厦门市社区老年慢性病共病与不良生活方式共存现状研究

目的 调查社区老年人常见的14种慢性病共病情况及不良生活方式共存现象。 方法 采用方便抽样的方法抽取厦门市社区906例老年人群为研究对象,使用自设问卷调查研究对象的慢病共存及不良方式共存现象,使用检验和多因素logistic回归方法进行分析。结果 共纳入906例老年人,慢性病患病率为79.5%,老年人慢性病共病患病率为58.9%。主要的不良生活方式是BMI异常(46.8%)、饮酒(40.5%)、睡眠时间少(37.9%)、缺乏锻炼(35.2%)、吸烟(32.8%)等。多因素logistic回归分析显示,女性(OR=2.232,95%CI:1.474～3.380,P＜0.001)、高龄(OR=2.038,95%CI:1.234～3.365,P=0.001)、有慢性病家族史(OR=2.854,95%CI:1.943～4.194,P＜0.001)、肥胖(OR=2.571,95%CI:1.096～6.033,P=0.030)、饮酒(OR=3.582,95%CI:2.531～5.071,P＜0.001)、吸烟(OR=1.789,95%CI:1.172～2.732,P=0.007)、嗜盐(OR=1.818,95%CI:1.170～2.823,P=0.008)、嗜油(OR=2.023,95%CI:1.153～3.550,P=0.010)、睡眠质量差(OR=2.091,95%CI:1.360～3.215,P=0.001)的老年人,慢性病共病的比例高。 结论 厦门市社区老年人慢性病共病和不良生活方式共存现象严重。肥胖、饮酒、吸烟、嗜盐、嗜油、睡眠质量差等行为生活方式是慢性病重要的可干预因素,社区工作者应提高社区居民对健康生活方式重要性的认识,促使其主动改变不良生活方式并长期坚持健康的生活方式,以降低其慢性病的发病风险,减少其伤残程度,提高生活质量。     

江苏省专科护士工作投入现状及影响因素调查分析

目的 了解江苏省省级专科护士工作投入现状及影响因素，为针对性管理提供参考。方法 采用一般资料调查问卷与专科护士工作投入量表对2 472名省级专科护士进行调查分析。结果 专科护士工作投入总均分为4.06±0.46;多元线性回归分析显示，性别、聘任方式、专科类别、工作类型、出任专科护理门诊、论文发表是专科护士工作投入的影响因素(P<0.05,P<0.01)。结论 专科护士工作投入水平较高，其影响因素较多，护理管理者应关注专科护士专业开展现况，采取针对性措施支持专科护理的有效开展，从而进一步提高专科护士的工作投入水平。     

Efficacy,immunogenicity, and safety of available vaccines in children on biologics: A systematic review and meta-analysis

Vaccinations are essential for preventing infectious diseases in children with chronic diseases as they have increased risk of infection from frequent use of biologics. Response to immunizations in this group is not well known.ObjectiveA systematic review was performed to evaluate three primary outcomes: efficacy; immunogenicity; and safety of vaccines in children with chronic conditions treated with biologics.MethodsThe protocol for our systematic review and meta-analysis was registered and published with PROSPERO. We searched electronic bibliographic databases for studies published from 2009 to 2019, focusing on vaccinations in children with chronic conditions treated with biologics.ResultsWe retrieved 532 records. Thirty-one full-text articles were selected, and 14 were included in the meta-analysis. No significant publication bias was found. Efficacy: limited data are available regarding the efficacy of vaccination, as most studies have focused on immunogenicity as surrogate outcome for efficacy. Immunogenicity: patients receiving anti-TNF-alpha therapy had a statistically significant risk of poor seroconversion (p = 0.028) and seroprotection by the serotype B influenza vaccine [inflammatory bowel disease (IBD) p = 0.013; juvenile idiopathic arthritis (JIA) p = 0.004]. We found adequate responses with H1N1 and H3N2 serotypes. Few studies existed for pneumococcal, hepatitis A virus, hepatitis B virus, varicella-zoster virus, Measles Mumps Rubella virus, and multiple vaccine administration. Safety: vaccine administration was not associated with serious side effects, but JIA patients on anti-TNF alpha therapy had a statistically significant risk of presenting with myalgia or arthralgia postinfluenza vaccine (p = 0.014).ConclusionsMore evidence concerning efficacy, immunogenicity, and safety of vaccinations is needed to guide physicians in the vaccine decision process for this pediatric population.     

原发性肺鳞癌中EGFR和ALK基因突变的临床研究北大核心

目的:探讨赣南地区原发性肺鳞癌患者EGFR和ALK基因突变的特点,科学指导此类患者优选靶向用药。方法:入组73例原发性肺鳞癌病例,采用ARMS-PNA技术检测EGFR基因第18、19、20、21外显子突变,应用不平衡法检测其中60例病例的ALK融合基因,回顾性分析EGFR和ALK基因突变患者的临床病理特征。结果:EGFR基因突变8例,阳性率为10.96%(8/73),4例为L858R突变,3例为19del突变,1例为G719X突变。女性患者突变率(66.67%,2/3)明显高于男性患者(8.57%,6/70)(P=0.030),EGFR基因突变在高龄(≥60岁)、进展期(N_(1-3)、Ⅲ+Ⅳ期)患者中相对较高,但差异无统计学意义(P>0.05)。EGFR基因突变与吸烟史、T分期以及肿瘤分布位置均无相关性(P>0.05);ALK融合基因表达2例,阳性率3.33%(2/60),与患者性别、年龄、吸烟史、TNM分期及肿瘤分布类型等各临床病理特征均无相关性(P>0.05);未发现EGFR和ALK基因共存突变病例。结论:赣南地区原发性肺鳞癌患者EGFR和ALK基因突变率相对不高,EGFR基因突变以L858R和19del突变为主,且好发于女性患者,可能是患者病情进展的预测因子之一。     

结直肠癌与自然杀伤细胞的相关性探讨北大核心

目的:研究结直肠癌及其配对的癌旁组织的自然杀伤(nature killer,NK)细胞数量及分布情况。方法:结直肠癌及其配对的癌旁组织各40例,以SP免疫组化法检测NK细胞。结果:结直肠癌及其配对的癌旁组织中均未检测到NK细胞的浸润。结论:结直肠癌及其配对的癌旁组织中缺乏NK细胞浸润可能与肿瘤微环境、生理微环境、未知的NK细胞亚型相关,结直肠癌患者可能不适用NK细胞进行免疫治疗。     

Human factors in pelvic surgery

In the pelvis, anatomic complexity and difficulty in visualization and access make surgery a formidable task. Surgeons are prone to work-related musculoskeletal injuries from the frequently poor design and flow of their work environment. This is exacerbated by the strain of surgery in the pelvis. These injuries can result in alterations to a surgeons practice, inadvertent patient injury, and even early retirement. Human factors examines the relationships between the surgeon, their instruments and their environment. By bridging physiology, psychology, and ergonomics, human factors allows a better understanding of some of the challenges posed by pelvic surgery. The operative approach involved (open, laparoscopic, robotic, or perineal) plays an important role in the relevant human factors. Improved understanding of ergonomics can mitigate these risks to surgeons. Other human factors approaches such as standardization, use of checklists, and employing resiliency efforts can all improve patient safety in the operating theatre.     

Primary and recurrent regional metastases for lateralized oral cavity squamous cell carcinoma

ObjectivesMap regional lymph node metastases for lateralized oral cavity squamous cell carcinoma (OCSCC) and evaluate factors associated with regional metastases and recurrence.Materials and methodsRetrospective cohort study of 715 patients with lateralized OCSCC surgically treated in 1997–2011. Analysis was performed using log-rank, Kaplan-Meier, and multivariable logistic and Cox regression.ResultsRegional metastases were identified in ipsilateral levels IIA (24%), IB (18%), III (13%), V (9%), IV (7%), IA (2%) and IIB (1%) and the contralateral neck (3%). Lymphovascular invasion (LVI) (Hazard Ratio [HR] 2.2, 95% Confidence Interval [CI] 1.2–3.9) and T category (T3 vs. T1: HR 4.1, 95% CI 1.9–9.3; T4 vs. T1: HR 2.3, 95% CI 1.2–4.3) were associated with regional metastases. Most (71%) isolated regional metastatic recurrences were in undissected levels of the neck, including 58% in levels IV and V. Tumors of the hard palate (HR 4.3, 95% CI 1.2–16.1), upper alveolus (HR 3.2, 95% CI 1.0–4.7) or with LVI (HR 2.0, 95% CI 1.0–3.9) were associated with isolated regional recurrence. For upper alveolar/hard palate tumors, depth of invasion (DOI) ≥4 mm (P = .003) and LVI (P = .04) were associated with regional metastases.ConclusionsFor lateralized OCSCC, elective neck dissection of level IIB or the contralateral neck may rarely be needed, but additional surgical or radiation treatment of levels IV and V may be considered based on patient risk factors, including T category 3–4 or LVI. For upper alveolar/hard palate tumors, DOI ≥4 mm is an appropriate threshold for elective neck dissection.     

Oral biosciences: The annual review 2021

BackgroundThe Journal of Oral Biosciences is devoted to advancing and disseminating fundamental knowledge concerning every aspect of oral biosciences.HighlightThis review features review articles in the fields of “Extracellular Vesicles,” “Propolis,” “Odontogenic Tumors,” “Periodontitis,” “Periodontium,” “Flavonoids,” “Lactoferrin,” “Dental Plaque,” “Anatomy,” “Induced Pluripotent Stem Cells,” “Bone Cell Biology,” “Dysgeusia,” “Dental Caries,” and “Dental Pulp Cavity,” in addition to the review article by the winners of the “Lion Award” (“Sox9 function in salivary gland development”) presented by the Japanese Association for Oral Biology.ConclusionThese reviews in the Journal of Oral Biosciences have inspired its readers to broaden their knowledge regarding various aspects of oral biosciences. The current editorial review introduces these exciting review articles.