全层缝合在预防阑尾炎术后切口感染中的应用

目的：探讨全层缝合在预防阑尾炎术后切口感染的治疗效果。方法：将皮肤、皮下组织、腹外斜肌腱膜全层褥式缝合(腹膜不予缝合)。结果：56例患者无一例感染，也未发现近期并发症。结论：此方法对预防切口感染有较好疗效，且能缩短手术时间，操作简单，建议值得临床应用。     

Medical Illustration of Today

The spectrum for the differential diagnosis of jaundice is more limited in the aged than in younger patients. Obstruction is the usual cause. The history is as helpful as biochemical and other investigations in excluding the causes of nonobstructive jaundice.

The first principle in management is to bring the patient to an optimal state for operation by a planned program. Other principles are to define the obstruction at operation, to employ simple measures to overcome it, and to insure a postoperative course free of complication.     

High satisfaction rate ten years after bilateral prophylactic mastectomy – a longitudinal study

WASTESON E., SANDELIN K., BRANDBERG Y., WICKMAN M. & ARVER B. (2010) European Journal of Cancer Care
High satisfaction rate ten years after bilateral prophylactic mastectomy – a longitudinal study Women from families with an increased risk for breast/ovarian cancer have undergone bilateral prophylactic mastectomy (BPM) since the early 1990s at the Karolinska University Hospital in Sweden. Perceptions of BPM as reported by the first women who underwent the procedure have previously been evaluated on a short‐term basis (1–3 years). The present study aims to evaluate the long‐term (10 years) physical and psychological consequences of BPM in the same cohort of women. Some of the very first women to undergo BPM participated in the present interview study (n= 13). The semi‐structured interviews focused on the women's long‐term experiences related to BPM and immediate breast reconstruction. Overall, the women were satisfied with their decision to undergo BPM and perceived a negligible remaining risk of getting breast cancer. For most women, the operation had not resulted in changes in family life or lifestyle (n= 8), although some described that the relationship with their spouse was affected (8/13), either in a negative (n= 5) or positive (n= 3) way. The cosmetic results were mainly positive (n= 10). Recurrent counselling and support during the whole process of decision, treatment and follow up is recommended.     

化学发光法测定中草药微量铜

本文以鲁米诺—氰化钾—二价铜离子为发光体系,在最佳优选条件下,实现对红花、党参、人参、枸杞子、天麻、败浆根、黄芪等中草药所含微量铜的测定,效果满意。     

INCREASED ANTICARDIOLIPIN ANTIBODIES ASSOCIATED WITH THE DEVELOPMENT OF ANETODERMA IN HIV-1 DISEASE

Background and Objective. Anetoderma has been reported in patients with HIV-1 disease. In patients with autoimmune disease, anetoderma has been associated with increased levels of antiphospholipid antibodies (APL) that include anticardiolipin antibodies (ACA) and lupus anticoagulant (LA). This has led to speculation that the autoimmune phenomena seen in HIV-1 disease and the immune dysregulation induced by HIV-1 disease may play a role in the development of these lesions. We have seen both primary and secondary lesions of anetoderma in patients followed for HIV-1 disease. In this study, we wanted to determine whether there was an association in the development of anetoderma and elevated anticardiolipin antibodies (ACA) in HIV-1 patients. Methods. Quantitative ACA levels were measured in eight HIV-1-infected patients with anetoderma and four HIV-1-infected patients without anetoderma. Results. Anticardiolipin antibodies were moderately elevated in seven of eight patients with lesions and were borderline in the four HIV-1-positive patients without lesions of anetoderma. Conclusions. There appears to be a correlation between increased ACA and the development of cutaneous lesions of anetoderma in HIV-I disease. Patterns of immune dysregulation, including APL, may predispose to the development of lesions of anetoderma in HIV-1-positive patients. Although some of the lesions appear to represent primary anetoderma, the majority of our patients develop lesions in areas secondary to well characterized eruptions.     

磁化水部份理化参数的测定

本文从实验的角度出发,测试了磁化水的部份理化参数,试图从实验数据的获得为理论上的研究提供一些依据和参考。     

Impact of mood disturbance,sleep disturbance,fatigue and pain among patients receiving cancer therapy

CHENG K.K.F. & YEUNG R.M.W. (2013) European Journal of Cancer Care 22 , 70–78 Impact of mood disturbance, sleep disturbance, fatigue and pain among patients receiving cancer therapy This paper describes the prevalence of mood disturbance, sleep disturbance, fatigue and pain (MSFP), either alone or in combination in patients receiving cancer therapy, and determines its impact and whether it is a predictor for functional status and the impairment of quality of life (QoL). This is a cross-sectional study using secondary data from a sample of 214 patients being treated by chemotherapy or radiotherapy. In all, 87%, 68%, 66% and 38% of the patients reported MSFP respectively. Co-occurrence of any three and all of the four symptoms, were reported separately at rates of 29% and 31%. Patients with all four symptoms recorded significantly lower Karnofsky Performance Scale (KPS) scores (mean 77.7 ± 12.9) and QoL scores (mean subscales scores 9.0–17.6) than those with none or up to any three of the symptoms (P < 0.001). Regression of the KPS and QoL scores against the MSFP revealed an increase in the explained variance of 25%, 43%, 27%, 37% and 41% respectively for KPS, physical, emotional, functional and total QoL. The results suggest that MSFP are highly prevalent, whether alone or in combination, in patients receiving cancer therapy, and may negatively influence the patient's functional status and QoL during cancer therapy.     

Patient factors,health care factors and survival from lung cancer according to ethnic group in the south of London,UK

NIMAKO K., GUNAPALA R., POPAT S. & O'BRIEN M.E.R. (2013) European Journal of Cancer Care 22 , 79–87 Patient factors, health care factors and survival from lung cancer according to ethnic group in the south of London, UK International and UK data suggest that there are ethnic differences in survival for some malignancies. The aim of the present study was to identify any health inequalities related to lung cancer and ethnicity. Data on 423 patients with a diagnosis of lung cancer treated at a large specialist cancer hospital in London UK were analysed. Data on stage of disease at diagnosis, co-morbidities, socio-economic status, treatments received and survival were collected and examined for differences by ethnic group. There was a significant difference between black and minority ethnic (BME) patients and White-European patients in socio-economic status (Chi-square test P-value < 0.001). BME patients were over-represented in the most deprived socio-economic groups and under-represented in the most affluent. There were no significant differences in histology, stage of disease, co-morbidities and performance status or treatments received between the different ethnic groups. Ethnicity was not associated with survival. Significant prognostic factors for overall survival were performance status (P < 0.001), stage of disease (P= 0.001) and gender (P= 0.003). Our findings suggest that patients from BME groups are over-represented in more deprived socio-economic groups; however, this did not impact on significant prognostic factors or the treatments that they received. Importantly ethnicity did not influence survival.