百色市麻风病畸形残疾情况调查分析

为了了解我市麻风治愈存活及现症病人的畸残情况,我们专门开展了麻风病畸残情况调查,现报道如下。 1 资料与方法 1．1 调查对象：病人基本资料来自本院麻风病病人档案．调查内容按全国麻风畸残康复需求调查工作手册进行。调查对象为本市1区11县1118例存活病人,其中现症病人46例,已治愈1072例。1．2方法：由市（县）专业人员经过业务培训后,按调查表采用上门询问方式,逐一检查登记。对病人的可见性畸残情况．由调查的麻防医生按照畸残诊断标准进行检查确诊。     

贵州省5655例麻风病畸残者调查分析

为掌握贵州省麻风存活病例的畸残程度,为制定贵州省麻风畸残预防措施及康复计划提供科学依据,我们于2009-03-2009-05在贵州省9个市(州、地)88个县(市、区)开展了麻风病患病情况现况调查.现将5655例麻风病畸残者畸残状况分析如下.     

西藏林芝地区2004～2005年麻风病患者生存状况调查

由于麻风具有较高的致残率,患者在治疗前、治疗期间甚至在治愈后都可能发生麻风反应、复发和神经炎,如果未能及时确认或确认后未能得到及时而规范的治疗,周围神经受到破坏将导致畸残发生,而正是由于麻风畸残使患者出现肢体功能障碍甚至毁容,成为社会歧视和排斥的根源。因此,麻风不仅是一种慢性传染病,更是一个典型的社会性疾病。为了解林芝地区麻风现症和治愈病例的生存状况与畸残、康复、需求情况,为政府制定相关规划计划提供科学依据,我们于2004年~2005年历时两年在5个县12个镇和19个乡开展了麻风现症和治愈患者生存状况调查。1对象与方法…     

肺癌合并结核病 177例临床特点及影响因素分析

目的 了解肺癌合并结核病的临床特点及影响因素.方法 回顾性分析安徽省胸科医院2013年1月至2016年12月肺癌合并结核病177例的基础状态、一般资料、结核病和肺癌等情况.结果 肺癌合并结核病的病人以65岁以上老人(67.2％)、男性(89.8％)、肺鳞癌(46.3％)、中晚期肺癌(60.5％)为多,新发生结核病的病人接近一半(47.5％).低体质量指数(BMI)(OR=3.000,95％CI:1.196～7.526)、低蛋白血症(OR=2.281,95％CI:1.418～3.669)、居住在农村(OR=1.975,95％CI:1.272～3.066)、慢性阻塞性肺病(COPD)(OR=3.882,95％CI:1.231～12.239)可能是肺癌合并结核病的危险因素;非文盲(OR=0.556,95％CI:0.360～0.859)、无糖尿病(OR=0.326,95％CI:0.163～0.649)可能是肺癌合并结核病的保护性因素.结论 对于来自农村、老年男性、伴有营养不良和COPD的中晚期肺鳞癌病人,应警惕结核病的发生.     

贵阳市63例麻风病例临床特征分析

麻风是由麻风杆菌引起的一种可治愈的慢性传染病,主要侵犯皮肤粘膜和周围神经,严重者可致残,因此早期发现、早期诊断和早期治疗对防止病人的畸残发生尤为重要。现将我市发现的63例麻风病人的临床特征分析如下。1资料与方法1.1病例资料收集2005-2009年由贵阳市所辖     

肺癌病人发生肺栓塞的危险因素和风险列线图模型

目的 探讨肺癌病人发生肺栓塞的危险因素,并建立相关列线图预测模型.方法 回顾性分析2018年8月至2019年8月因肺癌于攀枝花市中心医院治疗的211例病人的临床资料,肺癌合并肺栓塞的病人有52例,未并发肺栓塞的有159例,分别设为合并肺栓塞组和单纯肺癌组.对影响肺癌病人发生肺栓塞的相关因素进行分析,并建立相关预测模型.结果 单因素分析显示,两组病理类型[腺癌(51.92％)比(27.04％)]、TNM分期[Ⅲ～Ⅳ期(65.38％)比(40.25％)]、留置中心静脉导管[(15.38％)比(4.40％)]、化疗[(44.23％)比(22.01％)]、血红蛋白[≥140 g/L(63.46％)比(36.48％)]和D-二聚体[≥0.4 mg/L(53.85％)比(32.08％)]差异有统计学意义(P<0.05).logistic回归分析可知,腺癌(OR=2.835,95％CI:1.355～5.931)、Ⅲ～Ⅳ期肺癌(OR=2.263,95％CI:1.087～4.710)、留置中心静脉导管(OR=5.065,95％CI:1.535～16.718)、化疗(OR=2.321,95％CI:1.095～4.920)、血红蛋白≥140 g/L(OR=3.282,95％CI:1.569～6.866)及D-二聚体≥0.4 mg/L(OR=2.772,95％CI:1.341～5.728)是肺癌病人发生肺栓塞的独立危险因素(P<0.05).据此建立预测肺癌病人发生肺栓塞的列线图模型,模型验证结果显示,预测值同实测值基本一致,C-index为0.804(95％CI:0.769-0.839),表明模型具有良好的精准度和区分度.结论 腺癌、Ⅲ～Ⅳ期肺癌、留置中心静脉导管、化疗、血红蛋白≥140 g/L及D-二聚体≥0.4 mg/L是肺癌病人发生肺栓塞的独立危险因素,本研究构建的列线图模型能够有效预测肺癌病人的肺栓塞发生风险.     

98例肝吸虫病危险因素分析

目的:探索肝吸虫感染的影响因素,为采取相应干预措施提供科学依据.方法:采用以医院为基础的病例对照研究方法,对确诊病例及选取的对照进行问卷调查.结果:肝吸虫病相关危险因素包括年龄40～50岁(OR=4.034,95％ CI 1.334～12.203);文化程度:文盲及小学(OR=10.294,95％ CI 2.866～ 36.973)、初中(OR=3.219,95％ CI 1.228～8.820);经常及偶尔生食或半生食淡水鱼(OR=20.774,95％ CI 5.992～ 72.025),(OR=14.714,95％ CI 5.564～38.908);经常食用生或半生淡水虾(OR=3.151,95％ CI 1.533～5.865);经常有过抓生鱼后不洗手就抓食物吃(OR=2.759,95％ CI 1.262～6.033).结论:影响肝吸虫感染的主要因素为不同年龄、不同文化程度、是否生食或半生食淡水鱼、是否生食或半生淡水虾、是否有过抓生鱼后不洗手就抓食物吃.     

非创伤脓毒症幸存康复病人急性应激障碍的危险因素分析

目的 探讨非创伤脓毒症幸存康复病人急性应激障碍(ASD)的危险因素.方法 选择2017年1月至2019年1月重庆市巴南区人民医院收治的非创伤脓毒症幸存康复病人512例,使用斯坦福急性应激反应问卷(SASRQ)对病人进行ASD评定,同时记录病人的临床资料及治疗情况,分析非创伤脓毒症病人ASD的危险因素.结果 根据SASRQ评估,符合DSM-Ⅳ诊断标准,本组病人中81例合并ASD,发生率为15.82％.ASD组病人序贯器官衰竭评估(SOFA)评分≥6分、急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分≥15分、急性呼吸窘迫综合征(ARDS)、急性肾损伤(AKI)、有创机械通气、血液净化、住ICU、院内感染、阿片类镇痛药及苯二氮?类镇静剂使用病人均高于非ASD病人,差异有统计学意义(χ2值分别为122.543、101.388、61.172、57.539、107.416、21.429、67.314、16.394、33.638、64.721,P<0.001).Logistic回归分析显示,APACHEⅡ评分 ≥15分(OR=5.432,95％CI:1.033～25.497)、SOFA评分 ≥6分(OR=7.479,95％CI:1.345～31.451)、有创机械通气(OR=19.173,95％CI6.302～51.183)、住ICU(OR=16.545,95％CI:2.739～41.258)是非创伤脓毒症病人ASD的独立危险因素.结论APACHEⅡ评分 ≥15分、SOFA评分 ≥6分、有创机械通气及入住ICU是非创伤性脓毒症病人急性应激障碍的独立危险因素.     

非致残性缺血性脑血管事件病人氯吡格雷抵抗的临床相关因素分析

目的 探讨非致残性缺血性脑血管事件(NICE)病人氯吡格雷抵抗的临床相关因素.方法 连续收集2019年1―10月徐州医科大学附属医院神经内科收治的165例非致残性缺血性脑血管事件病人,并且给予阿司匹林联合氯吡格雷治疗,7～10 d后采用血栓弹力图检测其血小板抑制率.将二磷酸腺苷(ADP)诱导的血小板聚抑制率≤30％定义为氯吡格雷抵抗(CR).比较人口统计学、血管危险因素、实验室检查等临床资料,采用logistic多因素回归分析氯吡格雷抵抗的相关因素.结果 NICE病人,34例(20.6％)发生氯吡格雷抵抗.logistic模型分析显示,hs-CRP(OR1.143,95％CI:1.024～1.276;P=0.017)、PLR(OR1.014,95％CI:1.005～1.022;P=0.002)、Hcy(OR1.12795％CI:1.046～1.215;P=0.002)是氯吡格雷抵抗的独立相关因素.结论 hs-CRP、PLR、Hcy是非致残性缺血性脑血管事件病人氯吡格雷抵抗的独立相关因素.     

过敏性紫癜临床特征及其肾损害危险因素分析

目的 分析过敏性紫癜(Henoch schonlein purpura,HSP)患者临床特征及其肾损害的致病危险因素.方法 选择2005年1月至2013年12月在我院治疗并定期随访的187例HSP患者作为观察对象,根据病理资料分为肾损害(Renal impairment group,RIG)组和尿检正常(None renal impairment group,NRIG)组,对其病理资料进行回顾性分析.结果 IgA(OR=1.945,95％CI:1.015～3.764)、IgG(OR=1.182,95％ CI:1.023～1.354)、PDF(OR=1.068,95％ CI:1.004～10.63)、PLT(OR=1.005,95％CI:1.001～1.012)、WBC(OR=1.135,95％CI:1.035～1.246)和年龄(OR=1.025,95％CI:1.025～1.436)是HSP患者肾损害发生的危险因素.结论 血清IgA和IgG升高,PDF、PLT和WBC值超标,年龄偏大均为HSP患者肾损害的危险因素,对于有上述症状的HSP患者应及时进行干预和治疗,避免肾损害的发生.     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.     

Synthesis and anti-nociceptive and anti-inflammatory effects of gaultherin and its analogs

The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.     

Antiinfective and encrustation-inhibiting materials--myth and facts

Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.     

成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

Self-stimulation and amphetamine: Tolerance to d and l isomers and cross tolerance to cocaine and methylphenidate

The effects of the d and l isomers of amphetamine on self-stimulation responding were tested following acute and chronic administration. Tolerance and post-drug depression of responding occurred in tests with both isomers, indicating no role for p-hydroxynorephedrine (PHN) which is one of the metabolites of d-amphetamine. In the second experiment, d-amphetamine, methylphenidate and cocaine all produced quantitatively and qualitatively similar effects on self-stimulation responding following acute administration. Following chronic administration of d-amphetamine, animals showed tolerance to all three drugs, indicating cross-tolerance among them. These data are consistent with an hypothesis that tolerance and post-drug depression following chronic amphetamine treatment are the result of decreases in postsynaptic receptor sensitivity, which would lead to a decreased effectiveness of all three drugs, regardless of their pre-synaptic mechanisms.     

益生菌与肿瘤防治

益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.     

Interaction of estrone and estradiol with DNA and protein of liver and kidney in rat and hamster in vivo and in vitro

[6,7-³H] Estrone (E) and [6,7-³H]estradiol-17 (E₂) have been synthesized by reduction of 6-dehydroestrone and 6-dehydroestradiol with tritium gas. Tritiated E and E₂ were administered by oral gavage to female rats and to male and female hamsters on a dose level of about 300 g/kg (54 mCi/kg). After 8 h, the liver was excised from the rats; liver and kidneys were taken from the hamsters. DNA was purified either directly from an organ homogenate or via chromatin. The radioactivity in the DNA was expressed in the units of the Covalent Binding Index, CBI = (mol chemical bound per mol DNA-P)/(mmol chemical administered per kg b.w.). Rat liver DNA isolated via chromatin exhibited the very low values of 0.08 and 0.09 for E and E₂, respectively. The respective figures in hamster liver were 0.08 and 0.11 in females and 0.21 and 0.18 in the males. DNA isolated from the kidney revealed a detectable radioactivity only in the female, with values of 0.03 and 0.05 for E and E₂, respectively. The values for male hamster kidney were < 0.01 for both hormones. The minute radioactivity detectable in the DNA samples does not represent covalent binding to DNA, however, as indicated by two sets of control experiments. (A) Analysis by HPLC of the nucleosides prepared by enzyme digest of liver DNA isolated directly or via chromatin did not reveal any consistent peak which could have been attributed to a nucleoside-steroid adduct. (B) All DNA radioactivity could be due to protein contaminations, because the specific activity of chromatin protein was determined to be more than 3,000 times higher than of DNA. The high affinity of the hormone to protein was also demonstrated by in vitro incubations, where it could be shown that the specific activity of DNA and protein was essentially proportional to the concentration of radiolabelled hormone in the organ homogenate, regardless of whether the animal was treated or whether the hormone was added in vitro to the homogenate.Carcinogens acting by covalent DNA binding can be classified according to potency on the basis of the Covalent Binding Index. Values of 10³–10⁴ have been found for potent, 10² for moderate, and 1–10 for weak carcinogens. Since estrone is moderately carcinogenic for the kidney of the male hamster, a CBI of about 100 would be expected. The actually measured limit of detection of 0.01 places covalent DNA binding among the highly unlikely mechanisms of action. Similar considerations can be made for the liver where any true covalent DNA binding must be below a level of 0.01. It is concluded that an observable tumor induction by estrone or estradiol is unlikely to be due to DNA binding.Paper presented at the Satellite Symposium of the European Society of Toxicology, Rome, March 29, 1983     

Isolation and characterization of glycosylated and non-glycosylated prolactins from alligator and crocodile

Two molecular forms of prolactin (PRL). glycosylated and non-glycosylated, were isolated from pituitary glands of two reptiles, alligator and crocodile. The reptilian PRLs were extracted under alkaline conditions from the precipitate obtained after pituitaries were first extracted with 0.25 m sucrose, 1 mM NH₄HCO₃, pH 6.3. Purification was performed by ion exchange chromatography on DE-52, gel filtration on Sephadex G-75 superfine, and reversed phase high performance liquid chromatography. Two forms of both alligator and crocodile PRL, designated PRLI and PRLII, with molecular weights of 26000 and 24000 were isolated. Alligator and crocodile PRLI and PRLII were stained specifically in immunoblots with anti-sea turtle PRL and anti-ostrich PRL. Sequence analysis revealed that both forms of alligator and crocodile PRLs consisted of 199 amino acid residues with a glycosylation consensus sequence (Asn-Ala-Ser) at position 60 in alligator and crocodile PRLs with a molecular weight of 26000 (PRLI). In contrast, Thr was substituted for Asn at position 60 in the PRLs with a molecular weight of 24000 (PRLII). The sequences of alligator PRLs differed from crocodile PRLs only in position 134: Val for alligator PRLs and He for crocodile PRLs. There is a high degree of structural conservation between the reptilian PRLs isolated in this study and avian PRL; each showed 92% sequence identity with chicken PRL and 89% with turkey PRL.