腹腔镜辅助与开腹子宫肌瘤切除术的临床研究

目的 比较腹腔镜辅助和开腹子宫肌瘤切除术的临床效果.方法 回顾分析2007年1月～2010年1月笔者所在医院经腹腔镜辅助及开腹行子宫肌瘤切除术的患者临床资料.结果 腹腔镜辅助组术后使用止痛剂率、住院时间、肛门排气时间、体温恢复正常时间、生活恢复自理时间均明显短于开腹组,差异有统计学意义（P＜0.01）,两组手术时间、术中出血量、术后2年内复发率大致相同,无显著性差异（P＜0.05）.结论 腹腔镜辅助子宫肌瘤切除术具有创伤小、术后康复快、疼痛轻等优点,安全有效.     

Psychological and behavioural impacts of the 2008 China earthquake on blood donors

Background and Objectives On May 12, 2008, a severe earthquake hit Sichuan province in China. A post‐earthquake survey was conducted to study the earthquake’s effect on blood donor behaviour and stress at three blood centres at varying distances from the epicentre. Materials and Methods A questionnaire was developed to assess donor post‐traumatic stress disorders (PTSD) and attitudes toward giving blood. Responses were compared by centre and donor characteristics using multivariate logistic regression techniques. Results Of all 17 456 donors, the overall prevalence of PTSD was 13·2%. Donors who knew someone killed or injured by the earthquake were 2·1 times more likely to have PTSD than others (95% CI: 1·8–2·4). 85·2% of donors cited the earthquake as their reason for donating. 16·1% of donors felt it acceptable to be less honest about one’s health history in an emergency. After adjusting for PTSD, geographic and demographic characteristics, the donors knowing someone killed or injured by the earthquake were 1·4 times (95% CI: 1·2–1·7) more likely to cite the earthquake as reason for donating, and 1·8 times (95% CI: 1·5–2·1) more likely to accept being less honest about one’s health history in case of national emergency. Conclusions The psychological and behavioural impacts of the earthquake on blood donors extended far from the epicentre. After a disaster, it is important to emphasize that donors must be truthful on the donor questionnaire as some donors appear willing to be less than honest when they perceive an increased need for blood products.     

Dundee Ready Education Environment Measure: psychometric testing with Chinese nursing students

Title. Dundee Ready Education Environment Measure: psychometric testing with Chinese nursing students. Aim. This paper is a report of the psychometric testing of the Dundee Ready Education Environment Measure with Chinese nursing students. Background. Although the Dundee Ready Education Environment Measure has been widely used to measure educational environments in the healthcare professions, no psychometric evaluation of the measure with Chinese nursing students has been reported. Method. Data from 214 nursing students were collected during a 2‐month period between December, 2004 and January, 2005. Exploratory factor analysis, internal consistency reliability and Cronbach’s alpha were examined. Results. Five factors were found by principal components analysis with Oblimin with Kaiser Normalization rotation. The original factor names were maintained, but items in each factor changed. These five factors all achieved eigenvalues >1, and in total accounted for 52·186% of the variance. Cronbach’s alpha ranged from 0·623 to 0·9 across factors, with an overall alpha of 0·949. Conclusion. The Chinese version of the Dundee Ready Education Environment Measure could be a valuable measurement for nursing educators in professional development programmes and nursing curriculum design. Further studies need in different Chinese nursing schools and larger sample sizes to be conducted to validate its stability and factor structure.     

我院2003~2007年麻醉性镇痛药应用分析

目的:了解我院麻醉性镇痛药的应用情况及趋势。方法:对我院2003~2007年麻醉性镇痛药的应用数据进行统计、分析。结果:我院麻醉性镇痛药销售金额和用量均逐年增加,其中吗啡制剂尤为突出,而哌替啶注射液则逐年下降。结论:我院麻醉性镇痛药应用基本合理,但其剂型、种类还应增加。     

重组人促红细胞生成素引起纯红细胞再生障碍性贫血的研究综述

随着重组人促红细胞生成素在临床的广泛应用，由其引起的不良反应一纯红细胞再生障碍性贫血也越来越受到人们重视。本文重点阐述重组人促红细胞生成素引起的纯红细胞再生障碍性贫血的发病情况，影响重组人促红细胞生成素免疫原性的可能原因及危险因子，以及诊断治疗措施.     

刺五加注射液联合低分子肝素治疗原发性肾病综合征的研究

目的观察刺五加注射液联合低分子肝素治疗原发性肾病综合征的疗效及安全性。方法对照组常规应用泼尼松加刺五加注射液及其他常规对症治疗,观察组在对照组用药的基础上加用低分子肝素皮下注射。2组治疗前后分别检测24 h尿蛋白、血浆白蛋白、总胆固醇、三酰甘油、血液流变学、凝血酶原时间(PT)、部分凝血酶时间(APTT)、凝血酶时间(TT)、血小板计数,并观察临床症状改善情况及有无出血倾向。结果经4周治疗,2组患者临床症状减轻或消失,观察组总有效率96%,对照组88%(P<0.01)。治疗后2组患者尿蛋白减少,血浆白蛋白升高,血液黏度降低(P<0.05或0.01),观察组优于对照组(P<0.05或0.01);2组患者中无一例出血倾向。结论刺五加注射液联合低分子肝素治疗原发性肾病综合征可以更好地改善患者的高凝状态,降低血液黏度,减轻蛋白尿,升高血浆白蛋白,并有很好的安全性。     

A multiparametric panel for ovarian cancer diagnosis, prognosis, and response to chemotherapy.

PURPOSE: Our goal was to examine a panel of 11 biochemical variables, measured in cytosolic extracts of ovarian tissues (normal, benign, and malignant) by quantitative ELISAs for their ability to diagnose, prognose, and predict response to chemotherapy of ovarian cancer patients. EXPERIMENTAL DESIGN: Eleven proteins were measured (9 kallikreins, B7-H4, and CA125) in cytosolic extracts of 259 ovarian tumor tissues, 50 tissues from benign conditions, 35 normal tissues, and 44 tissues from nonovarian tumors that metastasized to the ovary. Odds ratios and hazard ratios and their 95% confidence interval were calculated. Time-dependent receiver operating characteristic curves for censored survival data were used to evaluate the performance of the biomarkers. Resampling was used to validate the performance. RESULTS: Most biomarkers effectively separated cancer from noncancer groups. A composite marker provided an area under the curve of 0.97 (95% confidence interval, 0.95-0.99) for discriminating normal and cancer groups. Univariately, hK5 and hK6 were positively associated with progression. After adjusting for clinical variables in multivariate analysis, both hK10 and hK11 significantly predicted time to progression. Increasing levels of hK13 were associated with chemotherapy response, and the predictive power of hK13 to chemotherapy response was improved by a panel of five biomarkers. CONCLUSIONS: The evidence shows that a group of kallikreins and multiparametric combinations with other biomarkers and clinical variables can significantly assist with ovarian cancer classification, prognosis, and response to platinum-based chemotherapy. In particular, we developed a multiparametric strategy for predicting ovarian cancer response to chemotherapy, comprising several biomarkers and clinical features.     

Genetic alterations and their relationship in the phosphatidylinositol 3-kinase/Akt pathway in thyroid cancer.

PURPOSE: To investigate the overall occurrence and relationship of genetic alterations in the phosphatidylinositol 3-kinase (PI3K)/Akt pathway in thyroid tumors and explore the scope of this pathway as a therapeutic target for thyroid cancer. EXPERIMENTAL DESIGN: We examined collectively the major genetic alterations and their relationship in this pathway, including PIK3CA copy number gain and mutation, Ras mutation, and PTEN mutation, in a large series of primary thyroid tumors. RESULTS: Occurrence of any of these genetic alterations was found in 25 of 81 (31%) benign thyroid adenoma (BTA), 47 of 86 (55%) follicular thyroid cancer (FTC), 21 of 86 (24%) papillary thyroid cancer (PTC), and 29 of 50 (58%) anaplastic thyroid cancer (ATC), with FTC and ATC most frequently harboring these genetic alterations. PIK3CA copy gain was associated with increased PIK3CA protein expression. A mutual exclusivity among these genetic alterations was seen in BTA, FTC, and PTC, suggesting an independent role of each of them through the PI3K/Akt pathway in the tumorigenesis of the differentiated thyroid tumors. However, coexistence of these genetic alterations was increasingly seen with progression from differentiated tumor to undifferentiated ATC. Their coexistence with BRAF mutation was also frequent in PTC and ATC. CONCLUSIONS: The data provide strong genetic implication that aberrant activation of PI3K/Akt pathway plays an extensive role in thyroid tumorigenesis, particularly in FTC and ATC, and promotes progression of BTA to FTC and to ATC as the genetic alterations of this pathway accumulate. Progression of PTC to ATC may be facilitated by coexistence of PI3K/Akt pathway-related genetic alterations and BRAF mutation. The PI3K/Akt pathway may thus be a major therapeutic target in thyroid cancers.     

匹伐他汀钙片治疗原发性高胆固醇血症疗效和安全性

［摘要］　目的：评价匹伐他汀钙片治疗原发性高胆固醇血症患者的疗效和安全性。方法：采用随机、双盲、双模拟、阳性药物平行对照研究。经4周安慰剂导入期后符合入选标准患者，随机接受匹伐他汀1 mg&#8226;d-1或阿托伐他汀10 mg&#8226;d-1治疗。服药治疗4周后剂量相应调整为匹伐他汀2 mg&#8226;d-1或阿托伐他汀10 mg&#8226;d-1治疗。治疗期共12周。结果：匹伐他汀组治疗12周后低密度脂蛋白胆固醇(LDL-C)显著下降，下降幅度为40.1％，阿托伐他汀组下降幅度为33.8％，两组无显著差异（P>0.05）；匹伐他汀降低三酰甘油(-13.5%)以及升高HDL-C（＋7.4％）的幅度与阿托伐他汀组差别无统计学意义。结论：匹伐他汀降低总胆固醇和LDL-C的作用与阿托伐他汀相当，不良反应较轻微，可用于高胆固醇血症的治疗。