高海拔地区精神分裂症患考临床特征分析

目的:了解高海拔环境对精神分裂症的影响。方法:对106例高海拔地区精神分裂症患者(高海拔组)的临床特征、疗效、药物副作用进行调查,与同期106例平原精神分裂症患者(平原组)对照。结果:高海拔组临床症状以幻觉、疑病妄想、夸大妄想、紧张冲动行为及焦虑、抑郁等精神症状出现频率较高,而对照组以被害妄想、情感淡漠等精神症状出现频率较高(P<0.01或P<0.05);入院时高海拔组总体病情较重(P<0.01);两组间疗效无显著性差异;高海拔组药物不良反应多于平原组。结论:高海拔地区精神分裂症患者临床特征、总体病情严重程度、药物不良反应与平原地区有一定区别,可能与高海拔环境有关。     

Evidence-based Medicine

Summary:  Evidence-based medicine (EBM) has become a watchword for "the new" medical practice in the new century. Whether it represents a paradigm shift or simply a codification of the scientific method in medicine will be debated for years to come. Regardless of the place of EBM in medicine, this "movement" has served an important role in moving physician practice into the realm of becoming more scientific (albeit empirical) and transparent. There are still many problems to be addressed in the global application of the best evidence for medical practice. These include low-quality studies, delays in implementation of clear-cut improvements, outright fraud and deceit, and wariness on the part of physicians to change their practice. By working to understand the underpinnings of EBM (basic statistical concepts and critical thinking) we can advance the practice of medicine along the moral high road of science.     

Primary malignant melanoma of the bladder

Primary malignant melanomma of bladder is extremely rare: 18 cases are reported to date. An 82 year-old man underwent trans-urethral resection of bladder for a bleeding tumor of the posterior wall. Histological diagnosis was melanoma of the bladder. There was no history of previous or regressed cutaneous malignant melanoma. Margins of the bladder lesion contained atypical melanocytes similar to those commonly seen in the periphery of primary mucous membrane lesions. Clinical studies and radiological examinations were negative for other primary site of melanoma. The patient had a bladder recurrence that was consistent with primary tumor and died of widespread disease 9 months after diagnosis.     

Cancer support groups – are they effective?

Cancer causes significatlt emotional distress to a considerable majority of patients. Many of these patients typically receive little formal psychological intervention. Support groups, however, have provided one forum from which patients can attempt to gain help and can use to overcome some psychological trauma that accompanies the cancer hagnosis, subsequent treatment and relapse. This article reviews past studies of professionally run cancer support groups as opposed to psychological intervention groups. These studies are considered in light of the proposed benefits and the methodological limitations frequently inherent in such studies.     

山东省淄博市1983—2003年肾综合征出血热流行趋势及流行特征分析

1983年淄博市首次发现肾综合征出血热(HFRS),1986年疫情达历史高峰;之后疫情总体呈下降趋势,现将近20年来淄博市HFRS的流行情况分析如下。1.资料与方法:人间疫情资料来源于各区县疫情报告统计,人口资料来源于淄博市统计局统计年鉴,数据用Excel 2000软件分析。2.结果: (1)流行趋势:①1983-2003年全省共发病15 507例,年均发病率为22.13/10万;病死116例,病死率为0.56%;发病率波动在0.27/10万～76.51/10万之间。20世纪80年代发     

绝经前后T1期乳腺癌患者临床特征的分析

目的:分析T1期(肿瘤直径<2cm)原发性乳腺癌女性患者绝经前后在肿瘤大小、病理分类、淋巴结转移率和数目。方法:常规病理检验以及应用免疫组化、HE法分别测定绝经前乳腺癌患者和绝经后乳腺癌患者者的ER、PR。结果:两组患者在肿瘤大小上无明显差异,但绝经前乳腺癌患者浸润导管癌的百分比为 84. 7%,绝经后乳腺癌患者的浸润导管癌百分比为 62. 2%,经χ2 检验,P<0. 01。两组淋巴结转移率分别为 39. 3%和 25. 5%,经χ2 检验,P<0. 01。两组ER和PR阳性伴淋巴结转移的比例经χ2 检验,P<0. 05。结论:绝经前乳腺癌患者和绝经后乳腺癌患者在病理分类、淋巴结转移率及数目、ER、PR阳性伴淋巴结转移上有显著性差异。对于T1原发性乳腺癌患者不论有无淋巴结转移,均应行癌肿切除伴Ⅰ、Ⅱ级淋巴结清扫。     

兔精原干细胞培养及生物学特征的初步研究

目的:建立精原干细胞的培养方法并对培养细胞的生物学特征进行研究.方法:用饲养层和无饲养层两种方法培养幼家兔精原干细胞,在倒置相差显微镜下观察培养细胞的生长和形态变化,并对细胞的糖原、脂质及c-kit受体的细胞化学和免疫细胞化学染色结果进行分析.结果:成功的分离并培养幼家兔精原干细胞.在培养细胞中精原干细胞为主体细胞,并可见少量间质细胞.根据精原干细胞体积大小和形态特点,可分为大、小两种类型.PAS染色,精原干细胞胞质呈阳性反应;免疫细胞化学染色显示,体积较小的精原干细胞c-kit受体呈强阳性反应,体积较大的大精原干细胞呈弱阳性反应;间质细胞PAS染色和c-kit受体染色呈阴性反应,而脂质染色呈强阳性反应.精原干细胞培养无论有无饲养层,均能呈集落状生长,但有饲养层的培养,细胞的生长明显优于无饲养层培养.结论:青春期前的睾丸生精小管是精原干细胞最集中、数量最多,且容易获取分离的部位;精原干细胞的成功培养为今后重建完整的生精细胞系的治疗性移植和对这类定向干细胞的发育及分化潜能的研究提供了细胞模型.     

The First‐Episode Psychosis Outcome Study: premorbid and baseline characteristics of an epidemiological cohort of 661 first‐episode psychosis patients

Aims: Studies conducted in first‐episode psychosis (FEP) samples avoid many biases. However, very few studies are based on epidemiological cohorts treated in specialized FEP services. The aim of this file audit study was to examine premorbid and baseline characteristics of a large epidemiological sample of FEP. Methods: File audit study of all patients admitted to the Early Psychosis Prevention and Intervention Centre between 1998 and 2000 using a specialized questionnaire. Results: There were 661 patient files included in the study. Premorbid evaluation revealed high rates of substance use disorder (74.1%), history of psychiatric disorder (47.5%), past traumatic events (82.7%) suicide attempts (14.3%) and family history of psychiatric illness (55.6%). Baseline characteristics revealed high intensity of illness (mean CGI 5.5), high prevalence of lack of insight (62%) and high rate of comorbidity (70%). Conclusion: High rates of traumatic events or episodes of mental illness before treatment for FEP must be considered when designing treatment approaches because a too narrow focus on positive psychotic symptoms will inevitably lead to incomplete treatment. Additionally, early intervention programmes need sufficient range of resources to address the multiple challenges presented by FEP patients such as high severity of illness, comorbidities and functional impairment. Finally, observation of an important degree of functional impairment despite short duration of untreated psychosis suggests that while early detection of FEP is a necessary step in early intervention, it may not be sufficient to improve functional recovery in psychosis and that efforts aimed at identifying people during the prodromal phase of psychotic disorders should be pursued.     

医学文献检索课中期刊论文分类标引的教学

针对当前的医学文献检索课中忽略期刊论文分类标引教学的问题,总结了几点教学实践,分别从期刊论文分类标引准确的重要性、期刊论文分类标引的步骤及原则、医学期刊论文分类标引的注意事项几个方面进行阐述.     

急性脑血管病病人应激状态的临床特点及护理

[目的 ]分析急性脑血管病(ACVD)应激状态的临床特点 ,探讨防治策略及护理对策。 [方法 ]回顾分析 3 62例ACVD病人的临床资料。[结果 ]ACVD病人应激反应的发生率为 47.5 1% ,病死率为 11.88%。 [结论 ]早期明确诊断与治疗 ,并采取措施积极调控机体应激状态 ,加强护理 ,有助于控制病情和促进康复 ,降低病死率。