Prognostic factors for patients with cervical cancer treated with concurrent chemoradiotherapy: a retrospective analysis in a Japanese cohort

Objective

Concurrent chemoradiotherapy (CCRT) is the primary treatment for locally advanced cervical cancer. We studied prognostic factors for patients treated with CCRT.

Methods

We retrospectively reviewed records of 85 consecutive patients with cervical cancer who were treated with CCRT between 2002 and 2011, with external beam radiation therapy, intracavitary brachytherapy, and platinum-based chemotherapy. Survival data were analyzed with Kaplan-Meier methods and Cox proportional hazard models.

Results

Of the 85 patients, 69 patients (81%) had International Federation of Gynecology and Obstetrics (FIGO) stage III/IV disease; 25 patients (29%) had pelvic lymph node enlargement (based on magnetic resonance imaging), and 64 patients (75%) achieved clinical remission following treatment. Median maximum tumor diameter was 5.5 cm. The 3- and 5-year overall survival rates were 60.3% and 55.5%, respectively. Cox regression analysis showed tumor diameter >6 cm (hazard ratio [HR], 2.3; 95% confidence interval [CI], 1.2 to 4.6), pelvic lymph node enlargement (HR, 2.2; 95% CI, 1.1 to 4.5), and distant metastasis (HR, 10.0; 95% CI, 3.7 to 27.0) were significantly and independently related to poor outcomes.

Conclusion

New treatment strategies should be considered for locally advanced cervical cancers with tumors >6 cm and radiologically enlarged pelvic lymph nodes.     

2010年临朐县企业职业病危害状况及服务需求调查

[目的]了解临朐县企业职业病危害与职业卫生的服务需求状况,为制定职业卫生管理机制和应对策略提供依据。[方法]2010年3~5月,选择临朐县91家存在职业病危害因素的企业,对工作场所有害因素进行检测,对工人进行职业健康体检和职业健康服务需求调查。[结果]在91家企业合计检测2 263个点,职业病危害因素合格的2 114个点,平均合格率为93.42%。检测合格率,噪声为91.51%,空气总粉尘为96.45%,一氧化碳为99.38%,二氧化碳为100.00%,硫酸为96.30%,氢氧化钠为96.15%,苯(甲苯、二甲苯)为86.49%,甲醛为6/6,硫化氢为9/9,高温为94.74%,氯气为5/5。检查接触噪声的1 838人,纯音听力异常率为32.10%,其中职业性听力损伤观察对象检出率为28.89%,轻度听力损伤罹患率为2.99%,中度听力损伤罹患率为0.22%;检查接触苯的815人,苯中毒观察对象检出率为3.56%,慢性轻度苯中毒检出率为0.98%,慢性中度苯中毒检出率为0.12%;检查接触粉尘的718人,观察对象检出率为0.28%。在8 752名调查对象中,上岗前、在岗期间接受过职业安全卫生知识培训的分别占41.00%、12.85%。[结论]临朐县企业存在较严重的职业病危害因素,职业卫生服务水平有待提高。     

"Technological advances,informatics and orthodontics"--a 'voiced' editorial.

Abstract

Extra-oral traction (E.O.T.) to a facebow is used with many types of removable, functional, and fixed orthodontic appliances. A versatile and popular method involves the elastic force being provided by an Interlandi headgear. The facebow, which is of necessity removable, can be displaced from its intra-oral attachments (whilst still connected to the headgear by the elastics) and may result in personal injury. This paper describes a suitable simply made device that can be incorporated to prevent facebow dislodgement, thereby improving safety.     

维持性腹膜透析患者发生肺部感染的危险因素及病原学特点

目的：探讨维持性腹膜透析患者发生肺部感染的危险因素及病原学特点。方法回顾性分析120例维持性腹膜透析患者的临床资料,比较肺部感染组和非感染组的临床特征,分析发生肺部感染的危险因素并观察肺部感染组的病原学特点。结果感染组年龄、心功能分级、患有糖尿病及脑血管疾病占比明显高于对照组,血红蛋白、血白蛋白明显低于对照组。感染组60例中痰培养阳性28例,其中革兰阴性菌14株（50%）,革兰阳性菌11株（39.29%）,真菌3株（10.71%）。结论高龄、贫血、低白蛋白血症、心功能分级高、患有糖尿病、脑血管事件是维持性腹膜透析患者发生肺部感染的独立危险因素;感染病原菌以革兰阴性菌为主。     

125I粒籽植入治疗辐射防护及关键控制技术探讨

目的 探讨碘-125（¹²⁵I）放射性粒籽植入治疗过程中可能存在的放射性职业病危害因素及辐射水平,探讨关键控制技术。方法 以5家开展¹²⁵I粒籽植入治疗项目的医疗机构为研究对象,采用放射卫生学现场调查、工作场所辐射防护水平检测、人员个人剂量监测等方法,调查粒籽植入涉源工作场所及相关人员的辐射水平;结合源项分析及放射卫生管理经验,根据危害分析与关键控制点（HACCP）的原理,探讨¹²⁵I粒籽植入治疗过程的关键控制点。结果 不同涉源场所中粒籽植入源运输包装、粒籽植入治疗室和专用病房工作场所各关注点的周围剂量当量率为本底~1.80 μSv/h（病房门处）,均小于2.5 μSv/h;35名放射工作人员全年个人剂量监测结果为0.20~1.80 mSv,平均为0.42 mSv。结论 不同涉源场所的辐射水平及人员的受照剂量均符合国家标准限值的要求;应根据关键控制措施,对¹²⁵I放射性粒籽植入治疗过程的关键环节予以控制。     

钦州市第二人民医院外科患者手术后切口感染危险因素的Logistic回归分析

[目的]对外科患者术后切口感染危险因素进行研究,为控制术后切口感染的发生提供科学依据。[方法]以钦州市第二人民医院2009年4399例外科手术患者为调查对象,参考文献及我院病案系统所收录的项目,调查包括年龄、性别、手术分级、手术持续时间、输血、手术部位、全麻、肿瘤、预防用药等项目,按医院感染诊断标准,将38例切口感染患者作为病例组,4361例切口未感染患者作为对照组。数据采用SPSS13.0统计软件进行分析,各变量现经单因素分析后,选择具有统计学差异的因素再进行非条件Logistic回归分析。[结果]钦州市第二人民医院外科切口感染的独立危险因素为手术分级、预防用药。[结论]通过控制外科切口感染独立危险因素,则很有可能降低外科切口感染率。