北京市1994～1998年梅毒流行病学分析

通过５年来北京市梅毒流行特性的分析，探讨导致梅毒发病大幅增加的因素，为今后的防治工作提供参考依据，方法收集近５年来北京市梅毒毒疫情资料进行分析。结果５年来北京市梅毒的发病率呈大幅度上升趋势，年平均增长速度高达３８７．６８％，年平均发病专率３．８１／１０万。     

综合疗法治疗淋菌性和非淋菌性宫颈炎合并盆腔炎42例

目的：研究淋菌性和非淋菌性宫颈炎合并盆腔炎的有效治疗方法。方法：对42例确诊为淋菌性、非淋菌性宫颈炎合并盆腔炎患者，采用氧氟沙星、替硝唑和阿奇霉素治疗，配合局部应用VLH－D多功能盆腔治疗仪治疗。观察治疗前后患者症状、体征及病原体的检测。结果：总有效率88．1％。结论：氧氟沙星、替硝唑、阿奇霉素联合应用可有效清除病原体；配以盆腔治疗仪治疗，可有效提高药物在盆腔的有效浓度，消除局部症状，改变阳性体征。     

云南省两地抗病毒治疗门诊注射吸毒HIV感染者入组美沙酮维持治疗的影响因素分析

目的 了解云南省两地抗病毒治疗(ART)门诊注射吸毒HIV感染者的基本特征并分析其入组美沙酮维持治疗(MMT)的影响因素。方法 将云南省两地艾滋病疫情数据库进行关联,在ART门诊筛选出由注射吸毒感染HIV的人群作为研究对象,分成两组,一组是正在参加MMT,另一组是从未入组MMT。提取这些研究对象的一般人口学特征、相关疾病史、高危行为等信息。对研究对象的基本信息进行描述,运用单因素和多因素非条件logistic回归模型分析其影响因素。 结果 635例研究对象中,247例(38.9%)正在参加MMT,388例(61.1%)从未入组MMT;男性536例(84.4%),女性99例(15.6%);年龄M=40.33岁;确证感染HIV时间的M=6.08年。多因素分析结果显示,女性(OR=2.40,95%CI:1.00～5.74)、初中文化程度(OR=3.28,95%CI:1.75～6.14)和高中及以上文化程度(OR=7.10,95%CI:1.90～26.62)、确证感染时间≥6年(OR=3.84,95%CI:2.11～6.98)、患有丙型肝炎(OR=6.21,95%CI:3.06～12.58)是入组MMT的促进因素;已婚(OR=0.38,95%CI:0.20～0.72)、有职业(OR=0.01,95%CI:0.00～0.02)是入组MMT的限制因素。结论 两地ART门诊的注射吸毒人群入组MMT的比例不高,为加强这类人群转介入组MMT,需要对具有不同特征的患者采取有针对性干预措施。     

Neoadjuvant chemotherapy in operable breast cancer

Primary chemotherapy in localised breast cancer may prevent tumour spread during surgical treatment and reduce proliferation of micrometastases. A randomised clinical trial, in 196 premenopausal and postmenopausal patients with operable (T2-3, N0-1b) breast cancer, was started in November 1983 at the Institut Curie to compare neoadjuvant and adjuvant regimens of chemotherapy with radiotherapy with or without surgery. The patients have been followed up for 35–70 months (median 54). A neoadjuvant group received two monthly cycles of intravenous doxorubicin/cyclophosphamide/5-fluorouracil before locoregional therapy and four cycles subsequently. Six months cycles following locoregional therapy were administered to the adjuvant group. Because of inclusion of postmenopausal and/or node-negative patients, compliance was less than optimal in 39 patients who were analysed separately according to actual dose received. Tumour response, evaluated after two cycles of neoadjuvant chemotherapy, was significantly associated with dose (P = 0.003). Survival showed a slight non-significant advantage for the neoadjuvant group. Survival plotted by actual dose was also similar. Neoadjuvant chemotherapy was safe and at least as effective as the adjuvant regimen. Patients have been accrued to a subsequent larger trial of chemotherapy as first-line treatment.