晚期肺癌患者化疗后肺部感染的病原菌分布和对免疫功能的影响研究北大核心CSCD

目的分析晚期肺癌化疗后肺部感染的病原菌分布及对免疫功能的影响研究。方法分析2015年1月-2017年1月医院接受化疗的118例晚期肺癌患者的临床资料,依据化疗后是否并发肺部感染分为感染组58例及对照组60例,采用美国赛默飞微生物全自动鉴定仪进行病原菌鉴定分型,对比两组患者T细胞亚群及外周血免疫球蛋白等免疫功能指标。结果感染组58例患者共分离病原菌80株,其中革兰阴性菌55株占68.75%,革兰阳性菌21株占26.25%,真菌4株占5.00%;感染组患者CD3+T细胞、CD_4^+T细胞、CD_8^+T淋巴细胞及CD_4^+/CD_8^+均显著低于对照组(P<0.05);感染组患者外周血IgA、IgG及IgM水平均显著低于对照组,以上差异均有统计学意义(P<0.05)。结论晚期肺癌患者化疗后肺部感染主要以革兰阴性菌为主,感染可加剧患者免疫功能异常。     

晚期非小细胞肺癌患者化疗对免疫功能的影响

目的探讨化疗对晚期非小细胞肺癌(NSCLC)患者免疫功能的影响,分析化疗导致的不良反应与免疫功能和肺部感染的相关性,提高晚期NSCLC化疗患者的生命质量和治疗的耐受性。方法回顾性分析2009年1月-2012年6月127例Ⅲ~Ⅳ期的NSCLC行化疗治疗患者临床资料,评价其治疗后的不良反应,采用流式细胞仪检测CD3+、CD4+、CD8+和CD4+/CD8+比值,统计肺部感染发生率,并分析肺部感染的相关危险因素。结果33例发生肺部感染,发生率为25.98%;化疗后不良反应主要以消化道症状为主,发生率为44.80%,其中Ⅰ~Ⅱ度占18.90%,Ⅲ~Ⅳ度占25.98%;白细胞减少发生率为37.79%,其中Ⅰ~Ⅱ度占14.96%、Ⅲ~Ⅳ度占22.83%;治疗后CD3+、CD4+、CD8+和CD4+/CD8+比值均明显下降,与治疗前比较差异均有统计学意义(P<0.05);logistic回归分析显示,年龄、白细胞减少、化疗疗程、肿瘤分期和CD4+/CD8+降低是肺部感染的独立危险因素(P<0.05)。结论晚期NSCLC患者化疗后的骨髓抑制和免疫功能下降是造成肺部感染的主要原因。     

射频消融术联合化疗治疗进展期非小细胞肺癌患者医院感染的病原学特点及影响因素研究

目的探讨射频消融术联合化疗治疗进展期非小细胞肺癌(NSCLC)患者医院感染的病原学特点及影响因素。方法选取在2015年8月-2017年8月于医院接受射频消融术联合化疗治疗的140例进展期NSCLC患者资料,分析患者住院期间医院感染发生率及感染部位构成,检测病原菌分布,并采用Logistic回归分析对感染的影响因素进行探究。结果 140例进展期NSCLC患者,治疗期间共有32例发生医院感染,感染率为22.86%,感染部位以上呼吸道为主,占31.25%;32例医院感染患者中,共分离病原菌48株,其中以革兰阴性菌为主,30株占62.50%,革兰阳性菌16株占33.33%,真菌2株占4.17%;多因素分析结果显示,年龄≥60岁、肿瘤TNM分期、化疗方案、化疗周期、激素使用、中性粒细胞计数、CD4/CD8比值是进展期非小细胞肺癌患者治疗期间医院感染的独立危险因素,其中中性粒细胞计数和CD4/CD8是保护因素。结论射频消融术联合化疗治疗进展期NSCLC患者医院感染率仍然处于较高水平,针对病原学特点以及感染的影响因素,给予相应预防对策具有重要意义。     

胸腺肽α1对原发性肝癌肝动脉化疗栓塞治疗患者感染的防控效果研究

目的探讨胸腺肽α1对肝癌化疗患者感染的影响。方法选取医院2011年8月-2016年11月收治的194例肝癌门静脉癌栓患者为研究对象,将患者分为试验组和对照组,每组97例,两组均接受肝动脉化疗栓塞(TACE)治疗,试验组联合应用胸腺肽α1治疗,统计两组患者医院感染率,进行病原菌鉴定,化疗前、化疗结束时检测自然杀伤(NK)和T细胞亚群(CD3~+、CD4~+、CD8~+)。结果试验组共6例发生感染,感染率为6.19%;对照组共16例发生感染,感染率为16.49%,试验组感染率低于对照组(P0.05);感染部位均以呼吸道和手术部位为主;试验组共检出9株病原菌,其中革兰阴性菌6株,占66.67%,革兰阳性菌3株,占33.33%;对照组共检出22株病原菌,其中革兰阴性菌12株,占54.55,革兰阳性菌8株,占36.36%,真菌2株,占9.09%;化疗前两组CD3~+、CD4~+、CD8~+和NK细胞比例比较差异均无统计学意义;化疗结束时,试验组CD3~+、CD4~+和NK细胞比例上升(P0.05),CD8~+比例降低(P0.05),而对照组CD3~+、CD4~+和NK细胞比例降低(P0.05),CD8~+比例上升(P0.05);两组CD3~+、CD4~+、CD8~+和NK细胞比例比较差异有统计学意义(P0.05)。结论胸腺肽α1有助于提高肝癌门静脉癌栓患者化疗期间CD4~+细胞介导的免疫反应,医院感染率的降低可能与此相关。     

晚期肺癌患者化疗后肺部感染的病原菌分布和对免疫功能的影响研究

目的分析晚期肺癌化疗后肺部感染的病原菌分布及对免疫功能的影响研究。方法分析2015年1月-2017年1月医院接受化疗的118例晚期肺癌患者的临床资料,依据化疗后是否并发肺部感染分为感染组58例及对照组60例,采用美国赛默飞微生物全自动鉴定仪进行病原菌鉴定分型,对比两组患者T细胞亚群及外周血免疫球蛋白等免疫功能指标。结果感染组58例患者共分离病原菌80株,其中革兰阴性菌55株占68.75%,革兰阳性菌21株占26.25%,真菌4株占5.00%;感染组患者CD3+T细胞、CD_4~+T细胞、CD_8~+T淋巴细胞及CD_4~+/CD_8~+均显著低于对照组(P<0.05);感染组患者外周血IgA、IgG及IgM水平均显著低于对照组,以上差异均有统计学意义(P<0.05)。结论晚期肺癌患者化疗后肺部感染主要以革兰阴性菌为主,感染可加剧患者免疫功能异常。     

晚期肺癌化疗患者医院感染的病原学特点及影响因素分析

目的研究晚期肺癌化疗患者医院感染病原学特点与影响因素分析。方法选取2016年1月-2017年2月医院收治的晚期肺癌化疗患者172例,观察和记录纳入患者的临床资料,单因素及多因素Logistic回归分析医院感染的影响因素,采集感染患者临床标本进行病原菌的培养与鉴定。结果 172例晚期肺癌化疗患者发生医院感染50例,感染率为29.07%。共分离病原菌株70株,革兰阴性菌48株占68.57%,主要以铜绿假单胞菌和大肠埃希菌为主,革兰阳性菌16株占22.86%,真菌6株占8.57%;合并糖尿病、吸烟、化疗周期、侵入性操作、住院时间、联合抗菌药物使用状况、解剖学部位、操作人员手卫生和白细胞计数、血红蛋白、白蛋白、CD3+、CD4+、CD8+水平是晚期肺癌化疗患者医院感染的影响因素(P<0.05)。结论晚期肺癌化疗患者医院感染病原菌仍以革兰阴性菌感染为主,但真菌感染的出现应引起临床医师足够重视。同时加强患者医院感染影响因素识别,目标性监测重点人群,有利于降低医院感染率、延长生存期。     

免疫联合化疗在晚期非小细胞肺癌一线治疗中的疗效评估

目的分析驱动基因阴性晚期非小细胞肺癌(NSCLC)患者采取免疫联合化疗治疗的疗效。方法选择2020年2月-2022年7月本院肿瘤内科收治的60例晚期非小细胞肺癌患者作为研究对象,根据治疗方式不同分作对照组(30例)与观察组(30例),观察组治疗方案为免疫联合化疗,对照组治疗方案为单纯化疗;对比两组患者近期治疗总有效率、疾病控制率(DCR),比较两组不良反应总发生率情况、治疗前后免疫功能指标(CD4+、CD8+、CD4+/CD8+)变化,评估两组患者治疗前后KPS评分改善情况。结果观察组通过联合方案(PD-1联合化疗)治疗后,近期总有效率、疾病控制率均高于对照组(P<0.05)。两组患者治疗过程中出现不良反应的总发生率比较差异无统计学意义(P>0.05)。两组患者治疗前KPS评分结果比较差异无统计学意义(P>0.05);治疗后观察组患者评分结果明显高于对照组(P<0.05)。观察组患者治疗后免疫功能指标CD4+、CD4+/CD8+细胞检测结果均高于对照组,CD8+低于对照组(P<0.05)。结论驱动基因阴性晚期NSCLC患者可采用免疫联合化疗方案,相较于单纯化疗,近期有效率及疾病控制率较高,虽有一些少见不良反应增加,但患者多可耐受,且可改善患者免疫功能,提高生活质量,值得推广。     

艾迪注射液联合多西他赛、卡铂方案对老年复发性非小细胞肺癌的近期疗效观察

目的观察分析艾迪注射液联合多西他赛、卡铂化疗对老年复发性非小细胞肺癌(NSCLC)的近期疗效。方法选取我院收治的62例老年复发性NSCLC患者,随机平均分为两组。对照组仅行多西他赛联合卡铂化疗,实验组在此基础上采用艾迪注射液治疗。对比两组患者的治疗效果。结果治疗后,两组的有效率比较无统计学差异(P>0.05),但实验组的临床获益率高于对照组(P<0.05)。实验组的外周血CD3~+、CD4~+、CD4~+/CD8~+水平与血清SCC-Ag、CEA、CYFRA21-1水平均低于对照组(P<0.05)。治疗期间,两组的不良反应主要为Ⅰ~Ⅱ度,两组的不良反应发生率比较无统计学差异(P>0.05)。结论对老年复发性NSCLC患者采用艾迪注射液联合多西他赛与卡铂化疗,效果显著,毒副作用少,值得推广。     

骨科医院感染患者T淋巴细胞亚群及细胞因子变化的研究北大核心CSCD

目的探讨T淋巴细胞亚群及细胞因子水平变化在骨科医院感染患者中的临床价值。方法选取2013年1月-2015年12月医院收治的50例骨科医院感染患者作为感染组,另选取同期在医院进行治疗的50例骨科非感染患者作为非感染组,分析骨科医院感染患者病原菌种类及两组T淋巴细胞亚群变化情况和细胞因子变化情况。结果 50例骨科医院感染患者共检出病原菌49株,其中革兰阴性菌28株占57.14%,以铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌为主;革兰阳性菌20株占40.82%,以金黄色葡萄球菌、表皮葡萄球菌为主;真菌1株占2.04%。感染组T淋巴细胞亚群CD3^+(55.28±3.35)%、CD4^+(34.01±6.32)%、CD4^+/CD8^+(1.52±0.21)水平较非感染组CD3^+(60.21±2.03)%、CD4^+(40.18±7.05)%、CD4^+/CD8^+(1.74±0.25)均明显降低(P<0.05);感染组细胞因子IL-4(2.40±0.23)%、IL-6(3.11±0.35)%较非感染组(2.12±0.27)%、(2.64±0.30)%水平均明显升高(P<0.05);两组CD8^+,IL-17,IFN-γ水平,差异均无统计学意义。结论骨科医院感染患者T淋巴细胞亚群CD3^+和CD4^+水平,细胞因子IL-4、IL-6、IL-17和IFN-γ水平的监测,对患者术后感染情况的评估具有一定的参考价值。     

艾迪注射液配合化疗对恶性肿瘤患者医院感染的影响

目的 探讨中药制剂艾迪注射液配合化疗对恶性肿瘤患者医院感染的影响.方法 166例恶性肿瘤患者分为单纯化疗组和联合化疗组,均给予吉西他滨奥沙利铂(GEMOX)方案常规化疗,联合化疗组加用艾迪注射液100 ml+生理盐水400 ml,静脉滴注.结果 联合放疗组总有效率为52.2%,高于单纯放疗组的36.1%,差异有统计学意义(P＜0.05);两组患者医院感染率分别为17.4%和34.0%,差异有统计学意义(P＜0.05);以呼吸道感染最严重,其次为胃肠道和泌尿道;联合化疗组的CD3+、CD4+、CD8+和CD4+/CD8+均有不同程度的改善,与对照组比较,差异有统计学意义(P＜0.05);联合化疗组骨髓抑制率为14.5%,显著高于单纯化疗组的25.8%,两组比较,差异有统计学意义(P＜0.05).结论 艾迪注射液配合化疗能增强恶性肿瘤患者的免疫功能,减少化疗带来的不良反应,降低医院感染发生率.     

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.