Does hormone therapy increase allergic reactions and upper gastrointestinal problems? Results from a population-based study of Swedish woman. The women's health in the Lund area (WHILA) study

Objectives: To delineate the use of various drugs particularly pertaining to allergy and upper gastrointestinal problems in relation to hormone status in middle aged women. Methods: An analysis from a population-based study on women born between 1935 and 1945 and lived in the Lund area southern Sweden. Of 10766 women, 6917 provided complete data sets; in turn 5673 were assessed for the use of medication in this study. Among the cohort, 9% of women were premenopausal (PM), 54% were postmenopausal without hormone replacement therapy (PM0) and 37% were current hormone replacement therapy users (PMT). Results: There were 7 (1.3%) women in PM, 11 (0.4%) in PM0 and 21 (1.0%) in PMT group who used loratadine regularly. There was a significant difference between the PM and PM0 groups and also between the PM0 and PMT groups in the use of loratadine (P<0.05). Among 21 loratadine users in PMT group 4 (19%) used transdermal patches and 17 (81%) used oral HRT. The result for omeprazole use was as follows: 4 (0.8%) of PM group, 39 (1.3%) of PM0 group and 42 (2.0%) of PMT group. The use of omeprazole was significantly higher in the PMT group than in the PM (P=0.05) and PM0 group (P<0.05). There was no relation between the use of omeprazole and smoking or alcohol consumption. Conclusions: Use of hormone replacement therapy seems to be related to a higher frequency of omeprazole and loratadine use, which implies that hormone replacement therapy, may be associated with more upper gastrointestinal symptoms as well as allergy.     

新形势下医疗机构的发展趋势和应对策略——《论“三项改革”及其对医疗机构发展的影响》之二

在"三项改革"的不断深化和中国加入 WTO的新形势下,医疗机构机遇与挑战并存,医疗资源合理配置、提高医疗服 务质量、医院经营管理是 21世纪医疗机构生存与发展的重要内容和发展趋势,同时探索了医疗机构及其管理者在 改革开发大潮中的应对策略.综合论述了提高医疗服务质量科学、现代、实用的对策措施;阐述了医院经营管理的 新理念,现代医院管理要改变过去传统的单一的医疗业务管理为综合的医疗服务管理和经营管理,作为医院领导 者要优化知识结构,既要懂得医疗服务专业管理,又要懂得经济管理,医疗机构要正确处理服务、经营、管理三者的 关系,以一流的管理经营促进医疗服务质量和水平的提高,同时初步提出了医院经营管理及其经营效果、资金运作、 医疗成本核算、医疗技术效果的概念、内容、应对策略和方法.     

Discordant effect of body mass index on bone mineral density and speed of sound

Background  

Increased BMI may affect the determination of bone mineral density (BMD) by dual X-ray absorptiometry (DXA) and speed of sound (SOS) measured across bones. Preliminary data suggest that axial SOS is less affected by soft tissue. The purpose of this study is to evaluate the effect of body mass index (BMI) on BMD and SOS measured along bones.     

中加两国精神障碍患者无责任能力评定跨文化比较研究

目的 :对中国湖南省和加拿大BC省两地无责任能力精神障碍患者人口学等资料进行比较 ,探讨不同的法律体系中无责任能力的精神障碍患者的基本特点。方法 :对两地已有的精神障碍患者责任能力评定数据库进行整合 ;共提取年龄、性别、婚姻、教育、犯罪史、精神病史、鉴定时案型、诊断 8个变量进行统计处理 ;BC组和湖南组入组病例数分别为 2 73例和 35 4例。结果 :除性别和精神病史外 ,其他各变量差异显著。BC组的离婚率、犯罪史、最高教育程度明显高于湖南组 ,评估时年龄明显大于湖南组 ;而湖南组的严重犯罪和精神分裂症的诊断比例明显高于BC组 (P均 <0 .0 1)。结论 :不同的法律体系、制度和社会文化背景是造成两地无责任能力精神障碍患者不同特点的主要原因     

Effect of obesity and other lifestyle factors on mortality in women with breast cancer

A few lifestyle characteristics before cancer diagnosis have been suggested to modify the prognosis of breast cancer. Follow-up information from 1,453 women with incident invasive breast cancer, diagnosed between 1991 and 1994 and interviewed within the framework of an Italian multicenter case-control study, was used to assess the effect of obesity and of a large spectrum of other factors on breast cancer mortality. Five hundred and three deaths, including 398 breast cancer deaths, were identified. Hazard ratios (HR) for all-cause and breast cancer mortality and corresponding 95% confidence intervals (CI), were calculated using Cox proportional hazards models and adjusted for age and breast cancer characteristics (stage and receptor status). Increased risk of death for breast cancer emerged for body mass index (BMI) >/= 30 kg/m(2) (HR = 1.38; 95% CI: 1.02-1.86), compared to <25, or waist-to-hip ratio (WHR) >/= 0.85 (HR = 1.27; 95% CI: 0.98-1.64), compared to <0.80, and the strongest association was observed for women with BMI >/=30 and high WHR (>/=0.85), compared to women with BMI <25 and WHR < 0.85 (HR = 1.57, 95% CI: 1.08-2.27). The unfavorable effect of high BMI was similar in women <55 and >/=55 years of age, whereas it was stronger in women with I-II stage than III-IV stage breast cancer. Low vegetable and fruit consumption and current or past smoking were also associated to marginally worse breast cancer survival. No significant relationship with survival after breast cancer emerged for several other major lifestyle factors, including physical activity, alcohol drinking, exogenous hormones use and fat intake. High BMI was the lifestyle risk factor that most consistently modified breast cancer prognosis in our study.     

邵静辨治胸痹心痛经验举要

胸痹心痛是由于正气亏虚,饮食、情志、寒邪等所引起的以痰浊、瘀血、气滞、寒凝痹阻心脉,以膻中或左胸部发作性憋闷、疼痛为主要临表现的一种病证,是威胁中老年人生命健康的重要心系病证之一,随着现代社会生活方式及饮食结构的改变,发病有逐渐增加的趋势,因而本病越来越引起人们的重视。邵静主任医师从医30年来,诊疗经验宏丰,尤擅心脑血管疾病的治疗,本文举邵静医师验案一则,以总结邵师经验。     

五年制高职口腔医学口腔组织病理学教学之我见

口腔组织病理学是口腔医学专业一门重要的医学基础课,由于知识的抽象,很多学生觉得该门课程枯燥乏味,该文介绍了口腔组织病理学的几种教学方法,并认为改进教学方法能激发学生的学习兴趣,提高教学效果。     

社区预防接种中的安全注射

探讨安全注射的具体措施。认为提高接种人员素质，严格执行规范要求，严格控制预防接种各环节的技术质量，才能减少不良反应的发生，最大限度地保证各类疫苗的安全注射。     

中职药剂专业《中药学》实践教学改革的方法

中职教育中的药剂专业学生实践教学是步入工作岗位的桥梁,也是使其能否成为一名合格的药剂工作者的重要环节。故实践教学应在教学计划中占有较大的比例,并不断改革教学方法,以利于培养实用型中医药人才。