以医院登记为基础的20万例恶性肿瘤患者生存报告

背景与目的：恶性肿瘤是全球重大的公共健康问题，患者生存率是评价恶性肿瘤诊治水平的重要指标。通过描述以医院登记为基础的20万例恶性肿瘤患者的生存情况，以真实世界数据从一个侧面反映我国恶性肿瘤的治疗效果。方法：纳入2008年1月1日—2017年12月31日之间在复旦大学附属肿瘤医院确诊为恶性肿瘤并接受住院治疗的患者共计202 542例。通过患者复诊病史资料、电话随访及死因数据链接等方式收集生存随访信息，随访统计时间截至2019年11月30日。应用寿命表法估计各个病种1年、3年和5年总生存率（overall survival，OS），以性别、年龄组、首次治疗时间分层。采用Kaplan-Meier生存曲线绘制各病种的总体生存曲线。结果：患者总体的1年、3年、5年OS分别为89.8%、77.4%和71.0%；男性患者5年OS为58.8%，女性患者为78.7%。在常见的恶性肿瘤中，甲状腺癌患者的5年OS最高，为98.6%；胰腺癌患者最低，为11.4%。2013—2017年首次治疗的乳腺癌、肺癌和肾癌患者5年OS分别为90.0%、55.9%和80.7%，显著高于2008—2012年首次治疗患者，其他肿瘤未见显著上升。结论：大部分恶性肿瘤患者经规范诊治可以获得较为理想的预后，女性生存情况显著优于男性，乳腺癌和肺癌患者的生存改善可能归功于新的临床治疗和早诊手段。     

Risk factors for total ankle arthroplasty failure: A Dutch Arthroplasty Register study

BackgroundStudies concerning total ankle arthroplasty could be influenced by several forms of bias. Independent national arthroplasty registries represent objective data on survival and patient reported outcomes. The aim of this study was to determine survival and identify risk factors for early failure in a nationwide series of total ankle arthroplasties from the Dutch Arthroplasty Register (LROI).Patients and methodsData of 810 patients, who received 836 total ankle arthroplasties between 2014 and 2020 were obtained from the Dutch Arthroplasty Register (LROI) with a median follow-up of 38 months (range 1–84 months). Survival was expressed in Kaplan-Meier analysis and associated hazard ratios for implant failure were determined. Implant failure was defined as the need for revision surgery for any reason or (pan)arthrodesis.ResultsDuring follow-up, we recorded 39 failures (4.7%) resulting in a implant survival of 95.3% with a median follow-up of 38 months (range 1–84 months). Medial malleolus osteotomy (HR = 2.27), previous surgery (HR = 1.83), previous osteotomy (HR = 2.82) and previous ligament reconstruction (HR = 2.83) all showed potentially clinically meaningful associations with a higher incidence of implant failure, yet only previous OCD treatment (HR = 6.21), BMI (HR = 1.09) and age (HR = 0.71) were statistically significant.InterpretationExcellent short-term survival (95.3%) with a median follow-up of 38 months was reported for TAA patients from the Dutch Arthroplasty Register. Patients with a lower age, a higher BMI or who had a prior surgical OCD treatment before TAA surgery appear to have a higher risk for revision after short-term clinical follow-up. Thorough patient selection with emphasis on risk factors associated with early implant failure might be essential to improve TAA survivorship.     

健康教育在白血病护理中的应用效果

目的评价血液科白血病疾病护理中应用健康教育的临床效果,为白血病护理工作提供参考。方法选择医院收治的白血病患者,总计60例。进行白血病患者随机分组护理,对照组与试验组各30例白血病患者,分别采取常规护理和常规护理+健康教育,比较2组白血病患者的负性情绪、自我效能状况评分以及护理满意度、护理依从率。结果试验组白血病患者干预后SAS、SDS、GSES评分均明显优于对照组,护理满意度与护理依从率均明显高于对照组,指标差异具有统计学意义,P>0.05。结论血液科白血病治疗期间配合落实常规护理、健康教育可以在提高患者自我效能的同时提高患者的依从性,符合患者身心护理需求,整体护理效果显著。     

The impact of frost-damage on the quality and quantity of the secreted antigen-specific IgG repertoire

Freezing of alum-based vaccines drastically alters their colloidal composition and leads to irreversible cluster formation. The loss of stability is well described, but the impact of frost damage on the functionality of the induced and secreted antibody repertoire has not been studied in detail. We therefore applied our single-cell measurement platform to extract the frequencies of Immunoglobulin G-secreting cells in combination with individual secretion rates and affinities. We showed that, frost-damaged or not, the tested vaccine was able to generate similar frequencies of total and antigen-affine IgG-secreting cells. Additionally, the frost-damaged vaccine stimulated a similar T-cell cytokine secretion pattern when compared to the regularly stored vaccine. However, frost-damaged vaccines induced no efficient affinity maturation and a complete collapse of the affinity distribution was observed. This study unveiled the impact of frost-damage to alum-based vaccines on the induced secreted antibody repertoire, and illustrated the power of functional single-antibody analysis.     

Recurrent respiratory papillomatosis in northern Sweden: Clinical characteristics and practical guidance

Conclusion: Recurrent respiratory papillomatosis (RRP) patients with high surgical treatment frequency (≥ 1/year, HF) were significantly younger and had a more widespread laryngeal disease compared to a low frequency treated group (< 1 treatment/year, LF). This study confirms the existence of a clinical RRP group, not primarily related to HPV sub-type, but more care-intensive and in need of more vigilant follow-up. Objectives: RRP is associated with high morbidity due to its influence on breathing and voice. The purpose of this study was to characterize RRP patients in northern Sweden and investigate possible predictor factors affecting therapeutic needs. Method: Patients from the regional referral area (northern Sweden) were categorized for age, disease duration, juvenile or adult onset, profile of disease development, number of surgical sessions in relation to disease duration, laryngeal deposition of papilloma, gender, and HPV sub-types, in order to identify patients with increased need for frequent surgical treatment. Results: The median age of the RRP patients (n = 48) was 44.5 years; 34 (71%) were males and 14 (29%) females, most were infected with HPV 6. Patients with high surgical treatment frequency/year were significantly younger and showed more widespread papillomatous vegetation in the larynx, compared to the low frequency treated group.