阿尔茨海默病与叶酸还原酶基因的关联研究

目的　探讨中国人群中阿尔茨海默病 (AD)的发生与 5 ,10 亚甲基四氢叶酸还原酶(methylenetetrahydrofolatereductase ,MTHFR)基因C6 77T错义突变的关系。方法　利用聚合酶链反应 -限制性片段长度多态性 (PCR RFLP)技术 ,检测 75例AD患者和 72例健康老人的MTHFR基因C6 77T位变异 ,并加以对照分析。结果　AD患者MTHFR/C6 77T错义突变的基因频率与健康老人之间无明显差异(基因型P >0 .0 5 ;等位基因P >0 .0 5 ) ,性别分组后亦未见有显著性差异存在。进一步以是否携有等位基因APOE 4分组 ,也未能发现AD患者的APOE 4携带者与MTHFR基因之间的相关性。结论　本研究未能发现MTHFR/C6 77T突变在阿尔茨海默病的发病中的作用。     

精神分裂症吸烟状况对免疫功能的影响

目的初步探讨吸烟对精神分裂症患者细胞因子及体液免疫的影响。方法把符合ICD-10关于精神分裂症诊断标准的精神分裂症患者分为吸烟组(均为男性)30例和非吸烟组43例,并以健康对照组比较,对患者组、健康组用酶联免疫吸附法(ELISA)测定血清IL-12、TNF-α水平;用透射比浊法测定IgA、IgM、IgG、C3、C4水平,患者组用阳性与阴性症状量表(PANSS)进行精神症状评定。结果精神分裂症患者的非吸烟组血清IL-12水平比吸烟组高,但未达到统计学上意义,其他的六个指标比较亦无显著差异。健康组非吸烟者的IL-12与IgG水平显著高于吸烟者(P<0.05)。吸烟的健康组与患者组相比,患者组C3、C4血清水平明显降低(P<0.01),IgG明显增高(P<0.01)。从性别比较,健康女性的IgG、IgM血清水平较男性高(P<0.05)。在患者组,女性较男性IgG、TNF-α的浓度明显增高(P<0.05)。结论吸烟、性别是影响精神分裂症患者免疫功能的重要因素之一,吸烟与精神分裂症共同作用于免疫系统,进一步加重其免疫功能紊乱。     

Predictive factors for developing acute cholangitis and/or cholecystitis in patients undergoing delayed cholecystectomy: A retrospective study

Background/Objective: We evaluated the risk of acute cholangitis and/or cholecystitis while waiting for cholecystectomy for gallstones.MethodsWe retrospectively enrolled 168 patients who underwent cholecystectomy for gallstones after conservative therapy. We compared clinical data of 20 patients who developed acute cholangitis and/or cholecystitis while waiting for cholecystectomy (group A) with 148 patients who did not develop (group B). We investigated surgical outcomes and risk factors for developing acute cholangitis and/or cholecystitis.ResultsPreoperatively, significant numbers of patients with previous history of acute grade II or III cholecystitis (55.0% vs 10.8%; p < 0.001) and biliary drainage (20.0% vs 2.0%; p = 0.004) were observed between groups A and B. White blood cell counts (13500/μL vs 8155/μL; p < 0.001) and C-reactive protein levels (12.6 vs 5.1 mg/dL; p < 0.001) were significantly higher in group A than in group B; albumin levels (3.2 vs 4.0 g/dL; p < 0.001) were significantly lower in group A. Gallbladder wall thickening (≥5 mm) (45.0% vs 18.9%; p = 0.018), incarcerated gallbladder neck stones (55.0% vs 22.3%; p = 0.005), and peri-gallbladder abscess (20.0% vs 1.4%; p = 0.002) were significantly more frequent in group A than in group B. A higher conversion rate to open surgery (20.0% vs 2.0%; p = 0.004), longer operation time (137 vs 102 min; p < 0.001), and higher incidence of intraoperative complications (10.0% vs 0%; p = 0.014) were observed in group A, compared with group B.ConclusionA history of severe cholecystitis may be a risk factor for acute cholangitis and/or cholecystitis in patients waiting for surgery; it may also contribute to increased surgical difficulty.     

Switch maintenance therapy with docetaxel and bevacizumab after induction therapy with cisplatin,pemetrexed, and bevacizumab in advanced non-squamous non-small cell lung cancer: a phase II study

Switch maintenance therapy, using alternative agents that were not administered during induction chemotherapy, is a treatment option for advanced non-squamous non-small cell lung cancer (NSCLC). Bevacizumab is known to increase the efficacy of other chemotherapeutic agents; however, switch maintenance therapy with docetaxel and bevacizumab has not been adequately studied. The goal of this study was to evaluate the efficacy and safety of switch maintenance therapy with docetaxel and bevacizumab following induction therapy with cisplatin, pemetrexed, and bevacizumab. Chemotherapy-naïve non-squamous NSCLC patients received induction therapy of four cycles of cisplatin (75 mg/m²), pemetrexed (500 mg/m²), and bevacizumab (15 mg/kg). Patients who achieved disease control after induction therapy then received maintenance therapy with docetaxel (50 mg/m²) and bevacizumab (15 mg/kg) until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival from enrollment. This study enrolled 49 NSCLC patients, among which 38 (77.6%) completed the four cycles of induction therapy and received maintenance therapy. The median progression-free survival from enrollment was 7.8 months (95% confidence interval: 4.7–11.0 months). The most common toxicities of grade 3 or higher were neutropenia (68.4%), leukopenia (50.0%), febrile neutropenia (31.8%), and hypertension. Switch maintenance therapy with docetaxel and bevacizumab following induction therapy with cisplatin, pemetrexed, and bevacizumab demonstrated modest efficacy and frequent hematologic toxicity in non-squamous NSCLC patients.     

Contraceptive Choice and Use of Dual Protection Among Women Living with HIV in Canada: Priorities for Integrated Care

CONTEXT

Preventing unintended pregnancy and HIV transmission is important for women with HIV, but little is known about their contraceptive use, particularly under current antiretroviral therapy (ART) recommendations for treatment and prevention.

METHODS

The prevalence of contraceptive use and of dual protection was examined among 453 sexually active women with HIV aged 16–49 and enrolled in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study in 2013–2015; multivariable logistic regression was used to identify correlates of use. Two definitions of dual protection were assessed: the World Health Organization (WHO) definition (consistent condom use alongside another effective method) and an expanded definition (consistent condom use or a suppressed HIV viral load alongside an effective method).

RESULTS

Overall, 73% of women used effective contraceptives, primarily male condoms (45%) or tubal ligation (19%). Eighteen percent practiced WHO‐defined dual protection, and 40% practiced dual protection according to the expanded definition. Characteristics positively associated with contraceptive use were younger age, having been pregnant, being heterosexual, being unaware of ART's HIV prevention benefits and having had partners of unknown HIV status (odds ratios, 1.1–6.7). Younger age and perceived inability to become pregnant were positively associated with both definitions of dual protection (1.04–3.3); additionally, WHO‐defined dual protection was associated with perceiving HIV care to be women‐centered and having had partners of unknown HIV status (2.0–4.1), and dual protection under the expanded definition was related to having been pregnant (2.7).

CONCLUSIONS

Future research should explore how sustained ART and broader contraceptive options can support women's sexual and reproductive health care needs.     

COMT基因多态性与伴TD的精神分裂症患者认知功能的相关性研究

目的探讨中国汉族人口中儿茶酚胺氧位甲基转移酶(COMT)基因Val108/158Met多态性与伴迟发性运动障碍(TD)的精神分裂症患者认知功能的关系。方法采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术对82例伴TD的精神分裂症患者COMT基因多态性进行检测,并选用连线测验(TMT)、韦氏记忆测验(WMS)、威斯康星卡片分类测验(WCST)对其认知功能进行评定。结果(1)COMT基因与TMT成绩显著相关,其中高活性G/G基因型PartA成绩显著低于中等活性G/A基因型,PartB成绩也显著低于低活性A/A基因型及中等活性G/A基因型。(2)COMT基因与记忆商数、背数成绩显著相关,其中G/G基因型记忆商数分显著低于A/A及G/A基因型,背数分也显著低于A/A基因型。(3)COMT基因与WCST成绩无显著相关性。结论COMT基因与伴TD的精神分裂症患者认知功能具有显著相关性,其中高活性G/G基因型患者认知损害更明显。     

文拉法辛缓释剂和氟西汀治疗首发抑郁症的对照研究

目的比较文拉法辛缓释剂和盐酸氟西汀治疗抑郁症首发患者的急性期疗效、安全性和依从性。方法采用前瞻性平行对照研究方法,184抑郁发作患者分别进行文拉法辛缓释剂和盐酸氟西汀治疗。文拉法辛组93例,平均剂量(99.41±38.72)毫克/天;氟西汀组91例,平均剂量(20.24±2.17)毫克/天,治疗8周。采用17项汉密尔顿抑郁量表(HAMD17)评价症状严重程度,治疗时出现的症状量表(Treatment Emergent Symptom Scale,TESS)评定不良反应,社会功能缺陷筛选量表(Social Disability Screening Schedule,SDSS)评价社会功能。结果(1)第6周文拉法辛组有效率(69.89%)和治愈率(31.18%)明显高于氟西汀组的[(53.85%)和(16.48%)](P<0.05)。第8周文拉法辛有效率为(77.42%)、缓解率(44.09%),氟西汀组有效率为(68.13%)、缓解率(36.26%),两组疗效差异无显著意义(P>0.05)。文拉法辛组SDSS评分为(1.63±2.98)分,氟西汀组为(1.69±2.70)分(P>0.05)。(2)文拉法辛组和氟西汀组与药物有关的不良反应出现频率的差异无统计学意义(P>0.05)。(3)文拉法辛组和氟西汀组脱落率(12.90%vs.17.58%)的差异无统计学意义(P>0.05)。结论文拉法辛和氟西汀治疗抑郁症首发患者的急性期疗效确切,第6周文拉法辛组有效率和治愈率明显高于氟西汀组,两组药物的不良反应和依从性相当。     

Reactivity of the Mirror System of the Brain and Intelligence Levels in School-Age Children

Neuroscience and Behavioral Physiology - Differences in measures of verbal and nonverbal intelligence (Wechsler test, WISC) were analyzed in 98 children of different age groups (younger children of...     

负压封闭引流技术治疗皮肤软组织缺失临床分析

目的 探讨负压封闭引力治疗皮肤软组织缺失的临床治疗效果及应用价值.方法 选择2012年8月至2013年8月在我院治疗的皮肤软组织缺失患者98例,随机数字表法随机化分为观察组和对照组,每组各49例,对照组给予传统换药模式,观察组采用负压封闭引流技术,记录患者临床疗效.结果 观察组患者二期植皮时间、植皮愈合时间以及复发感染率均短于对照组,创面缩小百分比高于对照组,换药次数、更换引流管次数、住院时间和住院费用均少于对照组,组间数据对比,差异具有统计学意义（P＜0.05）.结论 采用负压封闭引流技术治疗皮肤软组织缺失,临床效果较好,值得在临床推广使用.     

Sickness absence in relation to psychosocial work factors among daytime workers in an electric equipment manufacturing company

Associations between psychosocial work factors and sickness absence were investigated in a cross-sectional study of 833 daytime workers. Participants completed a questionnaire regarding psychosocial work factors using the US National Institute for Occupational Safety and Health Generic Job Stress Questionnaire (job control, quantitative workload, cognitive demands, variance in workload, intragroup conflict, intergroup conflict, supervisor support, coworker support, family support, job satisfaction and depressive symptoms) and the number of days of sickness absence within the previous year. Multivariate analyses of covariance with age and occupation as covariates (MANCOVA) were used to test the relationships between psychosocial work factors and sickness absence stratified by sex. In men, the age-adjusted MANCOVA showed that, quantitative workload was highest in the 0.5-4.5 d of sickness absence group (p<0.001). However, the levels of stress reactions (job satisfaction and depressive symptoms) in this group were almost identical to the levels recorded in the no sickness absence group. In contrast, low levels of job control (p<0.01), supervisor support (p<0.05), and job satisfaction (p<0.01) and higher symptoms of depression (p<0.001) were associated with 5 d or more sickness absence. In women, only high job satisfaction was associated with 5 d or more sickness absence (p<0.10). This study suggests that appropriate use of sickness absence at times of being exposed to high quantitative workload may help male workers to recover from stressful situations.