Transbronchial fine needle aspiration biopsy and rapid on‐site evaluation in the setting of superior vena cava syndrome

There is a paucity of prospective data on flexible bronchoscopy with rapid on‐site evaluation (ROSE) in the setting of superior vena cava (SVC) syndrome. The aims of this prospective study were to assess the diagnostic yield and safety of these investigations and specifically to evaluate the role of ROSE in limiting the need for tissue biopsies. Over a 5‐year period 48 patients (57.4 ± 9.7 years) with SVC syndrome secondary to intrathoracic tumors underwent flexible bronchoscopy with TBNA and ROSE. Endobronchial Forceps biopsy was reserved for visible endobronchial tumors with no on‐site confirmation of diagnostic material. ROSE confirmed diagnostic material in 41 cases (85.4%), and in only one of the remaining cases did the addition of a forceps biopsy increase the diagnostic yield (overall diagnostic yield of 87.5%). No serious complications were noted. The final diagnoses made included nonsmall lung cancer (n = 27), small cell lung cancer (n = 16), and metastatic carcinoma (n = 3). Two undiagnosed cases died of suspected advanced neoplasms (unknown primary tumors). We conclude that TBNA has a high diagnostic yield and is safe in the setting of SVC syndrome. With the addition of ROSE, tissue biopsy is required in the minority of cases. Diagn. Cytopathol. 2013;41:324–329. © 2011 Wiley Periodicals, Inc.     

氟化物与过氧化氢类漂白剂联用对大鼠牙髓影响的组织病理学观察

目的从组织学水平观察高浓度漂白剂与氟化物联用对大鼠牙髓的影响。方法将60只大鼠按处理方法不同随机分为加NaF漂白组、漂白组和空白组,其中NaF漂白组和漂白组分别按5、10和15 min 3个不同的治疗时间进行漂白处理,然后对即刻、3 d后和7 d后的牙髓情况进行组织病理学观察。结果全部受试牙中仅有1/3出现轻度牙髓反应,没有出现中度或重度牙髓反应,并且这些轻微牙髓反应在治疗结束后即可出现,一般在2周内恢复正常,NaF漂白组和漂白组之间无统计学差异。结论动物实验结果显示高浓度过氧化氢类牙齿漂白治疗可引发轻微、局限性的牙髓反应,漂白治疗术前氟化物的应用对牙髓反应等级无明显影响。     

14例正畸减数第一恒磨牙病例临床疗效分析及相关问题初探

目的 评价正畸减数第一磨牙的临床疗效,并就减数第一磨牙的相关矫治原则、间隙关闭情况及第三磨牙的建（牙合）等问题进行初步探讨.方法 选取我科近10年完成的14例减数第一磨牙矫治病例进行分析.通过对矫治前后模型的PAR指数和头颅侧位片,对矫治后磨牙间隙关闭、咬合关系及软组织侧貌进行评价;并通过曲面断层片,初步评价第二磨牙的牙根吸收和牙槽骨的改建以及第二磨牙和前磨牙的牙根平行状况.结果 14例患者平均疗程（29.5±4.3）个月,PAR疗效分析显示治疗后变差或无改变0例,改善5例,明显改善9例,提示拔牙间隙关闭满意,牙（牙合）关系良好;软组织侧貌协调,面型满意;曲面断层片显示第二前磨牙与第二磨牙牙根平行状况良好,第二磨牙牙根及牙槽骨无明显吸收.结论 减数第一磨牙病例只要严格把握适应证,合理的支抗设计和严谨的临床操作,可以获得满意的临床矫治效果.     

Cost-effectiveness of tobacco control policies in Vietnam: the case of personal smoking cessation support

Aims To examine the cost‐effectiveness of personal smoking cessation support in Vietnam. Design, setting and participants We followed‐up the population aged 15 years and over in 2006 to model the costs and health gains associated with five interventions: physician brief advice; nicotine replacement therapy (patch and gum); bupropion; and varenicline. Threshold analysis was undertaken to determine the price levels of pharmaceuticals for the interventions to be cost‐effective. A multi‐state life table model was constructed such that the interventions affect the smoking cessation behaviour of the age cohorts, and the resulting smoking prevalence defines their health outcomes. A health‐care perspective was employed. Measurements Cost‐effectiveness is measured in 2006 Vietnamese Dong (VND) per disability‐adjusted life year (DALY) averted. We adopted the World Health Organization thresholds of being ‘cost‐effective’ if less than three times gross domestic product (GDP) per capita (VND 34 600 000) and ‘very cost‐effective’ if less than GDP per capita (VND 11 500 000). Findings The cost‐effectiveness result of physician brief advice was VND 1 742 000 per DALY averted (international dollars 543), which was ‘very cost‐effective’. Varenicline dominated bupropion and nicotine‐replacement therapies, although it did not fall within the range of being ‘cost‐effective’ under different scenarios. The threshold analysis revealed that prices of pharmaceuticals must be substantially lower than the levels from other countries if pharmacological therapies are to be cost‐effective in Vietnam. Conclusions Physician brief advice is a cost‐effective intervention and should be included in the priority list of tobacco control policy in Vietnam. Pharmacological therapies are not cost‐effective, and so they are not recommended in Vietnam at this time unless pharmaceuticals could be produced locally at substantially lower costs in the future.     

温阳解毒化瘀方对肝衰竭大鼠内毒素血症的影响

目的:动态观察温阳解毒化瘀方对肝衰竭大鼠内毒素血症(ITEM)的影响。方法:将85只SD大鼠随机分为正常组、模型组、对照组(予乳果糖+三联活菌溶液)及温阳解毒化瘀颗粒组(实验组),采用D-半乳糖胺(D-gal)腹腔注射致肝衰竭ITEM大鼠模型。正常组在腹腔注射生理盐水12小时后处死,其余各组分别于造模后12小时、24小时各取10只大鼠处死,检测各组大鼠血清转氨酶(ALT、AST)、肝组织病理学、门静脉及结肠内毒素水平。结果:模型组12小时时ALT和AST较正常组升高(P<0.05),24小时时门静脉及结肠内毒素水平明显升高(P<0.01),肝组织大面积坏死;实验组及对照组在造模后12小时各观察指标与模型组比较,差异无显著性意义,造模后24小时两组ALT和AST、门静脉及结肠内毒素水平较模型组降低(P<0.05),肝组织病变减轻。结论:D-gal腹腔注射可建立大鼠肝衰竭ITEM模型,温阳解毒化瘀方可通过降低门静脉及结肠内毒素水平减轻ITEM而达到抗肝衰竭的效应。     

应用密切值法综合评价疟原虫血片质量

在疟原虫血片制作、 染色和清洁度3个单指标评价基础上, 利用密切值法对连云港市8个县 （区） 16个镜检站的血片质量进行了综合评价。结果显示, 连云港市各镜检站血片质量较高。密切值法原理简单、 评价结果合理、 易于操作, 具有一定的适用性。     

镇江市丹徒区血吸虫病综合治理效果评价

镇江市丹徒区实施血吸虫病综合治理项目以来,人群血吸虫感染率从2005年的0.083%下降至2010年的0;2007年后未发现急性血吸虫感染病例、未查出病畜;感染螺面积和感染螺平均密度逐年下降,至2010年未查出感染性钉螺。2010年全区达到了传播控制标准,疫情得到了有效控制。     

晚期血吸虫病救治绩效评估管理系统的开发研究

目的构建晚期血吸虫病(晚血)救治绩效评估管理系统,分析评价历年来晚血救治工作。方法运用数据库管理技术和C++编程技术开发该系统,录入历年晚血病案信息输入该系统进行管理,并应用相关信息对晚血救治工作进行成本效果、成本效用、成本效益及综合评价。结果制作了一套集晚血成本效益、成本效用分析和综合评价的软件计算公式系统,该系统具有构建清晰、操作简单、界面友好,方便录入、存储和查询晚血病案信息等特点,能对晚血救治工作进行绩效评估。结论该系统满足了现行晚血救治工作的需求,易于推广使用。     

老年重症肺炎患者血清内脂素变化的临床意义

目的探讨老年重症肺炎患者血清内脂素水平变化的临床意义。方法采用前瞻性研究,选择老年重症肺炎患者59例,老年非重症肺炎患者77例,及30例健康老年体检者作对照组。检测三组血清内脂素、TNF—α、CRP、白细胞介素6（IL-6）、白细胞介素8（IL-8）。老年重症肺炎和非重症肺炎组进行血气分析、APACHEⅡ评分。结果与对照组比较,老年重症肺炎组内脂素高于非重症肺炎组及对照组（P均〈0．01）,非重症肺炎组内脂素亦高于对照组（P〈0．01）。老年重症肺炎组中内脂素水平与TNF—α、CRP、IL-6、IL-8呈正相关俨〈0．05）,与PaO2、氧合指数呈负相关俨〈0．05）。结论老年重症肺炎患者血清内脂素升高,提示内脂素可能是一种促炎脂肪细胞因子,对于重症肺炎病情严重程度的判断具有一定的临床意义。