超声引导下热消融治疗继发性甲状旁腺功能亢进症的有效性及安全性:Meta分析

目的采用Meta分析评价超声引导下热消融治疗继发性甲状旁腺功能亢进症(SHPT)的有效性及安全性。方法检索PubMed、EMbase、Cochrane Library、中国知网、维普数据库及万方医学网中热消融治疗SHPT相关文献,检索时间自建库至2020年8月。依据纳入及排除标准筛选文献。采用ReveMan 5.3软件对消融前后血清全段甲状旁腺素(iPTH)、钙、磷水平及并发症行Meta分析。结果共纳入19篇文献、634例SHPT患者。热消融术后1天、1周、1个月及6个月,血清iPTH水平、钙及磷水平均较术前下降(P均0.01)。术后声音嘶哑发生率14.08%[OR=6.99,95%CI(3.00,16.26)],低钙血症发生率34.62%[OR=38.59,95%CI(16.64,89.47)]。结论超声引导下热消融治疗SHPT安全有效。     

The sorptivity and durability of gelling fibre dressings tested in a simulated sacral pressure ulcer system

Wound‐dressing performances are affected by exudate viscosity, resistance to flow because of gravity, and bodyweight loads, the level of which is related to the body position. Here, we focussed on two dressing properties: (a) Sorptivity—the ability of dressings to transfer exudate away from the wound bed by capillary action—and (b) Durability—the capacity of dressings to maintain their integrity over time and during their removal. Both properties are critically important for avoiding further tissue damage but require the development of new laboratory tests for their measurement. A computer‐controlled phantom of an exuding sacral pressure ulcer has therefore been developed and used to compare the performances of Exufiber (Mölnlycke Health Care) vs an alternative market‐leading dressing. Sorptivity was determined using weight tests, and durability was measured through tensile tests of the used dressings. For a supine configuration, the Exufiber dressing demonstrated ~three times higher sorptivity and better durability, withstanding ~five times greater strain energy than the other product before failure occurred. This work paves the way for quantitative, standardised testing of dressings in all aspects of exudate management. The reported tests are further suitable for testing dressing combinations or how dressings interact with negative pressure wound therapy.     

Mechanisms linking gut microbial metabolites to insulin resistance

Insulin resistance is the rate-limiting step in the development of metabolic diseases, including type 2 diabetes. The gut microbiota has been implicated in host energy metabolism and metabolic diseases and is recognized as a quantitatively important organelle in host metabolism, as the human gut harbors 10 trillion bacterial cells. Gut microbiota break down various nutrients and produce metabolites that play fundamental roles in host metabolism and aid in the identification of possible therapeutic targets for metabolic diseases. Therefore, understanding the various effects of bacterial metabolites in the development of insulin resistance is critical. Here, we review the mechanisms linking gut microbial metabolites to insulin resistance in various insulin-responsive tissues.     

拉萨市中小学生卫生应急素养的现况调查及影响因素分析

目的 初步了解拉萨市中小学生的卫生应急健康素养的水平现况,为制定提升中小学生卫生应急素养的综合干预措施提供参考依据。方法 采用分层整群抽样方法在拉萨市抽取三所学校进行自制卫生应急知识的问卷调查。结果 拉萨市中小学生卫生应急素养的合格率仅为12.62%。其中,卫生应急相关知识和灾害应急知识的合格率分别为44.79%、 12.36%。性别、民族、老师传播健康知识的渠道是卫生应急素养的主要因素。电视、老师和父母亲友告知是目前最广泛也是最受欢迎的健康知识传播渠道。结论 拉萨市中小学生的卫生应急素养水平整体较低,需要对小学生和藏族予以重点关注。为提升其卫生应急素养水平,需要将学校老师、专业指导人员、学生父母等作为传播主体,学校作为主要阵地,家庭和社会公共空间作为辅助阵地、建立多元传播渠道等以开展综合性卫生应急健康教育。     

安徽省2010—2019年9～18岁中小学生超重与肥胖流行趋势分析

目的 了解安徽省 2010—2019年中小学生超重和肥胖的流行趋势,为制定有效的干预措施提供依据。方法 于2010年、2014年和2019年分别采用分层整群随机抽样的方法获取安徽省在校中小学生有效数据7459份、8789份和5821份,应用中国肥胖工作组(WGOC) “中国学龄儿童青少年超重、肥胖筛查BMI分类标准”进行筛查,比较超重和肥胖变化情况。结果 2019年安徽省9～18岁中小学生的超重、肥胖检出率分别为15.3%和10.0%,男生超重、肥胖检出率分别为18.4%和13.0%,女生超重、肥胖检出率分别为12.2%和7.1%;城市学生超重、肥胖检出率分别为 16.3%和12.3%,乡村学生超重、肥胖检出率分别为14.2%和7.7%。2010—2019 年安徽省 9～18 岁中小学生超重、肥胖检出率表现出持续增长的趋势。结论 2010—2019年安徽省9～18岁中小学生超重、肥胖检出率处于增长趋势,超重、肥胖检出率存在性别及城乡差异。     

酵母重组乙型肝炎疫苗在中小学生中接种效果评价

目的 评价中小学生大规模乙型肝炎疫苗接种效果。方法 随机选取来实行乙型肝炎疫苗计划免疫管理的6－18岁中小学生1829名,采用血清流行病学方法观测大规模酵母重组乙型肝炎疫苗接种效果。结果 对HBsAg、抗－HBs和抗－HBc全阴性者,接种疫苗1年后,抗－HBs阳性率为70．55％,HBsAg和抗-HBc阳性率分别为0．56％和1．96％;该人群接种前HBVM阳性率为63．31％,接种后为85．51％,抗－HBs阳性率显著增高,且以6－12岁低年龄组人群更明显,而HBsAg和抗－HBc阳性率在接种后1年无明显变化。结论 酵母重组乙型肝炎疫苗大规模接种后,在中小学生中形成了乙型肝炎高保护性、低感染状态。     

实验性面神经麻痹次级突触间隙扫描电镜观察

目的：探讨面神经麻痹面肌运动点的兴奋性与运动科板次级突触间隙的关系方法岙神经麻痹模型,应用盐酸消化法制作口轮匝肌招揽世镜标本者观察。结果：压１０ｓ组镒级突触间隙隙沟数量比对照侧减少而变浅。压榨３０ｓ组次级突触间隙隙沟明显减少平坦。结论：运动点失神经支配程度表明次级突触间隙病变程度,也表明面神经受损伤程度。     

肝脏转移瘤的CT分析

目的　阐述肝脏转移瘤的 CT表现 ,探讨 CT检查的价值。方法回顾 90例肝脏转移瘤的CT资料分析肝脏转移瘤的数目、大小、密度、边界形态、在肝内的分布 ,肝脏及脾脏的大小 ,以及原发肿瘤的同时显示等多种表现。结果 65例 ,占 72 %转移瘤病灶数目在 3个以上 ,在肝内呈弥漫性分布 ;6例 ,占 7%有 2个病灶 ;19例 ,占 2 1%只有 1个病灶 ;其中 2 9个病灶位于靠近肝脏边缘的肝实质内。肿瘤大小由 0 .5～ 14cm不等。 87例肿瘤密度低于肝实质 ;3例肝脂肪变 ,肿瘤密度高于肝实质。 4 4例肿瘤内出现坏死。 31例呈弥漫多发病灶致肝脏增大变形 ;2 6例单发及两个病灶者 ,肝脏形态正常。 4 5例 CT检查同时发现原发肿瘤。结论肝脏转移瘤表现多样各异 ,以弥漫多发大小不等为常见。CT尤其可以发现临床尚属隐匿期的肝转移瘤。     

Bone scan of hemodialysis patients with secondary hyperparathyroidism before and after parathyroidectomy

Renal osteodystrophy (ROD) accompanied by long-term hemodialysis patients with chronic renal failure includes several forms of disorders of mineral and skeletal metabolism such as osteitis fibrosa attributed to secondary hyperparathyroidism, osteomalasia and adynamic bone disease. Bone scan is performed to detect of the mainly pathophysiology of ROD. We investigated bone scan of 25 hemodialysis patients with secondary hyperparathyroidism diagnosed clinically before and after parathyroidectomy (PTX). Before PTX an diffusely high accumulation of bone seeking agent in the whole skeleton especially skull in all patients (100%), vertebra in 24 out of 25 (96%), patella in 24/25 (96%), limbs in 23/25 (92%), sternum in 19/25 (76%), sacrum in 18/25 (72%) and costochondral junctions in 14/25 (56%) was noted in these patients. The radionuclide activity of the calvaria, maxilla and mandible in the skull was prominently high. Fourteen patients had an equally high activity in the calvaria, maxilla and mandible, 6 patients had higher activity in the maxilla and mandible than that of calvaria and 5 patients had higher in the calvaria than that of maxilla and mandible. After PTX the changes in the skull were obvious in 19 patients who showed a more markedly decreased in activity of the maxilla and mandible than that of the calvaria. In 3 patients showed a more markedly decreased in activity of the calvaria than that of the maxilla and mandible. Another 3 demonstrated equally decreased in activity in the calvaria, maxilla and mandible. It became clear that the highest activity of the skull was shown in all patients and the therapeutic changes of the skull are the most pronounced in maxilla and mandible in this study.     

Empowering family and friends: a new approach to the secondary prevention of addiction

This paper presents a typology and transactional model of how close relatives cope with excessive drinking, drug-taking or gambling in the family. These are illustrated with four examples taken from a series of research projects in which relatives have been interviewed to understand better how they react and respond. Such information is the groundwork for a World Health Organization initiative to help primary health care workers respond to the needs of relatives. The philosophy behind this initiative, and the steps that primary health care workers might take, are outlined. It is proposed that such workers can help close relatives to find the best coping methods in their circumstances, and that this approach might constitute an important, and hitherto neglected, form of secondary prevention.