介入化疗联合放疗治疗中晚期肺癌的临床观察

目的探讨支气管动脉灌注(BAI)化疗联合放疗治疗中晚期非小细胞肺癌(NSCLC)的疗效及不良反应.方法96例不能手术的中晚期NSCLC患者,随即分组为放介组(48例)和单放组(48例).放介组采用经支气管动脉灌注化疗,每3～4w一次,共2～3次,间歇期行放疗,放疗采用60Co-γ线常规照射,DT65～70Gy.单放组放疗方法同方介组.结果有效率放介组85.4%明显高于单放组66.7%;1、2年生存率放介组75%和43.8%高于单放组52.1%和22.9%.结论BAI联合放疗治疗中晚期非小细胞肺癌可提高近、远期疗效,副反应小.     

局部晚期非小细胞肺癌术前选择性支气管动脉灌注化疗的临床研究

目的 评估术前选择性支气管动脉灌注(SBAI)化疗对局部晚期(Ⅲ期)非小细胞肺癌(NSCLC)治疗的临床效果及对手术的影响因素.方法 92例局部晚期NSCLC患者随机分为两组:SBAI化疗组41例,先给予2个疗程的SBAI化疗后进行手术治疗;单纯手术组51例,确诊后直接手术.比较两组患者的手术完全切除率及临床疗效.结果 SBAI化疗组的临床有效率和组织学有效率分别为68.3%和51.2%.SBAI化疗组的手术完全切除率(923%)高于单纯手术组(80.4%),P＜0.05.1、2年生存率SBAI化疗组分别为100.0%和74.4%,单纯手术组分别为94.1%和58.8%.结论 术前SBAI化疗安全有效,可获得较好的临床和组织学疗效,并能提高Ⅲ期NSCLC的手术完全切除率.     

支气管动脉灌注长春瑞宾顺铂治疗非小细胞肺癌疗效分析

目的评价支气管动脉灌注(BAI)长春瑞宾(NVB)顺铂(DDP)治疗非小细胞肺癌(NSCLC)的近期疗效。方法对手术难度较大,难以手术切除或不愿意接受手术切除的非小细胞肺癌患者36例,用NVB+DDP行BAI共2次,每次间隔3w。结果经2次BAI后,其中CR4例,PR21例,有效率69.56%。结论支气管动脉灌注长春瑞宾顺铂治疗非小细胞肺癌具有较好的近期疗效。     

支气管动脉灌注化疗联合全身化疗治疗中晚期肺癌的临床观察

目的 对比分析中晚期肺癌支气管动脉灌注化疗（BAI）与全身静脉化疗的疗效.方法 中晚期肺癌患者40例,均经病理证实,分为支气管动脉灌注化疗组（治疗组）与全身静脉化疗组（对照组）.结果 治疗组和对照组近期疗效有效率分别为75%和40%,半年、1年、2年生存率分别为95%、85%、45%和80%、45%、10%,组间差异有统计学意义（P〈0.05）,而且在毒副反应方面治疗组明显低于对照组.结论 支气管动脉灌注化疗是治疗中晚期肺癌的最有效方法之一,比全身静脉化疗能更有效地控制肺内原发病灶,延长患者的生存期,减轻患者的毒副反应.     

肺癌手术前后支气管动脉灌注的疗效观察

目的　探讨支气管动脉灌注 (BAI)在肺癌手术前、后不同的辅助治疗作用。方法　选择 90例肺癌患者 ,随机分为两组 ,分别在手术前、后辅以BAI治疗 ,随访 1～ 5年。结果　手术后灌注组术后 3、5年生存率均明显高于手术前灌注组。结论　术后行支气管动脉灌注是肺癌辅助治疗的一项重要手段。     

晚期直肠癌术前局部灌注化疗的疗效观察

目的　探讨术前动脉灌注化疗对晚期直肠癌临床治疗效果的影响。　方法　回顾性分析 ,62例晚期直肠癌患者的临床资料 ,其中 2 7例术前行动脉灌注化疗 (治疗组 ) ,3 5例单纯手术治疗 (对照组 )。　结果　治疗组症状明显减轻 ,肿块缩小 ,有效率 (CR +PR)为 81.4%。随访 5年 ,局部复发率治疗组 11.1% ,对照组 3 1.3 % (P <0 .0 1)。治疗组 5年生存率 48.1% ,对照组 2 2 .9% (P <0 .5 )。　结论　晚期直肠癌术前动脉灌注化疗可以缩小肿瘤 ,降低分期 ,减少局部复发率 ,提高 5年生存率     

顺铂+5-氟脲嘧啶介入化疗晚期宫颈癌35例疗效

目的 观察超选择动脉插管+顺铂联合5-氟脲嘧啶方案化疗在局部肿块直径≥4 cm的Ⅱa～Ⅲb期宫颈癌治疗中的疗效.方法 分析35例肿瘤直径≥4 cm的Ⅱa～Ⅲb期宫颈癌患者根治术前给予子宫动脉灌注化疗,观察肿块缩小程度、后续治疗及随访情况.结果 完全缓解22例,部分缓解10例,总有效率91.4 %,手术成功率81.3%;介入化疗后手术再辅以放化疗患者中位生存期15(6～38)个月;介入化疗后再行放化疗患者中位生存期12 (3～38)个月.结论 超选择动脉插管+顺铂联合5-氟脲嘧啶方案化疗作为术前辅助化疗对局部晚期宫颈癌患者是安全有效的.     

肺癌介入治疗的进展

肺癌是一种严重威胁人类健康和生命的疾病。近年来，其发病率逐年上升，已成为最常见的恶性肿瘤之一。不少患者一经诊断多属中晚期已不能手术，而静脉化疗效果也不理想，介入治疗以其特有的优越性在临床上日益受到重视。因支气管肺癌主要由支气管动脉供血，故经支气管动脉灌注化疗(bronchial arterial infusion，BAI)和支气管栓塞(bronchial artery embolization，BAE)治疗是支气管肺癌的主要介入治疗手段。BAI可使药物直接进入肿瘤，有效地提高肿瘤局部的药物浓度。高浓度的抗癌药物不但能阻止肿瘤细胞DNA的合成，而且产生细胞毒性作用进一步破坏癌细胞，使疗效较一般静脉化疗提高2—9倍。在此基础上行BAE，可使高浓度的药物较长时间滞留于肿瘤内，同时又可以减少或阻断肿瘤的血供，使其缩小、坏死。患者的生存率和生活质量均优于全身静脉化疗。在BAI和BAE日益发挥重要作用的同时，也有很多问题需要进一步总结和探讨。     

支气管动脉灌注化疗加免疫治疗肺癌伴恶性胸水的价值研究

目的 探讨支气管动脉灌注化疗加免疫治疗肺癌伴恶性胸水的价值研究。方法 将2018年1月-2020年12月在大庆油田总医院治疗的70例肺癌伴恶性胸水患者随机分为对照组和观察组,每组35例,对照组使用胸腔内化疗,在此基础上,观察组使用支气管动脉灌注化疗加免疫治疗,对比两组的近期疗效、免疫功能指标变化、不良反应。结果 观察组治疗有效率为82.86%,明显高于对照组的65.71%(P<0.05);观察组治疗后CD³⁺、CD⁴⁺、CD⁴⁺/CD⁸⁺明显高于对照组,CD⁸⁺明显低于对照组(P<0.05);观察组发热、胸痛、恶心呕吐等不良反应发生率与对照组相比无明显差异(P>0.05)。结论 支气管动脉灌注化疗加免疫治疗肺癌伴恶性胸水的价值显著,能提升对恶性胸水的抑制效果,调节机体免疫功能,不增加不良反应,具有积极的临床意义。     

三氧化二砷介入性治疗肺癌临床观察

目的探讨三氧化二砷(As2O3)联合支气管动脉灌注化疗(BAl)与单纯BAI治疗中晚期原发性肺癌的疗效、生存率、毒副反应差异。方法76例中晚期肺癌均经病理学确诊。研究组39例,BAI同时经导管给予As2O310mg治疗。对照组37例,单纯行BAI治疗。结果术后两组患者临床症状大部分缓解,咯血、咳嗽、胸痛好转,情况无差异(P>0.05);研究组中胸水吸收消退程度优于对照组,其中2例完全吸收,消退时间为3个月和5个月。毒副反应均轻微,无统计学意义(P>0.05)。研究组近期有效率为75%,对照组59%(P>0.05)。1年、2年、3年生存率两组分别为51%、10.3%、3%和38%、5%、0(P<0.05)。两组均未出现脊髓损伤、死亡等严重并发症。结论两种疗法的近期疗效、毒副反应相当;但AsO联合BAI能提高中晚期肺癌患者生存率,改善预后。     

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.