【摘要】 目的 〖JP2〗探讨血管内皮生长因子（VEGF）联合血清肿瘤标志物对肺癌早期诊断意义。 方法 2008年1月-〖JP〗2009年8月收治的92例患者中肺癌患者64例，采集静脉血清标本采用酶联免疫法检测其VEGF水平。 结果 64例肺癌与28例非肺癌患者VEGF表达水平分别为（255.72±566.00）、（299.46±795.8） pg/mL，两者比较无统计学意义（Pgt;0.05）；43例中晚期肺癌VEGF值（125.07±68.2） pg/mL，表达显著高于12例早期肺癌（196.00±260.60） pg/mL （Plt;0.05）；CEA与CYFRA21-1的表达对判断26例发生胸膜转移的肺癌有统计学意义（Plt;0.05）。 结论 结合血清VEGF水平和常规肿瘤标志物，可评估现状及临床分期，VEGF结合CEA与CYFRA21-1表达水平为预测肺癌患者早期发生胸膜转移提供理论依据。【Abstract】 Objective To evaluate the effect of combined detection value of serum vascular endothelial growth factor (VEGF) and tumor markers on early diagnosis of lung cancer. Method Intravenous serum levels of VEGF and tumor markers were assayed by ELISA in 92 patients including 64 lung cancer from January 2008 to August 2009. Results The difference in serum levels of VEGF between the 64 patients with lung cancer [(255.72±566.0) pg/mL] and 28 health adult [(299.46±795.8) pg/mL] was not significant (Pgt;0.05). The level of VEGF in 43 patients with middle and late lung cancer [(125.07±68.2) pg/mL] was significantly higher than that in the 12 patients with early lung cancer [(196.00±260.60) pg/mL] (Plt;0.05). There were statistical significance in expression of serum CEA and CYFRA21-1 on diagnosis in 26 patients having lung cancer with early metastasis pleural fluid (Plt;0.05). Conclusion Combined diagnostic of serum VEGF and tumor markers can assess the state of an illness and clinical stage, and the serum levels of serum VEGF,CEA and CYFRA21-1 may be a good predictor for lung cancer with early metastasis pleural fluid.
Objective To understand the situation of commonly-used drugs, medical device and their storages in rural households among model well-off township hospitals in eastern, central and western China, and to provide the basis for the guidance of reasonably using and scientifically storing drugs. Methods The methods of combining simple random sampling and cluster sampling were used to investigate and analyze the situation of commonly-used drugs, medical device and their storages in 162 households from three well-off township hospitals in Shanghai, Zhejiang, and Sichuan provinces, respectively. Results The storage rates of commonly-used drugs of rural households in well-off towns were cold medicine (72.2%), wound paste (51.9%), cooling oil (39.5%), essential balm (36.4%), antihypertensive (27.8%), iodine tincture (14.2%), anti-diabetic drugs (13.0%) and other drugs (17.3%). The storage rates of medical devices were thermometer (50.0%), cotton swab (47.5%), sphygmomanometer (9.3%), injector (1.2%) and other devices (22.2%). A total of 66% of respondent families stored drugs and medical devices in a fixed drawer. Only 3.1% families stored drugs and medical devices in the special portable medical kit. Conclusion Rural families have a higher rate of household drugs among model well-off township hospitals in eastern, central and western China, and most drugs are OTC drugs. The storage rates of medical devices are not high. Many rural family-owned medical devices are linked with special chronic diseases in the family. A lot of rural families place drugs and medical devices randomly. There are many security risks, and it may affect the rational utilization of drugs.
Objective To understand the demands on portable medicine kit of rural residents in well-off township hospitals, and to provide the basis for scientifically designing portable medicine kit for rural residents. Methods The methods of combining simple random sampling and cluster sampling were used to investigate and analyze the demands on portable medicine kit for 162 households from three well-off township hospitals in Shanghai, Zhejiang, and Sichuan province, respectively. Results The demand rate of 162 rural households on portable medicine kit was 75.3% (122/162). The main drugs that demanders expected in the portable medicine kit were cold medicine (86.1%), wound paste (82.0%), cooling oil (61.5%), essential balm (54.9%) and antihypertensive (34.4%); and the main medical devices that demanders expected were thermometer (82%), cotton swab (73%) and sphygmomanometer (32.8%). The sizes of portable medicine kit that demanders expected were 23.7±8.5 cm in length, 17.1±6.4 cm in width, and 14.1±6.5 cm in height. The main function characteristics of portable medicine kit that demanders expected were applicability (74.6%), safety (60.7%), light weight (68.0%), economics (60.7%), and waterproof (46.7%). A total of 72.1% of demanders expected the price of less than 15 yuan, and 91.8% expected kit made of hard materials as plastic as the first choice. Conclusion The demand rate of rural residents on portable medicine kit is higher in well-off township hospital. The design and production of portable medicine kit should fully meet the demands of rural residents. Only when sufficiant respect for the market demand is paid, can the promotion and application of portable kits will be ensured.
Objective To investigate the disease constitution and drug application of inpatients in Yong’an Central Township Health Center (YaC) in Shuangliu County of Sichuan province in 2009, so as to provide baseline data for further research. Method Questionnaire and focus interview were carried out, case records and drug application information of YaC inpatients in 2009 were collected. The diseases were classified according to ICD-10 based on first diagnose. Drug application was analyzed based on pharmaceutical dosage form, pharmaceutical effect, cost, and clinical departments. Data including general information of the inpatients, discharge diagnosis, hospitalization expenses, and drug cost etc. were rearranged and analyzed by Excel software. Result a) The total number of inpatients was 4 335 and the female/male was 55.59% vs. 44.1%, their disease spectrum included 18 categories, which accounted for 85% of disease classes of ICD-10; b) The inpatients suffered from top 5 systematic diseases were 3 531, accounted for 81.45%, which included the respiratory, digestive, urinary tract and urogenital, circulatory systems, as well as trauma and toxicosis. Except the trauma and toxicosis, the female was more than the male in all the rest main systematic diseases; c) The top 15 single diseases were chronic bronchitis in acute stage, acute upper respiratory infection, pneumonia, acute gastroenteritis, chronic bronchitis, urinary stone, acute appendicitis, chronic gastritis, acute gastritis, vertebrobasilar ischemia, cesarean section, fracture, acute urticaria, and meniere disease; d) The total inpatients with top 15 single diseases accounted for 59.81%, including 6 chronic diseases and 9 acute diseases. The patients’ average costs of chronic disease were higher than that of acute disease; and e) The proportion of western medicine cost accounted for 80% to 90% of total cost, and the cost of anti-microbial drugs and drugs of humoral regulation ranked as the top two. Conclusion a) The inpatients in 2009 are mainly in age of 25 to 59, and over 60 years old as well. The top two diseases mainly attacked are in respiratory and digestive systems, acute diseases are more than the chronic; b) Except for pneumonia, urinary stone, uroschesis, urinary stone, trauma, and toxicosis, the female inpatients are more than the male for complaining all other diseases; c) The number of inpatients received hysterotomy is as 4.24 times as that of natural labor, and the rationality should be paid attention to; d) The commonly used drugs, according to the costs, involve in 4 kinds of drugs and 1 kind of vaccine, which are in accordance with the main burden of the diseases; e) Supervision should be focused on the drugs of high cost or the one most frequently used; and f) The 0.9% Sodium chloride injection, Glucose injection and Cefuroxime listed in the EML (2009) satisfy the needs of treatment for YaC inpatients in 2009.