46例首诊伴远处转移鼻咽癌的预后分析

Objective To retrospectively analyze the therapeutic results of patients with initially di-agnosed metastatic nasopharyngeal carcinoma (NPC). Methods From January 1995 to December 1998, 46 NPC patients with distant metastases were treated in Fujian provincial cancer hospital. Among these pa-tients, 43 were single site metastasis and 3 were multiple sites metastases;The site of metastasis were 19 pa-tients in the liver, 11 in the bone, 7 in the lung, 1 in the brain, 6 in mediastinal nodes and 6 in axillary lymph nodes. All patients received standard radiotherapy to the primary site and cervical node region with a median dose of 72 Gy. Forty-one patients (89%) received 1-5 cycles chemotherapy (cisplatin and 5-flu-orouracil), and 23 (50%) received palliative irradiation to the metastatic site. Results The median surviv-al time was 20 months. The 1-, 2-, 3-year and 5-year overall survival rates were 66%, 47%, 30% and 19%, respectively. Irradiation to the metastatic sites and KPS were the significant prognostic factors. Pa-tients with palliative irradiation to the metastatic site had longer survival than those without (39 months vs. 13 months, X2=8.63, P=0.012). Patients with good performance status (KPS≥80) had better outcomes thanthose with poor performance status (26 months vs. 12 months, X2= 3.95, P=0.035) . Conclusions Active therapy may prolong the survival of patients with initially diagnosed metastatic NPC, especially for those who have good performance status. Under systematic chemotherapy, radiotherapy to the primary site and supportive care, the palliative irradiation to the metastatic site may also yield a good result.     

一种朊蛋白错误折叠循环扩增方法的建立

目的建立一种类似于PCR的蛋白质扩增方法-蛋白错误折叠循环扩增技术(PMCA),用于朊病毒病脑组织中PrPSc的检测。方法将不同浓度的羊瘙痒因子263K毒株原液与正常仓鼠脑组织匀浆混合,经反复孵育/超声,共10~15个循环。WesternBlot检测扩增产物中蛋白酶K抗性PrPSc信号。结果在本研究试验体系下,263K毒株可以利用仓鼠脑组织为基质在体外迅速复制。所建立的PrPSc-PMCA技术可检测到10-5稀释的毒株原液中的PrPSc。与常规的脑组织免疫印记方法相比,敏感度提高了105~106倍。研究还显示PrPSc还可利用小脑和脑干为基质进行体外扩增复制。结论成功建立了PrPSc-PMCA技术,为朊病毒病的早期诊断和朊病毒生物学特性的研究提供了一种新的手段。     

46例首诊伴远处转移鼻咽癌的预后分析

Objective To retrospectively analyze the therapeutic results of patients with initially di-agnosed metastatic nasopharyngeal carcinoma (NPC). Methods From January 1995 to December 1998, 46 NPC patients with distant metastases were treated in Fujian provincial cancer hospital. Among these pa-tients, 43 were single site metastasis and 3 were multiple sites metastases;The site of metastasis were 19 pa-tients in the liver, 11 in the bone, 7 in the lung, 1 in the brain, 6 in mediastinal nodes and 6 in axillary lymph nodes. All patients received standard radiotherapy to the primary site and cervical node region with a median dose of 72 Gy. Forty-one patients (89%) received 1-5 cycles chemotherapy (cisplatin and 5-flu-orouracil), and 23 (50%) received palliative irradiation to the metastatic site. Results The median surviv-al time was 20 months. The 1-, 2-, 3-year and 5-year overall survival rates were 66%, 47%, 30% and 19%, respectively. Irradiation to the metastatic sites and KPS were the significant prognostic factors. Pa-tients with palliative irradiation to the metastatic site had longer survival than those without (39 months vs. 13 months, X2=8.63, P=0.012). Patients with good performance status (KPS≥80) had better outcomes thanthose with poor performance status (26 months vs. 12 months, X2= 3.95, P=0.035) . Conclusions Active therapy may prolong the survival of patients with initially diagnosed metastatic NPC, especially for those who have good performance status. Under systematic chemotherapy, radiotherapy to the primary site and supportive care, the palliative irradiation to the metastatic site may also yield a good result.     

中成药在精神科的应用情况分析及规范化管理实践分析

目的：调查了解中成药在精神科的应用情况,针对性的制定规范化管理方案,并评价应用效果。方法：调查了解2019—2021年之间医院精神科的中成药用药情况,按照中成药的类型分为安神类、清热类、解表类、理气类、补益类等,并按照世界卫生组织推荐的限定日剂量作为评价单位,按照《中国药典》中关于中成药的推荐剂量进行评价,统计2019—2021年中成药的日均费用、用药频度,统计不同类型中成药的用药占比,并统计2019—2021年精神科中成药的不合理用药情况。结果：2019—2021年间精神科中成药的日均费用、用药频度有逐渐上升趋势,但各组间比较无统计学差异(P>0.05);2019—2021年间精神科主要中成药用药类型均为安神类药物,不同时期中成药用药类型无显著变化(P>0.05);2019—2021年间精神科中成药的不良用药比例相对较低,且各年份之间比较并无显著差异(P>0.05)。结论：调查了解中成药在精神科的应用情况,能够为制定管理对策提供依据,能够进一步规范中成药在精神科的使用情况,减少不合理用药。     

单枚空心钉治疗未成年MeyersⅡ、Ⅲ型前交叉韧带胫骨止点撕脱骨折

目的 探讨在关节镜辅助下用单枚空心螺钉治疗未成年人MeyersⅡ、Ⅲ型前交叉韧带胫骨止点撕脱骨折的疗效.方法 选出我科2010年1月至2017年3月间收治的具有手术指征的10～18岁MeyersⅡ、Ⅲ型前交叉韧带胫骨止点撕脱骨折的未成年人21例,在关节镜辅助下复位骨折块,并用单枚空心螺钉在导针指引下行内固定治疗,通过测...     

新疆阿拉山口口岸2012年入境集装箱空箱卫生状况调查

目的对阿拉山口口岸2012年入境1514个需进行卫生处理集装箱空箱卫生状况和携带微生物情况进行调查分析,为加强入境集装箱空箱卫生检疫及卫生处理工作提供依据。方法对箱内携带垃圾进行分类分析,随机抽取集装箱,对其箱内表面采样,参考国家有关标准,采用显色培养基和生化培养试剂盒做微生物培养、鉴定菌种。结果处理集装箱空箱中,检查结果如下：携带动物尸体集装箱3个;携带动植物残留物集装箱101个;携带生活垃圾集装箱1373个;携带人类或动物传染病病原体集装箱48个;携带病媒生物集装箱37个。微生物检测情况如下：随机抽取处理集装箱空箱采集412份样品,检出金黄色葡萄球菌225株;沙门氏茵20株;大肠埃希氏菌61株;蜡样芽孢杆菌199株;链球菌31株等病原微生物。结论入境集装箱空箱携带垃圾、病原微生物为国际间疫病的传播提供了便利通道,给各国的卫生安全及人体健康带来威胁。应加强阿拉山口口岸入境集装箱空箱的卫生检疫及卫生处理工作。     

福建省2019—2021年免疫规划疫苗使用情况分析

目的 为更好地提高我省免疫规划疫苗的计划制定,为采取有效干预措施提供依据。方法 通过分析福建省2019—2021年免疫规划疫苗计划制定与实际使用的变动情况,探讨我省免疫规划疫苗制定计划环节的影响因素。结果近3年我省部分实际下发的免疫规划疫苗总体下发数逐年递减,各类疫苗间不均衡,总体使用计划量及使用率呈下降趋势。结论 提高免疫规划疫苗使用计划制定的准确性,为国家免疫规划工作提供更精准更有效的数据。     

单心室患者辅助循环设备的研究与应用进展

单心室由于其特殊的病理生理特点,一直是心脏外科治疗的难点之一,其术后低心排血量引起的心力衰竭是影响其生存率的重要问题之一。机械辅助支持(mechanical circulatory support,MCS)是治疗心力衰竭的有效手段,可以帮助患者渡过单心室术后短期低心排血量恢复,也可以进行长期辅助循环治疗慢性心力衰竭或过渡到心脏移植,有效挽救患者生命,但单心室辅助循环的成功率明显低于双心室的心力衰竭患者。我们总结了现在可用于单心室辅助循环支持的MCS装置和其单心室辅助的临床效果,并介绍针对功能性单心室特点正在研发或实验阶段的各种单心室辅助循环设备。     

保留桡骨茎突带桡动脉茎突支桡骨骨瓣移植治疗腕舟骨骨折不愈合

腕舟骨骨折是常见的骨折,由于其特殊的血供特点及解剖位置,骨不愈合的发生率为5％～10％,治疗较困难[1-2].2007年2月至2010年8月,我院采用带桡动脉茎突支桡骨骨瓣移植治疗腕舟骨骨折不愈合19例,疗效满意.资料与方法本组男12例,女7例.年龄21 ～ 45岁.病程8个月～12年.骨折部位:舟骨腰部骨折17例、近侧t/3骨折2例,其中3例近端缺血性坏死.临床表现:腕关节酸疼,持物时明显,握力下降,鼻烟窝区压痛.X线片显示:骨折线清晰,骨折断端硬化,断端骨吸收.近折端呈囊性变3例.