辽宁省常见癌症诊治规范执行现状分析

[目的]了解和掌握辽宁省常见癌症诊治规范执行情况,为提高全省癌症治疗水平和规范诊治率制定相应措施提供依据。[方法]采用整群二阶段随机抽样,抽取不同类型医疗机构内科、外科、放疗科常见癌症的病志,填写调查表。按照不同类型、不同级别医院进行频数分布描述及卡方检验。[结果]共收集有效调查表4508份,其中诊治规范的有1856份,仅占总体的41.17%。手术、化疗和放疗规范诊治率分别为33.38%、51.10%和37.38%,A类和B类医院高于C类医院,城市医院高于农村医院。2008年的规范诊治率与2002年比较增长了26.83%。[结论]如何推广常见恶性肿瘤诊治规范并实行质量控制,提高全省恶性肿瘤诊治的整体水平,已成为辽宁省肿瘤防治的一个重要问题,应加以重视和研究。     

原发性小肠肿瘤28例诊治分析

[目的]探讨原发性小肠肿瘤诊断及治疗。[方法]回顾性分析28例原发性小肠肿瘤的临床和病理资料。[结果]良性肿瘤5例，恶性肿瘤23例；术前诊断小肠肿瘤14例（其中位于十二指肠8例，空、回肠6例），诊断符合率50％；恶性肿瘤行根治性手术10例、姑息性手术9例、放弃手术4例：恶性肿瘤术后5年存活7例。[结论]小肠肿瘤术前诊断率低，恶性小肠肿瘤5年生存率低，预后差；改善预后早期诊断是关键．手术治疗是首选。     

影像学诊断恶性胆道梗阻和术前评估肿瘤切除的准确性

目的 探讨影像学诊断恶性胆道梗阻的价值和术前评估肿瘤切除的准确性。方法 对61例经病理或临床证实的恶性胆道梗阻病人，进行影像学检查资料总结。结果 对恶性胆道梗阻病人行B超、CT、ERCP或PTC、MRCP检查，术前临床诊断准确率分别为80.3%、85.2%、90.6%、90.0%、92.3%，术前评估肿瘤切除准确性:85%、78.4%、66.7%、73.1%、93.3%。结论 恶性胆道梗阻在定性诊断上MRCP、ERCP、PTC诊断率高于B超、CT，在手术可切除性评估方面MRCP、B超高于CT、ERCP、PTC，但均无统计学意义。     

上海市医院恶性肿瘤病理诊断比例研究

[目的]调查上海市各级肿瘤报告医院中肿瘤病例的病理组织学诊断的现状和登记报告情况,分析上海市肿瘤登记资料病理组织学诊断比例（MV％）低于欧美国家的原因。[方法]随机抽取18家医院2007年7月～8月报告的所有恶性肿瘤病例,调查病例病理组织学诊断比例和肿瘤登记报告情况,并与全市登记资料进行比较。[结果]三级医院诊治肿瘤病例的病理组织诊断比例为82．68％,而登记报告资料的病理组织诊断学比例为76．05％,病理组织学诊断信息报告的完整性为91．98％;二级医院的实际病理组织诊断比例为66．55％,而登记报告资料的病理组织学诊断比例为61．24％,病理组织学诊断信息报告的完整性为92．02％。如各级医院能完整地报出病理组织学诊断信息,肿瘤登记资料的病理诊断比例可提高6个百分点。[结论]上海市MV％低于发达国家的主要原因是肿瘤诊断水平不高所致,三级医院与发达国家比较差距较小,而二级医院差距较大。加强肿瘤登记工作管理也能使MV％有所提高．但十分有限．     

云南省5所综合性医院恶性肿瘤住院病人构成分析

[目的]分析云南省5所综合性医院恶性肿瘤住院病人构成情况,为云南省卫生部门制订肿瘤防治措施提供依据.[方法]收集云南省5所综合性医院1990～2000年16871例恶性肿瘤住院病人病案首页资料进行描述性分析.[结果]恶性肿瘤住院病人疾病构成排在前3位的主要是消化器官和腹膜肿瘤、淋巴和造血组织肿瘤以及呼吸和胸腔内器官肿瘤.男性和女性、不同年龄段病人的住院疾病顺位有所不同;从1996年以来恶性肿瘤住院构成比以及住院死亡构成比均呈逐年增加的趋势;50%以上的恶性肿瘤住院死亡人数集中在30岁～60岁之间.[结论]应加强对云南省恶性肿瘤防治措施的研究,以降低恶性肿瘤对人群的危害.     

癌症患者住院病志中TNM分期

[目的]统计分析癌症住院患者病志的TNM分期执行情况,为卫生行政相关部门制订工作计划及质量控制提供依据。[方法]采用整群随机抽样抽取辽宁省37所不同类型医疗机构内科、外科和放疗科常见癌症出院病志,调查TNM分期执行情况。[结果]共收集有效调查表4514份,执行TNM分期比例为50.6%;外科、化疗科和放疗科执行比例分别为55.3%、49.3%和41.5%。在各级医疗机构中,以治疗肿瘤为主的医院TNM分期执行比例最高,为65.3%。常见癌种中乳腺癌的TNM分期执行情况比例最高,为63.9%。[结论]规范TNM分期是保障癌症规范诊治的前提和基础,辽宁省各级医疗机构TNM分期执行情况还有待进一步提高。     

乳腺原发性血管肉瘤一例

正乳腺原发性血管肉瘤约占所有乳腺恶性肿瘤的0.05%,病情进展快,预后差[1-2]。因其无特异性临床及影像学表现,组织病理学表现各异,术前很难准确诊断,常造成漏诊、误诊。笔者回顾性分析甘肃省肿瘤医院收治的1例乳腺原发性血管肉瘤的病历资料,结合文献复习,探讨乳腺原发性血管肉瘤的诊断和治疗,以期提高临床医师对乳腺原发性血管肉瘤的认识,减少误诊、误治。     

皮肤镜图像分析技术对颜面部肿瘤的诊断价值

[目的]探讨皮肤镜图像分析技术在颜面部肿瘤的诊断价值。[方法]收集来院就诊并病理确诊的颜面部肿瘤患者共187例，分别经肉眼、皮肤镜偏振法（DP）和皮肤镜浸润法（DS）诊断，将结果进行回顾分析。[结果]皮肤镜诊断指征显示出较好的特异性，正确诊断率达92．51％，明显高于肉眼诊断率（70．05％）。[结论]在同一台皮肤镜中具备DP和DS两种性能的检查方法，对颜面部肿瘤的早期诊断具有重要意义。     

胆道肿瘤25例报道

近6年来,我院经手术病理证实的胆道肿瘤25例,其中良性8例,恶性17例(均为晚期),术前诊断为良性肿瘤3例,恶性肿瘤5例,诊断率为32％,提示胆道肿瘤术前诊断率低,早期确诊更难。本文回顾25例手术及病理所见,对照临床表现及影像学检查,探讨胆道肿瘤的术前诊断和治疗。     

恶性实体瘤医院感染70例特征分析

随着对恶性肿瘤治疗方案的完善，许多恶性肿瘤患者生存期延长、生活质量提高，但由于多种因素，恶性肿瘤患者易发生医院感染，直接或间接引起病人死亡，恶性血液病医院感染已有报告[1]，但恶性肿瘤中实体瘤医院感染未见详细报告。为提高对恶性实体瘤医院感染的认识，提供防治对策的依据，回顾性分析我科刀例恶性实体瘤医院感染主要特征，报告如下。临床资料一、一般资料：我科1995年4月一1997年12月共收治恶性实体瘤287例，均经临床、影像学、手术及病理证实。其中发生医院感染者70例，男42例，女28例。年龄24－78岁。原发肿瘤类型：肺癌23…     

Ringworm in animals in a farm in Assiut

Bericht über das Auftreten von Hautmykosen bei Tieren auf der Farm der Landwirtschaftlichen Fakultät der Universität Assiut. Von 70 Kälbern waren 42 pilzkrank, davon 22 durch T. mentagrophytes, 20 durch T. verrucosum. Von 180 Kühen waren 8 pilzbefalien, sämtlich durch T. mentagrophytes. Von 2 kranken Bullen wurde T. verrucosum isoliert. Auch die 3 Pferde und 2 Maultiere der Farm waren pilzinfiziert; Erreger war in diesen Fällen T. equinum. Auch ein Kalb war von T. equinum befallen. Die gleiche Pilzart wurde ferner von 3 Tierpflegern isoliert, die Pilzherde am Hals und an den Armen aufwiesen.     

Statistical challenges in preprocessing in microarray experiments in cancer

Many clinical studies incorporate genomic experiments to investigate the potential associations between high-dimensional molecular data and clinical outcome. A critical first step in the statistical analyses of these experiments is that the molecular data are preprocessed. This article provides an overview of preprocessing methods, including summary algorithms and quality control metrics for microarrays. Some of the ramifications and effects that preprocessing methods have on the statistical results are illustrated. The discussions are centered around a microarray experiment based on lung cancer tumor samples with survival as the clinical outcome of interest. The procedures that are presented focus on the array platform used in this study. However, many of these issues are more general and are applicable to other instruments for genome-wide investigation. The discussions here will provide insight into the statistical challenges in preprocessing microarrays used in clinical studies of cancer. These challenges should not be viewed as inconsequential nuisances but rather as important issues that need to be addressed so that informed conclusions can be drawn.     

Trends in zygomycosis in children

Zygomycosis, or mucormycosis, is associated with significant morbidity and mortality in both children and adults. Studies in adults have shown an increase in the incidence of zygomycosis, particularly among haemtopoietic stem cell transplant (HSCT) recipients and patients with haematologic malignancies. There is a paucity of data on the epidemiology of zygomycosis in children. We performed a retrospective analysis to describe trends in zygomycosis between 1 January 2003 and 31 December 2010. We used the Pediatric Health Information System (PHIS) database to identify paediatric patients who were diagnosed with zygomycosis during the study period. Administrative data on diagnoses, demographics, underlying conditions and clinical experiences were collected. Summary statistics were calculated and tests for trend were conducted. We identified 156 unique patients with zygomycosis. The prevalence of zygomycosis did not significantly increase over time (P=0.284). The most common underlying condition was malignancy (58%) and over half received intensive care. Voriconazole utilisation among all hospitalised children significantly increased during the period (P=0.010). Our study demonstrates that the incidence of zygomycosis is not significantly increasing. During the time period there was a significant increase in the use of voriconazole among children.     

Hemoglobin in lymphogranulomatosis in children

The peculiarities of hemoglobin content and properties in lymphogranulomatosis were studied in children by different methods. In most patients the content of fetal hemoglobin and methhemoglobin was found to increase and the rate of ferricyanide oxidation of hemoglobin also increases. Simultaneously, the rate of non-homogenicity of basic hemoglobin fractions was observed to increase on account of immunologically different components.     

Dermatomycosis in Goats in India

Summary: In an extensive survey involving 2176 goats 1.56% of goats manifested clinical lesions of ringworm infection. Animals below the age of 6 months were affected most (4.20%). The incidence of infection was higher during the winter months. T. verrucosum, T. mentagrophytes and M. gypseum were isolated from the skin scrapings of 12, 4, and 2 goats respectively. It is suggested that the infected animals could be a source of disease to human population in which the zoophilic dermatophyte invasion is characterized by severe inflammatory lesions of the skin. The zoonotic importance of different dermatophytes is stressed.
Zusammenfassung: In einer ausgedehnten Untersuchung an 2176 Ziegen wurden bei 1,56% klinische Zeichen einer Hautmykose festgestellt. Tiere, die jühger als 6 Monate alt waren, zeigten mit 4,20% am häfigsten Krankheitssymptome. In den Wintermonaten war die Erkrankungshäufigkeit am gröBten. T. vermcosum, T. mentagrophytes and M. gypseum wurden jeweils von 12,4 bzw. 2 Ziegen isoliert. Die inflzierten Tiere köinnen eine Infektionsquelle für die menschliche Bevölkerung darstellen und dort Mykosen mit stark entzündlichen Veränderungen auslösen. Die Bedeutung verschiedener Dermatophyten als Erreger von Zoonosen wird hervorgehoben.     

Sex hormones in women in rural China and in Britain

Plasma concentrations of certain hormones linked to breast cancer risk were measured in age-pooled samples from 3,250 rural Chinese women in 65 counties, and 300 British women, all aged 35-64. In age-groups 35-44, 45-54 and 55-64 respectively, mean oestradiol concentrations were 36% (P = 0.043), 90% (P less than 0.001) and 171% (P = 0.001) higher in the British than in the Chinese women, and mean testosterone concentrations were 48% (P less than 0.001), 68% (P less than 0.001) and 53% (P = 0.001) higher in the British than in the Chinese women. The difference in testosterone concentrations between the two countries appeared to be due largely to the lower average body weight in the Chinese women. Sex hormone binding globulin did not differ significantly between the two countries in age groups 35-44 and 45-54, but was 15% (P = 0.002) lower in the British than in the Chinese women at ages 55-64. Prolactin concentrations did not differ significantly between the two countries in any age group.     

Temozolomide treatment in glioma--experiences in two university hospitals in Finland

Thirty-two patients with relapsing glioma were treated with temozolomide in two university hospitals in Finland. One patient (3%) had complete response and 9 (28%) partial response, with 8 patients (25%) showing stable disease. Median progression-free survival for these 18 patients (56%) was 7 months (range 2-11+). The remaining either had progressive disease (25%) or only clinical evaluation (19%). Karnofsky score improved in 34% of patients and decreased in 3%. Symptoms were alleviated in 44% and deteriorated in 9%. Grade 3-4 toxicity was detected in 9% of the patients. Only 4% of the days in treatment were spent in hospital. An average 1.8 neuroradiological investigations, 6.9 laboratory visits, and 5.3 visits to the oncologist were made. This study confirms that temozolomide has positive effects on the outcome of often heavily pretreated glioma patients. High drug costs are compensated by prolonged home care and even the possibility to maintain working capacity.