放置节育器女性1～4年内发生异位的情况分析

目的:探讨B超诊治放置节育器女性发生异位的作用,以期提高妇女避孕安全性。方法:随机选取2008年6月至2009年5月的110例宫内放置节育器患者为研究对象,对所有的患者均定期进行B超检查,观察术后1~4年节育器异位情况。结果:1~4年内发生宫外异位、下移、节育器断裂或变形、嵌顿的例数逐年增多,节育器放置1年内异位比率为10.91%,第2年节育器异位比率为13.62%,第3年节育器位置异位比率为13.63%,第4年节育器异位比率为24.54%。此外还有少数发生脱环、带环受孕等情况。结论:节育器异位的发生会随着时间增长而增多,放置宫内节育器的妇女应注意定期体检复查。     

Trends in case detection influenced by leprosy elimination campaigns in certain areas of China

LECs were carried out from 1998 to 2000 in eight counties of west China. The number of cases detected during the year of LECs was much higher than that detected by routine methods before the year of the LEC. However, the annual number of cases detected during the year after the LEC showed different patterns. One pattern is that the number of new cases detected in the year after the LEC declined to the level similar to that before the year of the LEC. The second pattern is that the number of new cases detected in the year after the LEC declined steeply to less than that detected before the year of the LEC. Following peak case-detection during the year of the LEC, a gradual decrease in the number of new cases was observed in the subsequent years. The repeat LEC brought a weakly rebounding peak case-detection during the year following the first LEC carried out 3 years earlier. The operational, epidemiological and technical factors influencing the trends of case-detection during the LECs are discussed.     

睾丸生殖细胞肿瘤患者行睾丸部分切除术的1、3、5年生存率分析

目的：分析睾丸生殖细胞肿瘤患者行睾丸部分切除术后的1、3、5年生存率。方法：运用回顾性分析的方法 1998年10月至2008年10月110例来我院行睾丸部分切除术的睾丸生殖细胞肿瘤患者的临床资料,分析不同病理类型、术后行不同辅助治疗方式患者的1、3、5年生存率。结果：本研究中110例睾丸生殖细胞肿瘤患者行部分切除术后1年生存率为99.8%,3年生存率为92.8%,5年生存率为87.8%。睾丸精原细胞瘤患者的1年、3年、5年生存率分别为100%、96.6%、86.5%;睾丸非精原细胞瘤患者的1年、3年、5年生存率分别为98.7%、92.3%、80.2%,不同病理类型患者的1年、3年、5年生存率存在统计学差异（P〈0.0001）;不同病理类型的患者术后辅以不同的治疗方式1年、3年、5年生存率亦存在统计学差异（P〈0.05）。结论：睾丸生殖细胞肿瘤患者的1年、3年、5年生存率与病理类型及术后辅助治疗方式有关,睾丸精原细胞瘤患者的1年、3年、5年生存率高于睾丸非精原细胞瘤患者。     

One-Year Followup on the Impact of a Sun Awareness Curriculum on Medical Students' Knowledge, Attitudes, and Behavior

BACKGROUND: A one-week sun awareness curriculum was developed at the University of Western Ontario to educate first-year medical students on skin cancer risks and prevention. OBJECTIVE: To assess the retention of knowledge, attitudes, and behavioral practices one year after receiving education in sun awareness. METHOD: Three surveys were administered: before, immediately after the sun awareness teaching, and one year later. Actual practiced behavior in the past year was compared with the intended behavior. RESULTS: Half as many sunburns were reported in the year following the sun awareness curriculum compared with the previous year. Medical students demonstrated a good retention of the knowledge learned a year earlier. However, many students still believed that a tanned appearance looks healthy. While there was intent to adopt more healthy behavior after the curriculum, the actual behavior practiced varied. CONCLUSIONS: An undergraduate medical curriculum on sun awareness can be effective in improving the knowledge, attitudes, and behaviors of future physicians.     

吡柔比星联合维拉帕米膀胱灌注对膀胱癌术后复发的预防效果分析

目的:探讨吡柔比星联合维拉帕米膀胱灌注治疗应用于膀胱上皮癌术后复发的效果及安全性。方法:将本院收治的54例膀胱上皮癌行经尿道膀胱肿瘤电切术(TURBT)或膀胱部分切除术患者随机分为实验组和对照组,实验组患者给予吡柔比星联合维拉帕米膀胱灌注治疗,对照组患者给予吡柔比星膀胱灌注治疗。随访观察5年,比较两组患者1年、3年、5年的累计复发率,以及治疗过程中膀胱刺激征、血尿、化学性膀胱炎等不良反应发生率。结果:实验组1年、3年、5年的累计复发率分别为3.7%、7.4%、11.1%,不良反应发生率为51.9%;对照组1年、3年、5年的累计复发率分别为14.8%、29.6%、37.0%,不良反应发生率为48.1%。实验组3年、5年累积复发率显著低于对照组(P<0.05),不良反应发生率无显著差异(P>0.05)。结论:在吡柔比星膀胱灌注的基础上,联合应用维拉帕米能够显著降低膀胱上皮癌术后复发率并保留患者的性功能,且安全性较高,值得临床推广应用。     

Natural history of genital herpes simplex virus type 1 infection

BACKGROUND: Herpes simplex virus type 1 (HSV-1) has been increasingly reported as a cause of genital herpes, yet there have been few studies on the long-term natural history of this infection.GOAL The goal was to examine the clinical course of genital HSV-1 infection. STUDY DESIGN: This was a cohort study of patients presenting with culture-proven primary genital HSV-1 infection. RESULTS: The median follow-up of the 77 patients was 736 days. The overall rate of recurrences was 1.3/year in the first year of infection, decreasing to 0.7/year in the second year. In the first year of infection, 43% of study patients did not have a recurrence. In the second year of infection, 67% of study patients did not have a recurrence. CONCLUSION: Genital HSV-1 recurs infrequently in most patients, and the rate decreases further in the subsequent years of infection. Because the prognoses of genital HSV-1 and HSV-2 infections differ, determination of the viral type is important for patient counseling.     

Analysis on the detection of new leprosy cases before, during and after the year of leprosy elimination campaigns

To analyse the impact on of case finding of leprosy elimination campaigns (LECs), data on newly detected leprosy cases in a leprosy endemic area were collected before, during and after the year of LEC. The number of new leprosy cases detected during the year of LEC was significantly higher than previously. The number of newly detected cases after the year of LEC was similar to that of detected before the year of LEC in counties with persisting case finding activities. However, the number of newly detected cases after the year of LEC significantly decreased in counties without active case finding activities. The average distance from the homes of leprosy cases detected during LEC to the leprosy control unit at the count town was 62.8 km, which is farther than that of other leprosy cases detected before and after the year of LEC. The average time from disease onset to diagnosis of leprosy cases detected after the year of LEC shortened. The results also showed that carrying out LECs is unlikely to have a significant impact on the trend of case finding within a short time in local areas, but it may improve some indicators of leprosy patients and so promote leprosy control in local areas.     

2007-2009年昆明市延安医院水痘患者资料分析

目的了解昆明市延安医院门诊近3年来水痘患者的流行病学特征,并为有效控制水痘提供依据。方法对2007-2009年昆明市延安医院水痘报告病例的资料进行描述性流行病学分析。结果共统计了1193例水痘患者,男女比例1.09∶1;发病年龄3个月～50岁,但以1～14岁居多,且以学生为主,占54.23%;成人水痘发病的构成比有逐年上升的趋势,2009年达到了44.08%,近三年来成人水痘发病的构成比差异有统计学意义(P<0.01)。结论昆明市延安医院门诊近3年来水痘仍以1～14岁学生患者居多,成人水痘发病有上升趋势。     

Combination therapy with finasteride and low‐dose dutasteride in the treatment of androgenetic alopecia

We report on a 47‐year‐old man who was initially treated with finasteride for androgenetic alopecia. Despite continuous treatment, after year 4 his hair density was not as good as at year 2, and low‐dose dutasteride at 0.5 mg/week was added to the finasteride therapy. This resulted in a dramatic increase in his hair density, demonstrating that combined therapy with finasteride and dutasteride can improve hair density in patients already taking finasteride.     

Economic burden of psoriatic patients in Japan: Analysis from a single outpatient clinic

Topical and systemic agents have dramatically improved the treatment efficacy of psoriasis. Few reports, however, exist describing the economic burden in Japanese psoriatic patients. The aim of the study was to evaluate the total costs as well as cost versus efficacy of topical and systemic treatments of psoriatic patients under the Japanese health insurance system. The retrospective study was performed from the database of our clinic, which is located in Hokkaido Prefecture. Cost and effectiveness of psoriatic patients were evaluated during the 12‐month period from April 2015 to March 2016. Data were collected and calculated for the total cost per year, treatment efficacy and cost versus efficacy. The mean total cost of topical corticosteroid treatment was ¥18 184/year and was lowest among the treatments. The systemic treatment with biologics was most expensive and the costs were over ¥400 000/year. Among the topical treatments, calcipotriol/betamethasone dipropionate was most expensive (¥34 693/year). However, cost versus efficacy was not significantly different from that of topical corticosteroid treatments. The cost of secukinumab was highest among all the treatments (¥631 600/year). However, treatment day per cost was lowest of all the psoriasis treatments. Biologics showed the highest cost than topical or systemic treatments. However, they showed most marked efficacy in terms of improving the psoriatic skin lesions.