中国心身健康量表与SCL—90作为筛查工具的应用和适用性比较

目的：比较中心心身健康量表（CPSHS）和SCL90在筛选正常人群心理障碍方面的品质和适用性。方法：采用CPSHS和SCL－90同时测试457例学生。结果：CPSHS与SCL－90的筛查结果虽在判别阴、阳病例的总体上有显著性差异（P＜0．01）。但两者的阳性率（13．6％,10．9％）,经Mcnemar检验无显著性差异（P＞0．05）,一致性检验具有显著性意义（Kappa=0.451)。各量表筛查阳性病例中,CPSHS躯体体化因子的贡献率明显高于SCL－90（88．75,24．0％）。CPSHS与SCL－90的总分以及所有各因子均存在密切相关（r=0.139-0.707,P均＜0．01）。结论CPSHS既与CL－90有较好的平行效度,同时躯体症状因子和测试项目的增多更符合中国国情,对无效或不合作测试也能进行较好判别。完全可以作为中国正常人群心身问题的筛查工具。与SCL－90相比,具有更好的适用性。     

抗精神病药所致体重增加的研究

目的比较典型(氯丙嗪与舒必利)与非典型抗精神病药(维思通与氯氮平)对体重的影响.方法对单服维思通、舒必利、氯氮平、氯丙嗪其中一种的精神分裂症患者,于用药前后测定体重的变化.结果服药8周后四种药物引起体重增加如下维思通组2.40kg,舒必利组2.73 kg,氯氮平组3.71 kg,氯丙嗪组4.98 kg,其中维思通组与氯丙嗪组比较差异有极显著性(P＜0.01);舒必利组与氯丙嗪组比较差异有显著性(P＜0.05).各组男女体重变化差异无显著性,但男性平均体重的增加较女性高.结论典型与非典型抗精神病药均引起体重增加,其中对体重影响从小到大为维思通＜舒必利＜氯氮平＜氯丙嗪.对体重影响的不同也导致同患病率的不同.上述各药对男女体重影响无明显不同.     

Survival outcomes after breast-conserving therapy compared with mastectomy for patients with early-stage metaplastic breast cancer: a population-based study of 2412 patients

BackgroundPrevious studies revealed that patients with early-stage metaplastic breast cancer (MBC) underwent mastectomy more often than breast-conserving therapy (BCT) mainly due to the larger tumor size. This study was performed to compare the survival outcomes following BCT versus mastectomy for patients with early-stage MBC.MethodsSurveillance, Epidemiology, and End Results (SEER) database was used to identify women diagnosed with early-stage MBC (T1-3N0-3M0) between 2001 and 2016, who were treated with either BCT or mastectomy. We assessed overall survival (OS) and breast cancer-specific survival (BCSS) using the Kaplan-Meier method and hazard ratios using Cox proportional hazards models.ResultsA total of 2412 MBC patients were identified, 881 (36.5%) of whom underwent BCT and 1531(63.5%) underwent mastectomy. The median follow-up time was 73 months. Most of patients had older age (≥50 years old), larger tumor size, higher American Joint Committee on Cancer (AJCC) stage and hormone receptor negativity. After adjustment for confounding variables, patients who underwent BCT had significantly improved OS (5-year OS: 84.3% vs 62.5%; 10-year OS: 73.0% vs 52.1%; adjusted HR = 0.76, 95%CI: 0.59–0.97, p = 0.028) and BCSS (5-year BCSS: 89.1% vs 70.8%; 10-year BCSS: 83.9% vs 67.5%; adjusted HR = 0.72, 95%CI: 0.53–0.96, p = 0.026) than those who underwent mastectomy, and this improvement remained significant for all T and N stages of MBC except for N2-3 stage.ConclusionBCT conferred improved OS and BCSS compared with mastectomy for patients with early-stage MBC, and the improvement persisted in almost all of the subgroups of different T and N stages.     

First-Pass Arrival Interval of Ultrasound Contrast Medium in the Hepatic Artery and Portal Vein as a Marker for Assessment of Liver Transplant Recipients

BackgroundThis study measures the first-pass arrival times in the hepatic artery and portal vein of the transplanted liver using contrast-enhanced ultrasound (CEUS) and assess its correlation with graft performance in the early posttransplant period.MethodsThis study evaluated 35 liver transplant recipients who underwent CEUS examination within 1 month of transplant surgery. CEUS under contrast-specific harmonic imaging mode were recorded for 60 seconds immediately after intravenous administration of microbubble ultrasound contrast medium (Sonazoid, GE Healthcare, Oslo, Norway). The recorded video clips were reviewed by 2 readers to determine the first-pass arrival times in the hepatic artery and portal vein, and the difference between the 2 was defined as the arterial-portal arrival interval (APAI). Laboratory data on the same date of CEUS examination were collected as indicators to correlate with APAI.ResultsThe intra- and inter-rater reliability for APAI measurement were excellent, with intraclass correlation coefficients > .95. The mean APAI was 4.5 ± 1.8 seconds (range, 2.0-10.5 seconds). The APAI was positively correlated with the serum total bilirubin level (r = 0.357, P = .035) and negatively correlated with the platelet count (r = −0.354, P = .037). At the 5 second cutoff point, a total serum bilirubin of >8 mg/dL was reported in 5 of 11 patients (45.4%) with APAI of >5 seconds and in only 3 of 24 patients (12.5%) with APAI of <5 seconds (P < .05).ConclusionsThe APAI is a quantitative marker that links the hemodynamics and the clinical status of the liver graft.     

血清HBV DNA复制与慢性乙型肝炎肝脏损伤程度的研究

目的：探讨慢性乙型肝炎急性发作时,ＨＢＶ复制水平与肝脏组织损伤程度之间的关系。方法：Ｃ地４４例自发性发作的慢性乙型肝炎患者进行肝组织活检,并采用荧光定量多聚酶链反应测定血清ＨＢＶＤＮＡ含量。结果：血清ＨＢＶＤＮＡ含量与肝脏炎症程度（Ｇ１－Ｇ４）及纤维化程度（Ｓ１－Ｓ４）之间比较,无明显相关性（Ｐ〉０．０５）;与血清丙氨酸转氨酶（ＡＬＴ）、门冬氨酸转氨酶（ＡＳＴ）及总胆红素（Ｔ－ＢＩＬＩ）之间也无相     

1993年汕头口岸入出境人员HBV感染情况分析

本文作者对汕头卫生检疫局1993年从19129名入出境人员疾病监测体检中发现的1809名HBsAg阳性者进行HBV标志物(抗-HBs、HBeAg、抗-HBe、抗-HBc)测定结果的分析,提出今后继续加强开展乙型肝炎“二对半”检测,做好乙型肝炎预防工作的意见。     

增生性瘢痕和瘢痕疙瘩组织中Ⅰ、Ⅲ型前胶原及TGF-β_1 mRNA的表达

目的：探讨增生性瘢痕（Ｈ）和瘢痕疙瘩（Ｋ）组织中Ⅰ、Ⅲ型前胶原及ＴＧＦ－β１基因表达改变的相互关系及临床意义。方法：总ＲＮＡ抽提试剂盒抽提总ＲＮＡ,斑点杂交检测Ⅰ、Ⅲ型前胶原及ＴＧＦ－β１ｍＲＮＡ稳态水平的改变。结果：Ｈ和Ｋ组织中ＴＧＦ－β１ｍＲＮＡ（１．１９７±０．２３７,１．２０４±０．２４３）表达均高于正常瘢痕和正常皮肤（０．３２７±０．０８１,０．３３１±０．０７８）,Ｐ＜０．０１;Ｋ选择性地Ⅰ型前胶原ｍＲＮＡ表达增强,而Ｈ组织中Ⅰ、Ⅲ前胶原ｍＲＮＡ表达均增强,导致ＫⅠ、Ⅲ前胶原ｍＲＮＡ比值明显高于Ｈ（８．１６４±０．３００,１．６６６±０．２０１,Ｐ＜０．０１）。结论：Ｋ和Ｈ组织中胶原蛋白基因表达类型及强度不同,提示在Ｋ和Ｈ发生发展中具有不同的分子机理：ＴＧＦ－β１在增生性瘢痕疙瘩的发病机理中具有不同的分子机理;ＴＧＦ－β１在增生性瘢痕和瘢痕疙瘩的发病机理中具有一定作用。     

老年颅脑损伤234例临床特点及诊治探讨

目的探讨老年颅脑损伤的临床特点和诊治经验.方法回顾性分析2 34例年龄大于6 0岁颅脑损伤患者的临床特点及诊治情况.结果存活109例,死亡125例,老年颅脑损伤其合并伤、合并症、并发症较多见.结论针对老年人颅脑损伤临床特点积极并重诊治处理颅脑损伤、合并伤及合并症,以期减少并发症,提高本类病人的治疗效果.     

慢性严重误吸的手术治疗

目的：探讨不同病因所致慢性严重误吸患者的最佳手术治疗方式。方法：对8例慢性严重误吸患者分别采用3种手术方式治疗；①气管切开术(5例)、颈气管永久性造瘘术(1例)，气管套管佩带气囊，进食时气囊充气以阻止误吸；②会厌瓣缝合术(即喉口闭锁术，1例)；③胃永久性造瘘术(1例)。结果：8例患者均能经口进食，食物的性状种类不受限制，且未发现吸入性肺炎。其中5例带气囊者仅在进食后放气时，略有轻微刺激性咳嗽，1例喉癌行Arslan术式者，仍有较轻误吸现象，以上6例患者堵管时均能发声，可日常交谈；1例采用会厌瓣缝合术患者，术后经口进食已完全杜绝误吸现象；1例行胃永久性造瘘术者，能较好解决进食误吸，无胃反流现象。结论：会厌瓣缝合术(喉口闭锁术)、气管切开术(或颈气管永久性造瘘术)和胃永久性造瘘术3种术式，均是解决慢性误吸的外科治疗方法，可依不同的病因及患者的具体情况选择最佳术式。