应用GM(1,1)灰色模型预测全国甲状腺癌发病趋势北大核心

目的:探讨应用GM(1,1)灰色模型在全国及分性别、地区的甲状腺癌发病率预测中的可行性,为制定措施预防甲状腺癌发病提供参考。方法:甲状腺癌发病数据来源于2008至2018年《中国肿瘤登记年报》,通过建立模型评价其预测效果并预测未来5年的发病率。结果:全国及分性别(男、女)、地区(城市、农村)甲状腺癌发病率预测模型分别为x^((1))(k+1)=37.5326e^(0.1152k)-33.2326(C=0.2083,P=1.00)、x^((1))(k+1)=15.6257e 0.1239k-13.6457(C=0.1969,P=1.00)、x^((1))(k+1)=59.7419e^(0.113k)-53.0619(C=0.2150,P=1.00)、x^((1))(k+1)=35.4451e ^(0.1408k)-30.2251(C=0.1519,P=1.00)、x^((1))(k+1)=16.7016e^(0.1294k)-15.0216(C=0.4918,P=1.00)。结论:GM(1,1)灰色预测模型可较好的拟合全国及分性别、城市的甲状腺癌发病率变化趋势并预测,对农村的拟合效果稍差。预测未来5年全国及分性别、地区甲状腺癌发病率将持续上升,提示应采取有针对性的措施加以预防。     

Excitability of motor and sensory axons in multifocal motor neuropathy

ObjectiveTo assess excitability differences between motor and sensory axons of affected nerves in patients with multifocal motor neuropathy (MMN).MethodsWe performed motor and sensory excitability tests in affected median nerves of 20 MMN patients and in 20 age-matched normal subjects. CMAPs were recorded from the thenar and SNAPs from the 3rd digit. Clinical tests included assessment of muscle strength, two-point discrimination and joint position.ResultsAll MMN patients had weakness of the thenar muscle and normal sensory tests. Motor excitability testing in MMN showed an increased threshold for a 50% CMAP, increased rheobase, decreased stimulus-response slope, fanning-out of threshold electrotonus, decreased resting I/V slope, shortened refractory period, and more pronounced superexcitability. Sensory excitability testing in MMN revealed decreased accommodation half-time and S2-accommodation and less pronounced subexcitability. Mathematical modeling indicated increased Barrett-Barrett conductance for motor fibers and increase in internodal fast potassium conductance for sensory fibers.ConclusionsExcitability findings in MMN suggest myelin sheath or paranodal seal involvement in motor fibers and, possibly, paranodal detachment in sensory fibers.SignificanceExcitability properties of affected nerves in MMN differ between motor and sensory nerve fibers.     

Severe Obesity Increases Risk of Infection After Revision Total Hip Arthroplasty

BackgroundThe increasing prevalence of obesity has resulted in an increased number of revision total hip arthroplasties (rTHAs) performed in patients with a high body mass index (BMI). The aim of this study is to evaluate whether obesity negatively affects (1) complication rate, (2) reoperation and revision rate, and (3) patient-reported outcome in rTHA.MethodsIn this registry-based study, we prospectively followed 444 rTHAs (cup: n = 265, stem: n = 57, both: n = 122) performed in a specialized high-volume orthopedic center between 2013 and 2015. The number of complications, and reoperation and revision surgery was registered until 5 years postoperatively. Oxford Hip Score (OHS) was evaluated preoperatively, and at 1 and 2 years postoperatively. Patients were categorized based on BMI to nonobese (<30 kg/m², n = 328), obese (30-35 kg/m², n = 82), and severe obese (≥35 kg/m², n = 34).ResultsSevere obese patients, but not obese patients, had higher risks of complications and re-revision than nonobese patients. In particular, the risk of infection following rTHA was higher in severe obese patients (24%) compared to nonobese patients (3%; relative risk, 7.7). Severe obese patients had overall poorer OHS than nonobese patients, but improvement in OHS did not differ between severe obese and nonobese patients. No differences between obese and nonobese groups on OHS were observed.ConclusionIn our study, severe obesity was associated with an increased risk of infection following rTHA. Patients with high BMI should be counseled appropriately before surgery.     

灰色模型GM(1,1)在意外伤害死亡预测中的应用

目的 对西安市2006-2015年5岁以下儿童意外伤害死亡发生率进行模型拟合和预测,为制订相应预防和控制对策提供理论依据。方法 描述西安市儿童意外伤害死亡的一般情况,应用灰色模型GM(1,1)进行拟合和预测。结果 西安市城市儿童意外伤害死亡较多,意外窒息、交通意外居死因前两位。应用GM(1,1)对未来3年儿童意外伤害死亡发生率预测,结果显示总意外伤害死亡发生率逐年下降;男童死亡率较为平稳;女童死亡率逐年下降;窒息死亡率上升,交通意外死亡率较为平稳。结论 未来3年西安市儿童意外伤害死亡发生率总体呈下降趋势。     

Childhood polybrominated diphenyl ether (PBDE) exposure and executive function in children in the HOME Study

Prenatal exposure to polybrominated diphenyl ethers (PBDEs) have been reported to impair executive function in children, but little is known whether childhood PBDE exposures play a role. Using the Health Outcomes and Measures of the Environment (HOME) Study, a prospective birth cohort in the greater Cincinnati area, we investigated the association between repeated measures of PBDEs during childhood and executive function at 8 years in 208 children and whether effect modification by child sex was present. We used child serum collected at 1, 2, 3, 5, and 8 years to measure PBDEs. The Behavior Rating Inventory of Executive Function was completed by parents to assess executive function at 8 years. We used multiple informant models to examine childhood PBDEs during several exposure windows. Null associations were observed between early childhood PBDEs and executive function. However, we observed significant adverse associations between a 10-fold increase in concurrent concentrations of BDE-28 (β = 4.6, 95% CI 0.5, 8.7) and BDE-153 (β = 4.8, 95% CI 0.8, 8.8) with behavioral regulation. In addition, PBDEs at 8 years were significantly associated with poorer emotional and impulse control. No associations were noted between childhood PBDEs and metacognition or global executive function. However, child sex significantly modified the associations, with significantly poorer executive function among males with higher concurrent BDE-153, and null associations in females. Our study findings suggest that concurrent PBDE exposures during childhood may be associated with poorer executive function, specifically behavior regulation. Males may also be more sensitive to adverse associations of concurrent PBDEs on executive function.     

神经节苷脂GM1在帕金森氏病症状波动治疗中的应用

目的探讨神经节苷脂GM1治疗帕金森氏病(PD)的疗效和安全性。方法对33例长期服用左旋多巴等治疗帕金森氏病药物后出现症状波动的患者,加用神经节苷脂GM1100mg/d,静脉滴注,每日1次,疗程4周。分别在GM1治疗后2、3、4周对患者进行帕金森病统一评分量表(UPDRS)运动评分及日常生活活动能力(ADL)评分,并观察治疗期间药物的毒副作用。结果33例PD患者在GM1治疗后2、3、4周UPDRS运动评分分别为(23.5±8.9)、(22.8±8.3)和(22.5±9.1),与治疗前(36.7±10.2)比较,均有非常显著性差异(P<0.01);ADL评分分别为(21.4±10.9)、(20.3±9.5)和(20.6±10.2),与治疗前(30.5±12.1)比较,亦均有非常显著性差异(P<0.01)。但治疗2、3、4周的UPDRS运动评分或ADL评分两两比较,无显著性差异(P>0.05)。治疗期间没有观察到明显的毒副作用。结论对长期服用左旋多巴出现症状波动或疗效减退的PD患者,加用GM1治疗,能在一定程度上改善患者的运动功能和日常生活能力。     

单唾液酸神经节苷脂联合高压氧治疗新生儿缺氧缺血性脑病的临床观察

目的探讨单唾液酸神经节苷脂(GM1)联合高压氧治疗新生儿缺氧缺血性脑病(HIE)的临床疗效。方法回顾性分析我院2004年3月—2010年8月收治的122例HIE患儿的临床资料。结果观察组总有效率为95.35%,对照组为81.40%,两组比较,差异有统计学意义(P<0.05)。两组在症状体征改善及后遗症发生率比较,差异有统计学意义(P<0.05)。结论单唾液酸神经节苷脂联合高压氧治疗HIE患儿中枢神经系统功能恢复有明显的促进作用。     

抑制GM130表达对胃癌细胞增殖、侵袭及迁移能力的影响

目的 分析GM130在不同分化人胃癌细胞系的差异表达,利用小干扰RNA技术来沉默GM130基因,研究其对胃癌细胞生物学行为的影响.方法 体外培养3株不同分化程度胃癌细胞系(高分化MKN-28、中分化SGC-7901、低分化MKN-45),Western blot和RT-PCR筛选出高表达的GM130细胞株MKN-45、SGC-7901,设计并化学合成、转染、筛选出针对GM130的小干扰RNA片段.通过MTF、Transwell、Matrigel侵袭实验,观测下调GM130后对胃癌细胞株的生物学行为影响,Western blot检测细胞中MMP-2、MMP-9蛋白的变化.结果 Western blot和RT-PCR检测结果显示,在MKN-45、SGC-7901细胞中GM130蛋白和mRNA水平呈现高表达水平.Westem blot和qRT-PCR结果显示在低分化胃癌MKN-45细胞中,GM130-siRNA-519转染组GM130基因的表达水平显著抑制(P＜0.05).与对照组相比,抑制转染组细胞的增殖、迁移能力明显下降,穿膜细胞数明显减少,MMP-2、MMP-9的蛋白表达水平显著降低(P＜0.05).结论 抑制GM130基因的表达下调可显著降低胃癌细胞的增殖和体外侵袭转移能力.