Clinical outcome of adjuvant radiotherapy for squamous cell carcinoma of the breast; a multicenter retrospective cohort study

BackgroundBecause primary squamous cell carcinoma (SCC) of the breast is a rare disease, the standard therapy has not been established. We examined the clinical outcomes of postoperative adjuvant radiotherapy for breast SCC.Material and methodsWe conducted a multicenter retrospective cohort study. Patients diagnosed with primary breast SCC who received adjuvant radiotherapy as part of their primary definitive treatment were included. Overall survival (OS), breast cancer-specific survival (BCSS), and recurrence-free interval (RFi) were evaluated.ResultsBetween January 2002 and December 2017, 25 breast SCC patients received adjuvant radiotherapy as a primary treatment were included. Median follow-up time was 43.5 months. Three (12%), fifteen (60%) and seven (28%) patients had clinical stage I, II and III disease, respectively. Fourteen patients underwent breast-conserving surgery and subsequent adjuvant radiotherapy. Eleven patients underwent mastectomy and post-mastectomy radiotherapy. Ten patients received regional lymph node irradiation. Nine (36%) patients had disease recurrence. The first site of recurrence was locoregional in five, but distant metastasis arose in one. Concurrent local and distant metastasis were seen in two. Six cases of local recurrence occurred within the irradiated site. Seven patients died, and six of the deaths were due to breast cancer. Five-year OS, BCSS, and Rfi were 69%, 70%, and 63%, respectively. In multivariate analysis, age and lymphatic invasion were associated with increased risk of recurrence.ConclusionBreast SCC has a high incidence of locoregional recurrence and poor prognosis. Age and lymphatic invasion are significant risk factors for recurrence.     

An observational study of antibody responses to a primary or subsequent pertussis booster vaccination in Australian healthcare workers

Adult pertussis vaccination is increasingly recommended to control pertussis in the community. However, there is little data on the duration and kinetics of immunity to pertussis boosters in adults. We compared IgG responses to vaccination with a tetanus, low-dose diphtheria, low-dose acellular pertussis (Tdap) booster at 1 week, 1 month and 1 year post-vaccination in whole-cell (wP)-primed Australian paediatric healthcare workers who had received an adult Tdap booster 5–12 years previously, to those who received their first Tdap booster.Tdap vaccination was well tolerated in both groups. Previously boosted adults had significantly higher pre-vaccination IgG concentrations for all vaccine-antigens, and more were seropositive for pertussis toxin (PT)-specific IgG (≥ 5 IU/mL) (69.5%; 95% confidence interval (CI) 59.5–79.5) than adults in the naïve group (45.2%; 95% CI 32.8-57.5). Tdap vaccination significantly increased IgG responses 1 month post-vaccination in both groups. This increase was more rapid in previously boosted than in naïve adults, with geometric mean fold-increases in PT-IgG at 1 week post vaccination of 3.6 (95% CI 2.9–4.3) and 2.6 (95% CI 2.2–3.2), respectively. Antibody waning between 1 month and 1 year post-vaccination was similar between groups for IgG specific to PT and filamentous haemagglutinin (FHA), but was faster for IgG against pertactin (PRN) in the naïve group (GMC ratio 0.36; 95% CI 0.31–0.42) than the previously boosted group (GMC ratio 0.45; 95% CI 0.39–0.50). At baseline, all but one adult had protective IgG titres against tetanus toxin (TT) (≥ 0.1 IU/mL), and 75.6% in the previously boosted and 61.3% in the naïve group had protective IgG titres against diphtheria toxoid (DT) of ≥ 0.1 IU/mL.This study shows that pertussis immune memory is maintained up to 12 years after Tdap vaccination in wP-primed Australian adults. There was no evidence that pertussis immune responses waned faster after a booster dose. These findings support current recommendations of repeating Tdap booster vaccination in paediatric healthcare workers at least every 10 years. Clinical trials registry: ACTRN12615001262594.     

江陵县血吸虫病防治管理模式初探

该文通过对江陵县2009-2013年血吸虫病防治管理模式的回顾与总结,阐述了江陵县近5年以政策保障为支撑,县乡两级政府落实目标责任、完善监管机制。防治工作以质量控制为根本,采取样本集中检测、开展定期与不定期工作督导,真实掌握全县疫情。江陵县创造性地开展血吸虫病防治工作,提出"二个围绕,三个同步"工作原则,充分发挥网络平台作用,提高群众血防意识。该文将江陵县达到传播控制目标后,对今后血吸虫病防治迈向传播阻断进行了展望,提出建立高效敏感的监测体系及监测管理模式。     

Feline mitochondrial DNA sampling for forensic analysis: When enough is enough!

Pet hair has a demonstrated value in resolving legal issues. Cat hair is chronically shed and it is difficult to leave a home with cats without some level of secondary transfer. The power of cat hair as an evidentiary resource may be underused because representative genetic databases are not available for exclusionary purposes. Mitochondrial control region databases are highly valuable for hair analyses and have been developed for the cat. In a representative worldwide data set, 83% of domestic cat mitotypes belong to one of twelve major types. Of the remaining 17%, 7.5% are unique within the published 1394 sample database. The current research evaluates the sample size necessary to establish a representative population for forensic comparison of the mitochondrial control region for the domestic cat. For most worldwide populations, randomly sampling 50 unrelated local individuals will achieve saturation at 95%. The 99% saturation is achieved by randomly sampling 60–170 cats, depending on the numbers of mitotypes available in the population at large. Likely due to the recent domestication of the cat and minimal localized population substructure, fewer cats are needed to meet mitochondria DNA control region database practical saturation than for humans or dogs. Coupled with the available worldwide feline control region database of nearly 1400 cats, minimal local sampling will be required to establish an appropriate comparative representative database and achieve significant exclusionary power.     

北京取消药品加成政策对某三甲医院经济运行质量的影响研究

目的:探讨取消药品加成政策对公立医院经济运行质量的影响效应,分析医改政策效应持久性,为全面开展医药分开综合改革政策提供决策参考。方法:采用合成控制法,以2012年北京市试点取消药品加成的市属公立三甲Y医院为处理组,以未取消药品加成的其他市属三甲医院为对照组,分析取消药品加成对医院资产负债率的影响。结果:取消药品加成后,Y医院资产负债率降低,并且通过安慰剂检验证实Y医院资产负债率下降非偶然因素,但长期看,Y医院资产负债率有上涨趋势。结论:取消药品加成政策效应存在递减现象,建议实施改革配套措施以持续巩固政策实施效应。     

2018年全国外照射个人剂量监测能力考核结果与分析

目的 为了维护广大放射工作人员身体健康,提高全国个人剂量监测水平和能力。方法 根据考核方案,组织2018年全国个人剂量检测单位进行考核,通过分析考核结果,发现并解决技术服务机构个人剂量监测工作存在的问题。结果 参加本次个人剂量能力考核的放射卫生服务机构为345家,其中优秀单位90家,优秀率为26.1%,合格单位（含优秀）322家,合格率93.3%;不合格单位23家,不合格率为6.7%。结论 通过多年组织考核,全国个人剂量监测能力持续保持在较高水平。大多数参加考核的单位都能够按照考核方案较好的完成监测能力的考核工作。小部分单位的考核结果与参考值偏离较大,检测报告书写不够规范。不合格单位需要在检测中定期做好质量控制,加强工作人员的培训,进一步提高监测工作的规范性和测量结果的准确度。     

2018年上饶市CT性能现状分析

目的 2018年对上饶市医用X射线计算机断层摄影装置（CT）性能进行检测并分析其现状,为卫生行政部门管理和监督提供科学依据。方法 采用普查的方法,利用Catphan 500 等检测设备,根据国家检测标准对上饶市的CT进行性能检测。结果 全市有CT 104台,其中验收检测20台,状态检测84台,验收检测的合格率为100%,状态检测的合格率为83.33%。结论 上饶市的CT性能合格率较高,但仍需加强设备日常维护,淘汰不合格设备,提高CT设备的影像质量。