子宫内膜癌患者血清CA125水平与预后关系的再评价

目的探讨术前血清CA125水平指导子宫内膜癌治疗的价值。方法利用放射免疫法检测147例子宫内膜癌患者术前血清CA125水平。结果Ⅲ、Ⅳ期子宫内膜癌患者的CA125水平明显高于I、Ⅱ期（P〈0．01），CA125〉20kU／L诊断子宫内膜癌的敏感度和特异度分别为70．7％和98．0％。CA125〉35 kU/L诊断子宫内膜癌的敏感度和特异度分别为52．8％和100．0％。淋巴结转移阳性的患者血清CA125水平高于淋巴结转移阴性的患者。结论血清CA125值的检测对诊断子宫内膜癌及判断预后有一定的价值。     

人组织激肽释放酶4在子宫内膜癌中的表达和预后的关系

目的 探讨人组织激肽释放酶4（ KLK4）在子宫内膜癌中的表达和对预后的影响,为改善子宫内膜癌的预后提供新的思路。方法 免疫组化法检测81例子宫内膜癌、30例不典型增生的子宫内膜和30例正常子宫内膜中KLK4的表达情况,收集患者临床病理资料,结合随访资料做生存分析,并分析KLK4的表达和子宫内膜癌预后的关系。结果 KLK4在正常内膜、不典型增生内膜和子宫内膜癌中的高表达率分别为30％、53％、67％,差异有统计学意义（χ^212．059,P＝0．002）;KLK4的高表达和子宫内膜癌的分化程度及深肌层浸润相关（χ^2=7．985,P＝0．021;χ^2=4．629,P＝0．031）,与年龄、临床分期、淋巴结转移无关（χ^2分别为0．266、1．761、0．277,均P＞0．05）;KLK4高表达组的5年无进展生存率较低表达组更低,差异有统计学意义（P＝0．032）。结论 KLK4的高表达可能与子宫内膜癌细胞的分化和局部侵袭有关,其高表达提示早期复发,KLK4有可能作为预测子宫内膜癌早期复发的标志物。     

血清CA125水平与子宫内膜癌预后的关系

目的探讨糖类抗原125（CA125）测定对宫颈癌预后的关系。方法应用微粒子方法检测189例子宫内膜癌患者血清CA125值．将189例患者分别从手术一病理分期、组织类型影响顶后的其他因素等方面加以研究对比。结果手术病理分期程度与CA125阳性率呈正相关，且绝经后患者高于绝经前。CA125水平与病理组织类型有关，CA125水平与影响预后的其他目的有关。结论CA125水平越高，子宫内膜癌复发率越高。     

子宫内膜癌患者血清miR-125b水平及临床意义

目的探讨子宫内膜癌患者血清miR-125b水平及临床意义。方法选择2015年1月-2016年1月台州医院手术治疗的子宫内膜癌患者160例作为子宫内膜癌组,同期体检的健康者160例作为对照组。采用实时荧光定量聚合酶链反应(PCR)测定血清miR-125b水平。结果子宫内膜癌组血清miR-125b水平低于对照组(P<0. 05)。血清miR-125b水平与子宫内膜癌肌层浸润、临床分期、淋巴结转移有关(均P<0. 05),与子宫内膜癌患者年龄、组织病理分级、组织病理分型无关(P>0. 05)。子宫内膜癌术后血清miR-125b水平高于术前(P<0. 05)。以血清miR-125b为0. 87为临界值,血清miR-125b诊断子宫内膜癌的曲线下面积为0. 773,95%CI为0. 769～0. 777,灵敏度为56. 74%,特异度为85. 32%,P=0. 000。血清miR-125b低表达患者的总体生存期和无进展生存期短于miR-125b高表达患者(P<0. 05)。结论子宫内膜癌患者血清miR-125b水平降低,与子宫内膜癌肌层浸润、临床分期和淋巴结转移关系密切,在子宫内膜癌诊断、疗效评估和预后评估中具有重要意义。     

特殊病理类型的子宫内膜癌术前、术后相关因素分析

目的对比特殊病理类型(浆液性腺癌、透明细胞癌、癌肉瘤)子宫内膜癌与子宫内膜样腺癌术前、术后相关因素的影响。方法收集2011年12月-2016年12月在内蒙古医科大学附属医院或在其他医院门诊行分段诊刮术诊断为特殊病理类型的子宫内膜癌患者,均行分期手术,术后病理证实仍为此类病理类型的患者56例,与同一时间段子宫内膜样腺癌患者557例对比。结果子宫内膜样腺癌患者就诊年龄、初潮年龄显著低于特殊病理类型子宫内膜癌患者(P0. 05)。子宫内膜样腺癌患者中高血压、糖尿病、肥胖(BMI28 kg/m2)者所占比例显著高于特殊病理类型子宫内膜癌患者(P0. 05)。原发不孕、继发不孕、绝经年龄、绝经后阴道出血等方面比较差异无统计学意义(P0. 05)。子宫内膜样腺癌术前血清CA125阳性率显著低于特殊病理类型子宫内膜癌(P0. 05),而子宫内膜样腺癌血清CA199阳性率与特殊病理类型子宫内膜癌两组比较差异无统计学意义(P0. 05)。特殊病理类型子宫内膜癌患者的Ⅱ、Ⅲ、Ⅳ期所占比例明显高于子宫内膜样腺癌患者(P0. 05)。特殊病理类型子宫内膜癌患者发生肌层浸润深度≥1/2、宫颈间质浸润、子宫浆膜层和(或)输卵管卵巢转移、盆腔和(或)腹主动脉旁淋巴结转移、淋巴脉管浸润、膀胱和(或)肠黏膜或远处转移、腹水细胞阳性、雌激素受体阳性、P53阳性均高于子宫内膜样腺癌患者(P0. 05)。但孕激素受体阳性两组比较差异无统计学意义(P0. 05)。结论术前CA125增高,特殊病理类型子宫内膜癌可能性大。特殊病理类型的子宫内膜癌患者发病时期别较晚,恶性程度高,危险因素多,易复发,生存率低。故早发现、早治疗,对提高患者的预后具有重要意义。     

糖类抗原125、survivin在子宫内膜癌细胞中的表达及其与患者预后的相关性研究

目的 探讨糖类抗原125(CA125)、survivin在子宫内膜癌细胞中的表达及与预后相关性。方法 选择2018年5月-2019年5月本院收治的57例子宫内膜癌患者作为子宫内膜癌组,将同期于本院诊治的50例子宫内膜不典型增生患者纳入子宫内膜不典型增生组,另选择60例正常体检人员为正常组;分析子宫内膜细胞组织内CA125、survivin和子宫内膜癌临床病理特征关系,并探讨子宫内膜细胞组织内CA125、survivin和子宫内膜癌患者预后相关性。结果 子宫内膜癌临床Ⅲ期～Ⅳ期、组织学分级G3级、肌层浸润深度≥1/2、有淋巴结转移患者的survivin阳性表达率高于Ⅰ期～Ⅱ期、G1/G2级、肌层浸润深度1/2、无淋巴结转移患者(P 0. 05);子宫内膜癌细胞内CA125、survivin阴性表达患者的术后5年生存率均高于CA125、survivin阳性表达患者(P 0. 05);子宫内膜癌细胞内CA125、survivin阴性表达患者的生存时间均高于CA125、survivin阳性表达患者(P 0. 05)。结论 CA125、survivin在子宫内膜癌细胞中表达异常增高,与子宫内膜癌患者临床病理特征、预后存在相关性。     

血清HE4和CA125预测子宫内膜癌患者不良预后的价值

目的探讨术前血清HE4及CA125水平检测对子宫内膜癌患者不良预后的预测价值。方法选取2015年1月-2017年7月在九江市妇幼保健院肿瘤科初诊的子宫内膜癌患者60例为研究组,另选取同期在该院健康体检妇女70例为对照组。采用科华ST-360型免疫分析仪检测对照组血清HE4水平及研究组术前及标准化治疗后血清HE4水平,同时应用化学发光免疫分析仪检测CA125水平。分析血清HE4及血清CA125水平与研究组患者相关临床病理特征的相关性。结果研究组患者术前血清HE4、CA125水平显著高于对照组,两组差异有统计学意义(P0.05)。对照组年龄≥60岁妇女血清HE4水平显著高于年龄60岁妇女,差异有统计学意义(P0.05);对照组年龄≥60岁与年龄60岁妇女血清CA125水平比较,差异无统计学意义(P0.05)。研究组患者术后血清HE4、CA125水平显著下降,与术前相比差异有统计学意义(P0.05)。血清HE4水平与子宫内膜癌患者分期、病理类型、组织学分级无关(P0.05),与年龄、病灶范围、肌层浸润程度、淋巴转移情况有密切关系(P0.05)。血清CA125水平与子宫内膜癌患者病理类型、组织学分级无关(P0.05),与年龄、分期、病灶范围、肌层浸润程度、淋巴转移情况有密切关系(P0.05)。结论术前血清HE4及CA125水平的检测对子宫内膜癌患者不良预后因素的预测及随访监测有一定应用价值。     

血清 CA125和 CEA用于卵巢囊肿鉴别诊断中的价值分析

目的：探究血清糖类抗原（CA125）和癌胚抗原（CEA）用于卵巢囊肿鉴别诊断中的临床价值。方法选取2012年8月至2014年12月山东省烟台市北海医院妇产科收治的60例卵巢癌患者设为恶性组,同期收治的60例良性卵巢囊肿患者设为良性组,并选取同期体检的79例健康体检者作为对照组,所有患者均经病理诊断确诊,在所有受检者知情同意的情况下进行血清CA125和CEA的检测对比,分析阳性表达率与卵巢囊肿恶性程度的相关性。结果 CA125水平对比显示,恶性组显著高于良性组和对照组,差异具有统计学意义（t值分别为25．419、27．858,均P＜0．05）,良性组显著高于对照组（t＝4．677,P＜0．05）;CEA水平对比显示,恶性组同样显著高于良性组和对照组,差异具有统计学意义（t值分别为14．306、13．715,均P＜0．05）。恶性组患者的CA125、CEA水平均显著高于其他两组,差异具有统计学意义（t值分别为25．419、27．858、14．306、13．715,均P＜0．05）,良性组与对照组相比无显著差异（t＝1．709,P＞0．05）。 CA125阳性率恶性组显著高于良性组和对照组（χ2值分别为17．319、19．847,均P＜0．05）,良性组与对照组相比无显著差异（χ2＝2．007,P＞0．05）;CEA阳性率恶性组显著高于良性组和对照组（χ2值分别为8．665、9．404,均P＜0．05）,良性组与对照组相比无显著差异（χ2＝0．756,P＞0．05）;联合检出率恶性组显著高于良性组和对照组（χ2值分别为20．858、22．716,均P＜0．05）,良性组显著高于对照组（χ2＝2．437,P＜0．05）。从检出率对比来看,恶性组联合检出率显著高于CA125和CEA的单项阳性率（χ2值分别为3．906、,8．055,均P＜0．05）,良性组联合检出率与CA125和CEA的单项阳性率对比无显著差异（χ2值分别为0．413,1．796,均P＞0．05）。结论血清CA125和CEA能够对卵巢囊肿的良恶性作出鉴别诊断,联合检测能够为早期卵巢癌的诊断提供可靠依据,值得临床应用和推广。     

早期子宫内膜癌腹腔镜下分期手术的临床可行性及效果分析

目的：探讨腹腔镜分期手术治疗早期子宫内膜癌的临床效果及可行性。方法选取2012年6月至2014年1月江油市人民医院妇产科手术治疗的130例早期子宫内膜癌患者进行回顾性分析,其中67例患者采取腹腔镜分期手术治疗（腹腔镜组）、63例患者采取开腹分期手术治疗（开腹组）,对比两组患者的手术相关指标、手术并发症及手术前后患者免疫指标的变化。结果腹腔镜组患者的手术时间显著的长于开腹组患者,差异具有统计学意义（t＝6．832,P＜0．001）,腹腔镜组患者的手术出血量、术后排气时间、导尿管留置、住院时间均显著的低于开腹组患者,差异具有统计学意义（ t值分别为12．981、9．083、2．279、5．182,均P＜0．05）,两组患者淋巴结清扫数目差异不具有统计学意义（t＝1．461,P＝0．073＞0．05）;术后3d,腹腔镜组患者的CD4＋／CD8＋显著的高于开腹组患者,血清肿瘤坏死因子－α（ TNF-α）、降钙素原（ PCT）、白细胞介素－6（ IL-6）水平显著的低于开腹组患者,差异具有统计学意义（t值分别为5．017、17．982、5．352、7．880,均P＜0．001）;腹腔镜组患者的手术并发症率16．42％与开腹组患者的19．05％差异不具有统计学意义（χ2＝0．473,P＝0．491＞0．05）。结论腹腔镜分期手术治疗早期子宫内膜癌较开腹手术创伤小、恢复快、对患者免疫水平及炎症水平影响小。     

联合检测CA125、CA724在子宫内膜癌中的意义

目的:通过检测血清CA125、CA724在子宫内膜癌中的表达,探讨血清CA125、CA724水平对子宫内膜癌早期诊断及愈后预测的临床意义。方法:采用酶联免疫吸附测定ELISA方法检测子宫内膜癌患者术前术后、功能失调性子宫出血的患者、非子宫病变患者空腹静脉血中CA125、CA724的表达情况。结果:CA125、CA724在子宫内膜癌血清中呈高表达。CA125、CA724的表达水平与子宫内膜癌手术-病理分期的关系呈正相关。CA125、CA724对子宫内膜癌诊断特异性大于其敏感性。结论:血清CA125、CA724对于子宫内膜癌是否存在子宫外转移,以及疗效判定,评价预后及复发的早期诊断都具有很高的实用价值,在子宫内膜癌诊治过程中,CA724可以作为辅助诊断、判断预后的一项有价值标记物。     

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.     

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.