抗癌药物对心脏毒性反应(附五例报告)

本文报道五例肿瘤患者在用抗癌药的治疗过程中,出现对心脏不同程度的毒性反应,并就有关几种抗癌药物的毒性作用机理及防治进行了讨论。     

Management of infant sleep problems in a residential unit

Torrens House provides a short residential programme for families with a baby (8–12 months of age) identified by parents as having a sleep problem such as waking frequently at night and being difficult to settle. The programme involves the promotion of infant self-settling by the use of a controlled crying technique, together with wrapping, cessation of night feeds and establishment of a day-time routine. Twenty families (with 23 babies) were followed through the programme and for 3 months afterwards. There were significant decreases in the number of times the babies woke, the number of night-feeds and the length of time awake at night at 1 month follow-up, with a reduction in depressive symptomatology of the parents and a perceived improvement in their infants' behaviour. Twenty of the 23 babies were sleeping well at 3 month follow-up.     

腹腔镜下治疗输卵管妊娠术28例临床分析

目的 :对腹腔镜下治疗输卵管妊娠手术做出评价 ,并与传统剖腹手术方法比较。方法 :在电视腹腔镜下行保守性手术 8例及根治性手术 2 0例 ;对照组 2 8例采用传统剖腹手术方法。结果 :两组手术时间、尿TT恢复正常时间、切口感染差异均无显著性 (P >0 .0 5 ) ,两组术中出血、术后体温、肛门排气时间、下床活动时间、住院天数差异有显著性 (P <0 .0 1)。结论 :腹腔镜下治疗输卵管妊娠术具有创伤小 ,康复快 ,术中出血少 ,术后感染率低等优点 ,有助于提高患者生活质量 ,是临床上的理想手术方式     

Predictors of Maternal Responsiveness

PURPOSE: To explore maternal responsiveness in the first 2 to 4 months after delivery and to evaluate potential predictors of maternal responsiveness, including infant feeding, maternal characteristics, and demographic factors such as age, socioeconomic status, and educational level. DESIGN AND METHODS: A cross-sectional survey design was used to assess the variables of maternal responsiveness, feeding patterns, and maternal characteristics in a convenience sample of 177 mothers in the first 2 to 4 months after delivery. The 60-item self-report instrument included scales to measure maternal responsiveness, self-esteem, and satisfaction with life as well as infant feeding questions and sociodemographic items. An online data-collection strategy was used, resulting in participants from 41 U.S. states. FINDINGS: Multiple regression analysis showed that satisfaction with life, self-esteem, and number of children, but not breastfeeding, explained a significant portion of the variance in self-reported maternal responsiveness scores. In this analysis, sociodemographic variables such as age, education, income, and work status showed little or no relationship to maternal responsiveness scores. CONCLUSIONS: This study provides additional information about patterns of maternal behavior in the transition to motherhood and some of the variables that influence that transition. Satisfaction with life was a new predictor of maternal responsiveness. However, with only 15% of the variance explained by the predictors in this study, a large portion of the variance in maternal responsiveness remains unexplained. Further research in this area is needed.     

肠腔侧侧分流术治疗门静脉高压症的体会

本文报道了肠系膜上静脉与下腔静脉侧侧分流术7例,并介绍了手术的体会,认为应解剖、暴露肠系膜上静脉“外科干”与相应平面的下腔静脉,清除两者间的增生组织,缩短两者的间距,才易取得手术成功。本术既可使门静脉压下降适中,又对门静脉向肝血流干扰较小,且对组织损伤较轻。     

Mothers' Anticipation and Prevention of Unintentional Injury to Young Children in the Home

Investigated anticipation and prevention of children's unintentionalinjuries in the home. 150 mothers of 1-, 2-, and 3-year-oldchildren kept weekly diaries of anticipated injuries and unanticipatedinjuries/near injuries to their child. Mothers anticipated between57 and 67% of all injury events, a majority when the child wasin the same room as the injury-causing agent prior to interactingwith it. Few anticipated injuries led to injury. In these casesno significant differences were found depending on child's ageand sex. In contrast, mothers of younger children most frequentlyreported preventing injury by physically restricting or movingthe child away and by changing the environment, whereas mothersof older children more frequently engaged in teaching.     

小儿遗尿症指南和专家共识质量评价

背景 小儿遗尿症是儿科常见病之一,有效的小儿遗尿症诊疗指南有助于症状的规范化控制和缓解,而制定高质量的临床实践指南是提高小儿遗尿症诊疗水平的重要方式。目的 基于AGREEⅡ和RIGHT工具,评价2010年以来国内外发布的小儿遗尿症指南和专家共识的质量,以期为临床实践及后续指南的制订提供参考。方法 检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库和PubMed(补充检索医脉通、世界卫生组织以及英国国家临床示范研究所等数据库)2010-01-01至2022-01-31公开发表的小儿遗尿症相关的诊疗指南和专家共识。采用AGREEⅡ和RIGHT工具评价纳入文献的方法学和报告质量。根据AGREE Ⅱ工具评价结果,将各指南/共识推荐等级评定为“推荐(A级)”“更新后推荐(B级)”和“不推荐(C级)”。使用组内相关系数(ICC)进行一致性评价。结果 纳入8部指南和5部专家共识。共形成推荐意见185条,其中44条为诊断评估方面的意见,140条为治疗方面的推荐意见,1条为随访推荐意见。AGREEⅡ工具评价结果显示,范围和目的、参与人员、严谨性、清晰性、应用性和独立性6个领域的总得分(报...     

Undifferentiated Carcinoma of the Parotid Gland in a 10-Month-old Child

Malignant salivary gland tumors in children are very rare. This report describes the autopsy of a child with parotid gland cancer. The patient, a 10 month old girl, was admitted to the Nagoya First Red Cross Hospital with facial nerve palsy. lncisional biopsy of a post-auricular tumor was performed, and undifferentiated carcinoma was diagnosed. The patient died 6 months later of respiratory failure due to pulmonary lymphangitis carcinomatosis. Light and electron microscopic and immunohistochemical examinations of the tumor tissue were performed. The tumor cells were arranged in a medullary, sheet-like manner. Keratinization or mucus lakes were not observed. PAS-alcian blue staining demonstrated intracytoplasmic mucus as granules, and also small intercellular droplets of mucus that might otherwise have been unnoticed. Ultrastructurally, some of the tumor cells had tonofilament-like keratin filaments, and also small hollow spaces bounded by microvilli and containing secretory particles. These were stained by antisera against CEA and keratin. These findings are suggestive of differentiation to mucoepider-moid carcinoma. We also review and discuss malignant salivary tumors of epithelial origin in children. Acta Pathol Jpn 40: 149–152, 1990.     

High risk pregnancies in hypopituitary women

BACKGROUND: Various short papers have suggested that pregnancies in women with hypopituitarism are high risk but no formal assessment of pregnancy outcome has yet been reported. METHODS: An audit was carried out concerning the outcome of 18 pregnancies in nine women who underwent ovulation induction in a single centre over 20 years. RESULTS: The live birth rate was 61%, miscarriage rate 28% and mid-trimester uterine death rate 11% with no survivors from four sets of twins. The Caesarian section rate was 100% and half of the live births were on or below the 10th centile for weight. One woman successfully breast-fed. CONCLUSIONS: Women with hypopituitarism have high-risk pregnancies, perhaps because of a uterine defect secondary to endocrine deficiency. Fertility treatment must strive for singleton pregnancies with application of particularly strict criteria to avoid twin pregnancies. Early elective Caesarian section is probably warranted in this group.