pH对β-内酰胺酶抑制剂抑酶作用的影响

造择舒巴坦（ｓｕｌｂａｃｔａｍ）和克拉维酸（ｃｌａｖｕｌａｎｉｃ ａｃｉｄ）为研究对象,考察在不同ｐＨ条件下（６．０、７．０、８．０）两者对三种β－丙酰胺酶（ＴＥＭ－２、ＳＨＶ－１、ＯＸＡ－３）抑酶作用的变化。结果表明,克拉维酸对三种酶的抑制效力均较好,舒马坦对ＯＸＡ－３酶的抑制效力远较其它两种酶差,且舒巴坦对ｐＨ的敏感性强于克拉维酸,其在不同ｐＨ条件下的抑制效力差异较大,说明克拉维酸的抑酶效力在     

NEONATAL MORBIDITY OF S. G. A. INFANTS IN RELATION TO THEIR NUTRITIONAL STATUS AT BIRTH

ABSTRACT. 46 consecutively born term infants with a birthweight ≤ the 2.3 percentile for gestational age were divided into two groups according to their nutritional status at birth quantified by the ponderal index (100 × weight/length³). Though all infants had a ponderal index below the 50th percentile, those with a ponderal index below the 3rd percentile (about half of the study group) were more frequently affected by asphyxia, hypoglycaemia, hypothermia, and hyperviscosity than their more proportionally grown counterparts. On this account the identification of disproportionally grown small-for-gestational age infants by using the ponderal index as a yardstick of the nutritional status at birth, is necessary because they constitute a high-risk group among small-for-gestational age infants.     

膳食营养因素与脑卒中患病率相互关系的流行病学研究

目的:研究膳食中营养因素与脑卒中患病率的关系。方法：采用简单相关和逐步回归方法分析全国143个调查点居民1984-1986年各种食物营养因素摄入与1986年脑卒中患病率的关系。结果：蛋白质、糖类、钙与患病率呈负相关,维生素A、锌、铁与之呈正相关。结论：膳食营养结构对脑卒中患病有一定影响,高蛋白和高钙摄入是脑卒中的保护因素,而维生素A可能是脑卒中的危险因素。     

Nutritional Adequacy and Diet Quality Are Associated with Standardized Height-for-Age among U.S. Children

Nutritional status affects linear growth and development. However, studies on the associations between nutritional status, diet quality, and age-standardized height in children are limited. The aim of this study was to assess the relationship between macro- and micronutrient intake and food consumption and height-for-age Z score (HAZ) among US children in the National Health and Nutrition Examination Survey (NHANES). This cross-sectional population-based study included 6116 US children aged 2–18 years. The usual dietary intake of nutrients and food groups was estimated by the multiple source method (MSM) using two-day food consumption data from NHANES 2007–2014. After adjusting for covariates, HAZ was positively associated with intakes of energy, protein, carbohydrate, fat, vitamins A, D, E, B6, and B12, thiamin, riboflavin, niacin, calcium, and iron. Children in the highest tertile of HAZ were less likely to consume lower than the EAR for vitamin E and calcium. Major foods consumed by children with lower HAZ were soft drinks, high-fat milk products, cakes, cookies, pastries, and pies, whereas children with higher HAZ tended to consume low-fat milk products, tea, and low-calorie fruit juice. These findings suggest that adequate nutritional intake, diet quality, and nutrient-dense food are important factors for height in children.     

2017—2019年登革病毒NS1抗原阳性预测值及影响因素分析

目的 评价NS1抗原阳性预测值在登革热病例监测中的应用价值,为登革热病例早诊断、早隔离提供科学依据,为疫情防控争取黄金时间。 方法 对2017—2019年中山市登革热病例监测数据开展描述性流行病学分析,采用二分类logistic回归分析NS1抗原阳性预测值的影响因素。登革病毒NS1抗原检测方法为胶体金法和ELISA法,复核方法为荧光定量RT-PCR(登革病毒核酸检测)和ELISA法(登革病毒IgM和IgG抗体检测)。 结果 1 115例登革热监测病例中,NS1抗原阳性预测值为58.27%(634/1 088),多因素logistic回归分析显示,NS1抗原阳性预测值的影响因素为年龄(OR=1.021,95%CI:1.011～1.031)、发病前2周外出史(境外OR=54.993,95%CI:19.954～151.560;境内OR=2.628,95%CI:1.630～4.238)、社区出现本地疫情(本地流行OR=277.918,95%CI:75.691～1020.444;本地散发OR=13.831,95%CI:3.937～48.583)、白细胞(降低OR=79.981,95%CI:31.963～200.140;正常OR=25.019,95%CI:10.471～59.783)。确诊病例发病6 d内,白细胞和血小板降低比例逐渐升高,白细胞降低在第6 d高达92.00%(46/50),血小板降低在发病5 d内仅占13.52%(71/525)。 结论 不能明确诊断为其他疾病的发热病例,发病6 d内白细胞正常或降低的患者是登革病毒NS1抗原筛查的重点对象,根据流行强度,应采取不同的监测策略,在登革热大范围流行的社区,医疗机构检测的NS1阳性可直接作为疫情处置的依据。     

CT和MRI联合检查于晚期子宫内膜癌术前分期的价值

目的探讨计算机断层扫描（CT）和核磁共振成像（MRI）联合检查在子宫内膜癌术前分期的临床应用价值。方法选取武警浙江总队嘉兴医院收治的56例晚期子宫内膜癌患者作为研究对象，以手术病理分期为标准并以单纯CT检查和单纯MRI检查为对照，分析CT和MRI联合检查在晚期子宫内膜癌术前分期的准确性。结果CT和MRI联合检查对子宫内膜癌术前分期术前诊断准确率为85．71％，单纯CT为58．93％，单纯MRI检查为62．50％。CT和M砌联合检查的准确率显著高于单独CT（χ2=7．8637，P〈0．01）或MRI检查（χ2=10．0358，P〈0．01）。结论CT和MRI联合检查在晚期子宫内膜癌术前分期的准确率高，是一种理想的诊断方法。     

血脂异常患者健康价值与生活方式的相关性研究

目的针对血脂异常患者进行讨论其健康价值与生活方式,并研究二者之间的相关性。通过深入了解健康价值与生活方式,找到科学的护理干预措施来改善血脂异常患者的身体状况。方法采用患者调查表的方式,对144例患者的一把情况,健康价值与生活方式进行调查表分析,并通过这些来了解两种的关系。结果如果患者的生活方式水平较好,那么其健康价值水平也会较高,两种是正相关关系。结论通过提高血脂异常患者的健康价值水平,可以有效的改善患者的自我约束力,并通过改善不良的生活方式,可以有效减少血脂异常对患者造成的危害程度。     

Evaluating Frameworks That Provide Value Measures for Health Care Interventions

The recent acceleration of scientific discovery has led to greater choices in health care. New technologies, diagnostic tests, and pharmaceuticals have widely varying impact on patients and populations in terms of benefits, toxicities, and costs, stimulating a resurgence of interest in the creation of frameworks intended to measure value in health. Many of these are offered by providers and/or advocacy organizations with expertise and interest in specific diseases (e.g., cancer and heart disease). To help assess the utility of and the potential biases embedded in these frameworks, we created an evaluation taxonomy with seven basic components: 1) define the purpose; 2) detail the conceptual approach, including perspectives, methods for obtaining preferences of decision makers (e.g., patients), and ability to incorporate multiple dimensions of value; 3) discuss inclusions and exclusions of elements included in the framework, and whether the framework assumes clinical intervention or offers alternatives such as palliative care or watchful waiting; 4) evaluate data sources and their scientific validity; 5) assess the intervention’s effect on total costs of treating a defined population; 6) analyze how uncertainty is incorporated; and 7) illuminate possible conflicts of interest among those creating the framework. We apply the taxonomy to four representative value frameworks recently published by professional organizations focused on treatment of cancer and heart disease and on vaccine use. We conclude that each of these efforts has strengths and weaknesses when evaluated using our taxonomy, and suggest pathways to enhance the utility of value-assessing frameworks for policy and clinical decision making.     

模拟高原低氧环境对兔龈下菌斑影响的实验研究

目的:探讨高原低氧环境对兔龈下菌斑中定植的细菌种类、数量和内毒素水平的影响。方法:40只雄性大白兔随机分为平原对照组、平原实验组、高原对照组和高原实验组,每组10只,两实验组采用正畸丝结扎下颌中切牙并联合牙周炎食谱饲养的方法建立牙周炎模型,同时,两高原组送入低压氧舱(模拟海拔高度5 000m,23 h/d)内饲养。8周后检测牙周探诊深度(PD),附着丧失(AL)、菌斑指数(PLI)、牙龈指数(GI),pH试纸检测龈沟液pH值,采集龈下菌斑进行厌氧菌分离、培养、计数、镜检、内毒素检测。结果:高原实验组AL、PLI、GI等临床牙周指标以及龈沟液pH值、活菌数、内毒素水平等均明显高于其他各组(P<0.05),且细菌种类更为丰富;相关分析显示,龈沟液pH值、活菌数与AL、PLI、GI呈正相关,内毒素水平与AL呈正相关。结论:高原低压低氧的特殊环境更利于G-厌氧菌的定居,使牙周袋内氧气消耗量增加,pH值升高。     

扫描视野对乳腺癌调强放射治疗剂量学影响的研究

目的 研究不同扫描视野(FOV)CT图像对乳腺癌根治术后放射治疗中危及器官自动勾画及剂量计算精度的影响。方法 使用相同扫描条件在患者模拟定位CT等中心处及扩展扫描射野(eFOV)处建立50、60、70和80 cm FOV的电子密度转换曲线并比较其差异;扫描已知体积的标准模体,比较模体在不同FOV重建图像上自动勾画的差异。简单随机抽样选取2020年1月至2022年6月广东省第二人民医院乳腺癌患者30例,获取不同FOV模拟定位CT图像进行危及器官自动勾画,并与医师的勾画进行比较;基于FOV₅₀图像设计治疗计划,将计划移植到不同FOV重建图像进行剂量计算,比较剂量计算结果的差异。结果 以不同FOV重建CT图像建立的电子密度转换曲线基本一致。在等中心处,标准模体随FOV增大,模体勾画体积与实际体积差异增大,最大为6 cm³(4.8%);在自动勾画中,脊髓、气管、食管、甲状腺、健侧乳腺和皮肤的勾画精度随FOV增大而减小(t= -28.43~8.23,P＜0.05), 基于不同FOV图像的剂量计算比较中,锁骨上淋巴结区域靶区V₉₅、最大剂量和平均剂量,危及器官剂量学的差异无统计学意义(P>0.05); 计划靶区覆盖度随FOV增大而减小(最大差异为4.06%)。结论 乳腺癌根治术后放疗中危及器官自动勾画应选择FOV₅₀重建图像,电子密度转换曲线应依据eFOV区域电子密度模体影像建立,首选eFOV₈₀的重建图像进行剂量计算。