44例卵巢肿瘤的临床病理分析

目的 探讨卵巢肿瘤的临床病理特点.方法 对44例卵巢肿瘤的标本进行组织形态观察,以WHO制定的卵巢肿瘤分类法为诊断标准.结果 在44例卵巢肿瘤中,上皮性肿瘤16例,生殖细胞肿瘤25例,性索间质细胞肿瘤3例.结论 卵巢生殖细胞肿瘤发病率高于上皮性肿瘤,腹部包块和腹痛者应排除卵巢肿瘤的可能,治疗以手术切除为主.     

青春期前后少女卵巢肿瘤临床特点分析

目的:探讨青春期前后少女卵巢肿瘤的临床特点及治疗。方法:对北京妇产医院1982年1月~2006年5月间收治的全部20岁以下卵巢肿瘤患者174例进行回顾性分析。结果:174例患者有明显临床症状就诊的占67.2%。良性肿瘤144例(82.8%),恶性肿瘤30例(17.2%)。生殖细胞肿瘤患者97例(55.8%),上皮性肿瘤42例(24.1%),性索间质肿瘤8例(4.6%),卵巢瘤样病变27例(15.5%)。上皮性肿瘤中黏液性肿瘤占76.2%。初潮前、后上皮性肿瘤及卵巢瘤样病变所占比例有明显差别。恶性生殖细胞肿瘤患者全子宫+附件切除术后10年存活率与附件切除术者相比无增高。结论:青春期前后少女卵巢肿瘤以良性、生殖细胞肿瘤为主。黏液性肿瘤是上皮性肿瘤的主要病理类型。初潮是判断青春期少女卵巢肿瘤病理类型的一个重要因素。恶性肿瘤患者手术应尽可能保留生育功能。应重视青春期少女的临床表现并及时、定期妇科检查。     

卵巢恶性肿瘤53例临床分析

目的探讨卵巢恶性肿瘤的诊断、治疗和预后.方法回顾性分析自1995年～2003年我院收治的53例经手术、病理证实卵巢恶性肿瘤患者的临床资料.结果卵巢上皮性癌35例(占66.04%),卵巢性索间质恶性肿瘤5例(占9.43%)生殖细胞癌13例(占24.53%).结论卵巢恶性肿瘤的治疗仍以手术为主,化疗为辅的综合治疗方法,其预后与临床分期、病理类型、手术彻底性及术后积极、有效的多疗程化疗等综合因素有关.     

卵巢交界性肿瘤的诊治进展

卵巢交界性肿瘤(borderline ovarian tumor,BOT)是一种低度潜在恶性的卵巢肿瘤,占卵巢上皮性瘤的10％～15％.BOT好发于育龄期妇女,其中BOTⅠ～Ⅱ期患者占80％.临床上BOT表现为具有一定恶性的卵巢上皮性癌的组织学特点,但缺乏间质浸润,对化疗不敏感,多易晚期复发,但复发时多数仍为BOT.     

幼女及青春期少女卵巢肿瘤临床分析

目的探讨幼女及青春期少女卵巢肿瘤的临床特点及治疗方法。方法回顾性分析1999年2月～2009年4月收治的全部4～19岁卵巢肿瘤患者64例。结果患者平均年龄16.4岁,其中4～9岁3例(4.7%),10～14岁13例(20.3%),15～19岁48例(75%)。性索间质细胞瘤3例,上皮性肿瘤22例,生殖细胞肿瘤39例;交界性肿瘤2例,恶性肿瘤6例。所有患者均行手术治疗,4例生殖细胞恶性肿瘤患者行保留生育功能手术,2例上皮癌患者实施肿瘤细胞减灭术。4例接受了4～6疗程以顺铂为主的化疗。随访期间,6例恶性肿瘤患者中有3例死亡;余病例无复发。结论幼女及青春期少女卵巢肿瘤以生殖细胞肿瘤为主,随着年龄增长,上皮性肿瘤所占比例增高。生殖细胞恶性肿瘤可以采取保留生育功能的手术。     

幼女及青春期少女卵巢肿瘤临床分析

目的探讨幼女及青春期少女卵巢肿瘤的临床特点及治疗方法。方法回顾性分析1999年2月～2009年4月收治的全部4～19岁卵巢肿瘤患者64例。结果患者平均年龄16.4岁,其中4～9岁3例(4.7%),10～14岁13例(20.3%),15～19岁48例(75%)。性索间质细胞瘤3例,上皮性肿瘤22例,生殖细胞肿瘤39例;交界性肿瘤2例,恶性肿瘤6例。所有患者均行手术治疗,4例生殖细胞恶性肿瘤患者行保留生育功能手术,2例上皮癌患者实施肿瘤细胞减灭术。4例接受了4～6疗程以顺铂为主的化疗。随访期间,6例恶性肿瘤患者中有3例死亡;余病例无复发。结论幼女及青春期少女卵巢肿瘤以生殖细胞肿瘤为主,随着年龄增长,上皮性肿瘤所占比例增高。生殖细胞恶性肿瘤可以采取保留生育功能的手术。     

绝经后妇女卵巢肿瘤的临床分析

目的:探讨绝经后卵巢肿瘤的临床和病理学特征及诊断、治疗方法。方法:对我院2002年12月～2005年12月手术治疗的42例绝经后卵巢肿瘤患者进行回顾性分析。结果:绝经后卵巢恶性肿瘤14例,占33·3%,上皮性肿瘤29例,占69%,上皮性恶性肿瘤11例,占绝经后卵巢恶性肿瘤的78·6%。阴道超声提示囊实性肿瘤者与囊性比较,恶性率明显升高,P<0·01。上皮性恶性肿瘤CA125有不同程度的升高,CA125检测敏感性上皮性恶性肿瘤为81·8%。结合患者的年龄,肿瘤性质及有无严重内科合并症,采用不同的手术方法,可收到较好的治疗效果。结论:绝经后上皮性恶性肿瘤发生率高,尤其是囊实性或实性肿瘤合并CA125升高者;对绝经后卵巢肿瘤应及早诊断、及早手术治疗。     

133例卵巢肿瘤临床分析

目的:探讨卵巢肿瘤的临床特点及组织发生学特征。方法:对1998年1月~2004年12月收治的133例卵巢肿瘤的临床资料进行回顾性分析;结果:卵巢肿瘤发生年龄以20~40岁多见,多为良性;与产次关系密切,产次少的发生率明显升高;133例卵巢肿瘤中,上皮性肿瘤45例,占33.83%,生殖细胞肿瘤38例,占28.57%,性索间质肿瘤9例,占6.77%,瘤样病变41例,占30.83%。其中恶性卵巢肿瘤14例,占10.53%,5例发生转移。误诊3例,占2.26%。结论:妊娠对卵巢有一定的保护作用;详细询问病史可减少误诊率;约每8例卵巢肿瘤中1例为恶性,应引起注意;恶性卵巢肿瘤主要转移至大网膜、肠系膜。     

1081例卵巢肿瘤分析

<正> 本文对吉林地区1961～1990年经病理检查确诊的卵巢肿瘤1081例进行了分析. 一、资料 (一)肿瘤来源 1.在1081例中,生发上皮来源的肿瘤有619例,占57.3%.其中良性肿瘤558例,占90.1%,交界性肿瘤9例,占1.5%,恶性肿瘤52例,占8.4%. 2.在1081例中,性索一间质来源的肿瘤有47例,占4.35%.其中良性肿瘤18例,占38.3%,恶性肿瘤29例,占61.7%. 3.在1081例中,生殖细胞来源的肿瘤有371例,占34.3%.其中良性肿瘤338例,占91.1%,恶性肿瘤33例,占8.9%. 4.在1081例中,非特殊间质来源的肿瘤     

妊娠合并卵巢肿瘤的治疗及预后

目的 探讨妊娠合并卵巢肿瘤的特征、诊断、治疗、相互影响及预后。方法 对近5年我院收治及手术、病理诊断明确的105例妊娠合并卵巢肿瘤进行回顾性分析。结果 妊娠期卵巢肿瘤病理类型，生殖细胞肿瘤占44．8％(47／105)，体腔上皮来源的肿瘤和性索间质肿瘤各占19．0％(20／105)，卵巢非赘生性囊肿占17．1％(18／105)；恶性肿瘤发生率为1．9％(2／105)。恶性肿瘤多为I期，术后随访至今无明显异常。足月妊娠率95．2％(100／105)。孕中期因卵巢肿瘤蒂扭转急症手术2例、因肿瘤增大明显手术2例。结论 妊娠合并卵巢良性肿瘤可予定期监测、择期处理，良性肿瘤妊娠时手术最佳时间孕16～20周，恶性肿瘤则应及时手术。除急症或肿瘤可疑恶变需及时手术外，妊娠可至足月。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.