青岛市男性新型毒品滥用人群艾滋病病毒感染及危险行为调查

目的 了解山东省青岛市新型毒品滥用者使用新型毒品的情况、性行为特征及HIV感染状况。方法 采用横断面调查设计,2015-2016年在青岛市依托MSM社会组织和社区中男性新型毒品滥用者志愿者,滚雪球法招募男性新型毒品滥用者,样本量估计为933人。收集其吸毒、性行为,检测HIV、梅毒、HCV抗体,检测新型毒品滥用情况。采用EpiData 3.1软件建立数据库、SAS 9.4软件进行统计分析。结果 共招募1 034人,MSM组431人（占41.7%）和非MSM组603人（占58.3%）。与非MSM组相比,MSM组年龄较低,未婚比例较高,文化程度较高。最近6个月用过冰毒的比例MSM组和非MSM组分别为49.7%（214/431）和100.0%（603/603）,用过零号胶囊的比例分别为66.8%（288/431）和0.0%。最近6个月与多人共用毒品者的比例MSM组和非MSM组分别为87.9%（379/431）和97.7%（588/602）（χ²=39.84,P<0.01）。最近6个月使用毒品后发生性行为从未使用安全套的比例,非MSM组（47.5%,285/600）高于MSM组（7.4%,32/430）（χ²=190.10,P<0.01）。最近6个月使用新型毒品后发生多人性行为的比例,MSM组和非MSM组分别为78.1%（335/429）和5.5%（33/600）（χ²=573.73,P<0.01）。MSM组的和非MSM组的HIV抗体阳性率、梅毒抗体阳性率、HCV抗体阳性率分别为2.1%和0.2%、3.3%和6.3%、0.0%和0.3%。结论 青岛市男性新型毒品滥用人群中有较高比例的多人共同吸毒,在有男男性行为的新型毒品滥用人群中,使用毒品后的群体性行为发生率高,HIV抗体阳性率较高,安全套使用率低,应重点加强对这部分亚人群的干预。     

医学生个性特征对就业专业选择的影响

[目的]探讨在校医学生的个性特征对就业时临床专业方向选择的影响。[方法]采用现况研究设计,从某医学院不同院系中随机抽取2100名学生,以艾森克人格问卷测试其个性特征,让其选择出最想从事的专业,并获得其人口学资料,分析专业选择与个性特征的关系。[结果]内科、外科、妇产科、儿科、辅助诊断类（影像学专业、病理科、检验科）这五种专业,其E量表（内、外向性）得分的均分差异有统计学意义（11.34±3.70,12.31±3.41,12.26±3.56,11.88±3.34,10.93±3.33,F=4.77,P〈0.05）,对这五种专业的E量表得分进行两两比较,有差异的两专业及其得分对比情况为内科〈外科、内科〈妇产科、辅助诊断〈外科、辅助诊断〈妇产科、辅助诊断〈儿科,并可得到辅助诊断〈内科〈儿科〈妇产科〈外科。男、女间E量表均分差异有统计学意义（12.30±3.63,11.56±3.39,F=6.67,P〈0.05）、P量表（精神质）均分差异亦有统计学意义（6.79±3.56,4.95±2.79,F=67.20,P〈0.05）。[结论]根据在校医学生的个性特征可以预测其将来就业时的专业选择,学校和医院根据医学生的个性特征加强就业指导,可以缓解医学生的就业压力。     

Potential reductions in ultra-processed food consumption substantially improve population cardiometabolic-related dietary nutrient profiles in eight countries

Background and aimsThe negative effect on dietary nutrient profiles is the most obvious mechanism explaining the higher risk of cardiometabolic diseases associated with increased dietary share of UPF observed in large cohort studies.We estimate the proportion of diets with excessive energy density, excessive free sugars or saturated fat contents and insufficient fiber that could be avoided, if UPF consumption was reduced to levels among lowest consumers across eight countries, as well as the proportion of diets with multiple inadequacies.Methods and resultsUsing nationally-representative cross-sectional surveys from Brazil (2008–09), Chile (2010), Colombia (2005), Mexico (2012), Australia (2011–12), the UK (2008–16), Canada (2015), and the US (2015–16), inadequate energy density (≥2.25 kcal/g) or contents of free sugars (>10% of total energy intake), saturated fats (>10% of total energy intake) and fiber (<25 g/2000 kcal) population attributable fractions were quantified.Substantial reductions in nutrient inadequacies would be observed ranging from 50.4% in Chile to 76.8% in US for dietary energy density, from 15.5% in Colombia to 68.4% in Australia for free sugars, from 9.5% in Canada to 35.0% in Mexico for saturated fats, and from 10.3% in UK to 37.9% in Mexico for fiber. Higher reductions would be observed for diets with multiple nutrient inadequacies: from 27.3% in UK to 77.7% in Australia for ≥3 and from 69.4% in Canada to 92.1% in US, for 4 inadequacies.ConclusionsLowering dietary contribution of UPF to levels among country-specific lowest consumers is a way to improve population cardiometabolic-related dietary nutrient profiles.     

5种方法筛查无症状2型糖尿病的效果评价

目的构建受试者工作特征(ROC)曲线模型,评价空腹毛细血管血糖(FCBG)、空腹血浆血糖(FPG)、糖负荷2 h血浆血糖(2HPG)、糖化血红蛋白(HbA1c)和2型糖尿病(T2DM)危险评分表(DRS)筛查无症状糖尿病患者的效果。方法使用2006年青岛糖尿病预防计划中"未被医生告知患有糖尿病"的4 070名受试者的横断面调查资料,所有受试者均测FCBG、FPG、2HPG、HbA1c,填写DRS,并行口服糖耐量实验(OGTT),以确诊无症状T2DM。比较上述5种方法筛查无症状T2DM的灵敏度、特异度及ROC曲线下的面积(AUROC)。结果 FCBG筛查无症状T2DM的灵敏度、特异度和AUROC为64.08%、69.81%和0.712;FPG为60.10%、100.00%和0.896;2HPG为67.12%、100.00%和0.898;HbA1c为40.21%、81.96%和0.673;DRS为61.50%、63.72%和0.679。FPG和2HPG的AUROC与其他3个筛查指标的AUROC差别有统计学意义;FPG与2HPG的AUROC差别无统计学意义;FCBG、HbA1c与DRS的AUROC两两比较差别无统计学意义。结论 FCBG和DRS可作为筛查无症状T2DM简单有效的一线方法;HbA1c暂不适合于社区T2DM的筛查;适当降低FPG与2HPG筛查切点可提高灵敏度,减少漏诊率。     

2017-2018年青岛地区儿童急性上呼吸道感染病毒谱与流行特征

  目的  了解2017年3月-2018年3月青岛地区儿童急性上呼吸道感染病毒谱与流行特征。  方法  随机抽选青岛地区符合国家流感监测方案诊断标准的流感监测病例中的儿童流感样病例（influenza-like illness，ILI）作为研究对象，共检测359例。采集患儿咽拭子，采用多重实时荧光逆转录-聚合酶链反应进行核酸检测的方法，对9种呼吸道病毒进行筛查。  结果  359例标本中200例至少有1种病毒检测结果为阳性，阳性率为55.71%（200/359）。其中，阳性最多的是流感病毒B型（Influenza Virus B，IVB）Yamagata亚型29.50%（59/200），其次是肠道病毒（Human Enterovirus，HEV）15.00%（30/200），呼吸道腺病毒（Adenovirus，AdV）13.50%（27/200），呼吸道合胞病毒A型（Respiratory Syncytial Virus A，RSVA）12.50%（25/200），流感病毒A型（Influenza Virus A，IVA）H1N1亚型10.00%（20/200）等。2例3种病毒混合感染，1例4种病毒混合感染。  结论  2017年3月-2018年3月9种呼吸道病毒在青岛地区均有流行，IVB Yamagata亚型、HEV、AdV、RSVA亚型、IVA H1N1亚型为主要流行病毒。其中流感病毒、HEV、RSV、偏肺病毒（Human metapneumovirus，HMPV）具有明显的季节性分布。9种病毒在各病毒流行月份存在混合感染。     

Photon versus proton neurotoxicity: Impact on mitochondrial function and 8-OHdG base-excision repair mechanism in human astrocytes

This study assesses and compares the neurotoxic effects of proton and photon radiation on mitochondrial function and DNA repair capabilities of human astrocytes. Human astrocytes received either proton (0.5 Gy and 3 Gy), photon (0.5 Gy and 3 Gy), or sham-radiation treatment. The mRNA expression level of the DNA repair protein OGG1 was determined via RT-qPCR. The levels of 8-OHdG in the cell media were measured via ELISA. Real-time kinetic analysis of extracellular oxygen consumption rates was performed to assess mitochondrial function. Radiation-induced changes in mitochondrial mass and oxidative activity were assessed using fluorescent imaging with MitoTracker™ Green FM and MitoTracker™ Orange CM-H₂TMRos dyes respectively. PCR was used to quantify the alteration in the mitochondrial DNA content, measured as the mitochondrial to nuclear DNA ratio. A significant increase in mitochondrial mass and levels of reactive oxygen species was observed after radiation treatment. Additionally, real-time PCR analysis indicated a significant depletion of mitochondrial DNA content in the irradiated cells when compared to the control. This was accompanied by a decreased gene expression of the DNA base-excision repair protein OGG1 and reduced clearance of 8-OHdG adducts from the genome. Photon radiation treatment was associated with a more detrimental cellular impact when compared to the same dose of proton radiation. These results are indicative of a radiation-induced dose-dependent decrease in mitochondrial function, an increase in senescence and astrogliosis, and impairment of the DNA repair capabilities in healthy glial cells. Photon irradiation was associated with a more significant disruption in mitochondrial function and base-excision repair mechanisms in vitro in comparison to proton treatment.     

铁路女职工生殖健康状况及对心理健康的影响

目的了解铁路行业女职工生殖健康状况,探讨生殖健康对心理健康影响的危险因素,为制定铁路行业女职工劳动保护规定提供科学参考。方法采用整群抽样方法,选取济南、南宁、青藏、武汉铁路系统女职工作为研究人群,采用统一编制调查表,用Epidata3.1软件建立数据库,SPSS22.0软件进行统计处理。结果铁路女职工常见妇科疾病患病率为28.5%,发病前两位的是子宫肌瘤、阴道炎,主要发病年龄36~45岁;月经异常率20.4%,主要表现为经量异常和周期紊乱。单因素分析发现,阴道炎、外阴瘙痒和白带增多与心理健康问题有关。多因素Logistic分析发现,月经异常以及外阴瘙痒或白带增多是影响心理健康的生殖道疾患危险因素。结论建议采取积极有效的健康促进措施,增强铁路女工的自我保健意识和技能,及早治愈生殖系统疾病;同时,采取心理干预措施,减轻心理压力,缓解职业紧张。     

Haemaphysalis flava ticks as a competent vector of severe fever with thrombocytopenia syndrome virus

Severe fever with thrombocytopenia syndrome virus (SFTSV), a tick-borne Bunyavirus, causes an emerging hemorrhagic fever in humans with a high fatality in Asia. The tick vectors and hosts of SFTSV are not well studied. We evaluated SFTSV transmission in laboratory reared Haemaphysalis flava ticks. RT-PCR demonstrated that after acquisition feeding in SFTSV-infected rabbits, 10 % (4/40) engorged larvae, 25% (5/20) engorged nymphs, and 50% (5/10) engorged females of H. flava became SFTSV RNA positive; after engorged larvae and nymphs molted into nymphs and adults, respectively, 12.5% (3/24) newly molted nymphs and 20% (2/10) newly molted adults were SFTSV RNA positive. Among 30 engorged females that oviposited, 10% (3/30) clutches of eggs and 3.3% (1/30) colonies of larvae were RNA positive for SFTSV. RT-PCR also showed that 6 days after being infested with SFTSV-infected ticks, 100% (3/3) rabbits infested with larvae, 100% (2/2) rabbits infested with nymphs, and 100% (2/2) rabbits infested with adult ticks became SFTSV RNA positive. In conclusion, H. flava can acquire SFTSV from infected rabbits by feeding; there is transstadial and transovarial transmission of the virus and all three stages of H. flava can transmit SFTSV to rabbits by feeding. Thus, H. flava tick is an effective vector of SFTSV and may play a role in the transmission of SFTSV in wild animals and humans.     

MPO-ANCA–positive crescentic glomerulonephritis: A distinct entity of scleroderma renal disease?

Scleroderma renal crisis is characterized by intimal thickening of the afferent glomerular arterioles resulting in hypertension and fibrinoid necrosis of the capillary tuff. We report a 67-year-old man with long-standing systemic sclerosis who developed normotensive progressive renal failure, proteinuria, and a nephritic urinary sediment with serum myeloperoxidase-antineutrophil cytoplasmatic antibodies (MPO-ANCA). Renal biopsy showed pauci-immune crescentic glomerulonephritis but none of the typical vascular changes of scleroderma renal crisis. Because comparable cases have recently been reported from Japan, normotensive MPO-ANCA—positive crescentic glomerulonephritis may form an entity of progressive renal failure in scleroderma.     

正电子发射断层成像装置质量控制检测时操作人员眼部受照剂量水平分析

目的 探讨正电子发射断层成像装置（PET）质量控制检测时,检测操作人员眼晶状体受照剂量。方法 对山东省5台PET质量控制检测时,在分装前、制作点源、制作线源1和制作线源2时分别在2名检测操作人员的左眼部左侧、左眼部前方,左右眼中间、右眼部前方、右眼部右侧各佩戴1个热释光眼晶状体个人剂量计。对检测操作人员眼晶状体受照辐射剂量进行测量和分析,计算其最大年受照剂量。结果 检测5台PET,检测时操作人员的眼晶状体最大剂量是2 439.80 μSv,第一和第二检测操作人员左右眼晶状体剂量呈现相同趋势（χ²=15.629~16.155,P<0.05）,第一检测操作人员眼晶状体受照剂量高于第二检测操作人员（Z=2.611,P<0.05）。结论 单台PET检测所致检测操作人员眼晶状体受照剂量处于较低水平。