Human papillomavirus was not detected by PCR using multiple consensus primer sets in esophageal adenocarcinomas in Chinese patients

The role of human papillomavirus (HPV) infection in the development of esophageal squamous cell carcinoma is well established; however, there are few reports on the role of HPV in esophageal adenocarcinoma. To evaluate the putative role of HPV infection in esophageal adenocarcinoma, 57 formalin‐fixed, paraffin‐embedded esophageal adenocarcinoma specimens were collected from four hospitals in Shanghai and Anyang, China, between 1999 and 2008. HPV DNA was analyzed using PCR with multiple sets of consensus primers for HPV, GP5+/6+, CPI/CPIIG, SPF₁₀, pU‐1M/pU2R, and pU31B/pU2R. Glyceraldehyde‐3‐phosphate dehydrogenase (GAPDH), the internal control, was amplified successfully in all 57 specimens. However, HPV amplification was not detected in any specimens with any of the consensus primer sets used. The present study indicates that HPV infection is not likely to be a major factor in the etiology of esophageal adenocarcinoma in the Chinese population. J. Med. Virol. 85: 1053–1057, 2013. © 2013 Wiley Periodicals, Inc.     

穿支皮瓣修复口腔颌面-头颈部缺损专家共识

穿支皮瓣由皮肤穿支血管供血,是常用的组织缺损修复形式,但头颈部解剖复杂、缺损形式多样以及穿支血管解剖变异等,阻碍了穿支皮瓣在口腔颌面-头颈部缺损修复中的进一步应用。迄今为止,国内外对于穿支皮瓣修复口腔颌面-头颈部缺损临床应用缺少相关治疗指南,穿支血管的术前评价缺乏统一标准,穿支皮瓣的应用设计缺乏科学的规范,穿支皮瓣修复术后缺少客观的监测和评价体系。为进一步统一和规范穿支皮瓣在口腔颌面-头颈部缺损修复中的应用,提高重建效果,本共识总结全国多家著名医学院校及附属医院口腔颌面外科专家团队的实践经验,供临床医师参考。     

基于临床治疗指南及共识的使用华法林住院患者用药分析与评价

目的：对某院使用华法林的住院患者进行用药分析和评价,并对其出院后复诊情况进行追踪,以更好地发挥华法林的治疗作用,减少不良反应的发生。方法：采用回顾性的分析方法,对某院2018年7月-12月使用华法林的住院患者用药进行分析,结合指南、共识对其用药情况进行分析评价。结果：共调取509份病例,华法林的使用主要分布于心血管内科、心血管外科、呼吸内科。华法林应用临床诊断主要为肺栓塞、心房颤动、肺动脉高压、静脉血栓等;住院患者华法林用量范围为0.625~9 mg,平均日剂量（2.99±1.11）mg;全院服用华法林后INR总体测定率为79%,将INR值以"<2.0"、"2.0~3.0"、">3.0"分布进行统计,INR2.0~3.0占比为33.17%,最高的为呼吸内科。26例（5.11%）患者住院期间INR达到4.5~10.0,38.46%使用维生素K进行拮抗;2例（0.39%）患者INR大于10,全部使用维生素K进行拮抗。在院期间合用其他抗凝药中,低分子肝素使用率最高的为骨外科,心血管外科,心血管内科;普通肝素使用率最高的为呼吸内科;阿加曲班使用率最高的为神经内科;利伐沙班使用率最高的为心血管内科,根据相关指南共识分析用药基本合理。患者出院后一周内及总复诊率最高的均为呼吸内科。复诊后INR分布在2.0~3.0占比最高的也为呼吸内科,与呼吸科临床药师药学监护及用药教育相关。结论：目前华法林临床应用仍不够规范,INR达标率偏低,出院后复诊率较低,抗凝药物转换过程中有不规范的问题,积极开展药师药学监护、用药教育及随访具有重要意义。     

中国头颈黏膜黑色素瘤临床诊治专家共识

我国恶性黑色素瘤的发病率较欧美发达地区低,2009年上海市恶性黑色素瘤的发病率约为0.42/10万.但是由于我国人口基数大,因此临床上恶性黑色素瘤人数众多.2009年、2011年已经发布了2版《中国黑色素瘤诊治指南》,主要针对皮肤恶性黑色素瘤.在我国,黏膜恶性黑色素瘤是最常见的类型之一,但对黏膜恶性黑色素瘤的研究较少.而黏膜黑色素瘤的治疗手段和预后与皮肤黑色素瘤有许多不同.因此,制订符合我国国情的黏膜恶性黑色素瘤临床实践共识非常必要.     

Australian consensus guidelines for the safe handling of monoclonal antibodies for cancer treatment by healthcare personnel

These consensus guidelines provide recommendations for the safe handling of monoclonal antibodies. Definitive recommendations are given for the minimum safe handling requirements to protect healthcare personnel. The seven recommendations cover: (i) appropriate determinants for evaluating occupational exposure risk; (ii) occupational risk level compared with other hazardous and non‐hazardous drugs; (iii) stratification of risk based on healthcare personnel factors; (iv) waste products; (v) interventions and safeguards; (vi) operational and clinical factors and (vii) handling recommendations. The seventh recommendation includes a risk assessment model and flow chart for institutions to consider and evaluate clinical and operational factors unique to individual healthcare services. These guidelines specifically evaluated monoclonal antibodies used in the Australian cancer clinical practice setting; however, the principles may be applicable to monoclonal antibodies used in non‐cancer settings. The guidelines are only applicable to parenterally administered agents.