Pathological features of gastric cancer in Zhuanghe high-risk area in China during 1992–2005

Objective  To investigate the pathological features and chronological changes of 1003 cases with gastric cancer in Zhuanghe high-risk area during 1992–2005 and the relationship between the changes and etiology factors in order to make a clue for gastric cancer prevention. Methods  A total of 1003 gastric cancer specimens resected surgically between 1992–2005 in Zhuanghe Center Hospital were studied. The specimens were fixed in formalin and diagnosed by routine pathology. Results  The incidence of patients with gastric cancer was highest at age of 60–69, the next high was at age of 50–59 and it was significantly higher in male than in female (P<0.001), the ratio was 3.0:1. During the past 14 years, there were 159 (15.9%) EGC, 195 (19.4%) moderate and 649 (64.7%) advanced gastric cancer detected. In macroscopical features, type III remained dominant in EGC, the next was mixed type in EGC. In advanced gastric cancer the Borrmann’s type III remained the dominant, the next was type II. For nodal metastasis, positive cases were decreasing and negative were increasing in EGC, moreover negative cases were higher than positive ones each year. There was no obvious trend in advanced cancer but positive cases were higher than negative ones each year. In histological features, papillary, moderately and poorly differentiated tubular adenocarcinoma remained downtrend, mucus adenocarcinoma and undifferentiation cancer remained uptrend year after year. The radio of intestinal to diffuse type decreased from 0.78 to 0.62 during the past 14 years. Conclusion  There were significant chorological trends of pathological characteristic of gastric cancer in Zhuanghe high-risk area during the past 14 years. This work was supported by the National “Tenth-Five” Key Technologies R&D Program of China (2004BA703B04-02)     

辽宁省乡村医生农村卫生适宜技术推广意愿调查

目的:了解辽宁省农村卫生人力资源素质及农村卫生适宜技术推广意愿,为"十一·五"农村卫生适宜技术择优遴选推广人员提供依据.方法:对辽宁省六个示范县2952名村医和981名乡医进行问卷调查,分析其推广意愿水平及影响因素.结果:六个示范县乡村卫生人员适宜技术愿意推广率分别为96.6%和93.5%,乡医和工作年限长者推广意愿显著低于村医和年轻医生,对适宜技术推广必要性认识是影响推广意愿最主要因素(OR=18.8,95%CI=12.8-27.6).结论:应采取有力措施提高乡村医生对适宜技术推广必要性认识水平,重点提高乡医和年资较高乡村卫生人员的推广积极性.     

Pathological Features of Gastric Cancer in Zhuanghe High-risk Area in China during 1992-2005

Objective:To investigate the pathological features and chronological changes of 1003 cases with gastric cancer in Zhuanghe high-risk area during 1992-2005 and the relationship between the changes and etiology factors in order to make a clue for gastric cancer prevention.Methods:A total of 1003 gastric cancer specimens resected surgically between 1992-2005 in Zhuanghe Center Hospital were studied.The specimens were fixed in formalin and diagnosed by routine pathology. Results:The incidence of patients wit...     

1992～2005年辽宁庄河胃癌高发区1 003例胃癌病理形态学特征年代变化趋势

目的：从胃癌形态学方面，探讨辽宁省庄河地区胃癌高发区胃癌病理形态学特征及其年代变化趋势，探讨这种变化与胃癌发病影响因素之间的关系，为胃癌防治提供线索和依据。方法：选取1992-2005年在辽宁庄河市中心医院接受手术切除的胃癌标本共计1003例。标本均经4％甲醛固定，病理常规系统检查。结果：1003例胃癌患者平均发病年龄58．9岁（17～84岁）；不同年代胃癌高发年龄均为60～69岁，其次为50～59岁，男性胃癌患者明显多于女性患者（P〈0．001），男女患者之比为3．0：1。1003例胃癌患者中，共检出早期胃癌159例（15．9％），年均构成比为15．3％，中期胃癌195例（19．4％），晚期胃癌649例（64．7％）。各年间早期胃癌大体分型以Ⅲ型为主；进展期胃癌以BorrmannⅢ型为主。在淋巴结转移方面，早期胃癌各年间无淋巴结转移者多于有淋巴结转移者；进展期胃癌各年间有淋巴结转移者多于无淋巴结转移者。在组织学分型方面，乳头状管状腺癌、中分化管状腺癌、低分化管状腺癌和印戎细胞癌呈逐年下降趋势；黏液腺癌、未分化癌呈逐年升高趋势；若以Lauren分类为标准，在各年代间均以弥漫型胃癌占优势，并呈逐年上升趋势，肠型胃癌呈下降趋势，二者比值呈下降趋势。结论：随着年代的变迁，庄河地区胃癌临床流行病学特征有明显变化。     

辽宁省乡镇卫生院院长基本素质及适宜技术推广意愿调查

目的为了解辽宁省乡镇卫生院院长基本素质及适宜技术推广意愿,择优遴选推广乡村,制定有针对性的适宜技术推广管理方案提供依据。方法六个示范县所有乡镇卫生院院长共142人作为调查对象,采用自填式问卷对院长的基本情况及适宜技术推广意愿进行调查。结果回收问卷137份,回收率96．48％。45岁以上53人,占38．69％。受教育程度中专或高中及以下55人,占40．15％。初级及以下职称75人,占54．74％。所学专业以西医学专业最多,占76．64％。男性、年龄〈35岁、中专或高中及以下、初级职称、西医学专业、从医年限10年以上愿意参加技术推广的院长较多。性别、年龄、受教育程度、影响推广的因素中技术有效四个因素进入Logistic回归模型。结论辽宁省乡镇卫生院院长年龄偏大,素质偏低,要根据乡镇卫生院院长的实际情况,择优遴选推广乡村,针对不同人群采取不同政策,制定有针对性的适宜技术推广管理方案。