血清肿瘤标志物癌胚抗原及糖类抗原CA-199、CA-724联合检测在胃癌诊断中的应用探讨

目的探讨血清肿瘤标志物CEA、CA-199、CA-724联合检测在胃癌诊断中的应用价值。方法采用电化学发光技术对120例正常对照组,90例良性胃病组和60例胃癌患者血清CEA、CA-199、CA-724含量进行检测,并对其检测结果进行统计学分析。结果良性胃病组和健康对照组三项检测结果差异无统计学意义(P0.05),胃癌患者血清CEA、CA-199、CA-724含量水平明显高于健康对照组和良性胃病组(P0.01),联合检测血清CEA、CA-199、CA-724可明显提高对胃癌的阳性检出率和准确性(P0.05)。结论胃癌患者血清中CEA、CA-199、CA-724水平显著增高,联合检测三者对胃癌具有重要诊断价值。     

血清肿瘤标志物检测在结肠癌辅助诊断中的价值

目的探讨血清肿瘤标志物癌胚抗原(CEA)、血清糖类抗原199(CA199)、糖类抗原724(CA724)检测在结肠癌辅助诊断中的应用价值。方法选取结肠癌患者600例为结肠癌组,另选取结肠癌良性病变患者110例为良性病变组,健康体检人群100例为健康组。比较3组血清CEA、CA724、CA199的水平。结果结肠癌组CEA、CA199、CA724水平均显著高于良性病变组和健康组(P 0. 05)。CEA、CA199、CA724联合检测结肠癌的阳性率显著高于单独检测(P 0. 05)。采用CEA、CA199、CA724联合检测结肠癌的敏感性显著高于单独检测,而特异性显著低于单独检测(P 0. 05)。结论血清CEA、CA724、CA199联合检测对结肠癌的辅助诊断具有指导价值。     

血清CEA、CA-199和CA-125检测在原发性肝细胞癌诊断中的临床价值

目的探讨血清癌胚抗原(CEA)、糖类抗原199(CA-199)和糖类抗原125(CA-125)联合检测对原发性肝细胞癌(PHC)的诊断价值。方法回顾性分析2011年1月至2014年1月就诊的的PHC患者86例及其相关临床资料,同时以良性肝病(包括肝血管瘤、肝囊肿等)患者35例和普通门诊体检健康者48例作为该实验的对照组。结果 PHC组患者血清诊断肿瘤标志物CEA、CA-199以及CA-125的测定值相对于良性肝病组患者和正常对照组显著升高(P0.05)。三种血清诊断肿瘤标志物进行联合检测相对于单独检测能够显著提高PHC组患者的阳性诊断率(P0.05)。当PHC组患者血清诊断肿瘤标志物CEA、CA-199以及CA-125分别进行独检时其敏感度是67.5%、27.5%和42.5%,而三种标志物联检其敏感度可提高至95%。结论联合进行血清CEA、CA-199和CA-125检测能够显著提高诊断原发性肝细胞癌的敏感度。     

3项血清肿瘤标志物联合检测在胃癌早期诊断中的临床意义

目的研究血清糖类抗原199(CA199)、糖类抗原724(CA724)、癌胚抗原(CEA)在胃癌早期诊断中的临床意义,以筛选理想的肿瘤标志物组合,提高胃癌早期诊断的准确率。方法应用化学发光免疫分析仪检测98例胃癌患者、100例健康体检者血清中CA199、CA724、CEA的水平,同时分析单个肿瘤标志物和3种肿瘤标志物联合检测阳性率的差异。结果胃癌组CA199、CA724、CEA水平及阳性率均高于对照组,差异均有统计学意义(P0.05)。CA199+CA724明显高于2项单独检测阳性率,CA199+CEA明显高于CEA单独检测阳性率,CA724+CEA明显高于CEA单独检测阳性率,CA199+CA724+CEA联合检测胃癌阳性率明显高于3项单独检测,差异均有统计学意义(P0.05),其中CA199+CA724+CEA检测阳性率最高。结论 CA199、CA724、CEA 3项肿瘤标志物在胃癌诊断中具有较高的临床意义,联合检测优于单项检测。     

4种肿瘤标志物的检测对卵巢癌的诊断价值

目的 探讨肿癌胚抗原(CEA)、糖类抗原199(CA-199)、糖类抗原125(CA-125)和糖类抗原153(CA-153)等4种肿瘤标志物的检测对卵巢癌的诊断价值.方法 采用化学发光法检测49例卵巢癌患者、48例卵巢良性病变患者和40例健康体检者的口述4种肿瘤标志物,并探讨联合检测对诊断卵巢癌的临床价值.结果 49例卵巢癌患者血清CEA、CA-199、CA-125和CA-153阳性率明显高于卵巢良性病变组及健康对照组(均P<0.05),4项联合检测敏感性明显高于单项检测.结论 单项检测血清CEA、CA-199、CA-125和CA-153对卵巢癌的诊断有一定的临床价值,联合检测这4种标志物更具有临床意义.     

血清中CEA、CA199及CA724联合检测在结直肠癌诊断中的意义

目的 探讨联合检测血清CEA、CA199及CA724在结直肠癌诊断中的意义.方法 对45例结直肠癌患者、60例结直肠良性病变患者及50例正常体检者采用电化学发光法检测血清CEA、CA199及CA724,统计对比分析检验结果.结果 结直肠癌组患者血清CEA、CA199及CA724水平均明显高于结直肠良性病变组患者及健康体检组,相比差异有统计学意义(P＜0.05);而结直肠良性病变组与健康体检组相比差异吴统计学意义(P＞0.05);单项检测CEA对结直肠癌诊断的敏感度、特异度及检出率分别为62.22 %、60.00%及60.95%;联合检测CEA+CA199的敏感度、特异性分别为82.22%、76.66%及79.05%;而联合检测CEA+CA199+CA724为95.55%、90.00%及92.38%.结论 血清CEA、CA199及CA724检测在结直肠癌诊断中具有重要意义,三者联合检测可提高结直肠癌的检出率.     

血清4项指标联合检测在结直肠癌中的临床意义

目的探讨血清癌胚抗原(CEA)、糖链抗原199(CA199)、糖链抗原125(CA125)和糖链抗原724(CA724)联合检测在结直肠癌辅助诊断和临床参数的相关性。方法回顾性分析结直肠癌组164例、结直肠良性病变组56例、健康对照组49例的血清CEA、CA199、CA125和CA724浓度,统计分析4种肿瘤标志物在健康对照组、结直肠良性病变组和结直肠癌组中的阳性率以及其浓度与结直肠癌临床病理资料的相关性。结果结直肠癌患者血清CEA、CA199、CA125和CA724阳性率明显高于结直肠良性病变患者及健康者,差异有统计学意义(P0.05),联合检测血清CEA、CA199、CA125和CA724可明显提高结直肠癌诊断的敏感度;血清CEA与结直肠癌局部浸润程度、淋巴结转移、远处转移和临床分期相关;血清CA199、CA125和CA724浓度与远处转移相关;血清CA724在结直肠黏液腺癌中明显高于其他病理类型;血清CA125和CA724与大肠癌解剖部位有关;血清CEA和CA199与癌组织Ki-67表达水平呈负相关。结论血清CEA、CA199、CA125和CA724对结直肠癌临床辅助诊断有一定价值,4者联合检测可提高结直肠癌的检出率;血清CEA、CA199、CA125和CA724与结直肠癌临床病理参数有关,可作为结直肠癌预后和预测标志物。     

CEA、CA199、CA242、CA724联合检验在胃癌早期诊断中的临床价值

目的探讨CEA、CA199、CA242、CA724联合检验在胃癌早期诊断中的临床价值。方法选取我疗养院2012-02—2014-02诊治的30例胃癌早期患者(研究组),30例健康体检者(对照Ⅰ组),30例胃良性病变者(对照Ⅱ组),应用血清CA724、CEA、CA242、CA199指标予以检测,分析其检测结果。结果胃癌早期患者CA724、CEA、CA242、CA199水平比对照Ⅰ、Ⅱ组明显上升,差异有统计学意义(P0.05);联合检测在胃癌早期阳性率明显高于单项检测,差异有统计学意义(P0.05)。结论肿瘤标志物CA724、CEA、CA242、CA199在胃癌早期出现较为明显表达,四种指标联合检测阳性率较高。     

血清癌胚抗原、糖类抗原724和糖类抗原199对胃癌的早期诊断价值

目的研究血清癌胚抗原(CEA)、糖类抗原724(CA724)及糖类抗原199(CA199)对胃癌早期的诊断价值。方法选取病理诊断为胃癌的85例患者为A组,62例胃黏膜良性病变患者为B组,65例健康查体者为C组,检测3组研究对象血清CEA、CA724及CA199水平,比较肿瘤标志物单一检测与联合检测对胃癌诊断阳性率的影响。结果 3组研究对象的CEA水平差异有统计学意义(F=5.78,P=0.01);A组患者CEA水平明显高于B组、C组,差异有统计学意义(P0.05)。3组研究对象CA724水平差异有统计学意义(F=7.13,P0.05);A组患者CA724水平明显高于B组、C组,差异有统计学意义(P0.05)。3组研究对象CA199水平差异有统计学意义(F=6.06,P0.05);A组患者CA199水平明显高于B组、C组,差异有统计学意义(P0.05)。3组研究对象CEA检测阳性率差异有统计学意义(χ2=21.41,P0.05),且A组患者阳性率明显高于B组和C组。3组研究对象CA724检测阳性率差异有统计学意义(χ2=35.80,P0.05),且A组患者阳性率明显高于B组和C组。3组研究对象CA199检测阳性率差异有统计学意义(χ2=25.00,P0.05),且A组患者阳性率明显高于B组和C组。肿瘤标志物双联及三联检测的灵敏度明显高于单项检测,其中,CEA+CA724+CA199三联检测的灵敏度最高。结论 CEA、CA724及CA199可作为胃癌早期的辅助诊断指标,肿瘤标志物联合检测可提高胃癌检测的灵敏度。     

胰腺癌患者血清中CA199、CA242、CA125、CEA检测分析

目的探讨血清肿瘤标志物CA19-9、CA242、CA125、CEA检测在胰腺癌诊断及疗效监测的价值。方法用多肿瘤标志物蛋白芯片诊断系统测定87例胰腺炎患者、1150例健康体检者（对照组）1、33例胰腺癌患者,及30例胰腺癌患者手术前后血清中CA199、CA242、CA125、CEA含量。结果肿瘤标志物CA199、CA242、CA125、CEA胰腺癌组的阳性率为84.9%,炎症组阳性率为38.7%,正常对照组阳性率为1.6%,胰腺癌组阳性率显著高于胰腺炎组和健康体检对照组（P〈0.01）。胰腺癌患者手术前4项肿瘤标志物的水平表达高于手术后（P〈0.05）。结论联合检测血清CA199、CA242、CA125、CEA水平对胰腺癌辅助诊断有较好的临床参考价值。     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.

OBJECTIVE: Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology. DESIGN: Prospective study. SETTING: Antenatal counselling service for pregnant women. PATIENTS: Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C). INTERVENTIONS: All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively. OUTCOME MEASURES: Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation. RESULTS: Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002). CONCLUSIONS: The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

糖尿病视网膜病变筛查与防治中存在的问题及对策

目的探讨糖尿病视网膜病变(diabetic retinopathy,DR)患者筛查和防治中存在的问题及对策。方法以76例糖尿病DR患者为对象,调查未能早期接受眼科诊治的原因。结果存在问题主要是患者对DR防治知识不了解、血糖控制不理想、内科医生未建议进行专科检查等。结论眼科医护人员应密切与糖尿病专科的联系,尽早对DM患者进行DR健康教育,并开展社区DR防治工作。