城市女性与农村女性生活方式与乳腺癌发生的相关分析

目的 探讨云南省城市女性与农村女性生活方式与乳腺癌发生关系的差异,为实施有效的护理干预提供一定的依据.方法 对50例女性乳腺癌患者(城市女性25例,农村女性25例)进行随机问卷调查,收集资料,统计分析.结果 农村女性及城市女性在饮食结构、生育情况、生活习惯、精神状况、工作情况等方面差异有统计学意义(p<0.05).结论 针对乳腺癌高危因素,实施有效的护理干预,是实现乳腺癌一级预防的重要手段.     

老年黄斑变性与文化程度相关的病例对照研究

老年黄斑变性是一种视网膜黄斑区的退行性病变,其发病率随年龄的增长而逐渐升高,因此被称为年龄相关性黄斑变性(age-related macular degeneration,AMD).临床上通常将有软性玻璃膜疣、色素异常和地图样萎缩的AMD称作干性AMD,而将有脉络膜新生血管、视网膜色素上皮脱离或盘状纤维化的AMD称为湿性或新生血管性AMD.     

1204例车祸病例分析与护理对策

总结了车祸病例的特点、院前急救护理及应对措施.回顾性分析铜川市人民医院急救中心2007年1月～2009年12月1204例车祸患者的急救资料.认为普及交通安全知识和急救技能培训,是应对车祸的有利措施.     

复发性脑出血的治疗与预后分析

目的:通过对复发性脑出血患者的治疗和影响预后的因素进行分析,探讨复发性脑出血的预防与治疗措施.方法:比较存活患者与死亡患者情况,将存活的24例与死亡的8例患者的一般资料(年龄、性别)、临床资料(血压、血脂、出血部位、出血量等)和治疗等情况进行比较.并在治疗后随访存活患者1年后预后情况.结果:32例复发性脑出血患者治疗结果,治愈18例,好转6例,死亡8例,有效率占75%.住院时间为7～68d,平均19.5d.死亡患者死亡年龄平均为65.1±1.2岁;存活患者年龄平均为43.1±1.4岁,二者进行比较,P＜0.05,差异具有统计学意义,且存活例复发性脑出血患者治疗结果患者年龄小于死亡患者.性别两组无差异(P＞0.05).存活患者与死亡患者血压、血脂、出血部位、出血量和治疗等情况比较,P均＜0.05,差异有统计学意义.存活患者出血位置以基底节最多,死亡患者以脑干出血为主.24例存活患者中仅有1例出血次数≥3次,死亡患者7例均为出血次数≥3次.1年后随访,存活患者中1例患者死亡,1例出现出血复发.     

女性泌尿生殖道支原体感染与药物敏感性分析

目的:了解女性泌尿生殖道支原体感染状况及药物敏感性.方法:回顾性分析本院242例女性分泌物支原体检测情况.结果:242例支原体阳性患者中,单纯的Uu感染202例,占83.5%,单纯Mh感染22例,占9.0%,Uu和Mh混合感染6例,占2 5%.结论:支原体属培养阳性并不能作为诊断支原体感染的惟一依据,临床医生应结合病情及症状综合诊断考虑.治疗时考虑药敏试验并结合药物代谢动力学等特点来综合评价,可能会取得更好的治疗效果.     

平凡而伟大的女性——《哈利·波特与魔法石》中女性形象分析

在女性主义批评理论的观照下,从三个角度分析讨论了<哈利·波特与魔法石>中的女性形象:第一是哈利·波特的母亲,放弃了生的可能性,选择了死亡,由此产生的自我毁灭的勇气与美,表现了如圣母般的女性形象;第二是女主人公赫敏以自我意识及独立女性的形象颠覆了传统的女巫形象,塑造了一个罗琳心目中理想化的女性形象;第三是分析了小说中其他的女性形象,如魔法学校管理者麦格教授,最后得出结论:罗琳没有神化女性的形象,而是在平凡中折射出女性的伟大,女性在魔法世界起到了重大积极的影响.     

利福喷丁与利福平治疗肺结核疗效和安全性的Meta分析

目的:通过Meta分析方法评价利福喷丁与口服利福平治疗肺结核的疗效和安全性,为利福喷丁在临床上的应用提供较为科学、可靠的循证医学证据.方法:计算机检索Ovid-medline、CBMdisc、Pubmed、CNKI、万方及维普等数据库,手工检索肺结核相关的专业杂志,检索1999-2010年国内外期刊公开发表的关于利福喷丁与利福平治疗肺结核疗效和安全性的临床随机对照试验(RCT)或临床对照试验(CCT)文献(检索日期截止至2010年7月).结果:共纳入RCT 18篇,CCT 6篇.疗效方面,利福喷丁与利福平在初治肺结核组2个月痰菌阴转率、复治肺结核组疗程结束时病灶显效率及空洞闭合率、疗程结束后随访2～3年复发率比较差异均有统计学意义(P<0.05),利福喷丁组均优于利福平组;二者治疗复治肺结核2个月痰菌阴转率及疗程结束时初、复治肺结核组痰菌阴转率比较差异无统计学意义(P>0.05),疗程结束时初治肺结核组病灶显效率及空洞闭合率比较差异也无统计学意义(P>0.05).安全性方面,利福喷丁与利福平组药物过敏反应(皮疹、药物热)发生率比较差异无统计学意义(P>0.05),总的药物副反应发生率、肝功异常发生率、ALT升高发生率、血清胆红素升高发生率、胃肠道不良反应发生率及药物中止治疗发生率比较利福喷丁组均低于利福平组(P<0.05).结论:利福喷丁治疗肺结核疗效好,安全性较高,患者耐受性及依从性好,尤其适合复治肺结核患者的化疗.     

多西他赛联合塞替派与多西他赛联合卡培他滨治疗转移性乳腺癌的随机、对照临床研究

目的:比较多西他赛联合塞替派方案和多西他赛联合卡培他滨方案治疗转移性乳腺癌的临床疗效及其安全性.方法:选择北京大学临床肿瘤学院乳腺肿瘤内科2006年8月至2008年9月收治的女性乳腺癌患者共46例,采用多西他赛联合塞替派(A组)或卡培他滨(B组)方案进行随机、对照临床治疗试验,A组第1,8天多西他赛35 mg/衬静脉滴注,第1天塞替派60-65 m岁扩静脉滴注,B组第1,8天多西他赛35 mg/耐静脉滴注,第1~14天卡培他滨1000 mg/m2,口服,每日2次.21 d为1个周期,至少应用2个周期.结果:多西他赛联合塞替派组22例,多西他赛联合卡培他滨组24例,两组患者基线情况一致.可评价疗效多西他赛联合塞替派组21例,多西他赛联合卡培他滨组22例.两组疗效分别为部分缓解9.52%..27.27% (2/21例,6/22例),稳定52.38% vs31.82% (11/21例,7/22例),进展38.10%..40.91% (8/21例,9/22例),疾病控制率分别为61.90% vs.59.09%(13/21例,13/22例),中位无进展生存期分别为7.9个月(95% CI 0.77~15.03)vs.8.3个月(95% C14.01~12.59),1年生存率分别为88.2%..81%,P值均＞0.05,每两组间差异无统计学意义.无化疗相关死亡病例.多西他赛联合塞替派组和多西他赛联合卡培他滨组最常见的不良反应为骨髓抑制,主要不良反应Ⅲ~Ⅳ度发生率分别为白细胞减少45.45% vs..26.09%,中性粒细胞减少45.45%..21.74%,血小板减少9.09% vs.0%,手足综合征0% vs.13.04%.P值均＞0.05,每两组间差异无统计学意义.结论:多西他赛联合塞替派方案治疗转移性乳腺癌有一定近期疗效,不良反应可耐受,可以作为经济、有效的解救方案.     

30～50岁男性前列腺体积与体重指数、血压、血脂及血糖的相关性分析

目的:了解30～50岁男性前列腺体积与体重指数、血压、血脂及血糖的相关性.方法:从石景山区社会保险中心登记信息中随机抽取1 010名30～50岁男性作为研究对象,行体格检查并计算体重指数(body mass index,BMI),经腹B超测定并计算前列腺体积(prostate volume,PV);空腹抽血检测血糖(blood glucose,BG)、血胆固醇(blood cholesterol,CHOL)、甘油三酯(triglyceride,TG)、低密度脂蛋白(low density lipoprotein,LDL)、高密度脂蛋白(high density lipoprotein,HDL)等,测量血压(blood pressure,BP),应用SPSS13.0统计软件对PV和BMI、BP、BG、CHOL、TG、LDL、HDL的相关性进行统计学分析.结果:符合标准并资料全面者1002人,前列腺体积与年龄、BMI、BG、CHOL、LDL、HDL等因素有明显的相关性,P值分别为0.000、0.013、0.032、0.040、0.032、0.017,相关系数r值分别为0.62、0.57、0.52、0.51、-0.50、-0.48.与TG、收缩压(systolic pressure,SP)、舒张压(diastolic pressure,DP)无明显相关性,P值分别为0.313、0.213、0.782.调整年龄因素后,PV与BMI、LDL仍有较强的相关性,P值分别为0.029、0.001,相关系数r值分别为0.53、-0.49.与BG、CHOL、LDL、HDL、TG、SP、DP无明显相关性(P＞0.05).结论:在30～50岁男性人群中,前列腺体积和BMI及血脂异常明显相关,BMI、血脂异常是前列腺体积增大的危险因素.     

妥协与叛逆——《金粉世家》、《啼笑因缘》的女性形象对比分析

张恨水的代表作<金粉世家>和<啼笑因缘>描写了众多的女性形象,作为女性,她们在新旧时代交替下表现出了矛盾的本质--妥协或反叛.文章所选取的四位女性人物,即冷清秋和沈风喜、白秀珠和何丽娜,她们中有的妥协于男权社会,在传统的生活空间中遵循男权思想规范最后被毁灭,同时又有勇于反叛、超越传统视界勇敢出走的.本文从各方面对她们进行对比分析,通过她们对命运的不同抉择,探索女性追求独立与自尊的意义所在.     

A path analysis of factors associated with distress among first-degree female relatives of women with breast cancer diagnosis.

Patterns and predictors of psychological distress in first-degree female relatives (N = 624) of newly diagnosed breast cancer patients were explored. First-degree female relatives who were high monitors reported greater cancer-specific and general distress than did low monitors. Greater optimism was associated with lower cancer-specific distress. Optimism's effect on general distress was moderated by women's level of monitoring. Greater optimism was associated with lower general distress for both high and low monitors, but the effect was stronger for high monitors than for low monitors. Avoidance and engaged coping were associated with higher distress. A close relationship with the cancer patient was related to higher cancer-specific distress but lower general distress. Further understanding of the process of adjustment in these women awaits longitudinal study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

非含铂双药和非含铂单药治疗老年和/或PS差的非小细胞肺癌病人疗效:荟萃分析

Objective:The aim of the study was to compare the efficacies and toxicities of non-platinum doublets (doublets group) with a non-platinum single agent (single-agent group) in previously untreated advanced non-small cell lung cancer (NSCLC) patients with elderly age and/or poor performance status (PS).Methods:The PubMed database was screened.Subsequently,the hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS),relative risks (RRs) for overall response rate (ORR) and one-year survival,and odds ratios (ORs) for the different types of toxicities were pooled using the Review Manager 5.0 package.Results:This study comprised of 1427 patients enrolled in four randomized controlled trials.The pooled HR showed that the doublet group could increase ORR (P = 0.002) with no heterogeneity (P = 0.64),and might improve OS (P = 0.01 / P = 0.06) with heterogeneity (P < 0.001).There was no significant difference in PFS (P = 0.16) and one-year survival (P = 0.25) between two treatment groups.The doublet group led to more grade 3/4 neutropenia and thrombocytopenia than the single-agent group (P = 0.02 and P = 0.000,respectively).The incidences of grade 3/4 anemia,vomiting,mucositis,constipation,diarrhea,neurotoxicity,allergy,and fatigue between the two treatment groups were insignificant.Conclusion:Except for neutropenia and thrombocytopenia,the non-platinum doublets could increase ORR,and might improve OS for NSCLC patients with elderly age and/or poor PS without addition of more side effects;however,the doublets showed an increased rate of neutropenia and thrombocytopenia.The addition of doublets may not improve PFS and one-year survival.     

乳腺癌抗血管生成治疗:现状与前景

Tumor angiogenesis plays an important role in the growth, invasion and metastasis of breast cancer, therefore recently a very active area of breast cancer research involves the addition of antiangiogenic therapy. Numerous clinical studies for several antiangiogenic agents have recently been conducted in breast cancer patients and have shown clinically significant improvement in outcomes. This review gives a brief background to breast cancer angiogenesis, also focusing on current progress in the field of antiangiogenic therapy for breast cancer and issues regarding future therapeutic development.     

Emotional distress following genetic testing for hereditary breast and ovarian cancer: A meta-analytic review.

Objective: Meta-analysis was used to synthesize results of studies on emotional consequences of predictive genetic testing for BRCA1/2 mutations conferring increased risk of breast and ovarian cancer. Design: Studies assessing anxiety or cancer-specific distress before and after provision of test results (k = 20) were analyzed using a random-effects model. Moderator variables included country of data collection and personal cancer history of study participants. Main Outcome Measures: Standardized mean gain effect sizes were calculated for mutation carriers, noncarriers, and those with inconclusive results over short (0–4 weeks), moderate (5–24 weeks), or long (25–52 weeks) periods of time after testing. Results: Distress among carriers increased shortly after receiving results and returned to pretesting levels over time. Distress among noncarriers and those with inconclusive results decreased over time. Some distress patterns differed in studies conducted outside the United States and for individuals with varying cancer histories. Conclusion: Results underscore the importance of time; changes in distress observed shortly after test-result disclosure frequently differed from the pattern of distress seen subsequently. Although emotional consequences of this testing appear minimal, it remains possible that testing may affect cognitive and behavioral outcomes, which have rarely been examined through meta-analysis. Testing may also affect understudied subgroups differently. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress buffering effects of daily spousal support on women's daily emotional and physical experiences in the context of breast cancer concerns.

Objective: This study examined whether the relationship between daily spousal support and daily psychological and physical outcomes varied as a function of level of breast cancer related concern (stress buffering model). Design: Ninety-five women with early stage breast cancer completed daily reports of emotional and physical experiences and satisfaction with spousal support for 30 days. Women also rated problems dealing with three types of cancer specific concerns: emotional, physical, and social. Main outcome measures: Women's positive and negative affect and cancer related pain and fatigue. Results: Multilevel analyses supported a stress buffering effect for social concerns and a reverse stress buffering effect for emotional and physical concerns. Conclusion: Daily spousal support appears to be an important contributor to the daily emotional and physical wellbeing of women with breast cancer. Contrary to the tenets of the stress buffering model, these data suggest that the buffering effect of spousal support is attenuated when breast cancer related emotional and physical concerns reach high levels. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The yellow brick road and the emerald city: Benefit finding, positive reappraisal coping and posttraumatic growth in women with early-stage breast cancer.

Predictors and outcomes of benefit finding, positive reappraisal coping, and posttraumatic growth were examined using interviews and questionnaires from a longitudinal study of women with early-stage breast cancer followed from primary medical treatment completion to 3 (n=92) and 12 months (n=60) later. Most women (83%) reported at least 1 benefit of their breast cancer experience. Benefit finding (i.e., identification of benefits, number of benefits), positive reappraisal coping, and posttraumatic growth had distinct significant predictors. Positive reappraisal coping at study entry predicted positive mood and perceived health at 3 and 12 months and posttraumatic growth at 12 months, whereas benefit finding did not predict any outcome. Findings suggest that benefit finding, positive reappraisal coping, and posttraumatic growth are related, but distinct, constructs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A crossover study on the glucose metabolism between treatment with olanzapine and risperidone in schizophrenic patients.

Several studies have suggested that risperidone is superior to olanzapine in glucose tolerance; however, there is little information available about the risk of impaired glucose metabolism induced by atypical antipsychotics in the same patients. A 75-g oral glucose tolerance test (OGTT) was performed in 22 mildly obese, diabetes-free, Japanese patients with schizophrenia who received risperidone or olanzapine for at least 2 months. After the OGTT, the medication was switched to another by decreasing the previous dosage gradually over 2 to 8 months after the initiation of the second medicine. After at least 8 weeks of complete switching, the same OGTT procedure was conducted. Fasting insulin concentration and the homeostasis model assessment of insulin resistance (HOMA-IR) during olanzapine treatment were significantly higher compared with risperidone treatment. The area under the concentration-time curves of serum insulin concentrations from 0 to 120 min was different in patients receiving risperidone compared with patients receiving olanzapine; however, there were no differences in the insulinogenic index between the two groups. The present study suggests that olanzapine might impair glucose tolerance to some extent because of an increase in insulin resistance compared with risperidone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)