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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.
广西毛南族群体体成分与血脂和血尿酸的相关性   总被引:1,自引:0,他引:1  
目的 了解毛南族成年人的体成分与血脂、血尿酸的相关关系,探讨体成分变化对血脂、血尿酸的影响。 方法 广西毛南族自治县毛南族村寨毛南族成人584人(男237,女347),年龄20~80岁。用人体测高仪测量身高;用ANITA MC-180 仪测量体成分;用日立7600仪测量血脂和血尿酸。所得数据用SPSS 20.0统计学软件进行分析。 结果 毛南族男性年龄、身高、体重、去脂体重、肌肉量、推定骨量、身体水分、蛋白质、细胞外液、细胞内液和腰臀比大于女性(P<0.05);而脂肪量、体脂肪率、皮下脂肪含量小于女性 (P<0.01)。毛南族高尿酸血症和血脂异常患病率分别为13.9%和28.4%,其中男性高尿酸血症和血脂异常患病率大于女性(P<0.05)。血脂异常患者男性体重、体质指数、去脂体重、脂肪量、肌肉量、推定骨量、蛋白质、细胞外液、体脂肪率、内脏脂肪含量、皮下脂肪含量、腰臀比高于血脂正常组(P<0.05);女性年龄、体质指数、脂肪量、体脂肪率、内脏脂肪含量、腰臀比高于正常组。高尿酸血症组男性体重、去脂体重、推定骨量、身体水分、细胞外液高于正常组(P<0.05);女性年龄、体重、体质指数、脂肪量、细胞外液、体脂肪率、内脏脂肪含量、皮下脂肪含量、腰臀比高于正常组。 结论 广西毛南族成人的血脂异常、高尿酸血症检出率男性均高于女性。广西毛南族正常成人的体成分含量与高脂血症、高尿酸血症患者之间均存在明显差异。  相似文献   
6.
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   
7.
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   
8.
目的 检索、评价并整合国内外早产儿体位管理的相关证据,为临床实践提供参考。方法 计算机检索国际指南网、英国国家健康与临床优化研究所网站、苏格兰学院指南网、美国指南网、加拿大安大略注册护士协会网站、乔安娜布里格斯研究所循证卫生保健中心数据库、BMJ Best Practice、PubMed、Embase、OVID、万方数据库、中国知网、医脉通等网站或数据库中关于早产儿体位管理的所有证据,包括指南、证据总结、最佳临床实践手册、临床决策及系统评价,检索时限为建库至2020年8月31日。结果 共纳入10篇文献,其中指南3篇、系统评价5篇、技术报告1篇、临床决策1篇。从体位评估、体位摆放、体位辅助工具及使用、特殊疾病或情境下的体位管理4个方面总结了21条证据。结论 该研究总结了早产儿体位管理的最佳证据,为规范早产儿体位管理提供了循证依据,建议护理人员在应用证据时综合考虑临床实际情况选择性应用最佳证据,促进早产儿健康。  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.
《Pancreatology》2022,22(2):270-276
Backgroundand purpose: Zinc is an essential element for human health and plays an important role in metabolic, immunological and other biological processes. The present study was conducted to investigate the association between zinc deficiency (ZD) and the perioperative clinical course in patients with pancreatic ductal adenocarcinoma (PDAC).MethodsOf 216 patients with PDAC who underwent elective pancreatectomy between 2013 and 2017 at our institution, 206 patients with sufficient clinical data were retrospectively reviewed. The perioperative variables were compared and the risk factors associated with infectious complications were identified.ResultsZD was preoperatively present in 36 (17.5%) of 206 patients with PDAC. In the patients of the ZD group, a higher proportion of males, higher preoperative modified Glasgow prognostic scores, a higher neutrophil-to-lymphocyte ratio, and a higher occurrence of postoperative infectious complications after pancreatectomy were observed, compared to the non-ZD group. By a univariate analysis, three risk factors were significantly associated with infectious complications after pancreatectomy: ZD (vs non-ZD: p = 0.002), serum albumin <3.5 g/dl (vs ≥ 3.5 g/dl: p = 0.005), and the procedure of pancreaticoduodenectomy (vs others: p = 0.013). By multivariate logistic regression analysis, the occurrence of infectious complications was significantly associated with ZD (OR 3.430, 95%CI 1.570 to 7.490, p = 0.002) and the procedure of pancreaticoduodenectomy (OR 2.030, 95%CI 1.090 to 3.770, p = 0.025).ConclusionsThe current study newly demonstrated that ZD could serve as a preoperative predictor of infectious complications after pancreatectomies in the patients with PDAC.  相似文献   
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