MicroRNA基因多态性与肝细胞癌遗传易感性的Meta分析

目的综合评价microRNA基因多态性与肝细胞癌(hepatocellular carcinoma,HCC)遗传易感性的关系。方法全面检索相关文献,收集2014年9月前有关microRNA基因多态性与HCC易感性的病例对照研究,使用Stata10.0进行Meta分析。结果最终纳入病例对照研究13项。分析结果显示miR-146aG>C(rs2910164)和miR-196a-2C>T(rs11614913)等位基因多态性与HCC发生风险显著相关,其相对危险度(odds ratio,OR)和95%置信区间(confidence interval,CI)分别为0.92(0.87~0.98)和0.90(0.82~0.98),分层分析结果提示,miR-146a多态性和HCC之间的显著相关性仅存在于男性和亚洲人群中。结论 miR-146a和miR-196a-2基因多态性与HCC的遗传易感性相关,其C和T等位基因会降低HCC的发病风险。     

Incidence and Factors Contributing to Low Back Pain in the Nonobstetrical Patients Operated Under Spinal Anesthesia: A Prospective 1-Year Follow-Up Study

PurposeTo determine the incidence and factors contributing to postspinal anesthesia (SPA) low back pain (LBP) in patients undergoing nonobstetrical surgeries.DesignA prospective 1-year follow-up study.MethodsPatients having nonobstetrical surgery using SPA were included. The patients were followed up through phone calls and interviews every postoperative day for the first week, weekly for a month, and then monthly for a year after SPA. Patients' duration of LBP, duration of surgery, and need for LBP treatment were recorded.FindingsOf 410 patients, 5.8% (24 patients) experienced LBP. The incidence of LBP did not have a significant correlation with the recorded variables (P > .05). There was a negative significant correlation between duration of LBP and duration of surgery (r = −0.5096; P = .001). Of the 24 patients experiencing LBP, 16.7% (four patients) experienced it for less than 1 day, 66.7% (16 patients) 1 to 7 days, 16.7% (four patients) more than 7 days, and only one patient (4.2%) for up to 17 days. Special LBP treatment was not needed in any of the patients.ConclusionsThe incidence of LBP was very low, and those patients undergoing nonobstetrical surgery and receiving SPA did not experience persistent LBP.     

胎盘组织中3种细胞金属硫蛋白表达的免疫组化研究

目的探讨胎盘组织中蜕膜细胞、合体滋养层细胞及Hofbauer细胞金属硫蛋白（metallothionein，MT）表达的意义及其相关性。方法采用免疫组织化学法检测178例足月胎盘组织中MT的表达情况。结果胎盘组织蜕膜细胞、合体滋养层细胞及Hofbauer细胞MT表达的阳性率分别为49．69％（80／161）、53．37％（95／178）、33．15％（59／178）；胎盘组织3种类型细腿MT的表达强度有等级相关性（P〈0．0001）；胎盘组织3种类型细胞之间MT的表达差异有统计学意义（P〈0．0001）。结论胎盘组织蜕膜细胞、合体滋养层细胞及Hofbauer细胞可有MT的表达，提示MT在胎盘的屏障作用及物质转运中可能起着很重要的作用。     

Long-term immunogenicity of a quadrivalent human papillomavirus vaccine in systemic lupus erythematosus

ObjectivesTo evaluate the 5-year immunogenicity of a quadrivalent human papillomavirus (HPV) vaccine (GARDASIL) in patients with systemic lupus erythematosus (SLE).MethodsFemale SLE patients and controls, aged 18–35 years, who received GARDASIL in 2011 and sero-converted 12 months post-vaccination were followed for persistence of immunogenicity. Antibody measurement to HPV serotypes 6, 11, 16, 18 was repeated at 5 years. The rate of sero-reversion was compared between patients and controls, and factors associated with sero-reversion of the anti-HPV antibodies were studied.Results50 SLE patients and 50 controls were vaccinated with GARDASIL. Among subjects who sero-converted at 1 year and consented for this study, antibodies to HPV serotypes 6, 11, 16 and 18 at 5 years were persistent in 24/27 (89%), 26/31 (84%), 32/34 (94%) and 24/25 (96%) of the SLE patients; and 32/33 (97%), 32/33 (97%), 32/32 (100%) and 23/24 (96%) of the controls, respectively. Antibody titers to HPV-6 and 16 were significantly lower in patients than controls. Seven (21%) SLE patients had sero-reversion of ≥1 anti-HPV antibodies. Sero-reverted patients experienced significantly more SLE flares, particularly renal, and had received significantly higher cumulative doses of prednisolone, mycophenolate mofetil and tacrolimus than those with persistent immunogenicity. The cumulative doses of prednisolone correlated inversely and significantly with the anti-HPV 6, 11, and 16 titers at 5 years.ConclusionsImmunogenicity of the quadrivalent HPV vaccine was retained in a high proportion of SLE patients at 5 year. Patients with more SLE renal flares and had received more immunosuppression were more likely to have sero-reversion of the anti-HPV antibodies.Clinical trial registration number: US ClinicalTrials.gov (NCT00911521 & NCT02477254).     

Pubertal maturation and cortisol level in response to a novel social environment among female adolescents

Research indicates changes in HPA-axis activity across puberty. The current study extends existing work by evaluating pubertal status and cortisol level in a novel social environment (research laboratory) while controlling for several important biological, behavioral, and psychological variables. Participants were 30 girls (ages 9–16 years) from the United States. Pubertal status was assessed via the Pubertal Development Scale. Salivary samples were collected at laboratory-introduction and a matched at-home period; laboratory-introduction levels were regressed on basal cortisol levels to create standardized residual scores. After controlling for covariates, pubertal status was positively associated with residualized cortisol values. Findings indicate more advanced puberty related to greater cortisol response to the laboratory; data are discussed in terms of future research and building biopsychosocial models of the puberty-psychopathology linkage.     

Inter-center variability in neonatal outcomes of preterm infants: A longitudinal evaluation of 298 neonatal units in 11 countries

Collaboration and cooperation of clinicians and neonatal units at regional, national, and international levels are key features of many networks or systems that aim to improve neonatal outcomes. Network performance is typically assessed by comparing individual, unit-level outcomes. In this paper, we provide insight into another dimension, i.e., inter-center outcome variation in 10 national/regional neonatal collaborations from 11 high-income countries. We illustrate the use of coefficients of variation for evaluation of mortality and a composite outcome of mortality, severe neurological injury, treated retinopathy of prematurity, and bronchopulmonary dysplasia, as a measure of inter-center variation. These inter-center variation estimates could help to identify areas of opportunities and challenges for each country/region; they also provide “macro”-level evaluations that can be useful for clinicians, administrators, managers and policy makers.     

武汉市硚口区2003～2007年登记肺结核治疗结局分析

目的:了解武汉市硚口区2003～2007年登记肺结核治疗结局及其影响因素,为提高治愈率提出可行性措施。方法:回顾性分析武汉市硚口区2003～2007年肺结核患者登记资料,并查阅患者病历资料。结果:5年平均治疗成功率为90.6%,多因素logistic回归分析发现性别、诊断延误、治疗分类、依从性及诊断结果是影响治疗结局的主要因素,其相应的OR(95%CI)分别为1.859(95%CI:1.169～2.955)、0.396(95%CI:0.264～0.593)、2.673(95%CI:1.655～4.319)、26.648(95%CI:17.661～40.208)、0.595(95%CI:0.396～0.893)。结论:减少肺结核患者的诊断延误和提高患者的依从性是提高治疗成功率的关键因素。     

江苏省肿瘤低发区绿茶和大蒜对肺癌保护作用的病例对照研究

目的分析江苏省恶性肿瘤低发区赣榆县饮用绿茶、食用大蒜等与肺癌相关的主要因素及其交互作用。方法开展以人群为基础的病例对照研究,面对面询问收集主要人口学及与肺癌发生可能有关的行为、环境和饮食等资料。采用非条件logistic回归方法计算比值比(0R)及其95%CI,并进行单因素和调整可能混杂因素的多因素数据分析。结果饮用绿茶(OR=0．78,95%CI：0．65～0．95)、食用大蒜(OR=O．79,95%C1：0．66～0．95)及同时饮用绿茶和食用大蒜(OR=O．69,95%CI：0．53～0．89)与肺癌发生呈负性关联,并均减弱吸烟、油炸食物、炒菜油温等危险因素与肺癌发生的正性关联。不食用大蒜与吸烟存在相加交互作用,超额相对危险度(RERI)、交互作用归因比(AP)和交互作用指数(sI)分别为0．86、0．26和1．61;不饮用绿茶与炒菜油温低同时存在相加交互作用(RERI=-0.58,AP=-0.47,SI=0.30)和相乘交互作用(OR=O．64,95%CI：0．43～0．95)。结论饮用绿茶和食用大蒜可能是肺癌发生的保护因素。     

Menopausal transition enhances the atherogenic risk of smoking in middle aged women

Background

The presence of cardiovascular risk factors during the menopausal transition could be critical in the development of atherosclerosis. In the present study, we evaluated whether the menopausal transition has impact on traditional and newly discussed risk factors.

Methods

Six hundred ninety nine women from population-based study underwent ultrasound measurement of the intima-media thickness of the common carotid arteries (CIMT) — Prague Pre and Postmenopausal Females study (3PMFs). In addition, 40 women selected according to reproductive and smoking status were examined with regard to number of circulating endothelial progenitor cells, markers of reverse cholesterol transport and sex hormones, including their fluctuation — Hormone Variability study (HVs).

Results

Age, smoking, body mass index, systolic blood pressure and HDL cholesterol were independently associated with the CIMT in 3PMFs group. The increase in the CIMT with age was markedly steeper in current/past smokers than in non-smokers among perimenopausal women (p for equality of slopes = 0.005). This difference was not observed in premenopausal and menopausal women. In the HVs group, endothelial progenitor cells and reverse cholesterol transport were substantially higher while triglycerides and fluctuation of free testosterone were lower in non-smokers than in smokers in menopausal transition. In contrast, in menopausal women, the fluctuation of free testosterone was higher in non-smokers; no other differences between smokers and non-smokers were detected.

Conclusions

These results suggest that atherogenic effect of smoking may be enhanced during menopausal transition. The mechanism could be impaired reparative vascular processes, impaired reverse cholesterol transport and rapidly changing status of sex hormones.     

安徽省巢湖农村地区3岁组儿童生长发育状况及其影响因素分析

目的探讨安徽省巢湖农村地区3周岁儿童生长发育状况及其影响因素。方法采用整群随机抽样方法，以巢湖农村地区3周岁年龄组儿童作为调查对象。调查内容包括：儿童出生／喂养／患病情况、母亲孕期情况、家庭情况及主要照顾者的儿童喂养知识，同时测量儿童的身高、体重及皮脂厚度，并应用年龄别身高、年龄别体重、身高别体重等指标对其进行生长发育状况评价。结果共调查儿童418人，按年龄别身高评价生长发育迟缓儿童为4．3％、正常者为95．7％；按年龄别体重评价低体重儿童发生率为1．9％、超重儿童发生率为0．7％、正常体重者为97．4％；按身高别体重评价消瘦儿童发生率为0．5％、肥胖儿童发生率为14．9％，正常者为84．6％。对影响生长发育指标的因素进行多分类Logistic回归分析，结果性别为男、出生体重较重、父亲身体较高、饭前经常洗手的儿童，其生长发育指标Z评分高；而出生胎次靠后、家庭年收入高、母亲文化程度为文盲、母亲孕期服用保胎药、接触X线、家中分娩儿、主要照顾者为母亲、4个月内喂养方式为母乳和人工混合喂养、添加辅食时间〈3个月、经常吃营养补品、零食和挑食的儿童，其生长发育指标Z评分低。结论该地区3岁组儿童总体发育情况良好，但孕产期保健和儿童期保健仍有待加强。