2015年中国分地区恶性肿瘤发病和死亡分析

2015年广州市正式启动大肠癌筛查工作,开发应用了大肠癌筛查登记管理系统（简称系统）。目前,系统登记了413 866条初筛信息、19 683条肠镜信息、8 537条伺机筛查信息和8 845条一级亲属信息。全市使用系统的单位有233家社区和39家定点医院,11家区级项目管理机构负责审核质控。系统的开发和持续完善,实现了筛查流程的信息化管理,提高了全市筛查工作的效率和质量,有效支撑了大肠癌筛查工作的开展。     

新疫情防控形势下广州某三甲医院住院病人新型冠状病毒感染率及分析

【目的】2022年11月底广州执行最新的新型冠状（新冠）病毒防疫政策,开始逐步解封。在新防疫形势下,国内住院病人新冠病毒感染的情况尚不明确。据此,本文旨在研究新疫情防控形势下广州住院病人的新冠病毒感染情况。【方法】回顾性分析2022年11月底至2023年2月初我院的新冠病毒核酸检测结果。统计分析新防疫形势下医院病人的新冠病毒核酸检测的阳性率,以及住院病人的医院获得性新冠病毒感染率。【结果】回顾性分析了13 959人次病人的新冠核酸检测结果,包括6 966人次门诊病人和6 993人次住院病人。2022年11月30日,门诊病人的新冠病毒核酸检测结果开始出现阳性,新冠疫情已经开始暴发。12月7日,住院病人的新冠病毒核酸检测结果出现阳性,院内感染开始爆发。12月15日,门诊和住院病人的新冠病毒核酸检测阳性率（核酸阳性率）均超过40%,疫情进入高峰期。12月底之后,检测阳性率逐步下降,但住院病人的阳性率一直高于门诊病人。与2022年12月份相比,2023年1月份众多科室病人核酸阳性率明显下降,但肿瘤科病区的住院病人核酸阳性率显著升高（P <0.001）。进一步分析发现,住院病人的医院获得性...     

中国1990年与2010年感染性腹泻的疾病负担及变化研究

  目的   探讨广东省广州市感染性腹泻发病特征,评价rBS/WC霍乱疫苗的推广水平与感染性腹泻的关联性,为广州地区更有针对性地推广rBS/WC霍乱疫苗提供科学依据。  方法   根据rBS/WC霍乱疫苗的推广情况将感染性腹泻发病人群分为疫苗推广前（2015 — 2019年）和疫苗推广后（2020 — 2022年）两个群体。应用ArcGIS10.8进行空间自相关分析探索广州市感染性腹泻的空间聚集情况,运用R4.2.1 软件采用合成控制法结合贝叶斯时间序列模型（BSTS）的反事实预测方法将模型预测值与实际观测值的差值表示感染性腹泻的相对减少量来评价rBS/WC霍乱疫苗接种对感染性腹泻发病的影响。  结果   2015－2022年广州市感染性腹泻累计报告病例123582例,感染性腹泻年均报告发病率从2015 — 2019年（91.84/10万）下降到2020 — 2022年的（77.48/10万）,差异明显（χ² = 13891.686,P < 0.05）。在人群分布上,性别构成比在疫苗推广前后差异不大,但0～2岁和散居儿童发病在rBS/WC霍乱疫苗推广后发生较大变化（χ²分别为1263.733和1266.090,P均 < 0.05）。空间自相关分析结果显示感染性腹泻发病情况存在空间聚集性,Moran′s I均 > 0且（均有|Z| > 1.96,P < 0.05）,其空间表现趋势与rBS/WC霍乱疫苗接种水平的空间配置基本一致。BSTS模型发现自rBS/WC霍乱疫苗大规模接种计划启动以来的3年（2020 — 2022）,感染性腹泻实际观测到的病例数比模型预测病例数相对减少37.18%（95%CI = 13.81%～60.07%）,且保护效果因年龄和职业而异,推断rBS/WC霍乱疫苗对感染性腹泻不同病原具有一定的交叉保护作用。  结论  rBS/WC霍乱疫苗大规模推广后广州市感染性腹泻发病在时间、空间、人群中的分布都有下降趋势,一定程度上减少了广州市感染性腹泻的发病,值得继续推广应用。     

The indicator of clinical outcomes for patients with heterotopic pregnancy following in-vitro fertilization with embryo transfer

ObjectiveTo explore the early predictors for pregnancy outcomes in patients with heterotopic pregnancy (HP) following in-vitro fertilization with embryo transfer (IVF-ET).Material and methodsThis retrospective study reviewed 81 patients with HP following IVF-ET in our institution between January 2003 and September 2017. The relationships between clinical outcomes and general characteristics, sonographic features and different management options were analyzed by logistic regression analysis.ResultsThe gestational age at the time of diagnosis was 50.9 ± 12.3 days. Among these cases, 76 were accurately diagnosed by TVS, 1 was misdiagnosed as adnexal torsion by TVS, and 4 were confirmed to have IUPs after the surgical treatment. Hence, the sensitivity of TVS for detecting HP was 93.8% (76/81). However, forty-seven patients (58.0%) had suspected HP when they underwent the initial TVS. Among these patients, live births occurred for 60 patients, 11 of whom delivered preterm. The miscarriage rate was 58.3% (14/24) for patients without IUP cardiac activity at HP diagnosis, and 12.3% (7/57) for patients with IUP cardiac activity; a significant correlation was identified (χ² = 18.651, P < 0.001). Additionally, the abortion rate of patients following fresh non-donor embryo was higher than patients after frozen-thawed embryo (χ² = 10.437, P = 0.001). Further by logistic regression analysis, patients following frozen-thawed embryo and an IUP with cardiac activity at HP diagnosis were identified as two independent factors of pregnancy outcome. (OR = 0.060, 95%CI = 0.008–0.471, P = 0.007; OR = 0.010, 95%CI = 0.001–0.124, P<0.001).ConclusionsPatients following frozen-thawed embryo and an IUP with cardiac activity at HP diagnosis could be the independent predictors for a favorable prognosis.     

Amplitude screening improves performance of AMSA method for predicting success of defibrillation in swine model

PurposeA novel amplitude screening method, termed Optimal Amplitude Spectrum Area (Opt-AMSA) with the aim of improving the performance of the Amplitude Spectrum Area (AMSA) method, was proposed to optimize the timing of defibrillation. We investigated the effects of the Opt-AMSA method on the prediction of successful defibrillation when compared with AMSA in a porcine model of ventricular fibrillation (VF).Method60 male domestic pigs were untreated in the first 10 min of VF, then received cardiopulmonary resuscitation (CPR) for 6 min. Values of Opt-AMSA and AMSA were calculated every minute before defibrillation. Linear regression was used to evaluate the correlation between Opt-AMSA and AMSA. Receiver Operating Characteristic (ROC) analysis was conducted for the two methods and to compare their predictive values.ResultsThe values of both AMSA and Opt-AMSA gradually decreased over time during untreated VF in all animals. The values of both methods of defibrillation were slightly increased after the implementation of CPR in animals that were successfully resuscitated, while there were no significant changes in either method in those who ultimately failed to resuscitate. The significant positive correlation between Opt-AMSA and AMSA was shown by Pearson correlation analysis. ROC analysis showed that Opt-AMSA (AUC = 0.87) significantly improved the performance of AMSA (AUC = 0.77) to predict successful defibrillation (Z = 2.27, P < 0.05).ConclusionBoth the Opt-AMSA and AMSA methods showed high potential to predict the success of defibrillation. Moreover, the Opt-AMSA method improved the performance of the AMSA method, and may be a promising tool to optimize the timing of defibrillation.