Survival in cancer of the cervix: treatment in a population-based cancer registry in a developing country (Bangalore, India)

A survival analysis of treated cases of cervix cancer that were registered in the Bangalore (India) Population Based Cancer Registry between 1 January 1987 and 31 December 1989 was performed. Information on vital status of patients was obtained principally through follow-up visits to homes of patients. Follow-up information was available for 860 (92.7 percent) of 928 registered cases. Of the 860 cases, information on treatment was available for 559 patients, on whom the analysis of treatment outcome was performed. The overall five-year observed survival (5YS) was 41.1 percent with a relative survival of 46.3 percent. The 5YS was significantly (P = 0.01) influenced by clinical stage and by addition of brachytherapy (BT) to external radiotherapy (EXT) (5YS = 60.1 percent cf 27.4 percent, P = < 0.001). In 343 patients who received EXT only, comparatively better survival was seen in the group who had received between 4,800 to 5,999 centigray (cGy) (5YS = 36.1 percent) when compared with those who received less than 3,000 and 3,000 to 4,799 cGy (5YS = 16.7 percent and 24.9 percent, respectively). Doses of EXT higher than 5,999 cGy (in patients who were not suitable for BT) did not have any benefit in the 5YS (27.4 percent). The study has generated a specific hypothesis about possible needless excess dose of external radiotherapy.     

Socioeconomic status and cancers of the female breast and reproductive organs: a comparison across racial/ethnic populations in Los Angeles County, California (United States)

Objectives: Despite the fact that socioeconomic status (SES) has been shown to have important implications in health related issues, population-based cancer registries in the United States do not routinely collect SES information. This study presents a model to estimate the SES of cancer patients in the registry database.Methods: At the Los Angeles Cancer Surveillance Program (CSP), we developed a model to estimate each cancer patient's SES from aggregate measurements of the census tract of residence (n = 1,640) at time of diagnosis. We then applied the SES estimates to observe the relationship between SES and risk of cancers of the female breast and reproductive organs including cancers of the ovary, cervix uteri, and corpus uteri. The analyses were performed on the cumulative records (n = 127,819) of cancer patients diagnosed between 1972 and 1992 in Los Angeles County, California, for the mutually exclusive racial/ethnic groups of non-Hispanic Whites, Hispanic Whites, Blacks, Asians, and persons of other ethnic groups.Results: We found SES is positively associated with female breast cancer, ovarian cancer, and cancer of the corpus uteri, but inversely associated with cervical cancer. These SES trends were quite consistent across age groups among non-Hispanic White women. Variations by race/ethnicity in the SES patterns were also found, with Asians exhibiting little association.Conclusions: Our model of measuring SES is sufficiently sensitive to capture the trends. Adopting the aggregate approach to measure SES in population-based registry data appears to be useful.     

绝经后妇女雌激素受体基因多态性与骨和脂代谢的相关性研究

目的 研究绝经后妇女雌激素受体（ER）基因PvuⅡ、XbaⅠ限制性片段长度多态性与骨和脂代谢的关系。方法 随机选取57名已排除影响骨代谢、脂代谢疾病的绝经后妇女，采空腹血和晨尿，用PCR—RFLP法对ER基因多态性进行分析，DEXA测定腰椎正侧位及股骨骨密度，同时检测血骨钙素、尿Ⅰ型胶原N末端肽和血脂指标。结果 基因型分析xx29例，Xx24例，XX4例。XX组股骨干（SHAFT）骨密度明显低于Xx组（P〈0．05）。XbaI限制性片段长度多态性与股骨干骨密度相关（r=0．367，P=0．039）：XX组骨钙素高于xx（P=0．041）和Xx（P=0．011）组。apoAl含量和A1／B比值在xx、Xx、XX三组呈递增，各组间差异有显著性（P〈0．05）。脂蛋白a[Lp（a）]与股骨骨密度（除SHAFT外）呈负相关。结论ER基因XbaⅠ—RFLP是影响绝经后妇女骨和脂代谢的重要因素；X基因型可维持股骨骨量，xx基因型与低载脂蛋白A1（apoAl）含量和A1／B比值相关，Lp（a）也影响股骨骨密度。     

食物频率问卷在妇女人群中的应用

近几年来,食物频率问卷方法已经越来越普遍的应用在膳食营养调查研究之中。它不仅能提供目标人群营养状况的数据,还能结合人群的消耗和生理需求,提出合理搭配的指导性意义。通过食物频率问卷方法能够了解妇女饮食习惯,从而进行针对性指导,有利于改善生活质量,并且能在疾病与饮食关系中提供有力的膳食依据。该文就食物频率问卷方法在妇女中的应用进行了综述。     

妊娠期弓形虫感染及妊娠结局的探讨

【目的】　探讨孕妇弓形虫 (toxoplasmosis ,TOX)感染与胎婴儿先天感染和出生异常之间的关系。　【方法】　采用酶联免疫吸附试验 (enzymelinkedimmonosorbentassay ,ELISA)法和聚合酶链反应 (polymerasechainreac tion ,PCR)法分别检测 12 0 0例孕妇血清TOXIgM、TOXDNA。TOXDNA阳性孕妇其胎儿分娩 (包括流产 )时留取脐血 (或流产组织 )检测TOXDNA。　【结果】　孕妇TOXIgM阳性率为 6.3 3 % ,有不良孕产史者 12 .64 % ,明显高于正常妊娠 5 .2 1% ( χ2 =14 .3 7,P <0 .0 1)。垂直传播率为 3 7.10 % ,其中TOXIgM阳性组垂直传播率为 44 .68% ,明显高于阴性组 13 .3 3 % ( χ2 =4.79,P <0 .0 5 ) ,有不良孕产史组垂直传播率 5 7.14 % ,明显高于正常妊娠组 2 6.83 % ( χ2 =5 .47,P <0 .0 5 )。TOXIgM阳性组胎婴儿异常率 3 0 .2 6% ,明显高于阴性组 9.0 2 % ( χ2 =3 3 .73 ,P <0 .0 1)。　【结论】　孕妇弓形虫感染是导致胎婴儿发育异常的重要原因。     

HRT加用雄激素对绝经后妇女骨代谢影响的探讨

探讨雌孕激素替代治疗加用雄激素类药对绝经后妇女骨密度和骨代谢指标的影响及其治疗安全性。方法 :85例绝经后健康妇女随机分为两组 :试验组 4 5例 ,每日口服倍美安 (含天然结合型雌激素 0 .6 2 5 mg+醋酸甲羟孕酮 2 .5 mg) 1粒 +去氢甲基睾丸素 2 mg;对照组 4 0例 ,每日口服倍美安 1粒 ,两组均服药 8w,观察两组妇女用药前及用药 4 w末、8w末、用药后 1月、2月各观察点的骨密度值、血清碱性磷酸酶、尿羟脯氨酸 /肌酐、尿钙 /肌酐比值及血脂、副反应等。结果 :1两组治疗过程骨密度值均逐渐升高 ,尿羟脯氨酸 /肌酐、尿钙 /肌酐比值逐渐降低 ,用药 4 w末、8w末、用药后 1月两组间比较有显著性差异。2两组治疗过程血胆固醇、血甘油三酯、低密度脂蛋白逐渐下降 ,试验组改善脂质代谢的特点未受影响。3两组在治疗副反应上比较差异无显著性。结论 :绝经后妇女雌孕激素替代治疗中加入雄激素类药可以提高骨量 ,减少骨丢失。对血脂代谢无不利影响。是一种防治绝经后骨质疏松的安全有效的方法     

大豆异黄酮减缓绝经后妇女骨丢失的临床效应

目的:确定大豆异黄酮减缓绝经后雌激素缺失状态下骨丢失的生理效应及其有效剂量。方法:以骨量正常或低减的绝经后妇女87人为研究对象,随机单盲分为大豆异黄酮84 mg/d和126 mg/d两个剂量组及安慰剂对照组,另以绝经后妇女10人给予7-炔诺酮2.5 mg/d作为阳性对照组,追踪24 w,测定腰椎、股骨颈和Ward,s三角区试验前后的骨密度值。结果:试验后安慰剂对照组腰椎骨密度较试验前显著下降(P<0.05), 大豆异黄酮两组及雌激素对照组各部位骨密度试验前后无显著变化 (P>0.05);协方差分析表明,试验后大豆异黄酮126 mg/d组、和雌激素对照组腰椎部位骨密度均值及其变化率显著高于安慰剂组(P<0.05),回归分析表明大豆异黄酮对各部位的骨密度变化率均有显著的正向作用(P<0.05)。结论:大豆异黄酮84～126 mg/d可减缓绝经后妇女骨的丢失,维持骨密度的相对稳定,其显效剂量是126 mg/d。     

孕妇乳母二十二碳六烯酸摄入水平对母婴脂肪酸状况的影响

目的:追踪观察孕妇、乳母膳食二十二碳六稀酸(DHA)不同摄入水平对母体及婴儿血浆、红细胞膜DHA水平的影响。方法: 选取孕妇146名,在孕妇22 w、孕38 w、产后3月进行膳食调查。同时随机抽取48名及其母乳喂养婴儿出生、3月时用毛细管气相色谱法测定血浆、红细胞中DHA水平。按3次平均膳食DHA摄入量分成三组,A组14例,80 mg/d,B组22例,80～159 mg/d,C组12例,≥160 mg/d。 结果:孕妇、乳母日均DHA摄入量 为103.17±51.43 mg/d。C组母体孕38 w时血浆、红细胞、产后3月时血浆及脐血浆、脐血红细胞、婴儿3月龄时红细胞中DHA水平均显著高于A组。产后3月时A组和B组血浆 DHA水平均显著低于孕22 w时 ,而C组与孕22 w时无显著差异。结论: 摄入DHA<80 mg/d组孕妇、乳母孕38 w时血和婴儿脐血DHA不能达到摄入DHA≥160 mg/d组同等水平。孕妇、乳母DHA摄入在≥160 mg/d时,能遏制产后DHA水平的下降。     

1850例孕妇建卡状况分析及对策

目的 :了解孕妇建卡状况 ,加强围产期保健 ,促进生殖健康。方法 :在建立《孕产妇保健手册》时对 1850例建卡孕妇逐一询问 ,填写统一的调查表 ,所有资料输入微机并用 SPSS统计包进行分析。结果 :在 1850例孕妇中 ,计划妊娠占2 9 .78% ,非计划妊娠者占 70 .2 2 % ,其中早孕建卡者占 3 8.3 8%。推迟建卡的原因主要是不知道早孕建卡 (占 3 6.2 0 % ) ,以为 3个月后建卡 (占 2 0 .69% )及部分医务人员说 3个月后建卡 (占 11.97% )。先兆流产保胎或早孕反应过重者占 10 .98%。建卡的孕妇中有人工流产史的比例较高 ,占 48.65%。在建卡时发现的高危因素中 ,居前 3位的分别是疤痕子宫、高龄妊娠、人工流产≥ 3次。结论 :围产期保健应重视孕前保健 ,选择最佳生育年龄 ,提倡有计划妊娠 ,广泛宣传围产期保健知识 ,提高早孕建卡率 ,降低人工流产率及剖孕产率 ,减少高危妊娠的发生 ,保护妇女生殖健康     

孕妇锌 铜 钙 磷营养状况对新生儿的影响

目的 :观察孕妇锌、铜、钙、磷营养状况对新生儿的影响。方法 :测定未孕妇女及孕妇血清和新生儿脐血锌、铜、钙、磷水平 ,并对孕妇进行膳食调查。结果 :孕期血清锌有下降趋势 ,血清铜、磷显著升高 ,脐血锌、钙高于母血水平 ,铜、磷低于母血水平 ;孕晚期锌与新生儿出生体重呈正相关 ;孕妇膳食中锌、钙摄入量不足。结论 :孕妇锌、铜、钙、磷营养状况对新生儿有一定的影响