荧光分光光度法测定布美他尼片的溶出度

荧光分光光度法测定布美他尼片的溶出度滕南雁,陶宙（广西药品检验所,南宁５３００２１）布美他尼（Ｂｕｍｅｔａｎｉｄｅ）是一种强效利尿药,它具有起效迅速、作用短暂的特点。在中国药典、美国药典,日本药局方中均有收载［２］［３］［４］。布美他尼片每片含量为１...     

政策工具视角下我国延续性护理服务政策文本研究

目的 探讨我国延续性护理服务政策工具的分布情况,为优化延续性护理服务政策和开展延续性护理服务实践提供参考。方法 选取2012-2023年我国发布的28份延续性护理服务政策文本,基于政策工具与政策时期构建二维分析框架,采用内容分析法分析资料,以频数和百分比描述政策工具的数量和占比。结果 X维度中,供给型、需求型、环境型政策工具分别占25.49%、31.37%和43.14%。Y维度中,“十二五”“十三五”和“十四五”时期的政策工具分别占17.64%、50.98%和31.38%。结论 延续性护理服务政策以环境型和需求型政策工具为主,而供给型政策工具偏少。建议未来增加供给型政策工具的使用,临床需加强对延续性护理服务模式的实践探讨,以促进延续性护理服务政策落地。     

循环肿瘤细胞联合血清整合素β1对病理性乳头溢液患者乳管内恶性病变的诊断价值

［摘要］　目的　探讨循环肿瘤细胞（CTCs）联合整合素β1（ITG β1）对病理性乳头溢液（PND）患者乳管内恶性病变的诊断价值。方法　回顾性分析2022年1月至2023年9月北京市通州区妇幼保健院及首都医科大学附属北京朝阳医院收治的212例PND患者的临床资料,根据乳管病理检查结果将研究对象分为良性病变组（187例）和恶性病变组（25例）。采用差异富集-荧光免疫染色原位杂交技术（SE-iFISH）检测PND患者CTCs数量,采用酶联免疫吸附试验检测PND患者血清ITG β1水平。采用多因素logistic回归分析PND患者发生乳管内恶性病变的影响因素。通过受试者工作特征（ROC）曲线分析CTCs数量、血清ITG β1水平对PND患者乳管内恶性病变的诊断效能。结果　两组年龄、体质量指数（BMI）、月经状态、溢液类型、乳腺肿块比较差异有统计学意义（P<0.05）。恶性病变组CTCs数量多于良性病变组,血清ITG β1水平高于良性病变组,差异有统计学意义（P<0.05）。多因素logistic回归分析结果显示,年龄>50岁、BMI>24 kg/m²、血样溢液、较多的CTCs数量、较高的血清ITG β1水平是PND患者发生乳管内恶性病变的独立危险因素（P<0.05）。CTCs数量、血清ITG β1水平均具有诊断PND患者乳管内恶性病变的应用价值（P<0.05）,且两项指标联合检测的诊断效能更优［AUC（95%CI）=0.961（0.925～0.983）,P<0.001］,灵敏度和特异度分别为96.00%、84.49%。结论　CTCs数量、血清ITG β1水平在乳管内恶性病变的PND患者体内显著升高,二者联合对PND患者乳管内恶性病变具有较好的诊断价值。     

Changing socioeconomic inequalities in cancer incidence and mortality: Cohort study with 54 million person‐years follow‐up 1981–2011

Cancer is increasingly responsible for the mortality gap between high and low socioeconomic position groups in high‐income countries. This study investigates which cancers are contributing more to socioeconomic gaps in mortality and how this changes over time.New Zealand census data from 1981, 1986, 1991, 1996, 2001 and 2006, were linked to three to five years of subsequent mortality and cancer registrations, resulting in 54 and 42 million years of follow‐up cancer incidence and mortality, respectively. Age‐ and ethnicity‐standardised cancer mortality rates and the slope index of inequality (SII) by income were calculated.The contribution of cancer to absolute inequalities (SII) in mortality increased from 16 to 27% for men and from 12 to 31% for women from 1981–84 to 2006–11, peaking in 1991–94 for men and in 1996–99 for women and then levelling off, parallel to peaks in lung cancer inequalities. Lung cancer was the largest driver of cancer inequality trends (49% of the cancer mortality gap in 1981–84 to 33% in 2006–11 for men and 32 to 33% for women) followed by colorectal cancer in men (2 to 11%) and breast cancer in women (declining from 44 to 13%). Women in the lowest income quintile experienced no decline in cancer mortality.The contribution of cancer to income inequalities in all‐cause mortality has expanded in this high‐income country. Action to address socioeconomic inequalities should prioritise equitable tobacco control, obesity control and improved access to cancer screening, early diagnosis and high quality treatment for those with the lowest incomes.     

食管癌早期癌变的研究和annexin I表达的意义

目的 检查annexin Ⅰ在食管癌前病变到食管鳞癌不同病变过程中的表达。方法 按照研究食管癌早期病变的病理学取材方法取材,选择含有不同程度癌前病变的食管鳞癌标本11例,经连续取材制片和免疫组化分析,比较同一病例由食管癌前病变发展到食管鳞癌的全过程中annexin Ⅰ的表达改变。结果 Annexin Ⅰ表达水平在食管正常鳞状上皮中呈强阳性(11/11,100％),低度癌前病变(轻度不典型增生和中度不典型增生)减弱(3/8,37.5％),高度癌前病变(重度不典型增生和原位癌)明显减弱(12/14,85.7/％),食管浸润癌和淋巴结转移癌中阴性或显著减弱(15/15和3/3,100％)。Annex.in Ⅰ在食管低度癌前病变中的改变具有显著意义(P=0.002)。结论 Annexin Ⅰ是食管鳞癌早期侯选标志蛋白,在食管低度癌前病变时表达异常。     

The occurrence of hepatocellular carcinoma in different risk stratifications of clinically noncirrhotic nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) may be a cause of hepatocellular carcinoma (HCC), but its high prevalence challenges current surveillance strategies. We aimed to evaluate HCC incidences in different risk stratifications for noncirrhotic NAFLD. Using Taiwan's National Health Insurance Research Database, we located 31,571 patients with NAFLD between the years 1998 and 2012. After excluding other causes of hepatitis, underlying cirrhosis or malignancy, 18,080 patients were recruited for final analysis. Cumulative incidences of HCC were analyzed after adjusting for competing mortality. With a median follow‐up duration of 6.32 years in the study cohort, the 10‐year cumulative incidence of HCC was 2.73% [95% confidence interval (CI): 1.69–3.76%]. Hepatoprotectant was used as a surrogate marker for elevated serum alanine transaminase (ALT). After adjusting for age, gender, hypertension, hypercholesterolemia, diabetes mellitus, gout, statin use, metformin use and aspirin use, elevated ALT was independently associated with an increased HCC risk [hazard ratio (HR) 6.80, 95% CI: 3.00–15.42; p < 0.001]. Multivariate stratified analysis verified this association in all subgroups (HR> 1.0). Moreover, increased age (HR 1.08 per year, 95% CI: 1.05–1.11) and statin use (HR 0.29, 95% CI: 0.12–0.68) were also identified as independent risk factors. The 10‐year cumulative HCC incidence was highest in older (age >55 years) patients with ALT elevation (12.41%, 95% CI: 5.99–18.83%), but lowest in younger patients without ALT elevation (0.36%, 95% CI: 0–1.08%). The incidence of HCC was relatively low in patients with clinically noncirrhotic NAFLD, however, HCC risk was significantly increased in older patients experiencing an elevated serum ALT.     

带肌蒂腓骨段转位治疗膝部肿瘤切除后骨缺损

自1993年以来，应用带同侧比目鱼肌或股二头肌蒂腓骨段转位，治疗股骨下端、胫骨上端肿瘤切除后骨缺损6例。除1例近期手术者外，其余5例随访4～29个月，中位18个月，全部骨愈合。除1例受区为灭活骨外，其余4例在术后8周均见大量骨痂生长。这种骨连接的速度与不带血供的移植骨无法比拟。本法的优点是：转位的腓骨营养丰富，操作简单，便于推广，但使用范围尚有一定限制。     

纤维支气管镜肺减容术治疗绵羊肺气肿模型的实验研究

目的：探讨经纤支镜射频置管建立气道旁路肺减容术治疗绵羊肺气肿模型的有效性及优越性。方法：将16只6月龄雌性绵羊随机分为A、B 2组,木瓜蛋白酶方法建立肺气肿模型。A组经纤支镜射频建立气道旁路并放置支架,2组均给予内科治疗。分别测2组绵羊术前和术后24 h、4、8周的第1秒用力呼气容积（forced expiratory volume in one second,FEV1.0）,且进行比较,A组定期行胸部CT检查,2组动物治疗8周均予以处死,行病理学检查。结果：①成功复制绵羊肺气肿动物模型16只,A组术中、术后无并发症出现;②A组胸部CT示术后4周及8周,在治疗区均出现肺容积缩小,出现肺不张表现;③２组不同时间点FEV1.0水平差异有统计学意义（F时间=1 352.409,P=0.000）,２种治疗手段效果差异有统计学意义（F组间=5 004.278,P=0.000）,治疗手段和时间之间有交互作用（F交互=1 325.058,P=0.000）;④病理示A组治疗区见肺泡萎陷区,非治疗区域见肺气肿,肺泡萎陷区见粒细胞和淋巴细胞浸润;B组见肺气肿的肺泡组织。结论：该技术治疗绵羊肺气肿模型具有有效性及优越性。