Circulating CD62P small microparticles levels are increased in hypertension

The study aims to find a new biomarker in hypertension. Our study is the first time to demonstrate that the CD62P small microparticle (diameter is <0.5 um) was a new microparticle population and a new biomarker in hypertension.     

Primed neutrophil infiltrations into multiple organs in child physical abuse cases: A preliminary study

Physical abuse of the elderly induces a massive primed neutrophil infiltration into the lung and liver through chemotaxis by interleukin (IL)-8, similar to cases of traumatic or hemorrhagic shock. Here, we used immunohistochemical analyses to investigate this infiltration in cases of physically abused children. In addition, we examined the expression of neutrophil elastase (NE) as the inflammatory mediator and α1-antitrypsin (AAT) as the elastase inhibitor. The number of neutrophils in the abuse cases was increased significantly in the heart, lung, liver, and kidney, compared with that of control cases. IL-8-positive cells and NE-positive cells in all organs of abuse cases were significantly greater than those in control cases. Large quantities of oxidized AAT, which fails to inactivate NE and results in tissue damage, was detected in the liver of abuse cases. Neutrophil infiltration showed positive correlation with the degree of systemic accumulation of non-fatal injuries caused by repetitive abusive behavior. Although further investigation using more autopsy samples is necessary, results of our preliminary study indicate that massive neutrophil infiltration induced by IL-8 in multiple organs is a new complementary diagnostic indicator of physical abuse in children. Moreover, the demonstration of NE-positive cells and oxidized AAT provides firm evidence of tissue damage.     

Associations of OCA2-HERC2 SNPs and haplotypes with human pigmentation characteristics in the Brazilian population

Panels composed of Single Nucleotide Polymorphisms (SNPs) in genes related to pigmentation, when associated with different phenotypes, may assist in predicting the physical appearance of an individual, being very useful in forensic caseworks. We evaluated the association of seven OCA2-HERC2 SNPs and haplotypes with pigmentation characteristics (eye, skin, hair and freckles) in the highly admixed and phenotypically heterogeneous Brazilian population. All the seven SNPs evaluated presented one allele associated with phenotypes from at least two pigmentation features and the alternative allele associated with the opposite phenotypes from the same trait. The genotypic associations followed the same pattern for all seven SNPs. Nine haplotypes were observed in our sample and eight were associated with at least two pigmentation traits. Such SNPs and haplotypes could be deemed as good predictors for the presence of freckles and for skin, eye and hair pigmentation in the Brazilian population.     

McCune-Albright综合征患儿超说明书用药并文献复习

探讨甲羟孕酮、来曲唑和唑来膦酸超说明书用药的合理性。方法：1例6岁8个月男性患儿，出生时发现左臀部咖啡样色斑，4岁颅面部畸形，5岁时出现第二性征发育，同时出现骨龄超前，诊断为"McCune-Albright综合征"。入院后，相继给予甲羟孕酮片（4 mg bid po）+来曲唑片（1.25 mg qd po）+唑来膦酸注射液（3 mg once iv gtt）+碳酸钙片（250 mg qd po）和维生素AD滴剂（胶囊型）（1粒qdpo）治疗。结果：经过23 d的对症治疗后，患者一般情况及症状稳定，要求出院。结论：临床药师参与患者的药物治疗过程，对唑来膦酸和甲羟孕酮、来曲唑的超说明书用药有了进一步的认识，提高了药物的治疗水平。临床药师通过参与临床实践，协助医师参与患者的用药监护，提高药物治疗的安全性。     

Miscarriage history association with euploid embryo transfer outcomes

Research questionIs a history of miscarriage (including recurrent pregnancy loss) associated with euploid cryopreserved embryo transfer outcomes?DesignRetrospective cohort study from 2014 to 2018 of patients at an academic medical centre, undergoing their first cycle of IVF with 24-chromosome Day 5/6 preimplantation genetic testing for aneuploidies (IVF-PGT-A). Multivariate logistic regression was used to investigate the relationship between history of miscarriage and euploid single cryopreserved embryo transfer outcomes (ongoing pregnancy, miscarriage), adjusting for an extensive list of patient and cycle confounders.ResultsIn the study cohort of 283 patients, the overall unadjusted positive beta human chorionic gonadotrophin (bHCG) rate was 70.0%, ongoing pregnancy rate was 52.3%, and the total pregnancy loss (biochemical and clinical pregnancy loss) rate per positive bHCG cycle was 24.7%. While 35.3% of patients had a history of at least one previous miscarriage, 14.5% of patients had a history of recurrent pregnancy loss (RPL). For patients with a history of miscarriage, it was found that the adjusted odds ratios (OR) and 95% confidence intervals (CI) for positive bHCG were 1.30 (0.51–3.27), for ongoing pregnancy were 0.88 (0.38–2.03) and for total pregnancy loss were 1.41 (0.49–4.05), when compared with patients without a history of miscarriage. For RPL patients, OR for positive bHCG, ongoing pregnancy and total pregnancy loss also did not significantly differ when compared with patients with no history of miscarriage.ConclusionsIn this cohort, there was no significant association between miscarriage history and euploid cryopreserved embryo transfer outcomes (ongoing pregnancy, total pregnancy loss) after adjustment for potential confounders. Further study in larger data sets is warranted.     

A randomized,controlled, multicenter contraceptive efficacy clinical trial of the intravas device,a nonocclusive surgical male sterilization

Because of unavoidable complications of vasectomy, this study was undertaken to assess the efficacy and safety of male sterilization with a nonobstructive intravas device （IVD） implanted into the vas lumen by a mini-surgical method compared with no-scalpel vasectomy （NSV）. IVDs were categorized into two types： IVD-B has a tail used for fixing to the vas deferens （fixed wing） whereas IVD-A does not. A multicenter prospective randomized controlled clinical trial was conducted in China. The study was comprised of 1459 male volunteers seeking vasectomy who were randomly assigned to the IVD-A （n = 487）, IVD-B （n = 485） or NSV （n = 487） groups and underwent operation. Follow-up included visits at the 3rd-6TM and 12~ postoperative months, The assessments of the subjects involved regular physical examinations （including general and andrological examinations） and semen analysis. The subjects＇ partners also underwent monitoring for pregnancy by monthly interviews regarding menstruation and if necessary, urine tests, There were no significant differences in pregnancy rates （0.65% for IVD-A, 0 for IVD-B and 0.21% for NSV） among the three groups （P 〉 0.05）. The cumulative rates of complications at the 12th postoperative month were zero, 0.9% and 1.7% in the three groups, respectively. In conclusion, IVD male sterilization exhibits a low risk of long-term adverse events and was found to be effective as a male sterilization method, similar to the NSV technique. IVD male sterilization is expected to be a novel contraceptive method.     

中国医疗损害风险分担机制现状及对策

医疗损害风险是客观存在,目前中国还缺乏有效的医疗损害风险分担机制。通过对中国医疗损害风险分 担现状的分析,就完善中国医疗损害风险分担机制建议如下：完善医疗纠纷预防处理立法;建立多层次、多渠道、 综合全面的医疗损害风险分担体系;促进各种医疗损害风险保险救助制度与医疗纠纷人民调解制度的有机衔接,构 建高效医疗纠纷化解途径等。     

二、三级公立医院院长管理培训需求比较与对策研究

目的:通过对二、三级公立医院院长的管理培训需求进行异同比较,探讨建立针对不同级别公立医院院长管理知识储备课程的对策建议。方法:对276名公立医院院长进行问卷调查,采用描述、相关分析、方差分析等统计方法处理数据。结果:二、三级公立医院院长在管理培训需求上的重合率为68.4%,其中共性化需求13项,具有显著差异的差异化需求6项。结论:二、三级公立医院院长在管理培训需求内容上存在一致性,但在需求程度上存在差异性。需要建立针对不同级别医院院长的管理培训课程,同时更注重管理培训的实用性。