大剂量激素对脑创伤家兔脑微循环及血液流变性的影响

为探讨大剂量激素对脑创伤后脑微循环及血液流变性的影响，将２４只家兔随机等分为３组：标准对照组、损伤对照组和地塞米松治疗组。分别在伤前０．５ｈ、伤后０．５ｈ、１ｈ、２ｈ、３ｈ测量软脑膜微动脉管径和血流速度的变化及伤后３ｈ血液流变学指标。结果表明：大剂量激素在伤后０．５ｈ就能明显地扩张损伤处软脑膜的微动脉并使血流速度明显加快。伤后３ｈ能明显降低血沉、全血粘度、红细胞压积及纤维蛋白原含量，并明显增强红细胞的变形能力，降低其聚集性。这些结果表明大剂量激素能明显改善脑创伤后家兔的脑微循环及血液流变性     

Blood endotyping distinguishes the profile of vitiligo from that of other inflammatory and autoimmune skin diseases

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The Mainz Severity Score Index: a new instrument for quantifying the Anderson-Fabry disease phenotype, and the response of patients to enzyme replacement therapy

Anderson-Fabry disease (AFD) is an X-linked disorder caused by deficient activity of the lysosomal enzyme alpha-galactosidase A. The availability of enzyme replacement therapy (ERT) for this debilitating condition has led to the need for a convenient and sensitive instrument to monitor clinical effects in an individual patient. This study aimed to develop a scoring system--the Mainz Severity Score Index (MSSI)--to measure the severity of AFD and to monitor the clinical course of the disease in response to ERT. Thirty-nine patients (24 males and 15 females) with AFD were assessed using the MSSI immediately before and 1 year after commencing agalsidase alfa ERT. Control data were obtained from 23 patients in whom AFD was excluded. The MSSI of patients with AFD was significantly higher than that of patients with other severe debilitating diseases. The MSSI indicated that, although more men than women had symptoms classified as severe, overall, the median total severity scores were not significantly different between male and female patients. One year of ERT with agalsidase alfa led, in all patients, to a significant (p < 0.001) reduction in MSSI score (by a median of nine points). This study has shown that the MSSI score may be a useful, specific measure for objectively assessing the severity of AFD and for monitoring ERT-related treatment effects.     

The relationship between exposure duration,carboxyhemoglobin, blood glucose,pyruvate and lactate and the severity of intoxication in 39 cases of acute carbon monoxide poisoning in man

The relationship between exposure duration, COHb, blood glucose, pyruvate and lactate and the severity of intoxication was investigated in a group of 39 cases of acute CO poisoning treated in the Clinical Toxicology Center in ód, Poland.On the basis of clinical criteria the patients were classified into cases of mild, moderate, severe and very severe CO poisoning. COHb and carbohydrate metabolites were estimated in venous blood taken immediately after admission of the patient to hospital prior to treatment.The severity of intoxication did not correlate with blood COHb; variation in exposure duration seems to be responsible for this phenomenon. Severe and very severe poisonings were associated with longer exposures and were accompanied by a markedly higher blood lactate level, compared to mild and moderate cases. Blood pyruvate depended less than lactate on the severity of intoxication. Blood glucose depended neither on exposure duration nor on the severity of intoxication.Among the carbohydrate metabolic parameters studied, blood lactate determination can be helpful in the evaluation of the severity of CO poisoning in man.     

身体形态指数ABSI和身体圆度指数BRI的发展与应用

目的 对身体形态指数(ABSI)和身体圆度指数(BRI)的发展进行介绍,并对其应用情况进行综述,为人体形态测量提供参考。方法 在Pubmed、中国知网等电子文献数据库中进行文献检索,详尽收录迄今ABSI与BRI对高血压、糖尿病、代谢综合征、心血管疾病等常见疾病的发病率以及全因死亡率预测的相关研究。结果 ABSI与BRI均对高血压、糖尿病、代谢综合征、心血管疾病发病呈现出一定的预测能力。其中,BRI在预测糖尿病、代谢综合征发病方面优于ABSI,但与身体质量指数、腰围、臀围、腰高比等传统测量指标相比,并未表现出显著的差异。ABSI对全因死亡率的预测能力则明显优于传统测量指标和BRI。结论 ABSI与BRI作为两项新的形态学指标,是BMI等传统身体指数测量的补充,对疾病发病具有一定的预测能力和应用性。今后的研究可以从两项指标对疾病的单独作用以及与传统指标的联合作用着手,同时探索其在不同社会人口学特征人群中的拟合情况,提供更有利的研究证据和科学积累。     

联合检测NSE、S100B、hs-CRP及NIHSS评分对急性脑梗死患者病情严重程度的评估价值

目的探讨联合检测神经元特异性烯醇化酶(NSE)、 S100B、超敏C-反应蛋白(hs-CRP)及美国国立卫生研究院卒中量表(NIHSS)评分对急性脑梗死患者病情严重程度的评估价值。方法选取我院2019年1月至2020年3月收治的急性脑梗死患者80例,依据改良Rankin量表(mRS)评分将其分为重度组(mRS评分≥3分,n=36)及轻度组(mRS评分<3分,n=44);另选取同期在我院行健康体检的40例患者作为健康组。比较三组的NSE、 S100B、 hs-CRP及NIHSS评分。结果重度组的NSE、 S100B、 hs-CRP、 NIHSS评分均高于轻度组及健康组(P <0.05);Pearson分析显示,NSE、 S100B、 hs-CRP及NIHSS评分与急性脑梗死病情严重程度呈正相关(r>0, P <0.05)。结论 NSE、 S100B、 hs-CRP及NIHSS评分与急性脑梗死患者病情严重程度呈正相关,联合检测具有客观性。     

Sleep Problems among Mothers of Youth Stopped by the Police

Police stops are the most common form of criminal justice exposure in the USA, and are particularly common among urban youth, with 23% of them reporting a stop by the age of 15. While recent work has begun to illuminate the health impacts of police stops for these youth, little is known about the health consequences of youth police contact for the mothers of youth stopped by the police. The current study employs data from the Fragile Families and Child Wellbeing Study (FFCWS), a sample of urban, at-risk youth and their families. Multivariate logistic regression models are conducted to examine the link between youth police stops and sleep difficulties among mothers. Additional analyses examine whether the features and consequences of police stops are associated with sleep difficulties among mothers. The findings indicate that mothers with youth who have experienced police stops are more than twice as likely to report both depression- and anxiety-related sleep difficulties compared to their counterparts. Furthermore, stops with certain features—including those characterized by intrusiveness, high trauma, and high stigma—emerged as consistently significant predictors of maternal sleep difficulties. The findings suggest that mothers who are vicariously exposed to police contact via their children are a vulnerable group. Given the non-random distribution of police contact across the population of youth, with police contact concentrated among children of color, the findings suggest that police contact may exacerbate racial inequalities in sleep, which may itself contribute to racial disparities in broader mental and physical health outcomes.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11524-021-00518-1.     

我国医疗质量安全不良事件分类的思考

患者安全问题已经成为世界各国医疗质量管理关注的焦点,从国家层面对医疗质量安全不良事件进行统一定义和分类具有重要意义。通过总结世界卫生组织、美国、英国以及我国目前不良事件分类及严重程度分级情况,结合我国相关上报数据,分析存在问题,建议国家及各级卫生行政部门发挥引导推动作用,医疗机构利用现有国家医疗质量安全相关平台,参考借鉴相关分类,开展同质化医疗质量安全管理工作。     

人SR-AI转基因小鼠模型的主要形态学特性、血液学指标和血脂水平的研究

目的明确人SR-AI转基因小鼠的一些形态、脏器、血液学和血浆脂质参数,为人SR-AI转基因小鼠模型的应用提供相关依据.方法用游标卡尺和电子称量天平测量人SR-AI转基因小鼠的吻长、眶间距、体长、尾长及12个脏器系数并与C57BL/6J小鼠进行比较分析;用SysmexK-4500型全血自动多参数血液分析仪检测其血液学指标;并用酶法分别测定血浆总胆固醇、甘油三酯和高密度脂蛋白胆固醇含量.结果人SR-AI转基因小鼠外部形态指标和脏器系数与C57BL/6J小鼠比较差异没有显著意义(P>0.05);转基因小鼠的各项血液学指标无明显改变,血脂蛋白成分的改变亦未显示统计学意义(P>0.05),甘油三酯的浓度略有增高(P<0.05).结论人SR-AI转基因小鼠的外部形态指标、脏器系数及各项血液学指标均无明显改变,适合用作动脉粥样硬化模型的研究.