脑卒中后抑郁患者检测SEP与血浆5-羟色胺的临床意义

目的探讨脑卒中后抑郁(post-stroke depression,PSD)患者体感诱发电位(somatosensory evoked potential,SEP)与血浆5-羟色胺(5-hydroxytryptamine,5-HT)水平的变化及其相关性,为脑卒中后抑郁的诊断及预后提供科学依据。方法单纯脑卒中组(n=19)、脑卒中后抑郁组(n=17),采用汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)判断抑郁程度,另设正常对照组(n=12),检测3组体感诱发电位N9、N13、N20的潜伏期及波幅;检测各组血浆5-HT含量,比较分析3组体感诱发电位和血浆5-HT含量。结果脑卒中患者、脑卒中后抑郁患者正中神经测定N20的潜伏期及波幅异常率较正常人高(P0.05);脑卒中后抑郁组血浆中5-HT含量明显低于正常对照组或脑卒中组,差异显著均有统计学意义(P0.05);脑卒中后抑郁患者HAMD评分与N20潜伏期呈正相关、与N20波幅呈负相关,N9波幅、N9潜伏期、N13波幅、N13潜伏期、N20波幅无相关;脑卒中后抑郁组HAMD评分与血浆中5-HT含量呈负相关。结论脑卒中后抑郁患者血浆中5-HT含量明显低于正常人或脑卒中患者,并且脑卒中后抑郁患者及脑卒中患者正中神经测定N20波幅及潜伏期异常率明显高于正常组。因此,检测脑卒中患者的SEP中N20波幅、潜伏期及血浆5-HT水平,将对脑卒中后抑郁的诊断及预后具有很好的临床意义。     

SH-SY5Y神经细胞中α7神经型尼古丁受体基因过表达对CaMK Ⅱ和CREB的影响

目的研究SH-SY5Y神经细胞中α7 nAChR基因过表达对CaMKⅡ和CREB的影响。方法复苏稳定转染α7 nAChR-pc DNA3.1质粒及空载质粒的SH-SY5Y神经细胞后,用含G418的培养液进行筛选培养;应用实时荧光定量PCR法和蛋白印迹法(Western blot)检测α7 nAChR基因过表达组、空载质粒组和正常对照组细胞中CaMKⅡ、CREB mRNA及蛋白表达水平的变化。结果与对照组相比,α7 nAChR基因过表达细胞组的CaMKⅡ、CREB mRNA表达水平分别增加了116.8%和114.7%(P0.01);及CaMKⅡ、CREB蛋白表达水平分别增加了8.7%(P0.05)和41.4%(P0.05)。结论α7 nAChR的神经保护作用可能与上调细胞CaMKⅡ、CREB水平有关。     

Valuing health using EQ‐5D: The impact of chronic diseases on the stock of health

Chronic diseases strongly affect individuals' health status. In aggregate terms, this impact is reflected by the stock of health, which measures the amount of health of a population in a given period of time. The objectives of this study were to measure the relative burden of chronic illnesses by assessing health‐related quality of life using the EQ‐5D‐5L instrument, to rank diseases according to their associations with the stock of health, and to calculate the stock of health of the Spanish population and the amount of health loss attributable to each chronic disease from a social perspective. Data were gathered from the Spanish Health Survey (ENSE 2011–2012, N = 20,587). A population weighted least squares model was used. Chronic diseases represent 19.19% of the stock of health losses in Spain compared with a country free from those diseases. In Spain, the stock of health in 2011 was 31.86 million units on the visual analog scale. The diseases with the strongest impact in terms of loss of stock of health at the individual level were mental illness and embolism, stroke, or cerebral hemorrhage. Collectively, the diseases with the largest impact included osteoarthritis, arthritis, or rheumatism; chronic back pain; and high blood pressure.     

Benefits of cooperation among large-scale cohort studies and human biomonitoring projects in environmental health research: An exercise in blood lead analysis of the Environment and Child Health International Birth Cohort Group

A number of prospective cohort studies are ongoing worldwide to investigate the impact of foetal and neonatal exposures to chemical substances on child health. To assess multiple exposure (mixture) effects and low prevalence health outcomes it is useful to pool data from several studies and conduct mega-data-analysis. To discuss a path towards data harmonization, representatives from several large-scale birth cohort studies and a biomonitoring programme formed a collaborative group, the Environment and Child Health International Birth Cohort Group (ECHIBCG). In this study, an intra-laboratory trial was performed to harmonize existing blood lead measurements within the groups' studies. Then, decentralized analyses were conducted in individual countries' laboratories to evaluate blood lead levels (BLL) in each study. The measurements of pooled BLL samples in French, German and three Japanese laboratories resulted in an overall mean blood lead concentration of 8.66 μg l^?1 (95% confidence interval: 8.59–8.72 μg l^?1) with 3.0% relative standard deviation. Except for China's samples, BLL from each study were comparable with mean concentrations below or close to 10 μg l^?1. The decentralized multivariate analyses revealed that all models had coefficients of determination below 0.1. Determinants of BLL were current smoking, age >35 years and overweight or obese status. The three variables were associated with an increase in BLL in each of the five studies, most strongly in France by almost 80% and the weakest effect being in Norway with only 15%; for Japan, with the far largest sample (~18,000), the difference was 36%. This study successfully demonstrated that the laboratory analytical methods were sufficiently similar to allow direct comparison of data and showed that it is possible to harmonize the epidemiological data for joint analysis. This exercise showed the challenges in decentralized data analyses and reinforces the need for data harmonization among studies.     

Exposure assessment of Portuguese population to multiple mycotoxins: The human biomonitoring approach

Mycotoxins constitute a relevant group of food contaminants with several associated health outcomes such as estrogenic, immunotoxic, nephrotoxic and teratogenic effects. Although scarce data are available in Portugal, human biomonitoring studies have been globally developed to assess the exposure to mycotoxins at individual level. In order to overcome this lack of data, the present study concerned the analysis of mycotoxins in 24h urine and first-morning urine paired samples from 94 participants enrolled within the scope of the National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015–2016). Following a salt-assisted matrix extraction, urine samples were analysed by liquid chromatography–mass spectrometry for the simultaneous determination of 37 urinary mycotoxins’ biomarkers and data obtained used to estimate the probable daily intake as well as the risk characterization applying the Hazard Quotient approach. Results revealed the exposure of Portuguese population to zearalenone, deoxynivalenol, ochratoxin A, alternariol, citrinin and fumonisin B₁ through the quantification in 24h urine and first-morning urine paired samples. Risk characterization data revealed a potential concern to some reported mycotoxins since the reference intake values were exceeded by some of the considered participants. Alternariol was identified for the first time in urine samples from a European country; however, risk characterization was not performed due to lack of reference intake value. These results confirmed mycotoxins as part of the human exposome of the Portuguese population reinforcing the need for further studies regarding the determinants of exposure.     

Physical Performance Predictor Measures in Older Adults With Falls-Related Emergency Department Visits

ObjectivesIdentifying strong predictors for falls and mobility limitations in older adults with a falls-related emergency department visit is crucial. This study aimed to compare, in this clinical population, the incremental predictive value of the Short Physical Performance Battery (SPPB) component tests for incident falls, injurious falls, and mobility limitations.Design and measuresProspective cohort study.Setting and participantsA total of 323 community-dwelling older adults with a falls-related emergency department visit participated. Baseline physical performance was measured by the SPPB standing balance test, sit-to-stand test, and habitual gait speed test. Six-month prospective fall rate and self-reported mobility limitations at 6 months post baseline assessment were also measured. An injurious fall was defined as a fall for which the participant sought medical attention or that restricted his or her daily activities for at least 48 hours.ResultsIn multivariable proportional odds analyses adjusted for demographics and clinical covariates, higher levels of full-tandem balance and sit-to-stand performance were significantly associated with fewer incident falls (P = .04 and .02, respectively) and lower odds of mobility limitations (P = .05 and .03, respectively) and marginally associated with lower odds of injurious falls (P = .06 and .07, respectively). Habitual gait speed was the weakest predictor of falls but the strongest predictor (odds ratio 0.24, 95% confidence interval 0.08-0.70; P < .001) of mobility limitations.Conclusions/implicationsIn high-fall-risk older adults, the SPPB balance and sit-to-stand tests predicted falls whereas the SPPB gait speed test was adept at predicting mobility limitations. No one test is best across all situations, so the choice of test will depend on the goal of the assessment.     

我院2013年大肠埃希菌分布与耐药性分析

目的：了解南方医科大学附属郑州人民医院2013年大肠埃希菌分布及其对常用抗菌药物的耐药性,为临床选择抗菌药物提供参考。方法对2013年各科室标本中分离的630株大肠埃希菌进行抗菌药物敏感试验,依据2010年 CLSI 标准判读,并进行分析。结果630株大肠埃希菌中以中段尿、脓液及痰液检出最多,分别占50.00％、26.67％、17.94％。大肠埃希菌对一、二、三代头孢菌素,庆大霉素及喹诺酮类药物的耐药率较高,对阿米卡星、头孢西丁、碳青霉烯类抗菌药物、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的敏感性好,但出现了2株耐碳青霉烯类抗菌药物的大肠埃希菌。结论大肠埃希菌是泌尿道感染的常见致病菌,其对常用的抗菌药物耐药率较高。规范使用抗菌药物对防止和延缓细菌耐药具有重要意义。