海口市老年牙周炎患者牙齿缺失情况及影响因素

目的调查海口市老年牙周炎患者的牙齿缺失情况及其影响因素。方法选择在海南省人民医院牙周科因牙周炎导致牙齿缺失而就诊的268例老年患者进行问卷调查。结果共调查268人,男138人,女130人,共计缺牙数2 237颗,其中前牙522颗,后牙1 715颗,平均缺牙数为(8.35±6.42)颗。老年牙周炎缺失牙数与年龄、居住地、经济收入、学历、口腔卫生状况(吸烟、刷牙次数、刷牙时间、是否使用菌斑控制器及定期进行口腔卫生检查)、自身因素等因素有一定的相关性。结论海口市老年牙周炎患者牙齿缺失较多,需要针对不同的老年患者制定个性化预防措施。     

武汉市不同年龄公务员牙周炎危险因素的相关性研究

目的 调查武汉市不同年龄公务员牙周状况,并对其危险因素进行单因素和多因素分析. 方法 2007年1月至2008年3月采用随机整群抽样的方法 调查年龄30～79岁体检者493例的口腔状况,符合纳入标准458例,其中30～59岁(中青年组)288例,60～79岁(老年组)170例.其中牙周炎患者280例为病例组,无牙周炎178例为对照组.采用SQSERVER2000软件建立数据库,分别对年龄、性别、民族、学历、糖尿病、吸烟、饮酒、精神压力和口腔卫生习惯与牙周炎相关性进行单因素和多因素分析. 结果 458例检出280例牙周炎患者,患病率为61.1%.单因素分析结果 显示,年龄、学历,糖尿病、吸烟和口腔卫生习惯是患牙周炎的危险因素(OR值分别为0.44、2.27、3.44、1.75、9.82,P<0.05或P<0.01).多因素分析结果 显示,糖尿病和低学历(OR值分别为2.66、1.95,均为P<0.05)为牙周炎的危险因素.以年龄分层进行多因素分析时,中青年人糖尿病与牙周炎患病率无相关性.老年组糖尿病(OR=6.91,95%CI:1.27～37.42)是牙周炎的危险因素. 结论 牙周炎患病的危险因素较多,老年人糖尿病是牙周炎的患病的主要危险因素.     

老年抑郁症的心理社会危险因素研究

目的探讨老年抑郁症恢复期患者的心理社会危险因素。方法对98名老年抑郁症恢复期患者(病例组)以及正常社区老年人(对照组)采用自制一般情况调查表、老年抑郁量表(GDS)、社会支持量表(SSRS)、简易应对方式问卷、生活事件量表(LSE)、米隆临床多轴问卷(MC-MI-Ⅲ)进行测查,并对其心理社会危险因素进行分析。结果负性生活事件数高(OR=1.328)、负性事件总值高(OR=6.849)、抑郁型人格分值高(OR=2.142)、自我挫败型分值高(OR=2.118)会增加老年抑郁症发病的危险性。结论负性生活事件数、负性事件总值、抑郁型人格、自我挫败型人格与老年抑郁症的发病密切相关。     

北京城区2型糖尿病患者牙周状况研究

目的 调查北京城区的某社区2型糖尿病人群的牙周状况,探讨2型糖尿病与牙周炎的关系.方法 2005年5月至8月对北京市石景山区古城等4个社区内一队列人群的体检结果进行筛查,筛选出118例2型糖尿病患者、78例单纯高血压患者和50名无系统性疾病者进行牙周临床检查,记录全口牙的菌斑指数、出血指数、探诊深度、附着丧失和缺失牙数,比较3组间的牙周指标,并以Logistic回归分析糖尿病与牙周炎的相关性.结果 糖尿病组的缺牙数[(10±8)个]、菌斑指数(2.2±0.5)、探诊深度[(3.6±0.8)mm]、附着丧失[(4.9±1.9)mm]及重度牙周炎患病率(76.3%)均高于高血压组和无系统性疾病组(均P＜0.05);未调整其他因素时,糖尿病患者发生中重度牙周炎的风险是无糖尿病者的5.8～38.9倍;调整了年龄、性别、吸烟、菌斑控制等因素后,糖尿病患者血糖控制情况仍与发生中重度牙周炎独立关联,控制好者OR=6.99,控制差者OR=31.21.结论 北京城区2型糖尿病患者的牙周状况较无糖尿病者差,糖尿病患者血糖控制差可能与发生中重度牙周炎的风险增高独立关联.     

老年糖尿病合并慢性牙周炎的影响因素及牙周保健认知行为现况

目的探讨老年糖尿病(DM)合并慢性牙周炎的影响因素及牙周保健认知行为情况。方法选取2012年1月至2014年6月该院口腔科235例老年DM患者,根据是否合并慢性牙周炎将患者分为单纯性DM组(未合并慢性牙周炎)152例,轻度慢性牙周炎组50例,中度慢性牙周炎组24例,重度慢性牙周炎组9例,采用问卷调查方式分析老年DM合并慢性牙周炎的影响因素和了解牙周保健认知行为情况。结果单因素和Logistic多因素回归分析结果显示,血糖水平、口腔卫生习惯、文化程度、饮食习惯不同对老年DM患者慢性牙周炎并发症发生率及其程度的影响差异显著(P0.05),经牙周保健认知行为调查结果发现,牙周保健认知行为平均得分为(36.79±9.52)分,24项牙周保健认知行为题目中,"吸烟影响口腔健康"回答正确率最高,"牙线1次/d"回答正确率最低(P0.05)。单纯性DM患者牙周保健认知行为评分明显高于合并慢性牙周炎患者(P0.05),其中轻度慢性牙周炎患者牙周保健认知行为评分明显高于中重度患者,而中度患者亦显著高于重度患者(P0.05)。结论老年DM合并慢性牙周炎是血糖增高、不良口腔卫生、饮食习惯和低文化程度等多种因素作用下形成的,其中牙周保健认知行为在慢性牙周炎的形成和病情发展中具有重要的评估意义。     

老年急性冠状动脉综合征患者介入术后1年内主要不良心血管事件诺莫图的构建与评估

目的 构建老年急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后1年内主要不良心血管事件(MACE)的诺莫图预测模型。方法 回顾性收集2020年1月1日至2022年4月1日解放军空军特色医学中心确诊ACS并接受PCI的患者551例,根据1年内随访是否发生MACE分为MACE组176例和非MACE组375例。采用单因素及多因素logistic回归分析老年ACS患者PCI术后1年内发生MACE的危险因素,构建诺莫图预测模型,并采用ROC曲线下面积(AUC)评估该模型的预测效果。结果 MACE组Gensini评分、全身免疫炎症指数、全球急性冠状动脉事件注册评分明显高于非MACE组,预后营养指数明显低于非MACE组(P<0.01)。多因素logistic回归分析显示,近期吸烟(OR=2.222,95%CI:1.361～3.628,P=0.010)、高脂血症(OR=1.881,95%CI:1.145～3.089,P=0.013)、预后营养指数(OR=4.645,95%CI:2.788～7.739,P=0.001)、左心室射血分数(OR=5.177,95%CI:3.160～8...     

口腔健康对老年人营养状况的影响

正营养失调易导致老年人易被病毒感染、生活质量受损甚至死亡率增加[1～3]。口腔卫生不良、龋齿、牙周病或不合适的假牙是老年人的常见问题[4]。牙齿的分布和数量影响咀嚼的舒适性和易用性[5,6]。牙齿脱落最终影响摄入的食物组成结构,降低食欲,造成营养不良[7～9]。不良的咀嚼功能和口腔健康被称为营养不良风险因素[10]。无牙症会对咀嚼、营养产生负面影响。部分牙齿的缺失也是营养状况不良的可预测因素[11～15]。本综述旨在评估老年人口腔健康对营     

更年期妇女血管舒缩失调的影响因素

目的 探讨更年期妇女血管舒缩失调的影响因素,为建立有效的预防控制措施提供依据.方法 采用病例对照研究方法,对45～65岁的124名血管舒缩失调病例及100名健康对照妇女运用非条件Logistic回归单因素和多因素分析,探讨影响血管舒缩症状发生的危险因素.结果 多因素非条件Logistic回归分析显示,职业(OR=2.326,95% CI=1.420～3.811)、月经情况(OR=2.576,95% CI=1.634～4.061),Kupperman更年期指数(KMI)(OR=10.743,95% CI=3.683～31.333)和负性生活事件刺激(OR=2.974,95% CI=1.089～8.117)可能为血管舒缩症状发生的危险因素,常食用豆制品(OR=0.349,95%CI=0.175～0.696)可能是其保护因素.结论 更年期妇女血管舒缩失调与职业、月经情况、Kupperman更年期指数、负性生活事件刺激、食用豆制品有关;采取高危因素干预策略可降低血管舒缩失调症状发生.     

烟碱型乙酰胆碱受体亚单位a5基因多态性与吸烟老年人肺癌的关系

目的探讨烟碱型乙酰胆碱受体亚单位a5(CHRNA5)-rs 17486278位点基因多态性与吸烟老年人肺癌的关联性。方法采用病例对照研究方法,以216例吸烟老年原发性肺癌患者为病例组,以639例吸烟老年健康体检者为对照组,采用聚合酶链反应-限制性片段长度多态性方法(PCR-RFLP)检测CHRNA5-rs 17486278位点基因多态性,结合两组人群的健康资料,分析CHRNA5-rs 17486278位点基因多态性与肺癌的关联性。结果 Logistic回归分析结果显示吸烟年限、每天吸烟量、合并肺部疾病和营养认知行为是吸烟老年人肺癌发生的影响因素(P0.05);AC和CC基因型、C等位基因频率与原发性肺癌存在一定关联性(OR=1.701,95%CI:1.047～2.764;OR=1.656,95%CI:1.150～1.949;OR=1.676,95%CI:1.194～2.353);条件Logistic回归分析显示吸烟年限、每天吸烟的量与CHRNA5-rs 17486278位点基因多态性之间联合作用对肺癌发生的影响无统计学意义(P0.05)。结论 CHRNA5-rs 17486278位点基因多态性与吸烟老年人原发性肺癌发生有关,吸烟行为可增加CHRNA5-rs 17486278位点基因突变的风险,增加吸烟老年人原发性肺癌发生的风险。     

住院老年人社区获得性肺炎危险因素的病例对照研究

目的 探讨住院老年人社区获得性肺炎(CAP)的危险因素,为预防老年人CAP提供临床参考.方法 采用配对病例对照研究,将患者分为CAP组和对照组,进行问卷调查基础疾病和生活质量,检查和评价营养状态.采用条件Logistie回归进行住院老年人CAP的危险因素分析.结果 入选病例138例,男性90例(65%),女性48例(35%).CAP组69例,年龄61～94岁,平均(74.5±6.9)岁;对照组69例,年龄60～89岁,平均(73.6±6.9)岁.单因素分析结果提示,曾经吸烟(OR=5.71)、目前正在吸烟(OR=18.26)、慢性支气管炎(OR=3.75)、既往肺结核病史(OR=2.67)、入选前1年内因肺炎住院史(OR=14.93)、入选前1～2年因肺炎住院史(OR=5.99)、营养状况中等(OR=5.11)、营养状况较差(OR=11.55)、体质指数(OR=0.81)、血清白蛋白水平(OR=0.14)、外周血淋巴细胞计数(OR=0.50)、日常生活能力量表(ADL)评分(OR=0.46)、轻度体育活动(OR=0.24)、中度体育活动(OR=0,04)、进餐时间长短(OR=1.11)为老年人CAP的危险因素(均为P＜0.05).多因素回归分析显示,ADL评分(OR=0.34)、曾经吸烟(OR=15.98)、目前正在吸烟(OR=73.85)、慢性支气管炎病史(OR=22.88)、体质指数(OR=0.76)、人选前1年内因肺炎住院史(OR=55.56)、入选前1～2年因肺炎住院史(OR=30.30)是老年人CAP的独立危险因素,差异均有统计学意义(均为P＜0.05).结论 吸烟、慢性支气管炎、肺炎住院史、营养不良是老年人易患肺炎的危险因素.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.