A comparison of nine systems to diagnose schizophrenia

The files of 283 hospitalized patients discharged with a diagnosis of schizophrenia, schizoaffective schizophrenia, or paranoid state were examined without knowledge of the patient's subsequent history. These patients, most of whom had originally been diagnosed by DSM-I criteria, were retrospectively diagnosed by New York Research Diagnostic Criteria (RDC), the New Haven Schizophrenia Index (NHSI), the St. Louis criteria, Taylor-Abrams 1978 criteria, Schneider's first-rank symptoms (FRS), the Washington IPSS 12-Point Flexible System, Astrup's process/nonprocess distinction, and DSM-III. Kappa values measuring pairwise diagnostic agreement among the nine systems were typically low except among RDC, DSM-III, and St. Louis criteria. Long-term followup status was not significantly predicted by the FRS, NHSI, or Taylor-Abrams criteria. Diagnosis by means of the other systems, especially the Astrup process/ nonprocess distinction, was significantly correlated with followup. However, Astrup's “process” schizophrenia is not operationally defined and could not be expected to be used with the degree of interrater reliability desired by researchers. On the other hand, of the operationally defined systems, DSM-III schizophrenia has the highest correlation with followup and is thus suggested for use by researchers desiring a highly homogenous, although narrowly defined, population. Investigators wishing to cast a wider net could use a less restrictive system such as the RDC, with or without schizoaffectives included.     

Mechanisms of improved survival from intensive followup in colorectal cancer: a hypothesis

A meta-analysis of six randomised trials demonstrated that intensive followup in colorectal cancer was associated with an absolute reduction in all-cause 5-year mortality of 10% (95% confidence interval (CI): 4-16)--however, only two percent (95% CI: 0-5) was attributable to cure from salvage re-operations. We postulate that other factors, such as increased psychological well-being and/or altered lifestyle, and/or improved treatment of coincidental disease may contribute to the remaining lives saved, and form important future research questions.     

切缘大小对早期肾癌保肾手术远期临床效果的影响

 目的比较不同切缘保肾手术患者远期临床效果,探讨小切缘保肾手术治疗早期肾癌的安全性及有效性。方法回顾分析325 例对侧肾脏正常T1a期肾癌保肾手术,依切缘大小分为≤5 mm 组125 例,5~10 mm组102 例及跃10 mm组98 例。病理评估切缘状态并随访远期疗效。结果全部病例切缘病理均阴性,3 组切缘大小平均为,≤5 mm 组2.2 mm,5~10 mm 组6.7mm,>10 mm组11.8 mm,差异有统计学意义（ P<0.05）。平均随访79 个月（15~132 个月）,≤5 mm 组1 例出现同侧肾脏异位复发（0.74%）,5~10 mm组1 例出现原位局部复发（0.98%）,2 者经肾癌根治术治愈并存活至今。>10 mm 组无局部复发（0%）。各组复发率差异无统计学意义（跃0.05）。3 组患者均无远处转移及癌特异性死亡发生。Kaplan-Meier 生存分析5年总体生存率为≤5 mm 组99.2%,5~10 mm组99.0%,跃10 mm 组98.0%（ P>0.05）。结论不同切缘大小保肾手术远期临床效果相当,而小切缘保肾手术难度降低,并发症减少,且有利于保留更多的功能性肾单位,是早期肾癌有效的治疗手段。     

广东省消除疟疾行动计划中期评估报告

广东省地处亚热带,历史上是我国疟疾流行最严重的省份之一。据20世纪50年代调查,全省51.83%人口居住高疟区和中疟区,居民带虫率为14.83%。经过几十年综合防治,1972年广东省大陆地区消灭了恶性疟。2010年下半年开始,广东省全面开展消除疟疾工作,2010—2015年全省共完成了疟疾防治人员培训86 071人次,其中培训临床医生325 545人次,检验人员31 776人次;县级和乡镇级疟防人员、临床医生、镜检人员及乡村医生接受疟疾诊治培训及镜检知识培训的比例均达到95%以上。2010—2015年7月31日,全省共报告疟疾病例共773例,全为输入性。其中恶性疟478例、间日疟206例、卵形疟21例、三日疟4例、诺氏疟原虫1例、混合2例,未分型61例。死亡疟疾病例共5例。5年来全省利用各种方式开展疟疾健康教育,共发放各种宣传资料9 557 693份,有效地提高了全省人民的疟防意识,真正做到了"消除疟疾,全民参与"。全省取得的成绩主要有:2010—2015年疟疾病例实验室检测确诊率达到100%;疟疾病例诊断后24 h内报告率达到100%;疟疾病例规范治疗率达到100%;报告疟疾病例中3 d内开展流行病学调查的比例达到100%;报告疟疾病例中7 d内开展疫点处置的比例达到100%。     

河北省消除疟疾行动计划中期评估报告

上世纪建国初期,河北省疟疾年发病率在19.88/10万~74.51/10万之间,60年代和70年代曾有两次疟疾暴发,发病率分别高达368.38/10万和493.39/10万,病例主要集中在河北南部的部分地区。经过三十多年有组织大规模的抗疟行动,疟疾疫情逐渐得到有效控制,1987年后,全省疟疾病例报告数基本在几例至几十例之间。自2010年《中国消除疟疾行动计划(2010—2020年)》实施以来,认真落实各项措施,完成各项工作指标,达到消除疟疾目标要求。按照行动计划分类要求,当时全省172个县(市、区)全部为三类县,到2015年实现消除疟疾的目标。《行动计划》实施以来,累计报告全省疟疾病例273例,经证实全部为境外输入疟疾病例,未发生本地感染疟疾病例,于2014年各设区市卫生计生委(卫生局)组织完成对所辖县(市、区)消除疟疾县级考核,2015年省卫生计生委组织完成对所辖设区市的消除疟疾市级评估。在《行动计划》实施中,河北省成安县和任县消除疟疾国家试点县工作的成功经验,对推动消除疟疾工作意义重大,引领全省消除疟疾工作不断深入推进,于2015年11月,通过国家卫计委和质检总局联合开展的消除疟疾行动计划中期评估。本文较全面地总结了《行动计划》实施以来河北省消除疟疾工作完成情况,分析了面临的困难和挑战,对今后输入性疟疾疫情监测有重要的指导意义。     

山东省消除疟疾行动计划中期评估报告

山东省属于单一疟疾流行区,间日疟流行于全省各地。在上世纪60年代和70年代初期发生两次疟疾暴发流行。1988年通过原卫生部考核率先在全国范围内达到了基本消灭疟疾的标准。1989年以来,疟疾疫情有所波动,但均不超过1/10万。2010年山东省启动消除疟疾工作,原省卫生厅下发消除疟疾工作实施方案,提出到2018年全省达到消除疟疾的目标。连续两年下发消除疟疾考核评估方案,目前已顺利完成82个县和2个市的消除疟疾考核评估工作。自启动消除疟疾工作以来,山东省认真实施中央补助地方公共卫生专项疟疾项目,圆满完成项目规定的各项任务。另外,省财政每年列出专项经费用于疟防工作。2010—2015年山东省疟疾防治经费累计投入5 092.49万元,从经费上保证了消除疟疾工作顺利实施。为满足消除疟疾工作需要,该省通过分级培训的方式开展了各种技术培训,累计培训各级镜检员15 494人次,临床医生56 382人次,疟疾防治人员34 624人次。全省基本建成较为完善的省、市、县、乡四级疟疾镜检网络系统,每年均按照指标要求开展血检工作,2010—2015年共血检发热病人1 774 321人,检出疟疾病人747例,检出率为0.42‰。严格按照"1-3-7"工作管理要求开展病例的管理和疫点调查处置工作,2010—2015年山东省共报告疟疾病例819例,开展疫点处置819个,有效避免了疫情扩散及二代病例的发生。为动员全社会共同关注和支持消除疟疾工作,广泛宣传疟疾危害和防治知识,全省各级疾控机构结合"4.26"全国疟疾宣传日,每年均开展大规模的宣传活动,2010—2015年山东省累计发放健教材料7 040 504份。山东省已连续三年无本地感染病例,但逐年增加的境外输入性疟疾病例为消除疟疾工作带来新的挑战。针对当前疟疾形势,山东省在继续做好消除疟疾工作的同时必须加强对输入性疟疾的监测和管理,确保全省如期实现消除疟疾目标。     

Effects of Artemisia monosperma ethanolic leaves extract on implantation,mid-term abortion and parturition of pregnant rats

Aim of the study

The herb, Artemisia monosperma, is a perennial fragrant plant which grows widely and wildly in the Arabian deserts. The leaves of the plant are taken in folk medicine by certain women of Jordan for abortion induction. The aim of this study was to asses the ethanolic leaves extract of the plant on the outcome of rat pregnancy.

Materials and methods

In this study, sub-lethal doses of ethanolic extract of the plant leaves were used to evaluate the effects of the extract on implantation, mid-term abortion and parturition.

Results

The intraperetoneal administration of 150 mg/kg or 300 mg/kg of the plant ethanolic extract on days 3–5 of gestation exhibited a decrease of viable fetus implantation and an increased in the number of adsorbing sites compared to control. Meanwhile, the administration of 50 mg/kg or 300 mg/kg of the ethanolic extract on days 10–12 of gestation exhibited dramatic mid-term abortion. Furthermore, the administration of 150 mg/kg or 300 mg/kg of the ethanolic extract on days 19–21 of gestation exhibited a delay of onset of delivery and failure of the spontaneous delivery of rat and also resulted in significant increase in serum oxytocin hormone level.

Conclusion

Since, Artemisia monosperma caused a drastic harm of the pregnancy outcomes of rat, as shown in this study, therefore, taking the leaves of the plant by pregnant women is not advisable.     

经皮激光椎间盘减压术治疗颈性眩晕的中期疗效观察

目的:观察分析经皮激光椎间盘减压术治疗颈性眩晕的中期临床疗效。方法:2002年9月至2006年12月收治35例颈性眩晕患者,男14例,女21例,年龄35～79岁,平均59.1岁。均使用Nd:YAG激光治疗机(波长1064nm)行经皮激光椎间盘减压术治疗,随访观察治疗效果。应用数字评分法(NRS)评价眩晕及伴随症状的改善情况,应用改良Macnab评价标准进行优良率和有效率的评估。结果:患者术中及术后均未见神经损伤、感染等并发症发生。随访24～66个月,平均41.8个月。末次随访时,35例患者的眩晕及伴随症状的平均NRS评分较术前明显下降(P0.01)。患者总体疗效依据改良MacNab评价标准,优18例,良7例,可5例,差5例,总体优良率为71.43%,总体有效率为85.71%。60岁组和≤60岁组患者比较,优良率分别为75.0%和68.4%,有效率分别为81.25%和89.47%,两组比较差异无统计学意义(P0.05);男性组和女性组患者比较,优良率分别为85.71%和61.90%,有效率分别为85.71%和85.71%,两组比较差异无统计学意义(P0.05)。结论:应用经皮激光椎间盘减压术治疗颈性眩晕创伤小,安全性高,中期疗效较满意,不同年龄组及不同性别组患者的中期临床疗效均无明显差异。