新型冠状病毒肺炎出院患者生活质量及影响因素研究

目的:了解新型冠状病毒肺炎(COVID-19)患者出院后的生活质量及其影响因素,为优化早期干预方案,预防社区生活受限,制定相应社区康复措施提供依据。方法:选择2020年3—4月在武汉华润武钢总医院治愈出院的COVID-19患者57例,于2020年4—5月通过"问卷星"平台采用简明健康状况调查量表(SF-12V2)调查患者的生活质量;采用焦虑自评量表(SAS)调查患者的焦虑状态;采用抑郁自评量表(SDS)调查患者的抑郁状态;采用呼吸困难指数量表(mMRC)调查患者的呼吸困难程度。比较不同特征COVID-19患者生活质量的差异;分析患者生活质量与焦虑、抑郁和呼吸困难程度的相关性及其相关的影响因素。结果:共发放57份调查问卷,剔除重复及无效问卷3份,获得有效问卷54份,问卷有效率达94.74%。(1)COVID-19出院后患者生活质量情况:生理总评分和心理总评分分别为(37.02±12.32)分、(38.46±14.42)分;呼吸困难等级0~3级的分别为3例(5.56%)、45例(83.33%)、5例(9.26%)、1例(1.85%);有19例(35.19%)存在焦虑情绪(SAS≥50分)和抑郁情绪(SDS≥53分)。(2)不同特征COVID-19患者生活质量比较:不同疾病分型的患者在生理总评分方面差异有统计学意义(P<0.05)。(3)生活质量与焦虑、抑郁和呼吸困难程度的相关性分析:Pearson相关分析结果显示,SF-12V2生理总评分与焦虑程度(r=-0.34,P=0.011)和呼吸困难程度(r=-0.39,P=0.003)之间存在负相关性,SF-12V2心理总评分与焦虑程度(r=-0.46,P=0.001)和抑郁程度(r=-0.40,P=0.002)之间存在负相关性。(4)COVID-19患者生活质量的影响因素分析:多元线性回归分析显示,性别(β=8.27)、抑郁程度(β=-0.34)和疾病分型(β=-11.68)是患者SF-12V2生理总评分的重要决定因素(P<0.05);焦虑程度(β=-0.62)是患者SF-12V2心理总评分的重要决定因素(P<0.05)。结论:COVID-19出院患者存在呼吸困难、焦虑抑郁情绪和生活质量下降的问题;性别、疾病分型、抑郁程度和焦虑程度是COVID-19患者生活质量下降的重要因素。COVID-19患者(特别是女性患者和重型患者)出院后要尽早进行抑郁症和焦虑症的筛查和干预,减少患者负性情绪,鼓励患者适当参与康复训练,提高呼吸功能,从而促进生活质量提高。     

一种基于μ子进行核材料探测成像的模拟系统

宇宙射线斗子成像检测技术具有穿透力强、对高Z材料敏感等特点，特别适合检测特殊核材料，是监控核材料走私的有效方式之一。在搭建μ子成像检测硬件系统的同时，我们开发了一套针对实际硬件系统的模拟系统，并利用该系统开展斗子成像方法的研究。本文将介绍该模拟系统的有关情况，并给出利用该系统得到的仿真结果。相信这一工作将对实际宇宙射线μ子成像系统的设计给出指导意见。     

中国汉族人与美国高加索白人膝关节几何形态的比较

背景:有研究显示中国人膝关节胫骨近端前后径和横径均小于美国高加索人,所以在膝关节形态学方面存在一定差异,因此常发生进口假体系统应用于国人后出现匹配度不高的现象。目的:测量中国人和美国人股骨远端、胫骨近端的几何形态学参数,比较其差异。方法:选择北京清华长庚医院骨科拟行前交叉韧带重建的中国汉族患者50例,以及美国匹兹堡大学运动医学中心拟行前交叉韧带重建的高加索白人后裔患者40例,对90例受试者膝关节进行CT扫描,使用AW Volume Share 5软件进行三维重建,利用Geomagic软件对胫骨近端和股骨远端的各项参数进行测量。结果与结论:①股骨近端测量参数中,中国人的外侧胫骨平台内外径小于美国人(P=0.027),外侧胫骨平台后倾角大于美国人(P<0.05);两组间胫骨平台内外径、内侧胫骨平台外径、内侧胫骨平台前后径、外侧胫骨平台前后径与内侧胫骨平台后倾角比较差异均无显著性意义(P>0.05);②股骨远端测量参数中,中国人的股骨远端横径、外侧髁内外径、内侧髁前后径、外侧髁前后径及髁间窝高度均小于美国人(P<0.05),股骨外翻角大于美国人(P<0.05);两组间内侧髁内外径、髁间窝宽度及滑车沟宽度比较差异无显著性意义(P>0.05);③结果表明,中国人与美国人在膝关节形态学的多个参数存在差异,有必要针对中国人设计更为个体化的膝关节假体。     

持续泵入生长抑素时防止发生低血糖的方法

目的探讨安全使用生长抑素不发生低血糖反应的方法。方法密切监测血糖,在患者输完营养液后血糖低于6.1 mmol/L者用5%葡萄糖维持输入。结果用5%葡萄糖维持输入的患者未发生低血糖。结论在患者输完营养液后应用5%葡萄糖可防止低血糖的发生。     

Central composite design of pressurised hot water extraction process for extracting capsaicinoids from chili peppers

Pressurised hot water extraction (PHWE) was applied to chilies in order to optimise extraction yield of capsaicinoids (capsaicin, dihydrocapsaicin, nordihydrocapsaicin, nonivamide). Determination of the optimum extraction procedure was performed by comparison of the yield of the extracts. Capsaicinoids content was determined by HPLC coupled with mass spectrometry. An optimisation study was performed using water as an extraction solvent at constant extraction pressure (20 MPa), extraction temperature ranging from 120 to 240 °C and static extraction time ranging from 5 to 60 min as independent variables. The optimum PHWE conditions for all response variables were estimated; however, PHWE conditions resulting in the highest recovery of capsaicinoids (20 MPa, 200 °C and 10 + 20 min of static extraction time) were chosen for comparison with a conventional Soxhlet extraction (SOX) in the case of seven chili pepper fruit samples (chili peppers of species Capsicum chinenses: Trinidad Scorpion Moruga, Jamaican Hot Red, and Yellow Habanero, chilies of species Capsicum annuum: Yellow Bedder, Ring of Fire, and Chiltepin, chili pepper Tabasco of species Capsicum frutescens) and three chili spices (ground spices from Trinidad Scorpion Moruga, Bhut Jolokia, and Fatalii Red, all of species Capsicum chinenses).     

Molecular genetic analysis of Plasmodium vivax isolates from Eastern and Central Sudan using pvcsp and pvmsp-3α genes as molecular markers

In Sudan, Plasmodium vivax accounts for approximately 5–10% of malaria cases. This study was carried out to determine the genetic diversity of P. vivax population from Sudan by analyzing the polymorphism of P. vivax csp (pvcsp) and pvmsp-3α genes. Blood samples (n = 76) were taken from suspected malaria cases from 2012–2013 in three health centers of Eastern and Central Sudan. Parasite detection was performed by microscopy and molecular techniques, and genotyping of both genes was performed by PCR-RFLP followed by DNA sequence for only pvcsp gene (n = 30). Based on microscopy analysis, 76 (%100) patients were infected with P. vivax, whereas nested-PCR results showed that 86.8% (n = 66), 3.9% (n = 3), and 3.9% (n = 3) of tested samples had P. vivax as well as Plasmodium falciparum mono- and mixed infections, respectively. Four out of 76 samples had no results in molecular diagnosis. All sequenced samples were found to be of VK210 (100%) genotype with six distinct amino acid haplotypes, and 210A (66.7%) was the most prevalent haplotype. The Sudanese isolates displayed variations in the peptide repeat motifs (PRMs) ranging from 17 to 19 with GDRADGQPA (PRM1), GDRAAGQPA (PRM2) and DDRAAGQPA (PRM3). Also, 54 polymorphic sites with 56 mutations were found in repeat and post-repeat regions of the pvcsp and the overall nucleotide diversity (π) was 0.02149 ± 0.00539. A negative value of dN − dS (−0.0344) was found that suggested a significant purifying selection of Sudanese pvcsp, (Z test, P < 0.05). Regarding pvmsp-3α, three types were detected: types A (94.6%, 52/55), type C (3.6%, 2/55), and type B (1.8%, 1/55). No multiclonal infections were detected, and RFLP analysis identified 13 (Hha I, A1-A11, B1, and C1) and 16 (Alu I, A1-A14, B1, and C1) distinct allelic forms. In conclusion, genetic investigation among Sudanese P. vivax isolates indicated that this antigen showed limited antigenic diversity.     

重楼解毒酊外涂治疗新生儿毒性红斑50例临床观察

目的观察重楼解毒酊外涂治疗新生儿毒性红斑的临床疗效。方法选取2018年6-12月在北京市上地医院儿科住院治疗的新生儿毒性红斑患儿100例,按照随机数字表法分为对照组和治疗组,各50例。对照组予日常的皮肤护理,治疗组在对照组护理方法的基础上予重楼解毒酊外涂,治疗5 d后,比较2组的临床疗效。结果对照组总有效率为74%,治疗组为96%,2组比较,差异有统计学意义(P<0.05)。结论重楼解毒酊外涂治疗新生儿毒性红斑疗效确切,简便易行,值得临床推广应用。     

Influence of short- and long-term treadmill exercises on levels of ghrelin, obestatin and NPY in plasma and brain extraction of obese rats

This study aims to clarify the effects of exercise on levels of appetite regulatory hormones in plasma and hypothalamus of obese rats. Diet-induced obese rats undergo short- (40 min) and long-term (40 min, 5 days/week for 8 weeks) exercises. The rats ran at a speed of 20 m/min on a 5° slope treadmill. Rats undergoing short-term exercise were divided into C, E0, E1, E3, E12, and E24. Rats undergoing long-term exercise (LE) were compared to long-term control (LC). Concentrations of ghrelin, obestatin, and neuropeptide Y (NPY) were measured using radio immuno-assay. Expression of ghrelin receptor (GHSR-1a), putative obestatin receptor (GPR-39), and NPY in the hypothalamus was measured by quantitative RT-PCR. After short-term exercise, the plasma concentrations of ghrelin and obestatin were not changed, but NPY decreased. Ghrelin and obestatin in the hypothalamus decreased, and recovered 12 until 24 h. NPY increased and recovered after 24 h. Expression of GHSR-1a and NPY was not changed and GPR-39 was not observed. In LE, these changes are different in plasma and hypothalamus. It would be concluded appetite and body weight of obese rats are decreased by exercise through reduced level of ghrelin in the hypothalamus. Obestatin seems to have no effect in exercise-induced change in appetite.     

Systematic review of cost-effectiveness studies of human papillomavirus (HPV) vaccination: 9-Valent vaccine,gender-neutral and multiple age cohort vaccination

BackgroundThe success of human papillomavirus (HPV) national immunization program depends on effective strategies in optimizing the uptake of HPV vaccine. Given the increasing number of economic evaluations, this review was conducted to update the economic evidence on HPV vaccination, by focusing on: (i) 9-valent vaccine compared to bi- or quadrivalent vaccine; (ii) gender-neutral vaccination compared to female only vaccination; and (iii) multiple age cohort immunization compared to single age cohort immunization.MethodsSearches were performed until June 2016 using 4 databases: PubMed; Embase; Cochrane Library; and LILACS. The combined WHO, Drummond and CHEERS checklist were used to evaluate the quality of included studies.ResultsThirty-four studies were included in the review and most of them were conducted in high-income countries. The inclusion of adolescent boys in vaccination program was found to be cost-effective if vaccine price and coverage was low. When coverage for female was above 75%, gender-neutral vaccination was less cost-effective than when targeting only girls aged 9–18 years. Current evidence does not show conclusive proof of greater cost-effectiveness of 9-valent vaccine compared to the older HPV vaccines as the price for 9-valent vaccine was still uncertain. Multicohort immunization strategy was cost-effective in the age range 9–14 years but the upper age limit at which vaccination was no longer cost-effective needs to be further investigated. Key influential parameters identified were duration of vaccine protection, vaccine price, coverage, and discounting rates.ConclusionsThese findings are expected to support policy-makers in making recommendations for HPV immunization programs on either switching to the 9-valent vaccine or inclusion of adolescent boys’ vaccination or extending the age of vaccination.     

新型冠状病毒Omicron变异株的流行病学特征及防控研究

Omicron（B.1.1.529）变异株于2021年11月24日首次从南非报告给世界卫生组织,截至2021年12月8日全球共有57个国家和地区报告了Omicron感染病例。目前Omicron变异株在部分非洲国家已成为主导毒株,且传播速度快。尽管Omicron变异株引起的疾病症状较轻,多数病例为无症状感染者和轻型患者,但病例数量的快速增长可能给全球卫生系统带来沉重压力。此外,Omicron变异株的变异来源、传播特征、疫苗抗性等尚不明确,给各国和地区的疫情防控带来很大挑战。本文就Omicron变异株的病原学特征、变异来源、传播特征及可能的机制、流行现状、疫苗对其保护效果、防控措施等方面的研究进展进行综述,以期为科学防控Omicron变异株所致疫情提供参考。