刍议祖国医学中时间与人体的关系——34年1054例住院心脏病患者死亡时间规律探讨

本文从中医“天人相参”的基本观点出发,根据祖国医学中大量关于时间与人体关系方面的资料记载,结合本院34年住院心脏病死亡病例,就其死亡时间与人体关系进行分析讨论,应证了时间节律不但存在,而且对疾病的发生发展及预防和治疗都有十分重要意义.     

大气污染物短期效应对上海市浦东新区居民肺癌死亡影响的病例交叉研究

目的 分析大气污染物与浦东新区居民每日肺癌死亡人数的相关性,为制定针对肺癌病人的保护措施提供依据。方法 采集浦东新区2005年1月1日至2019年12月31日之间的每日大气污染物浓度、气象因素以及居民肺癌死亡资料,利用时间分层-病例交叉设计并结合分布滞后非线性模型,探讨大气污染物短期暴露对浦东新区居民肺癌死亡的影响。结果 大气污染物(PM₁₀, SO₂, NO₂)浓度与浦东新区居民肺癌死亡风险呈正相关。PM₁₀, SO₂, NO₂浓度对居民肺癌死亡风险的影响均在累积8 d(Lag 0～7)最强。PM₁₀, SO₂, NO₂浓度上升10 μg/m³累积8 d(Lag 0～7)居民肺癌死亡风险分别上升1.09%(95%CI:0.35%～1.83%), 3.78%(95%CI:1.98%～5.61%)与2.76%(95%CI:1.10%～4.44%)。女性人群肺癌死亡对PM₁₀与NO₂的影响不敏感(P>0.05)。大气污染物对高龄人群与低文化水平人群肺癌死亡效应较强,人群间效应差异不显著。结论 大气污染物短期暴露可以升高浦东新区居民肺癌死亡风险,以累积8 d(Lag 0～7)效应最强。     

1990—2019年中国人群早发性结直肠癌疾病负担及变化趋势分析

目的 分析1990—2019年我国早发结直肠癌（early-onset colorectal cancer,EOCRC）疾病负担及时间变化趋势。方法 利用全球疾病负担2019（Global Burden of Disease 2019,GBD 2019）数据库获取我国14～49岁人群1990—2019年间结直肠癌发病、死亡及伤残调整寿命年（disability-adjusted life years,DALYs）的数量和率,以及危险因素所致EOCRC相关DALYs百分比。计算年龄标化发病率（age-standardized incidence rate,ASIR）及死亡率（age-standardized mortality rate,ASMR）,并用Joinpoint软件对我国EOCRC的ASIR及ASMR行时间变化趋势分析。结果 2019年我国EOCRC新发病例及死亡人数为87383及26274,相比1990年分别增加264.53%及76.92%。我国EOCRC的ASIR及ASMR为10.31/10万及3.07/10万,较1990年分别增加140.32%及14.13%。时间变化趋势分析显示,我国EOCRC的ASIR及ASMR均呈显著上升趋势,其平均年变化百分比（average annual percentage change,AAPC）分别为3.0（95%CI为2.8～3.3）及0.3（95%CI为0.1～0.6）。我国EOCRC相关DALYs为1304828,占我国总体结直肠癌相关DALYs的20.40%及全球EOCRC相关DALYs的30.63%。归因分析提示我国42.85%的EOCRC相关DALYs可归因于饮食、行为及代谢因素。结论 我国EOCRC发病率及死亡率均明显升高,其导致的疾病负担十分严峻。     

Fish Hydrolysate Supplementation Containing n-3 Long Chain Polyunsaturated Fatty Acids and Peptides Prevents LPS-Induced Neuroinflammation

Neuroinflammation constitutes a normal part of the brain immune response orchestrated by microglial cells. However, a sustained and uncontrolled production of proinflammatory factors together with microglial activation contribute to the onset of a chronic low-grade inflammation, leading to neuronal damage and cognitive as well as behavioral impairments. Hence, limiting brain inflammatory response and improving the resolution of inflammation could be particularly of interest to prevent these alterations. Dietary n-3 long chain polyunsaturated fatty acids (LC-PUFAs) and low molecular weight peptides are good candidates because of their immunomodulatory and proresolutive properties. These compounds are present in a fish hydrolysate derived from marine-derived byproducts. In this study, we compared the effect of an 18-day supplementation with this fish hydrolysate to a supplementation with docosahexaenoic acid (DHA) on lipopolysaccharide (LPS)-induced inflammation in mice. In response to peripherally injected LPS, the fish hydrolysate supplementation decreased the hippocampal mRNA expression of the proinflammatory cytokines IL-6 (p < 0.001), IL-1β (p = 0.0008) and TNF-α (p < 0.0001), whereas the DHA supplementation reduced only the expression of IL-6 (p = 0.004). This decline in proinflammatory cytokine expressions was associated with an increase in the protein expression of IκB (p = 0.014 and p = 0.0054 as compared to the DHA supplementation and control groups, respectively) and to a modulation of microglial activation markers in the hippocampus. The beneficial effects of the fish hydrolysate could be due in part to the switch of the hippocampal oxylipin profile towards a more anti-inflammatory profile as compared to the DHA supplementation. Thus, the valorization of fish byproducts seems very attractive to prevent and counteract neuroinflammation.     

孕产妇梅毒感染确诊时机影响因素

目的分析孕产妇梅毒感染确诊时机的影响因素及临床治疗效果。方法选择2017年9月-2019年9月于海口市妇幼保健院接受定期产检的孕产妇为研究对象,采用巢式病例对照研究方式将孕期确诊梅毒的80例孕妇纳入孕期确诊组,按1∶2比例匹配160例产期确诊梅毒的患者纳入产期确诊组;分析患者年龄、孕产次等临床资料,归纳孕产妇不同时期确诊梅毒感染的影响因素,并比较两组治疗效果。结果两组民族、户籍、文化程度、职业、孕次、梅毒分期、感染途径比较差异无统计学意义,但产次、子女数及性伴侣感染比例比较差异有统计学意义(P<0.05),多因素分析结果显示产次、子女数、性伴侣感染是孕产妇不同时期确诊梅毒感染的影响因素(P<0.05);孕期确诊组不良妊娠结局发生率为22.50%(18/80)低于产期确诊组(P<0.001),先天性梅毒发生率为5.00%(4/80)低于产期确诊组(P<0.001)。结论产次、子女数、性伴侣感染是孕产妇不同时期确诊梅毒感染的影响因素,孕期确诊梅毒患者经治疗后具更低的不良妊娠结局风险及先天梅毒感染风险。     

基于ARIMA-GRNN组合模型预测医保补偿住院费用

目的 探讨ARIMA-GRNN组合模型在城乡居民基本医疗保险的医保补偿住院费用预测中的应用,比较它与ARIMA模型预测的效果。方法 收集2016年1月至2020年12月河南某市城乡居民基本医疗保险的住院补偿费用,使用Matlab R2016a建立ARIMA-GRNN组合模型,使用R 4.0.3建立ARIMA模型,用2020年5月至12月的数据对两模型的预测效果做评价。结果 ARIMA(0,1,1)(1,0,0)12模型相对最优,其拟合部分的MAE、MAPE、RMSE分别为3998.4、10.9%、5642.9,预测部分的MAE、MAPE、RMSE分别为6521.9、16.5%、6675.8。ARIMA-GRNN模型最优光滑因子为0.166,其拟合部分的MAE、MAPE、RMSE分别为4044.5、11.1%、5622.0,预测部分的MAE、MAPE、RMSE分别为5831.8、14.8%、6013.7。结论 ARIMA-GRNN组合模型预测效果比单纯ARIMA模型好,可短期预测医保补偿住院费用。     

基于Prophet等时间序列季节模型的肺结核发病预测及对比分析

目的 探索河南省2014—2019年肺结核发病趋势及季节性特征,比较Prophet模型、ARIMA季节模型和Holt-Winters模型的拟合及预测效果,为肺结核防控提供科学依据。方法 基于河南省2014年1月至2018年12月肺结核月发病数据,建立Prophet模型、ARIMA季节模型和Holt-Winters模型,采用2019年1月至12月肺结核月报告发病数据验证预测效果。评价指标选取均方根误差（RMSE）、平均绝对百分比误差（MAPE）、平均绝对误差（MAE）、平均置信区间宽度、真实值超出置信区间个数。结果 模型拟合结果显示,河南省肺结核发病呈逐年下降趋势,每年3—5月达到发病高峰,2月和10月出现低谷;Prophet模型拟合及预测表现最优,评价指标RMSE、MAPE、MAE、平均置信区间宽度均低于另外两个模型,Holt-Winters模型次之,ARIMA(0,1,1)×(0,1,1)12模型拟合及预测效果相对较差。结论 Prophet模型具有较高的拟合预测准确度和精确度,可以很好地捕捉河南省肺结核发病趋势,模型拟合结果对肺结核防控工作具有一定指导意义。     

Vestibular nerve activity in the alert monkey during vestibular and optokinetic nystagmus

Summary Activity of vestibular nerve fibers and eye movements were recorded in the alert monkey during natural stimulation. The animal was rotated about a vertical axis in the dark with velocity trapezoids (vestibular), or a striped cylinder was rotated around the stationary monkey (optokinetic), or these stimuli were combined.After velocity steps in the dark, neuronal activity declined with a dominant time constant of 5–6 s. The time constant of nystagmus recorded simultaneously was always longer, on average 23 s. Vestibular nerve activity was not influenced by optokinetic patterns or additional visual stimuli during combined visualvestibular stimulation. Thus, in contrast to vestibular nuclei neurons, vestibular nerve activity in the alert monkey is only determined by head acceleration and cannot be related to the nystagmus response or visual stimuli.Supported by a grant from the Swiss National Foundation for Scientific Research 3.343-2.78     

Simulation of time-resolved breast transillumination

A Monte Carlo simulation has been developed to predict the quality of time-resolved images of the breast by transillumination. The smallest diameter of a detectable carcinoma located in the breast has been computed. The simulation suggests that time-resolved imaging of the breast is possible and invaluable in the near infra-red (NIR) by transillumination. The enhancement of the transfer function by the introduction of time-resolved detection is limited by the contribution of noise at short integration times. The estimated diameter of the smallest detectable sphere is derived from the image quality index (IQI) theory and its value is around 4 mm. The simulated images of an absorbing sphere (approximating the carcinoma) within a homogeneous medium (approximating the surrounding tissue) show a significant improvement of the image with short integration time.     

In vivo brain (31)P-MRS: measuring the phospholipid resonances at 4 Tesla from small voxels

An optimized phosphorous ((31)P) three-dimensional chemical-shift imaging (3D-CSI) protocol was developed at 4 T to study the phospholipid metabolism from discrete regions in the human brain without the need for (1)H-decoupling or nuclear Overhauser enhancement (NOE). In this study, a spherically bound, weighted average, random point omission 3D-CSI technique was developed and tested, based on methods proposed in the literature. The technique yields a significant (p < 0.001, two-tailed, 5% confidence level) increase in signal-to-noise (SNR) efficiency over conventional 3D-CSI (phantom 32%), without an increase in voxel bleedthrough. An automated time-domain fitting procedure utilizing prior spectral knowledge quantified the individual brain phospholipid metabolites from 15 cm(3) effective (8.0 cm(3) nominal) volumes from the left/right-parieto-occipital cortex and left/right thalamus in 10 normal volunteers. Individual constituents from the phosphomonoester (PME) region; phosphoethanolamine (PEth), phosphocholine (PCh) and the phosphodiester (PDE) region; glycerophosphoethanolamine (GPEth), glycerophosphocholine (GPCh) and membrane phospholipids (MP) were separately quantified to assess the precision of our method at 4 T against previous (1)H-decoupled (31)P-MRS brain studies at lower fields and much larger voxels. Derived concentrations (mM/l tissue) for PEth, PCh, GPEth, GPCh and MP in the left-parieto-occipital cortex were 0.81 +/- 0.21, 0.46 +/- 0.14, 0.74 +/- 0.30, 1.15 +/- 0.43 and 1.54 +/- 0.95 mM, respectively, and 0.94 +/- 0.16, 0.46 +/- 0.17, 0.83 +/- 0.22, 1.14 +/- 0.40 and 1.26 +/- 0.78 mM for the right parieto-occipital cortex. Derived concentrations (mM/l tissue) for PEth, PCh, GPEth, GPCh and MP in the left-thalamus were 0.69 +/- 0.18, 0.42 +/- 0.16, 0.63 +/- 0.20, 1.05 +/- 0.42 and 0.93 +/- 0.56 mM, respectively, and 0.68 +/- 0.24, 0.34 +/- 0.18, 0.60 +/- 0.23, 1.09 +/- 0.36 and 0.74 +/- 0.48 mM for the right-thalamus. This is the first study to our knowledge that has been able to quantify each of these individual phospholipid metabolites from such small voxels in the brain within a clinically reasonable scan time and without (1)H-decoupling or NOE.