Post-cimetidine surveillance for up to ten years: incidence of carcinoma of the stomach and oesophagus.

The long-term effects of cimetidine on the occurrence of gastric and oesophageal cancer were assessed in a prospective cohort study of 9928 patients who had been prescribed cimetidine. They were first identified between 1978 and 1980, and cancer registrations and deaths were identified among them over a period of up to 10 years. One hundred and eleven cancers were identified after the start of cimetidine treatment: 71 were adenocarcinomas of the stomach, 27 were carcinomas of the cardia and/or oesophagus (22 adenocarcinomas, five unknown histology) and the remaining 13 tumours were squamous cell cancers of the oesophagus. Only six patients presented with early gastric cancers. Over a period of eight years the ratio of observed to expected (O/E) gastric cancer deaths has fallen from 10.7 (p < 0.001) to 1.2 (NS). The O/E ratio of oesophageal cancer deaths also fell over the first six years of study, from 5.4 (p < 0.01) to 1.4 (NS) but it has risen slightly in years 7 and 8 to 3.7 (p < 0.05). These findings do not suggest that there is an increased risk of developing oesophageal or gastric cancer from cimetidine treatment, and are generally consistent with cimetidine being used inadvertently to treat the early symptoms of gastric and oesophageal cancer. The slight rise in oesophageal cancer deaths in years 7 and 8 was unexpected and will be the subject of further observation.     

Carcinoma of the Stomach

Juvenile rheumatoid arthritis occurs most frequently between the ages of two and five years. Early clinical manifestations include daily high fever, rash, arthralgia, cardiac involvement, pulmonary inflammation, severe abdominal pain and rare systemic conditions. Arthritis may occur at any time. The cause of the disease is still unknown, and no specific diagnostic test has yet been devised. All drugs used in treatment are palliative; preservation of normal motility, good nutrition and emotional well-being are most important in the therapeutic regimen.     

Prospects for Earlier Diagnosis of Carcinoma of the Stomach

Cancer of the stomach is one of the most frequent causes of death in the United States today. Its onset is insidious, and it remains undiscovered until by its growth it interferes with function. Surgery offers only scant chance of cure. One bright spot looms on the horizon: the development of a device for intensification of the x-ray fluoroscopic image, by which diagnosis may be possible at an earlier date.     

B超在胃癌术前检查的价值

对67例胃癌患者做了术前B超检查,并与胃镜和X线钡餐检查进行对照.本组中胃镜诊断正确61例(91.0%),钡餐诊断正确59例(88.06%),B超诊断正确62例(92.54%),三种方法结合准确率达97.01%.结果表明:B超作为胃镜和钡餐的辅助和补充手段,能弥补二者的不足,获得更多的诊断信息,对于估计手术可切除性,制定手术方案,以及评估预后都有积极的作用,     

Prostate Carcinoma Metastatic to the Stomach: Report of Two Cases and Review of the Literature

We report two cases of prostate carcinoma metastatic to the stomach. In the first case, the patient had indolent disease before presenting with gastric metastasis. The patient responded to treatment with resolution of gastrointestinal bleeding and other symptoms. In the second case, the patient developed aggressive prostate carcinoma while on immunosuppressive therapy following kidney transplant. His tumor became widely systemic, and he ultimately died of his disease. Although rare, the possibility of prostate carcinoma metastatic to the stomach should be considered when a patient with a history of prostatic adenocarcinoma presents with gastrointestinal symptoms.     

发作性意识模糊，心悸10年余

一例老年男性患者因胰尾部胰岛素瘤反复发作导致低血糖,频繁发作意识障碍,因传统影像学的局限性难以具体定位肿瘤位置,且患者高龄伴慢性肾脏病,外科手术治疗风险较高。经多学科团队讨论后,采用前沿的影像学检查方法和新兴的内镜治疗技术,最终解决了患者的诊治难题。在该例患者诊治过程中,多学科团队应用本领域最新技术共同诊治,体现了多学科协作的重要性。     

Ten Years of Rizatriptan: From Development to Clinical Science and Future Directions

The year 2008 marked the 10th anniversary since rizatriptan was first launched for the acute treatment of migraine. In this article we discuss the concepts that motivated the preclinical and clinical development of rizatriptan, the clinical evidence that has driven its use over the past decade, rizatriptan's overall contribution to the field, and future directions for research.     

Ten Years and Counting: A Successful Academic-Practice Partnership to Develop Nursing Research Capacity

Achieving a decade long successful academic-practice partnership between a university-based school of nursing and a large private healthcare organization during a time of healthcare payment transformation is a significant accomplishment. Goals of the partnership are to provide evidence that 1. research collaboration and mentoring are instrumental in improving patient care by shaping nursing infrastructure and capacity and 2. consultation and mentoring activities will effectively engage faculty and staff nurses in an academic-practice research partnership. Nursing faculty and practicing clinicians collaborate on organizational priorities to improve patient care outcomes. Of the 28 approved studies, 17 are completed, five are in progress, and six were not completed. Dissemination products directly related to this partnership include: three publications, 23 podium presentations, and eight poster presentations delivered at local, national, and/or international conferences. Findings from seven of the 17 completed projects have been translated to improve practice. Several partnership participants have continued their academic progression and continue to conduct studies. This innovative partnership is a successful endeavor that bridges education and practice in our community, while developing research capacity in both institutions. This article adds to the emerging literature on models of academic-practice partnership to develop nursing research.     

胸腔镜辅助小切口食管下段贲门癌手术

目的：总结21例胸腔镜辅助下小切口完成食管下段及贲门癌手术的治疗经验和体会。方法：全组病例均采用全麻双腔气管插管，电视胸腔镜辅助下左胸6cm小切口完成食管下段及肿块的游离，上腹旁正中约10cm的切口完成胃大小弯及贲门肿块的游离和切除，残胃与食管在胸内完成吻合。结果：1例死于术后并发症。余顺利出院。结论：电视胸腔镜下小切口完成食管下段及贲门癌的切除的术式，具有创伤小、恢复快、操作易等优点。     

虚拟现实技术应用于脑卒中康复领域近十年研究的可视化分析

目的：揭示2011～2020年虚拟现实技术（VR）应用于脑卒中康复领域的研究状况及发展动态。方法： 以Web of Science（WOS）核心合集数据库为数据来源,通过CiteSpace对VR应用于脑卒中领域的相关文献 进行分析,采用引文分析方法以及信息可视化技术,对国家、机构、学科、关键词、突现词等研究要素绘制可 视化图谱。结果：共检索到1 967篇文献,年度发文量总体呈持续上升态势。可视化图谱显示,美国、加拿 大、意大利和中国是该研究领域的高产出国家。全球机构中,加拿大麦吉尔大学发文量最多,其次是美国犹 太医院和瑞士联储技术研究所。VR在脑卒中康复中的应用涉及众多学科领域,尤其与工程学、神经科学、 计算机科学、康复学及机器人科学等密切相关。在早期,该领域的热点关键词主要集中在手臂、环境、功能 性磁共振成像、棱镜适应训练、康复机器人、生物反馈,随后逐步转向上肢康复、触觉反馈、神经康复、疼痛、 姿势平衡、任天堂Wii健身。结论：VR技术在脑卒中康复中的应用前景广阔。     

连续3年流感嗜血杆菌对常用抗生素的耐药性监测

目的调查流感嗜血杆菌对6种常用抗生素的耐药性,为临床治疗提供实验室依据。方法回顾性分析2003年1月-2005年12月四川大学华西医院从临床标本中分离出的262株流感嗜血杆菌,采用Kirby-Bauer琼脂扩散法测定药物敏感性。结果流感嗜血杆菌对6种常用药物的敏感性测试结果显示环丙沙星耐药率高达22.2%-43.8%;氨苄青霉素及氯霉素的耐药率也分别达28.9%-38.3%和28.6%-34.3%;头孢噻肟的耐药率为14.3%-16.2%;阿奇霉素耐药率最低为4.4%-9.8%;阿莫西林/克拉维酸的耐药率明显低于氨苄青霉素仅为4.4%-14.3%。结论流感嗜血杆菌对环丙沙星、氨苄青霉素及氯霉素有较高的耐药率,它们作为第一线治疗药物地位受到挑战,阿奇霉素和阿莫西林/克拉维酸是目前治疗流感嗜血杆菌感染的有效抗生素。早期合理用药对提高呼吸道感染的门诊治愈率、缩短病程、减少住院率和节约医疗费用有重要意义。