血管内皮生长因子在妊高征胎盘中的表达研究

目的观察血管内皮生长因子(VEGF)在妊高征(PIH)胎盘中的表达情况.方法用免疫组织化学法,检测30例正常晚孕胎盘(对照组)和34例妊高征胎盘(妊高征组)中的VEGF表达水平,并作计算机图像分析,测定各组标本的阳性染色光度值.结果VEGF在正常晚孕胎盘和妊高征胎盘中均有表达,其分布基本一致,主要在滋养细胞、血管内皮及绒毛间质.计算机图像分析结果示,对照组VEGF阳性染色光度为0.23780±0.00434,妊高征组VEGF阳性染色光度为0.20688±0.01530,其中轻度0.22603±0.00828,中度0.20364±0.00365,重度0.19151±0.00441,妊高征组中VEGF表达明显低于对照组P＜0.01.且随妊高征病情的加重,VEGFF表达水平呈下降趋势.结论妊高征胎盘中VEGF表达水平降低可能与胎盘血管生成减少及胎盘滋养细胞侵入异常有关,在妊高征的发病中起重要作用.     

人白细胞介素18（hIL—18）的cDNA基因克隆及序列测定

目的：克隆人白细胞介素18（IL－18）全长cDNA基因,进一步探讨人白细胞介素18的功效。方法：采用RT－PCR的方法从人肝组织中扩增出人白细胞介素18（IL－18）基因,并克隆到真核表达的绿色荧光蛋白报告载体pEGFP-NI中,结果：经PCR及DNA序列测定得以证实其序列与文献报导一致,结论：该实验成功地克隆了IL－18cDNA,并将其重组构建了含有IL－18cDNA的真核表达载体pEGFP-N1-IL18。     

血清胆红素与冠脉病变程度及血脂的相关性分析

目的分析血清胆红素与冠脉病变程度及血脂的关系。方法对冠状动脉造影术确诊的冠心病者和非冠心病者进行病例-对照研究。结果冠心病组血清胆红素水平低于非冠心病组,差异有显著性(P＜0.05)。多元逐步回归分析血清直接胆红素进入回归方程,提示血清直接胆红素与冠脉病变程度呈独立负相关,其相关强度与甘油三脂(TG)和空腹血糖(FBS)相似。血清胆红素与血脂直线相关分析提示血清胆红素与甘油三脂、总胆固醇(TCHO)和低密度脂蛋白胆固醇(LDL-C)呈显著负相关。结论血清直接胆红素水平与冠脉病变程度呈独立负相关,低血清胆红素是冠状动脉粥样硬化的危险因素,血清胆红素与甘油三脂、总胆固醇和低密度脂蛋白胆固醇呈负相关。     

多因素作用对肾移植效果的影响

目的：探讨肾移植术后早期排斥反应、肾功能延迟恢复的高危因素及其机理。方法：分析167例次肾移植患者的年龄、性别、透析时间、移植史、输血次数、孕次、冷缺血时间、热缺血时间、HLA体液致敏及HLA错配数与术后早期排斥反应、肾功能延迟恢复发生的关系。结果：多因分析提示致敏与肾移植术后肾功能延迟恢复的发生相关,致敏及HLA错配数与早期排斥反应相关。结论：致敏及HLA错配影响是肾移植效果的主要危险因素。     

200例更年期综合征妇女精神心理及社会因素现况调查

目的：了解更年期综合征患者精神和心理障碍,探讨社会因素对其的影响,方法：通过问卷式表格填写的方法,对200例更年期综合征妇女进行进行躯体表现、精神和心理障碍,应激反应、性生活、应激事件等现况调查,结果：更年期货征妇女普遍存在精神心理障碍,65％应激反应下降,50％性功能下降,生活中应激事件与更年期的综合征互为影响,结论：提高这一人群的生命质量,激素替代治疗须配合心理支持治疗。     

肝内胆管结石患者行腹腔镜左肝切除术后远期生存质量的影响因素分析

目的:探讨肝内胆管结石行腹腔镜左肝切除术后远期生存质量的影响因素。方法:回顾分析2010年1月至2017年12月216例肝内胆管结石患者行腹腔镜左肝切除术的临床资料,根据远期生存质量情况分组,分析患者术后远期生存质量的影响因素。结果:79例行左半肝切除术,137例行左外叶切除术;术后随访25~80个月,中位随访时间34.0个月;随访评价生存质量良好192例,不佳24例;其中结石残留22例、复发16例、胆管炎反复发作24例、死亡6例。单因素分析结果显示,性别、肝胆手术史、血肌酐、白蛋白、活化部分凝血活酶时间、胆道镜使用情况、术后胆道引流情况、手术时间及术后结石残留情况与腹腔镜左肝切除术后远期生存质量有关(P<0.05)。多因素分析结果显示,肝胆手术史、术后胆道引流情况及手术时间是肝内胆管结石患者微创左肝切除术后远期生存质量的独立影响因素(P<0.05)。结论:有肝胆手术史、术后胆道引流及手术时间≥240 min的肝内胆管结石患者远期生活质量更差,预后不良风险更高。     

Immediate rehabilitation of a rheumatoid arthritis patient with single-piece implants

Introduction and importanceThe aim of this article is to report the long-term outcome of full mouth rehabilitation with single piece, smooth surface implants following immediate loading protocol on a patient suffering with RA and severe unilateral condylar resorption.Case presentationHere, we present a challenging case of a patient suffering from Rheumatoid Arthritis who was stabilized and completed successfully with a 4 year follow-up period. Prosthetic management optimized the inter-occlusal relationship to maintain both function and esthetic integrity. Single piece implants are designed to engage and take support from the cortical bone low in metabolic activities thus promoting the force transmission through apical threads that are engaged in the cortical bone.DiscussionRheumatoid Arthritis [RA] is an auto-immune inflammatory condition in which the inflamed and hypertrophic synovial membrane grows into the articulation surfaces. The Temporomandibular Joints [TM] are frequently involved in rheumatoid arthritis. According to the literature on RA, due to frequent periodontitis, decreased salivary secretion, medication, as well as decrease in bone regenerative potential, RA is often considered as a relative contraindication in the use of implants. Atrophic jaws and cases with comorbidities like osteoporosis, diabetes, rheumatoid arthritis, periodontally infected cases are restored with high success by single piece smooth surface.ConclusionTo the best of our knowledge, this may be the first case of immediate functional loading by bi-cortical single piece implants.     

Who receives influenza vaccinations at the Pharmacy? An analysis of the Texas Behavioral Risk Factor Surveillance System

IntroductionVaccination helps to prevent influenza infection and reduce associated costs but the influenza vaccination rate in Texas for adults between the ages of 18 to 64 years old is the lowest in the US. Pharmacies and alternative locations have been shown to help increase vaccination rates but many adults still go unvaccinated.ObjectiveThis research aims to determine the factors associated with obtaining influenza vaccination at the pharmacy compared to non-pharmacy locations in Texas.MethodThis study used pooled Texas Behavior Risk Factor Surveillance System datasets (2014 to 2018) for this assessment. The main outcome variable was categorized into pharmacy and non-pharmacy vaccination locations and analyzed using a logistic regression analysis. Further statistical analysis was done using a multinomial logistic regression after re-categorizing the outcome variable into pharmacy, doctor office, and other locations.ResultBlacks were 63% (AOR 0.37, C.I. 0.26, 0.50) and Hispanics were 38% (AOR 0.62, C.I. 0.48, 0.80) less likely to receive influenza vaccinations at the pharmacy respectively when compared to Whites. Furthermore, those who did not live in a Metropolitan Statistical Area (MSA) were 33% (AOR 0.67, C.I 0.53, 0.84) less likely to receive influenza vaccinations at the pharmacy compared to those who lived in an MSA. While there was no observed difference in the likelihood of receiving influenza vaccination, the unemployed population were 40% (AOR 1.40, C.I 1.15, 1.71) more likely to be vaccinated in the pharmacy compared to the employed population.ConclusionThere is potential for increased utilization of pharmacies as a source of influenza vaccination in Texas. Racial differences exist both for receiving influenza vaccinations and being vaccinated in the pharmacy. Influenza vaccination advocacy and education efforts may be necessary to improve pharmacy-based vaccination in Texas, especially for minorities and rural-dwelling Texans.     

公共卫生硕士专业学位研究生培养质量的调查研究

目的了解我国公共卫生硕士专业学位研究生的培养现状,探究培养质量影响因素,发现问题提出对策,为我国公共卫生硕士专业学位研究生培养提供依据。方法采用自编问卷对28所开设公共卫生硕士专业学位研究生教育院校的研究生进行问卷调查,采用描述性统计、探索性因子分析和多元线性回归分析对问卷结果进行分析。结果 53.68%的研究生认为课程教学中"重理论,与实践联系太少",9.81%的研究生表示没有专业实践机会,71.78%的研究生是单一导师制,44.79%的研究生在课题研究阶段进行基础类的实验研究。探索性因子分析降维提取"平台条件"、"专业实践"、"课程设置"、"导师队伍"、"奖惩机制"5个因子;多元线性回归分析发现"专业实践"、"导师队伍"和"平台条件"对研究生的自身培养质量评价呈正向影响。结论高校应该优化公共卫生硕士专业学位研究生的导师指导制度和导师队伍,规范专业实践培养过程,健全科研基础设备和完善专业实践基地建设,提高专业学位研究生的培养质量。