Précising definitions as a way to combat overdiagnosis

Roughly, overdiagnosis (ODx) occurs when people are harmed by receiving diagnoses (often accompanied by interventions) that do not benefit them, usually because the diagnosed conditions do not pose a threat to their health. ODx is a theoretical as well as a practical problem as it relates to definitions of disease. Elsewhere, it has been argued that disease is a vague concept and that this vagueness may contribute to ODx. In response, we develop a stipulative or précising definition of disease, for the specific purpose of decreasing or preventing ODx. We call this disease_ODx, aimed at distinguishing cases where it would be beneficial to identify (and treat the condition) from those where diagnosis is more likely to harm than benefit. A preliminary definition of disease_ODx is that X is a disease_ODx iff there is dysfunction that has a significant risk of causing severe harm. This paper examines the 3 concepts in this definition, using a naturalistic account of function, a Feinbergian account of comparative harm, and a probabilistic understanding of risk. We then test the utility of this approach using examples of clinical conditions that are currently overdiagnosed.     

5 117例股骨颈骨折患者流行病学调查分析

目的：分析2014至2019年收治的股骨颈骨折患者的流行病学特征及变化趋势。方法：对2014年1月至2019年12月期间广东省某三级甲等医院收治的股骨颈骨折患者资料进行回顾性分析,记录患者的性别、年龄、住院时间等数据,分析6年期间股骨颈骨折的流行病学特征及变化趋势。结果：共统计股骨颈骨折患者5 117例,男女比例为0.67:1,2014至2019年股骨颈骨折病例数总体呈逐年上升趋势;老年组、青壮年组、儿童组所占比例分别为70.22%、27.40%、2.38%;2014至2019年老年组患者所占比例逐步增加,青壮年组所占比例逐步下降;股骨颈骨折好发季节为冬季;88.27%的股骨颈骨折致伤原因为摔伤;70.50%的老年患者有合并症;43.37%的患者以急诊方式入院,91.12%的患者采用手术治疗。结论：2014至2019年股骨颈骨折病例数逐年上升,女性多于男性,老年女性为高发人群,70～79岁为高发病年龄段,冬季为股骨颈骨折的高发季节,应做好重点人群特定时间段的预防,以降低股骨颈骨折的发病率。     

Effect of low intensity pulsed ultrasound on repairing the periodontal bone of Beagle canines

Objective:To investigate the repairing effect of low intensity pulsed ultrasound(LIPUS)on the Beagle canines periodontal bone defect.Methods:A total of 12 Beagle dogs with periodontal bone defect model were randomly divided into control group,LIPUS group,guided tissue regeneration(GTR)group and LIPUS+GTR group,with three in each.After completion of the models,no other proceeding was performed in control group;LIPUS group adopt direct exposure to radiation line LIPUS processing 1 week after modeling;GTR group adopted treatment with GTR,following the CTR standard operation reference;LIPUS+GTR group was treated with LIPUS joint GTR.Temperature change before treatment and histopathological change of periodontal tissue after repair was observed.Results:There was no significant difference in temperature changes of periodontal tissue between groups(P0.05).The amount and maturity of LIPUS+GTR group were superior to other groups;new cementum,dental periodontal bones of GTR group were superior to the control group but less than LIPUS group;new collagen and maturity of the control group is not high relatively.Conclusions:LIPUS can accelerate the calcium salt deposition and new bone maturation,thus it can serve as promoting periodontal tissue repair,and shortening the periodontal tissue repair time.     

蟾毒灵对人肝癌细胞增殖与侵袭的影响

目的:研究蟾毒灵(bufalin,Bu)对肝癌BEL-7402细胞生长、迁移侵袭的作用.方法:体外培养人肝癌BEL-7402细胞,应用CCK-8比色法、流式细胞仪、Transwell小室迁移侵袭实验观测不同浓度和作用时间Bu对肝癌细胞增殖、迁移、侵袭的影响.结果:Bu明显抑制肝癌BEL-7402细胞生长和增殖,呈浓度-时间效应关系;0.085μg/mL Bu分别作用于肝癌BEL-7402细胞48、72 h,肝癌细胞周期阻滞于G2/S期[48 h(G2:t=-6.618,P<0.01;S:t=-5.339,P<0.01),72 h(G2:t=-14.273,P<0.01;S:t=-4.812,P<0.01)];0.085μg/mL Bu作用肝癌BEL-7402细胞72 h,显著抑制肝癌细胞迁移(t=11.717,P<0.01)和侵袭(t=5.437,P<0.01).结论:Bu能抑制肝癌细胞迁移、侵袭,并且通过阻滞肝癌细胞周期于G2/S期,抑制肝癌细胞增殖,其生长抑制作用呈时间和剂量依赖效应.