 months posttreatment than those before treatment (P 〈 0.01). EQ-5D scores followed a similar trend in patients with advanced cervical cancer (P = 0.04), though they did not statistically rebound after 6 months (0.84±0.19 vs. 0.86±0.11, P = 0.62). Regarding advanced cervical cancer, EQ-5D scores for women above 40 years of age appeared to recover more rapidly and reached higher levels than those for women below 40 years (P = 0.03). Caution and extra care are recommended in the early period of cervical cancer treatment given the slight deterioration in the QoL, and in particular, for younger cervical cancer patients. Our study implies that health care providers may need to improve the health-related QoL of cervical cancer patients.  相似文献   

11.
胡青  邱红  梅妮  冉凤鸣  臧爱华 《肿瘤防治研究》2010,37(12):1433-1435
 目的 探讨肿瘤专科医院患者对癌症疼痛知识认知程度和医务人员对癌症疼痛治疗的态度,以及患者回归社区医院后,社区医务人员对癌症疼痛治疗的认识,药品提供的方便程度。方法 采用自行设计的《疼痛调查问卷》,从2009年3月9日—4月9日对130名湖北省肿瘤医院内科住院患者进行问卷调查, 并对回收的120份调查表进行分析。结果 接受调查的肿瘤患者伴有疼痛的占43.3%。调查者接受的止痛治疗方式有药物止痛(59.6%)、理疗(26.9%)和放化疗(13.5%)。规律用药的只占34.6%。通过止痛治疗缓解程度达70%以上的占38.5%,25%的患者缓解程度不足50%。86.5%的调查者认为社区医院不能提供满意治疗。结论 癌症疼痛的止痛治疗尚不能达到控制疼痛的目标,应加强社区医院医务人员关于癌症疼痛规范化治疗的认识,推广WHO三阶梯止痛治疗原则可以使基层医院、社区医院癌症疼痛治疗效果得到改善。  相似文献   

12.
BACKGROUND: Pain is one of the most frequent and deleterious symptoms in cancer patients. This study was carried out to investigate the adequacy of pain management at the National Cancer Center Hospital East, Japan. METHODS: The available data were obtained from 138 ambulatory cancer patients with pain. The data included pain severity, which patients reported using the Japanese version of the M. D. Anderson Symptom Inventory, along with such medical information as cancer and treatment information and currently prescribed analgesics. Adequacy of pain management was assessed using the Pain Management Index, which revealed whether prescribed analgesic drugs were congruent with pain severity. RESULTS: Physicians undertreated pain in 70% of patients. Patients with non-advanced cancer (local cancer or no evidence of any recurrent cancer) were more likely to receive inadequate treatment than those with advanced cancer [P = 0.009, odds ratio = 0.18, Exp (95% CI) lower = 0.05, higher = 0.64] in the exploratory logistic regression analysis. Additionally, we found significant differences among physicians in ability to manage cancer pain, unrelated to a physician's years of experience as an oncologist. CONCLUSIONS: This study suggests that cancer pain management is insufficient at the investigated institute. Remedial action should be taken, including increasing awareness of symptom management in medical staff and incorporating existing knowledge into routine clinical practice.  相似文献   

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The principles of cancer pain management are well established, but evidence suggests that these are not incorporated into daily practice and patients are still in pain. Deficiencies in knowledge and inappropriate attitudes towards the use of opioids may partially explain why the management of cancer pain is still such a widespread problem. This study assessed the knowledge and attitudes of 135 nursing and medical staff working in a surgical unit, before and after working with a newly established Hospital Palliative Care Team. The baseline survey highlighted the existence of a number of myths and misconceptions in relation to opioid use. Results of the follow-up survey indicated that the knowledge and attitudes of doctors and nurses had improved after working with the team, but that this probably occurred as a result of good working relationships and case discussions rather than through formal teaching. The study provided a useful method of identifying deficiencies in knowledge and attitude among staff, and helped to raise awareness of the problem of cancer pain management. Our challenge now is to work with staff to ensure that positive changes in knowledge and attitudes are translated into the everyday practice of hospital nurses and doctors caring for patients with cancer.  相似文献   

17.
  目的   了解我国西南地区基层医务人员的癌痛认知状况,为提高基层癌痛控制水平提供依据。   方法   选择我国西南地区四川省宜宾市宜宾县横江镇及所辖部分村级医务人员,进行集中式癌痛问卷调查并进行癌痛知识宣教。   结果   横江镇医务人员认为仅有17%(8/46)的癌痛患者得到治疗;70%(32/46)医务人员不注重对患者进行癌痛治疗宣教;64%(40/46)医务人员对规范癌痛控制知识不了解;87%(40/46)医务人员认为麻醉止痛药不能满足患者需要;70%(32/46)的医务人员要求增加癌痛培训次数。   结论   横江镇医务人员癌痛认知状况较差,需要更多适应基层的癌痛知识培训,建议将癌痛控制纳入社区慢性病肿瘤的具体管理之中。   相似文献   

18.
目的:调查上海市医师对癌症疼痛的认识和治疗现状.方法:2007年1-3月对上海市106所二、三级医院1 982名医师进行癌痛治疗知识及治疗情况的问卷调查并进行统计学分析.结果:对"三阶梯止痛"治疗方案,52.3%的医师表示非常了解,比1999年上升了21.6个百分点,肿瘤科医师的了解程度明显好于非肿瘤科医师; 16.8%的医师对镇痛治疗剂量滴定的3个主要原则回答完全正确,肿瘤科医师回答的正确率高于非肿瘤科医师;强阿片类药物成为医师治疗重度癌痛的首选药物,应用杜冷丁治疗重度癌痛的比率下降;74.8%的患者通过治疗能使疼痛明显减轻,比1999年上升了25.4个百分点;81.1%的医师肯定疼痛治疗效果,肿瘤科医师对治疗效果更为乐观; 93.3%的医师认为有必要继续开展癌痛治疗知识的培训,其中非肿瘤科医师的需求更高.医院和政策法规限制过严是目前使用止痛药物的主要障碍.结论:医师对癌痛的认识和诊治水平较1999年有较大提高,但仍需进一步开展癌痛治疗知识的培训,推广规范性治疗并消除止痛药物的用药障碍.  相似文献   

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PURPOSE: A cross-sectional study was performed to evaluate the prevalence of pain in our radiotherapy (RT) department. The impact of RT practice on pain and pain management were analyzed. METHODS AND MATERIALS: Of 126 patients, 93 (73.8%) completed the questionnaire proposed in this survey. It was designed to assess the proportion of patients experiencing pain in the department, the impact of RT practice on pain, and patients' estimate of the quality of management of their pain by the medical staff. Pain intensity and patient satisfaction were assessed using an 11-point numeric rating scale. RESULTS: Of the 93 patients, 66 experienced pain during RT, 13 of whom were totally relieved by analgesic treatment. The mean pain intensity was 3.9 (SD 2.3). A total of 26 patients had a numeric rating >/=4, indicating that their pain was not sufficiently treated. The objective length of waiting time for a session, transportation, and mobilization for session positioning worsened the pain of a substantial proportion of patients. A total of 56% of patients had a favorable opinion about pain management in our department. A high percentage (72.2%) of patients found that the time spent by the medical staff for pain management was inadequate, and 54.5% believed that the psychological support they received was insufficient. Personnel in the RT department remained the primary source of information regarding pain control. However, 17.5% of patients did not report their pain or talked about it to non-health care professionals. CONCLUSION: The prevalence of pain was high in the department. The specific practice of RT worsened pain and nearly one-half of patients were not satisfied with its management. The necessity for medical staff to be more available was highlighted by patients.  相似文献   

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