Pre-vaccination vulnerability and suspected adverse events following HPV vaccination. A case-control study nested in the Danish national birth cohort

Previous studies have indicated that girls experiencing suspected adverse events (AE) following HPV vaccination were more vulnerable prior to vaccination. However, no study has previously investigated differences in vulnerability using prospectively collected self-reported measures of vulnerability. The objective of this study therefore was to describe the distribution of biological and psychosocial indicators of vulnerability in girls referred to a hospital setting due to suspected adverse events and compare it with a sample of non-referred HPV vaccinated girls.The study was conducted as a case control study based within the Danish National Birth Cohort. Cases were defined as HPV vaccinated girls referred to a hospital setting between 2015 and 2017 due to suspected adverse events (n = 80), and 5 controls were randomly selected from the remaining source population, matched to cases on age at vaccination, region of residence and year of vaccination. The final study population consisted of 480 girls. Prior exposures were based on information gathered from an 11 year follow up of the DNBC and included information on self-rated health, frequent health complaints, medication use, bullying, stressful life events and physical activity. Conditional logistic regression analysis was used to estimate the association between each exposure and referral.The percentage of individuals in the exposed category of each exposure was generally higher for cases than controls. Particularly, the odds of being referred were higher for those with low self-rated health compared to high (OR [95%-CI] 2.43 [1.07–5.5]1), those being bullied (OR 3.19 [1.17–8.73]), and those who had taken medication (OR 2.22 [1.32–3.67]).Overall, these results indicated that girls experiencing suspected AE following HPV vaccination were more vulnerable prior to vaccination.     

呼出气一氧化氮测定在COPD频繁急性加重表型患者中的临床意义

目的 探讨中央和外周气道呼出气一氧化氮(FeNO)在慢性阻塞性肺病(COPD)频繁急性加重表型患者中的临床意义。方法 收集2019年1月至2021年6月安徽医科大学第四附属医院呼吸与危重症医学科收治的90例COPD患者作为研究对象,在一年内因急性加重次数≥2次的患者纳入频繁急性加重组(n=23),急性加重次数≤1次的患者纳入非频繁急性加重组(n=67)。测定两组中央气道一氧化氮(FeNO₅₀)浓度和外周气道呼出气一氧化氮(FeNO₂₀₀)浓度、肺泡气一氧化氮(CaNO)浓度并收集白细胞计数、血嗜酸粒细胞百分比、血清总免疫球蛋白E(IgE)、慢性阻塞性肺疾病评估测试(CAT)评分及肺功能等相关指标,对进行对比分析。结果 COPD频繁急性加重组FeNO₂₀₀、CaNO、C反应蛋白(CRP)、血清总IgE、CAT评分均高于非频繁急性加重组,第一秒用力呼气容积占预计值百分比(FEV1%)低于非频繁急性加重组(P＜0.05)。在COPD急性加重患者中,FeNO₂₀₀、CaNO与FEV1%呈负相关(r=-0.305、-0.439,P＜0.05),与血清总IgE呈正相关(r=0.523、0.514,P＜0.05),其中CaNO还与CRP呈正相关(r=0.321,P=0.023)。结论 COPD频繁急性加重表型患者中央和外周FeNO浓度存在差异,FeNO₂₀₀、CaNO均可作为COPD患者外周小气道炎症指标。     

全局频繁闭项目集挖掘算法研究

频繁闭项目集挖掘是数据挖掘研究中的一个重要研究课题.目前已有的频繁闭项目集挖掘算法主要针对单机环境,有关分布式环境下的全局频繁闭项目集挖掘算法的研究尚不多见.为此,本文提出了一种快速挖掘全局频繁闭项目集算法,并对其更新问题进行了研究;提出了一种相应的频繁闭项目集增量式更新算法,该算法将充分利用先前的挖掘结果来节省发现新的全局频繁闭项目集的时间开销.实验结果表明算法是有效的.     

Levamisole in steroid-sensitive nephrotic syndrome of childhood: the lost paradise?

Among the different drugs used for sparing steroids in steroid-sensitive nephrotic syndrome (SSNS) with frequent relapses and steroid dependency, levamisole is the least toxic and the least expensive. However, it is neither approved for this indication nor widely used in Europe. This may be explained by the difficulty in obtaining levamisole in some countries and the lack of good quality evidence for its effectiveness. Evidence is limited to three clinical trials that all suffered from methodological limitations. Statistical synthesis of these trials showed that levamisole reduces the risk of a relapse during treatment (relative risk 0.60, 95% confidence interval 0.45–0.79). From the available information, no conclusions can be drawn on the steroid-sparing effect, the long-term efficacy, and safety, as well as possible differences in efficacy in different subgroups of SSNS patients. The confirmation of a favorable effect of levamisole on the reduction of the frequency of relapses and on sparing steroids in an adequately powered, double-blind, placebo-controlled, randomized, multi-center clinical trial will promote consensus on the place of levamisole in the treatment of SSNS of childhood. Follow-up should be at least 1 year to evaluate long-term efficacy and side effects. If the results of such a clinical trial confirm the beneficial effects of levamisole in nephrotic syndrome, this may allow registration for this indication and interest companies other than Jansen-Cilag, which only recently has decided to stop its production.     

Characteristics of frequent attenders in different age and sex groups in primary health care

Objective. To explore depression from a gender perspective, by capturing depressed women's and men's formulations of their experiences and understanding of their situation. Design. Qualitative interview study. Setting. A healthcare centre in northern Sweden. Subjects. Eighteen patients who had been diagnosed with depression and treated for at least 6 months were interviewed in depth, both women and men of different ages and social status. Open questions were posed around the themes of Malterud's key questions, focusing especially on how the informants conveyed their experiences. Interviewing and qualitative data analysis went on simultaneously. Results. The experience of depression held similarities for men and women, but the outward manifestations differed by gender as well as socioeconomic status. Though experiences of high demands underlay the narratives of all informants, home or work had different priority. Men talked more easily about physical distress – often the heart – than about emotions. Women verbalized more readily emotional distress – shame and guilt – while physical symptoms often revolved around the stomach. Men dealt with insecurity by aggrandizing their previous competence, women by self-effacement. Conclusion. As clinicians we must listen attentively not only to the manifest but to the avoided or unarticulated. By doing so we might counteract normative gender patterns that highlight the depression of women and conceal that of men.     

Carto系统与常规方法指导消融频发右室流出道室性早搏的比较

目的通过对应用Carto电解剖标测系统(Carto系统)与常规方法指导射频消融治疗频发右室流出道室性早搏(RVOT-PVCs)的比较,评价其临床应用。方法 68例频发RVOT-PVCs患者,其中Carto组36例,运用Carto系统重建右室流出道三维电解剖图后行电解剖标测靶点并予冷盐水灌注电极进行消融;另32例在X线下常规标测和消融,为常规组。比较两组的手术时间、靶点标测时间、X线曝光时间、总放电次数及有效放电率、消融成功率、并发症和随访复发结果。结果手术时间、即时成功率两组无差别(P0.05)。与常规组相比,Carto组靶点标测时间明显缩短(50.8±10.2minvs71.9±20.9min),X线曝光时间缩短(15.5±3.8minvs27.0±7.1min),总放电次数减少(5.8±1.2次vs9.4±1.8次),有效放电率增高(48.1%±12.2%vs31.5%±7.9%),复发率降低(2.8%vs9.4%),P均0.05。两组均无并发症。结论两种标测方法消融频发RVOT-PVCs均有效,安全。但Carto系统对复杂的多源多形早搏有明显的优势。     

半导体激光照射配合重组人IL-2治疗复发性生殖器疱疹

【目的】研究半导体激光照射骶神经节配合重组人IL-2治疗复发性生殖器疱疹的临床疗效及复发率。【方法】将160例确诊的复发生殖器疱疹患者随机分为2组,每组各80例。对照组仅口服伐昔洛韦。治疗组在此基础上加用半导体激光照射骶神经节配合重组人IL-2。【结果】治疗组痊愈率和总有效率均显著高于对照组（P〈0.01）,而复发率显著低于对照组（P〈0.01）。【结论】在常规抗病毒的基础上,加用半导体激光照射骶神经节配合重组人IL-2治疗复发性生殖器疱疹,具有较好的临床疗效,并能明显降低复发率,值得临床进一步研究探讨。     

排尿日记在60岁以上前列腺增生症患者夜尿原因分析中的作用

目的分析老年前列腺增生症患者夜尿次数增多的原因以及排尿日记对其作用。方法72例60岁以上前列腺增生症患者记录排尿日记、国际前列腺症状评分（IPSS）、生存质量评分,并测量前列腺体积及最大尿流率,进行尿动力学检查。将结果与患者的夜尿次数进行比较。结果4例（7％）全天尿量在2500ml以上。23例（40％）夜间尿量〉全天尿量的33％。夜尿次数增多组（14例）夜尿量及残余尿量相对于夜尿次数正常组（58例）显著增多;而单次最大尿量显著减少,差异有统计学意义（P〈0．01）。而两组年龄、前列腺体积、最大尿流率及IPSS评分差异无统计学意义。58例夜尿次数增多者尿动力学检查显示35例（60％）有不稳定膀胱,其中24例（69％）夜问平均每次尿量〈100ml。结论患者的夜尿量以及膀胱功能是影响患者夜尿次数的决定因素,而详细的排尿日记对于决定患者的治疗方案非常有益。     

Mycophenolate mofetil versus cyclosporine for remission maintenance in nephrotic syndrome

We performed a multi-centre randomized controlled trial to compare the efficacy of mycophenolate mofetil (MMF) to that of cyclosporine A (CsA) in treating children with frequently relapsing nephrotic syndrome and biopsy-proven minimal change disease. Of the 31 randomized initially selected patients, seven were excluded. The remaining 24 children received either MMF 1200 mg/m² per day (n = 12) or CsA 4–5 mg/kg per day (n = 12) during a 12-month period. Of the 12 patients in the MMF group, two discontinued the study medication. Evaluation of the changes from the baseline glomerular filtration rate showed an overall significant difference in favour of MMF over the treatment period (p = 0.03). Seven of the 12 patients in the MMF group and 11 of the 12 patients in the CsA group remained in complete remission during the entire study period. Relapse rate in the MMF group was 0.83/year compared to 0.08/year in the CsA group (p = 0.08). None of the patients reported diarrhea. Pharmacokinetic profiles of mycophenolic acid were performed in seven patients. The patient with the lowest area under the curve had three relapses within 6 months. In children with frequently relapsing minimal change nephrotic syndrome, MMF has a favourable side effect profile compared to CsA; however, there is a tendency towards a higher relapse risk in patients treated with MMF.     

前列腺增生患者前列腺电切术后发生尿频的影响因素分析

目的分析前列腺增生(BPH)患者前列腺电切术(TURP)术后发生尿频的影响因素。方法选择2017年5月至2020年10月我院收治的80例BPH患者作为研究对象,收集患者的临床资料并分析TURP术后发生尿频的影响因素。结果80例BPH患者TURP术后尿频发生率为10.00%。单因素和Logistic回归分析结果显示,膀胱颈纤维化、逼尿肌功能不稳定、泌尿系统感染是BPH患者TURP术后发生尿频的影响因素(OR>1,P<0.05)。结论膀胱颈纤维化、逼尿肌功能不稳定、泌尿系统感染可能会增加BPH患者TURP术后尿频的发生风险,临床可根据上述因素制定诊治方案以改善患者症状,降低尿频发生率。