Impact of bowel obstruction at the time of initial presentation in women with ovarian cancer

Objective  To determine whether the presence of bowel obstruction at the time of initial presentation has any prognostic significance in these women.
Design  Retrospective cohort study.
Setting  Dedicated gynaecological oncology service of a large tertiary institution.
Population  Women who had a bowel obstruction as part of their initial presentation of ovarian cancer were identified between 1995 and 2007. Each woman was matched with four control women (with disease but no obstruction).
Methods  Women with disease were compared with controls to determine the impact, if any, of bowel obstruction at presentation. Several prognostic variables including bowel obstruction were also evaluated in a Cox proportional hazard model.
Main outcome measures  Progression-free survival (PFS) and overall survival (OS).
Results  Forty-eight women with disease and 192 controls were identified during the study period. The median follow-up period was 19 months among women with disease versus 20 months in controls. No differences were seen in demographics and clinical characteristics of the women. Optimal cytoreduction rate was similar between the two groups (75% versus 78%, P  = 0.7). Patients with bowel obstruction had a shorter PFS and OS compared with controls [19 months versus 21 months ( P  = 0.01) and 22 versus 35 months ( P  = 0.008)], respectively. Bowel obstruction at presentation was an independent prognostic variable with a hazard ratio of 1.5 ( P  = 0.009). Other prognostic variables were age, stage and extent of surgical cytoreduction.
Conclusions  Bowel obstruction at the time of initial presentation is an adverse prognostic factor in women with ovarian cancer.     

疟疾性肝炎与肾病并存2例报告

作者在援圣普医疗队工作期间 ,收治 2例恶性疟疾性肝炎与肾病并存的患儿 ,临床少见 ,现报道如下。例 1,男 ,4岁。因发热、咳嗽 3d,伴黄疸浮肿 1d住院。既往无黄疸、浮肿史。体检 :T39.2℃ ,R48次 / min,BP11/ 6 .5k Pa。神志清楚 ,皮肤及巩膜中度黄染 ,全身显著浮肿 ,心肺(- )。腹部轻微膨隆 ,移动性浊音 ( ) ,肝右肋下 3cm,剑下5 cm,脾肋下 2 cm。阴囊明显水肿。神经系统未见异常。小便常规 :蛋白 ( ) ,红细胞 3～ 5个 /高倍 ,透明管型少许 ,血红蛋白尿 (- )。血常规 :Hb72 g/ L,WBC7.5× 10 9/ L,N0 .41,L 0 .5 6 ,M0 .0 3。肝功能…     

荔湾区2010～2013年艾滋病自愿咨询检测结果及影响因素分析

目的探讨艾滋病自愿咨询人群血清学检测结果及其影响因素,为荔湾区今后更好的开展VCT服务提供依据。方法以2010~2013年在荔湾区各VCT门诊接受VCT服务并登记上报的求询者作为研究对象,按照《全国艾滋病检测技术规范(2009)》要求开展HIV抗体初筛检测,阳性标本合做梅毒、丙肝、乙肝检测。采用非条件Logistic回归分析影响艾滋病自愿咨询人群艾滋病感染的相关因素。结果共调查艾滋病自愿咨询检测者6 423人,其中男性2 787人,占43.4%,女性3 636人,占56.6%;年龄集中在(32.4±10.8)岁。HIV抗体阳性98例,占1.5%,其中1例同时呈HIV、梅毒、丙肝、乙肝阳性,合并四重感染率为1%;HIV、丙肝合并感染者有42例,双重感染率为42.9%;HIV、梅毒合并感染有20例,双重感染率为20.4%;HIV、乙肝合并感染有8例,双重感染率为8.16%。经Logistic回归分析显示:对艾滋病自愿咨询检测人群艾滋病感染的影响因素是年龄、职业和人群特征。年龄段在21~60岁,吸毒者、同性恋、阳性配偶者为艾滋病感染的风险人群。结论政府组织与各部门共同担责,改进并完善自愿咨询检测服务,加强对艾滋病感染风险人群检测,向"零"艾滋迈进。     

附子酸性多糖提高免疫低下小鼠免疫功能的实验研究

目的观察附子酸性多糖对环磷酰胺所致免疫低下小鼠免疫功能的影响。方法采用植物化学方法得到附子酸性多糖,以灌胃和腹腔注射2种方式给药,观察免疫低下小鼠的胸腺、脾脏指数,腹腔巨噬细胞吞噬功能,血清溶血素,淋巴细胞转化率,自然杀伤细胞活性以及外周血白细胞计数等多项指标,与对照组比较评价附子酸性多糖对免疫低下小鼠细胞和体液免疫功能的影响。结果附子酸性多糖可显著提高正常小鼠和免疫低下小鼠的脾脏和胸腺指数,提高小鼠的腹腔巨噬细胞吞噬功能和抗体产生能力,促进淋巴细胞增殖,增强自然杀伤细胞活性,并且可以显著提高白细胞数量(P<0.05或P<0.01)。腹腔注射较灌胃给药的效果更为明显(P<0.01)。结论附子酸性多糖可以显著提高免疫低下小鼠体液免疫和细胞免疫功能,并可减轻由于环磷酰胺引起的白细胞降低,具有减轻化疗药的毒副作用。且不同给药途径可影响其疗效。附子酸性多糖具有广阔的开发应用前景。     

Nitric oxide synthase activity and localization do not change in uterus and placenta during human parturition

Animal studies have suggested that nitric oxide, a smooth muscle relaxant, is a fundamental mediator in the initiation of parturition. The purpose of this study was to test the hypothesis that the onset of human labour is associated with a reduction in the activity of the enzyme nitric oxide synthase (NOS), within the uterus. Samples of myometrium, placenta, decidua and fetal membranes were collected during Caesarean section from 11 women before and 11 women after the onset of labour at term. Immunocytochemistry was used to localize each of the three isoforms of NOS (endothelial NOS, brain NOS, and inducible NOS) in each of these tissues and the intensity of staining was qualitatively assessed. NOS enzyme activity was determined in homogenates of frozen myometrium, placenta and fetal membranes (with attached decidua), by measuring conversion of radio-labelled L-arginine to L-citrulline. Each of the three isoforms of NOS was localized in each of the tissues. We found no difference in either the expression or enzyme activity of NOS in myometrium, placenta or fetal membranes before and during labour at term. These results suggest that, in contrast to animal studies, a decrease in NOS enzyme activity may not be involved in the onset of parturition at term in the human.