Chemotherapy and novel therapeutics before radical prostatectomy for high-risk clinically localized prostate cancer

Although both surgery and radiation are potential curative options for men with clinically localized prostate cancer, a significant proportion of men with high-risk and locally advanced disease will demonstrate biochemical and potentially clinical progression of their disease. Neoadjuvant systemic therapy before radical prostatectomy (RP) is a logical strategy to improve treatment outcomes for men with clinically localized high-risk prostate cancer. Furthermore, delivery of chemotherapy and other systemic agents before RP affords an opportunity to explore the efficacy of these agents with pathologic end points.Neoadjuvant chemotherapy, primarily with docetaxel (with or without androgen deprivation therapy), has demonstrated feasibility and safety in men undergoing RP, but no study to date has established the efficacy of neoadjuvant chemotherapy or neoadjuvant chemohormonal therapies. Other novel agents, such as those targeting the vascular endothelial growth factor receptor, epidermal growth factor receptor, platelet-derived growth factor receptor, clusterin, and immunomodulatory therapeutics, are currently under investigation.     

远程胎儿监护的临床应用

远程胎儿监护是应用互连网及计算机技术，孕妇在家中或远程监护终端将胎心监护图形传输到中央监护站，医生即可通过电脑或手机APP远程判读。对高危孕妇实行远程监护，便于及时发现胎儿宫内缺氧情况和及时处理，改善围产儿结局。     

Aesthetic refinements in prophylactic mastectomy with immediate reconstruction

Immediate reconstruction of more than 1000 breasts was performed on high-risk patients on whom a prophylactic mastectomy was done. The mastectomy removes as much breast tissue as possible while leaving sufficient skin, and possibly the nipple-areola complex, to enable immediate reconstruction. The creation of symmetrical, well-balanced muscle pockets for the implant is the most important factor in producing satisfactory results in these cases.     

狂犬病蛰伏数年后卷土重来的警示

[目的]警示各级政府务必重视和坚持“预防为主”的方针,采取有力措施,加强对犬类的管理,从根本上控制住“狂犬病”疫情。[方法]广泛地开展防治狂犬病健康教育,提高群众的防范意识和自我保护能力;加强部门协作,对犬只实行“管、免、灭、测”的综合性防疫措施;通过多渠道、多途径全面掌握犬伤人员的伤口处理与疫苗注射情况,对经济困难的犬伤者由政府报销疫苗费等措施保障犬伤人员得到及时处理。[结果]2005年犬伤人员伤口处置与疫苗注射率达99.67%;犬只免疫87320只,免疫率占58.21%;农村捕杀野犬、恶犬22408只、城镇限养区捕杀1189只;随机对3只家犬进行了带毒检测,带毒率达66.67%;2005年1～7月发病数10例,8～12月发病2例。[结论]政府重视,部门协作,措施具体,宣传到位,犬伤人员能及时得到正确处置是控制和降低狂犬病发病的关键。     

河南食管癌高、低发区无症状人群食管固有膜血管乳头的变化

目的：探讨食管癌高、低发区无症状居民食管上皮固有膜血管乳头（简称乳头）增生特征（乳头密度和高度）及其与病变分布的关系，加深对食管癌变早期形态学变化特征的了解。方法：2480例无症状人群食管粘膜活检组织，采用食管癌高低发区食管纤维内镜检查，粘膜活检，组织病理学检查和形态学测量技术对食管乳头的分布特征及其与病变的关系进行分析。结果：食管癌高低发区居民食管中、下段乳头升高（≥上皮厚度的1／2）发生率之间差异并不明显（P＞0．05），但是，高发区居民食管中段乳头密度（乳头数目／mm)明显高于下段，并高于低发区居民食管中段的乳头密度（P＜0．05）；高发区居民食管上皮乳头升高伴基底细胞过度增生患者明显高于正常人（P＜0．05），而低发区未观察到类似情况。结论：乳头增生表现为乳头数目增多和乳头升高是食管癌高发区人群食管上皮特征性形态学变化，高分区居民上皮乳头升高伴明显基底细胞过度增生，提示乳头增生可能是食管癌变极早期阶段的重要形态学变化，反映了上皮细胞的增生状态。     

Effectiveness of a hospital-wide selective screening programme for methicillin-resistant Staphylococcus aureus (MRSA) carriers at hospital admission to prevent hospital-acquired MRSA infections

Screening of potential MRSA-positive patients at hospital admission is recommended in German and international guidelines. This policy has been shown to be effective in reducing the frequency of nosocomial MRSA transmissions in the event of an outbreak, but the influence of screening on reducing hospital-acquired MRSA infections in a hospital setting where MRSA is endemic is not yet well-documented. This study describes the effect of hospital-wide screening of defined risk groups in a 700-bed acute care hospital during a period of 19 months. In a cohort study with a 19-month control period, the frequencies of hospital-acquired MRSA infections were compared with and without screening. In the control period, there were 119 MRSA-positive patients, of whom 48 had a hospital-acquired MRSA infection. On the basis of this frequency, a predicted total of 73.2 hospital-acquired MRSA infections was calculated for the screening period, but only 52% of the expected number (38 hospital-acquired MRSA infections) were observed, i.e., 48% of the predicted number of hospital-acquired MRSA infections were prevented by the screening programme. The screening programme was performed with minimal effort and can therefore be recommended as an effective measure to help prevent hospital-acquired MRSA infections.     

梗阻性黄疸高危因素分析

目的 :通过探讨梗阻性黄疸临床指征 ,了解其病程中的高危因素。并及时降低并发症及死亡率 ,提高临床疗效。方法 :对我科 1993年— 2 0 0 0年收治的 2 92例梗阻性黄疸病人进行性分析 ,统计年龄、梗阻时间、性质、手术时间 ,入院 2 4小时内测尿素氮 (BUN)、白蛋白 (A)、总胆红素(TBIL)、白细胞 (WBC)、血红素 (HB)、腹水 ,分析其高危因素。结果 :年龄 >6 5岁并发症发生率为2 5 .2 0 % ,病死率 3.2 5 % ;梗阻时间超过 2 0天以上者 ,并发症 2 8.87% ,病死率 5 .15 % ;肝功能Child氏B级、C级者 ,并发症发生率为 2 9.2 0 % ,病死率为 5 .31% ,延期手术并发症发生率为 2 9.4 1% ,病死率为 4 .90 %。结论 :梗阻性黄疸病人年龄越大 ,梗阻时间越长 ,肝功能越差 ,不及时手术是各种并发症发生及病死率增高的高危因素     

应用地理信息系统分析中国肾综合征出血热的空间分布

目的　利用地理信息系统 (GIS)技术分析中国大陆肾综合征出血热 (HFRS)的空间区域分布 ,建立HFRS危险区域分布图。方法　收集中国 41个HFRS监测点 1 995～ 1 998年的人群发病资料建立数据库 ,以中国省级、县级、一级河流数字地图为背景 ,在ArcGIS软件的支持下 ,与建立的数据库关联并对监测点人群发病资料进行反距离权重插值分析 ;收集 1 998年 6月SPOT4卫星覆盖东南亚地区的植被影像 ,逐一提取出各监测点监测区域的归一化植被指数 (NDVI) ,与 1 995～ 1 998年HFRS监测点人群平均发病率进行相关分析 ;根据不同流行强度监测区域的NDVI值 ,对遥感影像使用不同的颜色进行密度分割。结果　HFRS监测点人群发病资料的空间分析预测模型显示 ,中国HFRS主要分布于黑龙江流域、黄河中下游地区、长江中下游地区及京杭大运河 淮河流域地区 ,与1 995～ 1 998年全国各县HFRS平均发病率分布图进行比较 ,发现两者基本一致 ;相关分析显示HFRS发病率与NDVI之间呈现正相关 (r=0 .41 7,P <0 .0 1 ) ,根据各监测点NDVI的差异建立了中国HFRS危险区域分布图。结论　根据监测点数据采用GIS技术建立的预测模型对预测全国HFRS的分布情况有重要意义     

术中皮质体感诱发电位与电刺激术定位脑功能区

目的探讨脑功能区手术中利用脑皮质体感诱发电位(SEP)及直接皮质电刺激定位脑功能区的方法及意义。方法对10例脑功能区病变病人在唤醒麻醉下进行手术，利用皮质SEP及皮质直接电刺激定位感觉区、运动区及语占区，住保护脑功能区的前提下，手术切除病变。结果7例病人利用SEP及皮质电刺激确定出运动感觉区，其中4例利用SEP位相倒置确定出中央沟，3例病变位于左侧额颞叶的病人通过皮质直接电刺激确定出语言区?术后功能均较术前明显好转。结论术中SEP及直接皮质电刺激可准确、实时确定脑功能区，最大程度地保护功能，切除病变。     

云南省边境地区疟疾防治资源分配分析

目的 分析云南省边境地区疟疾资源分配状况与疟疾传播的关系，为合理分配疟疾资源提供依据。方法 收集中老、中缅、中越边境地区有关疟疾统计资料，研究导致疟疾流行的危险因素。结果 结果表明来自国外和国内的波及效应数值和强度效应综合反映了这些边境县所面临的潜在疟疾传播危险因素。结论 该地区的疟疾防治资源分配不合理，有待进一步改善。