A prospective study of Toxoplasma-positive pregnant women in southern Brazil: a health alert

We evaluated anti-Toxoplasma gondii IgM-reactive pregnant women seen at a high-risk pregnancy outpatient clinic. From March 2005 to January 2008 in Paraná, Brazil, pregnant women seen by the Brazilian Public Health System, in any gestational period, who were anti-T. gondii IgM-positive, were followed. Clinical symptoms were noted, and tests performed including IgA, IgG avidity, ultrasonogram, and amniocentesis (PCR/inoculation in mice). Of 75 patients, 8 showed low, 3 intermediate and 31 high IgG avidity. Of those who underwent the avidity test, 31 (70.5%) were in the second trimester of pregnancy. Thirty-two (42.7%) pregnant women received specific treatment. Six received triple combination treatment; in three, tachyzoites were isolated, although only one was PCR-positive, showing changes in the cerebral sonogram, borderline IgA, and the Sabin tetrad. One fetus died, and one non-reactive IgM pregnant woman showed ocular recurrence. The municipality of residence, contact with cats during adulthood, and ingestion of unpasteurized milk were shown to be important risk factors. Congenital toxoplasmosis was observed in a pregnancy referred late for treatment. Follow-up of children born to mothers with diagnosed or suspected acute toxoplasmosis is crucial in the management of the changes that toxoplasmosis may cause.     

冠心病危险因素与冠状动脉病变程度的相关性研究

目的:探讨冠心病危险因素与冠状动脉病变程度的关系.方法:选取150例冠心病患者行冠状动脉造影术及各项化验检查,冠状动脉病变程度以Gensini积分值表示,对冠心病危险因素和冠状动脉病变程度进行统计分析.结果:经多因素线性回归证实:非高密度脂蛋白胆固醇为冠状动脉病变程度的独立危险因素(P=0.030),而性别、年龄、空腹血糖、糖尿病、高血压、吸烟、家族史及甘油三酯、低密度脂蛋白胆固醇均与冠状动脉病变程度无明确相关.结论:非高密度脂蛋白胆固醇对冠状动脉病变严重程度具有重要的影响.     

梗阻性黄疸高危因素分析

目的 :通过探讨梗阻性黄疸临床指征 ,了解其病程中的高危因素。并及时降低并发症及死亡率 ,提高临床疗效。方法 :对我科 1993年— 2 0 0 0年收治的 2 92例梗阻性黄疸病人进行性分析 ,统计年龄、梗阻时间、性质、手术时间 ,入院 2 4小时内测尿素氮 (BUN)、白蛋白 (A)、总胆红素(TBIL)、白细胞 (WBC)、血红素 (HB)、腹水 ,分析其高危因素。结果 :年龄 >6 5岁并发症发生率为2 5 .2 0 % ,病死率 3.2 5 % ;梗阻时间超过 2 0天以上者 ,并发症 2 8.87% ,病死率 5 .15 % ;肝功能Child氏B级、C级者 ,并发症发生率为 2 9.2 0 % ,病死率为 5 .31% ,延期手术并发症发生率为 2 9.4 1% ,病死率为 4 .90 %。结论 :梗阻性黄疸病人年龄越大 ,梗阻时间越长 ,肝功能越差 ,不及时手术是各种并发症发生及病死率增高的高危因素     

基于免疫系统非线性模型对中医正邪相争理论和扶正祛邪治则的一个非线性动力学诠释

文中基于免疫系统有关免疫活性细胞或分子与外来抗原相互作用的非线性的动力学模型对中医学正邪相争理论及其扶正祛邪治则进行了新的诠释,提出了新的研究思路。认为:中医学关于外感邪气致病的六经、卫气营血和三焦辨证在本质上是识别抗原与免疫活性细胞或分子相互作用的三种不同的非线性动力学诊断模式,其证相应于这一过程中不同的非线性动力状态,可以用一个或一组非线性动力学方程进行定量描述。一个证常常对应于抗原与免疫活性的细胞或分子非线性动力学相互作用相空间中的一个稳定或不稳定的极限环和混沌,这可以作为证诊断的图形或形象标识。以中医学扶正祛邪的治疗思想为先导,有可能研制出全新靶向的和更有效的治疗传染性疾病的药物。     

Adolescent alcohol initiation: A review of psychosocial risk factors

Longitudinal research studies focused on alcohol use initiation in adolescence were reviewed to determine which variables function as antecedent predictors or risk factors. Only studies that focused on time-1 abstainers were included. Classes of risk factors examined include sociodemographic, family, peer, personality, and behavioral variables. The most consistent antecedent risk factors for starting to drink in adolescence were parental and peer approval and models for drinking and drug use as well as adolescents’ own prior involvement in delinquent behavior. There was little evidence for gender differences in risk factors for alcohol use initiation. Secondary analyses of existing longitudinal data sets are encouraged to examine whether there are ethnic/racial differences in the risk factors for starting to drink and to establish those factors that serve a protective or buffering function, delaying onset of alcohol use in adolescence.     

常规放疗结合后程立体定向放射治疗老年非小细胞肺癌患者的预后分析

目的观察老年非小细胞肺癌立体定向放疗疗效,并探讨其预后因子。方法128例老年非小细胞肺癌患者行常规放疗结合立体定向放疗,定期随访。结果全组患者1年生存率65.72%,单因素分析表明肿瘤体积、肿瘤剂量、卡氏评分影响近期结果,多因素分析仅肿瘤体积和肿瘤剂量为近期疗效预后因子,与生存期有关的预后因素为近期疗效、肿瘤剂量、临床分期。结论立体定向放疗可延长生存时间,对Ⅲ期患者,肿瘤剂量提高至72Gy是安全的。     

Soluble CD14 at 2 yr of age: Gender-related effects of tobacco smoke exposure, recurrent infections and atopic diseases

The endotoxin receptor soluble CD14 (sCD14) has been implicated in the 'hygiene hypothesis' suggesting reduced allergic sensitization with bacterial stimulation. However, the relationship between early life sCD14 and allergic diseases is conflicting. We aimed to investigate whether possible risk factors for allergic diseases were associated with sCD14 levels at 2 yr of age. In the nested case-control study of the birth cohort studies 'Environment and Childhood Asthma study in Oslo' 411 children selected with recurrent bronchial obstruction (rBO) (n=241) and no bronchial obstruction (n=170) by 2 yr were investigated with skin prick test and structured parental interview at age 2 yr. Exposure to tobacco smoke, pets and infections was recorded semi-annually by questionnaires (0-2 yr). The sCD14 was analysed from frozen, stored serum by ELISA technique. Regression analyses were performed in all subjects with complete data (n=406, 180 girls), and in girls and in boys separately. Mean sCD14 (ng/ml) was significantly higher among girls 2035 (1973-2096) vs. 1947 (1890-2004) (boys). The sCD14 was significantly reduced among girls exposed to antenatal maternal smoking and with parental asthma, after adjusting for age, parental rhino-conjunctivitis, pet keeping and childhood infections. Recurrent otitis media (OM) increased and common colds significantly decreased sCD14 levels in girls. Boys with atopic dermatitis and rBO had reduced sCD14. Pet exposure was not significantly associated with sCD14. We report novel gender-related effects of sCD14 in early life and suggest that gender, tobacco smoke exposure, age and middle ear disease in particular should be accounted for when assessing the role of sCD14 in childhood allergic diseases.     

国人C型肝性脑病发病诱因分析

目的了解国人C型肝性脑病发病诱因及相关因素。方法对国内已经发表的11个研究样本（患者总样本量1131例）进行综合分析。结果在9类纳入统计分析的诱因中：消化道出血占43．8％、各种感染占33．9％、电解质紊乱占29．1％、医源性因素占28．2％、饮食不节占14．2％、肾功能衰竭占13．0％，分居前6位，另外腹泻占2．4％，便秘占1．8％，原因未明／无占2．7％。其中医源性因素按照发生频率依次为：大量利尿和／或放腹水占14．5％、手术／创伤占6．0％，药物占4．5％，输血／输复合氨基酸占3．2％。结论警惕肝性脑病多种诱因的存在，尤其不能忽视医源性因素。按照发病概率积极寻找并消除诱因，对于改善顸后尤为重要。     

小学生个性影响因素研究

【目的】分析影响儿童个性的有关因素，为培养儿童的健全人格提供依据。【方法】对西安市所属的七个区各随机抽取一所学校，每所学校抽取四、五、六年级各两个班．采用龚耀先修订的艾森克个性问卷（Eysenck Personality Questionnaire，EPQ）（儿童用）和自编的个人一般情况调查表，对2000名儿童进行调查。将调查所得数椐进行多元逐步回归分析。【结果】影响小学生个性精神性（Psy choticism，P）的因素有性别、是否班干部、父母关系；影响内外向（extrovision and intrnision，E）的因素有性别、父母关系、是否班干部、住所、母亲文化程度、所在学校；影响情绪稳定性（nearoticism，N）、掩饰性（lie,L）的均为性别、父母关系2个因素。【结论】儿童个性受家庭、学校环境等的多重影响。家长、教师应创造良好的家庭、社会环境，保持情绪乐观、稳定，避免对子女儿童的负面影响，以利于其个性向积极方向发展。