脉压/平均动脉压比率预测脑出血的可行性研究

目的通过对脑出血患者发病时脉压和脉压／平均动脉压比率与对照组的比较，探讨脉压／平均动脉压比率预测脑出血的可行性。方法选取脑出血患者108例，测定入院时的首次血压（不受治疗因素影响），计算其脉压（PP）、脉压／平均动脉压比率（PP／MAPRatio），与年龄、性别匹配的健康对照组102例的PP、PP／MAP Ratio进行比较、分析。结果脑出血组的PP、PP／MAP Ratio显著高于对照组（PP：χ^2=196．000，PP／MAP Ratio：χ^2=249．771，P〈0．01），PP、PP／MAP Ratio分布频率与对照组差异有统计学意义（PP：χ^2=87．469，PP／MAP Ratio：χ^2=18．960，P〈0．01）。全部病例进人Logstic回归分析，PP≥50 mmHg者脑出血发病的危险性是PP低于50mmHg者的5倍（0R=5．000，95％CI为2．642～9．461）；PP／MAP Ratio高于0．45者脑出血是PP／MAP Ratio低于0．45者的2．6倍（0R=2．647，95％CI为1．516～4．622）。PP〉50mmHg、PP／MAP Ratio〉0：45，脑出血的发病率明显增大。结论PP／MAP Ratio也和PP-样都可以用于预测脑出血发病的危险性，PP／MAP Ratio是无量纲值，具有可比性，因此优于PP。     

Incidence of Second Primary Cancers in Osaka Residents, Japan, with Special Reference to Cumulative and Relative Risks

This study was conducted to examine the incidence rates and cumulative risks of second primary cancers in Osaka and to compare the observed number of second primary cancers with the expected number calculated using cancer incidence rates among Osaka residents. Study subjects were all reported cases aged 0–79 who were first diagnosed as having a first primary cancer between 1966–86. Incidence of second primary cancer among the study subjects was examined through to the end of 1989. The total number of study subjects was 217,307. During the follow-up period (mean duration: 3.7 years), second primary cancers developed in 5,071 patients (2.3%). Incidence of synchronous (interval <3 months) and metachronous (interval ≥ 3 months) second primary cancers increased in the later years. Incidence rates of second primary cancers were significantly associated with gender (male), age and calendar year at diagnosis of the first cancer. Based on the incidence rates, cumulative risk of developing metachronous second primary cancer was calculated. The ten-year cumulative risk was estimated as 10% for those who developed their first cancer during their sixties in 1978–83. The observed number of second primary cancers (including synchronous) was compared with the expected number. The ratios of observed-to-expected numbers were generally lower than 1.0 among those who developed their first cancer in 1966–77, while these ratios were higher than 1.0 among those who developed their first cancer in 1978–86. The ratios were much higher than 1.0 among those who developed their first cancer in their childhood and youth. Patients who had developed cancer of the colon, larynx, lung, bladder, or breast (female) showed significantly higher risk of developing second primary cancer during the period 1–4 years after diagnosis of the first cancer.     

A case-control study on risk of changing food consumption for colorectal cancer

Objectives. To investigate the relative risk factor of food items for colorectal cancer in four time periods through a case-control study in a Chinese rural area.

Methods. Colorectal cancer patients diagnosed at a county cancer center, Hebei Province, China, and non-cancer outpatients with similar age, sex, and place of residence were selected for cases and controls, respectively. There were 102 (93.6%) colorectal cancer patients and 99 (90.8%) outpatients being the cases and controls, respectively in the present investigation, who agreed to be interviewed about their food intake, during a 20-year period, through a food frequency questionnaire. The risks of intake of different food items and lifestyle for colorectal cancer were compared between cases and controls.

Results. During the 20-year period, diets of both cases and controls changed with increase in intake of animal foods and fruits, and alcohol consumption tended to increase. In the food items, milk intake showed a protective effect in both males and females, and the odds ratios were 0.38 (95% CI 0.16-0.90) and 0.28 (95% CI 0.10-0.81) for males and females, respectively. A reduced risk of fruit intake could be seen in males, while a reduced risk of vegetables could be observed in females. Meat intake and saturated fats were the prominent risk factors for colorectal cancer in males and females, respectively. A comparison of life habits, showed that tea drinking had a consistent protective effect in females, and the odds ratios were 0.21 (0.08-0.58), 0.23 (0.08-0.67), 0.25 (0.10-0.64), and 0.11 (0.04-0.30) for periods of 20-, 10-, 5-years ago, and current time, respectively.

Conclusions. These findings indicate that change in food consumption is strongly associated with a change in risk of colorectal cancer, and dietary meat has increased the risk of colorectal cancer. Increase in the consumption of milk and fruits may be a significant measure for colorectal cancer prevention in low-incidence areas.     

宫内节育器与宫外孕关系的研究

本文对1986年2月～1987年10月上海市14所医院中发生的宫外孕802例,采用宫外孕病例和宫内妊娠、非妊娠的妇女为对照,进行回顾性研究。调查节育及其他病史和宫外孕的关系,重点调查宫内节育器使用情况并测定其相对危险度。结果提示:1.总体而言节育器不增加宫外孕的危险性。2.带器妊娠时宫外孕危险增加。3.宫外孕的危险性与腹部或子宫手术史可能有关。     

Work-related laryngeal cancer: Trends in France from 2001 to 2016

Objectives

As part of the 2014–2019 cancer plan and in order to improve our knowledge of work-related cancers, we analysed the work-related laryngeal cancer risk situations identified in the French national occupational disease surveillance and prevention network (rnv3p) from 2001 to 2016.

Changes of neurobehavioral and sensory functions due to toluene exposure below 50ppm?

Data of a follow up study with four examinations were summarized by odds ratio statistics in order to scrutinize the results of the earlier studies with cross sectional approaches.

For a “high”- (n = 106) and a “low”-exposed group (references, n = 86) current toluene exposures of 26 ppm versus 3 ppm and lifetime weighted average exposures of 45 ppm versus 9 ppm were ascertained. As measures of sensory functions vibration thresholds, colour discrimination, and auditory thresholds were used. Measures of psychological performances were attention (symbol–digit substitution, switching attention, simple reaction), memory (digit span forward, delayed reproduction of pictures), and psychomotor functions (steadiness, line tracing, aiming, tapping, peg board). Additionally, the frequency of diseases and symptoms were ascertained.

By odds ratio statistics including relevant cofactors no significant increase of “cases with impaired functions” among the high-exposed workers was found. Evidence for neurobehavioral effects due to long-term toluene exposure below 50 ppm was not established.     

The use of a bedside assay for plasma B-type natriuretic peptide as a biomarker in the management of patent ductus arteriosus in premature neonates

OBJECTIVE: To test the utility of the bedside plasma concentration of B-type natriuretic peptide (BNP) assay as a screen for patent ductus arteriosus (PDA) in premature neonates. STUDY DESIGN: Newborn infants admitted to the neonatal intensive care unit (NICU) had paired echocardiography and BNP measurements at enrollment and every 4 to 5 days. RESULTS: Twenty neonates (gestational age approximately 28.6 weeks and birth weight approximately 1161 g) had 81 paired echocardiography and BNP determinations. BNP ranged from 5 to 3900 pg/mL. Fifty-six of 81 echocardiograms showed PDA. Significant correlations were found between BNP and ductal size and degree of shunting. Correlation was greater in infants >2 days of age. BNP >300 pg/mL predicted significant PDA, whereas BNP <105 pg/mL predicted absence of significant PDA. CONCLUSION: Bedside measurement of BNP correlates with magnitude of PDA in premature newborns, particularly beyond day 2, and may be useful in guiding diagnostic and management strategies.     

Early brain injury in premature newborns detected with magnetic resonance imaging is associated with adverse early neurodevelopmental outcome

OBJECTIVE: To determine the neurodevelopmental outcome of prematurely born newborns with magnetic resonance imaging (MRI) abnormalities. STUDY DESIGN: A total of 89 prematurely born newborns (median age 28 weeks postgestation) were studied with MRI when stable for transport to MRI (median age, 32 weeks postgestation); 50 newborns were studied again near term age (median age, 37 weeks). Neurodevelopmental outcome was determined at 18 months adjusted age (median) using the Mental Development Index (Bayley Scales Infant Development II) and a standardized neurologic exam. RESULTS: Of 86 neonatal survivors, outcome was normal in 51 (59%), borderline in 22 (26%), and abnormal in 13 (15%). Moderate/severe MRI abnormalities were common on the first (37%) and second (32%) scans. Abnormal outcome was associated with increasing severity of white matter injury, ventriculomegaly, and intraventricular hemorrhage on MRI, as well as moderate/severe abnormalities on the first (relative risk [RR] = 5.6; P = .002) and second MRI studies (RR = 5.3; P = .03). Neuromotor abnormalities on neurologic examination near term age (RR = 6.5; P = .04) and postnatal infection (RR = 4.0; P = .01) also increased the risk for abnormal neurodevelopmental outcome. CONCLUSIONS: In premature newborns, brain abnormalities are common on MRI early in life and are associated with adverse neurodevelopmental outcome.     

Chemometric and derivative methods as flexible spectrophotometric approaches for dissolution and assaying tests in multicomponent tablets

Two derivative spectrophotometric (ratio derivative spectra and algorithm bivariate calibration) and a chemometric methods (partial least squares, PLS) are proposed for the simultaneous determination of binary mixtures in tablet analysis and dissolutions tests, without prior separation. These approaches are successfully applied to quantify trimethoprim (TMP) combined with sulfamethoxazole (SMX) or sulfamethazine (SMZ) or sulfafurazole (SFZ) using the information in the absorption spectra of appropriate solutions. Beer's law was obeyed in the concentration range of 0.98-17.5 microg/ml for TMP, 0.95-17.2 microg/ml for SMX, 1.16-17.5 microg/ml for SMZ and 0.97-17.4 microg/ml for SFZ. The first derivative (1D) bivariate algorithm method involves the use of four calibration curves: two for each compound at two different wavelengths, selected by Kaiser's method. Similarly, the first derivative ratio spectrophotometry employs the linear relationship between the ratio spectra of the analytes and the concentration range. The results were compared with those obtained by PLS multivariate calibration. The calibration models from PLS were pre-treated by orthogonal signal correction and evaluated by cross-validation using the 'SIMCA-P 9' software. Synthetic mixtures of TMP and sulfonamides were used in five different sets for the validity of the calibrations. Mean recoveries for derivative ratio, derivative bivariate and PLS methods were found to be between 99.7% and 102.0% for TMP, 99.4% and 100.2% for SMX, 99.3% and 101.0% for SMZ and 98.1% and 102.3% for SFZ. The calibrations of the three methods were successfully applied to the assaying and dissolution of placebo and commercial tablets without any prior separation. More than 85% of TMP, SMX and SMZ were dissolved within 15 min. For SFZ, only 85% of the compound was dissolved after 60 min. In this study, the three spectrophotometric methods can be satisfactorily used for the quantitative analysis and for dissolution tests of multicomponent dosage forms.     

Duration and morbidity of newly diagnosed idiopathic thrombocytopenic purpura in children: A prospective Nordic study of an unselected cohort

OBJECTIVE: To determine the duration of the risk period with platelet counts <20 x 10(9)/L and the frequency of bleeding episodes in unselected children with idiopathic thrombocytopenic purpura (ITP). STUDY DESIGN: We established a registry for patients with newly diagnosed ITP in the five Nordic countries, enrolling children aged 0 to 14 years with platelet counts <30 x 10(9)/L. Treatment centers prospectively reported presenting features, management details, and disease-related events during the first six months after diagnosis. RESULTS: At presentation (n=501), more than half of the children had a platelet count <10 x 10(9)/L, but only 15 (3.0%) had a hemorrhage requiring blood transfusion. During follow-up of 409 patients, thrombocytopenia resolved uneventfully in 277. A risk period was present in 376 cases. Among 283 with self-limiting ITP, 26 were at risk >1 month and 25 had 30 events. Among 93 patients with chronic ITP, 73 were at risk >1 month and 44 had 111 events. Events occurred with an average frequency of 0.39 per month at risk. Life-threatening hemorrhages did not occur in the first six months after diagnosis. CONCLUSION: Most children with ITP are at risk for serious bleeding for less than one month. Continuing severe thrombocytopenia is associated with little morbidity, bleeding episodes being infrequent and very rarely serious.