死胎肾脏组织中HBVDNA的表达的临床和病理研究

目的　观察死胎肾脏组织中HBVDNA表达的情况 ,探讨通过产妇传播到死胎肾脏组织中的HBV是否存在复制。方法　采集 40例乙型肝炎产妇产下的死胎 ,常规尸检 ,取肾脏组织。采用原位分子杂交法 ,检测其中的HBVD NA ;回访产妇产前静脉血HBV的检测结果。结果　死胎肾脏组织中HBVDNA的检出率为 2 6/ 4 0 (65 .0 % )例。产妇产前静脉血HBV呈高、低和无复制状态时 ,肾脏组织中HBVDNA的检出率分别为 1 4 / 1 6(88.0 % )例、2 / 4 (50 .0 % )例、1 0 /2 0 (50 .0 % )例 ;高、低、无复制者之间相互比较 ,差异显著 (P <0 .0 5)。HBVDNA颗粒在肾实质细胞 (近、远曲小管上皮细胞和肾血管球毛细血管内皮细胞 ,球内、外系膜细胞 ,球旁细胞 ,足细胞 )浆 ,肾脏血管中点、灶状分布 ,少数在肾实质细胞核上。结论　死胎肾脏组织中有HBV复制 ;死胎肾脏组织中HBVDNA表达与产妇血清中HBV复制状态有关     

早期护理健康教育对独生子女精神分裂症患者发病因素的影响

目的 了解独生子女精神分裂症患者个性特征及发病因素,并进行科学的护理干预对策.方法 对60例独生子女精神分裂症进行调查研究比较,用护士用住院病人护理观察量表(NOSIE)进行调查研究比较,通过护理干预对策如对家庭环境、成长环境、父母教育方式、教育行为干预、教育方法等干预措施.结果 对独生子女精神分裂症者采用护理对策,包括独生子女环境和个性的早期干预,对治疗效果、药物依从性比干预前升高到73.33％,病情复发率降低到45％,社会功能恢复等都有提高,可见对降低精神分裂症的发病率有利.结论 独生子女精神分裂症的发病原因复杂,通过早期护理健康干预措施,如父母健康教育,知识普及,成长环境干预等措施,对独生子女精神分裂症的发病频率,复发次数,疗效有积极的作用,对降低发病率长期有效.     

190例5岁以下儿童死亡原因监测分析

目的通过对5岁以下儿童死亡原因分析,探索有效的策略和干预措施,降低5岁以下儿童死亡率。方法对蚌埠市第一人民医院2008年1月-2012年12月报告的190例5岁以下儿童死亡监测资料进行整理、汇总和回顾分析。结果 190例5岁以下儿童死亡原因前3位依次是：早产和低出生体重（35例）、呼吸系统疾病（32例）、出生窒息（24例）。新生儿组死亡构成比明显高于其他3组（P〈0.01）,提示年龄越小儿童死亡率越高;在28 d~5岁儿童死因中,意外死亡排在首位;城镇儿童与农村儿童死前接受医疗服务情况基本一致（P〉0.05）。结论只有家庭、医疗保健机构和社会各部门共同努力,才能保证儿童健康成长。     

武汉地区1137例独生子女病残儿出生缺陷病种分析

目的通过近10年来武汉市独生子女病残儿鉴定出生缺陷情况分析,探讨减少出生缺陷疾病再发生的防治措施。方法武汉市辖区中申请病残儿鉴定的独生子女,资料进行审查和分析,经现场体检及相关的辅助检查,专家对疾病作出鉴定结论并进行归类。结果诊断为出生缺陷441例,占38.78%。其中遗传性疾病34种346例（78.45%）,非遗传性疾病27种95例（21.06%）,以神经系统为主。结论出生缺陷涉及病种多,病因复杂,应根据不同原因引起的出生缺陷,寻找对应的防治措施。     

Policy-related determinants of child nutritional status in China: The effect of only-child status and access to healthcare

This paper examines the determinants of child nutritional status in China, focusing specifically on those determinants related to health system reform and only-child status. Data are drawn from four waves of the China Health and Nutrition Survey (1991–2000). The empirical relationship between nutritional status, on the one hand, and income, access to quality healthcare and being an only-child, on the other hand, is investigated using ordinary least squares (OLS), random effects (RE), fixed effects (FE) and instrumental variables (IV) models. In the preferred model – a fixed effects model where income is instrumented – we find that being an only-child increases height-for-age z-scores by 0.12 of a standard deviation. By contrast, measures of access to quality healthcare are not found to be significantly associated with improved nutritional status.     

305例老年死亡病例医院感染回顾性调查

本文结果表明,305例老年死亡病例医院感染的发病率为33.8％。感染最多部位为肺部(66.9％),其次为尿路感染(19.4％)。高龄患者,侵袭性操作、多种抗生素联合应用,激素疗法等是诱发医院感染的危险因素。58.8％的病原菌为革兰氏阴性杆菌,37.2％为真菌。31株病原菌药敏结果显示耐药率为33.3％。本文指出合理应用抗生素是预防医院感染的重要措施之一。     

Once-monthly radiotherapy for the palliation of pelvic gynecological malignancy

Twenty-seven patients with advanced pelvic gynecological malignancies were treated using a once-monthly fractionation scheme of 10 Gy to a total dose of 30 Gy to the whole pelvis. This course was well tolerated and provided effective palliation with a minimum of hospitalization. The results obtained suggest this course merits consideration for the palliation of other pelvic malignancies.     

独生子女与非独生子女大学生心理健康比较

目的:研究家庭中子女数量与其心理健康的关系。方法:通过使用对比研究法,把大学生所在家庭根据其子女数量分为独生子女与非独生子女两类,同时使用中国大学生心理健康测评系统CSPA 1.0中的心理健康量表进行测试。结果:独生子女大学生与非独生子女大学生在躯体化(t=-2.033,P=0.042)、焦虑(t=-2.227,P=0.026)、抑郁(t=-3.931,P=0.000)、自卑(t=-5.711,P=0.000)、社交退缩(t=-7.077,P=0.000)、性心理障碍(t=-5.300,P=0.000)、强迫(t=-3.152,P=0.002)、依赖(t=-2.171,P=0.030)、冲动(t=2.303,P=0.021)与精神病倾向(t=-3.145,P=0.002)方面有显著的差异。结论:家庭中子女数量是影响大学生心理健康的重要因素,在躯体化、焦虑、抑郁、自卑、社交退缩、性心理障碍、强迫、依赖与精神病倾向方面,独生子女大学生心理健康水平明显偏高,而在冲动方面,非独生子女大学生的心理健康水平明显偏高。     

早期死亡的多发性骨髓瘤患者预后不良因素分析

目的探讨早期死亡的多发性骨髓瘤患者预后不良因素。方法对79例多发性骨髓瘤患者中的14例早期死亡(诊断后6个月内)临床资料进行回顾性分析,对这14例的临床和实验室指标进行单因素和多因素分析。结果单因素发现血β2-微球蛋白(β2-MG)、血乳酸脱氢酶(LDH)、血清蛋白水平、血肌酐和原始幼稚浆细胞比例是早期死亡的预后不良因素。多因素分析中确定只有血清蛋白水平、血肌酐、原始幼稚浆细胞比例、β2-MG和LDH是早期死亡的高危因素。结论高血β2-MG、高比例的原始及幼稚浆细胞、高LDH、低血清蛋白和肾功能不全被认为是早期死亡的预后不良因素。     

A multisite audit to assess how women with complex social factors access and engage with maternity services

Objectiveto audit women with socially complex lives’ documented access to and engagement with antenatal care provided by three inner city, UK maternity services in relation to birth and neonatal outcomes, and referral processes.Backgroundwomen living socially complex lives, including young mothers, recently arrived immigrants, non-English speaking, and those experiencing domestic violence, poor mental health, drug and alcohol abuse, and poverty experience high rates of morbidity, mortality and poor birth outcomes. This is associated with late access to and poor engagement with antenatal care.Methoddata was collected from three separate NHS trusts data management systems for a total of 182 women living socially complex lives, between January and December 2015. Data was presented by individual trust and compared to standards derived from NICE guidelines, local trust policy and national statistic using Excel and SPSS Version 22. Tests of correlation were carried out to minimise risks of confounding factors in characteristic differences.Findingsnon-English speaking women were much less likely to have accessed care within the recommended timeframes, with over 70% of the sample not booked for maternity care by 12 weeks gestation. On average 89% primiparous women across all samples had less than the recommended number of antenatal appointments. No sample met the audit criteria in terms of number of antenatal appointments attended. Data held on the perinatal data management systems for a number of outcomes and processes was largely incomplete and appeared unreliable.Conclusionthis data forms a baseline against which to assess the impact of future service developments aimed at improving access and engagement with services for women living with complex social factors. The audit identified issues with the completeness and reliability of data on the perinatal data management system.