一起流行性脑脊髓膜炎暴发疫情的流行病学调查

目的通过对新疆莎车县一起流行性脑脊髓膜炎（流脑）疫情的流行病学调查,分析流脑流行原因,以便采取措施,控制疫情。方法采用现况调查的方法研究该次流脑疫情分布特点和流行原因。结果该次暴发疫情的发病率为3.36/10万,死亡率为0.28/10万,病死率为8.33%。结论该次疫情是由于长年未接种流脑疫苗而引起的一起以县城为中心的A群流脑暴发疫情。     

Human papillomavirus type-distribution in cervical cancer in China: the importance of HPV 16 and 18

Prophylactic vaccination against HPV 16 and 18 has the potential for effective prevention of high-grade precancer (cervical intraepithelial neoplasia [CIN)] 2/3) and ICC caused by these viruses (globally 50 and 70%, respectively) when employed in women prior to starting sexual activity. To provide data for decisions on HPV vaccination in China, we determined HPV type-distribution in ICC and CIN 2/3 from women of different regions within China. A multicenter study was conducted by randomized sampling of paraffin blocks of 664 ICC (630 squamous cell carcinoma [SCC]; 34 adenocarcinoma [ADC]), 569 CIN 2/3 cases from seven regions of China. Histological diagnosis was confirmed in 1,233 cases by consensus review. HPV DNA was detected using the SPF10 LiPA25 version 1 assay. HPV prevalence was 97.6% in SCC, 85.3% in adenocarcinoma, and 98.9% in CIN 2/3. HPV 16 (76.7%) and HPV 18 (7.8%) were the most common, together accounting for 84.5% of SCC, followed by HPV 31 (3.2%), HPV 52 (2.2%), and HPV 58 (2.2%). HPV positivity in SCC did not differ notably by region. However, SCC cases from women ≤34 years had higher HPV 16 positivity than women over 50 years, among whom HPV 52, 58, and 39 were more common. HPV 16 and 18 were under-represented, whereas HPV 31, 52, and 58 were over-represented in CIN2/3 compared to SCC. The potential impact of vaccines against oncogenic HPV types 16 and 18 is estimated to be high (84.5%) against total SCC. These data are critical for China’s future evaluation of the cost-effectiveness of current cervical cancer vaccines and of HPV-based screening guidelines.     

门诊预约服务体系的建立及效果评价

目的研究某三级甲等医院预约诊疗服务体系,为优化预约就诊流程和服务内容提供依据。方法统计2010年1月-2012年12月通过电话预约、现场预约、诊间预约、网络预约和118114电话预约的患者人数,并对预约就诊人数及患者满意度进行对比分析。结果 2010年1月-2012年12月门诊就诊人数平均增长23.61%,预约率平均增长93.49%,患者满意度较2009年增长8.2%,差异具有统计学意义(P<0.05)。结论建立门诊预约诊疗体系对优化门诊就诊流程、提高门诊工作效率、缩短患者非医疗等候时间发挥重要作用。门诊预约服务的发展依赖于医患双方行为的转变,形成良性就医行为。     

Prohibitin in squamous cell carcinoma of the lung: its expression and possible clinical significance

rohibitin is localized to mitochondria where it might have a role in the maintenance of mitochondrial function and protection against senescence. In this study, we show that prohibitin is up-regulated in lung squamous cell carcinoma tissues compared with adjacent normal tissues using agarose 2-dimensional differential gel electrophoresis and immunoblotting. Prohibitin expression was further evaluated by immunohistochemistry. We statistically analyzed the association of prohibitin expression with clinicopathologic indicators in 78 patients with lung squamous cell carcinoma. Our data suggested that prohibitin expression was positively correlated with the International Union Against Cancer (UICC) classification of tumor grade (P < .001), pathologic stage (P < .001), tumor size (P = .01), and lymph node metastasis (P = .004). Furthermore, we found that prohibitin expression was an independent prognostic indicator (P = .037) for overall survival of patients with lung squamous cell carcinoma by multivariate analysis using the Cox regression method. These findings may encourage further studies investigating prohibitin function in lung squamous cell carcinoma.     

人乳头状瘤病毒L1蛋白与宫颈病变相关性研究进展

人乳头状瘤病毒(HPV)被认为是宫颈癌发生的必要因素,宫颈癌发展期间对宫颈上皮内瘤变早诊断、早治疗可以有效阻止病变进程.HPV L1蛋白具有与宿主细胞识别并黏附的抗原表位,在HPV感染及引发官颈癌变过程中发挥重要作用.     

第二代杂交捕获法检测高危型人乳头瘤病毒的临床应用价值

目的 评价第二代杂交捕获(HC2)法检测高危型人乳头瘤病毒(HR-HPV)载量的临床应用价值.方法 2009年8月1日至2010年5月31日对就诊于新疆维吾尔自治区人民医院的2851例门诊或住院患者,接受HC2法检测HR-DNA,联合或未联合液基细胞学检查.二者中有任何一项阳性则行阴道镜检查并或活组织检查.结果 组织病理学诊断为慢性宫颈炎648例,CIN Ⅰ 150例,CINⅡ43例,CINⅢ64例,宫颈癌119例,炎症及阴性2475例,不同级别宫颈病变中HR-DNA阳性率为:炎症及阴性17.7％ (438/2475),CINⅠ 84.0％ (126/150), CINⅡ76.7％( 33/43), CINⅢ 81.3％(52/64),宫颈癌90.8％ (108/119),P＜0.05.HC2检测的HR-DNA病毒负荷载量在不同级别宫颈病变中分别为:慢性宫颈炎(223.60±476.55),CIN Ⅰ (448.38±758.86),CINⅡ(890.41±1036.29),CINⅢ(608.36±683.98),宫颈癌(1047.84±1008.43),P＜0.05.结论 病毒负荷量与宫颈癌前病变程度无关,但是病毒载量越高,宫颈病变程度越严重的可能性越大.HC2检测在宫颈癌前病变的筛查、管理和治疗后随访过程中有重要意义.     

240例实习护生锐器伤及低上报率原因分析

目的了解实习护生对锐器伤知识的掌握及影响上报率的因素,为护生防护措施提供依据。方法对240例在我院实习的护生进行有关标准预防知识及行为等方面的问卷调查。结果240例实习生中发生锐器伤167人（69．5％）,未上报人数为127人（76％）,被污染针头刺伤为90人（53．8％）。结论实习护生防护措施不容乐观,尤其是受伤后的处理及上报制度不完善,医院和有关部门应采取切实可行的措施改善实习护生目前现状及条件,提高上报率,防止职业暴露的危害。     

Adeno-associated virus-mediated local delivery of LIGHT suppresses tumorigenesis in a murine cervical cancer model

LIGHT is a tumor necrosis factor superfamily ligand that is considered as a promising candidate for cancer therapy. It has a potent antitumor activity through establishing lymphoid-like tissues inside tumor sites and recruiting naive T cells into the tumor. In this study, we examined the possibility of antitumor activity by expressing LIGHT in cervical cancer (CC) model. A recombinant adeno-associated virus (AAV) vector was chosen for the transfer, based on its transfection efficiency and lack of detectable pathology. In vitro transfer of recombinant AAV vector expressing LIGHT (AAV-LIGHT) stimulated T-lymphocyte proliferation and activation. AAV-mediated gene transfer of LIGHT by intratumoral injection exerted a very potent antitumor effect against preexisting TC-1 cell CC in C57BL/6 mice. This study confirmed that AAV-LIGHT regressed tumor growth by activating cytotoxic T lymphocyte, enhancing infiltration of inflammatory cells in tumor and increasing stimulatory cytokine expression in tumor microenvironment. Therefore, AAV-LIGHT therapy might have potential utility for the treatment of CC.     

阴道镜检查698例分析

目的: 通过阴道镜检查早期发现宫颈上皮内瘤样病变,阻断向宫颈癌的发展途径,预防宫颈癌的发生.方法: 经阴道镜检查拟为宫颈癌前病变(CIN)的698例患者进行多点取宫颈组织进行病理检查.结果: 病理结果正常415例,宫颈炎181例;湿疣3例;CINⅠ53例;CINⅡ～CINⅢ 34例;宫颈癌12例.结论: 将阴道镜检查作为宫颈病变的筛查手段,有利于早期发现宫颈上皮内瘤样病变及宫颈癌.     

腮腺病变的CT诊断

目的探讨腮腺良、恶性病变的CT特点。方法回顾性分析52例经手术病理及临床证实的腮腺病变的CT表现,其中良性肿瘤29例,恶性肿瘤13例,结核4例,慢性腮腺炎6例。结果52例中,48例表现为腮腺内或腮腺区肿块,良性肿瘤形态规则,边界清楚,占82.8%(24/29);恶性肿瘤形态不规则,边界模糊不清,占76.9%(10/13);腮腺结核表现为密度不均、边界较模糊的结节或肿物,并有结节样钙化和腮腺周围淋巴结肿大,病灶及肿大淋巴结均呈环形强化;4例弥漫性炎症表现为一侧或双侧腮腺弥漫性肿大,密度增高;2例为局限炎症,呈形态不规则肿块状,边界不清。结论CT扫描对腮腺病变定位敏感性为100%,对各类腮腺病变的定性诊断有重要价值,增强扫描可提高其定性诊断率。