2017—2021年内蒙古自治区新报告HIV/AIDS病例晚发现情况分析

目的 分析2017—2021年内蒙古自治区新报告艾滋病感染者/艾滋病病人（HIV/AIDS）晚发现的情况，为制定进一步的防控措施提供依据。方法 从艾滋病综合防治信息系统中，选取2017—2021年内蒙古自治区新报告的HIV/AIDS病例进行分析；计算晚发现比例；采用χ2趋势检验分析各年度晚发现比例的变化趋势；运用多因素logistic回归模型对其影响因素进行分析。结果 2017—2021年内蒙古自治区新报告HIV/AIDS病例共计4 464例，其中晚发现病例1 248例，晚发现比例为27.96%。各年度晚发现比例呈现上升趋势（χ2 = 7.655，P＜0.05）。蒙古族各年度晚发现比例差异无统计学意义（χ2 = 1.806，P = 0.179）。多因素logistic回归结果表明年龄、文化程度和样本来源是晚发现的主要影响因素，随着年龄的增长晚发现比例升高，其中与0～19岁组相比，50～59岁组及60岁以上病例OR值（95%CI）分别为8.859（5.078～15.456）和8.117（4.480～14.707）；与大专及以上文化程度相比，高中或中专以及初中的晚发现风险较高，其OR值（95%CI）分别为1.290（1.068～1.566）和1.270（1.055～1.533）；与医疗机构相比，检测咨询和其他来源的OR值（95%CI）分别为0.570（0.469～0.681）和0.430（0.342～0.538）。结论 2017—2021年内蒙古自治区新报告HIV/AIDS病例晚发现比例逐年升高，蒙古族各年度晚发现比例变化不明显。年龄、文化程度和样本来源是造成晚发现的主要影响因素，应当采取有效措施以推动病例的早期发现。     

波前像差引导LASIK手术的研究进展

随着波前像差引导的个体化准分子激光原位角膜磨削术(LASIK)在临床中的广泛应用,高阶像差也逐渐成为视觉质量研究的热点问题。通过波前像差引导LASIK手术可矫正术前的高阶像差和控制术中增加的高阶像差,进而提高视觉质量。本文就波前像差的概念、测量方法及其在准分子角膜磨削术中的应用作一综述。     

颈椎前路微型记忆加压合金板的有限元分析

目的 评估微型记忆加压合金板在前路颈椎椎间盘切除融合术中置入后的生物力学性能,为该内植物的临床应用、术后护理及后续实验研究与改进提供依据。 方法 随机选择一名健康成年女性志愿者,建立C5、C6颈椎-微型记忆加压合金板三维有限元模型,对各工况下内植物上应力集中区域的应力分布情况进行比较分析。 结果 中立位时,该内植物上分布的应力相对较为均匀且应力值较小;前屈状态时,各个区域的平均应力相对其余工况均为最大,最大平均应力位于区域6即下钩部分,为（45.89±5.32）MPa;后伸状态时,区域1、2、3、4即加压部件的应力分布较为均匀（P>0.05）;侧屈工况下,该内植物整体应力分布不均,屈侧平均应力远大于伸侧（P<0.05）;旋转工况下,应力在旋转对侧上部与同侧下部较为集中,左旋转时分别为（23.66±6.24）MPa和（23.62±7.07）MPa,右旋转时分别为（24.16±5.42）MPa和（24.58±5.30）MPa。除中立位外,在其余六种工况下,置入椎体内部的上下钩固定部分受到的应力均较大。 结论 颈前植入该微型记忆加压合金板后,应减少做前屈动作,避免过于频繁或过于激烈的侧屈、旋转动作,保持中立位最为稳妥。在后续研究及改良过程中,可考虑加强内植物上下钩的固定强度。     

Infantile giant cell hepatitis with autoimmune hemolytic anemia

Giant cell hepatitis (GCH) is characterized by large and multinucleated (syncytial) hepatocytes in the context of liver inflammation. Infantile GCH is typically associated with autoimmune hemolytic anemia in the absence of any other systemic or organ-specific autoimmune comorbidity. The etiology is unknown; concomitant viral infections (as potential trigger factors) have been identified in a few patients. The pathogenesis reportedly relies upon immune-mediated/ autoimmune mechanisms. This condition should be considered in any infant developing Coombs-positive anemia; indeed, anemia usually precedes the development of hepatitis. The clinical course is usually aggressive without the appropriate immunosuppressive therapy, which may include steroids, conventional immunosuppressors (e.g., azathioprine and cyclophosphamide as first-line treatments), intravenous immunoglobulin, and biologics (rituximab). Improvements in medical management (including the availability of rituximab) have significantly reduced the mortality of this condition in the last decade.     

Magnetite-based adsorbents for sequestration of radionuclides: a review

As a result of extensive research efforts by several research groups, magnetite-based materials have gained enormous attention in diverse fields including biomedicine, catalysis, energy and data storage devices, magnetic resonance imaging, and environmental remediation. Owing to their low production cost, ease of modification, biocompatibility, and superparamagnetism, the use of these materials for the abatement of environmental toxicants has been increasing continuously. Here we focus on the recent advances in the use of magnetite-based adsorbents for removal of radionuclides (such as ¹³⁷Cs(i), ¹⁵⁵Eu(iii), ⁹⁰Sr(ii), ²³⁸U(vi), etc.) from diverse aqueous phases. This review summarizes the preparation and surface modification of magnetite-based adsorbents, their physicochemical properties, adsorption behavior and mechanism, and diverse conventional and recent environmental technological options for the treatment of water contaminated with radionuclides. In addition, case studies for the removal of radionuclides from actual contaminated sites are discussed, and finally the optimization of magnetite-based remedial solutions is presented for practical application.

As a result of extensive research efforts by several research groups, magnetite-based materials have gained enormous attention in diverse fields.     

Autoimmune pancreatitis and pancreatic cancer: Epidemiological aspects and immunological considerations

Ordinary chronic pancreatitis is a well-known risk factor for pancreatic cancer, whereas such an association with autoimmune pancreatitis (AIP) is widely debated. Due to the rarity of the latter disorder, there are few specific clinical and epidemiological studies investigating the relation between AIP and pancreatic cancer, which do not seem to support it. However, these studies are affected by several limitations and, therefore, a link between AIP (and, specifically, type 1 AIP) and pancreatic cancer cannot be ruled out definitively on this basis. Moreover, several immunopathological aspects of type 1 AIP and, in general, immunoglobulin G4-related disease can create an immunological context that may impair the tumoral immunosurveillance and promote the pancreatic carcinogenesis and its progression. In detail, Th2 immunological dominance, type 2 macrophage polarization and basophil infiltration observed in type 1 AIP, may play a permissive role in creating a favorable immunological environment for pancreatic carcinogenesis, in addition to the immunosuppressive therapies that can be used in these patients.     

慢性应激对糖尿病大鼠血清胰高血糖素等含量影响的实验研究

[目的]从糖尿病多因素致病角度出发,探讨情志因素对糖尿病发病的作用机制--气机失调证,以及具有理气降逆散结功效的复方中药心身5号方的调节作用.[方法]采用旋转、拥挤、限制3种情志刺激结合腹腔注射少量链脲佐菌素(STZ)的实验方法,制作了糖尿病大鼠模型,实验动物分为正常组、应激组、STZ组、应激 STZ组和中药组.检测血清胰高血糖素和肝脏环磷酸腺苷(cAMP)含量,同时观察具有理气降逆散结功效的复方中药心身5号方的调节作用.[结果]慢性情志应激可促使STZ鼠血清胰高血糖素含量,肝脏中cAMP含量明显升高,与其他组比较有极显著性差异(P＜0.01),中药可降低血清胰高血糖素和肝脏中cAMP含量.[结论]慢性情志刺激引起实验性糖尿病大鼠血清胰高血糖素和肝脏cAMP含量的升高是糖尿病发病机制之一.同时具有理气降逆散结功效的复方中药心身5号方有明显调节作用.     

PBL结合CBL教学法在肾病内科临床实习教学中的应用

目的观察PBL结合CBL教学法在肾病内科临床实习教学中的应用效果。方法对照组(n=41)给予传统PBL教学模式授课,观察组(n=42)给予PBL结合CBL教学模式授课,对比两组的医师理论知识、实践技能考核得分及实习满意度情况。结果观察组客观题得分均明显优于对照组,差异有统计学意义(P<0.05)。观察组满意率高于对照组,两组比较差异有统计学意义(P<0.05)。结论PBL结合CBL教学法在肾病内科临床实习教学中的应用效果显著,可全面提高实习医师的临床综合能力,实习满意度高。