17β-雌二醇对子宫内膜异位症患者在位子宫内膜间质细胞β-catenin mRNA和蛋白表达的影响

目的研究17β-雌二醇(17β-E2)对子宫内膜异位症(内异症)患者在位子宫内膜间质细胞β-catenin mRNA和蛋白表达的影响,探讨Wnt/β-catenin信号通路在介导雌激素促进内异症发生发展的作用。方法体外分离培养内异症患者在位子宫内膜间质细胞。用不同浓度17β-E2处理子宫内膜间质细胞48 h;此后选用10-10mol/L 17β-E2处理子宫内膜间质细胞12、24和48 h,逆转录聚合酶链反应(RT-PCR)和免疫印迹法(Western blotting)检测17β-E2处理前后子宫内膜间质细胞β-catenin mRNA和蛋白的表达水平。同法分析雌激素受体拮抗剂ICI182,780(10-6mol/L)对17β-E2促进β-catenin mRNA和蛋白表达的影响。免疫组织化学染色观察17β-E2作用后β-catenin在子宫内膜间质细胞中的定位。结果17β-E2能明显促进内异症患者在位子宫内膜间质细胞β-catenin mRNA和蛋白的表达,并呈剂量和时间依赖性,于10-10mol/L作用48 h最明显。雌激素受体拮抗剂ICI182,780能明显抑制17β-E2对子宫内膜间质细胞β-catenin mRNA和蛋白的表达。免疫组织化学染色发现17β-E2能促进β-catenin在子宫内膜间质细胞核内的表达。结论雌激素可能通过激活Wnt/β-catenin信号通路促进内异症在位子宫内膜的异位种植。     

Impact of patient age on biochemical recurrence rates following radical prostatectomy

PURPOSE: Increased age has been suggested to predict worse clinical outcomes in patients with prostate cancer. An explanation that was proposed for this observation is that it is due to inherent differences in the biological properties of prostate cancer in older men. Stage migration, prostate specific antigen and prostate biopsy pathology are variables that may confound the interpretation of age as an independent prognosticator of outcomes following radical prostatectomy. MATERIALS AND METHODS: Matched pairs analysis was performed comparing the 3 age cohorts 46 to 55, 56 to 65 and older than 65 years to a cohort of 435 patients who were 45 years or younger based on propensity scores calculated with all known preoperative variables. Postoperative clinical and pathological characteristics were compared among the 4 matched age cohorts. A Cox hazards model was used to compare time to prostate specific antigen recurrence across the different age cohorts and the actuarial risk of recurrence was calculated using Kaplan-Meier and log rank survivor analyses. RESULTS: Younger patients showed lower grade disease (p <0.001), and lower rates of positive surgical margin rates (p = 0.035) and extraprostatic extension (p <0.001) but they did not have higher rates of lymph node involvement (p = 0.85) or seminal vesicle invasion (p = 0.56). Kaplan-Meier analysis showed no significant differences in biochemical recurrence across the age cohorts (log rank 0.38). On multivariate analysis prostatectomy Gleason score, pathological stage, positive surgical margins (each p <0.001) and preoperative prostate specific antigen (p = 0.04) were independently predictive of biochemical recurrence. CONCLUSIONS: We report that increased age is not associated with worse biochemical outcomes following radical prostatectomy and it should not be considered an independent prognosticator for disease recurrence. Rather, age is a surrogate for known predictors of biochemical recurrence following surgery.     

Is OSNA better than imprint cytology for intraoperative diagnosis of cancer involvement of axillary sentinel node in breast cancer?

ObjectiveThe study aim was to establish Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value (NPV), and Accuracy Values of both imprint cytology (IC) and the OSNA assay for intraoperative assessment of axillary sentinel node (SN) cancer involvement in breast cancer. Specifically, we wished to find out if true positive and false negative results of IC were associated to axillary lymphadenectomy (ALND). Also, we addressed a comparative cost analysis between techniques.Methods244 patients treated for breast cancer in the Breast Unit of Hospital Germans Trias i Pujol from 2011 to 2015 were prospectively included. A transversal, consecutive design was applied to assess IC compared to the reference test (OSNA). Inclusion criteria were: T1 and T2 tumors with negative nodes, both clinically and on ultrasound.ResultsSensitivity of IC for macrometastases was 70%. The NPV of IC for macrometastases was 95,75%. Accuracy of IC was 96,12%. In the comparative cost analysis, the release time of results for OSNA doubled that of IC and was associated with an increased cost of € 370.ConclusionsIC has been stated as a good technique for intraoperative cancer involvement SN with high sensitivity and NPV compared to the OSNA assay. It allows keeping the whole node tissue and thus the possibility of improved histopathological evaluation, which can be useful for adjuvant, and offers the advantage of being less time consuming. Cost analysis shows a higher cost for OSNA, which may exceed the benefit of sorting out false negatives from IC.     

北京市朝阳区流动人口乙型肝炎预防 健康知识的现状分析

目的 了解北京市朝阳区流动人口乙型肝炎（以下简称乙肝）预防健康知识现状,为制定流动 人口健康教育策略提供依据。方法 采用多阶段随机整群抽样方法,选择北京市朝阳区居住≥ 6 个月且年 龄≥ 18 岁外来务工人员1 136 例进行面对面问卷调查。结果 乙肝传播途径中,乙肝母婴传播和不经日常生 活接触传播的知晓率分别为56.43% 和51.14%。知晓新生儿出生后24 h 内接种乙肝疫苗的占59.95% ;知晓目 前预防乙肝最主要方法是接种乙肝疫苗的占63.12% ;明确知道自己已全程接种乙肝疫苗/ 甲乙肝联合疫苗的 占19.10% ;乙肝预防健康素养具备率为52.20%。采用多因素Logistic 回归分析显示,年龄、工作场所、文化 程度及是否认为有必要接种乙肝疫苗是影响乙肝预防健康素养具备率的主要因素（P <0.05）。结论 流动人 口的乙肝防控健康教育应重点突出乙肝疫苗接种和乙肝传播途径这两方面知识,重视对建筑工地工作者的健 康教育,并加强对≤ 30 岁年龄人群和小学及以下学历人群的健康教育。     

Quality Measurements in Radiology: A Systematic Review of the Literature and Survey of Radiology Benefit Management Groups

PurposeAs the US health care system transitions toward value-based reimbursement, there is an increasing need for metrics to quantify health care quality. Within radiology, many quality metrics are in use, and still more have been proposed, but there have been limited attempts to systematically inventory these measures and classify them using a standard framework. The purpose of this study was to develop an exhaustive inventory of public and private sector imaging quality metrics classified according to the classic Donabedian framework (structure, process, and outcome).MethodsA systematic review was performed in which eligibility criteria included published articles (from 2000 onward) from multiple databases. Studies were double-read, with discrepancies resolved by consensus. For the radiology benefit management group (RBM) survey, the six known companies nationally were surveyed. Outcome measures were organized on the basis of standard categories (structure, process, and outcome) and reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsThe search strategy yielded 1,816 citations; review yielded 110 reports (29 included for final analysis). Three of six RBMs (50%) responded to the survey; the websites of the other RBMs were searched for additional metrics. Seventy-five unique metrics were reported: 35 structure (46%), 20 outcome (27%), and 20 process (27%) metrics. For RBMs, 35 metrics were reported: 27 structure (77%), 4 process (11%), and 4 outcome (11%) metrics. The most commonly cited structure, process, and outcome metrics included ACR accreditation (37%), ACR Appropriateness Criteria (85%), and peer review (95%), respectively.ConclusionsImaging quality metrics are more likely to be structural (46%) than process (27%) or outcome (27%) based (P < .05). As national value-based reimbursement programs increasingly emphasize outcome-based metrics, radiologists must keep pace by developing the data infrastructure required to collect outcome-based quality metrics.     

Evaluating peer support for prostate cancer: the Prostate Cancer Peer Support Inventory

OBJECTIVE: To develop and test a measure for assessing peer support for men attending prostate cancer support groups, and to describe socio-demographic, medical and adjustment characteristics of Australian men who attend these support groups. PATIENTS AND METHODS: In all, 1224 men (51% response) from 44 prostate-cancer support groups across Australia were recruited by mail. Men completed self-report measures that included the Prostate Cancer Peer Support Inventory (PCSI), the UCLA Prostate Cancer Index bother scales, psychological distress, quality of life (QoL), bother from pain and tiredness, perception of the clinician's support for group participation. Group-level variables were also included in the analyses. RESULTS: Peer support was rated positively by most men; a high satisfaction with support groups was related to better QoL, lower pain, younger age, higher perceived clinician support for group participation, use of alternative therapies, lower education, and regular attendance; dissatisfaction with support groups was related to higher psychological distress, lower QoL, and lower perceived clinician support for group participation. Group variables did not predict positive or negative support. Overall QoL was similar to community norms and psychological distress was low, with only 8% of men reporting high distress. The most common physical symptom was sexual bother, with 74% of men reporting moderate or high bother. CONCLUSIONS: The PCSI was a useful measure of peer support. Perception of the benefits of peer support was related to individual but not group differences. The clinicians' attitudes to participation in support groups influenced the men's experience of these groups, and this finding has implications for developing support services for these men.     

Effects of plasma treatment time on modification of acrylic denture material

Objective：To study the relationship between plasma treatment time acrylic resin denture material in the size of 2 mm × 10 mm × 10 mm. and efficacy. Methods：Test specimens were prepared from an Plasma treatment was carried out on the surface of Polymethyl methacrylate（PMMA） at different time. XPS studies, IR spectra studies and measurement of wetting angle were performed. Results： XPS showed the peak corresponding to C-O getting higher as the treatment proceeded, however at 120 seconds, the peak did not increase any longer and partly crossed with the peak at the duration of 60 seconds. IR spectra showed the wave corresponding to C-H was reduced as O2-plasma treatment proceeded, and then changed little, Wetting angle initially decreased dramatically, however, as the reaction proceeded, wetting angle increased slightly. Conclusion：Equilibrium was reached for introducing oxygen-containing groups and changing of C-H. As the treatment proceeded, wetting angle increased slightly.     

歧义病案产生的影响因素分析

目的 分析歧义病案产生的影响因素,为医院开展相关DRGs管理提供决策依据.方法 回顾性调查2019年1月1日-2019年12月31日广州市某三甲医院45856份手术病案,利用国家版DRGs分组器筛查出518份歧义病案.采用单因素卡方检验及多因素Logistic回归分析歧义病案产生的影响因素.结果 45856份手术患者住...