子宫肌瘤患者及接受UAE治疗后血清性激素水平分析

目的：探讨性激素在子宫肌瘤发病中的意义。方法：采用化学发光技术检测正常对照61例(对照组)、子宫肌瘤患6l例(患组)以及44例子宫肌瘤接受子宫动脉栓塞治疗(UAE)后的患，血清促卯泡成熟激素(FSH)、促黄体生成激素(LH)、雌激素(E2)、垂体泌乳素(PRL)、睾酮(T)水平。结果：子宫肌瘤患组的血清FSH、LH、PRL、T水平均明显高于对照组；血清E2水平与对照组无显差异。其中44例接受UAE治疗的子宫肌瘤患术后血清LH、E2、PRL、T水平均比术前明显降低，FSH与术前无显差异；术后血清FSH、PRL、T水平均明显高于对照组，LH、E2水平明显低于对照组。结论：PRL、T是子宫肌瘤的发病因素。     

Disability,depression and somatization in a low back pain population

Objective: The aim of this study was to determine the prevalence of low back pain (LBP) in a primary care setting population and examine its association with the symptoms of depression and somatization. Methods: This is a cross‐sectional study, utilising a survey carried out in primary health care clinics (PHCs) in Al‐Ain, United Arab Emirates (UAE). A multistage stratified sampling design was used and a representative sample of 1304 UAE nationals aged 18–65 years who attended PHC clinics for any reason were included and 1103 (84.5%) subjects agreed to participate and responded to the questionnaire during a period from June 2001 to January 2002. A specially designed questionnaire with three parts was used for the data collection: socio‐demographic information of the studied subjects, modified version of the Roland‐Morris scale for evaluating back‐related functional disability and SCL‐90 R for depression and somatization subscales was used to assess depressive and somatic symptoms. Results: Of the total number of subjects surveyed (1103), 586 (53.1%) were men and 517 (46.9%) women. The mean age was 34.9 ± 13.4 years for men and 33.5 ± 11.8 years for women. The prevalence of LBP in the studied subjects was 64.7% (95% CI, 60.7–68.5] with 46.7% among men and 53.3% among women. There were a significant differences between the subjects with LBP and without LBP with respect to gender (P < 0.001), body mass index (BMI) (P < 0.001), occupational status (P < 0.001) and living environment (P = 0.016). Functional disability was higher in patients with LBP. Young patients in aged 15–34 years, patients with preparatory/secondary educational level and students showed higher depressive symptoms. A similar pattern was found in patients with somatic symptoms. Factor analysis revealed a strong association between depression and somatization in LBP patients. Conclusions: Functional disability was higher in with LBP. Furthermore, symptoms of depression and somatization are prevalent among LBP patients.     

经皮子宫动脉栓塞术治疗子宫肌瘤39例临床观察

目的探讨子宫动脉栓塞术(UAE)治疗子宫肌瘤的临床疗效及副反应。方法行常规UAE术。结果UAE治疗6~12个月后临床症状明显缓解。其中UAB治疗后第12个月显效者35例(35/39),有效者4例(4/39);UAB治疗后第18个月显效者23例(23/26),有效者3例(3/26)。结论UAE可有效缩小肌瘤及子宫的体积,并明显改善子宫肌瘤的临床症状。*     

Secular change in height,sitting height and leg length in rural Oaxaca,southern Mexico: 1968–2000

Objective: To evaluate secular changes in height, sitting height and estimated leg length between 1968 and 2000 in residents in a rural Zapotec-speaking community in Oaxaca, southern Mexico.

Materials and methods: Height and sitting height were measured in school children 6–13 years (1968, 1978, 2000), in adolescents 13–17 years (1978, 2002) and adults 19–29 years (1978, 2000). Leg length was estimated as height minus sitting height. The sitting height/height ratio was calculated. Subjects were grouped by sex into four age categories: 6–9, 10–13, 13–17 and 19–29 years for analysis. The Preece–Baines Model I growth curve was fitted to cross-sectional means for 1978 and 2000.

Results: There were no differences between children 6–9 and 10–13 years in 1968 and 1978 with the exception of the sitting height ratio in girls 6–9 years. Children of both sexes 6–13 years and adolescent boys 13–17 years were significantly larger in the three dimensions in 2000 compared to 1978; adolescent girls differed only in height and sitting height. Adult males in 2000 were significantly taller with longer legs than those in 1978, but the samples did not differ in sitting height and the ratio. Adult females in 1978 and 2000 did not differ significantly in the three dimensions. Rates of secular change in height and sitting height between 1978 and 2000 were reasonably similar in the three age groups of male children and adolescents, but the rate for estimated leg length was highest in 10–13-year-old boys. Secular gains were smaller in adult males, but were proportionally greater in estimated leg length. Girls 6–9 and 10–13 years experienced greater secular gains in height, sitting height and estimated leg length than adolescent and young adult females, while secular gains and rates decreased from adolescent girls to young adult women. Ages of peak velocity for height, sitting height and estimated leg length declined in boys, while only ages of peak velocity for height and estimated leg length declined in girls.

Conclusions: There are major secular increases in height, sitting height and estimated leg length of children and adolescents of both sexes since 1978. Secular gains in height are of similar magnitude in boys and girls 6–13 years, but are greater in adolescent and young adult males than females. The secular increase in height of young adults of both sexes is smaller than that among adolescents. Estimated leg length accounts for about 60% of the secular increase in height in children of both sexes. Estimated leg length and sitting height contribute equally to the secular increase in height in adolescent boys, whereas estimated leg length accounts for about 70% of the secular increase in height in young adult males. Sitting height contributes about two-thirds of the secular increase in height in adolescent and young adult females.     

金水宝胶囊联合舒洛地特治疗早期糖尿病肾病的临床研究

目的探讨金水宝胶囊联合舒洛地特治疗早期糖尿病肾病的临床效果。方法选取2015年1月—2018年1月河北大学附属医院收治的早期糖尿病肾病患者80例,随机分成对照组(40例)和治疗组(40例)。对照组口服舒洛地特软胶囊,1粒/次,2次/d。治疗组在对照组基础上口服金水宝胶囊,6粒/次,3次/d。两组患者均连续治疗4个月。观察两组患者临床疗效,同时比较治疗前后两组患者尿白蛋白排泄率(UAE)、24 h尿蛋白定量(24 h-UTP)值、血清肌酐(Cr)和尿素氮(BUN)水平、血脂、内皮功能、炎症及氧化应激指标和肾动脉血流参数。结果治疗后,对照组的总有效率为75.0%,显著低于治疗组的92.5%,两组比较差异具有统计学意义(P0.05)。治疗后,两组UAE、24 h-UTP值及血清Cr、BUN水平均显著降低(P0.05),且治疗组患者UAE、24h-UTP值及血清Cr、BUN水平明显低于对照组(P0.05)。治疗后,两组血清三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、内皮素(ET)-1、C反应蛋白(CRP)浓度及外周血中性粒细胞与淋巴细胞比值(NLR)较治疗前均显著降低(P0.05),血清降钙素基因相关肽(CGRP)、超氧化物歧化酶(SOD)水平则均显著升高(P0.05),且治疗组患者上述血脂、内皮功能、炎症及氧化应激指标水平明显好于对照组(P0.05)。治疗后,两组患者肾动脉血流参数RI和PI值均显著降低(P0.05),且治疗组患者RI和PI值明显低于对照组(P0.05)。结论金水宝胶囊联合舒洛地特治疗早期糖尿病肾病能有效减少患者尿蛋白排泄,保护肾功能,纠正脂质代谢紊乱,改善微循环及肾脏血流动力学。     

Efficacy of patient-controlled hydromorphone analgesia in those undergoing uterine fibroid artery embolization via the right radial artery

ObjectiveTo evaluate the efficacy and safety of patient-controlled analgesia (PCA) with hydromorphone as perioperative analgesia during uterine artery embolization (UAE) via the right radial artery.Patients and methodsA total of 33 patients with uterine fibroids, who underwent UAE at the authors’ hospital between June 2021 and March 2022, were selected. Hydromorphone (10 ​mg) was dispensed into a 100 ​ml PCA pump with normal saline. Pump administration was initiated 15 ​min before the start of the procedure, and the intraoperative dose was adjusted according to patient pain level. A numerical rating scale was used to evaluate pain immediately after embolization, 5 ​min after embolization, at the end of the procedure, and 6, 12, 24, 48, and 72 ​h after the procedure. Side effects were also observed.ResultsThirty-three patients underwent uterine artery embolization via the right radial artery. Patient pain was well controlled at all time points surveyed, and patients reported satisfaction with analgesia. The median length of hospital stay was 5 days. There were 7 cases of adverse reactions, but no serious side effects were observed.ConclusionPatients reported positive experiences with arterial embolization of uterine fibroids via the right radial artery. Hydromorphone PCA effectively controlled pain. The PCA pump is easy to operate, has a low incidence of adverse reactions, and offers economic benefits at the patient and institutional levels.     

IL-33 receptor ST2 deficiency attenuates renal ischaemia–reperfusion injury in euglycaemic,but not streptozotocin-induced hyperglycaemic mice

Aim

Kidney hypoxia can predispose to the development of acute and chronic renal failure in diabetes. Ischaemia–reperfusion injury (IRI) causes inflammation, and diabetes is known to exacerbate this inflammatory response in the kidney, whereas alarmin IL-33 could act as an innate immune mediator during kidney IRI. Thus, the present study examined the impact of genetic IL-33 receptor ST2 deficiency (ST2?/?) on renal IRI in euglycaemic and hyperglycaemic mice.

Low serum bilirubin concentration is a novel risk factor for the development of albuminuria in patients with type 2 diabetes

Objective

Bilirubin has been recognized as an important endogeneous antioxidant. Previous studies reported that bilirubin could prevent atherosclerosis. The aim of this study was to investigate if serum bilirubin concentration could be a predictor for the development of albuminuria in patients with type 2 diabetes.

Materials and Methods

We measured serum bilirubin in 320 consecutive patients with normoalbuminuria. We performed follow-up study to assess the development of albuminuria, mean interval of which was 3.2 ± 0.9 years. Cox proportional hazards regression was used to examine the relationship between serum bilirubin concentration and the development of albuminuria.

Results

During follow-up duration, 43 patients have developed albuminuria. In multivariate analysis, after adjusting for comprehensive risk factors, the risk of developing albuminuria was higher in the lowest quartile of serum bilirubin concentrations than that in the highest quartile of serum bilirubin concentrations (Hazard ratio, 5.76; 95% CI, 1.65 to 24.93).

Conclusions

Low serum bilirubin concentration could be a novel risk factor for the development of albuminuria in patients with type 2 diabetes.