肺癌发病率与死亡率居癌症之首

新华网北京5月29日专电（记者朱玉）卫生部29日发布《2006年中国“吸烟与健康”报告》。调查表明，我国肺癌的发病及死亡年龄有年轻化的趋向。     

产毒性大肠杆菌致集体腹泻爆发流行

1991年5月20日至27日,成都驻军某部食堂发生一起急性腹泻暴发流行,发病率高达64％。现将流行病学调查和病原学鉴定结果报告如下: 材料与方法一、调查对象与标本收集调查患者发病情况填写方案调查登记表,同时用无菌棉签试子采集典     

林芝地区妇女应用Norplant皮下埋植避孕法380例应用分析

1992年5月1日-2007年5月1日，我们对林芝地区应用Norplant皮下埋植避孕法的妇女进行随访观察，现将随访满5年者380例结果报告如下。     

一起水净化系统失效致伤寒局部暴发的卫生学分析

驻粤某部在1993年5月3日至6月22日期间，营区范围先后出现一批原因不明的发热、肌肉酸痛、腹泻等症状的病人共42人。经流行病学调查和血细菌培养，证明为伤寒局部暴发，并查明是水净化系统失效所致。现将卫生学分析结果报告如下。部队概况和发病特点某部驻扎于粤中某地，营区包括两个单位，分别为某汽车独立团545人和共野战陆军团948人。生活饮用水除个别连队取用井水外，均为自制自来水。病人于5月3日开始陆续出现，分布广、散，无明显连排聚集世，但均在营区自来水供水范围内。经对水净化系统进行处理后，无续发病人出现。病人分布见表1。…     

武警部队精神疾病流行病学调查

为了解武警部队精神疾病（不含神经症，下同）的患病率，我们以1998年5月15日零点为调查时点，历时3个月，在武警部队7个总队（河南、四川、辽宁、上海、甘肃总队、北京二总队、8630部队）进行了精神疾病流行病学调查，现报告如下。1对象和方法11调查对象采用系统、分层、整群多级抽样方法，在上述7个总队各抽取2个支队（机动、执勤支队各1个，北京二总队。8630部队为机动部队，抽取全总队），所有在编人员做为调查对象。12方法121调查工具1982年中l习12地区及1993年中国7地区精神疾病流行病学调查使用的精神病筛查表'；根据武警部队特点设…     

西安地区4498名航天职工口腔卫生健康状况调查

1997年10月～1998年5月，我科对西安地区067基地4498名航天职工的口腔卫生健康状况进行了调查，调查内容主要有龋病、牙龈炎、牙周炎、楔状缺损和牙列缺失，调查的主要目的是了解职工的口腔健康状况，以便更有针对性地开展口腔疾病的防治和口腔卫生的宣传工作。现将调查结果报告如下。     

武警部队神经症流行病学调查

为了解武警部队神经症的患病率，我们以1998年5月15日零时为调查时点，对武警部队7个总队进行了凋查，现报告如下。1对象和方法11调查对象在武警部队7个总队（河南。四川、辽宁、上海、甘肃、北京二总队、8630部队）精神疾病流行病学调查总样本中按比例系统抽取1／3为神经症调查对象。12方法1．2、1调查工具1993年中国7地区神经症调查使用的神经症筛查表一'－；根据武警部队特点设计了一般资料调查表、心理卫生筛查表与神经症病史表，分别用于记录调查对象的一般资料、神经症筛查结果及确诊神经症病人的病史。122诊断标准中国1994年精神疾病…     

芦山地震伤员伤情特点及早期救治转运（附52例分析）

自2008年5月12日以来我国发生了多次地震，我们亲历的2008年5月12日汶川地震震级最高、烈度最大、损失最严重，2013年4月20日8时02分四川省雅安市芦山县发生7.0地震。我院作为第一支到达雅安市宝兴灵关镇的救援队伍第一时间收治转送伤员，本文就其伤情特点，早期救治及转运处理等报告如下。     

一起麻疹暴发性流行的调查

1994年5月14日～6月4日驻地某排在较短时间内突然发生一起以发热及不典型皮疹为主要临床表现的病人，经流行病学及血清学调查证实是一起麻疹暴发性流行，全排15人有9人发病，总罹患率60．0％，现将调查结果报告如下。1疫情概况1．1发病地点该排宿舍位于营区宿舍二楼西侧，走廊北面，全排15人居住一室，上下双层辅。南墙有一门，一窗，北墙有二个窗户，因西邻为公厕，平日基本不开，故通风不良。1．2发病情况第1例病人5月14日始发热，在单位接感冒服用对乙酸氨基酚（扑热息痛）、复方磺胺甲基异唑（复方新诺明）、乙酸螺旋霉素等治疗无效，5…     

某部新兵眼病调查分析

2005年12月23日-27日我科参加了某部2006年新兵体格复检工作，结合眼科检查，对新战士眼病情况进行调查，现将结果报告如下。     

A Little to a Lot or a Lot to a Little?

PURPOSE: To determine whether a little dose to a large normal lung volume or a high dose to a small lung volume is more critical for induction of clinical pneumonitis. The second question is if dose-volume histogram (DVH) parameters are more reliable, if the lungs are analyzed as separate organs or as a whole organ. PATIENTS AND METHODS: We analyzed the clinical and DVH data from 49 patients treated for a thoracic malignancy using 3-D conformal treatment plans. 18 patients had developed a clinical pneumonitis (CTC II or III). The majority of patients (n = 48) received radiochemotherapy for non-small-cell lung cancer (NSCLC) with a combination of paclitaxel and carboplatin. Patients were generally treated 5 fx/week, single dose 2 Gy, using a two-series approach (shrinking field) up to a total dose of 60-70 Gy. For every individual patient, the overall dose distribution was recalculated in the Helax-TMS by means of adding dose plans according to the total dose applied in each series. The lungs were defined both as separate organs and as a whole organ. Low-dose volume (< or = 10 Gy, Vlow), moderate-dose volume (> 10-40 Gy, Vmod) and high-dose volume (> 40 Gy, Vhigh), as well as V10-V40 and mean lung dose (MLD) were defined from the cumulative DVH. Dose-effect relationships were fitted with a logistic regression model. RESULTS: Manifestation of clinical pneumonitis was within 3 months from termination of irradiation in all cases. For the ipsilateral lung, the incidence of pneumonitis was closely correlated to Vhigh. The pneumonitis rate increased from 13% up to 60%. By contrast, with increasing Vlow the pneumonitis rate dropped to < 10%. A similar but less pronounced effect was seen for the total lung. The lung volumes Vlow, Vmod and Vhigh of the ipsilateral, contralateral and whole lung were significantly correlated to the corresponding MLD. The incidence of pneumonitis increased with increasing MLD for the ipsilateral lung with a D50 of 32 Gy and a gamma 50 of 0.98. For the whole lung, the observed increase was less steep. MLD showed a close correlation to NTCP calculated by the Kutcher model. However, NTCP calculation overestimated the pneumonitis risk for the ipsilateral lung and underestimated the risk for the whole lung due to the steeper gradient. The logistic regression curve for the DVH parameters V10-V40 showed an increase of steepness toward higher doses. From the logistic regression curves, a DVH template indicating critical borders of V10-V40 was generated for the ipsilateral as well as for the total lung. CONCLUSION: Our data indicate that it is reasonable to disperse the dose outside the target volume over large areas in order to reduce the volumes of lung receiving > 40 Gy. Reducing the high-dose volume reduces the pneumonitis rate more than a corresponding reduction in the low-dose regions of the DVH. Landmarks for DVH optimization as defined in this analysis may serve as a basis for DVH contrains in IMRT planning. Separate organ analysis produced more reliable results and should be preferred to whole-organ analysis, if techniques mainly involving one side of the lung are applied. Further validation of these constraints is necessary prior to general recommendation.     

Identification of a cannabimimetic indole as a designer drug in a herbal product

A cannabimimetic indole has been identified as a new adulterant in a herbal product being sold illegally in Japan for its expected narcotic effect. Liquid chromatography-mass spectrometry and gas chromatography-mass spectrometry analyses indicated that the product contained two major compounds. One was identified as a cannabinoid analog (1RS,3SR)-3-[4-(1,1-dimethyloctyl)-2-hydroxyphenyl]cyclohexan-1-ol (1) by direct comparison with the authentic compound, which we reported previously. The other compound (2) showed a molecular weight of 341 daltons, and accurate mass spectral measurements showed its elemental composition to be C₂₄H₂₃NO. Both mass and nuclear magnetic resonance spectrometric data revealed that 2 was 1-pentyl-3-(1-naphthoyl)indole [or naphthalen-1-yl-(1-pentylindol-3-yl)methanone] being identical to JWH-018, which was synthesized by Wiley and coworkers in 1998. This compound was reported as a potent cannabinoid receptor agonist possessing a pharmacological cannabimimetic activity.     

Suicide by a rifle with a muzzle brake: a particular entrance wound

The authors describe a case in which a 21-year-old male committed suicide using a rifle equipped with a muzzle brake, placed in contact with his head. A muzzle brake for firearms is a device positioned at the mouth of a weapon, which dissipates the gases, that are generated subsequent to the gun being discharged. Generally, when a gun is pressed against an anatomical region, where the skin lies on the bone surface without interposition of other soft parts, the entrance wound consists of many lacerated branches, originating from a central lack of tissue. In this case report, the use of a rifle with a muzzle brake generated an unexpected wound, circular in shape, with a diameter of 0.8 cm. This lesion was surrounded by a bruised area, circular in shape, and an abrasion collar of the height of 0.5 cm. In addition, a muzzle imprint mark consisting of intradermal bruises, composed of a narrow red line concentrically encircling the entrance hole, was found. In order to analyze in detail if this particular entrance wound could be associated with a weapon equipped with the muzzle brake, ballistic tests – with weapons compatible with that used by the victim – were performed.     

Death of a seven-month-old child in a washing machine: a case report

The authors present a case which brings out a unique modality of child homicide by placing the baby in a washing machine and turning it on. The murder was perpetrated by the baby’s mother, who suffered from a serious depressive disorder. A postmortem RX and then a forensic autopsy were performed, followed by histologic examinations and toxicology. On the basis of the results of the autopsy, as well as the histology and the negative toxicological data, the cause of death was identified as acute asphyxia. This diagnosis was rendered in light of the absence of other causes of death, as well as the presence of typical signs of asphyxia, such as epicardial and pleural petechiae and, above all, the microscopic examinations, which pointed out a massive acute pulmonary emphysema. Regarding the cause of the asphyxia, at least two mechanisms can be identified: drowning and smothering. In addition, the histology of the brain revealed some findings that can be regarded as a consequence of the barotrauma due to the centrifugal force applied by the rotating drum of the washing machine. Another remarkable aspect is that we are dealing with a mentally-ill assailant. In fact, the baby’s mother, after a psychiatric examination, was confirmed to be suffering from a mental illness—a severe depressive disorder—and so she was adjudicated not-guilty-by-reason-of-insanity. This case warrants attention because of its uniqueness and complexity and, above all, its usefulness in the understanding of the pathophysiology of this particular manner of death.

     

Hemodynamic during a postexertional asystolia in a healthy athlete: a case study

Hemodynamic events leading to spontaneous postexertional vasovagal syncope are not completely understood because of the lack of beat-to-beat data. We report a case study of a young athlete who undergoes a syncopal episode during the recovery period following a maximal cycle-ergometer test. The episode was monitored by an impedance cardiograph which can gather noninvasively beat-to-beat the flow of heart rate (HR), stroke volume (SV), cardiac output (CO), diastolic filling rate (SV/DT), and myocardial contractility index (PEP/LVET). The most important findings of this report are the dramatic reduction of SV/DT preceding the syncope, the increment of SV together with the reduction of HR preceding and following the syncope, the prompt recovery of CO values after the syncopal episode despite the bradycardia, and the reduction of PEP/LVET after the syncope. This report confirms the importance of active recovery immediately after strenuous exercise and supports the hypothesis that the reduction of SV/DT in the presence of an inotropic stimulation can trigger the vasovagal reaction.     

Atypical manifestation of a fistula between a hydatid cyst of a liver and a gallbladder: A case report

The hydatid cyst of the liver is the most common location of hydatid disease. Complications in this form are dominated by superinfection of the cyst and rupture into the bile ducts or the peritoneal cavity. We report the case of a 54-year-old female patient with a hydatid cyst of the liver complicated by a rupture in the gallbladder revealed by urinary symptoms.