PPH与Milligan-Morgan手术治疗重度痔的疗效比较

目的：比较PPH与Milligan-Morgan手术治疗重度痔的疗效。方法：将130例重度痔患者半随机分为治疗组（PPH）和对照组（Milligan-Morgan术）,分别采用相应的方法治疗,对比观察两组的手术时间、住院时间、住院费用、创面愈合时间、治疗有效率和术后近期及6～24个月后并发症、肛门功能等指标。结果：两组手术有效率无统计学差异（P〉0.05）,治疗组手术时间、平均住院日、创面愈合时间明显低于对照组（P〈0.01）;术后并发症发生率（疼痛、肛缘水肿、出血等）低于对照组（P〈0.01）,肛门功能恢复优于对照组（P〈0.05）,住院费用、术后肛门坠胀、下腹疼痛发生率高于对照组（P〈0.01）。术后6～24个月肛门狭窄、瘙痒和残留皮赘发生率两组差异均无统计学意义（P〉0.05）。结论：PPH治疗重度脱垂痔的近期疗效明显优于Milligan—Morgan手术,但费用较大,远期疗效尚需进一步追踪随访。     

近红外光谱法快速测定消渴丸药粉中葛根素含量

目的:采用近红外光谱法对消渴丸药粉中葛根素含量进行快速测定.方法:以HPLC分析值作为参照,采用近红外漫反射光谱技术采集消渴丸药粉的近红外光谱,结合偏最小二乘法建立葛根素含量的快速测定方法,并对未知样品进行了含量预测.结果:建立的葛根素校正模型R2,RMSECV,RPD分别为0.980 1,0.131,7.09.对预测集样品预测平均相对偏差为3.2%.结论:该方法准确、快速、简便,可作为消渴丸中间产品质量检测和实时在线质量控制的方法.     

New concepts for the old challenge of African relapsing fever borreliosis

Relapsing fever, caused by spirochaetes belonging to the genus Borrelia , was once the cause of worldwide epidemic disease. This was largely through infection with the louse-borne form of the disease, caused by Borrelia recurrentis (louse-borne relapsing fever (LBRF)). During the last century, we have witnessed the demise of this infection, largely owing to improved standards of living and the introduction of the insecticide DDT, resulting in a reduction in the incidence of the body louse, the vector for relapsing fever. In areas of extreme poverty this disease persists, causing a significant burden of disease. It is now looking probable that this infection is caused by a louse-adapted variant of Borrelia duttonii , transmitted by Ornithodoros moubata 'soft' ticks in East Africa. Like LBRF, infection still causes impact, particularly affecting young children and pregnant women. Over recent years, the true burden of relapsing fever caused by infection with the closely related Borrelia crocidurae , transmitted by Ornithodoros sonrai ticks, has only just begun to emerge. Here, the current state of knowledge concerning relapsing fever in Africa is reviewed.     

340例咽异感症与食道疾病的相关性探讨

目的对咽异感症和食道疾病的相关性进行研究。方法选取本院于2010年1月-2014年1月收治的340例因咽部伴有异物感而就诊的患者,明确排除口腔、鼻腔、咽喉和颈部疾病,并对患者进行食道X线钡餐检查。结果所有患者中,172例（50．59％）的患者确诊患有食道疾病。其中包括食道返流性疾病患者55例（16．18％）,食道癌13例（3．80％）,食道炎75例（22．00％）,食道憩室29例（8．53％）,所有患者经对症给药后,102例（59．30％）患者咽异感症症状消失,51（29．65％）例患者咽异感症症状有显著缓解,19（11．04％）例患者咽异感症症状无明显改善。结论食道疾病会诱发咽异感症,且与咽异感症的发生有密切联系。     

乐商对教师主观幸福感的影响:品味的中介作用

目的:探索品味在乐商与幸福感间的作用。方法:采用乐商量表、牛津幸福感量表、品味信念量表对1295名中小学教师进行问卷调查。结果:(1)东部地区教师的乐商和品味显著高于中西部地区(F=6.100,9.983;P0.001);(2)在乐商、品味指标上,女教师显著高于男教师(t=-3.373,P0.01;t=-4.984,P0.001),城市教师显著高于农村教师(t=-4.869,P0.001;t=-3.335,P0.01);此外,城市教师的幸福感高于农村教师(t=-3.389,P0.01);(3)教师的乐商、主观幸福感、品味两两之间存在显著正相关(r=0.158~0.919,P0.001);(4)品味在乐商与主观幸福感之间存在中介效应[95%CI为(0.0760,0.1377)]。结论:乐商和品味是影响主观幸福感的重要因素,且品味起到中介作用,故应培养教师积极体验的能力。     

Validation of the Risk Model: High-Risk Classification and Tumor Pattern of Invasion Predict Outcome for Patients with Low-Stage Oral Cavity Squamous Cell Carcinoma

The Risk Model is a validated outcome predictor for patients with head and neck squamous cell carcinoma (Brandwein-Gensler et al. in Am J Surg Pathol 20:167–178, 2005; Am J Surg Pathol 34:676–688, 2010). This model may potentially shift treatment paradigms for patients with low-stage cancers, as current protocols dictate that they might receive only primary surgery. Here we test the hypothesis that the Risk Model has added prognostic value for low-stage oral cavity squamous cell carcinoma (OCSCC) patients. 299 patients with Stage I/II OCSCC were characterized according to the Risk Model (Brandwein-Gensler et al. in Am J Surg Pathol 20:167–178, 2005; Am J Surg Pathol 34:676–688, 2010). Cumulative incidence and competing risk analysis were performed for locoregional recurrence (LRR) and disease-specific survival (DSS). Receiver operating characteristic analyses were performed for worst pattern of invasion (WPOI) and the risk categories. 292 patients were analyzed; 30 T1N0 patients (17 %) and 26 T2N0 patients (23 %) developed LRR. Disease-specific mortality occurred in 9 T1N0 patients (6 %) and 9 T2N0 patients (10 %). On multivariable analysis, the Risk Model was significantly predictive of LRR (p = 0.0012, HR 2.41, 95 % CI 1.42, 4.11) and DSS (p = 0.0005, HR 9.16, 95 % CI 2.65, 31.66) adjusted for potential confounders. WPOI alone was also significantly predictive for LRR adjusted for potential confounders with a cut-point of either WPOI-4 (p = 0.0029, HR 3.63, 95 % CI 1.56, 8.47) or WPOI-5 (p = 0.0008, HR 2.55, 95 % CI 1.48, 4.41) and for DSS (cut point WPOI-5, p = 0.0001, HR 6.34, 95 % CI 2.50, 16.09). Given a WPOI-5, the probability of developing locoregional recurrence is 42 %. Given a high-risk classification for a combination of features other than WPOI-5, the probability of developing locoregional recurrence is 32 %. The Risk Model is the first validated model that is significantly predictive for the important niche group of low-stage OCSCC patients.     

Estrogen plus progestin and risk of benign proliferative breast disease

Women with benign proliferative breast disease are at increased risk of subsequent breast cancer. Estrogens and progesterone exert proliferative effects on mammary epithelium, and combined hormone replacement therapy has been associated with increased breast cancer risk. We tested the effect of conjugated equine estrogen plus progestin on the risk of benign proliferative breast disease in the Women's Health Initiative (WHI) randomized controlled trial. In the WHI trial of estrogen plus progestin, 16,608 postmenopausal women were randomly assigned either to 0.625 mg/day of conjugated equine estrogen plus 2.5 mg/day of medroxyprogesterone acetate or to placebo. Baseline and annual breast exams and mammograms were required. The trial was terminated early (average follow-up, 5.5 years). We identified women who had had a biopsy for benign breast disease, and subjected histologic sections from the biopsies to standardized review. Overall, 178 incident cases of benign proliferative breast disease were ascertained in the estrogen plus progestin group and 99 in the placebo group. The use of estrogen plus progestin was associated with a 74% increase in the risk of benign proliferative breast disease [hazard ratio, 1.74; 95% confidence interval (CI), 1.35-2.25]. For benign proliferative breast disease without atypia the hazard ratio was 2.00 (95% CI, 1.50-2.66), while for atypical hyperplasia it was 0.76 (95% CI, 0.38-1.52). The risk varied little by levels of baseline characteristics. The results of this study suggest that the use of estrogen plus progestin may increase the risk of benign proliferative breast disease.     

泛影葡胺治疗突发性聋的疗效观察

目的 :探讨应用泛影葡胺治疗突发性聋的疗效 ;方法 :应用前瞻性的随机分组方法进行临床试验 ,分为泛影葡胺组及常规药物组 ,两组病人均常规给予扩张血管、改善微循环、营养神经治疗 ,泛影葡胺组在此基础上 ,应用泛影葡胺治疗 ;结果 :共收治突聋患者 72例 81耳 ,泛影葡胺组和常规药物组各 3 6例 ,泛影葡胺组总有效率为 85.4% ( 3 5 41 ) ,常规药物组为 67.5% ( 2 7 40 ) ,泛影葡胺组疗效明显高于常规药物组 (P <0 .0 5) ;结论 :突发性聋应用泛影葡胺治疗可明显提高疗效