高尿酸血症在北京地区1997人中的患病情况及相关因素分析

目的调查人群中高尿酸血症的患病率并对其相关因素进行分析。方法对1997名体检人群进行横断面调查,通过Logistic多元回归模型分析与高尿酸血症相关的人口学特征、饮食和生活习惯及临床指标。结果该人群中男性高尿酸血症的患病人数163例,占13．8％;女性46例,占6．0％。Logistic多元回归模型显示男性、少数民族（回族）、肾功能重度受损、使用利尿剂、超重／肥胖、高血压、高甘油三脂血症与高尿酸血症的危险性升高相关,而退休与高尿酸血症的危险性降低相关。结论男性、少数民族（回族）、肾功能重度受损、使用利尿剂、超重／肥胖、高血压、高甘油三酯血症可能是高尿酸血症的危险因素;退休可能是保护因素。     

Risk factors of osteoporosis in soldiers of the Armed Forces: A cross-sectional study from Western India

BackgroundOsteoporosis may result from risk factors such as smoking, alcohol, low body mass index, less physical exercise, and dietary calcium deficiency. The risk of osteoporosis fractures can be reduced with lifestyle changes, which include diet, exercise, and preventing falls. The present study is an effort to measure the burden of risk factors of osteoporosis in adult male soldiers in the Armed Forces.MethodsThe present study was a cross-sectional study among serving soldiers in South-Western part of India, and 400 participants consented to be included in the study. After obtaining informed consent, the questionnaire was distributed. Venous blood samples were collected to measure serum calcium, phosphorus, vitamin D, and parathyroid hormone (PTH).ResultsThe prevalence of vitamin D3 severe deficiency (<10 ng/mL) was 38.5%, and the prevalence of vitamin D3 deficiency (10–19 ng/mL) was 33%. Low serum calcium (<8.4 mg/dL) and serum phosphorus (<2.5 mg/dL) were found among 19.5% and 11.5%, respectively, whereas a raised serum PTH level (>66.5 pg/mL) was seen in 5.5% of the participants. A statistically significant association was found between consumption of milk and milk products and levels of calcium. With a cutoff value of 20 ng/mL for vitamin D3 deficiency, a statistically significant association was found for consumption of fish, physical activity, and sun exposure.ConclusionA remarkably large percentage of otherwise normal healthy soldiers have deficiency or insufficiency of vitamin D and might be prone to osteoporosis. Despite significant advances in our understanding and management options for male osteoporosis, there still remain important gaps in knowledge which needs to be looked into.     

新疆维吾尔自治区三个县女性不孕症现况调查

目的 了解新疆维吾尔自治区女性不孕症的分布现况、民族差异及影响因素,为不孕症的预防及诊治提供指导依据.方法 于2008年10月至2009年3月新疆医科大学第一医院采用分层随机整群抽样方法,对新疆维吾尔自治区福海县、和丰县、鄯善县1895例已婚育龄妇女进行问卷调查和妇科检查.用EpiData软件建立数据库,采用SPSS 17.0进行统计分析.结果 3个县中患病率最高为26.2％(144/550),最低为7.5％(76/1014),平均患病率为15.2％(279/1835).鄯善县及当地聚居的维族居民患病率最高.文化程度越低、收入水平越低不孕症患病风险越高;职业为农牧民、初次性交年龄≤20岁、体质量指数＜ 18.5 kg/m2、患有多囊卵巢综合征(PCOS)或盆腔炎、具有流产史者不孕风险高.结论 应指导人们正确的生活方式,提高偏远农牧区的生殖保健意识,提供必要的性与避孕咨询与服务,尤其避免或减少青少年婚前性行为和未婚人工流产,预防或减少不孕症的发生,加强不孕症的诊治,提高生殖健康水平.     

Skin diseases in the Da Qing Diabetes Study: a cross-sectional study

Background:The prevalence of skin diseases and diabetes mellitus (DM) are prominent around the world. The current scope of knowledge regarding the prevalence of skin diseases and comorbidities with type 2 DM (T2DM) is limited, leading to limited recognition of the correlations between skin diseases and T2DM.Methods:We collected 383 subjects from the Da Qing Diabetes Study during the period from July 9th to September 1st, 2016. The subjects were categorized into three groups: Normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and T2DM. The prevalence and clinical characteristics of skin diseases were recorded and investigated.Results:In this cross-sectional study, 383 individuals with ages ranging from 53 to 89-year-old were recruited. The overall prevalence of skin diseases was 93.5%, and 75.7% of individuals had two or more kinds of skin diseases. Additionally, there were 47 kinds of comorbid skin diseases in patients with T2DM, of which eight kinds of skin diseases had a prevalence >10%. The prevalence of skin diseases in NGT, IGT, and T2DM groups were 93.3%, 91.5%, and 96.6%, respectively; stratified analysis by categories showed a statistically significant difference in “disturbances of pigmentation” and “neurological and psychogenic dermatoses”. The duration of T2DM also significantly associated with the prevalence of “disturbances of pigmentation” and “neurological and psychogenic dermatoses”. Subsequently, the prevalence of “disturbances of pigmentation” was higher in males than females in NGT (P < 0.01) and T2DM (P < 0.01) groups. In addition, the difference in the prevalence of “disturbances of pigmentation” was also significant in NGT and T2DM groups (P < 0.01).Conclusions:There was a high prevalence of skin diseases in the Da Qing Diabetes Study. To address the skin diseases in the Da Qing Diabetes Study, increased awareness and intervention measures should be implemented.     

Paediatric surgical conditions in Malawi - A cross-sectional nationwide household survey

BackgroundUntreated surgical conditions may lead to lifelong disability in children. Treating children with surgical conditions may reduce long-term effects of morbidity and disability. Unfortunately, low- and middle-income countries have limited resources for paediatric surgical care. Malawi, for example, has very few paediatric surgeons. There are also significantly inadequate infrastructures and personnel to treat these children. In order to strengthen resources that could provide such services, we need to begin by quantifying the need.AimTo estimate the approximate prevalence of surgical conditions among children in Malawi, to describe the anatomical locations and diagnoses of the conditions and the presence of injuries.MethodsA cross-sectional, nationwide survey of surgical needs was performed in 28 of 29 districts of Malawi. Villages, households and household members were randomly selected. A total of 1487 households were visited and 2960 persons were interviewed. This paper is a sub analysis of the children in the dataset. Information was obtained from 255 living children and inquiry from household respondents for the 255 children who had died in the past year. The interviews were conducted by medical students over a 60-day period, and the validated SOSAS tool was used for data collection.ResultsThere were 67 out of 255 (26.3%) total children living with a surgical condition at the time of the study, with most of the conditions located in the extremities. Half of the children lived with problems due to injuries. Traffic accidents were the most common cause. Two-thirds of the children living with a surgical condition had some kind of disability, and one-third of them were grossly disabled. There were 255 total deceased children, with 34 who died from a surgical condition. The most prevalent causes of death were congenital anomalies of the abdomen, groin and genital region.ConclusionAn extrapolation of the 26% of children found to be living with a surgical condition indicates that there could be 2 million children living with a condition that needs surgical consultation or treatment in Malawi. Congenital anomalies cause significant numbers of deaths among Malawian children. Children living with surgical conditions had disorders in their extremities, causing severe disability. Many of these disorders could have been corrected by surgical care.     

6243例体检人员B超检查脂肪肝患病率及病因的调查分析

目的:调查体检人群脂肪肝的患病率,探讨长期过量饮酒以及肥胖、糖尿病在脂肪肝发生、发展中的作用及交互影响。方法:采用东芝SSA-550A超声诊断仪,对2007～2009年6243例体检人群进行平卧位和侧卧位常规扫查肝脏。结果:6243例体检人员中检出脂肪肝患者856例,检出率达13.71%。脂肪肝患病率男性明显高于女性(P<0.01)。2007年、2008年、2009年脂肪肝患病率分别为11.08%、13.49%、15.90%,各年份比较差异有统计学意义(P<0.01)。脂肪肝年龄构成比以41～50岁组最高,31～40岁组其次,<30岁组占11.10%。长期过量饮酒者脂肪肝患病率最高,达38.32%;肥胖患病率其次,占36.92%;糖尿病再次,为18.93%。结论:脂肪肝患病率呈逐年增加趋势,小于30岁青年脂肪肝患者并不少见,长期过量饮酒、肥胖、糖尿病在脂肪肝的发生、发展中起重要作用。     

血清PA在肝功能检测中的应用研究

探讨血清前白蛋白（PA）在肝功能检测中的意义。选取114例病毒性肝炎患者及20例健康对照，均应用免疫法测定PA水平。测定结果显示：病毒性肝炎患者血清PA浓度低于对照组。从最高到最低的减少幅度如下：肝硬化→慢性肝衰竭→亚急性肝衰竭→慢性肝炎（重度）→慢性肝炎（中度）→急性黄疸型肝炎→慢性肝炎（轻度）。分析得知：血清PA是肝功能检测的关键指标，值得在临床工作加以关注与重视。     

Long-term efficacy and safety of once-daily nevirapine in combination with tenofovir and emtricitabine in the treatment of HIV-infected patients: a 72-week prospective multicenter study (TENOR-Trial)

Background

There is an unmet medical need for simplified antiretroviral therapy regimens to improve patient''s compliance and quality of life. The purpose of this study was to evaluate the efficacy and safety of a once-daily regimen with Tenofovir (TDF), Emtricitabine (FTC) and Nevirapine (NVP) for adult patients with HIV-1 infection.

Methods

70 patients were enrolled in a prospective, multicenter, non-randomized, single arm, open-label cohort study. Patients were either naïve or had problems with their current ART and needed to be changed to another regimen. Daily drug dosage was 300 mg Tenofovir, 200 mg Emtricitabine and 400 mg Nevirapine once daily. Follow-up was performed over 72 weeks.

Results

After 72 weeks, the regimen was still continued by 52 patients (74,3%). Of these, 44 patients (84,6%) had a viral load below detection limit. The median viral load had decreased by 2,5 log and the median CD4 cell count had increased by 44,8%. Most side-effects occurred at an early stage during the study. Resistances were rare (only two resistances were considered as newly developed) and occurred rather late during the study.

Conclusion

A once-daily regimen of Tenofovir, Emtricitabine and Nevirapine is an attractive treatment option since it is safe, effective, and well tolerated.     

天津市社区老年人身体活动能力与认知功能关联的横断面研究

目的：探讨社区老年人身体活动能力与认知功能的关联，为认知功能改善提供建议。方法：采用整群抽样的方法选取社区老年人，记录受试者的人口学资料，使用韦氏成人智力量表—中国修订版评估认知功能，得出总智商（FIQ）。采用闭眼单腿站立测试、步速测试、5次起坐试验、握力测试评估身体活动能力。采用SPSS23.0进行t检验、单因素方差分析、简单直线回归和多重线性回归分析。结果：本研究共纳入868名老年人，年龄（76.73±9.43）岁。男性297人，占34.22%，女性571人，占65.78%。受教育程度：大学本科339名，占39.06%；中学414名，占47.70%；小学及以下115名，占13.25%。多因素分析结果显示：在校正了混杂因素后，闭眼单腿站立时间（β=0.053,P=0.025）、低握力（β=-2.157,P=0.044）与FIQ的关联有统计学意义，闭眼单腿站立时间与FIQ呈正向关联，低握力与FIQ呈负向关联。结论：老年人身体活动能力与认知功能有关，坚持平衡和握力的练习可能对改善认知功能有重要作用。     

Implications of Cytogenetic Abnormalities and Azoospermia Factor Microdeletions in Assisted Procreation

Assisted procreation techniques have revolutionized the management of infertility and have offered hope to millions of infertile couples. The main aim of these proce- dures is to produce healthy offspring. However recent studies on short term outcome of ART have reported a higher incidence of low birth weight, development delay, imprinting defects, sex and autosomal structural abnormalities, major and minor congenital malformation and certain cancers in babies conceived via ART. Further the health of ART conceived children beyond the neonatal period have been less well evaluated. A large number of infertile couples opting for ART have an underlying genetic aetiology. These genetic aberrations are iatrogenitically transmitted via ART. Thus it is important that all couples undergo a detailed and comprehensive genetic evaluation prior to ART.     

Evaluation of quantitative liver function tests in HIV-positive patients under anti-retroviral therapy

Background and aims

Quantitative tests of liver function (QTLF) which are based on the hepatic metabolism or clearance of test substances have been successfully used to predict prognosis of a variety of different liver diseases. Still sufficient data in HIV-patients under anti-retroviral therapy (ART) are lacking. Therefore, the aim of this prospective study was to investigate if and to what extent ART influences a broad panel of quantitative tests of liver function in patients with HIV-infection.

Patients and methods

Nineteen patients (14 males, 5 females, mean age 40 years) with HIV-infection underwent QTLF including lidocaine half-life test (LHT), galactose elimination capacity (GEC), and indocyanine green clearance (IGC). These tests were performed before and 3 to 6 months after initiation of anti-retroviral therapy. Twenty age-matched healthy, medication-and virus-free adults served as controls.

Results

Lidocaine half-life was significantly lower in HIV-patients without ART. Combining anti-retroviral therapies shifted cytochrome p450 activity back into standard ranges. Galactose elimination capacity as a parameter of cytosolic liver function and indocyanine green clearance as a parameter of liver perfusion were not affected by ART.

Conclusions

QTLF may be a tool to predict prognosis or hepatic complications in HIV-infected patients with liver disease. Early determination of lidocaine half-life seems to be useful - this should be considered during the treatment of HIV-positive individuals.     

Knowledge regarding Ebola Hemorrhagic Fever among private dental practitioners in Tricity,India: A cross-sectional questionnaire study

Background:

Ebola viral fever, a highly contagious haemorrhagic disease has today become a major public health concern in the developing countries worldwide.

Aim:

The purpose of this study was to assess knowledge among dental practitioners regarding Ebola Haemorrhagic Fever (Ebola HF) in Tricity, (Chandigarh, Panchkula and Mohali).

Materials and Methods:

A total of 500 private dental practitioners were randomly approached to participate in this cross-sectional survey. A self-structured, closed ended questionnaire was administered to each participant to record demographic and professional characteristics followed by their knowledge regarding Ebola HF. Knowledge section included questions related to communicability; symptomatology and diagnostics; at-risk individuals; prevention and treatment; and, virus characteristics of Ebola HF.

Results:

The results were expressed in percentages. Multivariable linear regression analysis was carried out to assess the association of participants''s demographic and professional characteristics with the knowledge scores. Statistically significant difference was seen when mean knowledge scores were compared based on the locality and qualification of the participants (P < 0.05).

Conclusion:

Dental practitioners from urban areas with higher qualification had better knowledge yet there were notable deficiencies regarding the virus characteristics, diagnostics, elimination and treatment.     

上海社区糖尿病及糖调节受损人群周围神经病变的横断面调查

目的 了解上海社区糖尿病(DM)及糖调节受损(IGR)人群周围神经病变(PN)的患病率及其主要危险因素.方法 对1998-2001年上海市华阳及曹杨社区代谢综合征流行病学基线调查建立的IGR及DM队列人群进行PN的筛查,共完成筛查739例,男347例,女392例,年龄21～104岁,平均年龄为(66.4±13.2)岁.原有IGR患者再次接受75 g葡萄糖耐量试验,以进一步确定糖代谢状态,PN采用密歇根神经病变筛选法(MNSI)进行诊断.对与PN有关的各影响因素进行逐步Logistic回归分析.结果 社区IGR和DM人群的PN患病率分别为24.6%和36.6%,其中在新诊断DM人群中为25.3%,在已诊断DM人群中为39.9%.Logistic回归分析显示,年龄(OR=1.076,95%CI为1.057～1.096,P<0.001)、糖尿病病程(OR=1.305,95%CI为1.122～1.518,P<0.001)、体质指数(OR=1.083,95%CI为1.026～1.143,P=0.004)及糖化血红蛋白(HbA1c,OR=1.159,95%CI为1.007～1.335,P=0.040)是与PN相关的独立危险因素,HbA1c7.4%患者的PN患病风险约为HbA1c<6.5%患者的1.8倍(OR=1.777,95%CI为1.009～3.130,P=0.044).结论 上海社区高血糖人群中,近1/3患PN,不仅在DM,且在DM前期IGR阶段PN即有较高的患病率.加强血糖控制以及减轻体重可能对PN的防治具有重要意义.     

结节病患者肺功能变化研究

目的：肺结节病患者肺功能测试的研究。方法：40例肺结节病患者不同时期肺功能测试结果和应用激素的回顾分析。结果：显示此类患者有限性通气功能障碍并伴有弥散功能下降和小气道功能受限,PaO2明显下降,pH升高,PaCO2也有下降的趋势。激素治疗结果显示,患者的MMF有明显的提高。其它肺功能指标如VC,RV,RV/TLC,MVV,FEV1,DLCO等都有升高的趋势。结论：VC,RV,MMF,DLCO,DLCO/VA等对诊断结节病的病情发展有直接参考价值,而MMF在糖皮质激素治疗后有显著的变化,提高MMF对结节病的治疗和预后具有动态参考价值。     

Measles,mumps, and rubella: A cross-sectional study of susceptibility to vaccine-preventable diseases among young people in India

BackgroundGlobal elimination of vaccine preventable diseases, such as measles, mumps and rubella is a priority. Many countries have reported diminishing of antibody titres against these diseases among young population as immunization coverage of adolescents and adults in not monitored. The objective of this study was to determine the susceptibility against measles, mumps and rubella among young adults.MethodsIn this cross-sectional study serological evidence of susceptibility to measles, mumps and rubella was determined by qualitative detection of IgG antibody titres by commercially available enzyme linked florescence assay (VIDAS, bioMerieux) in serum samples young adults.ResultsA total of 335 young individuals (mean age: 20.54 ± 1.37 years) participated voluntarily between May 2017 to September 2018, of which 183 (54.63%) were males. Seroprotection against measles, mumps and rubella were 87.16%, 82.69% and 79.10% respectively.ConclusionSerological surveillance is important to monitor immune status in population. Susceptibility of young adults to measles, mumps, and rubella indicates need for booster vaccination. With the recent launch of measles-rubella vaccination campaign in India, country specific data will be required to plan periodicity of such campaign, which in turn would be based on accumulation of susceptible individuals in a community. Lastly, inclusion of mumps vaccine in the national universal immunization program needs consideration.