Overview of breast cancer prevention: what's the next?

Breast cancer is the leading cause of death among women at the ages of 20-59 years[1].The incidence of breast cancer in Asia is also shown to be increasing recently, especially in the more affluent cities, and the peak incidence of breast cancer is at the age of 45-50 years[2].Breast cancer prevention has started from secondary prevention strategy of early detection of the disease with different modalities in Asia[3-5] despite the absence of unified nationwide screening program.There are a lot of discussion about the benefits and harms of breast cancer screening[6-8] and still a lot of controversial issues such as stratification of breast cancer risk, choice of screening modalities, ways of information dissemination, different culturo-religious beliefs, and various levels of medical resources, especially in Asia, remain unresolved.In no doubt, a cost-effective prevention method should be more widely accepted.

KEY POINTS■ Cardiovascular disease continues to be the number one cause of death in the United States.

脓毒症的免疫紊乱机制

Sepsis is considered as a symptom complex resulted from an invasion of pathogen(s), provoking a cascade of harmful physiological changes including fulminating inflammatory responses detrimental to structures and functions of tissues and organs. The process may end in septic shock or terminate into multiple organ dysfunction syndrome (MODS) and multiple organ failure, and they are both lethal. As yet both the incidence and mortality of sepsis remain high, and it has become the leading cause of death of non-cardiac diseases in different countries, mainly because its underlying pathogenetic mechanisms are not well elucidated. Thus it continues to be an indocile challenge to human health and economical development worldwide[1].

我院10年围产儿死亡原因和出生缺陷的分析

围产儿死亡率是国际通用衡量一个国家或地区经济、文化及医疗卫生工作质量的重要指标,在先进国家或地区一般低于1%[1].本文对我院1997年-2006年围产儿死亡情况、早期新生儿的死亡原因以及围产儿出生缺陷进行回顾性分析,以便有针对性地改进围产期保健工作,降低围产儿死亡率.

早期康复治疗对脑卒中偏瘫患者预后的影响

INTRODUCTIONCerebral apoplexy has high morblity, mortality, disablement rate. InChina the resident's cause of death was of cis-position in 2000 year. Incities cerebrovascular patients were 127.9%thousands, in countries115.20% thousands. All the cause of death was at the second posi-tion. One month survival rate of cerebral apoplexy was about 70% -90% ,one year survival rate was about 50% - 80%. Most survivors haddysfunction to varying degrees and they needed recovery treat-ment. Early rehabilitation' s purpose is to protect from complications,disuse syndrome and to develop normal motor reaction and motor form.

流行性出血热1333例临床分析

本文报告了流行性出血热患者的临床特征、常规检验数据、异形淋巴细胞比率、免疫检查结果以及本病各期的血液流变学、血气分析、放射性核素肾图和甲皱微循环的变化规律,分析了死亡原因和影响预后的因素.1,333例中,死亡55例,病死率4.12%,其中1983～1984年病死率降至1.85%.主要治疗体会是抓"三早"、把"三关",早期定度抓重点,各种手段齐监测,预防(性)治疗是关键;针对各期特点采用扩、扩、稳、平的治疗原则.

马来西亚男性健康的概述:问题与挑战

Current treatment in chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is defined by fixed airflow limitation associated with an abnormal pulmonary and systemic inflammatory response of the lungs to cigarette smoke. COPD represents an increasing burden worldwide, reported to be the sixth leading cause of death in 1990 and the fourth in 2000. Discouragingly, it is projected to jump to third place by the year 2020.There is increasing evidence that COPD is a more complex systemic disease than an airway and lung disease. In particular, cachexia, skeletal muscle abnormalities, diabetes, coronary artery disease, heart failure, cancer and pulmonary vascular disease are the most common comorbidities. It is associated with a wide variety of systemic consequences, most notably systemic inflammation. Because COPD patients have in general ahigher cardiovascular risk than the average population, cardiovascular safety in a COPD medication is of critical importance.SINGH et al performed a systematic review and recta-analysis of 17 clinical trials enrolling 14 783 patients treated with inhaled anticholinergic drugs used for the treatment of COPD. Inhaled anticholinergics significantly increased the risk of cardiovascular death, MI, or stroke ( 1.8 % vs 1.2 % for control; RR, 1.58 (95 % CI,1.21 - 2.06); P < 0.001 ). However, UPLIIFT (Understanding the Potential Long-Term Impacts on Function with Tiotropium) , a large, 4-year, placebo controlled clinical trial with tiotropium in approximately 6 000 patients with COPD. The preliminary results of UPLIFT showed that there was no increased risk of stroke with tiotropium bromide compared to placebo.A meta-analysis is always considered less convincing than a large prospective trial designed to assess the outcome of interest. However, COPD is a systemic disease. COPD management needs to focus on four major areas: smoking cessation, pharmacologic therapy, exercise training, and pulmonary rehabilitation. Clinicians and patients should always carefully consider any potential risks of intervention in the treatment of COPD.