食管癌患者血缘亲属及不同性别食管癌患病风险比较研究

目的 对比分析食管癌病例组与对照组血缘亲属食管癌患病风险,并了解食管癌家族中危险亲属人群患病的新线索.方法 采用病例对照研究方法 ,对食管癌病例组及对照组各720例进行逐层分析,以比较两组各血缘亲属父系、母系食管癌患病危险度(OR)的大小及差异.结果 (1)病例组Ⅰ级亲属食管癌患病危险度(1.34%～2.24%)显著高于对照组(0.78%～1.21%)(P＜0.01);Ⅰ级亲属中病例组父母亲食管癌患病危险度为6.11%,显著高于对照组父母亲食管癌患病危险度2.97%(P＜0O01).(2)以血缘亲属中父系和母系亲属逐层分析可见,病例组父系食管癌患病危险度(0.87%～1.01%)与母系患病危险度(0.50%～0.79%)均显著高于对照组父系食管癌患病危险度(0.53%～0.65%)与母系患病危险度(0.38%～0.47%)(P＜0.05).进一步分析显示,病例组父系中男性亲属与母系中女性亲属,即父系中祖父、父亲、叔伯食管癌患病危险度为2.68%与母系中外祖母、母亲、姨的食管癌患病危险度1.91%均显著高于对照组父系中男性亲属食管癌患病危险度1.50%与母系中女性亲属食管癌患病危险度0.92%(P＜0.01).结论 山西省食管癌患者血缘亲属发病危险主要是父亲及其兄弟、母亲及其姐妹,其下代患食管癌风险要大.     

Bone growth patterns in Chinese children and adolescents: a 6-year follow-up study provides evidence for sexual dimorphism and tracking

Summary We prospectively examined bone growth patterns in 894 children aged 6–17 years at the baseline visit, with a 6-year follow-up. Results show bone “tracking” over a six-year interval and sexual dimorphism of bone attained levels and timing of peak bone growth. Our findings underscore childhood and adolescence as critical periods for building bone and developing gender differences. Introduction Bone growth patterns were prospectively examined in 894 Chinese children (496 males), aged 6–17 yrs, from a population-based twin cohort. Whole-body bone area (BA), bone mineral content (BMC), and bone mineral density (BMD) were measured by DEXA at baseline and a 6-yr follow-up. Methods Graphic smoothing plots and generalized estimating equations were used to model bone attained levels, growth, and “tracking”. Results Attained levels of BMC and BA increased curvilinearly with age. Male attained levels were higher than females after age ∼15 yr, but BMD was lower between 13–17 yrs (Tanner stage I to IV). In both genders, peak BMC and BMD growth lagged ∼2 yrs behind peak BA growth, which lagged 2 yrs behind peak height growth. Peak bone growth occurred 1–3 yrs later in males. Over the 6-yr follow-up, all bone measurements “tracked”, but “shifting” across ranks also occurred, and baseline tertile ranking influenced bone growth. Females with early menarche had higher attained levels than females with late menarche at age 12–13 yrs. Conclusion Our findings confirm and expand previous studies on peak bone growth conducted in Caucasian cohorts, particularly sexually dimorphic and maturational effects. The significant “tracking” of bone measurements in this 6-yr follow-up study underscores the importance that osteoporosis prevention should begin in childhood and adolescence. Fengxiu Ouyang and Binyan Wang contributed equally to this article. Source(s) of support: This study is supported in part by grant R01 HD049059, R01 HL0864619 and R01 AR045651 from the National Institute of Health and by the Food Allergy Project.     

腮腺良性和恶性多形性腺瘤的超声研究

目的研究腮腺良性和恶性多形性腺瘤的超声特点,为临床医师诊治提供有效依据。方法选取腮腺良性多形性腺瘤患者79例和恶性多形性腺瘤患者15例,对其肿块的大小、硬度、内部回声、彩色多普勒血流显像(CDFI)特点结合病理学诊断进行对照研究。结果恶性多形性腺瘤的声像图特点与良性多形性腺瘤相似,但其肿瘤相对较大,质地更硬,内部回声分布更紊乱。不同性质的肿瘤的大小和质地有显著性差异,(P<0.01)。结论多形性腺瘤的超声诊断主要依据二维图像之特点。当多形性腺瘤大于3.0 cm,硬度较硬,内部回声分布不均多提示恶性。     

脂质体阿霉素为主方案治疗高龄非霍奇金淋巴瘤的临床研究

目的 观察脂质体阿霉素联合治疗高龄非霍奇金淋巴瘤患者的有效性和安全性.方法 应用脂质体阿霉素联合COP为主的方案化疗或联合利妥昔单抗等其他治疗方案治疗34例患者,观察患者应用脂质体阿霉素过程中及其后的毒副反应及疗效.结果 全组34例患者共接受176个疗程化疗,平均每个患者累计应用脂质体阿霉素127.0 mg治疗,总有效率(CR+PR)为88.2%(30/34),其中CR 24例(70.6%),PR 6例(17.7%),SD 1例(2.9%),PD 3例(8.8%).毒副反应主要为骨髓抑制,未出现严重感染.心脏毒性发生率14.7%(5/34),无化疗相关死亡.结论 脂质体阿霉素联合治疗高龄非霍奇金淋巴瘤具有较高的安全性和有效性.     

Feasibility of treating hyperfibrinogenemia with intermittently administered batroxobin in patients with ischemic stroke/transient ischemic attack for secondary prevention.

This study evaluated the safety and efficacy of batroxobin in treating hyperfibrinogenemia for secondary stroke prevention. Patients with ischemic stroke or transient ischemic attack (TIA) were measured for plasma fibrinogen levels. Selected participants had concomitant hyperfibrinogenemia (plasma fibrinogen > or = 3.0 g/l). Patients enrolled between 1 July 2003 and 31 December 2004 were treated with batroxobin; patients enrolled between 1 January 2002 and 30 June 2003 were treated without batroxobin. Batroxobin was administered intermittently via intravenous injection at 3-monthly intervals. Patients in both groups were followed for 1 year. Any cerebrovascular events and suspected adverse events were recorded. In total, 112 ischemic stroke/TIA patients with concomitant hyperfibrinogenemia were enrolled, 52 being treated with batroxobin and 60 without batroxobin. Six patients (11.5%) with batroxobin and 16 patients (26.7%) without batroxobin had recurrent cerebral ischemic events during follow-up. Stroke/TIA recurrence in patients without batroxobin was higher than that in patients with batroxobin (P < 0.05). Two patients with batroxobin and two patients without batroxobin developed hemorrhagic stroke during follow-up. There were five deaths (9.6%) in the batroxobin group, and seven deaths (11.7%) in the nonbatroxobin group during follow-up (P > 0.05). Intermittent intravenous injection of batroxobin can efficiently reduce the risk for stroke/TIA recurrence in patients with concomitant hyperfibrinogenemia.     

外刊速览

中国研制出抗禽流感药物——路透社目前,中国已研制出一种与“达菲”相应的抗禽流感病毒药物,但并没有说明该药物何时会投入使用,以及它与“达菲”的可比性。鉴于缺乏禽流感疫苗,世界卫生组织已经建议各国政府储备“达菲”。该药虽然不能治愈禽流感,但可以抑制病毒发展,减缓病毒扩散。全球唯一能够生产“达菲”的瑞士罗氏公司上星期宣布,他们已经停止在中国市场     

抗非典精神刍议

全同非典进行特死斗争过程中，医护人员表现出一种临危不惧、挺身而出、全力救治、不怕牺牲、恪尽职守、患者至上、竭诚服务、科学防治的“抗非典精神”值得宣传，学习和效法。     

Enhancing laboratory report contents to improve outpatient management of test results

In today''s environment, providers are extremely time-constrained. Assembling relevant contextual data to make decisions on laboratory results can take a significant amount of time from the day. The Regenstrief Institute has created a system which leverages data within Indiana Health Information Exchange''s (IHIE''s) repository, the Indiana Network for Patient Care (INPC), to provide well-organized and contextual information on returning laboratory results to outpatient providers. The system described here uses data extracted from INPC to add historical test results, medication-dispensing events, visit information, and clinical reminders to traditional laboratory result reports. These “Enhanced Laboratory Reports” (ELRs) are seamlessly delivered to outpatient practices connected through IHIE via the DOCS4DOCS clinical messaging service. All practices, including those without electronic medical record systems, can receive ELRs. In this paper, the design and implementation issues in creating this system are discussed, and generally favorable preliminary results of attitudes by providers towards ELRs are reported.     

纯氧和空气复苏患儿24个月随访观察

目的 探讨纯氧和空气复苏对新生儿发育的影响,为新生儿复苏用氧选择提供依据.方法 对2005年1月-2007年1月在保定市妇幼保健院进行窒息复苏的30例患儿在24个月时进行随访,依据复苏用氧浓度分为纯氧复苏组(20例)和空气复苏组(10例),内容包括出生时胎龄、出生体重、身长、头围、阿氏评分(1 min,5 min)、心率(1 min,5 min)、随访时体重、身长、头围及运动发育标志(坐、爬、站、走时间).结果 出生时患儿身体数据差异无统计学意义,24个月随访,患儿身高、体重、头围及运动发育标志差异均无统计学意义(P>0.05).结论 空气复苏对新生儿窒息患者是安全有效的.     

两出口的医院网络用户管理解决方案

目的：由于办公需要，将以前走电信出口的图书馆、医疗二系及研究生处的用户改道为走科研教育网出口，和华中科技大学校总部相连，并在不改变原来管理模式下同时管理两出口的用户信息。方法：通过配置流分类，规定重定向行为以及配置策略路由进行实现。结果：将认证流和数据流分开，成功实现了医院内部两出口的需求。结论：利用原有设备的流分类和重定向功能．既可解决两出口的内部需求，也能在不增加设备的情况下对用户信息进行管理，为医院节省了开支。