参附注射液治疗老年重症肺炎的疗效研究

目的探讨参附注射液对老年重症肺炎疗效及N末端B型利钠肽原(NT-pro BNP)的影响。方法选择2016年6月—2019年6月医院收治的老年重症肺炎患者80例,以随机数表法将其分为两组,即对照组与研究组各40例。对照组患者接受常规对症治疗,研究组在此基础上应用参附注射液治疗。对比两组临床疗效,治疗前与治疗3 d、5 d时血浆NT-pro BNP水平,以及不良反应情况。结果研究组治疗的总有效率为95.00%,高于对照组77.50%(P<0.05)。治疗后3 d与5 d时研究组血浆NT-pro BNP水平均低于对照组(P<0.01)。两组治疗期间均未见明显的药物不良反应。结论参附注射液能够有效提高老年重症肺炎患者的疗效,调节脑钠肽水平。     

The individual and joint effects of maternal 25(OH)D deficiency and gestational diabetes on infant birth size

Background and aimsTo examine the independent effect of maternal serum 25-hydroxyvitamin D [25(OH)D] deficiency and its joint effect with gestational diabetes mellitus (GDM) on infant birth size.Methods and resultsThis retrospective cohort study was conducted in 15,724 mother-offspring dyads in Beijing, China between 2016 and 2017. Outcomes included infant birth weight Z-score (adjusted for gestational age and sex) and large for gestational age (LGA). Exposures were maternal 25(OH)D concentrations. Linear and logistic regression models were used to assess the associations of exposures with continuous and binary outcomes, respectively. Exposure-outcome associations were not observed when analyzing 25(OH)D concentrations continuously or in quartiles (P > 0.05); however, mothers with severely deficient 25(OH)D concentrations (n = 307) had a decreased risk of LGA compared with those with sufficient 25(OH)D concentrations (≥30.0 ng/mL; n = 5400) (adjusted odds ratio (OR): 0.63; 95% confidence interval (CI): 0.42, 0.93). Compared to mothers with no 25(OH)D deficiency (≥20.0 ng/mL) and no GDM (n = 7975), those with both 25(OH)D deficiency and GDM (n = 1090) had 0.15 (95% CI: 0.09, 0.21) higher infant birth weight Z-score and a higher risk of LGA (OR: 1.29; 95% CI: 1.09, 1.52). Maternal 25(OH)D deficiency and GDM had additive interaction on the risk of LGA (relative risk due to interaction: 0.18).ConclusionMothers with severely deficient 25(OH)D might have a decreased risk of LGA. However, the joint effect of maternal 25(OH)D deficiency and GDM might increase the risk of LGA. Our findings have clinical and public health implications and provide potential directions for future studies.     

Age-related differences in motives for contacting out-of-hours primary care: a cross-sectional questionnaire study in Denmark

Abstract

Objective

Demands for out-of-hours primary care (OOH-PC) services are increasing. Many citizens call because of non-urgent health problems. Nevertheless, the patients’ motives for requesting medical help outside office hours remains an understudied area. This study aimed to examine motives for calling OOH-PC services in various age groups.     

Mock jurors’ awareness of age-related changes in memory and cognitive capacity

While age-related changes in memory have been well documented, findings about jurors’ perceptions of older witnesses are conflicting. We investigated the effect of victim age (25 vs. 75?years old) and crime severity (victim injured vs. not injured) on mock jurors’ decisions in a robbery trial. Jury-eligible participants (120 women; 84 men) read a mock trial summary and delivered their verdicts online. Mock jurors believed the young victim more than the older victim when the crime was severe, while no age differences emerged for the less severe crime. Whereas previous research demonstrated that juror characteristics were generally associated with culpability, we demonstrated that with case-specific information, these general views became less important. In all, mock jurors were aware of age-related decline in memory provided by eyewitnesses only to a limited extent. Accordingly, in trials involving older witnesses, jurors will benefit from educative information about age-related memory changes.     

Longitudinal blood pressure patterns and cardiovascular disease risk

Abstract

Observational and interventional studies have unequivocally demonstrated that “present”, i.e. single-occasion, blood pressure is one of the key determinants of cardiovascular disease risk. Over the past two decades, however, numerous publications have suggested that longitudinal blood pressure data and assessment of long-term blood pressure exposure provide incremental prognostic value over present blood pressure. These studies have used several different indices to quantify the overall exposure to blood pressure, such as time-averaged blood pressure, cumulative blood pressure, blood pressure trajectory patterns, and age of hypertension onset. This review summarises existing research on the association between these indices and hard cardiovascular outcomes, outlines the strengths and weaknesses of these indices, and provides an overview of how longitudinal blood pressure changes can be measured and used to improve cardiovascular disease risk prediction.

• KEY MESSAGES

• Numerous recent publications have examined the relation between cardiovascular disease and long-term blood pressure (BP) exposure, quantified using indices such as time-averaged BP, cumulative BP, BP trajectory patterns, and age of hypertension onset.

• This review summarises existing research on the association between these indices and hard cardiovascular outcomes, outlines the strengths and weaknesses of these indices, and provides an overview of how longitudinal BP changes can be measured and used to improve cardiovascular disease risk prediction.

• Although longitudinal BP indices seem to predict cardiovascular outcomes better than present BP, there are considerable differences in the clinical feasibility of these indices along with a limited number of prospective data.

     

高龄产妇产后抑郁影响因素的质性研究

目的 探究高龄产妇产后抑郁的影响因素，为护理人员今后在临床工作中提供个性化的护理服务提供参考依据。方法 采用质性研究中的现象学研究法对2021年12月至2022年4月在内蒙古医科大学附属医院妇产科建档分娩的16例高龄产妇进行半结构式访谈，并以Colaizzi现象学研究方法进行资料分析。结果 提炼出影响高龄产妇产后抑郁的4个主题：躯体性压力源；负性心理体验；社会支持缺乏，矛盾出现；角色转变对高龄产妇的影响。结论 需重视高龄产妇产后的主观感受，加强产前产后健康宣教，构建以家庭为中心的高龄产妇产后护理模型，减少产后抑郁的发生。     

Prospective assessment of reproducibility of three-dimensional ultrasound for fetal biometry

PurposeTo compare fetal ultrasound measurements performed by two observers with different levels of experience and evaluate the potential contribution of the use of three-dimensional (3D) ultrasound on repeatability, reproducibility and agreement of two-dimensional (2D) and 3D-derived measurements.Materials and methodsTwo observers (one senior and one junior) measured head circumference (HC), abdominal circumference (AC) and femur length (FL) in 33 fetuses (20 to 40 weeks of gestation). Each observer performed two series of 2D measurements and two series of 3D measurements (i.e., measurements derived from triplane volume processing). Measurements were converted into Z-scores according to gestational age. Variability between the different series of measurements was studied using Bland–Altmann plots and intra-class correlation coefficients (ICC).ResultsAgreement with the 2D measurements of the senior observer was higher in 3D than in 2D for the junior observer (systematic differences of −0.4, −0.2 and −0.8 Z-score vs. −0.1, −0.1 and −0.6 for HC, AC and FL on 2D and 3D datasets, respectively). The use of 3D ultrasound improved junior observer repeatability (ICC = 0.94, 0.88, 0.90 vs. 0.94, 0.94 and 0.96 for HC, AC and FL in 2D and 3D, respectively). The reproducibility was greater using the junior observer 3D datasets (ICC = 0.75, 0.60 and 0.45 vs. 0.79, 0.89 and 0.63 for HC, AC and FL, respectively).ConclusionThe use of 3D ultrasound improves the consistency of the measurements performed by a junior observer and increases the overall repeatability and reproducibility of measurements performed by observers with different levels of experience.     

Improved prediction of brain age using multimodal neuroimaging data

Brain age prediction based on imaging data and machine learning (ML) methods has great potential to provide insights into the development of cognition and mental disorders. Though different ML models have been proposed, a systematic comparison of ML models in combination with imaging features derived from different modalities is still needed. In this study, we evaluate the prediction performance of 36 combinations of imaging features and ML models including deep learning. We utilize single and multimodal brain imaging data including MRI, DTI, and rs‐fMRI from a large data set with 839 subjects. Our study is a follow‐up to the initial work (Liang et al., 2019. Human Brain Mapping) to investigate different analytic strategies to combine data from MRI, DTI, and rs‐fMRI with the goal to improve brain age prediction accuracy. Additionally, the traditional approach to predicting the brain age gap has been shown to have a systematic bias. The potential nonlinear relationship between the brain age gap and chronological age has not been thoroughly tested. Here we propose a new method to correct the systematic bias of brain age gap by taking gender, chronological age, and their interactions into consideration. As the true brain age is unknown and may deviate from chronological age, we further examine whether various levels of behavioral performance across subjects predict their brain age estimated from neuroimaging data. This is an important step to quantify the practical implication of brain age prediction. Our findings are helpful to advance the practice of optimizing different analytic methodologies in brain age prediction.