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1.
目的 探索贵州省男性主要少数民族骨量异常的影响因素,为骨量异常的防控提供参考依据。 方法 基于中国多民族队列,采用多阶段分层整群抽样方法调查贵州省苗族、布依族、侗族男性共5 727名。采用随机森林算法、非条件logistic回归和限制性立方样条回归探讨骨量异常的影响因素。结果 骨量异常重要的前5名的因素依次是职业、午睡时长、年龄、BMI、静态行为。布依族(OR=1.223,95%CI:1.065~1.405)、年龄≥50岁(OR=1.254,95%CI:1.038~1.515)、吸烟(OR=1.191,95%CI:1.060~1.338)、有关节炎(OR=1.259,95%CI:1.001~1.583)和有骨折史(OR=1.528,95%CI:1.227~1.902)可能是骨量异常的危险因素。而农林牧渔劳动者(OR=0.787,95%CI:0.626~0.990)、午睡时长≥90分钟(OR=0.725,95%CI:0.612~0.858)、中水平体力活动(OR=0.818,95%CI:0.708~0.946)和高水平体力活动(OR=0.824,95%CI:0.696~0.975)可能是贵州省主要男性少数民族骨量异常的保护因素。BMI与骨量异常的患病关联强度呈非线性关系,业余静态行为时长与骨量异常的患病关联强度呈线性关系。结论 影响贵州省男性主要少数民族骨量异常的因素包括多方面,包括非可控因素和可控因素,建议加强对可控因素的管理以预防骨量异常的发生。  相似文献   
2.
目的研究2型糖尿病(T2DM)患者发生慢性肾脏病(CKD)的危险因素,并着重分析肥胖与CKD发生的关系。方法纳入2009年1月至2019年6月在南京鼓楼医院就诊的18至75岁诊断为T2DM的患者,收集一般资料包括性别、年龄、体重指数(BMI)、收缩压、舒张压、糖尿病病程以及实验室指标包括血红蛋白(Hb)、白蛋白、丙氨酸转氨酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、尿酸、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、尿白蛋白/肌酐比值和估算的肾小球滤过率。肥胖定义为BMI≥28 kg/m2,超重定义为24 kg/m2≤BMI<28 kg/m2。根据是否合并CKD,将研究对象分为合并CKD组和不合并CKD组。在不合并CKD的T2DM患者中,选取至少随访一次,随访时间超过12个月且随访数据完整的患者,按是否发生CKD分为发生CKD组和未发生CKD组。两组间各指标的比较采用t检验、非参数检验以及χ2检验。采用单因素及多因素logistic回归分析法分析T2DM患者发生CKD的危险因素,采用Cox比例风险模型分析随访的T2DM患者CKD发生的危险因素。采用限制性立方样条(RCS)拟合Cox回归模型来评估不同的BMI截点与CKD的关系。结果共纳入3194例T2DM患者,其中合并CKD组620例,不合并CKD组2574例。与不合并CKD组相比,合并CKD组T2DM患者BMI明显增高(P=0.005)。单因素logistic回归分析结果显示,性别、肥胖、收缩压、舒张压、Hb、白蛋白、TG、TC、FPG及HbA1c为T2DM患者发生CKD的影响因素(均P<0.05),将上述指标作为自变量,进行多因素logistic回归分析,结果显示,肥胖(OR=1.058,95%CI 1.079~2.018),收缩压增高(OR=1.027,95%CI 1.018~1.035),TG增加(OR=1.087,95%CI 1.008~1.171),FPG增高(OR=1.042,95%CI 1.003~1.083)是T2DM患者发生CKD的影响因素(均P<0.05)。不合并CKD组中随访时间超过12个月且随访数据完整的T2DM患者共753例,其中,发生CKD组182例,未发生CKD组571例。Cox比例风险模型分析结果显示,在校正年龄、糖尿病病程、收缩压、AST、TG及FPG后,超重为发生CKD的危险因素(OR=1.95,95%CI 1.05~3.61)。RCS拟合Cox回归模型结果显示,T2DM患者BMI与CKD发生风险呈非线性关系,BMI在28~31 kg/m2的T2DM患者CKD的发生风险增加(均P<0.05)。结论T2DM患者肥胖与CKD密切相关,肥胖的T2DM患者,特别是BMI在28~31 kg/m2,容易发展为CKD。  相似文献   
3.
《Vaccine》2022,40(30):4038-4045
PurposeAs protection from COVID-19 following two doses of the BNT162b2 vaccine showed a time dependent waning, a third (booster) dose was administrated. This study aims to compare the antibody response following the third dose versus the second and to evaluate post-booster seroconversion.MethodsA prospective observational study conducted in Maccabi Healthcare Services. Serial SARS-CoV-2 Spike IgG tests, 1,2,3 and 6 months following the second vaccine dose and one month following the third were obtained. Neutralizing antibody levels were measured in a subset of participants. Per individual SARS-CoV-2 Spike IgG titer ratios were calculated one month after the booster administration compared to titers one month following the second dose and prior to booster.ResultsAmong 110 participants, 56 (51%) were women. Mean age was 61.7 ± 1.9 years and 66 (60%) were immunocompromised. One month after third dose, IgG titers were induced 7.83 (95 %CI 5.25–11.67) folds and 2.40 (95 %CI 1.90–3.03) folds compared to one month after the second, in the immunocompromised and immunocompetent groups, respectively. Of the 17 immunocompromised participants who were seronegative after the second dose, 4 (24%) became seropositive following the third. Comparing the titers prior to the third dose, an increase of 50.7 (95 %CI 32.5–79.1) fold in the immunocompromised group and 25.7 (95 %CI 19.1–34.7) fold in and immunocompetent group, was observed.ConclusionA third BNT162b2 vaccine elicited robust humoral response, superior to the response observed following the second, among immunocompetent and immunocompromised individuals.  相似文献   
4.
5.
气管支气管异物是儿童耳鼻咽喉头颈外科常见病,具有起病急,病情进展快的特点,严重时可危及生命。本文结合湖南省儿童医院35年气管支气管异物的救治经验,对该病的发展概况、诊断、手术、术后处理、并发症处理及健康教育等方面进行阐述,希望对儿童气管支气管异物的防治工作具有借鉴和参考作用。  相似文献   
6.
目的 探讨全麻下硬性支气管镜下儿童气管支气管异物取出术发生低氧血症的相关因素。方法 回顾性研究432例全麻下气管支气管异物患儿的临床资料,分析患儿术中发生低血氧血症的程度与其年龄、异物停留位置、异物停留时间及术前肺部并发症的相关性。结果 患儿术中发生轻度、中度低氧血症与其年龄、异物停留位置、异物停留时间及术前肺部并发症之间不存在相关性(P>0.05),而患儿术中发生重度低氧血症与其年龄、异物停留位置、异物停留时间及术前肺部并发症之间存在相关性(P<0.05)。结论 患儿年龄、异物停留位置、异物停留时间及术前肺部并发症和术中重度低氧血症发生存在相关性。  相似文献   
7.
Tsukamurella species are obligate aerobic, gram-positive, weak acid-fast, nonmotile bacilli. They are found in various environments, such as soil, water, sludge, and petroleum reservoir wastewater, and belong to the order Actinomycetales. In 2016, there was a reclassification of species within the genus Tsukamurella, merging the species Tsukamurella tyrosinosolvens (T. tyrosinosolvens) and Tsukamurella carboxydivorans. Tsukamurella species are clinically considered to be a rare opportunistic pathogen, because most reported cases have been related to bacteremia and intravascular prosthetic devices and immunosuppression. To date, it has been isolated only from human specimens, and has always been associated with clinical disease; human infections are very rare. Reported infections have included pneumonia, brain abscesses, catheter-related bloodstream infections, ocular infections, bacteremia, and sepsis presenting with septic pulmonary emboli in patients who are immunocompromised. To date, there is no commercially available test for identification. On the other hand, sequence-based identification, including matrix-assisted laser desorption ionization time-of-flight mass spectrometry, is an alternative method for identifying clinical isolates that are either slow growers or difficult to identify through biochemical profiling. The golden standards for diagnosis and optimal management still remain to be determined. However, newer molecular biological techniques can provide accurate identification, and contribute to the appropriate selection of definitive therapy for infections caused by this organism. Combinations of several antimicrobial agents have been proposed for treatment, though the length of treatment for infections has yet to be determined, and should be individualized according to clinical response. Immunocompromised patients often experience severe cases due to infection, and life-threatening T. tyrosinosolvens events associated with dissemination and/or failure of source control have occurred. Favorable prognoses can be achieved through earlier identification of the cause of infection, as well as successful management, including appropriate antibiotic therapy together with source control. Further analyses of similar cases are required to establish the most adequate diagnostic methods and treatment regimens for infections.  相似文献   
8.
BackgroundDiabetes mellitus is a major risk factor for coronary artery disease (CAD) and may provoke structural and functional changes in coronary vasculature. The coronary volume to left ventricular mass (V/M) ratio is a new anatomical parameter capable of revealing a potential physiological imbalance between coronary vasculature and myocardial mass. The aim of this study was to examine the V/M derived from coronary computed tomography angiography (CCTA) in patients with diabetes.MethodsPatients with clinically suspected CAD enrolled in the ADVANCE (Assessing Diagnostic Value of Non-invasive FFRCT in Coronary Care) registry and known diabetic status were included. Coronary artery volume and left ventricular myocardial mass were analyzed from CCTA and the V/M ratio was calculated and compared between patients with and without diabetes.ResultsOf the 3053 patients (age 66 ?± ?10 years; 66% male) with known diabetic status, diabetes was present in 21.9%. Coronary volume was lower in patients with diabetes compared to those without diabetes (2850 ?± ?940 ?mm3 vs. 3040 ?± ?970 ?mm3, p ?< ?0.0001), whereas the myocardial mass was comparable between the 2 groups (122 ?± ?33 ?g vs. 122 ?± ?32 ?g, p ?= ?0.70). The V/M ratio was significantly lower in patients with diabetes (23.9 ?± ?6.8 ?mm3/g vs. 25.7 ?± ?7.5 ?mm3/g, p ?< ?0.0001). Among subjects with obstructive CAD (n ?= ?2191, 24.0% diabetics) and non-obstructive CAD (16.7% diabetics), the V/M ratio was significantly lower in patients with diabetes compared to those without (23.4 ?± ?6.7 ?mm3/g vs. 25.0 ?± ?7.3 ?mm3/g, p ?< ?0.0001 and 25.6 ?± ?6.9 ?mm3/g vs. 27.3 ?± ?7.6 ?mm3/g, respectively, p ?= ?0.006).ConclusionThe V/M ratio was significantly lower in patients with diabetes compared to non-diabetics, even after correcting for obstructive coronary stenosis. The clinical value of the reduced V/M ratio in diabetic patients needs further investigation.  相似文献   
9.
ObjectiveTo determine the long-term cardiovascular disease risk of astronauts with spaceflight exposure compared with a well-matched cohort.MethodsNational Aeronautics and Space Administration (NASA) astronauts are selected into their profession based upon education, unique skills, and health and are exposed to cardiovascular disease risk factors during spaceflight. The Cooper Center Longitudinal Study (CCLS) is a generally healthy cohort from a preventive medicine clinic in Dallas, Texas. Using a matched cohort design, astronauts who were selected beginning April 1, 1959, (and each subsequent selection class through 2009) and exposed to spaceflight were matched to CCLS participants who met astronaut selection criteria; 1514 CCLS participants matched to 303 astronauts in a 5-to-1 ratio on sex, date of birth, and age. The outcome of cardiovascular mortality through December 31, 2016, was determined by death certificate or National Death Index.ResultsThere were 11 deaths caused by cardiovascular disease (CVD) among astronauts and 46 among CCLS participants. There was no evidence of increased mortality risk in astronauts (hazard ratio [HR]=1.10; 95% confidence interval [CI], 0.50 to 2.45) with adjustment for baseline cardiovascular covariates. However, the secondary outcome of CVD events showed an increased adjusted risk in astronauts (HR=2.41; 95% CI, 1.26 to 4.63).ConclusionNo increased risk of CVD mortality was observed in astronauts with spaceflight exposure compared with a well-matched cohort, but there was evidence of increased total CVD events. Given that the duration of spaceflight will increase, particularly on missions to Mars, continued surveillance and mitigation of CVD risk is needed to ensure the safety of those who venture into space.  相似文献   
10.
[目的] 通过测量健康成年人手指寸及下肢骨度分寸的长度,并进行相关性分析,为指寸定位法在下肢的应用提供依据。[方法] 本研究共纳入健康成人49例,采用游标卡尺和软尺分别测量其拇指同身寸、中指同身寸、横指同身寸及下肢胫骨内侧髁至内踝尖(小腿内侧寸)和腘横纹至外踝尖(小腿外侧寸)骨度分寸的长度。分别计算各手指寸及下肢骨度分寸1寸的长度,并进行相关性分析。[结果] 分析数据表明,就不同部位1寸的长度来看,指寸定位法中,拇指同身寸平均1寸长度为(1.92±0.13) cm,中指同身寸平均1寸长度为(2.01±0.18) cm,横指同身寸平均1寸长度为(2.14±0.13) cm。骨度折量定位法中,小腿内侧寸平均1寸长度为(3.03±0.11) cm,小腿外侧寸平均1寸长度为(3.41±0.09) cm。就指寸定位法与骨度折量定位法相关性分析来看,拇指同身寸与小腿内侧寸、小腿外侧寸的相关系数分别为0.214和0.338,横指同身寸与小腿内侧寸、小腿外侧寸的相关系数分别为0.288和0.307,中指同身寸与小腿内侧寸、小腿外侧寸的相关系数分别为0.356和0.294。[结论] 各指寸定位法1寸长度的差异较大,在穴位定位时不建议交叉采用。骨度折量定位法中小腿内外侧的1寸长度存在差异,内外侧腧穴定位时应以其所在部位骨度分寸为准;使用横指同身寸于下肢进行腧穴定位时,相较于小腿内侧,横指同身寸在小腿外侧的腧穴定位准确性更高。  相似文献   
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