"南海模式"早期胃癌筛查策略在基层社区中的应用评价

目的 基于全科医学+医共体的"南海模式"早期胃癌筛查策略在基层社区无症状人群应用过程的实施研究.方法 通过全科医学+医共体构建"南海模式"早期胃癌筛查策略,统计2019年1月至2019年12月在佛山市南海区里水镇早期胃癌筛查的实施研究中的相应数据;纵向对比本地区在开展胃癌筛查工作前后的内镜应答率及早癌检出率,并对早期胃...     

蓝激光内镜联动成像联合京都胃炎分类构建全科医生消化亚专长培训模式

目的 本研究联合蓝激光内镜联动成像(LCI)与京都胃炎分类构建一个全科医生消化亚专长培训模式,旨在提高全科医生判断幽门螺旋杆菌(H.pylori)感染状态的能力.方法 随机收集2020年1月至2020年10月经南方医科大学第七附属医院内镜中心行胃镜检查并行13C-尿素呼气试验的受检者71例,使用蓝激光内镜LCI及普通白...     

松弛素对高糖环境心脏成纤维细胞胶原基因表达的影响

目的探讨人重组松弛素（rhRLX）对高糖环境大鼠心脏成纤维细胞胶原基因表达的影响。方法原代培养Sprague-Dawley大鼠心脏成纤维细胞。用RT-PCR方法分别观察在正常糖（NG,5.6mmol/L）和高糖（HG,25mmol/L）环境下二代成纤维细胞胶原基因和松弛素基因的表达;rhRLX（100μg/L）分别与NG,HG共同作用72h后成纤维细胞胶原基因的表达。结果HG促进Ⅰ型前胶原mRNA和Ⅲ型前胶原mRNA的表达,rhRLX可以抑制上述作用。HG组松弛素基因的表达比较明显。结论rhRLX对HG促进的Ⅰ型和Ⅲ型胶原基因的表达具有抑制作用。     

心律平对闭式胸腔麻醉犬心脏电生理效应

本文采用心脏程序电刺激方法观察心律平(propafenone)对闭式胸腔麻醉犬的心脏电生理效应,结果示该药抑制犬窦房结功能,抑制冲动在心房、房室结内传导以及延长心房及房室结不应期,尤其显著地抑制室房逆向传导。     

TUVP治疗高龄高危良性前列腺增生59例报告

目的：探讨经尿道前列腺电汽化（TUVP）术治疗高龄、高危良性前列腺增生症（BPH）患者的安全性及有效性。方法：2004年7月至2006年6月，对59例高龄且合并心、肺、脑、肾等重要脏器疾病的高危患者施行TUVP术。充分的个体化术前准备后，均行连续硬膜外麻，25．5F连续灌注式气化电切镜，冲洗液为4％甘露醇，肾功能不全患者使用5％葡萄糖，液面高度60cm，如腺体460g，则彻底切除；如腺体〉60g，年龄〉80岁，则作一椭圆形通道切除。观察手术效果并行．IPSS评分。结果：全部病例均安全耐受手术。手术时间25～126min，平均57min，切除前列腺组织平均重量37g，无输血病例，未出现电切综合症，3～5d拔除导尿管，均排尿通畅，术后IPSS平均12.1分。结论：TUVP治疗高龄、高危BPH患者安全、有效。     

我院诊断学2003年教学效果评价与分析

诊断学是运用基本理论、基本知识和基本技能对疾病进行诊断的一门科学.是为医学生基础医学各门学科过渡到学习临床医学各科而设立的一门必修课[1].但随着学校办学规模的扩大,教学层次逐渐增多,教学人员和临床基地的缺乏,使诊断学教学面临许多困难.为了较全面地了解诊断学的教学情况,我们于2003年对我院2001级本科同学进行问卷调查,并对结果进行分析.     

老年病人的心理特点及护理对策

老年病人的病种有心脑血管系统疾患后遗症，老年痴呆，晚期癌症等疾病，其疾病特点有其独特的规律性，尤其应注意的是老年人敏感多疑，情绪不稳定，医护人员对这种现象应该充分重视。现就老年患者的心理特点及护理对策作一分析探讨。1老年患者的心理特点老年病人由于社会环境，人际关系等变化而导致心身疾病，老年病人因病情变化而产生惆怅、忧烦、苦恼、失眠、焦虑等反应属于心身疾病的一种表现。1．1不同的情绪可以使机体各个系统引起相应的变化。研究证实，心理活动是通过神经、体液和免疫三个环节密切联系对健康产生影响消极的心理活动…     

颈动脉炎引起双眼视神经萎缩1例

大动脉炎是一种比较少见的慢性血管病,多见于青年女性,因颈动脉炎引起双侧视神经萎缩较为罕见。患者党××女20岁学生双眼视力逐渐下降10个月。近2个月头晕、嗜睡、间歇性左颞部麻木及四肢发冷发麻。双眼视力指数/眼前,双眼瞳孔等大,约3mm,直接间接对光反射迟钝。双眼屈光间质正常,双眼视乳头边界整齐,颞侧色苍白,黄斑区     

欧洲癌症研究与治疗组织风险评分表在非肌层浸润性膀胱尿路上皮癌中的临床应用初探

Objective To evaluate the feasibility of European Organization for Research and Treatment of Cancer (EORTC) risk tables in non-muscle invasive bladder cancer in Chinese patients.Methods A retrospective analysis was performed on the data from 185 patients with non-muscle invaaive urothelial bladder cancer from January 2003 to February 2009. Among the 185 patients, 128 patients were stage Ta compared with 57 patients who were stage T1. There were 87, 53 and 45 patients with grade G1, G2 and G3 respectively. Transurethral resection of the bladder tumor was performed on all the patients and all the patients received routine post-operative intravesical instillation. A telephone interview follow-up was conducted on all the patients, and the average follow-up period was 36 months. EORTC risk tables were used to calculate risk scores for recurrence and progression for each patient. The recurrence and progression rates of different risk groups were recorded and compared with the estimated rates by EORTC risk table. Statistical analysis was used for comparison. ResultsTotal 1-year recurrence rate and progression rate for these patients were 25.9% and 3.8% respectively. According to calculated values of the patients, the 1-year recurrence rates of Group 0, Group 1-4, Group 5-9, Group 10-17 were 10.4%(5/48), 21. 5%(14/65), 35. 2% (19/54), 55.6%(10/18), respectively. The 1-year progression rates of Group 0, Group 2-6, Group 7-13, Group 14-23 were 0% (0/43), 1.5% (1/67), 6. 7% (4/60), 13. 3% (2/15). There was no significant difference between the real rates and estimated rates of the EORTC risk tables (P＞0. 05). However,the 1-year recurrence and progression rates between the low risk group, the medium risk group and the high risk group showed significant differences respectively (P ＜ 0. 05 ). Conclusions The EORTC risk tables are feasible to evaluate the recurrence and progression risk of non-muscle invasive bladder cancer in the present cohort. Nevertheless, the long term value and feasibility need more research to confirm.     

欧洲癌症研究与治疗组织风险评分表在非肌层浸润性膀胱尿路上皮癌中的临床应用初探

目的 评价欧洲癌症研究与治疗组织风险评分表(European Organization for Research and Treatment of Cancer risk tables,EORTC风险评分表)用于非肌层浸润性膀胱尿路上皮癌患者预后评估的可行性.方法 回顾性分析2003年1月至2009年2月收治的185例非肌层浸润性膀胱尿路上皮癌患者临床资料,其中Ta128例、T1 57例;G1 87例、G253例、G345例;肿瘤数目为单发、2～7个、≥8个者分别120、36、29例;肿瘤直径＜3 cm者131例、≥3 cm者54例;伴发原位癌者6例.185例均行经尿道膀胱肿瘤电切术,术后均行常规膀胱灌注化疗.采用电话随访方式,随访6～77个月,平均36个月.应用EORTC风险评分表进行预后风险评分,计算各评分组患者的1年复发率和进展率,并与EORTC评分表的预计值进行比较.结果 185例中1年内复发48例(25.9%),1年内出现肿瘤进展者7例(3.8%).根据患者实际情况计算,0、1～4、5～9、10～17分4组患者1年实际复发率分别为10.4%(5/48)、21.5%(14/65)、35.2%(19/54)、55.6%(10/18);0、2～6、7～13、14～23分患者1年实际进展率分别为0(0/43)、1.5%(1/67)、6.7%(4/60)、13.3%(2/15).经x2检验,结果与评分表的预计值差异无统计学意义(P＞0.05);而低危、中危、高危3组患者1年复发率及进展率差异有统计学意义(P＜0.05).结论 EORTC风险评分表可用于非肌层浸润性膀胱尿路上皮癌术后复发和进展风险的短期预测,对长期预测的应用及广泛人群的适用性尚待进一步验证.

Abstract：

Objective To evaluate the feasibility of European Organization for Research and Treatment of Cancer (EORTC) risk tables in non-muscle invasive bladder cancer in Chinese patients.Methods A retrospective analysis was performed on the data from 185 patients with non-muscle invaaive urothelial bladder cancer from January 2003 to February 2009. Among the 185 patients, 128 patients were stage Ta compared with 57 patients who were stage T1. There were 87, 53 and 45 patients with grade G1, G2 and G3 respectively. Transurethral resection of the bladder tumor was performed on all the patients and all the patients received routine post-operative intravesical instillation. A telephone interview follow-up was conducted on all the patients, and the average follow-up period was 36 months. EORTC risk tables were used to calculate risk scores for recurrence and progression for each patient. The recurrence and progression rates of different risk groups were recorded and compared with the estimated rates by EORTC risk table. Statistical analysis was used for comparison. ResultsTotal 1-year recurrence rate and progression rate for these patients were 25.9% and 3.8% respectively. According to calculated values of the patients, the 1-year recurrence rates of Group 0, Group 1-4, Group 5-9, Group 10-17 were 10.4%(5/48), 21. 5%(14/65), 35. 2% (19/54), 55.6%(10/18), respectively. The 1-year progression rates of Group 0, Group 2-6, Group 7-13, Group 14-23 were 0% (0/43), 1.5% (1/67), 6. 7% (4/60), 13. 3% (2/15). There was no significant difference between the real rates and estimated rates of the EORTC risk tables (P＞0. 05). However,the 1-year recurrence and progression rates between the low risk group, the medium risk group and the high risk group showed significant differences respectively (P ＜ 0. 05 ). Conclusions The EORTC risk tables are feasible to evaluate the recurrence and progression risk of non-muscle invasive bladder cancer in the present cohort. Nevertheless, the long term value and feasibility need more research to confirm.