模糊状态风险分析的广义Logistic 回归理论与应用(1)

论述了“微弱相关影响因素”概念及其在预防医学中的重要意义,并研究了适宜处理此类资料的统计方法。借助模糊状态概念、交叉积差和统计量和信息量寻优标准,发展了暴露水平聚类优化、状态变量选择通用算法,可明显提高检测、识别微弱相关影响因素的效能与统计分析水准     

抑郁障碍患者主观与客观认知功能的差异性研究

背景 抑郁障碍患者的主观认知功能与客观认知功能存在差异。目前,关于主客观认知功能差异影响因素的研究有限。目的 探索抑郁障碍患者主观和客观认知功能的差异及其影响因素,为进一步理解抑郁障碍患者认知功能受损情况提供参考。方法 纳入2022年1月13日—2023年12月11日在成都市第四人民医院门诊就诊或住院治疗的、符合《精神障碍诊断与统计手册（第5版）》（DSM-5）抑郁障碍诊断标准的77例患者为研究对象。采用蒙哥马利-艾森贝格抑郁量表（MADRS）评定患者抑郁症状严重程度,采用抑郁感知缺陷问卷（PDQ-D）和中国简版神经认知成套测验（C-BCT）分别评定患者的主观认知功能和客观认知功能,采用席汉残疾量表（SDS）评定患者的社会功能,以临床总体印象量表-疾病严重程度量表（CGI-SI）评定患者病情严重程度。采用Pearson相关分析考查年龄、受教育年限、MADRS总评分、SDS总评分、CGI-SI评分与主客观认知功能及其差异的相关性。采用多元线性回归探索主客观认知功能差异的影响因素。结果 是否用药的抑郁障碍患者PDQ-D总评分和主客观认知功能差异（D值）比较差异均有统计学意义（t=-4.2...     

人参不同药用部位皂苷类成分差异性分析

目的:探讨人参不同药用部位（人参、人参叶、人参花）中皂苷类成分的差异性,为其质量评定提供参考。方法:采用超高效液相色谱-串联四级杆飞行时间高分辨质谱（UFLC-Triple-TOF-MS/MS）分析人参、人参叶、人参花中皂苷类成分含量,采用SynergiTM Hydro-RP 100 A柱,0.1%甲酸水溶液（A）-乙...     

社区残疾人药学服务需求现状及差异性研究

背景 残疾人群是多种疾病的高发人群,目前对于其医疗服务需求的研究多集中在定期体检、上门服务、康复指导等方面,而针对其药学服务需求的研究相对较少。目的 了解社区残疾人的药学服务需求,基于基本人口学特征、社会经济地位、残疾类别和残疾等级探讨其药学服务差异。方法 于2017年11—12月,采用单纯随机抽样法在上海市某街道的在册残疾人中抽取230例进行问卷调查。主要内容包括：残疾人的基本人口学特征（性别、年龄、婚姻状况）、社会经济地位（文化程度、工作状态、家庭人均月收入）、残疾类别与残疾等级、药学服务需求（需求内容、需求来源、需求程度）。结果 共回收有效问卷226份（98.3%）。残疾人的药学服务需求内容排在前2位的为“用法用量及疗程”（73.0%,165/226）、“适应证和禁忌证”（51.3%,116/226）;需求来源主要为医生（85.4%,193/226）;需求程度为非常/比较需要者占48.2%（109/226）。在需求内容上,不同工作状态者对“药品说明书解读”服务的需求率比较,差异有统计学意义（P<0.05）;不同家庭人均月收入者对“用法用量及疗程”服务的需求率比较,差异有统计学意义（P<0.05）。在需求来源上,不同年龄、工作状态、残疾等级者对由医生提供药学服务的需求率比较,差异有统计学意义（P<0.05）;不同年龄者对通过媒体获得药学服务的需求率比较,差异有统计学意义（P<0.05）。在需求程度上,不同文化程度、工作状态、残疾类别、残疾等级者对药学服务的需求程度比较,差异有统计学意义（P<0.05）。结论 不同情况残疾人的药学服务需求内容差异性不大,但需求来源、需求程度差异性较大,尤其是需求程度。社区药师应采用多种形式对残疾人开展用药宣教和个性化药学服务。     

Antisense oligonucleotide eluforsen improves CFTR function in F508del cystic fibrosis

BackgroundCystic fibrosis (CF) is caused by mutations in the CF transmembrane conductance regulator (CFTR) gene. In this study we assessed the effect of antisense oligonucleotide eluforsen on CFTR biological activity measured by Nasal Potential Difference (NPD) in patients with the most common mutation, F508del-CFTR.MethodsThis multi-centre, exploratory, open-label study recruited adults with CF homozygous or compound heterozygous for the F508del-CFTR mutation. Subjects received intranasal eluforsen three times weekly for 4 weeks. The primary endpoint was the within-subject change from baseline in total chloride transport (Cl-free+iso), as assessed by NPD. Secondary endpoints included within-subject change from baseline in sodium transport.ResultsIn the homozygous cohort (n = 7; per-protocol population), mean change (90% confidence interval) in Cl-free+iso was ?3.0 mV (?6.6; 0.6) at day 15, ?4.1 mV (?7.8; ?0.4, p = .04) at day 26 (end of treatment) and ? 3.7 mV (?8.0; 0.6) at day 47. This was supported by improved sodium transport as assessed by an increase in average basal potential difference at day 26 of +9.4 mV (1.1; 17.7, p = .04). The compound heterozygous cohort (n = 7) did not show improved chloride or sodium transport NPD values. Eluforsen was well tolerated with a favourable safety profile.ConclusionsIn F508del-CFTR homozygous subjects, repeated intranasal administration of eluforsen improved CFTR activity as measured by NPD, an encouraging indicator of biological activity.     

凉山州彝族、汉族妇女对宫颈病变高危因素认知差异的研究

[目的]通过对凉山州彝族、汉族妇女宫颈病变的流行病学调查结果,找出彝族、汉族妇女宫颈癌发病的高危因素差异,探讨降低宫颈癌发病率和病死率的有效措施。[方法]以凉山州内5个地区县城及各乡镇周边村的成年妇女为调查对象进行问卷调查,调查内容包括一般资料、既往病史、性行为和生育史、避孕史及吸烟史、生活习惯等方面。[结果]多因素Logistic回归分析显示:彝族妇女患宫颈癌危险因素中初次性生活年龄、生育次数、教育程度、妇科病治疗地点、怀孕次数等高于汉族妇女。[结论]凉山州彝族、汉族妇女间宫颈癌发病高危因素存在差异性,为制定进一步的防治措施提供理论依据。     

Impact of Plasma-Lyte pH 7.4 on acid-base status and hemodynamics in a model of controlled hemorrhagic shock

OBJECTIVE:

Intravenous infusion of crystalloid solutions is a cornerstone of the treatment of hemorrhagic shock. However, crystalloid solutions can have variable metabolic acid-base effects, perpetuating or even aggravating shock-induced metabolic acidosis. The aim of this study was to compare, in a controlled volume–driven porcine model of hemorrhagic shock, the effects of three different crystalloid solutions on the hemodynamics and acid-base balance.

METHODS:

Controlled hemorrhagic shock (40% of the total blood volume was removed) was induced in 18 animals, which were then treated with normal saline (0.9% NaCl), Lactated Ringer''s Solution or Plasma-Lyte pH 7.4, in a blinded fashion (n = 6 for each group). Using a predefined protocol, the animals received three times the volume of blood removed.

RESULTS:

The three different crystalloid infusions were equally capable of reversing the hemorrhage-induced low cardiac output and anuria. The Lactated Ringer''s Solution and Plasma-Lyte pH 7.4 infusions resulted in an increased standard base excess and a decreased serum chloride level, whereas treatment with normal saline resulted in a decreased standard base excess and an increased serum chloride level. The Plasma-Lyte pH 7.4 infusions did not change the level of the unmeasured anions.

CONCLUSION:

Although the three tested crystalloid solutions were equally able to attenuate the hemodynamic and tissue perfusion disturbances, only the normal saline induced hyperchloremia and metabolic acidosis.     

Behavioral deficits and cellular damage following developmental ethanol exposure in rats are attenuated by CP-101,606, an NMDAR antagonist with unique NR2B specificity

NMDAR-mediated excitotoxicity has been implicated in some of the impairments following fetal ethanol exposure. Previous studies suggest that both neuronal cell death and some of the behavioral deficits can be reduced by NMDAR antagonism during withdrawal, including antagonism of a subpopulation of receptors containing NR2B subunits. To further investigate NR2B involvement, we selected a compound, CP-101,606 (CP) which binds selectively to NR2B/2B stoichiometries, for both in vitro and in vivo analyses. For the in vitro study, hippocampal explants were exposed to ethanol for 10 days and then 24 h following removal of ethanol, cellular damage was quantified via propidium iodide fluorescence. In vitro ethanol withdrawal-associated neurotoxicity was prevented by CP (10 and 25 nM). In vivo ethanol exposure was administered on PNDs 1-7 with CP administered 21 h following cessation. Activity (PNDs 20-21), motor skills (PNDs 31-33), and maze navigation (PNDs 43-44) were all susceptible to ethanol insult; treatment with CP (15 mg/kg) rescued these deficits. Our findings show that CP-101,606, a drug that blocks the NR2B/2B receptor, can reduce some of the damaging effects of “3rd trimester” alcohol exposure in our rodent model. Further work is clearly warranted on the neuroprotective potential of this drug in the developing brain.     

Ablation of p21-activated kinase-1 in mice promotes isoproterenol-induced cardiac hypertrophy in association with activation of Erk1/2 and inhibition of protein phosphatase 2A

Earlier investigations in our lab indicated an anti-adrenergic effect induced by activation of p21-activated kinase (Pak-1) and protein phosphatase 2A (PP2A). Our objective was to test the hypothesis that Pak-1/PP2A is a signaling cascade controlling stress-induced cardiac growth. We determined the effects of ablation of the Pak-1 gene on the response of the myocardium to chronic stress of isoproterenol (ISO) administration. Wild-type (WT) and Pak-1-knockout (Pak-1-KO) mice were randomized into six groups to receive either ISO, saline (CTRL), or ISO and FR180204, a selective inhibitor of Erk1/2. Echocardiography revealed that hearts of the Pak-1-KO/ISO group had increased LV fractional shortening, reduced LV chamber volume in diastole and systole, increased cardiac hypertrophy, and enhanced transmitral early filling deceleration time, compared to all other groups. The changes were associated with an increase in relative Erk1/2 activation in Pak-1-KO/ISO mice versus all other groups. ISO-induced cardiac hypertrophy and Erk1/2 activation in Pak-1-KO/ISO were attenuated when the selective Erk1/2 inhibitor FR180204 was administered. Immunoprecipitation showed an association between Pak-1, PP2A, and Erk1/2. Cardiac myocytes infected with an adenoviral vector expressing constitutively active Pak-1 showed a repression of Erk1/2 activation. p38 MAPK phosphorylation was decreased in Pak-1-KO/ISO and Pak-1-KO/CTRL mice compared to WT. Levels of phosphorylated PP2A were increased in ISO-treated Pak-1-KO mice, indicating reduced phosphatase activity. Maximum Ca²⁺-activated tension in detergent-extracted bundles of papillary fibers from ISO-treated Pak-1-KO mice was higher than in all other groups. Analysis of cTnI phosphorylation indicated that compared to WT, ISO-induced phosphorylation of cTnI was blunted in Pak-1-KO mice. Active Pak-1 is a natural inhibitor of Erk1/2 and a novel anti-hypertrophic signaling molecule upstream of PP2A.     

辽宁汉族指长及指长比特点

目的 探讨辽宁汉族指长比的特点。 方法 在知情同意情况下随机整群选取20~22岁健康辽宁汉族728人（男270,女458）,排除手指有畸形、损伤和有内分泌及代谢病者,其母孕期间均未服用激素类药物,直接测量法测量其指长, SPSS140软件包对数据进行分析。 结果 辽宁汉族指长均呈现：3D＞4D＞2D＞5D,女性2D>男性（P<0.001）、男性4D>女性（P<0.001）;辽宁汉族指长比具有3D:5D＞4D:5D＞2D:5D＞3D:4D＞2D:4D＞2D:3D趋势;辽宁汉族指长比存在性别、侧别差异,以2D:4D较为明显;辽宁汉族指长比大于宁夏汉族、回族指长比,与其他国家群体之间也存在差异。 结论 辽宁汉族指长比具有性别、侧别差异性,其中以2D：4D最为显著;指长比可能还存在民族、地区及人种的差异。