Surgical treatment of lung cancer: promise and problems of early diagnosis

Recent studies have shown that the survival of patients with lung cancer is improved if the tumour is resected before it becomes larger than 3 cm in diameter and before it spreads to lymph nodes. While this suggests a positive benefit from early detection, recent mass-screening studies have claimed that the benefit obtained from this procedure is illusory because it relates to a lead-time bias. This study reports the results of surgical resection of 143 primary lung cancers. The data confirmed that the predicted 5-year survival was greatest (74%) following resection of lesions that were less than 3 cm in diameter without node involvement. Analysis showed that the age of these patients was 63 +/- 8 years, the same as in patients with larger tumours and more extensive node involvement. This suggests that tumours progress rapidly from a stage at which resection is beneficial to stages at which it is not. Although it is desirable that tests predict the presence of small tumours, the high requirements for sensitivity and specificity at current prevalence rates for lung cancer make this goal impractical.     

以白舒非联合环磷酰胺作为异基因干细胞移植预处理方案的不良反应的观察及护理体会

目的 报道白消安注射液（白舒非）联合环磷酰胺作为异基因干细胞移植的预处理方案的相关毒性及其护理要点，以提高护士对相关病情的观察及护理水平。方法对2例异基因干细胞移植的患者行移植前的各项准备，并行外周中心静脉导管置管术。预处理方案均行白消安加环磷酰胺。结果 2例患者均顺利度过预处理期，并成功接受异基因干细胞移植。结论 在预处理过程中，移植护士准确的操作及全面、细致的观察病情的变化，并正确处理药物的各种不良反应是预处理成功的关键因素之一。     

Comparative double-blinded study between mupirocin and tetracycline ointments for treating skin infections

A double-blinded study was conducted to compare the effects of mupirocin and tetracycline ointments in the treatment of skin infections. 111 patients were available for clinical assessment, of which 53 were treated with mupirocin and 58 treated with tetracycline. Clinically, both groups were improved, and there was no significant difference. Bacteriological assessment however revealed a better response to mupirocin. Staphylococcus aureus and Streptococcus pyogenes were the most common organisms isolated. 99% of Staphylococci were sensitive to mupirocin compared with 61% to tetracycline and 29% to penicillin G. 57% of Group A beta haemolytic Streptococci were resistant to tetracycline compared to 14% to mupirocin. Gram-negative organisms were mostly resistant to both preparations. No side effects were observed in both treatment groups. This study suggests that mupirocin is a safe and effective topical preparation for treating most of our common skin infections.     

步行量和体成分的中日比较研究

目的 为了解中日儿童及成人的步行和体成分及其相互关系.方法 以中国上海市和日本琦玉县的小学生和成人为对象,采用西铁城 TW02-001电子式步数计测定步行量,FUTREX-5000A体成分测定仪测量体脂百分比.结果 1.中国男女小学生的平均每日步行量分别为12426步和10387步,低于日本小学生(男15 340步,女11 617步),体脂百分比中国男女生分别为21.2%和15.8%,高于日本(男18.9%,女13.1%).中国男女成人的平均每日步行量分别为9826步和8748步,高于日本成人(男:8411步,女7599步);体脂百分比分别为17.5%(男)和25.8%(女),而日本男性为19.8%,女性为26.0%.2.不同活动水平的小学生和成人,其血压和体成分均有差异,步行量高者的血压和体脂百分比都较低.本研究还计算出以肱三头肌皮脂厚度以(X)推测儿童体脂百分比(Y)的回归方程为:Y=10.6646+0.5856X.结论 作为日常生活的步行可促进肥胖发生率的降低.     

Gallium uptake in the thyroid gland in amiodarone-induced hyperthyroidism

Amiodarone is an iodinated antiarrhythmic agent that is effective in the treatment of atrial and ventricular arrhythmias. A number of side effects are seen, including pulmonary toxicity and thyroid dysfunction. A patient with both amiodarone-induced pneumonitis and hyperthyroidism who exhibited abnormal gallium activity in the lungs, as well as diffuse gallium uptake in the thyroid gland is presented. The latter has not been previously reported and supports the concept of iodide-induced "thyroiditis" with gallium uptake reflecting the inflammatory response.     

A personal computer database system for head and neck cancer records

The computerized database system described was initially developed in 1986 to facilitate analysis of retrospective head and neck cancer data from the Royal Adelaide Hospital Department of Otolaryngology. This has now been expanded to become an on-going patient information management system. It is based on the dBase-III-Plus database package and is implemented on an IBM XT compatible computer. The system was designed to be used by staff without specialist computer skills and is therefore largely “menu-driven.” The main functions include patient record creation, update, and retrieval, and the production of reports including graphical presentations. There is also a powerful but easy to use query facility. The system has already provided much useful epidemiological material but is now beginning to fulfill an even more important role in patient follow-up and in assisting evaluation of alternative treatment protocols.     

Frailty评分对枸橼酸伊沙佐米治疗多发性骨髓瘤不良反应的预测价值

目的 探讨Frailty评分对枸橼酸伊沙佐米治疗多发性骨髓瘤(multiple myeloma, MM)不良反应的预测价值。方法 选取MM患者72例,均予以枸橼酸伊沙佐米联合沙利度胺、地塞米松方案治疗,观察治疗效果及不良反应。并根据患者不良反应程度分为Ⅰ～Ⅱ级组和Ⅲ～Ⅳ级组。比较2组Frailty评分;采用Cox回归模型分析化疗相关Ⅲ～Ⅳ级不良反应的影响因素;采用ROC曲线模型分析Frailty评分对化疗相关Ⅲ～Ⅳ级不良反应的预测价值。结果 72例MM患者均实施枸橼酸伊沙佐米治疗,总有效率为80.55%;出现不良反应70例、以乏力占比最高,发生率为72.22%,其次为淋巴细胞降低25.00%、贫血18.06%,未出现任何不良反应2例。Ⅲ～Ⅳ级组Frailty评分高于Ⅰ～Ⅱ级组(P<0.05)。70例出现不良反应患者均随访12个月,其平均生存时间(22.30±2.28)个月。Cox回归分析结果显示,Frailty评分≥2分是MM患者发生Ⅲ～Ⅳ级不良反应的影响因素。ROC曲线分析显示,Frailty评分预测化疗相关Ⅲ～Ⅳ级不良反应AUC值为0.925(95%CI:0.816～1.00...     

基于正念的补充替代疗法对妊娠期糖尿病孕妇血糖水平和炎性因子及脂肪因子的影响研究

背景 妊娠期糖尿病(GDM)的发病率居高不下,且在全球普遍流行,在中国GDM发生率高达14.8%,妊娠期高血糖严重威胁母婴健康。目的 探讨GDM孕妇采用基于正念的补充替代疗法的干预效果。方法2021年3—12月采用便利抽样法选取在长沙市中心医院门诊进行产前检查的64例GDM孕妇,采用随机数字表法分为试验组(n=31)和对照组(n=33)。对照组采取常规心理护理、饮食宣教、运动指导,试验组在常规心理护理基础上采用8周基于正念的补充替代疗法。收集患者基线资料,比较两组孕妇干预前后血糖水平及炎性因子、丝氨酸蛋白抑制剂(vaspin)水平,随访新生儿结局指标(出生体质量、随机血糖)。结果 干预后试验组孕妇空腹血糖、餐后1 h血糖、餐后2h血糖、白介素6、白介素8、肿瘤坏死因子α、vaspin水平低于对照组(P<0.05);干预后试验组空腹血糖、餐后1h血糖、餐后2 h血糖、白介素6、白介素8、肿瘤坏死因子α、vaspin低于干预前(P<0.05);试验组GDM孕妇分娩时体质量、分娩时体质指数、妊娠期增重、分娩前糖化血红蛋白,新生儿出生体质量均低于对照组(P<0.05),试验组...     

二氧化硅活化巨噬细胞中早期生长反应因子-1及其信号转导通路的研究

目的 探讨早期生长反应因子(Egr-1)及其信号转导在矽肺发生发展中的作用。方法用细胞免疫荧光、原位杂交方法检测二氧化硅(SiO2)刺激后Egr-1的表达定位,用报道质粒及EMSA检测其活性改变;用激酶活性分析法检测si0：刺激巨噬细胞后ERK1／2活性改变,进一步用激酶抑制剂初步探讨SiO2活化Egr-1的信号转导通路。结果SiO2刺激RAW264．7细胞短时间Egr-1核蛋白表达及转录因子明显增加;且在处理后30～60min,Egr-1核蛋白结合活性明显升高(为未处理组的20倍);在刺激后15min ERK1／2活性开始升高,30min达高峰(活性为对照组的29倍)而后渐降至基础水平;进一步用激酶阻断发现,Egr-1 mRNA及蛋白表达均减少。结论SiO2能激活巨噬细胞中Egr-1,且此过程可能由ERK1／2、p38介导,提示SiO2-ERK1／2、p38-Egr-1通路可能在矽肺发生发展过程中起重要作用。