EPP模型在江苏省艾滋病疫情估计、预测与分析中的应用

目的评估江苏省艾滋病疫情流行情况,用EPP模型估计及预测艾滋病疫情,为相关政策的制定提供依据。方法依据江苏省艾滋病病例报告、哨点监测、专题调查等获得的数据,参考有关资料,运用EPP模型对江苏省疫情进行估计和预测。结果经模型估计江苏省首例HIV感染者出现在1987年,至2009年现存活的HIV/AIDS为12099例,总人群的感染率为0.02%。结论这是EPP模型初次运用于我国单个省份,结果显示目前江苏省处于艾滋病低流行阶段,但流行形式不容乐观,性接触传播所占的比例逐年升高。     

中俄双边口岸地区鼠形动物监测名录

目的于2006至2009年间对中俄黑龙江、内蒙古双边11个口岸地区的鼠形动物进行本底调查。方法 5 m夹夜法、弓形夹法及电弧捕鼠器捕捉法。结果编著中俄双边11个口岸鼠形动物名录。结论该名录为中俄口岸公共卫生及鼠传疾病的防治提供本底资料。     

New frontiers of retinal therapeutic intervention: a critical analysis of novel approaches

A recent wave of pharmacologic and technologic innovations has revolutionized our management of retinal diseases. Many of these advancements have demonstrated efficacy and can increase the quality of life while potentially reducing complications and decreasing the burden of care for patients. Some advances, such as longer-acting anti-vascular endothelial growth factor agents, port delivery systems, gene therapy, and retinal prosthetics have been approved by the US Food and Drug Administration, and are available for clinical use. Countless other therapeutics are in various stages of development, promising a bright future for further improvements in the management of the retinal disease. Herein, we have highlighted several important novel therapies and therapeutic approaches and examine the opportunities and limitations offered by these innovations at the new frontier.

KEY MESSAGES

• Numerous pharmacologic and technologic advancements have been emerging, providing a higher treatment efficacy while decreasing the burden and associated side effects.
• Anti-vascular endothelial growth factor (anti-VEGF) and its longer-acting agents have dramatically improved visual outcomes and have become a mainstay treatment in various retinal diseases.
• Gene therapy and retinal prosthesis implantation in the treatment of congenital retinal dystrophy can accomplish the partial restoration of vision and improved daily function in patients with blindness, an unprecedented success in the field of retina.

     

两种经脐单孔微创阑尾切除术的安全性比较

目的通过对经脐单孔免气腹和经脐单孔气腹阑尾切除术的比较,总结单孔免气腹手术的优势。方法采用经脐单孔免气腹和经脐单孔气腹阑尾切除术各30例。结果经脐单孔免气腹手术均获成功,无中转开腹,术后恢复快,所有患者均痊愈出院,无手术并发症及死亡。经脐单孔气腹手术有1例中转开腹,2例术后肺部感染,1例术后心脏功能不全,所有手术患者均痊愈出院,无死亡患者。结论免气腹腹腔镜单孔行阑尾切除术增加了手术的安全性,减少并发症。     

乳腺癌患者上臂输液港植入方式改进

目的探讨超声联合改良塞丁格技术在乳腺癌患者上臂输液港植入的应用效果。方法选取73例乳腺癌患者为研究对象,采用超声引导联合改良塞丁格技术植入上臂输液港,即血管超声下穿刺成功后送入0.018英寸导丝,插入5Fr微插管鞘,退扩张器及微导丝,送入含支撑导丝(0.035英寸)的5Fr导管,并行导丝引导腔内心电图定位确定导管长度,制作囊袋放入港体,缝合皮肤并固定。观察植港操作时间、成功率及植港即刻并发症发生率。结果患者上臂输液港植港成功率为95.89%,植入操作时间为15～45(25.46±6.22)min。患者植港术中疼痛评分为(1.63±0.74)分,术后24 h为(2.94±0.67)分,仅有1例误穿神经。结论采用超声联合改良塞丁格技术植入输液港,在保证成功植入的同时,可缩短操作时间,改善患者疼痛程度,且有效预防植港并发症发生。     

江苏省糖尿病患者疾病经济负担实证研究

目的掌握江苏省糖尿病患者疾病经济负担状况,为进一步控制糖尿病患者医疗费用、减轻糖尿病患者经济负担和优化糖尿病健康管理策略提供实证依据。方法在江苏省苏南、苏中和苏北6县(市、区)开展糖尿病患者问卷调查,共计2 444例患者纳入分析,测算患者直接经济负担、间接经济负担、无形经济负担和总疾病经济负担,采用方差分析比较不同合并症与并发症数量间糖尿病患者的疾病经济负担差异。结果调查前一年,调查对象的人均直接经济负担为3 566元,其中药品费用占比达到64.7%,间接经济负担为737元,无形经济负担为3 783元,总疾病经济负担为8 086元。江苏省糖尿病患者的年总疾病经济负担为271.0亿元。随着并发症数量的增加,糖尿病患者的疾病经济负担也呈明显上升趋势。结论江苏省糖尿病患者无形经济负担较重,药品费用是直接经济负担的主要来源,并发症是造成患者疾病经济负担的主要因素。应当重视对糖尿病患者生命质量的动态评价,积极开展个性化健康干预指导,落实以家庭医生签约服务为抓手的分级诊疗制度建设,加强对糖尿病的早诊断和早治疗,从而预防并发症的发生,减轻糖尿病患者的疾病经济负担。     

胆囊切除术后腹泻的研究进展

胆囊切除术后腹泻(PCD)是胆囊切除术后综合征(PCS)的常见症状之一,不仅发病率高,且严重影响患者的工作和生活。因此,PCD的治疗已逐渐成为研究热点。然而,目前PCD的发病机制及其治疗方法尚不明确。本文就PCD的相关流行病学、病理生理、发病机制及治疗策略等方面进行综述。     

Internal retraction in single-port laparoscopic cholecystectomy: Initial experience and learning curve

Abstract

Introduction: We report our experience and learning curve in single-port laparoscopic cholecystectomy (SPLC) using an internal anchored retraction system. Methods: Usefulness of the retraction system was analysed in 18 SPLC. The first eight, the following ten SPLC and 20 consecutive four-port laparoscopic cholecystectomies (4PLC) were compared. Duration of operation, burns on nontarget tissue and gallbladder perforations were assessed by reviewing videotapes recorded during the procedures. Results: Use of the retraction system failed in three out of five patients (60%) with intraoperative signs of chronic inflammation and in one out of 13 (7.1%) without such signs (p = 0.0441). Median operation time was 90 (45–120) in the first eight and 55 (40–180) minutes in the following ten SPLC (p = 0.0361). Whereas the first eight SPLC lasted longer compared to 4PLC (70 (40–140) minutes, p = 0.0435) the difference disappeared after eight procedures (p = 0.2076). Median number of burns to nontarget tissue was seven (1–16) in the first eight and one (0–8) in the following ten SPLC (p = 0.0049). There was no difference in perforation of the gallbladder. Discussion: Internal retraction enables a safe exposure of the Calot triangle avoiding bile spillage in cholecystectomies without intraoperative signs of inflammation. Familiarisation with SPLC was rapidly achieved. Operation time and dexterity were equal to 4PLC after eight SPLC.     

江苏省昆山市2006~2014年卵巢癌发病率趋势分析

[目的]了解江苏省昆山市卵巢癌发病率趋势,预测2015～2020年发病率.[方法]2006～2014年卵巢癌病例来源于昆山市肿瘤登记数据,用中国2000年第5次人口普查年龄结构计算年龄标化发病率(中标率).使用年度变化百分比(annual change percentage,APC)评价发病率变化趋势;用时间趋势与自回归模型预测至2020年卵巢癌发病率.[结果]江苏省昆山市卵巢癌粗发病率从2006年的3.63/10万上升到2014年10.19/10万(APC=8.6％,95％CI:3.6％～13.6％);中标率从2006年的2.70/10万上升到2014年的7.19/10万(APC=7.1％,95％CI:1.7％～12.5％);年龄别发病率在30～60岁快速上升,60～64岁达到高峰.时间趋势与自回归模型预测结果显示2015～2020年卵巢癌预粗发病率分别为10.22/10万、10.76/10万、11.30/10万、11.84/10万、12.39/10万和12.93/10万.[结论]江苏省昆山市卵巢癌发病率明显上升,未来也将继续上升.     

江苏省耐药结核病抽样调查研究

目的:了解江苏省耐药结核病流行状况,为江苏省结核病防治规划修订和完善提供科学依据?方法:按WHO/IUATLD《结核病耐药监测指南》要求进行抽样和药物敏感性检测?结果:①江苏省肺结核患者总耐药率为40.96%,初始耐药率为32.80%,获得性耐药率为55.90%;总耐多药率16.61%,初始耐多药率7.63%,获得性耐多药率33.07%;②不同年龄组?不同学历?不同地区和是否有中断史的肺结核患者的耐药分布有差异?结论:江苏省肺结核患者的耐药情况不容乐观,需要引起重视?耐药主要发生在经济欠发达地区,以中年和文化程度低者为主,有中断治疗史患者发生耐药危险较高?