Laser induced thermal injury of rabbit cornea and treatment with anti-inflammatory agents

A moderately severe thermal injury of the central cornea of 48 Dutch-belted rabbit eyes was produced with a carbon (CO₂) laser. The lesions were photographed with a slit lamp (SL) camera immediately following the injury and at 1, 2, 4, 7, 14, 21, 30 and 60 days after the exposure. Lesion size, opaqueness, and depth were graded clinically by SL biomicroscopy at the same intervals. No significant differences were found (p 0.05) between groups of eyes treated with flurbiprofen (0.03%), prednisolone acetate (1%), and vehicle control four-times-a-day for three weeks following injury. Additionally, eyes were studied histopathologically at 3 and 60 days following injury by light and transmission electron microscopy, and clinically at 30 and 60 days by endothelial specular microscopy. Important clinical and histopathological findings included coagulative necrosis of the corneal epithelium, epithelial sloughing, fusion of stromal collagen, stromal edema and inflammatory cell infiltration, stromal scar formation, corneal thinning, endothelial hyperplasia and metaplasia, fibrinous anterior chamber reaction with hypopyon, and retrocorneal fibrous membrane formation.     

Radiotherapy and combination chemotherapy with carmustine,vincristine, and procarbazine (BVP) in primary brain tumors

Summary 26 patients with astrocytoma grade 11–111, and 36 with malignant glioma (astrocytoma grade IV or glioblastoma) were submitted three days after surgery to a cycle of combination chemotherapy, including BCNU, VCR, PCZ (BVP). Eighteen days after surgery, patients received 40 Gy (astrocytoma grade 11–111) or 45 Gy (malignant glioma) of megavoltage whole-brain irradiation, with an additional boost to the tumor bed of 20 Gy, delivered in 6 weeks. Vincristine was injected weekly during radiotherapy. At the end of radiotherapy, patients received BVP every 6 weeks for at least 8 cycles or until a recurrence or progressive disease. Performance status of grade 1 or 2 was achieved in 15 (60%) and in 5 (20%), respectively, of patients with astrocytoma grade 11–111 after 6 months, and in 6 ps. (29%) and in 9 ps. (42%) after 12 months of follow-up. Only 2 (5.5%) and 18 (64%) patients with malignant glioma achieved a performance status of grade 1 or 2 after 6 months, and these proportions are 6% and 35%, respectively, after 12 months. After a 5-year follow-up, 59% of patients with astrocytoma are still alive, with a median survival time of 60+ months, whereas only 4% of patients with malignant glioma are alive, with a median of 11.2 months.     

Pretherapeutic flow cytometric DNA investigations in radiotherapy patients with maxillo-facial carcinomas

In order to analyze the possible meaning of cellular DNA content and cell cycle phases for the radiosensitivity and the prognosis of human malignant tumors, flow cytometric measurements have been performed in biopsies of 131 patients with histologically proven squamous cell carcinomas of the maxillo-facial region. In two-thirds of the patients (88/131; 67%), aneuploid tumor cell lines have been found, only 33% (43/131) had a diploid DNA distribution pattern. The average DNA index (DI) of the aneuploid carcinomas was 3.4 +/- 0.6 (normal nonmalignant tissue DI = 2.0). The frequency of S-phase cells, which represents the "proliferative activity", was between 4.8 and 63.2%, regardless of the ploidy stages. The aneuploid carcinomas had about twice as many S-phase cells (mean 23.7 +/- 11.8%) than diploid tumors (mean 12.7 +/- 4.8%). Mean survival for patients with diploid carcinoma and aneuploid carcinoma was 12 and 9.5 months, respectively. Concerning the relationship of S-phase frequency and survival times in our material there was a high negative statistical correlation (Spearman-Rank test) in patients with diploid carcinomas. A high S-phase fraction resulted in short survival times. No correlation was found in the aneuploid carcinomas: patients with tumors in high S-phase values in their biopsies showed no difference in prognosis in comparison to tumors with lower S-phase fractions.     

2011—2020年郑州市二七区居民恶性肿瘤死亡趋势及减寿分析

目的了解郑州市二七区居民2011—2020年恶性肿瘤死亡流行趋势及对居民寿命的影响情况,为制定恶性肿瘤防治对策提供科学依据。方法对2011—2020年郑州市二七区居民恶性肿瘤死亡资料进行分析,计算恶性肿瘤死亡率、潜在减寿年数(potential years of life lost,PYLL)、标化潜在减寿年数(standardized potential years of life lost,SPYLL)、标化潜在减寿率(standardized potential years of life lost rate,SPYLLR)和人均减寿年数(average years of life lost,AYLL)等指标,采用年度变化百分比(annual percent change,APC)分析率的时间变化趋势。结果2011—2020年郑州市二七区居民恶性肿瘤年均死亡率为114.68/10万,标化死亡率为103.52/10万,男性年均死亡率(146.09/10万)高于女性(84.56/10万)。恶性肿瘤前5位死因依次为肺癌、肝癌、胃癌、结直肠癌和食管癌,共占恶性肿瘤死亡构成的65.36%。2011—2020年该区居民恶性肿瘤死亡率呈上升趋势(APC=3.70%,P<0.001)。0~44岁年龄组恶性肿瘤死亡率处于较低水平,45岁后随年龄增长逐渐升高,75岁以后迅速升高。恶性肿瘤总PYLL为39067人年,SPYLLR为6.73‰,AYLL为12.59年。结论肺癌、肝癌、胃癌、结直肠癌和食管癌是二七区恶性肿瘤预防控制的重点工作,同时宫颈癌和乳腺癌对女性健康的影响不可忽视,应针对主要恶性肿瘤和重点人群开展综合防控措施,以降低恶性肿瘤的死亡率。     

Survival of Patients with Multi-Level Malignant Bowel Obstruction on Total Parenteral Nutrition at Home

Home parenteral nutrition (HPN) may improve the survival in selected patients with malignant bowel obstruction. This retrospective, medical registry-based study aimed to identify clinical and laboratory markers predicting short survival, which would allow a more accurate selection of patients that would benefit from HPN in inoperative bowel obstruction. In a retrospective analysis of 114 patients receiving HPN, the median survival was 89 days after discharge home, and the three and six-month survival probability was 48% and 26%, respectively. Parenteral nutrition was provided during 98% of overall survival time and ended on a median of one day before the patient’s death. Discontinuing chemotherapy, anemia, severe hypoalbuminemia, and water retention appeared correlated with survival shorter than three months. In these cases, routine initiation of HPN should be discouraged, as it may not bring any benefits to the patient. The decision on the initiation of HPN should be made along with continuing or initiating chemotherapy.     

恶性血液病合并血流感染患者病原菌分布及其预后影响因素

 目的 分析恶性血液病合并血流感染患者的病原学特征及其预后影响因素。方法 选取2016年1月-2022年5月遵义医科大学附属医院血液内科的恶性血液病合并血流感染的住院患者为研究对象。根据患者发生血流感染30 d内的治疗结局分为生存组和死亡组。分析患者的病原学特征及预后情况,并采用单因素及logistic回归分析影响恶性血液病合并血流感染预后的危险因素。结果 共纳入185例患者,基础疾病以急性白血病为主(125例,67.6%)。共分离197株病原菌,革兰阴性菌109株(55.3%),其中大肠埃希菌55株(27.9%);革兰阳性菌86株(43.7%),其中人葡萄球菌24株(12.2%);真菌2株(1.0%)。大肠埃希菌中产超广谱β-内酰胺酶(EBSLs)菌株28株(50.9%);肺炎克雷伯菌中产EBSLs菌株2株(10.0%);耐甲氧西林的人葡萄球菌、表皮葡萄球菌、金黄色葡萄球菌的检出率分别为70.8%、71.4%、36.4%。单因素分析表明,年龄≥70岁、粒细胞缺乏持续时间≥7 d、未合理使用抗菌药物、合并心功能不全、合并急性肾功能不全、感染性休克、肺部感染患者的30天病死率较高,差异均有统计学意义(均P<0.05)。多因素logistic回归分析表明,粒细胞缺乏持续时间≥7 d[OR=3.306,95%CI(1.224~8.927)]、合并心功能不全[OR=6.291,95%CI(1.930~20.508)]、合并急性肾功能不全[OR=8.419,95%CI(2.198~32.241)]、感染性休克[OR=22.150,95%CI(3.639~134.806)]均为恶性血液病合并血流感染患者30天内死亡的独立危险因素(均P<0.05)。结论 恶性血液病合并血流感染最常见的病原菌中,革兰阴性菌以大肠埃希菌为主,革兰阳性菌以人葡萄球菌为主。影响恶性血液病合并血流感染患者预后的危险因素较多,缩短粒细胞缺乏持续时间,改善心功能不全、肾功能不全,积极控制感染性休克是减少恶性血液病合并血流感染患者30天内死亡的有效措施。     

住院恶性肿瘤患者的社会心理护理诊断分类及分析

目的了解恶性肿瘤不同的社会、心理状态,有针对性的做好各项护理工作。方法系统观察了92例住院肿瘤患社会、心理方面护理诊断分类及发生频率,对不同性别、年龄、职业和不同分期患的社会、心理护理诊断分类进行分析。结果具有焦虑和惧怕心理的患达50％以上;30％～40％的患存有抑郁、无望、无能为力和调适障碍;近10％的患存在不合作及潜在性暴力行为。近1／2的患家庭应付能力低下(妥协和失去能力)。男性患无望感和社交活动障碍较女性患多,少部分年轻患具有潜在的暴力行为,中年(31～55岁)患焦虑、抑郁、预期性哀伤和调适障碍均较显;而老年患抑郁、孤独感、家庭应付能力低下和社会隔离相对较多。结论不同的恶性肿瘤患具有不同的社会、心理状态,受到性别、年龄、职业、病期等因素的影响,可以引起许多问题,这些为更好地做好护理工作提供了依据。     

225例绝经后阴道出血临床病理分析

目的 分析绝经后阴道出血的临床病理特点。方法 对本院1992－2000年间收治的225例绝经后阴道出血病例的临床病理资料进行分析总结。结果 临床表现为阴道不规则出血,血性分泌物及接触性出血;其中良性病变12例（54．2％）,子宫内膜功能性变化45例（20．0％）,恶性肿瘤26例（11．6％）。随着年龄的增大,绝经时间延长,恶性肿瘤的发病率增大。结论 绝经后阴道出血病因复杂,多样,临床应根据病理检查,结合临床表现和其它辅助检查进行综合诊断,尤应警惕恶性肿瘤的发生。     

血管影像在乳腺癌诊断中的重要作用(附100例乳腺癌及200例良性乳腺增生对照分析)

[目的 ]提高对乳腺病血管像的认识 ,进而提高对乳腺良恶性病的诊断率。 [方法 ]选取经手术病理证实为乳腺癌的病例 1 0 0例 ,从乳腺体检中发现或经追踪观察为乳腺轻度增生的病例 2 0 0例乳腺 X线影像进行对照分析。 [结果 ]乳腺恶性与良性病变在血管像上有一定区别 :1血管像增粗。血管像横径大于2 .0 mm为增粗 ,乳腺恶性病变有 76例 ( 76.0 % ) ,良性病变有 40例 ( 2 0 .0 % ) ;2血管像增多。血管像条数多于 3条为增多 ,乳腺恶性病变有 61例 ( 61 .0 % ) ,乳腺良性病变有 46例 ( 2 3.0 % ) ;3血管像增大。弯曲度小于 1 5 0°血管像迂曲明显 ,乳腺恶性病变有 83例 ( 83.0 % ) ,乳腺良性病变有 42例 ( 2 1 .0 % ) ;4血管像走行特点。呈花瓣状 ,恶性病变有 33例 ( 33.0 % ) ,良性病变有 2例 ( 1 .0 % ) ;呈残端状 ,恶性病变有 34例 ( 34.0 % ) ,良性病变有 3例 ( 1 .5 % ) ;呈放射状 ,恶性病变有 1 3例 ( 1 3.0 % ) ,良性病变有 1例( 0 .5 % )。 [结论 ]掌握乳腺病血管像的特征 ,可以帮助确定乳腺病病变性质 ,提高对隐性癌和微小癌的诊断率和治愈率 ,从而延长生存期