甲状腺癌患者术后症状群的研究进展

甲状腺癌患者在确诊、手术治疗以及康复期会出现各种各样的症状,这些症状不是单一出现的,也不是在特定的时间出现,往往伴随着多种症状同时发生,并且这些症状之间相互协同、相互作用,对疾病的预后以及术后的生活质量造成严重的负面影响。本文旨在总结甲状腺癌患者症状群的国内外研究现状、测评工具和管理方法,分析目前甲状腺癌症状群的研究中存在的问题,为今后甲状腺癌患者症状群的针对性护理以及症状群管理提供理论依据。     

多发性骨髓瘤患者外周血CD38+细胞及细胞免疫功能变化的研究

目的：探讨多发性骨髓瘤(MM)细胞免疫功能和CD38)+细胞的表达。方法：采用免疫学方法检测了25例MM患者外周血T-淋巴细胞亚群和CD38)+细胞的含量，同时检测了18例正常献血员的细胞免疫功能和CD38)+细胞。结果：MM患者CD3+细胞、CD4+细胞、CD4+／CD8+比值下降，CD8+细胞比值增高(P均＜0.05)；MM患者外周血CD38)+细胞明显增多，并显著高于正常对照组(P＜0.05)。结论：MM患者存在细胞免疫功能紊乱，并表现为外周血中CD38)+细胞显著增高，与诊断密切相关。     

癌症患者前哨症状的研究进展

癌症患者在疾病治疗过程中会出现多种症状,常以集群的方式存在,严重影响患者的生活质量和预后。以前哨症状为切入点开展症状群干预,有利于了解症状群发生及变化的潜在机制,从而优化症状评估和管理。前哨症状在国内处于起步阶段,本文拟从癌症患者前哨症状发生现状、识别与确定、管理优点、研究不足、干预措施方面进行综述,分析和总结目前研究中存在的问题,为未来研究提供新思路,并为临床护理人员制定个性化、针对性的护理措施提供参考。     

卵巢癌患者化疗期间不同时间点症状群的变化规律及其与生活质量的关系

目的探讨卵巢癌患者化疗期间在不同时间点症状群的变化规律及其与生活质量的关系。方法选取2012年2月至2015年2月间完成5次化疗的112卵巢癌患者作为研究对象,在4个不同时间点对患者进行问卷调查。应用基于记忆症状评估量表(MSAS)和卵巢癌患者生命质量测定量表(FACT-O)对患者症状严重程度以及生活质量进行评价和纵向对比。结果分析各症状的主成分,共提取出躯体化症状群、情感性症状群、胃肠道症状群和不良反应症状群。在T1时期出现2个症状群,T2~T3时期均出现4个症状群。方差结果显示,卵巢癌患者在化疗期间不同时间点的生活质量总分差异有统计学意义(P<0.05)。卵巢癌患者化疗期间不同时间点的生活质量各维度评分中,功能状况维度评分最低,其次是生理状况。结论卵巢癌患者在化疗过程中存在多个严重影响患者生活质量的症状群,护师应根据患者在化疗期间每个阶段症状群的严重程度,有侧重地进行干预,准确及时地对症状进行评估,并进行有效管理,以提高患者的生活质量。     

多发性骨髓瘤111例临床分析

目的 探讨多发性骨髓瘤(MM)的临床特征.方法 对111例MM患者临床资料进行回顾性分析.结果 MM首发症状出现率最多的是骨痛,依次为贫血、病理性骨折、蛋白尿、反复发生的感染及.肾功能异常.结论 MM起病隐匿,临床表现多样化,易误诊,提高对:MM的临床表现的认识将有利于诊断率的提高.     

多发性骨髓瘤硼替佐米治疗后以肠梗阻为首发症状的周围神经病变2例

多发性骨髓瘤(MM)为血液系统常见的恶性浆细胞疾病,国内外推荐硼替佐米作为MM的一线治疗药物[1-2],近年来其相关副作用也逐渐被人们所重视。硼替佐米的主要副作用之一是周围神经病变,同时该药也可以引起消化系统的症状,其中个别患者在病情严重时可并发肠梗阻[3-5],肠梗阻多为单独发生,很少合并感觉、运动等周围神经病变。我院在应用硼替佐米为主的方案治疗MM的过程中,出现2例以肠梗阻为首发症状的周围神经病变的病例,现报告如下。     

食管癌患者症状群与生活质量的相关性分析

目的：描述食管癌患者的症状群种类,分析其与患者生活质量的相关性。方法收集190例食管癌患者的一般资料,采用埃德蒙顿症状评价系统量表（ESAS）和癌症治疗功能评价系统（FACT-G）对癌症患者症状和生活质量进行调查;通过主成分分析提取食管癌的症状群,通过Pearson相关分析探讨症状群与生活质量各维度间的相关性,并利用多元线性回归分析生活质量和不同症状群间的关系。结果食管癌患者同时受多种症状困扰,症状频率和严重程度最高的是疲乏为180（94.6%）,（6.13±1.65）分;食管癌患者生活质量总得分为（63.53±12.44）分,处于中等水平。评分最低为情感状况（14.37±4.72）分,最高为社会/家庭状况（17.45±3.40）分;食管癌患者存在胃肠道、情感及病感3种症状群,且症状群与患者生活质量相关（P﹤0.05）;胃肠道症状群和病感症状群是食管癌患者生活质量主要的影响因素（P﹤0.05）。结论食管癌患者存在症状多,受多个症状群困扰,生活质量水平中等。护理人员应根据症状群特点,制定更高效、更个体化的干预机制,提高患者生活质量。     

左前胸壁肿物合并胸腔积液的多发性骨髓瘤一例并文献复习

 目的　分析以胸壁肿物合并胸腔积液为首发症状的多发性骨髓瘤（MM）患者肺部浸润的临床病理特征。方法　分析1例MM肺部浸润患者的全部临床资料,同时复习相关文献。结果　根据临床症状、体征、各项理化和影像学检查及胸壁肿物细针穿刺的病理学特征,明确诊断为MM（IgG型 ,ISS分期Ⅲ期）。结论　胸壁肿物合并大量胸腔积液为首发表现的MM非常少见,在临床上极易被误诊,全面观察病情及各项检查结果对诊断及临床治疗有重要意义。     

激活素A在多发性骨髓瘤发病中的研究进展

摘 要：多发性骨髓瘤（MM）是恶性浆细胞肿瘤,引起血钙升高、肾损害贫血和骨损害（CRAB症状,症状性骨髓瘤）。在MM患者中,高水平的激活素A不仅与MM的病情进展有关,与MM的溶骨性骨质破坏、贫血也相关,且影响MM患者的预后。抗激活素A疗法的应用,不仅可治疗MM相关的骨质破坏、贫血,也能改善MM患者的预后,故激活素A可能是MM或肿瘤性骨病的有希望的治疗靶点,特别是合并肿瘤性贫血的患者     

多发性骨髓瘤的新药治疗方案：第57届美国血液学会年会报道

随着对多发性骨髓瘤（MM）生物学认识的加深和新药的出现，含新药的联合化疗方案加深了MM的治疗反应并延长了患者的生存期。文章总结了第57届美国血液学会年会报道的免疫调节剂、蛋白酶体抑制剂、去乙酰化转移酶抑制剂及单克隆抗体等新药联合治疗在MM中的进展。同时，微小残留病（MRD）也随之被用于评价缓解的深度。为使MM患者达到更长期缓解和更高生命质量的目标，新药组合的方案更受推荐，尤其对于复发或高危的MM患者。     

Ringworm in animals in a farm in Assiut

Bericht über das Auftreten von Hautmykosen bei Tieren auf der Farm der Landwirtschaftlichen Fakultät der Universität Assiut. Von 70 Kälbern waren 42 pilzkrank, davon 22 durch T. mentagrophytes, 20 durch T. verrucosum. Von 180 Kühen waren 8 pilzbefalien, sämtlich durch T. mentagrophytes. Von 2 kranken Bullen wurde T. verrucosum isoliert. Auch die 3 Pferde und 2 Maultiere der Farm waren pilzinfiziert; Erreger war in diesen Fällen T. equinum. Auch ein Kalb war von T. equinum befallen. Die gleiche Pilzart wurde ferner von 3 Tierpflegern isoliert, die Pilzherde am Hals und an den Armen aufwiesen.     

Statistical challenges in preprocessing in microarray experiments in cancer

Many clinical studies incorporate genomic experiments to investigate the potential associations between high-dimensional molecular data and clinical outcome. A critical first step in the statistical analyses of these experiments is that the molecular data are preprocessed. This article provides an overview of preprocessing methods, including summary algorithms and quality control metrics for microarrays. Some of the ramifications and effects that preprocessing methods have on the statistical results are illustrated. The discussions are centered around a microarray experiment based on lung cancer tumor samples with survival as the clinical outcome of interest. The procedures that are presented focus on the array platform used in this study. However, many of these issues are more general and are applicable to other instruments for genome-wide investigation. The discussions here will provide insight into the statistical challenges in preprocessing microarrays used in clinical studies of cancer. These challenges should not be viewed as inconsequential nuisances but rather as important issues that need to be addressed so that informed conclusions can be drawn.     

Trends in zygomycosis in children

Zygomycosis, or mucormycosis, is associated with significant morbidity and mortality in both children and adults. Studies in adults have shown an increase in the incidence of zygomycosis, particularly among haemtopoietic stem cell transplant (HSCT) recipients and patients with haematologic malignancies. There is a paucity of data on the epidemiology of zygomycosis in children. We performed a retrospective analysis to describe trends in zygomycosis between 1 January 2003 and 31 December 2010. We used the Pediatric Health Information System (PHIS) database to identify paediatric patients who were diagnosed with zygomycosis during the study period. Administrative data on diagnoses, demographics, underlying conditions and clinical experiences were collected. Summary statistics were calculated and tests for trend were conducted. We identified 156 unique patients with zygomycosis. The prevalence of zygomycosis did not significantly increase over time (P=0.284). The most common underlying condition was malignancy (58%) and over half received intensive care. Voriconazole utilisation among all hospitalised children significantly increased during the period (P=0.010). Our study demonstrates that the incidence of zygomycosis is not significantly increasing. During the time period there was a significant increase in the use of voriconazole among children.     

Hemoglobin in lymphogranulomatosis in children

The peculiarities of hemoglobin content and properties in lymphogranulomatosis were studied in children by different methods. In most patients the content of fetal hemoglobin and methhemoglobin was found to increase and the rate of ferricyanide oxidation of hemoglobin also increases. Simultaneously, the rate of non-homogenicity of basic hemoglobin fractions was observed to increase on account of immunologically different components.     

Dermatomycosis in Goats in India

Summary: In an extensive survey involving 2176 goats 1.56% of goats manifested clinical lesions of ringworm infection. Animals below the age of 6 months were affected most (4.20%). The incidence of infection was higher during the winter months. T. verrucosum, T. mentagrophytes and M. gypseum were isolated from the skin scrapings of 12, 4, and 2 goats respectively. It is suggested that the infected animals could be a source of disease to human population in which the zoophilic dermatophyte invasion is characterized by severe inflammatory lesions of the skin. The zoonotic importance of different dermatophytes is stressed.
Zusammenfassung: In einer ausgedehnten Untersuchung an 2176 Ziegen wurden bei 1,56% klinische Zeichen einer Hautmykose festgestellt. Tiere, die jühger als 6 Monate alt waren, zeigten mit 4,20% am häfigsten Krankheitssymptome. In den Wintermonaten war die Erkrankungshäufigkeit am gröBten. T. vermcosum, T. mentagrophytes and M. gypseum wurden jeweils von 12,4 bzw. 2 Ziegen isoliert. Die inflzierten Tiere köinnen eine Infektionsquelle für die menschliche Bevölkerung darstellen und dort Mykosen mit stark entzündlichen Veränderungen auslösen. Die Bedeutung verschiedener Dermatophyten als Erreger von Zoonosen wird hervorgehoben.     

Sex hormones in women in rural China and in Britain

Plasma concentrations of certain hormones linked to breast cancer risk were measured in age-pooled samples from 3,250 rural Chinese women in 65 counties, and 300 British women, all aged 35-64. In age-groups 35-44, 45-54 and 55-64 respectively, mean oestradiol concentrations were 36% (P = 0.043), 90% (P less than 0.001) and 171% (P = 0.001) higher in the British than in the Chinese women, and mean testosterone concentrations were 48% (P less than 0.001), 68% (P less than 0.001) and 53% (P = 0.001) higher in the British than in the Chinese women. The difference in testosterone concentrations between the two countries appeared to be due largely to the lower average body weight in the Chinese women. Sex hormone binding globulin did not differ significantly between the two countries in age groups 35-44 and 45-54, but was 15% (P = 0.002) lower in the British than in the Chinese women at ages 55-64. Prolactin concentrations did not differ significantly between the two countries in any age group.     

Temozolomide treatment in glioma--experiences in two university hospitals in Finland

Thirty-two patients with relapsing glioma were treated with temozolomide in two university hospitals in Finland. One patient (3%) had complete response and 9 (28%) partial response, with 8 patients (25%) showing stable disease. Median progression-free survival for these 18 patients (56%) was 7 months (range 2-11+). The remaining either had progressive disease (25%) or only clinical evaluation (19%). Karnofsky score improved in 34% of patients and decreased in 3%. Symptoms were alleviated in 44% and deteriorated in 9%. Grade 3-4 toxicity was detected in 9% of the patients. Only 4% of the days in treatment were spent in hospital. An average 1.8 neuroradiological investigations, 6.9 laboratory visits, and 5.3 visits to the oncologist were made. This study confirms that temozolomide has positive effects on the outcome of often heavily pretreated glioma patients. High drug costs are compensated by prolonged home care and even the possibility to maintain working capacity.