碳纤维头超声洁治术治疗种植体周围炎的效果评估

目的:分析碳纤维头超声洁治术对种植体周围炎的治疗效果。方法:选取医院收治的30例牙周炎患者,采用随机数表法将其分为对照组和观察组,每组15例,对照组通过生理盐水漱口方式清洗种植体,观察组采用碳纤维头超声洁治术对种植体进行洁治。两组连续治疗2个疗程后,比较种植体周围组织的牙周改良菌斑指数(mPLI)、牙龈指数(GI)、临床附着水平(CAL)、龈沟出血指数(SBI)、探诊深度(PD)以及种植体龈沟液中白细胞介素1α和1β(IL-1α,IL-1β)的水平变化。结果:治疗后观察组中mPLI、GI、CAL、SBI及PD分别为(1.89±0.29)、(1.53±0.41)、(1.07±0.11)、(2.13±0.61)和(3.03±0.11),显著低于对照组的(2.95±0.38)、(2.47±0.39)、(2.87±0.71)、(3.51±0.68)和(3.79±0.12),差异有统计学意义(t=2.76,t=2.76,t=3.04,t=2.76,t=2.36;P<0.05);治疗后观察组患者龈沟液中IL-1α和IL-1β浓度水平分别为(16.81±1.39)ng/ml和(15.11±1.89)ng/ml,显著低于对照组的(27.05±1.54)ng/ml和(27.41±1.59)ng/ml,差异有统计学意义(t=2.76,t=3.04;P<0.05)。结论:碳纤维头超声洁治术对种植体周围炎可起到良好的抑制作用,明显改善炎症症状,是种植体周围炎的有效辅助治疗手段。     

Evaluation of clonal herbs of Lamiaceae species for management of diabetes and hypertension

In the current study, we screened 7 clonal lines from single seed phenotypes of Lamiaceae family for the inhibition of alpha-amylase, alpha-glucosidase and angiotensin converting enzyme (ACE) inhibitory activity. Water extracts of oregano had the highest alpha-glucosidase inhibition activity (93.7%), followed by chocolate mint (85.9%) and lemon balm (83.9%). Sage (78.4 %), and three different clonal lines of rosemary: rosemary LA (71.4%), rosemary 6 (68.4%) and rosemary K-2 (67.8%) also showed significant alpha-glucosidase inhibitory activity. The alpha-glucosidase inhibitory activity of the extracts was compared to selected specific phenolics detected in the extracts using HPLC. Catechin had the highest alpha-glucosidase inhibitiory activity (99.6 %) followed by caffeic acid (91.3 %), rosmarinic acid (85.1%) and resveratrol (71.1 %). Catechol (64.4%), protocatechuic acid (55.7%) and quercetin (36.9%) also exhibited significant alpha-glucosidase inhibitory activity. Results suggested that alpha-glucosidase inhibitory activity of the clonal extracts correlated to the phenolic content, antioxidant activity and phenolic profile of the extracts. The clonal extracts of the herbs and standard phenolics tested in this study did not have any effect on the alpha-amylase activity. We also investigated the ability of the clonal extracts to inhibit rabbit lung angiotensin I-converting enzyme (ACE). The water extracts of rosemary, rosemary LA had the highest ACE inhibitory activity (90.5%), followed by lemon balm (81.9%) and oregano (37.4 %). Lower levels of ACE inhibition were observed with ethanol extracts of oregano (18.5 %) and lemon balm (0.5 %). Among the standard phenolics only resveratrol (24.1 %), hydroxybenzoic acid (19.3 %) and coumaric acid (2.3 %) had ACE inhibitory activity.     

861株多药耐药菌耐药表型回顾性分析

目的 了解医院多药耐药菌(MDROs)的分布及流行情况.方法 收集医院2006年1月-2010年12月住院患者各类标本中分离出的非重复菌株资料,以WHONET5.4软件进行数据分析.结果 23 405份标本中检出病原菌6779株,检出阳性率为29.0％,其中革兰阳性菌704株占10.4％、革兰阴性菌4480株占66.1％、真菌1750株占25.8％;检出MDROs 861株,占12.7％,其中,产ESBLs细菌307株、耐碳青霉烯类肠杆菌科细菌(CRE)18株、耐甲氧西林凝固酶阴性葡萄球菌(MRCNS) 137株、耐甲氧西林金黄色葡萄球菌(MRSA) 127株、耐碳青霉烯类鲍氏不动杆菌(CRAB) 103株、多药耐药铜绿假单胞菌(MDRPA) 72株、泛耐药铜绿假单胞菌(PDRPA)19株及耐万古霉素肠球菌(VRE)2株;主要来源于下呼吸道457株占53.1％、尿液152株占17.7％、脓性分 泌物150株占17.4％、血液56株占6.5％,MDROs在ICU检出率最高占21.7％,其次为脑外科占10.7％、呼吸科占9.1％、肿瘤科占8.9％.结论 MDROs耐药表型中以产ESBLs细菌、MRCNS、MRSA为主;MDROs在下呼吸道、尿液、脓性分泌物标本中检出率较高,在ICU、脑外科、呼吸科、肿瘤科,MDROs流行情况严重.     

Trends of the internal phthalate exposure of young adults in Germany--follow-up of a retrospective human biomonitoring study

The exposure of the general population to phthalates is of increasing public health concern. Variations in the internal exposure of the population are likely, because the amounts, distribution and application characters of the phthalate use change over time. Estimating the chronological sequences of the phthalate exposure, we performed a retrospective human biomonitoring study by investigating the metabolites of the five most prominent phthalates in urine. Therefore, 24 h-urine samples from the German Environmental Specimen Bank (ESB) collected from 240 subjects (predominantly students, age range 19–29 years, 120 females, 120 males) in the years 2002, 2004, 2006 and 2008 (60 individuals each), were analysed for the concentrations of mono-n-butyl phthalate (MnBP) as metabolite of di-n-butyl phthalate (DnBP), mono-iso-butyl phthalate (MiBP) as metabolite of di-iso-butyl phthalate (DiBP), mono-benzyl phthalate (MBzP) as metabolite of butylbenzyl phthalate (BBzP), mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP), mono-(2-ethyl-5-oxohexyl) phthalate (5oxo-MEHP), mono-(2-ethyl-5-carboxypentyl) phthalate (5cx-MEPP) and mono-(2-carboxymethyl hexyl) phthalate (2cx-MMHxP) as metabolites of di(2-ethylhexyl) phthalate (DEHP), monohydroxylated (OH-MiNP), monooxidated (oxo-MiNP) and monocarboxylated (cx-MiNP) mono-iso-nonylphthalates as metabolites of di-iso-nonyl phthalates (DiNP). Based on the urinary metabolite excretion, together with results of a previous study, which covered the years 1988–2003, we investigated the chronological sequences of the phthalate exposure over two decades. In more than 98% of the urine samples metabolites of all five phthalates were detectable indicating a ubiquitous exposure of people living in Germany to all five phthalates throughout the period investigated. The medians in samples from the different years investigated are 65.4 (2002), 38.5 (2004), 29.3 (2006) and 19.6 μg/l (2008) for MnBP, 31.4 (2002), 25.4 (2004), 31.8 (2006) and 25.5 μg/l (2008) for MiBP, 7.8 (2002), 6.3 (2004), 3.6 (2006) and 3.8 μg/l (2008) for MBzP, 7.0 (2002), 5.6 (2004), 4.1 (2006) and 3.3 μg/l (2008) for MEHP, 19.6 (2002), 16.2 (2004), 13.2 (2006) and 9.6 μg/l (2008) for 5OH-MEHP, 13.9 (2002), 11.8 (2004), 8.3 (2006) and 6.4 μg/l (2008) for 5oxo-MEHP, 18.7 (2002), 16.5 (2004), 13.8 (2006) and 10.2 μg/l (2008) for 5cx-MEPP, 7.2 (2002), 6.5 (2004), 5.1 (2006) and 4.6 μg/l (2008) for 2cx-MMHxP, 3.3 (2002), 2.8 (2004), 3.5 (2006) and 3.6 μg/l (2008) for OH-MiNP, 2.1 (2002), 2.1 (2004), 2.2 (2006) and 2.3 μg/l (2008) for oxo-MiNP and 4.1 (2002), 3.2 (2004), 4.1 (2006) and 3.6 μg/l (2008) for cx-MiNP. The investigation of the time series 1988–2008 indicates a decrease of the internal exposure to DnBP by the factor of 7–8 and to DEHP and BzBP by the factor of 2–3. In contrast, an increase of the internal exposure by the factor of 4 was observed for DiNP over the study period. The exposure to DiBP was found to be stable. In summary, we found decreases of the internal human exposure for legally restricted phthalates whereas the exposure to their substitutes increased. Future investigations should verify these trends. This is of increasing importance since the European Commission decided to require ban or authorization from 1.1.2015 for DEHP, DnBP, DiBP and BzBP according to REACh Annex XIV.     

肝硬化腹水治疗中实施医护同组责任制的效果观察

目的 分析医护同组责任制护理对肝硬化腹水患者肝功能及生活质量的影响。方法 选取2019年7月—2021年1月本院肝硬化腹水患者92例,按随机数字表法分为研究组(n=46)和对照组(n=46),对照组采用常规护理,研究组在对照组基础上采用医护同组责任制护理。对比2组遵医行为(合理饮食、戒烟戒酒、遵医嘱用药、合理运动、定期复查)、干预前后肝功能[丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)]及生活质量(生理功能、心理功能)。结果 研究组合理饮食率为95.65%(44/46)、戒烟戒酒率为91.30%(42/46)、遵医嘱用药率为95.65%(44/46)、合理运动率为91.30%(42/46)、定期复查率为100.00%(46/46),分别高于对照组的73.91%(34/46)、69.57%(32/46)、76.09%(35/46)、63.04%(29/46)、71.74%(33/46)(P均<0.05);干预后,研究组ALT为(30.68±4.13)U/L 、AST为(33.72±4.03)U/L,分别低于对照组的(46.26±4.59)U/L、(52.08±4.46)U/L(t=17.114,20.716,P<0.001);干预后,研究组生理功能评分为(19.56±1.78)分、心理功能评分为(19.23±1.68)分,高于较对照组的(15.56±1.39)分、(15.74±1.42)分(t=12.013、10.761,P均<0.001)。结论 医护同组责任制护理应用于肝硬化腹水患者,可提高遵医行为,改善肝功能,提高生活质量。     

109例不孕妇女血清抗透明带抗体检测结果分析

目的:探讨抗透明带抗体(AzpAb)在不孕症中的作用。方法:用ELISA间接法测定109例不孕妇女(包括原发和继发不孕)血清的AzpAb,47例早孕妇女做对照。结果:109例不孕妇女中AzpAb阳性者21例,阳性率为19.3%;47例对照组阳性1例,阳性率为2.1%,差异有统计学意义(P<0.01)。23～30岁组77例中AzpAb阳性者14例,阳性率18.2%;31～42岁组32例中AzpAb阳性者7例,阳性率21.9%。原发不孕组48例中AzpAb阳性者10例,阳性率20.8%;继发不孕组61例中AzpAb阳性者11例,阳性率18%。差异无统计学意义(P>0.05)。结论:Az-pAb可以导致原发或继发不孕,且与年龄无关。     

本科助产专业人才培养目标及课程体系设置调查

目的 探讨符合我国社会需求的本科助产人才培养目标及课程体系设置。方法 通过文献回顾法和专题小组讨论法自行设计问卷,利用问卷调查法对校园招聘现场147名对象进行调查,结果采用SPSS 22.0统计软件进行分析。结果 本科助产专业人才培养目标调查结果较好;课程体系设置中被调查对象认为有必要开设的课程中,公共基础类课程排前5位的依次是卫生法学(14.6%)、法律(11.7%)、大学英语(11.5%)、计算机基础(9.1%)、社会学(9.0%),医学基础类课程排前5位的是人体解剖学(15.0%)、生理学(13.6%)、组织胚胎学(12.3%)、病理学(12.2%)、医学遗传学(9.3%),专业类课程排前5位的是高级助产学(10.4%)、妇产科护理学(10.1%)、妇幼保健学(9.0%)、儿科护理学(8.5%)、急救护理学(8.2%),人文社会科学类课程排前3位的是护士人文修养(21.0%)、护理心理学(20.6%)、护理伦理学(14.2%),实习的科室依次是产房(23.2%)、妇产科(22.3%)、儿科(20.9%)、其他科室(13.8%)、内科(12.1%)、外科(7.7%)。结论 本科助产专业人才培养目标需要进一步完善,以求更符合我国实际;本科助产专业课程体系设置调查符合助产专业特点,可为开设本科助产专业提供课程设置依据。     

The influence of COPD on health-related quality of life independent of the influence of comorbidity

BACKGROUND/OBJECTIVES: The goal of this study was to determine the influence of chronic obstructive pulmonary disease (COPD) on health-related quality of life (HRQL) independent of comorbidity. METHODS: Patients with COPD in general practice, >/=40 years, were selected. To recruit controls, a random sample of persons without COPD and >/=40 years, was taken. HRQL was assessed with the SF-36 and comorbidity was determined by questionnaire. RESULTS: The influence of COPD on HRQL independent of comorbidity (represented by adjusted regression coefficients) was significant for physical functioning (-27.6), role functioning due to physical problems (-21.6), vitality (-14.4), and general health (-25.7), and was minor and not significant for social functioning (-5.6), mental health (-1.3), role functioning due to emotional problems (-2.7), and bodily pain (-2.5). Comorbidity contributed significantly to the HRQL of all domains (-7.6 to -27.1). CONCLUSIONS: COPD patients can be impaired in all domains of HRQL. However, impairments in physical functioning, vitality, and general health are related to COPD and to some extent to comorbidity, while impairments in social and emotional functioning do not seem to be related to COPD, but only to comorbidity.     

银杏叶提取物抗动脉粥样硬化的实验研究

目的 探讨银杏叶提取物(effects of Extract of Ginkgo Biloba EGB)是否通过诱导血红素氧合酶-1 (HO-1)表达发挥抗动脉样硬化(atherosclerosis AS)作用.方法 选用雄性Wistar大鼠40只,随机均分为A、B、C、D、E5组,A组给普通饲料喂养,其余各组均给高脂饲料喂养,C组、D组、E组分别给予腹腔注射EGB 30 mg/kg、锌原卟啉(ZnPPⅨ) 7.5 mg/kg、EGB 30 mg/kg+ ZnPPⅨ7.5 mg/kg,每两天1次,A组及B组则同法注射等量生理盐水.12周后检测主动脉HO-1蛋白表达量、HO-1蛋白活力及AS病变程度.结果 与A组相比,B组及C组HO-1蛋白表达量及活力均明显升高,C组升高尤为显著,D组及E组HO-1蛋白表达量及活力则显著降低.与B组比较,C组AS程度明显减轻,而D组及E组AS程度则显著加重.结论 EGB主要通过诱导HO-1表达发挥显著的抗AS作用.     

Unmanned assessment of respirator carbon dioxide levels: comparison of methods of measurement

A study was performed to determine average inhaled carbon dioxide (F(I)CO2) concentrations of multiple respirators using unmanned test methods, and to compare results among test procedures to determine whether they could be used interchangeably. Respirator experiments were performed according to the National Institute for Occupational Safety and Health (NIOSH) (NF(I)CO2), standard European (ENF(I)CO2), and a modified method of the European test (BF(I)CO2) using full-facepiece air-purifying respirators and one air-purifying escape respirator. Bland-Altman statistics for determination of limits of agreement were applied to assess agreement among the various test methods. A considerable lack of agreement was found between NF(I)CO2 and ENF(I)CO2 methods and between BF(I)CO2 and NF(I)CO2 methods for average F(I)CO2. The modified EN136 method produced F(I)CO2 averages about 0.13% to 0.23% above unmodified EN136 values, but the agreement between methods was generally acceptable. These results demonstrate that NIOSH and European unmanned test methods for determining respirator average F(I)CO2 concentrations produce different results for like respirators. However, the findings suggest that the ENF(I)CO2 and BF(I)CO2 unmanned methods could be used interchangeably for quantifying respirator F(I)CO2 concentrations.     

某部军人家庭健康相关行为调查分析

目的了解某部军人家庭健康相关行为的现状。方法于2016年3月采用问卷调查的形式对某部驻地军人家庭共计572户进行调查,内容包括家庭概况、家庭生活习惯以及家庭健康开支等。结果大多数家庭成员未全面了解家庭成员的健康状况(67.31%,385/572)和家族中是否存在心血管早发疾病、恶性肿瘤等遗传性疾病(69.93%,400/572);家庭成员中经常患的疾病,排在前3位是呼吸系统疾病(37.94%,217/572)、运动系统疾病(36.36%,208/572)、消化系统疾病(33.04%,189/572),获取健康知识主要是通过网络(73.95%,423/572);家庭中存在诸多危害健康的行为,如有部分家庭经常发生不愉快的争吵(1.05%,6/572)、不吃早餐(12.94%,74/572)、经常食用隔夜菜(17.83%,102/572)、饮食口味偏重(50.00%,286/572)、缺乏体育锻炼(20.10%,115/572)、吸烟(58.04%,332/572)及酗酒(54.54%,312/572);大多数家庭完全没有健康档案(69.58%,398/572),35.84%(205/572)的家庭成员从不体检或偶尔体检,在家庭健康开支方面,86.19%(493/572)的家庭去年健康投资占家庭总支出的15%以下,家庭健康投资项目排在前3位的是健康体检(55.77%,319/572)、运动健身(51.05%,292/572)、购买健康保险(37.24%,213/572)。结论某部许多军人家庭对健康重视不够,在日常生活行为方面存在健康隐患,部队卫生部门应加强健康教育,指导矫正不良的行为习惯。     

109例子宫瘢痕妊娠诊治分析

目的探讨不同治疗方案在子宫下段剖宫产后切口瘢痕处妊娠(cesarean scar pregnancy,CSP)的价值。方法回顾性分析2011年2月至2015年6月南京医科大学附属南京市妇幼保健院收治的109例CSP患者的临床资料,按治疗方案不同分为A、B、C 3组。A组采用子宫动脉甲氨蝶呤(Methotrexate,MTX)灌注+子宫动脉栓塞(uterine artery embolization,UAE)治疗(22例);B组采用子宫动脉MTX灌注+UAE联合清宫术(62例);C组采用米非司酮配伍米索前列醇药物流产联合清宫术(25例)。比较3组患者治疗情况。结果 B组患者治疗前后血清β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-HCG)下降率(84.63%)和成功率(98.39%)最高,与A组(55.02%、94.45%)、C组(57.91%、80.00%)比较,差异有统计学意义(P0.05);B组刮宫术中出血量(27.74 m L)低于C组(110.40 m L)(P0.05);但B组的住院费用和住院时间(11 901.37元、10.18 d)均高于C组(4 545.81元、5.32 d)(P0.05)。介入术后7 d内刮宫术中出血量(16.46 m L)少于7 d后刮宫术中出血量(49.76m L)(P0.05)。结论经子宫动脉化疗栓塞后7 d内联合清宫术治疗瘢痕妊娠治疗成功率最高,综合效果最佳。     

Effects of environmental and organizational factors on the health of shiftworkers of a printing company

This study explored the effects of environmental and organizational stressors on the health of shiftworkers in a printing company (n = 124). A questionnaire was used to gather data on work history, organizational factors, psychosocial characteristics, medical history, present health, occupational and non-occupational exposures, and lifestyle factors. The perception of environmental and organizational conditions was associated (P < 0.05) with chronic back pain (odds ratio [OR], 1.29), varicose veins (OR, 1.35), allergic rhinitis (OR, 1.27), depression (OR, 1.45), and gastritis (OR, 1.15). Anxiety scores were associated with allergic rhinitis (OR, 1.14) and skin allergy (OR, 1.09). Shiftwork was a significantly risk factor for conjunctivitis (OR, 3.68), depression (OR, 0.23), cardiac arrhythmia (OR, 7.13), and gastritis (OR, 4.38). Other associations included tenure and chronic back pain (OR, 4.89), toluene exposure and skin allergy (OR, 3.76), worksite and conjunctivitis (OR, 7.0), and worksite and dermatitis (OR, 1.24 to 4.95). The number of hours of exercise per week was associated with varicose veins (OR, 4.33), and alcohol intake was associated with cardiac arrhythmia (OR, 6.74).     

35例类鼻疽病例临床特点分析

目的分析类鼻疽的临床特点,并探讨其诊断及治疗的方法。方法回顾性分析某院2012年3月—2017年2月收治的有明确病原学依据的35例类鼻疽患者。结果 35例类鼻疽患者在入院时2例(5.7%)因有外院培养结果而确诊,3例(8.6%)高度疑似患者主要有相对典型的临床特点,误诊30例(85.7%),疑似患者入院后均经各种标本培养检出类鼻疽伯克霍尔德菌确诊;采用抗感染、外科穿刺引流(11.4%)及手术(20.0%)治疗,病情好转或痊愈26例(74.3%),放弃治疗2例(5.7%),死亡7例(20.0%)。临床首发症状以发热(88.6%)最常见,其次为咳嗽(34.3%)、气促(28.6%)、腹痛(14.6%)、上下肢痛(11.4%)、关节痛(5.7%);感染部位居前五位的分别为血液(85.7%)、肺(54.3%)、脾(20.0%)、皮肤软组织(20.0%)、肝(14.3%);以血培养出类鼻疽伯克霍尔德菌最为常见,占85.7%,其次为各种穿刺液(37.1%)、痰(20.0%)。结论类鼻疽的临床特点复杂多样,误诊率高,早期确诊和及时、合理、足疗程的治疗可降低病死率和复发率。     

276例急性上消化道大量出血病因分析

目的:分析急性上消化道大量出血的病因及急诊诊断方法,以提高其急诊诊断水平.方法:回顾近十年来收治急性上消化道大量出血患者276例资料,分析急诊诊断方法及结果,并将入院诊断与最后诊断对比.结果:48小时内参与B超检查阳性率50.61%(83/164),胃镜检查阳性率95.24%(100/105),血管造影100%(5/5).入院诊断消化性溃疡、食管胃底静脉曲张破裂、肿瘤、出血性胃炎、贲门黏膜撕裂、血管畸形和Dieulafoy病构成比分别为38.77%、45.65%、8.70%、6.52%、0.36%、0,而最后诊断分别为35.14%、34.78%、21.74%、2.54%、1.45%、4.35%;诊断符合率分别为73.20%、86.46%、20.00%、71.43%、25.00%、0,其中最高是食管胃底静脉曲张破裂,最低是血管畸形和Dieulafoy病.结论:单凭病史作出急性上消化道大量出血的病因诊断可能存在一定误差,非创伤性B超检查有助于病因诊断,急诊胃镜及血管造影检查能作出病因诊断.     

Assessment of safety of frozen foods

This study aimed to assess the microbiological quality of 90 frozen food samples (50 samples of raw frozen vegetables including molokeya, okra, green peas, peas + carrot, and artichoke, 20 of frozen poultry products and 20 of frozen meat products), and to assess the level of women practice during handling. A cross-sectional study was conducted. Results showed that the mean aerobic mesophilic plate count of frozen vegetables was 3.4 x 10(5) +/- 7.3 x 10(5) cfu/g. The mean mold and yeast count was 3.9 x 10(3) +/- 1.1 x 10(4) cfu/g. The mean coliform count was 3.9 x 10 +/- 6.6 x 10 m.o./g. In case of meat product, the mean aerobic count was 2.3 x 10(5) +/- 3.2 x 10(5), that of mold and yeast was 2.5 x 10(5) +/- 8.8 x 10(5) cfu/g and that of coliform was 3.2 x 10(2) +/- 3.8 x 10(2) m.o./g. Poultry products on the other hand had a mean aerobic count of 6.8 x 10(5) +/- 1.6 x 10(6), a mean mold and yeast count of 3.5 x 10(5) +/- 7.4 x 10(5) cfu/g and a mean coliform count of 6.4 x 10(2) +/- 5.2 x 10(2) m.o./g. Fecal coliforms were detected only in 60.0% of meat product samples and in 45.0% of poultry product samples. On the other hand Staph aureus was detected only in 10.0% of poultry product samples. Difference between the 5 types of vegetables was statistically significant (P = 0.00, and 0.02, respectively) for total plate and mold and yeasts counts. Among the 113 interviewed women, 80 used frozen food products. Twenty six of them (32.5%) had scores < 50%, those were classified as being bad as they were handling frozen food improperly which would contribute to outbreaks of food borne diseases. Less than 4% of the users used satisfactory practice during handling frozen foods. Illiteracy affected significantly the level of practice.     

白血病抑制因子对异位妊娠早期诊断的价值评估

目的:检测血清中白血病抑制因子(Leukemia inhibitory factor,LIF)、LIFR、IL-1α、TNF-α水平,评估其对早期异位妊娠的诊断价值。方法:选取异位妊娠患者60例作为观察组;正常宫内妊娠20例作为对照组。采用ELISA法测血清LTF、LIFR、IL-1α、TNF-α水平。结果:①血清LIF水平在异位妊娠组及正常早孕组分别为(5·26±0·51)pg/ml及(5·88±0·26)pg/ml;血清LIFR水平在异位妊娠组及正常早孕组分别为(3·82±1·6)pg/ml及(2·95±1·70)pg/ml。异位妊娠组与正常早孕组血清LIF及LIFR水平分别比较,差异均有统计学意义(P<0·01)。异位妊娠组血LIF较正常早孕组低,而LIFR则较正常早孕高。②血清TNF-α水平在异位妊娠组及正常早孕组分别为(66·71±9·31)pg/ml及(54·4±8·36)pg/ml;血清IL-1α水平在异位妊娠组及正常早孕组分别为(0·29±0·20)pg/ml及(0·28±0·13)pg/ml。异位妊娠组与正常早孕组血清TNF-α及IL-1α水平分别比较,差异均有统计学意义(P<0·01)。异位妊娠组血TNF-α、IL-1α较正常早孕组高。结论:检测血清LIF水平有助于鉴别异常宫内妊娠与异位妊娠;联合检测LIF、LIFR、TNF-α、IL-1α可作为临床早期诊断异位妊娠高效、有力、敏感的指标。     

放置宫内节育器妇女术前焦虑因素及对策分析

目的 探讨放置宫内节育器妇女术前的焦虑因素.方法 对收集要求放置宫内节育器妇女1 072例进行问卷调查分析.结果 99.36%的妇女有焦虑情绪及焦虑因素.避孕失败为所有组别最为担心的问题,大专及以上文化程度妇女对是否影响性生活的焦虑程度不同,分别占16.2%,3.1%,差异有显著性(P＜0.05).已婚妇女术前对疼痛的焦虑程度高于未婚组,分别为47.4%,20.7%,差异有显著性(P＜0.05).已生育妇女术前对取器困难的焦虑程度高于未生育组,分别为20.7%和6.7%,差异有显著性(P＜0.05).未生育妇女对取器后是否影响生育的焦虑程度更高,分别为10.2%和0.2%,差异有显著性(P＜0.05).结论 对不同文化程度、婚姻状态、生育状态的妇女置器前知情选择服务的侧重内容不同.     

CoMFA analysis of the human beta(1)-adrenoceptor binding affinity of a series of phenoxypropanolamines

A series of 36 phenoxypropanolamines was examined to determine the structure--activity relationships of beta-adrenoceptor (beta-AR) antagonists for the human beta(1)-AR. The binding affinities of all the compounds were determined for human beta(1)-ARs expressed in Chinese hamster ovary cells and the antagonist potency for rat atrial beta(1)-ARs was determined for 32 of these compounds for comparative purposes. The compounds, based upon a phenoxypropanolamine core structure with various meta-, ortho-, para- and amine-substituents, displayed binding affinities (pK(i)) for the human beta(1)-AR ranging from 5.49 to 9.35. Antagonist potencies (pA(2)) in the rat ranged from 5.52 to 9.56 and correlated with the human binding affinities (r(2)=0.86). Twenty-six compounds were used as the training set for comparative molecular field analysis (CoMFA) of antagonist binding affinity at the human beta(1)-AR and also of antagonist potency for rat atrial beta(1)-ARs. The CoMFA models were derived using both the CoMFA electrostatic and steric field parameters. The initial human beta(1)-AR model (n=26, q(2)=0.59, ONC=6, SE(CV)=0.70, r(2)=0.98, SE(non-CV)=0.16, F(6,19)=148) predicted the binding affinities of seven out of ten test compounds, not included in the training set, with residual pK(i) values less-than-or-equal0.50. The final human beta(1)-AR model (n=36, q(2)=0.66, ONC=5, SE(CV)=0.61, r(2)=0.95, SE(non-CV)=0.24, F(5,30)=107), consisting of the training set plus the test set of compounds, may prove useful in the design of new phenoxypropanolamine type beta(1)-AR antagonists. The initial rat beta(1)-AR model (n=26, q(2)=0.42, ONC=6, SE(CV)=0.76, r(2)=0.94, SE(non-CV)=0.25, F(6,19)=47) predicted the affinities of five out of six test compounds with residual pA(2) values less-than-or-equal0.50. The final rat beta(1)-AR model (i.e. training set plus test set of compounds) (n=32, q(2)=0.38, ONC=5, SE(CV)=0.69, r(2)=0.93, SE(non-CV)=0.24, F(5,26)=67) in particular has a low q(2) value, indicating that, at least for the rat, the biologically active phenoxypropanolamine conformation may be quite different to the low energy extended conformation chosen for this CoMFA study.