快速康复外科理念在膀胱癌患者根治性全膀胱切除术围术期护理中的应用效果

目的 分析快速康复外科(FTS)理念在膀胱癌(BC)患者根治性全膀胱切除术围术期护理中的应用效果。方法 回顾性收集我院147例BC患者,均接受根治性全膀胱切除术治疗,将2017年1月～2018年10月在围术期接受常规护理干预的73例作为对照组,将2020年1月～2021年10月在围术期接受FTS理念干预的74例作为观察组,比较两组围术期情况、不同时间点(术前1d、术后1h、1d)疼痛程度、并发症。结果 观察组术后首次下床活动、术后首次排气以及住院时间均短于对照组(P＜0.05);两组不同时间、组间、交互作用下视觉模拟疼痛评分(VAS评分)比较,差异具有统计学意义(P＜0.05),两组术前1d VAS评分比较,无明显差异(P＞0.05);而与对照组术后1h、1d VAS评分相比,观察组均较低(P＜0.05);观察组、对照组并发症发生率分别为31.08%、41.10%,组间比较,无明显差异(P＞0.05)。结论 FTS理念应用于BC患者,能减轻疼痛程度,缩短术后首次下床活动、术后首次排气时间,促进术后恢复。     

羧酸酯酶1和羧酸酯酶2基因表达量与体质量指数的关系及其基因多态性分析

目的 通过检测健康志愿者的羧酸酯酶1 (carboxylesterase 1,CES1)和羧酸酯酶2 (carboxylesterase 2,CES2)的基因多态性和基因表达水平,探索CES1和CES2在代谢中的作用。方法 从48例健康志愿者获得血样并提取DNA,对DNA进行二代基因测序,并提取总RNA检测基因表达量。使用多元线性回归分析CES1和CES2基因表达量与性别、年龄、体质量指数(body mass index, BMI)的关系。结果 CES1的基因表达量为141.8(72.7,237.8),CES2的基因表达量为74.4(30.8,133.6)。多元线性回归分析中,BMI与CES2的基因表达有关,性别、年龄和BMI与CES1的基因表达无关。发现CES1 20个基因变异,其中10个会引起氨基酸序列改变;发现CES2 6个基因变异,其中2个引起氨基酸序列改变。结论 发现CES2的表达水平与BMI相关,CES1的表达水平与BMI无明显相关,基因预测结果提示CES1的遗传变异可能影响其功能表达。     

IL-6–174G/C genotype is associated with the bone mineral density response to oestrogen replacement therapy in post-menopausal women

A reduction in interleukin-6 (IL-6) activity may contribute to the beneficial effects of hormone replacement therapy (HRT) on the menopausal decline in bone mineral density (BMD). We have examined this hypothesis using a genetic strategy. The –174C (rather than G) IL-6 gene variant is associated with lower IL-6 expression. As such, we might anticipate the C allele to be associated with a greater response to HRT. We have tested this hypothesis. Mean three-site [spine (L1-L4), neck of femur, and Wards triangle] BMD was measured in 65 women in a 1-year randomised controlled trial of HRT with 0.625 mg oestrogen/day and 0.15 mg norgestrel (n=30). Baseline BMD was genotype-independent for both the control and HRT group. In the control group, the percentage change in BMD after 1 year was similar between genotypes (P=0.45). In contrast, in the HRT group, the rise was genotype-dependent. Those homozygous for the G allele showed a 3.62 (2.14)% increase in BMD compared with 10.44 (4.68)% for the C-homozygous group. Heterozygotes had an intermediate BMD increase of 5.6 (2.82)% [P=0.006 (P value for interaction between HRT and genotype was 0.04)] Although the study was limited by its small sample size, these are the first data to demonstrate the importance of IL-6 genotype in determining response to oestrogen therapy, rather than its physiological withdrawal.     

父母文化程度与高师学生心理健康问题研究

目的 了解高师学生心理健康现状和父母文化程度对高师学生心理健康水平的影响。方法 对河南省部分高师学生进行问卷调查。结果 河南省大部分高师学生心理健康状况是好的和比较好的；15.13%的高师学生心理健康状况不良，教师、咨询人员和家长应高度重视，密切配合，正确地对他们进行引导和教育。结论 父母文化程度不同对高师学生心理健康水平的影响有差异。但差异不显著。     

精神分裂症患者G72基因表达水平的研究

目的 本工作旨在检测精神分裂症（Schizophrenia）患者外周淋巴细胞中G72基因的表达情况，进而探讨G72基因的表达与精神分裂症的相关关系。 方法 工作在56例精神分裂症患者和84名年龄性别相匹配的对照中进行，在新鲜外周血样本中抽提总RNA，反转录成cDNA，基因表达量的检测在ABI Prism7900HT型序列监测系统上进行，采用TaqMan的方法对患者及对照组样本的mRNA进行定量，采集的荧光数据经SDS2.1软件自动处理，每个样本作三次平行检测，取平均值作为该样本的最终定量。数据应用SPSS统计软件进行处理，对组间基因表达水平的差异采用独立样本的T检验，调用本实验室G72基因单核苷酸多态性（SNPs）资料，用单因素方差分析的方法分析SNP与基因表达水平的关联性。结果 1.检测得到G72基因在对照组中的表达量为0.0586±0.0114amol/ng cDNA, 在精神分裂症患者组中的表达量为0.0498±0.0121amol/ng cDNA。2.经显著性检验， G72基因的表达水平在病例和对照组间差异无统计学意义，t=-0.512，df138，P=0.609，95%CI:-4.258~2.506。3.单因素方差分析结果显示，rs947267位置上的SNP与该基因的表达水平无相关，F=0.355，df2，χ2=0.703；而rs2181953位置上的SNP与G72基因表达水平相关联，F=6.275，df2，χ2=0.004。A/A基因型的患者基因表达水平显著高于其他基因型。结论：精神分裂症患者G72基因的表达量总体上较正常人并无显著变化，但rs2181953位置上的基因型会影响精神分裂症患者该基因的表达。     

Effects of intracerebral implants of steroid hormones on scent marking in the ovariectomized female gerbil (Meriones unguiculatus)

The effects of intracerebral implants of steroid hormones on scent marking in the female gerbil (Meriones unguiculatus) were studied in two experiments. In Experiment 1 various steroids were implanted alone or in combination into the preoptic and anterior hypothalamic area of ovariectomized females. Unilateral implants of testosterone + estrogen, estrogen, estrogen + progesterone, testosterone and testosterone + progesterone stimulated a significant level of marking when compared to controls. Experiment 2 utilized bilateral implants of estrogen dissolved in paraffin in order to explore the distribution hormone sensitive areas in the brain which might be important in the regulation of scent marking in the female gerbil. Pellets of estrogen-paraffin were implanted stereotaxically into either the anterior hypothalamus, preoptic area, septum, hippocampus, thalamus, amygdala or anterior olfactory nucleus of ovariectomized females. Total dosage of hormone implanted was 8.2–8.4 μg. A significant level of marking resulted in animals receiving implants into the anterior hypothalamus, preoptic area and septum when compared to controls. Marking appeared at about the same rate in each of these groups; however, the level of marking attained differed. By the last trial, anterior hypothalamic implanted animals were marking significantly more often than animals in either the preoptic or septum groups. Although there was no evidence of ieakage from the brain, the data suggested that some rapid diffusion of hormone, largely restricted to the brain, was taking place or that the three areas were differentially responsive to the hormone. The data do indicate that some localization of function does exist with respect to regulation of scent marking in the female.     

Cardiovascular risk factors in people with different genotypes in the insertion/deletion (I/D) polymorphism at the locus for angiotensin I-converting enzyme (ACE)

The deletion (D) allele of an insertion/deletion (I/D) polymorphism at the locus for angiotensin I-converting enzyme (ACE) has been reported to be an independent risk factor for myocardial infarction (MI), particularly in people lacking traditional risk factors. Furthermore, a borderline association between Lp(a) lipoprotein level and the I/D polymorphism at the ACE locus was reported in one study. We have searched for possible "level gene" or "variability gene" effects of ACE genes on Lp(a) lipoprotein, total cholesterol (TC), high density lipoprotein (HDL) cholesterol (HDLC), low density lipoprotein (LDL) cholesterol (LDLC), triglycerides (TG), apolipoprotein B (apoB), apolipoprotein A-I (apoA-I), and body mass index (BMI). None of these variables differed significantly between genotypes in the I/D polymorphism in any of three population samples. A single population sample created by combining the three series, exhibited an insignificant trend towards individuals carrying the D-allele having a higher level of Lp(a) lipoprotein than those lacking it, and DD homozygotes had a significantly higher Lp(a) lipoprotein level than the combined group of ID/II individuals (p = 0.03). These results may indicate that the D-allele of the I/D polymorphism at the ACE locus could influence the level of Lp(a) lipoprotein.     

眼底图像畸变的校正及多幅图像的特征点拼接算法

对于眼底图像 ,由于不在正视点取像造成的几何畸变和由于荧光素从血管壁渗漏等造成的灰度畸变 ,几乎是不可避免的。为临床诊断提供丰富信息的需要出发 ,进行多幅眼底图像的拼接是必要的。本文为此提出了几个新的处理方法 ,如基于大窗口的滤波灰度校正方法、基于透视投影原理的几何校正方法与基于小波子空间上的拼接算法 ,均具有效果好和耗时少的优点。     

Changes in the withdrawal bleeding pattern and endometrial histology during 17β-estradiol —dydrogesterone therapy in postmenopausal women: a 2 year prospective study

Objective: To describe changes in the withdrawal bleeding pattern and endometrial histology during a sequential 17β-estradiol —dydrogesterone regimen in postmenopausal women. Design: Open-label, non-comparative, prospective study. Setting: Gynecological outpatient department of a university hospital. Patients: Twenty-seven healthy nonhysterectomized postmenopausal women. Interventions: Continuous micronized 17β-estradiol supplementation, 2 mg daily, and cyclic administration of dydrogesterone, 10 mg daily for the first half of each 28 day treatment cycle. Main Outcome Measures: Changes in the characteristics of the withdrawal bleeding pattern and the endometrial biopsy histology during 2 years of treatment. Results: The initial withdrawal bleeding was comparable to normal menstruation with respect to amount and duration. During the 2 years of treatment the bleeding showed a significant tendency to become shorter with less blood loss. This was mainly the result of the decrease (P < 0.001) in the number of days per cycle with bleeding grade II (normal menstruation). None of the women developed endometrial hyperplasia, and in almost all women the given hormone replacement therapy regimen induced secretory or atrophic changes of the endometrium. Conclusions: This sequential 17β-estradiol —dydrogesterone regimen can be regarded as safe with respect to the prevention of endometrial disease and appeared to foster patient compliance.     

On the role of additive hormone monotherapy with tamoxifen,medroxyprogesterone acetate and aminoglutethimide,in advanced breast cancer

Summary We analyzed the results of clinical studies on the therapeutic efficacy of hormone monotherapy with tamoxifen, medroxyprogesterone acetate, and aminoglutethimide in metastatic breast cancer, which were published between 1971 and 1986 and involved altogether 7000 patients. The overall response rates in patients treated with these hormonal single agents at various dose levels ranged from 31%–42%. When only estrogen receptor-positive patients were considered, the response rates lay between 41% and 54% in groups which were treated with the antiestrogenic agents tamoxifen or aminoglutethimide. The duration of remission was 12 months for tamoxifen- and aminoglutethimide-treated women, whereas medroxy-progesterone acetate effected remissions lasting from 6–16 months. The overall mean survival from start of therapy in tamoxifen- and aminoglutethimide-treated groups was 20 months, whereas information concerning this therapeutic parameter was available only in a minority of medroxyprogesterone acetate-treated groups. With respect to the response by site of metastatic lesions, all three agents caused a significantly higher degree of remissions in the soft tissue as compared to visceral disease.Abbreviations AG Aminoglutethimide - MPA Medroxyprogesterone acetate - TAM Tamoxifen