Incidence and risk factors of suicide among patients diagnosed with bladder cancer: A systematic review and meta-analysis

Background: Patients with bladder cancer have a high risk of suicide. This study aimed to assess how bladder cancer increases suicide risk and to identify the demographic and clinical factors associated with suicidal death among patients with bladder cancer. Methods: Literature search of MEDLINE, PsycINFO, Embase, Web of Sciences and Cochrane Library databases was conducted up to April 2020 to identify eligible studies related to the incidence and risk factors of suicide after bladder cancer diagnosis. Summary multivariate-adjusted risk estimates and their associated 95% confidence intervals (CIs) were calculated using inverse variance method with random or fixed-effect modeling. Results: Five retrospective cohorts comprising 563,680 patients with bladder cancer were included. Higher risk of suicide by 1.90-fold was observed among patients with bladder cancer (hazard ratio, HR = 1.90, 95% CI: 1.29–2.81; P = 0.001; I² = 81.2%), especially in those aged 70 years or older (HR = 1.36, 95% CI: 1.29–1.43; P < 0.001; I² = 0%), unmarried (HR = 1.72, 95% CI: 1.61–1.83; P < 0.001; I² = 0%), and those with regional bladder cancer (HR = 1.88, 95% CI: 1.10–3.21; P = 0.021; I² = 96.3%), compared with those without bladder cancer. Furthermore, gender and race were not associated with increased suicide risk among patients with bladder cancer. Conclusions: Suicide risk is increased among patients with bladder cancer, particularly those aged 70 years or older, unmarried and those with regional bladder cancer. Hence, early psychological support must be provided during the follow-up period of these special populations with a high suicide risk.     

“They Assume That You’re Not Having Sex”: A Qualitative Exploration of How Paediatric Healthcare Providers Can Have Positive Sexuality-Related Conversations with Youth with Disabilities

Sexuality and Disability - Every individual should have equal access to sexuality-related information and services. Regrettably, societal stigma revolves around the sexuality of youth with...     

双上斜肌麻痹的临床特征与治疗

双眼上斜肌同时麻痹称为双上斜肌麻痹,近年来受到国内外眼科学者的重视。本文报告13例,均是我科近年来手术治疗并在术后观察3个月以上者。13例病人都无明显外伤史,发病在出生时及出生后早期,为先天性病变。手术次数1～2次。临床特征:不对称病变以单眼上斜视,代偿头位为主要表现,其中有一部分病人为潜在型双侧病变。对称型以两侧同向注视时的反向上斜视为主要表现,双侧Bielschowsky征为阳性。不少病人同时有V型斜视。需要手术治疗的病人一般应做双眼手术。可根据病情决定是同时做双侧手术,还是分次做,以及术式、术量。术后大部分病人能获得满意的头位及眼位。     

The conduct of in vitro and in vivo drug-drug interaction studies: a Pharmaceutical Research and Manufacturers of America (PhRMA) perspective.

Current regulatory guidances do not address specific study designs for in vitro and in vivo drug-drug interaction studies. There is a common desire by regulatory authorities and by industry sponsors to harmonize approaches, to allow for a better assessment of the significance of findings across different studies and drugs. There is also a growing consensus for the standardization of cytochrome P450 (P450) probe substrates, inhibitors and inducers and for the development of classification systems to improve the communication of risk to health care providers and to patients. While existing guidances cover mainly P450-mediated drug interactions, the importance of other mechanisms, such as transporters, has been recognized more recently, and should also be addressed. This article was prepared by the Pharmaceutical Research and Manufacturers of America (PhRMA) Drug Metabolism and Clinical Pharmacology Technical Working Groups and represents the current industry position. The intent is to define a minimal best practice for in vitro and in vivo pharmacokinetic drug-drug interaction studies targeted to development (not discovery support) and to define a data package that can be expected by regulatory agencies in compound registration dossiers.     

实验性偏头痛动物模型c-fos、c-jun基因表达

目的　复制实验性偏头痛动物模型并探讨其c -fos、c -jun基因表达。方法　采用CristinaTassorelli硝酸甘油法复制大鼠实验性偏头痛模型。免疫组化ABC法研究偏头痛大鼠脑组织即刻早期基因c -fos、c -jun的表达。结果　硝酸甘油型实验性偏头痛大鼠出现双耳发红、甩头、前肢频繁搔头 ,活动增加等外在表现 ,脑组织c -fos、c -jun基因表达阳性细胞数增加 ,基因表达阳性细胞的面积扩大、灰度降低或变化不大。结论　硝酸甘油型实验偏头痛大鼠模型复制方法简单、重复性较好、脑组织c -fos和c -jun基因异常表达明显 ,可以作为偏头痛治疗药物筛选、药效评价和发病机理研究的动物模型。     

Thromboelastography as a perioperative measure of anticoagulation resulting from low molecular weight heparin: a comparison with anti-Xa concentrations

Low molecular weight heparin (LMWH) is commonly used to prevent postoperative thromboembolism. Currently, there is no convenient test to measure the degree of anticoagulation from LMWH. This prospective study examines the relationship of thromboelastography and serum anti-Xa concentration in patients treated with enoxaparin. Twenty-four adult patients scheduled for orthopedic surgery using epidural anesthesia were enrolled. Epidural catheters were removed the morning after surgery before the commencement of subcutaneous enoxaparin 30 mg twice daily. Venous blood samples were obtained at 1) the induction of anesthesia (baseline), 2) immediately before the third dose of enoxaparin postoperatively (Day 2-trough), 3) 4 h after the third dose postoperatively (Day 2-peak), and 4) immediately before the fifth dose postoperatively (Day 3-trough). Whole blood samples were obtained for thromboelastography, activated clotting time, and anti-Xa level analyses at each of the four time intervals. At the four sample intervals, the r time (mean +/- SEM). (20 +/- 1, 25 +/- 2, 51 +/- 6, 31 +/- 3 mm) and the k time (9 +/- 0. 7, 12 +/- 1, 27 +/- 5, 14 +/- 2 mm) of the thromboelastograph were significantly correlated with the expected peak and trough levels of LMWH and serum anti-Xa levels (P: < 0.05). At the Day 3-trough, thromboelastograph r times exceeded the normal range in 6 of 25 patients (25%). Prolongation of r time and k time on postoperative Day 3 may indicate an exaggerated response to LMWH. Thromboelastography is a test that could potentially correlate with the degree of anticoagulation produced by low molecular weight heparin. Implications: Thromboelastography is a test that could potentially correlate with the degree of anticoagulation produced by low molecular weight heparin. The r time from the thromboelastogram correlates with serum anti-Xa concentration.     

光学相干断层成像(Optical Coherence Tomograpyhy,OCT)原理及应用

光学相干断层成像术(OpticalCoherenceTomography,OCT)是一种新的光学诊断技术,可进行活体眼组织显微镜结构的非接触式、非侵入性断层成像.OCT是超声的光学模似品,但其轴向分辨力取决于光源的相干特性,可达10um,且穿透深度几乎不受眼透明屈光介质的限制,可观察眼前节,又能显示眼后节的形态结构,在眼内疾病尤其是视网膜疾病的诊断,随访观察及治疗效果评价等方面具有良好的应用前景.     

"糟得很"和"好得很"——聚焦企业医院转型中的高管心态

当转型后手中的权力即将随着医院剥离、重组而付之东流,能否做到泰山崩于前而不为所动?当新东家的到来将让你在所有同僚面前扬眉吐气,是否还能义正词严地拒绝他们的光荣策反?当进和退都意味着遭遇深渊,如何选择两种死亡中的任何一项必然?医院转型、重组、剥离对谁来说都不是一件轻松的事。在利益和权力的角逐中,有沧海横流的英雄本色,更有勾心斗角的人心真实……     

体外循环降温期不同氧分压对二尖瓣膜置换患者术后的影响

目的评价体外循环降温期不同的氧分压对二尖瓣置换患者术后的影响。方法75例二尖瓣置换术患者，按体外循环降温末期动脉血氧分压数，分成低氧组、常氧组和高氧组，记录体外循环结束后第1、8、16小时多巴胺用量。术后麻醉清醒时间和呼吸机辅助时间，同时记录患者的年龄、体重、体外循环时间、升主动脉阻断时间和左室射血分数。结果体外循环术后第1小时内，常氧组多巴胺用量明显小于低氧组和高氧组（P〈O．05），术后第8小时，常氧组多巴胺用量明显小于低氧组（P〈O．05）。术后麻醉清醒时间和呼吸机辅助时问各组问无显著性差异。结论二尖瓣置换术体外循环降温期，常氧分压氧合有利于术后早期患者心功能恢复。     

无症状高尿酸血症男性患者的心电图分析

目的：研究无症状高尿酸血症患者的心电图异常情况，以了解血尿酸与心血管疾病是否有关联。方法：对172名无症状高尿酸血症男性患者进行12导联的心电图检查，所获得资料以SPSS10．0软件包吉行X检验分析。结果：病例组心电图异常率较对照组高，并有显著差异性，病例组的心电图异常多见心肌缺血表现，并与对照组有显著差异性。结论：显示高尿酸对心脏存在一定的损害，与心肌缺血存在一定相关性。需要进一一步研究。