四川省艾滋病抗病毒治疗6~12个月病毒学失败患者耐药性分析

目的 分析四川省接受艾滋病抗病毒治疗6~12个月病毒学失败患者的耐药影响因素和耐药特征。方法 对2016—2019年接受治疗6~12个月且病毒学失败患者进行HIV-1基因型耐药检测,采用统计学logistic回归和卡方检验分析病毒学失败患者耐药发生的影响因素,以及不同地区和亚型毒株间耐药突变特征。结果 3626例患者符合调查标准,成功获得序列2915例（80.39%）,其中1246（42.74%）例耐药,多因素logistic回归分析发现,注射吸毒者的耐药突变是异性性传播患者的1.90倍;艾滋病的耐药突变是HIV感染者的1.75倍;基线CD4+T淋巴细胞计数≥350个/μl和200~349个/μl的耐药突变是CD4+T淋巴细胞计数＜200个μl的0.76和0.64倍;初始治疗方案含洛匹那韦/利托那韦（LPV/r）的二线治疗方案的耐药突变是是含齐多夫定的0.37倍;感染CRF01_AE亚型毒株的耐药突变是感染CRF07_BC亚型毒株的1.34倍。成都平原、川东北、川西北、川南和攀西地区耐药率分别为45.41%、37.47%、54.84%、43.38和34.34%,卡方检验有统计学意义（P＜0.05）;主要流行亚型CRF07_BC、CRF01_E、CRF08_BC和CRF85_BC耐药率分别为39.60%、48.55%、34.17%和44.27%,卡方检验有统计学意义（P＜0.05）。结论 四川治疗6~12个月艾滋病患者病毒学失败的耐药率较高,耐药突变状况复杂多样,感染途径、基线CD4+T淋巴细胞计数、病程、感染毒株亚型、初始治疗方案是治疗6~12个月病毒学失败患者发生耐药的影响因素,且各地区耐药发生和各亚型耐药突变特征不同。     

军人心理弹性与疲劳的关系：社会支持与自我效能感的多重中介作用

目的 研究军人疲劳与心理弹性、社会支持以及自我效能感的关系。方法 采用多维疲劳量表(Multidimensional fatigue inventory scale, MFI-20),心理弹性量表(The Connor-Davidson Resilience scale, CD-RISC),一般自我效能感量表(General Self Efficacy Scale, GSES),中文版社会支持问卷(Chinese Version Social support revalued scale, SSRS)对812名军人进行测试。采用相关性分析,回归分析探讨变量间的关系并通过建构结构方程模型检验社会支持、自我效能感在心理弹性与疲劳之间的中介作用。结果 共回收到794份有效问卷,有效率为97.78%。相关性结果分析表明疲劳与心理弹性、社会支持以及自我效能感负相关(P < 0.01),心理弹性与社会支持、自我效能感正相关(P < 0.01), 社会支持与自我效能感正相关(P < 0.01)。回归分析结果表明心理弹性可独立预测疲劳水平(P < 0.001),同时社会支持和自我效能感对疲劳的回归显著(P < 0.001),三者可解释疲劳46.6%的方差变异。结构方程模型结果表明社会支持、自我效能感在心理弹性与疲劳之间的中介作用显著(P = 0.026,P < 0.001, 95%置信区间都不包含0),同时,两者的链式中介在心理弹性与疲劳的也存在显著中介作用(P < 0.001, 95%置信区间都不包含0)。结论 加强军人心理弹性水平训练,增强军人社会支持水平,提高军人自我效能感对军人增强疲劳应对能力,降低疲劳反应,提高作业效能具有重要意义。     

"Fatigue on rest" and associated symptoms (headache, vertigo, blurred vision, nausea, tension and irritability) due to locally asymptomatic, unerupted, impacted teeth.

"Fatigue on Rest", headache, vertigo and the feeling of loss of balance, blurred vision, nausea, tension and irritability, were found to be prevalent amongst patients who had locally asymptomatic, unerupted impacted teeth. A comparative pressure sign was developed, which, when positive, confirmed the relationship between the impacted teeth and the medical symptoms. Removal of the impactions resulted in the alleviation of the symptoms. Stress and psychogenic factors are considered as trigger mechanisms, rather than as basic causes of the symptoms.     

中枢、神经—肌肉接头、肌肉疲劳的实验模型及其应用研究

目的：建立研究中枢、神经－肌肉接头和肌肉疲劳动物模型,为各种因素对运动性疲劳的影响及机制的研究,提供一种新的实验方法。方法：用铂金电极刺激蟾蜍脊髓,保护电极刺激坐骨神经干,直刺电极刺激腓肠肌,用MS302实验系统记录坐骨神经干的动作电位和腓肠肌的收缩曲线。观察丹参和生脉注射液对上述疲劳的影响。结果：中枢出现疲劳时间最短;神经－肌肉接头次之;肌肉出现疲劳时间最长。丹参和生脉注射液使中枢、神经－肌肉接头和肌肉出现疲劳时间都相应延长。结论：运动性疲劳首先发生在中枢,其次是神经－肌肉接头,最后是肌肉疲劳,丹参和生脉具有抗疲劳的作用。     

彩色多普勒能量图对不孕症妇女子宫动脉血流变化的观察

利用彩色多普勒能量图测定子宫的血流 ,即血流的脉冲指数 (pulsative index,PI)及阻力指数 (resistantindex,RI)来探索不同原因的女性不孕症。 6 7例不孕症妇女经腹腔镜诊断确诊不孕原因后 ,于月经周期第 2 0～ 2 3d作腹部 B超彩色多普勒能量图 (CDE)检查。其结果两侧子宫动脉 PI、RI可因各种不孕原因不分侧别平均 PI、RI均高于正常组 (P<0 .0 1) ,而且不受病情轻、中、重所影响。反映了子宫周围血管阻力较高所致子宫动脉血流灌注不足是引起不孕症的基础 ,可能也干扰孕卵着床而致不孕。     

住院肺结核病人耐药状况与疗效分析

目的　了解结核病医院中住院病人的耐药及多耐药结核病 ( MDR-TB)流行情况、特点及影响因素。方法　用临床流行病学方法进行统计和分析。结果　耐药率为 3 0 .71 % ,MDR-TB发病率为1 1 .68% ,初始 MDR-TB为 2 .55% ,继发 MDR-TB为 9.1 3 % ,MDR-TB死亡率为 9.4 8%。结论　耐药及MDR-TB发病率逐年增加 ,高死亡率。     

泸州某医院手术室多重耐药菌感染现状研究

目的分析某医院手术室患者多重耐药菌(MDRO)感染现状,找出相关因素。方法选择2020年2月至2021年1月泸州某医院手术室12619例成年患者作为研究对象,调查患者资料,进行病原菌检测和细菌药敏试验,统计手术室MDRO感染发生情况,分析MDRO感染的菌种、科室分布、耐药情况和MDRO感染发生的相关因素。结果医院手术室患者MDRO感染发生率为2.10%。MDRO感染占比较大的科室是普外科(34.28%)、骨科(23.78%)、泌尿外科(15.22%)。手术室患者MDRO感染中较常见的菌种是鲍曼不动杆菌(46.99%)、金黄色葡萄球菌(19.91%)、铜绿假单胞菌(12.04%)。鲍曼不动杆菌对头孢曲松完全耐药,对氨苄青霉素、环丙沙星、头孢他啶、头孢吡肟、庆大霉素、妥布霉素耐药率超过80.00%,仅对左氧氟沙星耐药率不超过30.00%;金黄色葡萄球菌对青霉素、苯唑西林完全耐药,对红霉素、氯林可霉素的耐药率超过80.00%;铜绿假单胞菌对头孢曲松、氨苄青霉素完全耐药,对头孢他啶、环丙沙星、复方新诺明耐药率超过80.00%,仅对阿米卡星耐药率不超过30.00%。Logistic回归分析结果显示,入住ICU(OR=5.943)、侵入性操作(OR=2.704)、抗菌药物使用时间长(OR=2.244)、合并糖尿病(OR=1.955)是医院手术室患者MDRO感染的影响因素。结论泸州某医院手术室患者MDRO感染发生率较高,可能受入住ICU、侵入性操作、抗菌药物使用时间长、合并糖尿病的影响。     

使用中消毒剂分离CNS的抗消毒剂性研究

定量杀菌实验结果表明,使用中消毒剂分离的８３析ＣＮＳ对洗必泰,新洁尔灭,乙醇和碘伏的抗性率分别为１５．６２％、１５．６２％、１２．５％、６．２５％。对上述四种消毒 一种以上具有抗性的抗性率为３４．４８％（１１／３２）,多重抗性率为６．２５％（２／３２）,１１株性菌株共有抗新洁尔灭,洗必泰,乙醇,碘伏－乙醇－洗必泰和碘伏－乙醇－洗必泰－新洁尔灭５种抗消毒剂谱。     

Prospective feasibility study of a mindfulness-based program for breast cancer patients in the southeastern US

BackgroundMindfulness interventions can improve psychological distress and quality of life (QoL) in cancer survivors. Few mindfulness programs for cancer recovery exist in Southeastern U.S. The primary objective of this study was to assess the feasibility of a modified mindfulness-based stress reduction (MBSR) program for breast cancer patients in Birmingham, Alabama. The secondary objective was to explore potential program effects on mindfulness skills and QoL.MethodsThis study was a prospective, quasi-experimental feasibility study conducted over 10 months at a university hospital. Feasibility was achieved if 80% of eligible patients screened enrolled in the study and 70% of enrolled patients attended all 8 program sessions. Effectiveness was estimated by changes in mindfulness and QoL indicators measured with validated scales administered at 3 time points and assessed with a non-parametric Friedman test. Sessions included meditation, yoga, and an attention practice called body scan. There were 3 groups of 2–5 patients.ResultsThe sample totaled 12 patients. Forty-four percent (12/27) of eligible patients enrolled in the study, and two out of 12 enrolled patients completed 8 program sessions, resulting in 16.7% (2/12) retention. However, more than half (66.7%) of participants completed at least 7 sessions. Between baseline and 8-week follow-up, patients demonstrated statistically significant improvements in distress, general wellbeing, and fatigue-related QoL.ConclusionsFeasibility objectives were not achieved. However, a majority of participants (66.7%) completed 7 of 8 program sessions. Program effects were promising for distress, fatigue, and wellbeing. Results warrant further research on MBSR-like programs for breast cancer patients in Alabama.     

Error-related processing during a period of extended wakefulness

The nature of error detection as manifested by the error-related negativity was examined in both a Sternberg memory search task and a visual search task. Both tasks were performed in conditions with consistent or varied stimulus-response mapping and loads of three or six letters. After subjects were trained extensively in all conditions, they performed the tasks throughout the night without sleeping. The data suggest that the effectiveness of error detection decreases over time because of a decrease in the quality of perceptual processing. Error detection also suffers when performance requires more search-related resources. In both cases, the representation of the correct response is compromised. These results indicate that error detection depends on the same perceptual and cognitive processes that are required for correct performance.