间餐与中学生脑力工作能力关系研究

为阐明课间加餐对中学生上午学习能力的影响，采用剂量作业试验，通过自身前后对比，分析了间餐与脑力工作能力的关系，结果表明间餐不仅加快了脑力工作速度，控制了末节课的错误率，而且较有效地降低了显著疲劳发生率，经ｌｏｇｉｓｔｉｃ逐步回归分析，显示间餐及高质量早餐均为阻遏疲劳发生之保护因子。     

艺术大学生自我效能、主观幸福感及其关系的研究

目的研究艺术大学生自我产能与主观幸福感的关系。方法用幸福感指数量表、一般自我效能感量表494艺术大学生进行了测量。结果①艺术大学生的主观幸福感和自我效能感有显着的独生和性别差异。②艺术大学生的高、低自我效能与主观幸福感存在显着的差异和相关。结论自我效能是影响幸福感的重要因素。     

应用替硝唑软膏治疗细胞性阴道病102例疗效观察

目的：观察替硝唑软膏对１０２例细菌性阴道病的疗效。方法：选择１９８例患者,随机分为实验组（１０２例替硝唑软膏阴道给药）和对照组（９６例口服替硝唑片）。结果：实验组和对照组症状缓解有效率分别为９８．０％、９３．３％;线索细胞阴转率为７１．５％、４４．８％,平均缓解日：４天、６天;平均治疗日：７天、１０天。两组相比差异有显著性（Ｐ〈０．０１）。结论：应用替硝唑软膏对治疗细菌性阴道病疗效显著。     

Significant hyperbilirubinemia among well neonates due for discharge at Kawempe-Mulago Hospital,prevalence, factors associated,and accuracy of transcutaneous bilirubinometry for screening

BackgroundNeonates in low resource settings with a lack of pre-discharge screening and early intervention are at risk for complications associated with significant hyperbilirubinemia (SHB).ObjectivesTo determine the prevalence, factors associated and performance of transcutaneous bilirubin (TCB) in identifying well neonates with SHB.MethodsOver a one month period 235 well neonates 24 to 72 hours of age due for discharge at Kamempe-Mulago Hospital were enrolled in this study. Visual inspection using Kramer rule, transcutaneous bilirubin over the sternum using Draeger JM103 bilirubinometer, and serum bilirubin were determined. Neonates with SHB (total serum bilirubin warranting treatment) were referred for treatment. Relevant data were analyzed. A P-value of <0.05 was considered significant at 95% confidence interval.ResultsThirty two (13.6%) of the neonates had SHB and three (1.3%) had levels above exchange transfusion threshold. Significant hyperbilirubinemia was independently associated with CRP ≥ 10mg/l (AOR 3.96, CI 1.23–12.73, p 0.021), ABO discordance (AOR 3.67, CI 1.28–10.49, p 0.015), jaundice in a previous sibling (AOR 3.565, CI 1.10–11.51, p 0.034) and time of first feed > 1 hour (AOR 2.74, CI 1.10–6.90, p 0.007). The sensitivity, specificity, positive and negative predictive values of TCB were 96.5%, 84.6%, 47.5% and 99.4% respectively compared to 31.2%, 98.5%, 76.9% and 90% respectively for visual assessment (Kramer grading).ConclusionsA significant number of well neonates have SHB. Transcutaneous bilirubinometry is a suitable screening tool in this setting. Early initiation of feeding should be promoted. The cause for high CRP among well neonates with SHB needs to be studied further.     

圆形分布在流行病学中的应用——2845例伤寒发病时间分析

应用圆分布分析法对莱芜市22年间两次伤寒流行的发病时间进行了分析。第一次流行在1958年—1968年共发生2239例,按月发病时间计算的平均角度为287.4°(291天),发病高峰在10月18日。第二次流行在1975年—1985年共发生606例,平均角度为294.5°(299天),发病高峰在10月26日。对两个平均角进行显著性检验,F=9.4,P<0.01。即两次流行发病时间的平均角间有高度显著性差异。     

Contemporary Role of Systematic Prostate Biopsies: Indications,Techniques, and Implications for Patient Care

Context

Prostate cancer (PCa) screening to detect early stage PCa has resulted in increased identification of small-volume, low-grade PCa, many of which meet criteria for clinically indolent disease. Nevertheless, there remains some degree of underdetection of high-risk PCa in substantial numbers of men despite current diagnostic strategies.

Objective

To discuss the contemporary role of prostate biopsy (PB), focusing on the indications, techniques, and limitations of current PB techniques and evolving techniques affecting patient care.

Evidence acquisition

A comprehensive Medline search was performed using the medical subject heading search terms prostate cancer, detection, prostate biopsy, significant cancer, and diagnosis, with restriction to the English language. Emphasis was given to publications within the past 5 yr.

Evidence synthesis

Because abnormal digital rectal examination (DRE) and prostate-specific antigen (PSA) tests alone lack specificity for cancer, there is no universal indication for PB. This lack has inspired exploration for a cancer-specific biomarker and prediction tools such as risk calculators. Indication for biopsy should involve a balance between the underdiagnosis of high-risk cancers and the potential risks for the overdetection of clinically insignificant cancers as well as biopsy-related morbidity. Evidence supports the inclusion of laterally directed cores during transrectal ultrasound (TRUS) PB in addition to the traditional sextant pattern, which significantly improves cancer detection without a demonstrable increase in morbidity. These data indicate that such PB templates, typically 12 cores, represent the optimal template in initial PB. Optimised techniques and templates for repeat PB remain controversial. However, debate continues regarding indications, sampling number, and location as well as on the potential of modern image-guided approaches or three-dimensional (3D) mapping biopsy in this unique setting. Additional limitations of repeat PB techniques include associated procedural risks if general anaesthesia is required and inherent sampling errors of template-based techniques that are not targeted to the specific tumour site.

Conclusions

Current data support the utility of extended PB templates for initial TRUS PB intended to detect clinically significant PCa. Repeat PB in the setting of prior negative PB on the grounds of clinical suspicion or for risk-stratified approaches to management of low risk PCa requires balancing overdetection of low-risk cancer with the potential to miss significant cancer. Several options, including modern image-guided targeting, biomarker development, transrectal saturation PB, and 3D template mapping PB, are changing the clinical paradigms for evaluation and management. Evidence to support adopting approaches other than the current established standards should be tested through appropriately designed prospective studies.     

A retrospective review on atypical glandular cells of undetermined significance (AGUS) using the Bethesda 2001 classification

OBJECTIVE: The Bethesda system for reporting cervicovaginal cytologic diagnoses was recently revised in 2001. Pathologists are required to report not only whether the smear favors neoplastic changes, but also the origin of the abnormal cells. In this study, archival smears were reviewed to evaluate the usefulness of the new classification. METHODS: Smears having atypical glandular cells taken between January 1995 and December 1997 were reviewed and subclassified according to the revised Bethesda classification. Case records were then reviewed and cases with discrepancies between the cytological evaluation and corresponding final histological diagnoses were further reviewed. RESULTS: There were 138 smears reviewed. The mean age of the patients was 47 (range, 18 to 78). Thirty-four smears favored neoplasia and 104 favored "NOS" ("not otherwise specified"). Sixty smears favored endocervical origin and 78 endometrial origin. Forty-three patients (31%) had significant pathologies, including 12 (8.7%) patients with high-grade CIN, 2 (1.4%) with low-grade CIN, 5 (3.6%) with HPV infection, 7 (5.1%) with carcinoma of the corpus, 1 (0.7%) with cervical adenocarcinoma in situ, 4 (2.9%) with adenocarcinoma of the cervix, 3 (2.2%) with endometrial hyperplasia, and 5 (3.6%) with carcinoma of the ovary. Two (1.4%) patients had double primary female genital malignancies and 2 patients (1.4%) had extragenital malignancies. Significant correlation was found between smears "favor neoplasia" and a final diagnosis with significant pathology (chi(2) test, P < 0.05). Significant association was found between AGC favored endocervical origin and a final diagnosis with cervical diseases (chi(2) test, P < 0.05). Four of the 43 patients who had significant pathologies had lesions found during their subsequent visits and all of them had cervical smears classified as AGC "favor neoplasia". CONCLUSION: AGC found on cervical smears are an indication for early and intensive investigation.     

Immunohistochemical expression of prostate tumor overexpressed 1 in cystoprostatectomies with incidental and insignificant prostate cancer. Further evidence for field effect in prostatic carcinogenesis

Prostate tumor overexpressed 1 was recently identified as a novel gene and protein during a differential display screening for genes overexpressed in prostate cancer. It has been suggested that overexpression of prostate tumor overexpressed 1 can contribute to the proliferative status of prostate tumor cells and, thus, to their biologic behavior. Prostate tumor overexpressed 1 and Ki-67 were immunohistochemically evaluated in prostate cancer, high-grade prostatic intraepithelial neoplasia, and normal-looking epithelium in 20 cystoprostatectomies and 20 radical prostatectomies with pT2a Gleason score 6 prostate cancer. The aim was to see whether there were differences in marker expression between cystoprostatectomies and radical prostatectomies. The proportions of prostate tumor overexpressed 1– and Ki-67–positive cells in the cystoprostatectomies and radical prostatectomies increased from normal-looking epithelium through high-grade prostatic intraepithelial neoplasia, away from and adjacent to prostate cancer, to prostate cancer. Prostate tumor overexpressed 1 expression in prostate cancer in cystoprostatectomies was lower than in radical prostatectomies, the differences being significant; there were significant differences in Ki-67 indices. In conclusion, our findings related to prostate tumor overexpressed 1 expression in high-grade prostatic intraepithelial neoplasia, evaluated adjacent and away from prostate cancer, and in incidental and clinical cancers give further support to the concept of field effect in prostatic carcinogenesis as well as to differences in the process of prostatic carcinogenesis between cystoprostatectomies and radical prostatectomies.