2008年山西省大骨节病病情调查

目的 调查山西省儿童及成人大骨节病的病情现状及消长趋势,评估防治效果,为调整防治策略提供科学依据.方法 2008年,按照<2007年度国家大骨节病防治项目技术方案>的要求,在山西省选取2个大骨节病历史重病区村作为儿童大骨节病病情调查点,对全部7～12岁儿童进行临床检查及右手X线拍片检查,X线片观察部位为掌指骨及腕关节;在山西省13个大骨节病病区县,选取50个村作为成人大骨节病病情调查点,对16岁及以上的常住人口进行大骨节病病情调查.大骨节病诊断按<大骨节病诊断标准>(GB 16003-1995)执行.成人大骨节病临床检查结果按病情进行分度和按年龄进行分组,计算检出率.结果 儿童大骨节病共调查181人,临床未检出阳性病例.X线检出2例干骺端阳性病例,检出率为1.10%;骨端未检出阳性病例.成人大骨节病共调查13 871人,临床检出病例数801名,检出率为5.77%.患者主要分布在51岁以上人群中,大骨节病检出率随着年龄的增加而增加,占总检出人数的70.66%(566/801);51岁以上各年龄段Ⅱ度、Ⅲ度检出率,占所有Ⅱ度、Ⅲ度检出率的71.78%(206/287).结论 山西省儿童大骨节病病情稳定在基本控制范围内,成人大骨节病检出率较高,成人大骨节病救治问题应引起有关部门重视.     

Long-term deterioration of quality of life in adult patients with celiac disease is associated with treatment noncompliance

Background

Deterioration of quality of life in the long term has been suggested for celiac disease patients on a gluten-free diet.

Aims

To determine long-term quality of life of celiac disease patients and to assess the benefits of gluten-free diet compliance.

Patients

We prospectively evaluated 53 newly diagnosed adult celiac disease patients.

Methods

The Short Form 36 Health Survey, the Gastrointestinal Symptoms Rating Scale and the Beck Depression Inventory were employed at the time of diagnosis, 1 year, and beyond 4 years (median: 53 months) on treatment.

Results

At 1 year, a significant improvement from baseline in quality of life indicators was observed (p < 0.001 to p < 0.0001) with comparable scores to healthy subjects. At 4 years, the Short Form 36 Health Survey scores (p < 0.002 to p < 0.0002) and Beck Depression Inventory score (p < 0.002) show significant deterioration compare with 1 year. Most scores remained significantly better than those at diagnosis (p < 0.03 to p < 0.0005). No changes were detected in the Gastrointestinal Symptoms Rating Scale scores. The long-term impairment of quality of life was attributable to the deterioration of most dimensions in patients who were not strictly compliant with the gluten-free diet (p < 0.05 to p < 0.001).

Conclusions

Long-term deterioration of quality of life outcomes after the first year of gluten-free diet was associated with the lack of strict compliance with the diet.     

探讨早期乳腺癌局部复发的预后和预测因素

乳腺癌是危害妇女健康的主要疾病,其发病率高居西方女性恶性肿瘤的首位,近年来在我国呈快速上升趋势。随着妇女疾病普查和自我保健意识的推广,以及乳腺癌的诊疗技术的更新,越来越多原位癌和Ⅰ期、Ⅱ期的早期乳腺癌得以早期发现和治疗。     

125例鼻咽癌后程三维适形放射治疗失败病例原因分析

目的分析初治鼻咽癌患者后程三维适形放射治疗后部分病例治疗失败的原因,以指导今后治疗。方法对1999年1月至2007年12月在本院接受后程三维适形放疗的125例鼻咽癌病例进行回顾性分析,计算局部控制率、无远处生存率、无瘤生存率及总生存率,分析患者治疗后出现死亡、复发、转移的原因。结果 3年、5年、10年局部区域控制率分别为98%、95%、94%。3年、5年、10年无远处转移生存率分别为96%、94%、86%,总生存率分别为93%、86%、78%。全组死亡18例（其中10例死于远处转移,1例死于局部复发,2例死于远处转移及局部复发,2例死于鼻咽大出血,2例死于放射性脑病后反复吸入性肺炎致肺衰竭,1例脑出血死亡）。鼻咽原发灶及颈部淋巴结区域复发6例,3DCRT野内复发4例,野边缘复发2例。结论初治鼻咽癌采用后程三维适形放疗能取得较好的治疗疗效。患者治疗失败的主要原因为肿瘤靶区范围不足、放疗计划设计不周全、出现远处转移,如综合多种影像技术,提高阅片能力,给予准确的射野设计,及放化疗结合有望减少治疗的失败。     

The Short Time Exposure (STE) test for predicting eye irritation potential: Intra-laboratory reproducibility and correspondence to globally harmonized system (GHS) and EU eye irritation classification for 109 chemicals

Short Time Exposure (STE) test is an easy in vitro eye irritation test that assesses cytotoxicity in SIRC cells (rabbit corneal cell line) following a 5 min dose treatment. To assess intra-laboratory reproducibility, medium control, three vehicles (saline, saline containing 5% (w/w) dimethyl sulfoxide, and mineral oil) and three standard chemicals (sodium lauryl sulfate, calcium thioglycolate, and Tween 80) were evaluated. Assessments were repeated 30 times for vehicles and 18 times for standard chemicals; resulting in almost the same cell viability and a low coefficient of variation value. In addition, the STE eye irritation rankings of three standard chemicals, as calculated on the cell viabilities in 5% and 0.05% solutions were in agreement in all tests. Based on these results, high intra-laboratory reproducibility was confirmed.In addition, the irritation category (irritant and non-irritant) was evaluated for 109 chemicals with STE test, globally harmonized system (GHS) classification, and European Union (EU) classification. The results of the evaluation found the STE classification to have an accuracy with GHS classification of 87% and with EU classification of 83%, which confirmed the excellent correspondence.The correspondence of STE rankings (1, 2, and 3) based on the prediction model by STE test with the eye irritation rankings by GHS (non-irritant, categories 2 and 1) and EU (non-irritant, R36, and R41) was 76% and 71%, respectively.Based on the above results, STE test was considered to be a promising alternative method for assessing eye irritation that has high intra-laboratory reproducibility as well as an excellent predictability of eye irritation.     

In silico prediction of rhabdomyolysis of compounds by self-organizing map and support vector machine

Rhabdomyolysis is a potentially lethal syndrome resulting in leakage of myocyte intracellular contents into the plasma. Some drugs, such as lipid-lowering drugs and antihistamines, can cause rhabdomyolysis. In this work, a dataset containing 186 chemical compounds causing rhabdomyolysis and 117 drugs not causing rhabdomyolysis was collected. The dataset was split into a training set (containing 230 compounds) and a test set (containing 73 compounds). A Kohonen’s self-organizing map (SOM) and a support vector machine (SVM) were applied to develop classification models to differentiate compounds causing and not causing rhabdomyolysis. Using the SOM method, classification accuracies of 93.3% for the training set and 84.5% for the test set were achieved; using the SVM method, classification accuracies of 95.2% for the training set and 84.9% for the test set were achieved. In addition, the extended connectivity fingerprints (ECFP_4) for all the molecules were calculated and analyzed to find the important features of molecules relating to rhabdomyolysis.     

Survival and Morbidities in Infants with Birth Weight Less than 500 g: a Nationwide Cohort Study

BackgroundThis study aimed to investigate the survival and morbidities of infants in the Korean Neonatal Network (KNN) with birth weight (BW) < 500 g.MethodsThe demographic and clinical data of 208 live-born infants with a BW < 500 g at a gestational age of ≥ 22 weeks who were treated in the neonatal intensive care units of the KNN between 2013 and 2017 were reviewed.ResultsThe survival rate of the infants was 28%, with a median gestational age and BW of 24^3/7 weeks (range, 22^0/7–33^6/7) and 440 g (range, 220–499), respectively. Multivariable Cox proportional hazards analysis demonstrated that survival to discharge was associated with longer gestation, higher BW, female sex, singleton gestation, use of any antenatal corticosteroids, and higher Apgar scores at 5 minutes. The overall survival rates were significantly different between the BW categories of < 400 g and 400–499 g. However, there was no significant difference in the incidence of any morbidity between the BW groups. Half of the deaths of infants with BW < 500 g occurred within a week of life, mainly due to cardiopulmonary and neurologic causes. The major causes of death in infants after 1 week of age were infection and gastrointestinal disease. Among the surviving infants, 79% had moderate to severe bronchopulmonary dysplasia, 21% underwent surgical ligation of patent ductus arteriosus, 12% had severe intraventricular hemorrhage (grade III–IV), 38% had sepsis, 9% had necrotizing enterocolitis (stage ≥ 2), and 47% underwent laser treatment for retinopathy of prematurity. The median length of hospital stay was 132 days (range, 69–291), and 53% required assistive devices at discharge.ConclusionDespite recent advances in neonatal intensive care, the survival and morbidity rates of infants with BW < 500 g need further improvement.