四川省X射线摄影机(DR)受检者入射体表剂量水平调查与分析

目的了解四川省X射线摄影所致受检者的入射体表剂量水平。方法选取四川省7个市州12家不同级别的医疗机构中324例X射线摄影机(DR)受检者为研究对象,采用热释光剂量计测量受检者不同部位的入射体表剂量(entrance surface dose,ESD)。多组组间M比较采用完全随机设计Kruskal-Wallis H检验,两组组间M比较采用Mann-Whitney U检验,非正态分布资料的相关分析采用Spearman相关分析,检测水准α=0.05。结果不同投照部位ESD差异具有统计学意义(H=190.22,P<0.05),其中,以胸部正位检查的ESD最低,腰椎侧位的最高;不同级别医院间ESD的差异有统计学意义(H=19.82,P<0.05),其中,一级医院最大,三级医院最小。结论被调查的受检者X射线摄影的入射体表剂量水平低于我国现行相应诊断项目推荐的指导水平。     

Polymorphism of the serum alpha-amylase in the population of the South Central and South Eastern regions of Bulgaria and its relationship with the erythrocyte blood group systems ABO and MNSs

INTRODUCTION: The goal of the study was to investigate the relationship between the polymorphism of alpha-amylase and the erythrocyte systems--ABO, MNSs, and determine their population distribution and individual phenotype and gene incidence. MATERIAL AND METHODS: Parallel examinations of identical blood samples were carried out to determine the phenotypes of alpha-amylase and ABO and MNSs blood group systems. Blood was obtained by venipuncture in the Serological Laboratory of the Department of Forensic Medicine at the Medical University of Plovdiv. Amylase phenotypes were determined by the authors' own modification of Kompf's method using continuous horizontal electrophoresis of blood serum on agarose gel. Only the classical phenotypes of the examined blood group systems--alpha-amylase, ABO and MNSs were determined in the study. RESULTS. The analysis of the data by chi-square analysis using Pearson criterion found no relationship between the polymorphism of the serum alpha-amylase and ABO and MNSs erythrocyte systems. The allele frequencies determined were 1(a) = 0.9595, 1(b) = 0.0388, 1(o) = 0.0017 for Amyl and 2(a) = 0.9579 and 2(b) = 0.0421 for Amy2. CONCLUSION: The difference between the observed and expected phenotypes of the examined blood group systems alpha-amylase, ABO, MNSs is short of statistical significance. This indicates genetic stability of the examined blood group systems in the studied population.     

High urinary isoflavone excretion phenotype decreases plasma cholesterol in golden Syrian hamsters fed soy protein

Apparent absorption of isoflavones varies greatly among individuals but is relatively stable within an individual. We hypothesized that high urinary isoflavone excreters would show less plasma non-HDL cholesterol (non-HDL-C) than low isoflavone excreters after soy protein feeding. Fifty Golden Syrian hamsters were fed a high-fat/casein diet (n = 10) or a high-fat/soy protein diet (n = 40) for 4 wk. We identified 2 distinct urinary isoflavone excretion phenotypes based upon HPLC analysis of urinary glycitein using a pairwise correlation plots analysis, or based upon total urinary isoflavone using a hierarchical cluster test. High isoflavone excreters showed greater urinary isoflavones (P < 0.05) than did low isoflavone excreters at wk 1 and 4. The low urinary glycitein excretion phenotype was more stable than the high urinary glycitein excretion phenotype by McNemar's test. High urinary isoflavone excreters had significantly less non-HDL-C than did the low isoflavone excreters or casein-fed controls (P < 0.05). Plasma total and non-HDL-C were negatively correlated with urinary daidzein, glycitein, and total isoflavone excretion (r = -0.45 to -0.58, P < 0.05). Urinary isoflavone excretion phenotypes predicted the cholesterol-lowering efficacy of soy protein. Isoflavone absorbability, probably due to gut microbial ecology, is an important controllable variable in studies of effects of soy protein on blood lipids.     

Quantifying ethanol by high performance liquid chromatography with precolumn enzymatic conversion and derivatization with fluorimetric detection

We quantified ethanol by measurement of the subsequent increase in acetaldehyde after reaction with alcohol dehydrogenase and nicotinamide adenine dinucleotide (ADH-NAD) with a fluorimetric HPLC method. Ethanol standards ranging from 0.3 to 200 mg/dl were investigated and the limit of quantitation of the fluorimetric HPLC method was found to be 6 mg/dl. The accuracy of the HPLC method was assessed by assaying blood samples containing 6–200 mg/dl of ethanol and comparing its results to those of the ADH-NAD enzymatic method (r² = 0.993). The coefficients of variation for intraassay (assayed ten times) and interassay (assayed on 7 consecutive days) were 6.7% and 9.3% for blood samples containing 50 mg/dl of ethanol and 4.0% and 17.9% for blood samples containing 200 mg/dl of ethanol. The blood ethanol concentrations of a volunteer after a pulse of 0.3 g/kg of ethanol determined with the described HPLC method were correlated to the results from the ADH-NAD enzymatic method (r² = 0.986). In conclusion, the fluorimetric HPLC method for measurement of ethanol here described is of potential clinical utility.     

Emotional Self-Disclosure in Online Breast Cancer Support Groups: Examining Theme,Reciprocity, and Linguistic Style Matching

The present study investigated emotional self-disclosure (ESD) patterns and their effects in online support groups specific to different stages of breast cancer. Linguistic features of messages posted to an online breast cancer support group were analyzed. ESD was common, and was consistent across four stage forums. Emotional talk was linked to a variety of themes, but most prominently in the context of discussions about social connections rather than health or death. Linguistic style matching mediated the relationship between ESD in posts and reciprocal ESD in comments, suggesting a key role for mutual understanding and engagement between posters and commenters. Implications for health communication theory and practice were discussed.     

银川市中学生高三酰甘油腰围表型与血压异常的关系

目的 探讨宁夏银川市城区儿童青少年高三酰甘油腰围(HTW)表型与血压异常的关系,为儿童青少年及成人期高血压的识别和防治提供科学依据.方法 2018-2020年采取整群抽样的方法,抽取银川市1566名学龄儿童青少年作为研究对象,所有研究对象均完成问卷调查、体格测量和血液生化检验.结果 调整年龄、吸烟、饮酒和高血压家族史后...     

Rapid and simple measurement of retinol in human dried whole blood spots

We describe an improved method for the measurement of retinol in dried blood spots (DBS) on filter paper. Retinol in human DBS on filter paper was analyzed by normal phase HPLC after a simple extraction method. Retinol associated with its binding protein was eluted from the paper into aqueous solution facilitated by ultrasonic agitation. Retinol associated with retinol binding protein was denatured with acetonitrile, and then retinol was isolated in a single hexane extract and analyzed directly by HPLC. When analyzing DBS, the individual plasma volume of the spots was calculated by measuring the sodium content or by weighing the blood spots. The described method yielded low intra- and interassay variability (<6%), with sufficient sensitivity (detection limit, 0.1 micromol/L) and good recovery (97% spike). Compared with matching plasma samples, DBS retinol consistently decreased 18-23% during the 1st wk of storage. After 1 wk, retinol remained stable in the blood spots at 23 degrees C for >3 mo. In conclusion, the analysis of retinol in DBS by HPLC is comparable to retinol analysis in serum. The variability of the method was reduced by using sodium concentration to estimate sample volume. Collection of DBS for retinol analysis is appropriate under field conditions, where it is difficult to centrifuge or freeze blood samples.     

内镜下黏膜切除术与内镜下黏膜剥离术对直径为2～3cm的早期食管癌及癌前病变的疗效分析

目的对内镜下黏膜切除术（EMR）与内镜下黏膜剥离术（ESD）治疗直径为2～3em的早期食管癌及癌前病变的效果进行评价。方法回顾性分析内镜下治疗的77例直径为2—3cm的早期食管癌及癌前病变患者临床资料。采用EMR治疗37例（EMR组）42处病灶,采用ESD治疗40例（ESD组）41个病灶。观察两组术中出血、穿孔发生情况,术后食管狭窄、复发情况。结果EMR组出血、穿孔发生率分别为7．1％（3／42）、0,均显著低于ESD组的24．4％（10／41）、17．1％（7／41）,差异有统计学意义（p〈0．05或〈0．01）。两组食管狭窄发生率比较差异无统计学意义（P〉0．05）。EMR组复发率为14．3％（6／42）,显著高于ESD组的0,差异有统计学意义（P〈0．05）。结论在治疗直径为2．3cm的早期食管癌及癌前病变的有效性方面ESD优于EMR,但ESD发生出血和穿孔的风险较高,二者在术后食管狭窄方面无显著差异。     

江西省X射线摄影受检者入射体表剂量调查

目的 调查2017年度江西省X射线摄影所致受检者的入射体表剂量水平,阐述江西省X射线诊断的医疗照射现状。方法 随机选取南昌市、上饶市、赣州市、萍乡市、宜春市和九江市共6个地级市不同级别的20家医院,利用热释光剂量计测定1 273人次受检者不同照射部位的ESD值。结果 2017年江西省CR和DR摄影所致受检者的ESD范围分别为0.08~17.81 mGy和0.04~30.91 mGy,胸部正位和侧位、腰椎正位和侧位、颈椎正位和侧位、骨盆及髋关节的X射线摄影检查所致受检者的ESD值的范围分别为0.07~2.40 mGy、0.13~7.27 mGy、0.33~23.29 mGy、0.62~30.91 mGy、0.09~1.69 mGy、0.10~1.79 mGy、0.29~23.46 mGy。结论 江西省胸部侧位X射线摄影所致受检者的入射体表剂量75%百分位值超过医疗照射指导水平,部分照射部位ESD值较全国"九五"期间调查值有显著下降,DR摄影所致受检者剂量比CR高,应采取措施降低DR摄影所致受检者的辐射剂量。     

数字化X射线摄影设备(DR)曝光条件与剂量学参数相关性研究

目的 研究数字X射线摄影设备曝光条件与剂量参数相关性。方法 巴拉库达系统检测确认数字X射线摄影设备处于良好状态,在使用模体条件下,测试kV、mAs、过滤曝光等条件对剂量与面积之积(DAP)、输出量和入射体表剂量(ESD)等剂量参数的影响,分析曝光参数与剂量参数的相关性。结果 从60 kV到120kV,DAP由173.80 mGy·cm²降低到33.39 mGy·cm²,X射线球管的输出量由0.010Gy/(A·s)增加到0.032 Gy/(A·s),ESD由0.74 mGy降低到0.17mGy。70kV、90 kV、110 kV条件下,DAP和ESD随mAs数的增加而呈逐渐增加趋势。在2.5mmAl+1mmCu或3.3 mmAl+1mmCu过滤条件下,DAP与ESD随管电压升高而降低的幅度明显小于采用3.3 mmAl或4.1 mmAl过滤时的情况。在过滤条件不变的情况下,数字X射线摄影机的剂量与面积之积、模体的入射体表剂量与kV曾明显的负相关(P<0.05),而与mAs呈明显的正相关(P<0.05);输出量与kV曾明显的正相关(P<0.05),而与mAs呈明显的负相关(P<0.05),这种相关性不受kV或mAs变化的影响。结论 对于DR,适当提高kV条件,或降低mAs可有效降低受检者剂量。     

内镜下黏膜剥离术和内镜下黏膜切除术治疗食管黏膜病变的疗效比较

目的 将内镜下黏膜剥离术（ESD）和内镜下黏膜切除术（EMR）进行比较,评价ESD治疗食管黏膜病变的有效性及安全性.方法 分析25例经ESD治疗（ESD组）和45例经EMR治疗（EMR组）的食管黏膜病变患者的临床资料,比较两种方法病灶整块切除率、组织学治愈性切除率、手术时间、并发症情况及局部复发率.结果 ESD组病灶整块切除率为60.0％（15/25）,组织学治愈性切除率为48.0％（12/25）,均优于EMR组的48.9％（22/45）和40.0％（18/45）,差异有统计学意义（P＜0.05）.ESD组局部复发率为4.0％（1/25）,明显低于EMR组的20.0％（9/45）,差异有统计学意义（P＜0.05）.两组术后迟发性出血、穿孔、狭窄等严重并发症的发生率比较差异无统计学意义（P＞0.05）.ESD组手术时间（64.3±27.1） min,明显长于EMR组的（27.6±14.1） min,差异有统计学意义（P＜0.05）.结论 ESD和EMR相比,病灶整块切除率及组织学治愈性切除率高,局部复发率低,是治疗食管黏膜病变更为安全有效的方法.     

Thiamine pyrophosphate determination in whole blood and erythrocytes by high performance liquid chromatography

A sensitive method for the measurement of thiamine pyrophosphate in whole blood and erythrocytes, using a straight-phase high performance liquid chromatography (HPLC), is described. The method was based on sample extraction with trichloracetic acid, conversion of the vitamer to the corresponding high fluorescent thiochrome ester, and separation and measurement of the derivative by HPLC. Evidence for reproducibility and accuracy of the assay is presented. Data indicating the thiamine pyrophosphate levels to be expected in blood and erythrocytes of healthy humans are included.     

结肠息肉样早癌患者早期血清炎症因子变化

目的探求结肠息肉样早癌的早期相关性炎症因子及抑癌基因指标,以期为临床早期诊断提供指导。方法通过结肠镜检查结肠息肉样变350例患者,电子结肠镜下息肉行粘膜切除（EMR）或剥离（ESD）后病理学检查证实结肠息肉样早癌变病例120例,检测血清促炎因子TNF-a、IL-6、Cox2及抑炎因子IL-10水平,并检测组织抑癌基因APC、PTEN、PHLPP的表达及230例单纯腺息肉患者与200例查结肠镜提示结肠粘膜正常对照组以上指标进行比较分析。结果病理活检证实结肠息肉癌变组与单纯结肠腺息肉组、正常结肠组比较,血清促炎因子IL-6、Cox2表达量增高（P〈0.05）,抑炎因子IL-10检测量减低（P〈0.01）,抑癌基因APC、PTEN、PHLPP,表达水平减低（P〈0.01）,血清TNF-a无统计学意义。结论对血清一些促炎症因子及抑炎症因子检测水平变化,与结肠息肉组织抑癌基因表达基本相一致,能对部分结肠早癌筛查及诊断提供临床指导,促炎症因子及抑炎症因子可能参与结肠息肉向早癌的演进。     

内镜下黏膜剥离术治疗消化道病变的临床研究

目的 证明内镜下黏膜剥离术（ESD）治疗消化道病变的临床意义.方法 选取行ESD治疗患者112例,术前经消化道超声内镜检查定位提示病变尚未侵及肌层后行ESD.结果 112例中96例完整剥离并切除病变组织,术后病理显示基底部和切缘未见病变组织且被膜完整,完整切除率85.7％（96/112）.术中未出现难以控制的大出血,也未出现钛夹无法夹闭消化道穿孔、腹腔感染、皮下气肿等情况.对于12例早期癌症的患者进行术后1年的随访,未出现残留和复发现象.结论 ESD对于消化道病变是一种安全、有效、痛苦小、可以将病变组织一次性完整切除的手术.     

Paediatric dose measurements for chest X-ray examinations at Maternity and Children Hospital in Najran - Saudi Arabia

The entrance skin dose (ESD) of chest X-ray examinations for AP and PA projections of paediatric patients at Maternity and Children Hospital in Najran, Saudi Arabia have been obtained using DoseCal software. The majority of the results obtained show low measured ESD for chest X-ray examinations. The mean of ESD for the AP projection was found to be 37.5, 40.5, 41.3, and 52.3 μ Gy for age groups 0-1, >1-5, >5-10, and >10-15 years respectively. However, the ESD for PA projection was found to be 50.7 and 56.7 μ Gy for age groups >5-10, and >10-15 years respectively.     

48例RhD阴性孕妇的Rh表现型分析

目的了解RhD阴性孕妇Rh表现型的构成和不规则抗体的存在情况.方法采用盐水试管法检测RhD抗原,采用微柱凝胶法检测RhCcEe抗原和不规则抗体.结果 48例RhD阴性孕妇中,以Rhccee型为主,占56.22%,RhCcee型占33.3%,其它表现型少见或罕见.有5例孕妇不规则抗体阳性.其中有4例可被确证为Rh血型不合引起新生儿溶血病.结论应重视对孕妇产前进行血型鉴定和不规则抗体筛查,为早期发现新生儿溶血病,尽早采取相应的治疗措施提供实验依据.     

Blood group phenotypes A and B are risk factors for cerebral malaria in Odisha, India

There is increasing evidence that the ABO blood group phenotypes modulates Plasmodium falciparum rosetting and may influence the clinical manifestation of severe malaria. Whether blood group phenotypes are associated with risk of severe falciparum malaria in Odisha, we analyzed 343 adult malaria patients. The results showed high prevalence of blood group B in both mild (n=110) and severe malaria (cerebral malaria [CM]; n=130 and non-cerebral severe malaria [NCSM]; n=103) categories among the non-O group and while type O is significantly associated with protection against CM, patients with type A and B group had increased risk for developing CM. Further, the strength of association for B group (p=< 0.0001) was high and has double the risk of (OR=5.0) of developing CM compared to blood group A (OR=2.5). Such findings may probably be due to strain specific blood group preferences of P. falciparum and high prevalence of B group. However, the ABO blood group distribution of mild malaria was comparable with that of the NCSM group of patients. The lack of association of ABO phenotypes with NCSM is evidence for the hypothesis that the underlying pathogenesis cascades are different in CM and NCSM clinical presentations.     

豫北地区无偿献血者ABO和Rh血型抗原分布调查

摘要:目的　调查豫北地区无偿献血者ABO、Rh抗原分布状况,便于解决临床用血供需平衡。方法　采用血型群体遗传学研究方法,调查247 658名无偿献血人群ABO、Rh抗原表型及其基因频率,计算单倍型频率和预期值,观察ABO表型观察值与预期值、Rh阴性献血者ABO血型分布是否符合Hardy-Weinberg群体基因平衡。结果　无偿献血人群中ABO表型特征O＞B＞A＞AB,基因频率r＞q＞p,期望值和观察值符合Hardy-Weinberg群体基因平衡定律;Rh（D）阴性占0.13%,多表现为ccdee和Ccdee表型,单倍型频率cde最高,男性和女性之间ABO血型分布差异无统计学意义,ABO血型抗原分布和Rh表型分布均符合Hardy-Weinberg群体基因平衡。结论　豫北地区ABO血型与Rh血型分布符合群体遗传学中的Hardy-Weinberg平衡,对合理制定采供血计划、招募无偿献血者、血液储备和建立稀有血型库均具有重要参考价值。     

Ability in daily activities after early supported discharge models of stroke rehabilitation

More knowledge is needed about how different rehabilitation models in the municipality influence stroke survivors’ ability in activities of daily living (ADL). Objectives: To compare three models of outpatient rehabilitation; early supported discharge (ESD) in a day unit, ESD at home and traditional treatment in the municipality (control group), regarding change in ADL ability during the first three months after stroke. Methods: A group comparison study was designed within a randomized controlled trial. Included participants were tested with the Assessment of Motor and Process Skills (AMPS) at baseline and discharged directly home. Primary and secondary outcomes were the AMPS and the modified Rankin Scale (mRS). Results and conclusions: Included were 154 participants (57% men, median age 73 years), and 103 participants completed the study. There were no significant group differences in pre–post changed ADL ability measured by the AMPS. To find the best rehabilitation model to improve the quality of stroke survivors’ motor and process skills needs further research. Patients participating in the ESD rehabilitation models were, compared with traditional treatment, significantly associated with improved ADL ability measured by the mRS when controlling for confounding factors, indicating that patients with social needs and physical impairment after stroke may benefit from ESD rehabilitation models.     

胃异位胰腺患者应用内镜黏膜下剥离术和内镜黏膜下隧道剥离术的诊治分析

目的 探讨内镜黏膜下剥离术（ESD）和内镜黏膜下隧道剥离术（STER）在胃异位胰腺诊治中的价值.方法 86例疑诊为胃异位胰腺患者住院接受ESD或STER,随访观察治疗效果和安全性.结果 术后病理确诊胃异位胰腺54例,位于胃窦43例,胃底体交界7例,胃体4例;其中45例行ESD,9例行STER,完整切除率88.9％ （48/54）,余6例剥离后有少许组织残留.术后迟发性出血1例（1.9％,1/54）,无术中及术后穿孔.术后随访1～ 32个月未见复发.结论 ESD能完整大块地切除病变组织,能提供标本获得准确的病理学诊断,是胃异位胰腺有效且安全的诊治手段,STER可能为胃异位胰腺的诊治提供一种新的方法.