758例艾滋病抗病毒治疗患者生活质量现状及相关因素研究

目的 了解艾滋病抗病毒治疗患者生活质量的现状并分析其相关因素.方法 应用SF-36量表评价758例艾滋病抗病毒治疗患者的生活质量,同时调查可能影响生活质量的人口学特征和与HIV感染相关的特征.采用t检验、方差分析进行均数显著性检验,采用多元线性回归模型分析艾滋病抗病毒治疗患者生活质量生理健康总分和心理健康总分的相关因素.结果 758例艾滋病抗病毒治疗患者生理健康总分45.34±8.77,心理健康总分41.92±12.01.患者年龄越小生理健康总分越高,心理健康总分则越低.抗病毒治疗时间越长心理健康总分越低.男性、血CD4+T淋巴细胞计数水平高的患者生理和心理健康总分比女性、血CD4+T淋巴细胞计数水平低的患者得分高.性途径、静脉吸毒途径和其他途径或尚不明确途径感染生理和心理健康总分高于单采血浆途径.结论 应加强对年龄较小、女性、单采血浆感染、血CD4+T淋巴细胞计数水平低、抗病毒治疗时间较长的艾滋病感染者或患者的心理健康辅导,以提高其生活质量.     

Genetic variants at 10q23.33 are associated with plasma lipid levels in a Chinese population

Plasma lipid abnormalities are implicated in the pathogenic process of type 2 diabetes. The IDE-KIFII-HHEX gene cluster on chromosome 10q23.33 has been identified as a susceptibility locus for type 2 diabetes. We hy- pothesized that genetic variants at 10q23.33 may be associated with plasma lipid concentrations. Seven tagging single nucleotide polymorphisms （SNPs： rs7923837, rs2488075, rs947591, rs11187146, rs5015480, rs4646957 and rs1111875） at 10q23.33 were genotyped in 3,281 subjects from a Han Chinese population, using the Taq- Man OpenArray and Sequenom MassARRAY platforms. Multiple linear regression analyses showed that SNP rs7923837 in the 3＂-flanking region of HHEX was significantly associated with triglyceride levels （P = 0.019, 0.031 mmol/L average decrease per minor G allele） and that rs2488075 and rs947591 in the downstream region of HHEX were significantly associated with total cholesterol levels （P = 0.041, 0.058 mmol/L average decrease per minor C allele and P = 0.018, 0.063 mmol/L average decrease per minor A allele, respectively）. However, the other four SNPs （rs11187146, rs5015480, rs4646957 and rs1111875） were not significantly associated with any plasma lipid concentrations in this Chinese population. Our data suggest that genetic variants in the IDE-KIF11- HHEX gene cluster at 10q23.33 may partially explain the variation of plasma lipid levels in the Hart Chinese pop- ulation. Further studies are required to confirm these findings in other populations.     

Vaginal bleeding and diethylstilbestrol exposure during pregnancy: relationship to genital tract clear cell adenocarcinoma and vaginal adenosis in daughters

Comparing 186 cancer cases and 1772 cancer-free controls and reexamining several previously published studies, we found genital tract clear cell adenocarcinoma and vaginal adenosis to be moderately, but nonsignificantly, associated with vaginal gestational bleeding when in utero diethylstilbestrol exposure was statistically controlled. Considering the prevalence of diethylstilbestrol exposure in the general population, the relative risks of vaginal clear cell adenocarcinoma for in utero exposure were 365.6 and 459.0 when vaginal bleeding did and did not occur during the index pregnancy, respectively. The relative risks of vaginal adenosis for such diethylstilbestrol exposure were 15.4 and 92.8, respectively, for these women. The strong associations between in utero diethylstilbestrol exposure and both vaginal adenosis and genital tract clear cell adenocarcinoma cannot be attributed to the occurrence of problem pregnancy. However, among daughters exposed to diethylstilbestrol, maternal vaginal bleeding during the index pregnancy does appear to be associated with reduced risks of vaginal adenosis and vaginal clear cell adenocarcinoma.     

Cigarette smoking and alcohol consumption and the risk of pancreatic cancer: a case-control study in Shanghai,China

Cancer of the pancreas has been rising in incidence in Shanghai, China since the early 1970s. In 1987–89, this malignancy ranked eighth in cancer incidence among men and ninth among women in Shanghai. To examine risk factors for this tumor in urban Shanghai, a population-based case-control study was conducted. Cases (n=451) were permanent residents of Shanghai, 30 to 74 years of age, newly diagnosed with pancreatic cancer between 1 October 1990 and 30 June 1993. Deceased cases (19 percent) were excluded from the study. Controls (n=1,552) were selected among Shanghai residents, frequency-matched to cases by gender and age. Cases and controls were interviewed about their demographic background and potential risk factors, including tobacco, alcohol and beverage consumption, diet, and medical history. Adjusted odds ratios (OR) and 95 percent confidence intervals (CI) were estimated using logistic regression models. Current cigarette smoking was associated with excess risk of pancreatic cancer in both men (OR=1.6, CI=1.1–2.2) and women (OR=1.4, CI=0.9–2.4). ORs increased significantly with number of cigarettes smoked per day, and with duration and packyears of smoking. Risk increased three-to sixfold among those in the highest categories of cigarette consumption, while risk decreased with increasing years since smoking cessation. Former smokers who stopped smoking for 10 or more years had risks comparable to nonsmokers. No association was found between alcohol use and pancreatic cancer. After adjustment for potential confounding factors, it was estimated that during the study period, nearly 25 percent of pancreatic cancer cases among men and six percent of cases among women could be attributed to smoking. Our findings add to the accumulating evidence linking smoking and pancreatic cancer, and suggest that the rising incidence of this malignancy in Shanghai may be related at least partly to the increasing prevalence of smoking.Dr Ji, formerly with the Shanghai Cancer InstituteDr McLaughlin, formerly with the National Cancer InstituteDr Hatch, formerly with Columbia University     

安徽省高校大学生运动员疲劳性骨膜炎的流行病学调查

疲劳性骨膜炎又称应力性骨膜炎,是一种过度使用性损伤,在运动员和体育运动参加者中非常多见.疲劳性骨膜炎是骨的反应性炎症,在急性炎症阶段如能调整运动量,并给予适当治疗就可使炎症消退,组织修复,从而由不适应转化为新的适应,并可使负荷能力提高,否则有可能使病情进一步发展,甚至产生疲劳性骨折[1].     

肾小球滤过率不推荐在现有知识的基础上进行筛查

肾小球滤过率（GFR）降低预示着心血管疾病、终末期肾脏病（需要透析或移植）或死亡。在本期杂志中（见第16页）发表了一项基于人群的研究报告，Hallan和他的同事分析了旨在识别低GFR人群时不同筛选策略的收益率。美国肾脏疾病结局质量启动组织（K／DOQI）制定的指南将慢性肾脏病定义为GFR持续〈60ml／min／1．73m^2、持续尿检异常或临床相关的结构异常，并且推荐在高危人群中测量血清肌酐来决定估算的GFR值（eGFR）^2。全球改善肾脏病预后工作组（一个改善肾脏病患治疗和预后的国际性组织）和英国指南草案赞同这个分类，但在目前尚不主张筛查孔。[第一段]