区域性空中医疗救护体系构建

目的探讨构建区域性空中医疗救护体系的必要性、可行性和体系构建后的运行。方法综合分析外军及联合国维和部队空中救护体系,参考我国灾害救援中的有关经验。结果指挥系统、区域性医疗救援中心、运输工具、空中医疗救援队及现场分类救援力量是该体系构建的重点。结论区域性空中医疗救护体系是未来的一个重点方向。     

Timeline for maximal subjective outcome improvement following total ankle arthroplasty

BackgroundMaximal medical improvement (MMI) establishes the timepoint when patients no longer experience clinically significant improvements following surgery. The purpose of this investigation is to establish when patients achieve MMI following total ankle arthroplasty (TAA) through the use of patient reported outcome measures (PROMs).MethodsA systematic review to identify studies on TAA which reported consecutive PROMs for two years postoperatively was performed. Pooled analysis was done at 6 months, 12 months, and 24 months. Clinically significant improvement was defined as improvement between time intervals exceeding the minimal clinically important difference.ResultsTwelve studies and 1514 patients met inclusion criteria. Clinically significant improvement was seen up to 6 months postoperatively in both the American Orthopaedic Foot and Ankle Society Ankle Hindfoot Score and Visual Analog Scale scoring systems. The Short Musculoskeletal Function Assessment Dysfunction and Bother subsections showed maximal clinically significant improvement by 1 year postoperatively.ConclusionFollowing TAA, MMI is seen by one year postoperatively. Physicians may allocate the majority of resources within the first year when most of the improvement is perceived. This data may help inform preoperative counseling as it establishes a timeline for MMI.Level of evidenceIV.     

低山带气候疗养对白大褂高血压患者的康复疗效观察

目的研究分析低山带气候疗养对白大褂高血压患者的康复疗效。方法选择2009—2011年每年07—08月期间在鸡公山疗区疗养科住院疗养的23名白大褂高血压患者,充分利用鸡公山的自然疗养因子结合健康教育、心理咨询及运动疗法进行为期15d的康复疗养,对疗养前后患者动态血压平均值、人工测量血压平均值进行比较。结果动态血压监测在疗养前后收缩压(P=0.052)及舒张压(P=0.124)无显著差异;人工测量血压在疗养后收缩压(P=0.002)及舒张压(P=0.007)较疗养前均有显著降低。结论低山带疗养地自然疗养因子结合健康教育、心理咨询及运动疗法可以对白大褂高血压患者有良好的康复效果。     

Enhanced antitumor efficacy by combination treatment with a human umbilical vein endothelial cell vaccine and a tumor cell lysate-based vaccine

Angiogenesis inhibitors combined with other anticancer drugs have been shown to inhibit tumor growth in animal models and some of them were recently used in clinical trials. In the present study, a whole hepatocellular carcinoma cell lysate based vaccine with diphtheria toxin (DT) and two tandem repeats of microbial HSP70 peptide epitope 407-426 (2 mHSP70407-426, M₂) as adjuvant, which was called HDM, was combined with a whole human umbilical vein endothelial cell (HUVEC) vaccine to develop a combination treatment regimen. This combination treatment regimen was named HUVEC-HDM, which was supposed to enhance its antitumor efficiency. HUVEC-HDM was administrated subcutaneously in both prophylactic and therapeutic procedures. Compared to either single vaccine, HUVEC-HDM induced a more significant inhibition on the growth and metastasis of H22 hepatocellular carcinoma in mice and prolonged the survival of tumor-bearing mice. Besides, HUVEC-HDM immunization elicited strong humoral and cellular immune responses targeting tumor cell as well as tumor angiogenesis, which could be responsible for the enhanced antitumor effect. Moreover, histochemistry analysis showed that HUVEC-HDM induced large areas of continuous necrosis within tumors, correlating well with the extent of tumor inhibition. These results not only highlight the superiority of the combined HUVEC-HDM treatment regimen, but also support the translation of such approaches into the clinic for the treatment of patients with hepatocellular carcinoma.     

Association between the NBS1 Glu185Gln polymorphism and breast cancer risk: a meta-analysis

Nijmegen breakage syndrome 1 (NBS1), a vital DNA repair protein in the homologous recombination repair pathway and a signal modifier in the intra-S phase checkpoint, plays a critical role in cellular response to DNA damages and the maintenance of genomic stability. The NBS1 Glu185Gln (NBS1 E185Q, NBS1 8360G>C, rs1805794) polymorphism has been indicated to be involved in the development of cancer, but results of previous individual studies on the association between NBS1 Glu185Gln polymorphism and breast cancer risk remain controversial and inconclusive. Our meta-analysis investigated this association for the first time by pooling the odds ratios with corresponding 95 % confidence intervals (95 % CIs) of all individual publications available to date. Overall, 14 separate studies with 6,642 cases and 7,138 controls were finally included into the present meta-analysis after a comprehensive literature search of the PubMed, Embase, Web of Science, and China National Knowledge Infrastructure databases up to October 21, 2012. Overall analysis and subgroup analyses by ethnicity and source of controls were performed. Meta-analysis of total studies showed that the NBS1 Glu185Gln variant carriers were not susceptible to breast cancer (OR_{Gln vs. Glu}?=?1.05, 95 % CI 0.80–1.39, P _OR?=?0.719; OR _{Gln/Gln vs. Glu/Glu}?=?0.82, 95 % CI 0.62–1.08, P _OR?=?0.154; OR _{Glu/Gln vs. Glu/Glu}?=?1.00, 95 % CI 0.90–1.13, P _OR?=?0.939; OR_{Gln/Gln + Glu/Gln vs. Glu/Glu}?=?0.96, 95 % CI 0.83–1.11, P _OR?=?0.551; OR_{Gln/Gln vs. Glu/Glu + Glu/Gln}?=?0.84, 95 % CI 0.67–1.05, P _OR?=?0.134). Similar results were observed in heterogeneity-adjusted meta-analysis of all studies. Furthermore, subgroup analyses by ethnicity and source of controls did not identify any appreciable relationship of the NBS1 Glu185Gln polymorphism with breast cancer susceptibility in any populations. Sensitivity analysis by sequentially omitting individual studies confirmed the stability and reliability of our results. Our meta-analysis of currently available data shows no association between the NBS1 Glu185Gln polymorphism and breast cancer risk.     

妇幼保健医院门诊实施艾滋病PITC策略效果

目的了解在妇幼保健医院实施医务人员提供艾滋病检测咨询（PITC）策略的可行性，探讨艾滋病检测率的影响因素，为在艾滋病防治工作中推广实施PITC策略提供参考。方法2010年6月-2011年8月，选择广州市番禺区妇幼保健医院作为临床医疗机构试点，共选择3个门诊量较大的门诊科室作为试点，收集试点工作报表和访谈结果等资料进行分析。结果项日周期内，共计为57309人提供PITC服务，其中19809人（34．57％）接受艾滋病检测，婚检科、产科和妇科的艾滋病检测人数分别为9817人（100．00％）、6157人（35．63％）和3569人（12.37％）。产科艾滋病检测率高于妇科，差异有统计学意义（X^23514．72，P〈0．01）。在接受检测的19809人中，确认HIV阳性者3人（0．15％。1。产科和妇科调查对象拒绝艾滋病检测的主要原因均为认为自身没有感染艾滋病的可能性，分别占41．00％和59．00％。产科和妇科检测率与前15个月相比，差异均有统计学意义（P〈0．01）。结论在妇幼保健医院实施PITC策略具有可行性，政策支持、检测费用等对PITC的开展有重要影响。     

郑州地区3～13岁6705名儿童体格发育的调查

目的调查郑州地区3~13岁儿童的身高、体重及超重、肥胖的患病情况。方法抽取了郑州地区6 705名学龄儿童,收集身高、体重及计算体重指数;以2005年九省市儿童体格发育调查数据的标准,计算超重、肥胖的检出率,并分析其特点。结果 1)男生和女生平均身高相同,男生体重明显高于女生。2)9岁组男生身高落后于全国参考值、13岁组男生身高与全国参考值相当外,余年龄组均高于全国参考值;3~7岁组女生身高均高于全国参考值,9岁、13岁组与全国水平相当,10~12岁组女生低于全国参考值。3~9岁组、12岁组男女生的体重均高于全国参考值,而10岁、11岁、13岁组男女生体重均与全国参考值相当。3.超重的总检出率为12.11%,肥胖的总检出率为4.50%,其中男生分别为11.58%和6.05%,女生分别为7.81%和2.64%;男生超重、肥胖的检出率均高于女生。结论该地区儿童存在身材偏低及超重、肥胖,因此建议相关部门重视儿童的体格发育,加强宣传教育,增强户外体育锻炼.促使其养成良好的生活习惯。     

CIP2A is a poor prognostic factor and can be a diagnostic marker in papillary thyroid carcinoma

Papillary thyroid carcinoma (PTC) is the most common type of thyroid carcinoma. CIP2A has recently been described as a prognostic marker in many cancers. In this study, we assessed the value of this novel prognostic marker in PTC. A total of 178 surgical specimens of both benign and malignant thyroid tumors were collected. Immunohistochemical staining for CIP2A, HBME‐1, galectin‐3, and CK19 was performed. Western blotting for CIP2A was also performed. CIP2A was expressed in 85.3% of malignant tumors and 12.1% of benign tumors. ROC analysis showed that the AUC for CIP2A was higher than those for other tumor markers. Western blotting showed that CIP2A expression was higher in PTC than in other tumors. Poor progression‐free survival was observed in the high‐CIP2A expression group. High CIP2A expression is a poor prognostic factor and can be a diagnostic marker in PTC. The presence of any two of the three indicated makers (CIP2A, galectin‐3, and HBME‐1) is strongly correlated with the diagnosis of PTC.     

某院医务人员手和工作服清洁度调查

目的了解某院工作中医务人员手和工作服的清洁度。方法对该院各病房工作中的医务人员手和工作服进行采样检测。结果共采集342份标本,其中手标本173份,工作服标本169份,总合格率为78.65%,其中手、工作服合格率分别为76.30%、81.07%。不同医务人员手、工作服合格率分别比较,差异均具有统计学意义(均P0.05);均以护士最高(分别为87.93%、92.86%),医生次之(分别为75.86%、87.72%),医辅人员最低(分别为64.91%、62.50%)。普通病房医务人员手和工作服合格率进行相关性分析,两者的相关系数为0.930(P0.01)。结论该院工作中医务人员手和工作服的清洁度需要进一步提高,尤其是医辅人员;医务人员工作服的清洗频次和使用中的清洁标准还需要更深入的研究。