后腹膜肿瘤23例临床分析

目的探讨后腹膜肿瘤的种类及诊治方法。方法回顾性分析后腹膜肿瘤23例的临床资料。结果 23例患者均行手术治疗,其中3例（13.1%）为腹腔镜手术,术后根据病理检查结果再行后续治疗。结论后腹膜肿瘤的来源多样性,手术切除肿瘤是治疗的关键。     

老年大鼠股骨颈骨折术后认知功能及Aβ1～40、Bax、Bcl-2的改变

目的 探讨老年大鼠股骨颈骨折术后空间学习记忆能力、血清Aβ1 ～40及海马内抗凋亡基因Bcl-2和促凋亡基因Bax表达的变化.方法 SD老年大鼠35只随机分为三组:空白组(K组,n=7)、对照组(D组,n=14)、手术组(S组,n=14).D、S组根据处理时间不同各分2个亚组,D1、D3、S1、S3组(每组7只).Moms水迷宫测试大鼠的学习记忆能力,ELISA法检测血清Aβ1 ～40浓度,RT-PCR检测海马内Bcl-2和Bax mRNA的表达.结果 学习记忆能力测试表明:S组逃逸潜伏期显著延长(P＜0.05),穿过原平台的次数明显减少(P＜0.05);S组血清Aβ1～40浓度明显升高,与K组、D组相比,差异均有统计学意义(P＜0.05);S组Bax mRNA的表达比K组和D组都显著升高(P＜0.01),Bcl-2 mRNA的表达比K组显著降低(P＜0.01,P＜0.05),Bcl-2/Bax值比K组和D组都显著降低(P＜0.01,P＜0.05).结论 老年大鼠股骨颈骨折术后可暂时影响大鼠的空间学习记忆能力,可能与血清Aβ1 ～40浓度升高以及海马内Bcl-2/Bax比例降低有关.     

Meta-analysis shows significant association between dopamine system genes and attention deficit hyperactivity disorder (ADHD)

Molecular genetic investigations of attention deficit hyperactivity disorder (ADHD) have found associations with a variable number of tandem repeat (VNTR) situated in the 3'-untranslated region of dopamine transporter gene (DAT1), a VNTR in exon 3 of dopamine receptor 4 gene (DRD4) and a microsatellite polymorphism located at 18.5 kb from the 5' end of dopamine receptor 5 gene (DRD5). A number of independent studies have attempted to replicate these findings but the results have been mixed, possibly reflecting inadequate statistical power and the use of different populations and methodologies. In an attempt to clarify this inconsistency, we have combined all the published studies of European and Asian populations up to October 2005 in a meta-analysis to give a comprehensive picture of the role of the three dopamine-related genes using multiple research methods and models. The DRD4 7-repeat (OR=1.34, 95% CI 1.23-1.45, P= 2 x 10(-12)) and 5-repeat (OR=1.68, 95% CI 1.17-2.41, P=0.005) alleles as well as the DRD5 148-bp allele (OR=1.34, 95% CI 1.21-1.49, P= 8 x 10(-8)) confer increased risk of ADHD, whereas the DRD4 4-repeat (OR=0.90, 95% CI 0.84-0.97, P=0.004) and DRD5 136-bp (OR=0.57, 95% CI 0.34-0.96, P=0.022) alleles have protective effects. In contrast, we found no compelling evidence for association with the 480-bp allele of DAT (OR=1.04, 95% CI 0.98-1.11, P=0.20). No significant publication bias was detected in current studies. In conclusion, there is a statistically significant association between ADHD and dopamine system genes, especially DRD4 and DRD5. These findings strongly implicate the involvement of brain dopamine systems in the pathogenesis of ADHD.     

2007～2008年北京市中药饮片市场质量情况分析

目的分析北京市中药饮片市场的质量情况,提出市场监管重点。方法对2007～2008年北京市中药饮片抽验情况进行统计分析,归纳总结。结果北京市中药饮片一部分品种混乱,有掺伪现象,应作为重点监管对象。结论准确地分析了北京市中药饮片市场的质量状况,归纳总结出混乱的品种。     

氯吡格雷联合阿托伐他汀治疗缺血性心脑血管疾病的系统评价

目的:系统评价氯吡格雷与阿托伐他汀联合应用对缺血性心脑血管疾病的影响。方法:以"clopidogrel"、"atorvastatin"、"ClinicalTrial"、"氯吡格雷"、"阿托伐他汀"、"临床试验"为检索词,分别在EMBase、PubMed、Cochrane图书馆和中国期刊网数据库(CNKI)4个中英文数据库中进行检索,用ReviewManager5.0软件进行数据分析。结果:共有5项研究被纳入,以氯吡格雷为对照的相关临床研究有4篇(n=5874),以阿托伐他汀为对照的相关临床研究有3篇(n=6790)。结果显示,(1)氯吡格雷与阿托伐他汀联合应用时,心肌梗死、脑卒中和缺血性死亡综合事件的发生率比单独使用氯吡格雷低39%(合并RR=0.61,95%C(I0.51～0.74))。(2)氯吡格雷与阿托伐他汀联合应用时,综合终点事件发生率比单独使用阿托伐他汀低19%(合并RR=0.81,95%CI为(0.71～0.93))。结论:在临床上,氯吡格雷与阿托伐他汀的联合应用存在协同效应,比单独应用氯吡格雷或阿托伐他汀对缺血事件的预防作用更强。     

Zoonotic potential of highly pathogenic avian H7N3 influenza viruses from Pakistan

H5 and H7 avian influenza viruses can become highly pathogenic in chickens after interspecies transmission. These viruses have transmitted directly to humans from birds in Eurasia and Africa (H5N1), the Netherlands (H7N7), and Canada (H7N3). Here we report antigenic, sequence, and phylogenetic analyses of H7N3 viruses isolated from chickens in Pakistan from 1995 to 2002. We compared the pathogenic and zoonotic potential of the Pakistani viruses in avian and mammalian hosts. In chickens, all of the isolates showed high pathogenicity with poor transmissibility to contact birds. Viral shedding from the trachea and cloaca was equivalent, but cloacal shedding occurred longer; dissemination of virus into the tissues was widespread. In contrast, the viruses replicated poorly in 6-week-old mallard ducks. In mammalian hosts, of the two Pakistani H7N3/02 viruses that caused weight loss, one also caused 40% mortality in mice without prior adaptation, and preliminary experiments in ferrets showed significant virus multiplication in the lungs, intestine, and conjunctiva. We conclude that the H7N3/02 isolates from Pakistan show limited antigenic drift and have evolved slowly during their 8-year circulation in chickens; however, these viruses have the potential to infect mammals.     

3～6岁儿童家长的儿童忽视相关知识、态度、行为现况调查

目的了解3～6岁儿童家长的儿童忽视相关知识、态度、行为现况,为进行防治儿童忽视干预提供科学依据。方法采用自行设计的调查问卷,对广东省东莞、惠州、中山、佛山四市3～6岁的儿童家长621人进行儿童忽视相关知识、态度、行为现况调查。结果仅5.4%听说过儿童忽视也知道内容;55.9%以前从来没有获得过防治"儿童忽视"的知识;90.7%～97.4%的家长愿意接受、需要和认为应该进行防治儿童忽视知识的教育和宣传;91.0%愿意为防治儿童忽视做力所能及的事情;家长对孩子经常有的行为依次是:温情、理解(72.4%)、严厉(48.6%)、责骂(43.3%)、过度保护(19.6%)、拒绝(18.2%);对孩子从来没有的行为依次是:恐吓(65.2%)、过分干涉(50.5%)、惩罚(38.7%)、过度保护(37.4%)、否认(29.7%)。他们认为儿童忽视主要发生在以下地方:家庭(78.3%)、幼儿园(61.0%)、公共场合(40.3%);认为保护3～6岁儿童的责任应在于家长(95.3%)、幼儿园老师(76.7%)、相关机构(39.4%)、政府(29.9%);认为目前防治儿童忽视的教育未普及的可能原因是政府、社会不重视(59.9%)、没有成立相应的专业机构(57.8%)、家长或老师本身缺乏相应知识(57.4%)、社会、医疗和教育机构宣传不力(47.4%)、宣传形式和内容不佳(40.7%)、没有相应的立法(37.3%)等;同时95.4%的家长呼吁应该成立相应的防治儿童忽视的机构、法律援助机构或立法保护儿童。结论 3～6岁儿童家长儿童忽视相关知识严重匮乏,相应的健康教育远远不足,而家长态度是肯定的、对其需求迫切,但现实与需求相差甚远。应加强健康教育,注意家庭、幼儿园是健康教育的重点,同时呼吁政府、社会、家长、老师应关注防治儿童忽视。     

The experience of being disabled and obese

Purpose. This qualitative study was designed to explore the experiences of disabled and severely obese people living in the community. The challenges that their size and disabilities posed within their homes and in accessing community facilities were explored, with particular reference to the provision and use of assistive technologies.

Methods. The study comprised in-depth interviews with a sample of six severely obese, disabled people using a grounded theory approach.

Results. Three key themes emerged: the experience of daily life; accessing services; and responses to challenges. The study participants found that their home and community environments were seldom adequate for their size. Difficulties were identified in relation to accessing and using NHS services and negative attitudes and treatment from staff. Assessments and quality of assistive devices and housing adaptations received were criticised by some. Participants identified a range of responses to these challenges.

Conclusion. The challenges that obesity bring are compounded by disability, including the need for higher levels of care and the higher costs of assistive devices for this client group. The study suggests there may be a need for training for professionals who work with obese, disabled people to ensure their needs are met in appropriate and cost-effective ways.     

广西A县0~14岁儿童重大疾病医疗保障研究

目的:了解0～14岁重大疾病儿童医疗费用负担,对提高儿童重大疾病医疗保障水平,进一步推进儿童医疗保障制度提供有效可行的建议.方法:运用SPSS 17.0统计软件对广西A县0～14岁重大疾病儿童就医费用数据等进行分析.结果:0～14岁重大疾病儿童新农合实际补偿比极低,极易发生灾难性卫生支出.结论:提高儿童重大疾病医疗保障水平,建立儿童社会医疗保障体系;因地制宜、因需制宜地选择儿童重大疾病定点医疗机构;探索异地就医的结算方式;控制部分儿童重大疾病的发生.