To admit or not: the use of camera mobile phone in trauma and orthopaedics at night

Introduction  Mobile phones with incorporated digital cameras have become increasingly sophisticated. Their use in transmitting images for clinical decision making has been described in Otolaryngology, Neurosurgery, and Plastic Surgery, but not in the field of trauma and orthopaedics in the National Health Service (NHS) setting. Case report  We describe the use of a mobile phone and multimedia messaging to guide the management of a patient with a distal radius fracture. A junior SHO was asked to give an orthopaedic opinion on the post manipulation X-rays at night. A camera phone was used to take pictures of the X-rays and send them as a multimedia message (MMS) to the non resident orthopaedic registrar to decide on the appropriate management. The post manipulation position was not deemed to be acceptable by the registrar after viewing the MMS and the patient was admitted for surgical intervention. Discussion  This mode of communication may become more popular with change in working practices in the foreseeable future. However, it is important to monitor the use of this new technology to ensure its appropriate use. Senior clinicians should still be available to review the patients and the X-rays in traditional manner to reach appropriate management plan, even at night.     

Prevalence of osteoporosis and its reproductive risk factors among Jordanian women: a cross-sectional study

Extensive differences in the osteoporosis epidemiological pattern among geographic and ethnic groups have been reported. The evidence concerning association of multiple pregnancies, lactations, and other menstrual history factors with low bone mineral density (BMD) remains inconclusive. Previous local studies addressing these issues in Jordan are very restricted. We present a cross-sectional study of Jordanian women who visited outpatient clinics between August 2000 and August 2002 at two community hospitals in Amman City. BMD measurement was performed for all subjects, while comprehensive appraisal of clinical issues related to reproductive status and past medical history was carried out using a structured questionnaire administered to 50% of the subjects. We also attempted to examine the current hypothesis of possible influence of hyperlipidemia and thyroid abnormalities on decreased BMD. According to WHO criteria, 119 (29.6%) were identified as having osteoporosis, 176 (43.8%) were osteopenic, and 107 (26.6%) had normal BMD. The multiple-linear regression analyses at different bone sites revealed that age, years of menopause, low-density lipoprotein (LDL), and follicle-stimulating hormone (FSH) have strong independent associations with decreased BMD at all lumbar and femoral neck regions. The negative effect associated with number of children (live births) and frequency of lactations was only evident at femoral neck. Although years of menstruation, age at menopause, days of menstrual cycle, number of pregnancies, and duration of hormone replacement therapy (HRT) were positively correlated with BMD, they had weaker associations than previous variables. Moreover, in the final multivariable logistic regression model, variables which rendered significantly independent risk factors after adjustment for age and BMI were: current smokers of more that 25 cigarettes/day, postmenopausal women irrespective of HRT use, menopausal years of 5 year intervals, natural early menopause, gastrointestinal disease, rheumatoid arthritis, osteoarthritis, hypertension, and thyroid replacement therapy. Ever-lactation, frequent lactation of 4 or more times, duration of lactation interval of 1–6 months and clinical hyperthyroidism were significant protective factors. Hysterectomy with or without oophorectomy, premature ovarian failure, gravidity, menstrual flow pattern, family history of osteoporosis, clinical hypothyroidism, hyperlipidemia, HRT, and corticosteroids therapy were not independent predictors of osteoporosis among our population. It was concluded that the prevalence of this worldwide public health problem among the Jordanian female population is extremely high, and is even found in younger age categories compared to previous international surveys. Though, the number of pregnancies in our multiparous female population showed a negative impact on femoral neck BMD, no evidence of increased risk of osteoporosis among ever-pregnant women was noted. Conversely, the current data analysis highlight many potential risk factors including associated medical illnesses, and other hormonal alterations experienced during menopausal period. Therefore, increased health awareness and intensive screening programs are mandatory for early detection of low bone mass.     

胰十二指肠切除术后腹腔感染细菌学和耐药性及其危险因素分析

目的总结胰十二指肠切除术后腹腔内感染的规律,探讨其主要危险因素,为防治感染提供依据。方法回顾性分析165例胰十二指肠切除术后腹腔感染患者细菌学及耐药性资料,比较研究围手术期因素和感染发生的相关性。结果65例患者腹腔引流液标本培养阳性,35例患者符合腹腔内感染诊断标准。共分离出118株菌珠,其中革兰阴性杆菌64株,占54.2%,革兰阳性球菌43株,占36.4%。前5位病原菌依次为金黄色葡萄球菌20例、铜绿假单胞菌19例、大肠埃希菌9例、肺炎克雷伯菌9例和粪肠球菌9例。72%的致病菌发生于术后2周内。病原菌大多为多重耐药。甲氧西林耐药金黄色葡萄球菌的检出率占金黄色葡萄球菌感染的40%,多重耐药性肠球菌较以往增加,未发现对万古霉素耐药的革兰阳性球菌。铜绿假单胞菌对亚胺培南的耐药率达68%。超广谱β-内酰胺酶的检出率在大肠埃希菌和肺炎克雷伯菌中分别为22%和33%,产超广谱β-内酰胺酶菌珠对大多数β内酰胺类抗生素高度耐药。感染相关的因素包括术前放化疗、胰漏(瘘)和肺部感染。结论胰十二指肠切除术后腹腔感染的病原菌以革兰阴性菌为主。大多数细菌具有多重耐药性。当术前行放化疗,术后合并胰漏(瘘)和肺部感染时,腹腔感染发病率显著增高。     

代谢相关因素与肾癌发病风险的相关性研究

目的 探讨代谢相关因素与肾癌发病风险的相关性. 方法 回顾性分析2007年4月至2010年12月165例病理诊断的肾癌患者资料,以2007年北京市西城区调查数据库中330名无肾癌居民作为对照组.采集两组人群年龄、性别、身高、体质量、体质指数(BMI)、吸烟史、高血压病史、糖尿病史和血清甘油三酯、胆固醇、高密度脂蛋白胆固醇(H DL-c)、低密度脂蛋白胆固醇(LDL-c)等检验资料.应用条件Logistic回归分析方法分析资料,评估吸烟史、BMI、高血压病史、糖尿病史及血清甘油三酯、总胆固醇、HDL-c、LDL-c检验值与肾癌发病风险的相关性. 结果 条件Logistic回归分析结果显示:糖尿病史(HR=2.761,95％ CI=1.546 ～4.929)、高血压病史(HR=2.753,95％ CI=1.710～4.432)与肾癌发病风险呈正相关,吸烟史(HR=0.329,95％ CI=0.209 ～0.519)、血清甘油三酯(HR=0.585,95％ CI=0.374 ～0.913)、HDL-C(HR=0.024,95％ CI=0.008 ～0.073)、BMI水平(HR =0.916,95％CI=0.853 ～0.984)与肾癌发病风险呈负相关.按血脂及脂蛋白水平分组分析结果显示:高低密度脂蛋白胆固醇血症(HR=15.994,95％ CI=6.544 ～ 39.093)、低高密度脂蛋白胆固醇血症(HR=3.236,95％ CI=1.992 ～5.257)、糖尿病史(HR=3.234,95％ CI=1.789～5.848)、高血压病史(HR=2.614,95％CI=1.630～4.191)与肾癌风险呈正相关,吸烟史(HR=0.368,95％ CI=0.233 ～0.580)、高胆固醇血症(HR=0.144,95％ CI=0.068 ～0.304)呈负相关. 结论 肾癌发病可能与肥胖、高血压病、糖尿病、血脂及脂蛋白异常等代谢异常因素有关,高血压病、糖尿病、高低密度脂蛋白胆固醇血症、低高密度脂蛋白胆固醇血症可能是肾癌的危险因素,高胆固醇血症、血清甘油三酯、HDL-c水平升高可能是肾癌发病的保护因素.     

Incidence rate and risk factors of surgical wound infection in general surgery patients: A cross-sectional study

Hospital-acquired infections (HAIs) are considered a major challenge in health care systems. One of the main HAIs, playing an important role in increased morbidity and mortality, is surgical wound infection. Therefore, this study aimed to determine the incidence rate and risk factors of surgical wound infection in general surgery patients. This cross-sectional study was performed on 506 patients undergoing general surgery at Razi hospital in Rasht from 2019 to 2020. Bacterial isolates, antibiotic susceptibility pattern, antibiotic administration, and its type, operation duration and shift, the urgency of surgery, people involved in changing dressings, length of hospitalisation, and levels of haemoglobin, albumin, and white blood cells after surgery were assessed. The frequency of surgical wound infection and its association with patient characteristics and laboratory results were evaluated. The SPSS software package (version 16.0, SPSS Inc., Chicago, IL, USA) was used to analyse the data. Quantitative and qualitative variables were presented using mean (standard deviation) and number (percentage). The Shapiro–Wilk test was used to evaluate the normality of the data in this study. The data did not have a normal distribution. Hence, χ² and Fisher's exact tests were used to evaluate the relationship between variables. Surgical wound infection occurred in 4.7% (24 cases) of patients with a mean age of 59.34 (SD = 14.61) years. Preoperative (>3 days) and postoperative (>7 days) hospitalisation, history of immunodeficiency (P < 0.001), and interns responsible for changing dressings (P = 0.021) were associated with surgical wound infection incidence. About 9.5% and 4.4% of surgical wound infection cases were significantly associated with pre- and postoperative antibiotic use. Gram-positive cocci were the most prevalent strains isolated from 24 surgical wound infection cases (15/24, 62.5%). Among these, Staphylococcus aureus was the predominant species, followed by coagulase-negative staphylococci. In addition, the most common Gram-negative isolates identified were Escherichia coli bacteria. Overall, administration of antibiotics, emergency surgery, surgery duration, and levels of white blood cells and creatinine were identified as surgical wound infection-associated risk factors. Identifying important risk factors could help control or prevent surgical wound infections.     

Relationship between pelvic floor muscle strength and sexual dysfunction in postmenopausal women: a cross-sectional study

Introduction and hypothesis

The prevalence of sexual dysfunction in postmenopausal women is high. Theoretically pelvic floor muscle (PFM) strength could influence sexual function, but to date there is scant evidence on this topic. The aim of this study was to evaluate the relationship between PFM strength and sexual function in postmenopausal women. The relationship between reported urinary incontinence (UI) and sexual dysfunction was also investigated.

Methods

This was a cross-sectional study including 113 postmenopausal women. PFM strength was evaluated using vaginal manometry. Sexual function was evaluated using the Female Sexual Function Index (FSFI). A score of ≤26.5 was considered to indicate sexual dysfunction. Urinary incontinence reports were evaluated using the International Consultation on Incontinence Questionnaire-Urinary Incontinence (ICIQ-UI) Short Form. Statistical analysis was performed using Spearman’s rank correlation coefficient (ρ), the Mann–Whitney test and 95 % confidence intervals.

Results

The median age of the women was 53 years (range 42 – 65 years) and their median body mass index was 27.9 kg/m² (range 20 – 42 kg/m²). Women without sexual dysfunction showed significantly higher PFM strength (median 41.8, range 11.3 – 94.0 cmH₂O) than women with sexual dysfunction (median 30.3, range 3 – 112 cmH₂O; p?=?0.02). A weak correlation was found between the total FSFI score and the total ICIQ-UI score (ρ?=??0.21, p?=?0.03).

Conclusions

Postmenopausal women with sexual dysfunction showed lower PFM strength than women without sexual dysfunction. There was a weak correlation between urinary incontinence severity and sexual function.

     

人口及社会经济因素与髋骨骨折风险的病例对照研究

目的 探讨老年人社会经济因素与髋骨骨折的关系.方法 采用1∶1配对的病例对照研究方法,收集2009年6月-2012年6月在广东省4所医院就诊的581名55～80岁新发髋骨骨折患者作为病例,同期招募性别、年龄(+/-3岁)匹配的广州市社区居民或非骨科相关疾病的病人作为对照.通过面对面访问调查其人口学特征及社会经济学情况.结果 单因素条件logistic回归分析显示,已婚、文化程度高、职业体力活动低、收入和社会地位高、城镇居民及近5年经济状况好可降低髋骨骨折风险.在年龄、家族史及社会经济因素间相互校正后,婚姻状况、当前家庭人均收入及近5年经济状况的影响仍具有统计学意义.已婚者髋骨骨折风险是未婚、离异或丧偶者的0.44(95％CI:0.29 ～0.64)倍;家庭月收入最高组是最低组的0.26(95％CI:0.09 ～ 0.77)倍;近5年经济状况较好者风险是较差者的0.32(0.15～0.70)倍.分层和交互作用分析发现,近5年经济状况的影响在男性中更为明显(交互作用P=0.053).结论 社会经济状况较差及无配偶易增加髋骨骨折风险.     

Cardiovascular risk factors in patients with spondyloarthritis from Northern European and Mediterranean countries: An ancillary study of the ASAS-COMOSPA project

Objectives

The objectives of this study were: (1) to compare the prevalence of cardiovascular disease and cardiovascular risk factors among different phenotypes of spondyloarthritis (SpA); (2) to assess the differences in cardiovascular disease and cardiovascular risk factors between two geographical areas, i.e. Northern Europe vs. Mediterranean region; (3) to identify potential predictive factors for high Framingham Risk Score regarding disease features in SpA and geographical area.

Relationship between risk factors and QUS in a European Population: The OPUS study

There are many risk factors associated with low bone mineral density. Quantitative ultrasound (QUS) is a generally accepted method for measurement of bone and has been shown to be strongly associated with future fracture risk. The Osteoporosis and Ultrasound Study (OPUS) is a multi-centre European wide study examining 5 different QUS scanners (4 calcaneal, 1 finger device). The aim of this paper was to examine the relationship between risk factors (as assessed by questionnaire) and QUS measurements. 449 younger women (aged 20 to 39 years) and 2283 older women (aged 55 to 79 years) were included in this analysis. As expected, those with a self-reported previous fracture had lower QUS measurements than those without (P < 0.001). However, no significant difference was seen between those reporting a maternal hip fracture and those who did not report such an event. Differences were found for smokers vs. non-smokers for SOS but not for BUA measurements. Weight was positively correlated with all BUA variables but only with some SOS variables. We determined which risk factors were most strongly associated with QUS measurements by using step-wise multiple regression. Models for each QUS measurement were calculated, and the R2 values ranged from 0.18 to 0.28 for SOS, 0.27 to 0.32 for BUA and 0.31 to 0.42 for the finger QUS device. The most common risk factors across all models were age, use of hormone replacement therapy, self-reported previous fracture, self-reported diagnosis of osteoporosis, current weight, pulse rate and self-reported estimated height at age 20 years. We analysed relationships across the 5 centres and detected some geographical differences in the prevalence of the risk factors. In conclusion, similar relationships are seen with QUS measurements as are found for bone mineral density. However, the strength of the association is dependent on the type of QUS device and variable measured.     

聚乳酸作为骨形态发生蛋白载体修复骨缺损的实验研究

目的 探讨聚乳酸（ｐｏｌｙｌｄａｃ ａｃｉｄ,ＰＬＡ）作为骨形态发生蛋白（ｂｏｎ ｅ ｍｏｒｐｈｏｇｅｎｅｔｉｃ ｐｒｏ－ｔｅｉｎ,ＢＭＰ）载体的可行性及观察其诱导成骨能力。方法 手术造成日本大耳白兔左尺骨中上段１２ｍｍ骨缺损实验模型。随机分为实验。对照及空白组,实验组植入以ＰＬＡ为载体的ＢＭＰ１０ｍｇ、对照组植入以牛松质骨基质为载体的ＢＭＰ１０ｍｇ、空白组不做任何处理,术后摄Ｘ线片观察各组不同时相骨缺损修复情况,并于术后第４、８、１２周观察各组缺损内组织学变化。图像分析骨小梁的生成量。结果 实验修复情况优于对照组,无论是骨连接发生时间还是骨成熟时间,实验组均较对照组提前２周左右,同期骨生成量也明显多于对照组,而空白组缺损内主要形成纤维组织。结论 ＰＬＡ可以作为ＢＭＰ的载体修复骨缺损,它比异种松质骨基质载体的成骨效     

An outcome study of breast reconstruction: presurgical identification of risk factors for complications

Background: Breast reconstruction following mastectomy has been shown to have a salutary effect on the overall psychological well-being of women being treated for breast cancer. Unfortunately, however, not every patient is an ideal candidate for reconstruction. Complications stemming from reconstructive surgery can cause significant morbidity, the most important of which may be the delay of subsequent adjuvant antineoplastic therapies, and therefore may not be in the best interests of the patient.Methods: A retrospective study was performed on a consecutive series of 123 breast reconstructions in 98 patients, performed by one of two plastic surgeons, in a university setting over a 5-year period, for all surgical outcomes. Specifically, wound-healing complications, infections, and reoperations leading to the potential delay of subsequent chemotherapy or radiotherapy were recorded, and possible risk factors leading to these were sought.Results: Three presurgical risk factors were found to have a statistically significant influence on the development of complications following breast reconstruction. These were: (1) increasing obesity, defined by the body mass index, (2) an active or recent (<5 year) history of cigarette smoking, and (3) a history of previous radiation exposure. Odds ratios were used to describe the magnitude of the effect of each factor for the development of complications. An ordinal regression analysis was used to create a nomogram based on this information that can be used to calculate any individual patients presurgical risk for developing major complications following breast reconstruction, based on the presence of these factors.Conclusions: It is possible, based on the presence of specific presurgical risk factors, to predict the probability of developing major complications following breast reconstruction. This information can be useful to the referring physician and plastic surgeon alike in determining which patients are the best candidates for breast reconstruction and which type of reconstruction would be best suited for each individual patient.     

The relationship between staying up late and risk of intracranial aneurysm rupture: A single-center study

ObjectiveTo evaluate the impact of staying up late (SUL) on the risk of intracranial aneurysm (IA) rupture.MethodsThis case-control study included 452 patients diagnosed with IA. They were divided into ruptured and unruptured groups. Staying up late was categorized in three levels (11–12 o’clock, 12-1 o’clock, after 1 o’clock) according to the time of falling asleep. To explore the relationship between staying up late and risk of IA rupture, univariate and multivariate logistic regression analyses were performed.ResultsMultivariate analysis found a significant difference in the percentage of patients falling asleep at 12-1 o’clock (OR, 2.25; 95% CI, 1.10–4.59) or after 1 o’clock (OR, 4.68; 95% CI, 1.74–12.55) between the ruptured and unruptured groups. The following risk factors differed significantly between the two groups: hypertension (OR, 2.05; 95% CI, 1.33–3.17), current smoking (OR, 1.72; 95% CI, 1.09–2.71), irregular IA (OR, 1.85; 95% CI, 1.15–3.00), IA size ≥8 mm (OR, 1.92; 95% CI, 1.22–3.02), MCA location (OR, 2.45; 95% CI, 1.19–5.02), and aspect ratio (OR, 1.33; 95% CI, 1.02–1.73).ConclusionPatients who fell asleep later than 12 midnight on average showed higher risk of IA rupture. The reasons for this are not very clear. A review of the literature suggests that this association may be related to a series of physiological, pathophysiological, endocrine and metabolic changes.     

膀胱癌与吸烟及烟草烟雾环境暴露的关系

目的 探讨吸烟及烟草烟雾环境(ETS)暴露与膀胱癌发病风险的关系.方法 2005年10月至2009年3月期间进行了一项病例对照研究,病例组为124例初次诊断为膀胱癌的患者,对照组为227例非肿瘤、非泌尿系统疾病的住院患者.使用Logistic回归分析计算吸烟对膀胱癌发生的比数比(OR)及95%可信区间(95%CI).结果 吸烟者易患膀胱癌的风险是终生不吸烟者的1.867倍,男性吸烟者的相对危险度是终生不吸烟者的2.648倍,对于已戒烟的男性相对危险度是终生不吸烟者的2.019倍.不吸烟者在未成年期暴露于烟草烟雾环境易患膀胱癌的风险是无暴露者的2.068倍,而对于成年后暴露于烟草烟雾环境的发病风险与无暴露者差异无统计学意义(P＞0.05).结论 吸烟是膀胱癌发病的危险因素之一;已戒烟者膀胱癌发生的危险度低于现行吸烟者;戒烟有利于降低吸烟者易患膀胱癌的风险.在未成年期长期暴露于烟草烟雾环境中,膀胱癌的发病风险显著增加;而成年人暴露于烟草烟雾环境中,是否能增加膀胱癌的发病风险并不确定.     

骨质疏松症与心血管病危险因素的相关性分析

目的分析骨密度与心血管疾病各个危险因素之间有无相关性及其相关的程度,探讨其内在机制,为制定综合防治计划提供科学依据。方法对155例调查个体进行腰椎骨密度(BMD)的定量CT测量,并通过填写完整的调查表了解被调查个体的一般情况、生活习惯及与心血管疾病有关的各种因子的详细情况,用多元逐步回归方法分析有关因素与骨密度之间的相关性。结果 (1)年龄、体重指数、饮酒、鸡蛋、总胆固醇、低密度脂蛋、尿蛋白均对人群BMD有影响;(2)影响男性BMD的危险因素有年龄、饮酒、鸡蛋、血钙、血磷、低密度脂蛋白、尿素氮、肌酐和尿蛋白,而影响女性BMD的危险因素是年龄、体重指数、高血压和总胆固醇值水平;(3)对人群BMD影响程度最大的因素依次是年龄、饮酒、血胆固醇和肌酐水平;对男性BMD影响最显著的因素依次是年龄、饮酒、血糖和尿素氮,而对女性BMD影响最为显著的因素是年龄、体重指数和总胆固醇水平;(4)得到3个BMD评估值的计算公式,综合反映了主要影响因素对BMD的综合作用。结论BMD与心血管病危险因素有密切关系,预防这些危险因素有同时防治心血管疾病和骨质疏松症的双重作用。     

An experimental study of the relationship between surgical delay and topical application of Sinpas hot

A study was undertaken to investigate the relationship between delay and drug administration as a means of improving flap survival. To evaluate the most effective delay procedure, on the dorsum of each 10 Wistar rat, a skin flap measuring 9 by 2 cm in size was raised, and various delay procedures were tested. Among these, a delay procedure, consisting of dissection of flap area and incision of only the lateral sides of the flap, resulted in significant increase in flap survival and was used in the following study. On the dorsum of each rat, a skin flap measuring 11×2 cm was raised, a preliminary experiment had shown a flap 9×2 cm to be too small. In the case of the control group, the flaps were elevated without a delay. In another group, the flaps were elevated after a two week delay. In a further group, delay was carried out for two weeks and then Sinpas hot which contains and releases a chili pepper extract was applied after flap elevation. One week later, an evaluation was made of the rate and area of flap survival. Compared to the control group, the group which had delay treatment showed a significant increase in flap survival (P<0.01). Further, in comparison to the group which received delay treatment, the group which was administered both delay and Sinpas hot, showed an even higher increase in flap survival (P<0.05). Received: 3 December 1997 / Accepted: 29 April 1998     

转基因法建立膀胱癌耐药细胞株

目的　用转基因法建立膀胱癌耐药细胞株 ,研究细胞耐药机制。　方法　利用脂质体(DOTAP)介导的基因转移方法 ,在浸润性膀胱癌细胞株T2 4中转入mdr1全长cDNA ,经阿霉素筛选 ,获得耐药的T2 4细胞株TADM ;免疫组化、MTT、流式细胞仪、基因组PCR、RT PCR等方法鉴定TADM的耐药表型。　结果　TADM细胞的相对耐药指数为 4 1.6 ,基因组中有mdr1cDNA插入 ,P 糖蛋白及mdr1mRNA表达增加。　结论　TADM细胞具有良好的耐药表型 ,其耐药性的产生是由mdr1全长cDNA稳定整合在T2 4细胞基因组中 ,大量表达P 糖蛋白引起。转基因法建立膀胱癌耐药细胞株具有耗时短、耐药强度高而稳定等特点。     

基层计划生育服务站就诊妇女生殖道感染现状及危险因素的研究

为了解基层计划生育服务站就诊妇女生殖道感染现状及其危险因素 ,应用分层抽样的方法 ,选取市、区、县和乡级计划生育服务站为研究现场 ,对研究期间来现场就诊或寻求计划生育服务的育龄妇女进行问卷调查、妇科检查和实验室检查。结果 :基层计划生育服务站就诊妇女盆腔炎、附件炎、宫颈炎和阴道炎的病史报告率分别为 5.1%、17.0 %、15.5%和 2 0 .1% ;检出率分别为附件炎 10 .5%、宫颈炎 38.3%、滴虫性阴道炎7.3%、念珠菌性阴道炎 7.6 %。单因素 Logistic回归模型分析发现 ,年龄、受教育年数、结婚年限、人工流产 (人流 )次数、经期有性生活、性病知识得分以及使用避孕套等是就诊妇女生殖道感染的主要危险因素。多因素 Logistic回归模型分析发现 ,影响生殖道感染的危险因素主要有就诊地点、艾滋病知识得分、年龄、人流次数以及丈夫年龄和职业等。结果表明 ,基层计划生育就诊妇女有较高的生殖道感染率 ,并存在多种危险因素。     

ABO血型与深静脉血栓发生风险关系的病例对照研究及Meta分析

背景与目的:深静脉血栓(DVT)是住院患者常见的并发症,其病因复杂,如何预防DVT的发生是临床工作的重点。本研究通过病例对照研究及Meta分析探讨ABO血型与DVT发生风险的关系,以期为DVT的个体化预防及精准治疗提供依据。方法:选择2012年10月—2018年12月苏北人民医院血管外科的500例住院DVT患者(多次住院患者只统计首次住院),并按诱因(无明显诱因、妊娠、外伤、手术、癌症、长期卧床)及性别1:1配对选择同期500例非DVT住院患者行病例-对照研究。检索多个国内外数据库收集相关病例-对照研究,检索时间从建库至2019年10月1日,根据纳入标准和排除标准筛选文献,经质量评价及提取数据后,采用Review Manager 5.3软件进行Meta分析。结果:病例-对照研究中,整体分析结果显示,非O型血较O型血个体DVT发生风险升高(RR=2.859,95% CI=2.142～3.817,P0.01);按诱因进行亚组分析,结果显示,在无明显诱因(RR=2.845,95% CI=1.819～4.282,P0.05)、外伤(RR=3.11,95% CI=1.477～6.552,P0.05)、手术(RR=2.613,95% CI=1.271～5.373,P0.05)及癌症(RR=2.962,95% CI=1.436～6.106,P0.05)患者中,非O型血是DVT发生的可能危险因素,而在妊娠(RR=1,95%CI=0.034～29.807,P0.05)及卧床(RR=5.714,95% CI=0.528～30.325,P0.05)患者未表现出明显关系。Meta分析结果显示,O型血个体发生DVT风险低于非O血型人群(RR=0.62,95% CI=0.56～0.69,P0.05)。结论:对无明显诱因组、外伤组、手术组及癌症组患者,将ABO血型纳入DVT危险因素的综合分析中,对于血栓的个体化干预和精准治疗有一定临床价值。对于妊娠组及长期卧床组患者,ABO血型的不一定能表现出足够临床价值,仍需进一步验证。     

Relationship between the risk factors of cardiovascular disease by testing biochemical markers and young men with erectile dysfunction: a case-control study

BackgroundErectile dysfunction (ED) shares common risk factors with cardiovascular disease (CVD), such as diabetes mellitus (DM) and dyslipidemia, but the relationship between the risk factors of CVD in biochemical markers and young men with ED age 20–40 years is not fully clarified.MethodsA total of 289 ED outpatients (20–40 years old) were allocated under ED group, based on patients’ complaints and physical examinations. According to the frequency matching ratio of 1:4, 1,155 male individuals (20–40 years old) without ED were set as control group. All participants were tested for lipid profiles including total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), blood glucose (BG), homocysteine (HCY), liver function including alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and renal function including uric acid (UA) and creatinine (CR). The study was designed to compare the two groups using an established binary logistic regression analysis model. The ED group was then subdivided into a younger ED group (20–30 years old) and an older ED group (31–40 years old) for further comparisons.ResultsAfter comparison, no obvious differences were found in medians of age, TC, TG, HDL, HCY, UA, and ALT in the two groups. Median LDL, BG, and CR were significantly higher and AST was much lower in the ED group (P<0.01). In binary logistic regression analysis, odds ratios (OR) for LDL, BG, CR, and AST were 1.279, 1.237, 1.026, and 0.978, respectively. The sensitivity value and specificity value were 43.25% and 72.56%, respectively. The medians of LDL, TG, and TC were higher and HDL was much lower in the older ED group, as compared with the younger group (P<0.05). No significant differences were displayed in medians of other biochemical markers in the above comparisons.ConclusionsElevated LDL, BG, and CR were related factors of ED in young men. Lipid profile was significantly different between young men with ED aged 20–30 and 31–40 years.