内蒙古地区胃肠道间质瘤804例临床数据分析

目的 分析内蒙古地区7个临床中心胃肠道间质瘤(gastrointestinal stromal tumors,GIST)数据库中患者的临床病理特征、免疫组织化学、基因分型及预后情况.方法 回顾性分析2013年1月至2019年1月间内蒙古地区的GIST数据,分析GIST患者性别、年龄、发病部位、肿瘤直径、核分裂像和美国国...     

Chemotherapy Dose Intensity and Overall Survival Among Patients With Advanced Breast or Ovarian Cancer

Background

The effects of chemotherapy dose intensity on patient outcomes in advanced cancer are not well understood. We studied the association between chemotherapy relative dose intensity (RDI) and overall survival (OS) among patients with advanced breast or ovarian cancer.

An Outline of the Need for Psychology Knowledge in Health Professionals: Implications for Community Development and Breast Cancer Prevention

Knowledge of health and community psychology in health professionals influences psychosocial and community determinants of health and promoting participation in disease prevention at the community level. This paper appraises the potential of knowledge on psychology in health care professionals and its contribution to community empowerment through individual behavior change and health practice. The authors proposed a schematic model for the use of psychological knowledge in health professionals to promote participation in healthinterventions/disease prevention programs in developing countries. By  implication, the paper provides a vision on policies towards supporting breast cancer secondary prevention efforts for community health development in Asian countries.     

An mHealth Model to Increase Clinic Attendance for Breast Symptoms in Rural Bangladesh: Can Bridging the Digital Divide Help Close the Cancer Divide?

Objective.

To demonstrate proof of concept for a smart phone-empowered community health worker (CHW) model of care for breast health promotion, clinical breast examination (CBE), and patient navigation in rural Bangladesh.

Methods.

This study was a randomized controlled trial; July 1 to October 31, 2012, 30 CHWs conducted door-to-door interviews of women aged 25 and older in Khulna Division. Only women who disclosed a breast symptom were offered CBE. Arm A: smart phone with applications to guide interview, report data, show motivational video, and offer appointment for women with an abnormal CBE. Arm B: smart phone/applications identical to Arm A plus CHW had training in “patient navigation” to address potential barriers to seeking care. Arm C: control arm (no smart phone; same interview recorded on paper). Outcomes are presented as the “adherence” (to advice regarding a clinic appointment) for women with an abnormal CBE. This study was approved by Women’s College Hospital Research Ethics Board (Toronto, Ontario, Canada) and district government officials (Khulna, Bangladesh). Funded by Grand Challenges Canada.

Results.

In 4 months, 22,337 women were interviewed; <1% declined participation, and 556 women had an abnormal CBE. Control group CHWs completed fewer interviews, had inferior data quality, and identified significantly fewer women with abnormal breast exams compared with CHWs in arms A and B. Arm B had the highest adherence.

Conclusion.

CHWs guided by our smart phone applications were more efficient and effective in breast health promotion compared with the control group. CHW “navigators” were most effective in encouraging women with an abnormal breast examination to adhere to advice regarding clinic attendance.     

转移性骨肿瘤897例临床分析

目的总结分析转移性骨肿瘤的发病特点及临床特征。方法回顾性分析1980年1月，2003年12月本院临床诊断为转移性骨肿瘤897例，统计分析转移性骨肿瘤的发病特点及临床特征。结果转移性骨肿瘤好发于男性，以41～70岁多见，原发病灶男性最常见者依次来自肺（25．6％）、前列腺（11．4％）、肝（7．6％），女性则以肺（26．7％）、乳腺（12．1％）、胃肠（5．7％）；来源不明占24．0％。早期单发以脊柱、骨盆最为多见，晚期易全身多处转移。患者常因肢体疼痛（51．8％）、肿物（10．5％）、功能障碍（7．7％）、病理性骨折（7．5％）甚至截瘫（3．1％）等就诊，26．8％的患者因原发病灶症状就诊检查时发现骨转移。影像学以溶骨性改变（82．1％）多见。治疗以对症处理、缓解疼痛、化疗、放疗为主，手术多为姑息治疗。结论转移性骨肿瘤的临床特征复杂，应掌握其发病特点，争取早期诊断、早期治疗。     

基于放疗流程的信息整合平台系统研发与应用

目的 结合国内实际需求与科室特有流程,系统开发放疗信息整合平台MOSAIQ Integration Platform^CHN (MIP)。 方法 MIP采用C/S架构模式,后台数据库基于计划系统和MOSAIQ 数据库,独立运行在医院局域网络上。该系统硬件的5台网络服务器,运行基于“云服务”搭建的数据存储和网络服务平台;该系统软件基于Microsoft Visual Studio平台开发,使用C#网络编程语言编写。约200台网络工作站,可并行进行数据录入、查询、统计和打印等操作。 结果 MIP具有公告、预约、计费、单据管理(申请、执行)和系统管理等15个核心功能模块,已基本涵盖整个放疗流程。截至 2016年6月已接诊患者13546人、计划申请单13533张、实施放疗15475人次、结束小结14656人次、收费记录567048条、工作量记录506612例。 结论 MIP操作直观,实时性强,数据安全,运行稳定,是放疗信息化建设的重要组成部分;数字化、无纸化便于检索和统计,各类数据便于信息共享和科室管理。后续还可根据新的需求,及时对其进行必要更新和完善。     

基于放疗流程的放疗信息管理系统软件设计与实践

目的 结合科室实际工作需求自行研制开发放疗信息管理系统(RTIMS)软件,并作为瓦里安Varis或Aria治疗网络的有益补充。方法 网络服务器1台,用于运行Apache+PHP+MySQL搭建的数据库和网络服务平台;约30台网络工作站和20台个人计算机,可通过IE浏览器访问网络服务器提供的网络服务,进行数据录入、查询、统计和打印等操作。由于部分网络工作站为英文版Windows和IE,因而一些功能还开发了英文版。结果 将近 5年时间里,随着RTIMS在科室的深入应用和进一步需求,设计和实现了大量实用功能,已基本涵盖放疗整个流程。截至 2011年9月已录入患者数据如下:患者 3900例、门诊放疗记录 2600例、病程记录 6800例、结束小结 1900例、收费记录 6700例、工作量记录 83000例、计划申请单 3900例、IGRT记录 1600例等。结论 基于放疗流程的RTIMS数据安全可靠,系统运行稳定,使用简单方便,数据数字化便于检索和统计,各类数据便于信息共享和科室管理。由于是科室自行研发,还可根据新的需求及时对系统功能作必要更新和完善。     

Sun exposure concern,sun protection behaviors and physical activity among Australian adults

Objective Sun protective behavior and physical activity are both important for cancer prevention, and are currently promoted separately. Few studies have examined sun protective behaviors, in association with physical activity. This study aimed to explore the interrelationships between sun protective behaviors and physical activity. Method In an observational epidemiological study, 1,992 adults aged between 20 and 65 years provided responses to self-completion survey items on their concern about sun exposure, sun protection behaviors, physical activity, indoor sedentary behaviors, and their socio-demographic attributes. Results Men and women, and those who were active and inactive used different sun protection measures. Women reported more frequent use of sunscreen and seeking shade when outdoors, while men reported more hat wearing; women and those who were physically inactive were more concerned about sun exposure and skin damage. After controlling for age, education, and income, concern about sun exposure was associated positively with use of sun protection behaviors; however, those most concerned about sun exposure also tended to be physically inactive and spent more time in indoor sedentary behaviors. Conclusion To promote physical activity and sun protection simultaneously, it is important to take into account findings on their interrelationships, including the significant gender differences that we have identified.     

Urinary tuberculosis is associated with the development of urothelial carcinoma but not renal cell carcinoma: a nationwide cohort study in Taiwan

Background:

Obstructive uropathy and chronic urinary tract infection increase the risk of urinary tract cancer. Urinary tuberculosis (UTB) can cause chronic urinary tract inflammation, lead to obstructive uropathy, and potentially contribute to the development of urinary tract cancer. However, the association between UTB and urinary tract cancer has not been studied.

Methods:

This study enrolled 135 142 tuberculosis (TB) cases (male, 69%) from a nationwide health insurance research database in Taiwan and investigated the risk factors for urinary tract cancer, with emphasis on a history of UTB. The incidence of urinary tract cancer in the general population without TB was also calculated for comparison.

Results:

The TB patients had a mean age of 57.5±19.5 years. Of the 1287 UTB and 133 855 non-UTB patients, 15 (1.2%) and 396 (0.3%) developed urothelial carcinoma, respectively (P<0.001); and 2 (0.2%) and 96 (0.1%) developed renal cell carcinoma, respectively (P=0.240). Cox regression analysis revealed that age, male sex, end-stage renal disease, obstructive uropathy, arsenic intoxication, organ transplantation, and UTB (hazard ratio: 3.38 (2.01–5.69)) were independent risk factors for urothelial carcinoma. The hazard ratio of UTB was higher among female patients (5.26 (2.12–13.06)) than that among male patients (2.96 (1.57–5.60)).

Conclusion:

Urinary tuberculosis had a strong association with urothelial carcinoma, but not with renal cell carcinoma. In TB endemic areas, the urinary tract of TB patients should be scrutinised. It is also imperative that these patients be followed-up carefully in the post-treatment period, and urinalysis, ultrasonography or endoscopy should be an integral part of the follow-up.     

Impact of an electronic chart on the staff workload in a radiation oncology department

BACKGROUND: In order to improve the efficiency of patient care, we developed an electronic medical record system, named the Comprehensive Radiation Oncology Management System (C-ROMS). C-ROMS was used together with a commercial record-and-verify system, LANTIS (Siemens Medical Systems Inc., Concord, CA, USA). The impact of the C-ROMS/LANTIS system on the staff workload in the Radiation Oncology Department was quantified and evaluated. METHODS: Thirty-four breast cancer patients were divided into two groups based on the method of the charting and the delivery of radiation treatment. The paper chart and manual treatment were used for one group, and the C-ROMS/LANTIS for the other. For each group of patients, the workload per patient for each staff group in the department-nursing/clerical staff, simulation staff, dosimetry/physics staff and technologist staff-was measured and compared. RESULTS: The average total staff workload with the C-ROMS/LANTIS system was 28.2% less than that with the paper chart/manual treatment method. The workloads for nursing/clerical staff, simulation staff and technologist staff were reduced by 85.7, 61.2 and 20.6%, respectively. The workload for dosimetry/physics staff was increased by 28.4%. CONCLUSION: The C-ROMS/LANTIS system significantly decreased the averaged total staff workload, and thus increased the efficiency of patient care.     

青年与老年胃癌的临床特征与预后分析*

目的　探讨青年与老年胃癌的临床病理特点及影响预后的因素。方法　回顾性分析６６９例胃癌患者的临床资料,并根据年龄分为≤３０岁组、３１～７０岁组和＞７０岁组。对３组患者的病理特征及淋巴结转移等方面进行比较,Ｋａｐｌａｎ-Ｍｅｉｅｒ法计算患者的生存率,Ｌｏｇ-ｒａｎｋ检验分析年龄与患者预后的关系。结果　不同年龄胃癌组之间在组织分化程度、组织类型、浸润深度以及淋巴结转移均存在差异,≤３０岁组具有分化程度差、恶性程度高、侵袭力强、进展快的特点,其总生存率及预后最差,其次为＞７０岁组,３１～７０岁组预后相对较好。结论　年龄与胃癌的临床病理特征关系密切,不同年龄人群具有不同的发病特点。     

Outcomes of Elderly Patients Who Receive Combined Modality Therapy for Locally Advanced Non–Small-Cell Lung Cancer

Background

The objective of this study was to review our institution's experience among patients with locally advanced non–small-cell lung cancer (LA-NSCLC) treated with chemotherapy and radiation and to determine the prognostic significance of age.

Dietary and Other Risk Factors of Ovarian Cancer among Elderly Women

The age-specific mortality rate of ovarian cancer is increasing among women over 50 years of age, but remaining at a stable level among women under 50. This case-control study of ovarian cancer was undertaken to assess the environmental factors which may increase the mortality of the disease in the elderly. Fifty-six women with primary epithelial ovarian cancer whose ages were 50 years old or over were compared with two age-matched control groups. The results of the Mantel-Haenszel analysis were as follows. More cases were found to have never married than controls ( P <0.05), a larger proportion of cases were nulliparous ( P <0.05), a smaller proportion of cases had experienced an induced abortion ( P < 0.05) or had undergone permanent sterilization by tubal ligation ( P <0.05), the occurrence of breast or uterine cancer was more common in the mother or sisters of cases ( P <0.01), a larger percentage of cases used to eat meat daily ( P < 0.01) or used to eat fish daily ( P < 0.05), and a larger proportion of cases weighed under 40 kg ( P <0.05). Daily meat consumption was significantly associated with the occurrence of ovarian cancer even after adjusting for reproductive and other risk factors by conditional logistic regression analysis. The attributable risk for ovarian cancer in the elderly was 19.2% for daily meat consumption. The recent change in dietary habits might in part explain the rise of the mortality rate among the Japanese elderly.     

青岛市563例肺癌患者高危险因素的回顾性研究

目的筛查青岛地区肺癌高危险因素,以指导青岛地区人群进行肺癌综合预防工作。方法563例已确诊为原发性肺癌的患者作为病例组,按照1：1配对的方法,选择我院与病例组近亲属的同性别、同年龄的外伤患者作为健康对照组。所有病例均调查其发病前可能的危险因素,对于研究的项目,采用单因素条件Logistic回归分析和多因素条件Logistic回归分析,最终进入模型的项目为肺癌发病的独立危险因素或保护因素。结果单因素条件Logistic回归分析结果显示,共筛选出19项因素有统计学意义,最终进入模型有统计学意义的因素共6项,其中家族史、吸烟、生活应激强度大（5年内）、吃熟肉制品和抑郁等是肺癌发病的危险因素,而运动是肺癌发生的保护性因素。结论家族史、吸烟、生活应激强度大（5年内）、吃熟肉制品和抑郁等可引起青岛市人群肺癌发病增加,运动可以减少肺癌的发病风险。