慢性病患者反刍思维干预研究进展

慢性病具有病因复杂、病程漫长、迁延不愈、经济负担重等特点,已成为全球死亡与疾病负担的主要原因。慢性病不仅造成患者的躯体负担,同时会给患者的心理造成负面影响,反刍思维是个体对于消极的感受和低落的情绪进行持续、反复、被动思考的行为,其存在增加患者各类心理问题发生的风险,妨碍慢性病的康复。本文对慢性病患者反刍思维的现状、不良影响及干预策略进行综述,旨在提高医护人员对慢性病患者反刍思维的认识,为针对性干预提供依据。     

小而密低密度脂蛋白胆固醇与冠心病患者经皮冠状动脉介入治疗术后围术期心肌损伤的相关性

目的 探讨小而密低密度脂蛋白胆固醇(sdLDL-C)与冠心病患者经皮冠状动脉介入治疗(PCI)围术期心肌损伤(PMI)的相关性及其预测价值。方法 选取2021年1月至2022年6月在江苏大学附属宜兴医院行择期PCI治疗的冠心病患者141例,包括心绞痛98例和急性心肌梗死43例;以及同期非冠心病66例。收集临床基线资料及术中冠状动脉病变情况,常规检测术前血脂以及术前术后心肌肌钙蛋白I(cTnI)等指标。接受PCI治疗的患者根据术后cTnI是否升高分为观察组(cTnI升高,n=86)和对照组(cTnI正常,n=55),对比2组间各项指标的差异。同时比较非冠心病,心绞痛,急性心肌梗死3组间sdLDL-C水平的差异。采用SPSS 16.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ²检验。3组之间两两比较采用方差分析及趋势检验。采用二分类logistic回归分析评价sdLDL-C与术后cTnI升高的关系。结果 观察组sdLDL-C、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、植入支架数、支架总长度均高于对照组,差异均有统计学意义[(0.74±0.26)和(0.56±0.27)mmol/L,(4.51±1.17)和(3.90±1.04)mmol/L,(2.77±0.80)和(2.25±0.73)mmol/L,(1.74±0.91)和(1.33±0.62),(52.52±27.93)和(36.92±19.41)mm;均P<0.05]。logistic回归分析显示,sdLDL-C(OR=14.798,95%CI 1.112~196.904),LDL-C(OR=3.074,95%CI 1.138~8.302)是冠心病患者PCI术后PMI的独立危险因素(P<0.05)。sdLDL-C在受试者工作特征(ROC)曲线下面积是0.727(95%CI 0.637~0.817,P<0.05),最佳截断值为0.518mmol/L,诊断PMI灵敏度为86.0%,特异度为56.4%,约登指数为0.424。非冠心病、心绞痛、急性心肌梗死3组的sdLDL-C分别是(0.541±0.144),(0.621±0.257),(0.776±0.289)mmol/L,两两比较差异均有统计学意义(P<0.05),呈显著上升趋势(P<0.05)。结论 术前高水平sdLDL-C是冠心病患者PCI术后围术期心肌损伤的危险因素,sdLDL-C与疾病严重程度呈正相关。     

湖北省枣阳市全球基金项目疟疾基线调查报告

目的了解全球基金疟疾项目启动前枣阳市疟疾流行情况和实际发病人数,以及疟防措施落实情况。方法按照《全球基金疟疾基线调查技术方法》,根据近3年的疟疾疫情,采用分层随机不等比例抽样法。结果走访群众4 803人,发现病例70人,正规治疗率5.71%(4/70),疟史休治率12.85%(9/70),疫情报告率14.29%(10/70)。门诊抗疟处方疫情报告率19.48%(52/267),血检阳性疫情报告率93.54%(333/356);居民和中小学生的疟防知识知晓率分别为24.09%(285/1 182)和67.54%(514/761);居民蚊帐使用率为95.34%(4 579人/4 803)。9个村共有14个乡村医生,其中11个人经过培训。中小学生的荧光抗体阳性率1.55%(14/903)。部分门诊血检技能及质量较差。经用捕获-再捕获方法(CMR)估算,该市2002年疟疾发病18102例,是疫情报告数(2 588)的6.99倍。结论现症病人正规治疗率低,疟史病人休治率低,疟疾疫情漏报严重。     

Garcinia buchananii bark extract is an effective anti-diarrheal remedy for lactose-induced diarrhea

Ethnopharmacological relevance: The extract from the stem bark of Garcinia buchananii trees is used as an anti-diarrhea remedy in sub-Saharan Africa. We tested the hypothesis that G. buchananii bark extract and its anti-motility fractions are effective treatments against lactose-induced diarrhea.     

Use of measles supplemental immunization activities (SIAs) as a delivery platform for other maternal and child health interventions: Opportunities and challenges

Measles supplementary immunization activities (SIAs) offer children in countries with weaker immunization delivery systems like India a second opportunity for measles vaccination. They could also provide a platform to deliver additional interventions, but the feasibility and acceptability of including add-ons is uncertain. We surveyed Indian programme officers involved in the current (2010–2012) measles SIAs concerning opportunities and challenges of using SIAs as a delivery platform for other maternal and child health interventions. Respondents felt that an expanded SIA strategy including add-ons could be of great value in improving access and efficiency. They viewed management challenges, logistics, and safety as the most important potential barriers. They proposed that additional interventions be selected using several criteria, of which importance of the health problem, safety, and contribution to health equity figured most prominently. For children, they recommended inclusion of basic interventions to address nutritional deficiencies, diarrhoea and parasites over vaccines. For mothers, micronutrient interventions were highest ranked.     

海南南桥试点60年抗疟进程及全球基金项目实施抗疟进展

目的剖析南桥试点半个世纪的抗疟进程,探讨高疟区消除疟疾的规律和经验,为海南消除疟疾提供参考。方法采用描述流行病学方法对试点的抗疟措施及其成果进行回顾和分析。结果杀虫剂滞留喷洒后,主要媒介微小按蚊迅速被消灭,致使疟疾大幅度下降;由于仍存在重要媒介大劣按蚊,致使疟疾下降缓慢,长期徘徊;由于土地和森林不断开垦,大劣按蚊密度下降,加之增加了蚊帐使用,减少了人蚊接触,使疟疾得以持续稳定下降,但偶尔出现小幅波动。表明控制蚊媒是控制疟疾的关键,继续减少人蚊接触和降低媒介能量是巩固抗疟成果,成功消除疟疾的关键。近10年全球基金疟疾项目实施期间抗疟成果得到巩固和发展。结论南桥试点60年的抗疟成绩巨大,现正进入消除疟疾阶段,全球基金疟疾项目实施抗疟成果得到巩固和发展。     

兰德公司的资金来源、支出结构与智库服务质量

美国民间智库在美国军事领域扮演着重要角色,其运行机制和发展经验对我国军方智库建设具有借鉴和启示意义。采用案例研究法,以美国国家战略咨询机构兰德公司为例,从资金来源和支出结构角度进行分析,通过网站和文献进行调研,研究兰德公司的资金来源、使用结构和使用成效,并总结其特征和优势。美国民间智库强调智库建设资金来源的多样化,注重对人才招募和建设的资金投入,重视对自主性课题研究的资金支持,为智库的发展壮大提供了良好的经济支撑。     

抗人活化B淋巴细胞单克隆抗体制备及鉴定

自儿童手术摘除的新鲜扁桃体分离人Ｂ淋巴细胞，经ＰＭＡ（佛波醇）激活后得到人活化Ｂ淋巴细胞，用于免疫ＢＡＢＬ／Ｃ小鼠后，取免疫小鼠之脾细胞与小鼠骨髓瘤细胞ＳＰ２／０融合，融合后细胞于含ＨＡＴ－ＩＭＤＭ完全培养基的２％甲基纤维素半固体培养基选择生长，经细胞酶联免疫吸附（ＣＥＬＩＳＡ）筛选间接免疫荧光流式细胞仪鉴定，获培养上清对活化Ｂ细胞及３Ｄ５细胞株细胞反应阳性，而Ｊｕｒｋａｔ细胞株细胞反应阴必的杂交     

The urgent need for in vitro tests in ecotoxicology

Ecotoxicological risk assessment should be regarded as consisting of several elements including molecular biology, cell toxicology, toxicology, ecology, chemistry and computer modelling [including quantitative structure-activity relationship (QSAR) considerations]. A successful risk assessment requires an approach that integrates data and knowledge from all the separate elements. The relative importance of a certain element will vary, depending on the situation or the chemical in question. One important, perhaps the most important, piece of information needed in risk assessment is the information about the concentration range at which a chemical exerts adverse effects on the organisms living in the aquatic environment. Without such information no prediction can be made or safety factors established. A combination of good in vitro tests could provide that information. A proper choice of endpoints in in vitro testing could also provide information on sublethal effects and toxic mechanisms involved, enabling even a more efficient approach than whole animal testing. For aquatic in vitro toxicology to progress further, there is a need for a more integrated, a more comparative and a more mechanistic approach and for large-scale evaluations. It would be beneficial if researchers could agree on using a common set or a few sets of reference chemicals in their studies and if some organization would take the scientific responsibility for aiding in the development of a more integrated strategy.