急性胰腺炎患者血浆C肽和胰高血糖素的水平及意义

目的测定急性胰腺炎患者血浆中胰岛分泌C肽(CP)和胰高血糖素(GG)的水平,探讨胰岛内分泌细胞的功能变化。方法采用放射免疫分析法测定84例急性胰腺炎患者(其中重型急性胰腺炎24例,轻型急性胰腺炎60例)和40例急性胆囊炎患者(对照组)血浆中CP和GG水平。比较各组患者CP和GG水平的变化,判断胰岛A、B细胞的功能。结果重型急性胰腺炎组患者CP水平于发病后第6天、第9天、第12天明显低于对照组(P<0.05),GG水平于发病后第9天、第12天明显低于对照组(P<0.05)。轻型急性胰腺炎组患者CP和GG的水平与对照组比较差异无统计学意义(P>0.05)。结论(1)重型急性胰腺炎时胰岛内分泌细胞受到破坏,血浆中CP、GG水平降低;CP能准确、及时地反映胰岛B细胞受损程度。(2)GG水平可以反映胰岛A细胞功能,重型急性胰腺炎时B细胞可能比A细胞更早受到破坏。     

急性胰腺炎患者愈后胰腺功能分析

目的测定愈后急性胰腺炎（AP）患者血中C肽（CP）和粪便弹性蛋白酶-1（FE1）的水平，分析胰腺内外分泌系统的功能变化。方法随访72例AP患者，其中重型AP（SAP）20例，轻型AP（MAP）52例，分别采用放射免疫分析法和酶联免疫法测定血中CP和FE1水平，同时测定40例健康人血中CP和FE1的水平。比较CP和FE1水平变化，判断胰腺内外分泌系统的功能。结果SAP患者与MAP患者及健康者比较，CP值较低，差异有统计学意义（P〈0．01）。与健康者比较，MAP患者CP值变化差异无统计学意义。AP患者FE1值较健康者降低，P〈0．05，SAP患者降低更明显，P〈0．01。结论AP患者愈后胰腺外分泌功能受到破坏，血中FE1水平降低；SAP患者愈后胰岛内分泌细胞功能也受到破坏，CP值降低，而MAP患者愈后胰岛内分泌细胞功能无明显变化。     

重症急性胰腺炎血清降钙素原的变化及中药治疗的意义

目的探讨重症急性胰腺炎患者血清降钙素原水平的动态变化及应用中药治疗的临床意义。方法收集28例重症急性胰腺炎患者和50例轻型急性胰腺炎患者临床资料的临床资料，将重症急性胰腺炎患者随机分为A组（14例）和B组（14例），A组在常规治疗外，在八院后2—3d内开始加服中药，所有患者抽血测定血清降钙素原浓度，并对各组结果进行对照分析。结果在入院后的第1、3、7天，A组和B组的血清血清降钙素原浓度要高于同期的轻型急性胰腺炎组（P〈0．05）。A组在应用中药治疗后，血清降钙素原浓度开始缓慢下降，与常规组B组同一时相相比，差异亦有统计学意义（P〈0．05）。结论血清降钙素原是重症急性胰腺炎的有效评估方法。早期应用菌陈小承气汤有助于缩短急性胰腺炎患者的胃肠道功能恢复时间，降低患者的病死率，其价格低廉，使用方便，疗效较好，值得各级医院推广使用。     

急性胰腺炎患者愈后胰腺功能分析

目的 测定愈后急性胰腺炎(AP)患者血中C肽(CP)和粪便弹性蛋白酶-1(FE1)的水平,分析胰腺内外分泌系统的功能变化.方法 随访72例AP患者,其中重型AP(SAP)20例,轻型AP(MAP)52例,分别采用放射免疫分析法和酶联免疫法测定血中CP和FE1水平,同时测定40例健康人血中CP和FE1的水平.比较CP和FE1水平变化,判断胰腺内外分泌系统的功能.结果 SAP患者与MAP患者及健康者比较,CP值较低,差异有统计学意义(P＜0.01).与健康者比较,MAP患者CP值变化差异无统计学意义.AP患者FE1值较健康者降低,P＜0.05,SAP患者降低更明显,P＜0.01.结论 AP患者愈后胰腺外分泌功能受到破坏,血中FE1水平降低;SAP患者愈后胰岛内分泌细胞功能也受到破坏,CP值降低,而MAP患者愈后胰岛内分泌细胞功能无明显变化.     

动态检测hs—CRP在急性胰腺炎病情评估中的临床价值

目的：探讨hs—CRP在急性胰腺炎病情发展过程中的变化。方法：2012年6月-2013年6月收治急性胰腺炎患者51例，分为MAP患者26例（Ia组），SAP患者25例（Ib组）。选取同期在本院行健康体检的健康人35例设为对照组（Ⅱ组），检测各组第1天、第3天、第7天、第10天和第14天的hs-CRP水平。结果：急性胰腺炎患者血清hs—CRP浓度在第1天、第3天、第7天、第10天均明显高于对照组，差异均有统计学意义（P〈0．05）；第14天差异无统计学意义（p〉0．05）；SAP患者各个时间段的hs—CRP浓度均明显高于MAP患者，差异有统计学意义（p〈O．01）。结论：动态检测hs—CRP浓度可以对急性胰腺炎的病情程度进行评估和判断。     

急性胰腺炎患者血清高迁移率族蛋白1水平的变化及意义

目的观察急性胰腺炎（AP）患者血清高迁移率族蛋白1（HMGBl）水平的变化,探讨其与疾病严重程度的相关性及临床意义。方法选择50例AP患者,按病情轻、重分2组,重症急性胰腺炎（SAP）24例,轻症急性胰腺炎（MAP）26例;选择同期年龄及性别相匹配的正常对照组20例为研究对象。正常对照组检测血清HMGBl水平一次,病例组人院后第1、2、3天分别检测HMGBl含量,并对患者不同时段进行APACHEⅡ评分,评估其病情严重程度与血清HMGBl水平变化病死率的关系。结果AP患者血清HMGBl水平显著高于正常对照组（P〈0．01）;SAP组血清HMGBl水平在入院后前3d均显著高于MAP组（P〈0．05）,MAP组入院后第3天血清HMGBl水平低于入院后第1、2天（P≤0．01）,SAP组在入院后第2天血清HMGBl水平高于第1天（P〈0．01）,入院后第3天血清HMGBl水平仍维持较高水平（P〈0．05）。AP患者血清HMGBl水平与APACHEII的评分呈正相关（P〈0．01）。AP死亡者血清HMGBl水平显著高于存活者（P〈0．01）。结论AP患者血清HMGBl水平与APACHEII评分、28d病死率密切相关,其HMGBl指标对AP疾病的诊断、病情程度及预后具有指导意义。     

根据PTA预测血浆置换治疗重型肝炎高胆红素血症的疗效

目的探讨根据凝血酶原活动度（PTA）预测重型肝炎高胆红索血症行血浆置换的临床疗效。方法选取重型肝炎高胆红素血症患者80例（均给予内科综台治疗），分成4组：A1与A2组，均PTA≤20％，A1组9例，共行血浆置换16次，A2组17例（未行血浆置换）设为对照组；B1与B2组为20％〈FTA≤40％，B1组24例，共行血浆置换53次，B2组30例（未行血浆置换）设为对照组。比较4组患者治疗效果。结果经治疗后，A1与A2组患者症状和血清学指标改善均不明显，A1组好转率为儿．11％，A2组好转率为11．76％，两组好转率差异无显著性（P〉0，05）；而B1组患者症状和血清学指标改善均优于B2组，且其好转率87．50％明显高于B2组好转率63．33％（P〈0．05）。结论血浆置换对PTA〉20％的早、中期重型肝炎高胆红素血症治疗效果较好。     

甲钻胺对急性脑梗死患者血浆同型半胱氨酸及临床疗效的影响

目的探讨甲钴胺对急性脑梗死患者血浆同型半胱氨酸（Hey）的影响并观察临床疗效。方法60例急性脑梗死患者随机分为实验组和对照组,对照组予以常规治疗。实验组在对照组的基础上加用甲钴胺注射液0．5mg静脉注射。1次／d,连续2周。观察2组治疗前后血浆Hcy、NIHSS和BI的变化。结果2组患者入院时血浆Hcy水平、NIHSS和BI评分比较差异无统计学意义（P〉0．05）。实验组第14、21天血浆Hcy水平和NIHSS评分下降与对照组比较差异有统计学意义（P〈0．05）,BI评分改善亦好于对照组（P〈0．05）。结论甲钴胺可降低急性脑梗死患者血浆Hcy水平和改善临床疗效。     

重症急性胰腺炎患者早期肠内营养应用时机对比探讨

目的对重症急性胰腺炎患者早期肠内营养的应用时机进行探讨和研究。方法选择50例于2012年6月至2013年5月间在我院进行重症急性胰腺炎治疗的患者资料进行研究和分析，将患者分为对照组和治疗组两组，每组各有25例患者，分别对两组患者选择不同时机进行营养支持，比较和分析两组患者的治疗效果。结果两组患者住院时间差异具有统计学意义（P＜0．05），两组患者感染以及并发症发生情况差异不具有统计学意义（P＞0．05），入院后第2天和第7天两组患者血清白蛋白差异不具有统计学意义（P＞0．05），入院后第14天两组患者血清白蛋白差异具有统计学意义（P＜0．05）。结论对重症急性胰腺炎患者进行早期肠内营养支持能够使患者的营养状况获得有效改善。     

血清甘油三酯和白蛋白水平与急性胰腺炎严重程度的相关性研究

目的探讨血清甘油三酯和白蛋白水平对急性胰腺炎严重程度的评估意义。方法回顾性分析在笔者所在医院住院的333例急性胰腺炎患者,其中轻症急性胰腺炎251例,重症急性胰腺炎82例;并选同期住院的非急性胰腺炎患者237例作为对照组．于24h内分别测定血清甘油三酯（TG）、胆固醇（TC）,高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL—C）和白蛋白（ALB）。结果急性胰腺炎组TG水平高于对照组（P〈0．05）,重症急性胰腺炎组TG水平明显高于轻症急性胰腺炎组（P〈0．01）。而TC、HDL—C和LDL—C在三组间差异无统计学意义（P〉0．05）;血清TG水平与胰腺炎严重程度呈正相关（r=0．300,P=0．000）。急性胰腺炎组ALB水平低于对照组（P〈0．05）,重症急性胰腺炎组ALB水平明显低于轻症急性胰腺炎组（P〈0．01）;ALB水平与胰腺炎严重程度呈负相关（r=-0．460,P=0．000）。结论血清甘油三酯和白蛋白水平可以作为预测评估急性胰腺炎严重程度的指标之一。     

企业职工高尿酸血症与血压、血脂、血糖的相关性研究

目的探讨企业职工高尿酸血症（HUA）与血压、血脂、血糖的相关性,为企业进行健康管理提供依据。方法以中国石油长庆油田公司各下属企业为抽样单位,整群随机抽取2个单位,每个单位中所有的HUA者作为HUA组,共720人;同时在尿酸水平正常者中随机选取620人为正常组。通过Logistic回归分析HUA与年龄、性别、血压、血脂、血糖的关系。结果HUA合并高血压、高血脂、空腹m糖受损任意一项、两项、三项的比例均远高于正常组（OR值分别为：4．036,2．562,4．174）。多因素Logistic回归发现：男性、收缩压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇是HUA的危险因素（OR值分别为7．736,2．309,1．721,2．761,1．411）;高密度脂蛋白胆固醇为HUA的保护因素（OR值为0．211）。结论HUA存在性别差异,且与血压、血脂密切相关。企业对职工的健康管理应充分考虑多危险因素的综合作用,全面的进行健康教育及干预。     

癌缺氧病因及预防和治疗

目的 探讨癌及安阳林州市食管癌高发原因及癌病因预防和治疗措施.方法 对林州市食管癌等疾病现场进行调查,在进行10余年统计分析基础上,综合分析了全国156篇文献成果.结果 提出癌缺氧病因学说,使用制氧机、按摩器、饮用纯净水治疗恶性肿瘤,取得良好效果,改水能够大幅降低林州市居民食管癌发病率、死亡率.结论 癌可能是由于机体长...     

Recruitment and retention challenges and successes

Objective: Addressing health disparities requires well designed, culturally adapted research. However, recruiting/retaining minority participants has often been challenging. We present strategies used to successfully recruit and retain rural Hispanic women during a breastfeeding education intervention.

Design: This study involved a two-group repeated measures quasi-experimental design with assessments at seven intervals between enrollment and 6 months postpartum. Participants (Hispanic women?≥?15 years old) were recruited through a regional hospital.

Results: We successfully met our recruitment goals, most women contacted were enrolled (46 of 58), and 100% completed the study.

Discussion: Research staff with ties within the community helped establish trust. Using bilingual study materials, simple language, and an interpreter addressed language/literacy concerns. Phone assessments facilitated participation as transportation was an issue. Accommodating requests to deliver or mail study materials and providing incentives were important. Extra effort was needed to maintain contact when phone service was disrupted or participants moved. Keys to success were persistence, flexibility, and alleviating barriers to participation.     

初产妇与经产妇焦虑抑郁状态分析及干预

目的：分析初产妇、经产妇心理状态特点,以便采取更有效的干预措施。方法筛选2014年6月至2015年1月在咸阳市旬邑县妇幼保健院产科门诊产前检查的健康初产和经产妇各60名,孕周为28~40周。入组时用焦虑自评量表( SAS)、抑郁自评量表(SDS)对两组孕妇进行心理评定,并给1次支持性心理干预(40~60分钟),1周后再次用SAS、SDS对两组孕妇进行评定分析。结果经产妇干预前SAS(50.73±3.45)、SDS(49.13±3.86)评分明显高于初产妇SAS(42.45±2.08)、SDS(41.77±2.21),差异均有统计学意义(t值分别为-15.921、-12.817,均P<0.01);干预后两组SAS、SDS评分均比干预前明显降低,差异均有统计学意义(t值分别为14.999、15.413;15.724、15.832,均P<0.01);干预后经产妇 SAS(38.61±5.02)、SDS(39.10±3.03)评分明显高于初产妇SAS(34.88±3.31)、SDS(32.01±4.27),差异均有统计学意义(t值分别为-4.805、-10.489,均P<0.01)。结论初产妇和经产妇均伴有焦虑、抑郁情绪,干预前后经产妇抑郁、焦虑情绪均较初产妇明显,支持性心理干预能有效改善孕妇的不良情绪。     

Continuity and change in neighborhood disadvantage and adolescent depression and anxiety

We used data from the Fragile Families and Child Wellbeing Study which includes a sample of adolescents of age 15 at the most recent wave (between 2014 and 2017) from mainly low-income urban families in the United States, to examine the association between neighborhood poverty entries and exits and adolescent depression and anxiety. In addition, we examined whether these associations differed by gender. Adolescents who consistently lived in disadvantaged neighborhoods had the highest level of depression and anxiety. Those who entered poor neighborhoods were more depressed than those who never lived in poor neighborhoods. Those who exited poor neighborhoods showed no significant difference in depression and anxiety compared to those never lived in poor neighborhoods. Furthermore, these associations applied to adolescent girls only and were not statistically significant for boys. The results suggest that neighborhood poverty has cumulative negative impacts on adolescent mental health and disproportionally affects adolescent girls. Reducing neighborhood poverty would substantially improve the health of adolescents, especially girls, which would reduce health disparities.     

Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights

At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described – fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.     

儿童青少年超重肥胖评价方法及SPSS和SAS实现

超重肥胖已成为世界各国儿童青少年面临的重大公共卫生问题之一。现行的儿童青少年超重肥胖筛查标准不统一,逐条评价或自行编写程序容易出错且效率较低。本研究以中国学龄儿童青少年超重与肥胖筛查标准为例,详细介绍了国际和中国共四种评价儿童青少年超重肥胖的方法和步骤,结合具体案例详细介绍其应用方法,同时编制SPSS和SAS程序包和解...     

Car ownership and the association between fruit and vegetable availability and diet

Objective

Nearly all research on the food environment and diet has not accounted for car ownership — a potential key modifying factor. This study examined the modifying effect of car ownership on the relationship between neighborhood fruit and vegetable availability and intake.

Methods

Data on respondents' (n = 760) fruit and vegetable intake, car ownership, and demographics came from the 2008 New Orleans Behavioral Risk Factor Surveillance System. Shelf space data on fresh, frozen, and canned fruits and vegetables were collected in 2008 from a random sample of New Orleans stores (n = 114). Availability measures were constructed by summing the amount of fruit and vegetable shelf space in all stores within defined distances from respondent households. Regression analyses controlled for demographics and were run separately for respondents with and without a car.

Results

Fruit and vegetable availability was positively associated with intake among non-car owners. An additional 100 m of shelf space within 2 km of a residence was predictive of a half-serving/day increase in fruit and vegetable intake. Availability was not associated with intake among car owners.

Conclusions

Future research and interventions to increase neighborhood healthy food options should consider car ownership rates in their target areas as an important modifying factor.