2019年重庆市30岁及以上人群归因于被动吸烟的肺癌疾病负担研究

目的 分析重庆市肺癌发病死亡和疾病负担归因于被动吸烟的情况,为开展肺癌防治提供建议。 方法 肺癌死亡个案数据来源于2019年重庆市肿瘤登记报告系统,被动吸烟率来自2013年重庆市慢性病及危险因素监测。计算人群归因危险度百分比(population attributable risk percent, PAR%)、被动吸烟导致的肺癌发病、死亡和疾病负担。采用Excel 2010与SPSS 25.0进行统计分析,率的比较采用χ²检验。 结果 2013年30岁及以上成年人被动吸烟率为52.37%。2019年重庆市30岁及以上人群肺癌发病率与标化发病率分别为118.44/10万与80.83/10万,死亡率与标化死亡率分别为96.51/10万、63.58/10万。肺癌发病率和死亡率归因于被动吸烟的PAR%分别为19.76和19.04,归因发病率与归因标化发病率分别为23.41/10万和16.34/10万,归因死亡率与归因标化死亡率分别为18.38/10万和12.40/10万。2019年重庆市30岁及以上肺癌早死所致寿命损失年率(years of life lost,YLL)、残疾所致寿命损失年率(years lived with disability,YLD)、调整伤残寿命损失年率(disability adjusted life year,DALY)分别为21.16‰、0.31‰、21.47‰,YLL率、YLD率、DALY率归因于被动吸烟的PAR%分别为21.16、19.76和20.49,归因YLL率为4.34‰,归因YLD率为0.06‰,归因DALY率为4.40‰。 结论 2019年重庆市30岁及以上人群肺癌发病率、死亡率、YLL率、DALY率高,被动吸烟率高,肺癌归因于被动吸烟的疾病负担重,应加强落实控烟工作。     

在膀胱肿瘤并发前列腺增生症患者中采用同次施行膀胱肿瘤切除术和保留尿道粘膜前列腺切除术探讨

目的 探讨膀胱肿瘤并前列腺增生症患者同期施行膀胱肿瘤切除术和保留尿道粘膜前列腺切除术的可行性.方法 对同期施行经尿道膀胱肿瘤切除术及保留尿道粘膜前列腺切除术的16例膀胱癌合并前列腺增生症患者的临床资料进行了回顾性分析.结果 该组患者均顺利康复,无明显合并症,术后复诊,随访时间2～4年,3例出现肿瘤复发.结论 同期施行膀胱肿瘤切除术和保留尿道粘膜前列腺切除术,安全、效果肯定,值得基层医院推广应用.     

Efficacy and safety of herbal medicines for idiopathic Parkinson's disease: a systematic review.

The objective of this study is to assess the efficacy and safety of herbal medicines (HMs), as a monotherapy or adjunct therapy, compared to placebo or conventional approaches in the treatment of idiopathic Parkinson's disease (PD). We conducted a systematic review of randomized controlled trials from both conventional and alternative medicine sources. Outcome measures were overall improvement, quality of life, reduction of levodopa dose, and adverse events. Nine studies were included, each testing a different HM. Six of the trials had limited internal validity due to major flaws in design, including the lack of proper randomization; insufficient blinding; unclear inclusive criteria in terms of diagnostic criteria, baseline staging, and duration of disease; lack of proper sample size calculation; and insufficient data analysis. Imbalances in gender and ethnicity among the patients in the included trials were observed. No major adverse events emerged, and no specific pattern was detected from the trials describing such data. In addition to major methodological defects, heterogeneity in (1) HM tested, (2) control treatment, and (3) outcome measure hindered in-depth data analysis and synthesis. Current evidence is insufficient to evaluate the efficacy and safety of various HMs. Further studies with improved trial design and reporting, with assessment on cost-effectiveness, quality of life, and qualitative data are warranted.     

张继泽主任医师逆转萎缩性胃炎经验举隅

慢性萎缩性胃炎是以胃黏膜上皮和腺体萎缩、黏膜变薄为特征的慢性疾病。属中医胃脘痛、胃痞等范畴。其病因病机较为复杂,多与饮食不调、情志不畅有关,尤其是饮酒、过食刺激之品,致使脾胃受损,阳气郁遏不振,纳运失司,化源不足,气血阴液亏乏;或中焦运化无力,湿邪滞塞,郁而化热;或     

脑前循环系统动脉瘤的外科治疗

本文报告113例脑前循环系统动脉管其中包括颈内动脉后交通动脉瘤75例.前交通动脉瘤17例,大脑中动脉瘤10例,人脑前动脉-胼周动脉瘤3例,颈内动脉-眼动脉瘤2例,颈内动脉海绵窦段动脉瘤1例.多发动脉瘤5例.共118个动脉瘤在显微镜下直视手术,动脉瘤直接夹闭术108例.孤立或包裹术5例:5例多发动脉瘤行同期手术3例,分期手术2例.术中发生动脉瘤破裂18次.Hunt和HessⅠ～Ⅱ级病人中有例行早期手术.全组术后死亡率为7.9%.着重讨论手术时机.术中动脉瘤破裂处理及多发动脉瘤的治疗.     

缺氧缺血性脑病新生鼠补钙前后脑细胞,红细胞内外钙的变化

为了观察一般剂量补钙对缺氧缺血性脑病（ＨＩＥ）脑细胞和红细胞内外钙变化的影响，以探讨ＨＩＥ时补钙是否增加脑细胞钙超载，用ＨＩＥ新生动物模型进行了实验研究，结果表明：（１）缺氧缺血时红细胞、脑细胞及脑组织出现钙积聚；（２）补钙后，血浆总钙浓度明显升高，而脑细胞、脑组织及红细胞钙积聚并未加重；（３）血浆总钙浓度与脑细胞或红细胞胞浆游离钙离子浓度无相关关系。提示：（１）ＨＩＥ时钙内流可能是全身性的；（２）对ＨＩＥ并低钙血症患儿吸氧后一般剂量补钙可能是安全的。