中国北方汉族、维吾尔族、哈萨克族DYS19基因座的遗传多态性

目的;研究DYS19基因座在中国北方汉族、维吾尔族、哈萨克族群体中的遗传多态性及其法医学应用。方法：应用聚合酶链反应后变性聚丙烯酰胺凝胶电泳分离扩增产物结合银染显带的方法,对101例北方汉族、56例维吾尔族、30例哈萨克族无关男性个体的DYS19基因座进行检测。结果：DYS19基因座在3个群体中共检出5种等位基因,基因频率分布范围分别为0．069－0．594,0．071－0．500,0．100－0．667;个人识别机率分别为0．600,0．675,0．491。χ^2检验表明等位基因分布具有明显的人群差异。家系调查符合单体父系遗传方式。结论：DYS19基因座个人识别机率高,属较高鉴别能力的遗传标记系统,且具有明显的人群分布差异,在法医学及人类遗传学研究中具有重要的应用价值。     

人胚胎肾上腺皮质褪黑素受体亚型蛋白的分布

目的：研究褪黑素（Mel)受体亚型在人胚胎肾上腺皮质的分布。方法：应用免疫组化染色检测Ｍel受体亚型的人胚胎肾上腺皮质的分布。结果：在人胚胎肾上腺皮质的球状速、束状带和网状带均存在Ｍel受体mt1(Mella)和ＭＴ２（Ｍellb)亚型蛋白的表达,且主要分布于细胞质。结论：人胚胎肾上腺皮质存在Ｍel受体mt1和ＭＴ２亚型。     

基于Kano模型的养老机构老年人护理服务需求属性分析

目的 分析养老机构老年人护理服务需求属性,为制订针对性干预措施提供参考.方法 基于Kano模型设计养老机构老年人护理服务需求调查问卷,对天津市7所养老机构共687名老年人进行调查.结果 养老机构老年人护理服务需求34个条目中,魅力属性需求10条(29.4％),均位于保留区Ⅳ;期望属性需求10条(29.4％),其中7条位于优势区Ⅰ;必备属性需求11条(32.4％),其中7条位于待改进区Ⅱ;无差异属性需求3条(8.8％),均位于次要改进区Ⅲ.生理健康与医疗需要维度中,魅力属性2条,期望属性4条,必备属性5条,无差异属性1条;安全需要维度中,期望属性1条,必备属性4条,无差异属性2条;尊重需要维度中,魅力属性1条,期望属性3条,必备属性2条;爱与归属需要维度中,魅力属性4条,期望属性2条;自我实现需要维度的3条均为魅力属性.结论 养老机构老年人必备、期望属性护理服务需求主要集中在生理健康与医疗、安全及尊重需要,魅力属性需求主要集中在爱与归属、自我实现需要.养老机构应在维持和完善必备、期望属性需求的基础上,发展和创新魅力属性需求,客观分析和优化改造无差异属性需求.     

Protection From the Second Warm Ischemic Injury in Kidney Transplantation Using an Ex Vivo Porcine Model and Thermally Insulating Jackets

BackgroundKidney transplantation is the optimum treatment for kidney failure in carefully selected patients. Technical surgical complications and second warm ischemic time (SWIT) increase the risk of delayed graft function (DGF) and subsequent short- and long-term graft outcomes including the need for post-transplant dialysis and graft failure. Intraoperative organ thermal regulation could reduce SWIT, minimizing surgical complications due to time pressure, and limiting graft ischemia-reperfusion injury.MethodsA novel ischemic-injury thermal protection jacket (iiPJ) was designed and fabricated in silicone composite and polyurethane (PU) elastomer prototypes. Both were compared with no thermal insulation as controls. Time to reach ischemic threshold (15°C) and thermal energy transfer were compared. A water bath model was used to examine the thermal protective properties of porcine kidneys, as a feasibility study prior to in vivo translation.ResultsIn both iterations of the iiPJ, the time taken to reach the warm ischemia threshold was 35.2 ± 1.4 minutes (silicone) and 38.4 ± 3.1 minutes (PU), compared with 17.2 ± 1.5 minutes for controls (n = 5, P < .001 for both comparisons). Thermal energy transfer was also found to be significantly less for both iiPJ variants compared with controls. There was no significant difference between the thermal performance of the 2 iiPJ variants.ConclusionProtection from SWIT by using a protective insulation jacket is feasible. With clinical translation, this novel strategy could facilitate more optimal surgical performance and reduce transplanted organ ischemia-reperfusion injury, in particular the SWIT, potentially affecting delayed graft function and long-term outcomes.     

腹腔镜右半结肠癌切除术后消化道重建的研究现状及前景

腹腔镜右半结肠癌切除术后腹腔内吻合正逐渐成为结直肠手术领域中的热点。研究者发现:腹腔内吻合与腹腔外吻合比较,前者在促进病人术后恢复,降低术后并发症发生率等方面有潜在优势。且腹腔内吻合较腹腔外吻合病人术后胃肠功能恢复更快、术后疼痛评分更低。但对于腹腔内吻合的并发症发生率,尤其是重要指标吻合口漏的比较,尚缺乏足够证据。而手术技术不统一、吻合口漏定义不明确是目前研究的主要困难。多项高质量的前瞻性随机对照试验目前正在进行中,对于腹腔镜右半结肠癌切除术的客观评价仍需要更高级别的循证医学证据验证。笔者综合分析国内外研究进展,系统阐述腹腔镜右半结肠癌切除术后消化道重建的研究现状及前景,旨在为我国结直肠外科临床研究探索新方向。     

永久性结肠造口患者造口影响状况及其影响因素分析

目的调查永久性结肠造口对患者生活影响的状况并分析其影响因素。方法采用一般资料调查问卷以及造口影响评分对218例永久性结肠造口患者进行问卷调查。结果218例永久性结肠造口患者中54.6%认为永久性结肠造口对其生活的影响大,其中对患者影响最大的是造口异味以及造口袋渗漏。多因素回归分析结果显示年龄(OR=1.137,P<0.001)、每日清理造口次数(OR=1.438,P=0.015)、术后时间(OR=0.789,P<0.001)以及是否与造口护士有规律联系(OR=0.098,P=0.002)为造口影响评分的影响因素。结论永久性结肠造口对患者生活影响较大,医护人员应在临床对老年患者予以更多关注,帮助患者形成规律的排便习惯,加强出院后患者的延续性护理服务并为患者提供专业支持,从而减少造口影响,提高患者的生活质量。     

Association of TERT gene polymorphisms with clinical benign prostatic hyperplasia in a Chinese Han population of the Northwest region

BackgroundTo investigate the association between single nucleotide polymorphisms (rs10078761, rs12696304, rs2853669, rs16847897, rs2736100, rs10069690) of telomerase gene (TERT) and the risk clinical benign prostatic hyperplasia (BPH) in a Chinese Han population of the Northwest region.MethodsA total of 150 BPH patients and 150 healthy older males from the northwest Chinese Han population were included in this study. The sample size for this unmatched case-control study was estimated by the look-up table method. Meanwhile, the general information and disease data of patients were collected. Age was only collected in healthy control subjects for statistical correction. Genotypes were detected using a multiplex PCR + ligase detection reaction (LDR). Typing results and clinical data were statistically analyzed using multiple linear regression and logistic regression. Pearson correlation was used for Hardy-Weinberg equilibrium.ResultsThe included population is in Hardy-Weinberg equilibrium. There was no significant association between SNP and the risk of BPH by correlation analysis. However, 4 haplotypes (TCTGGT, TCTGTC, TGCCTC, and TGTGTC) were identified as risk factors of BPH by haplotype analysis. The SNP rs2853669 is an independent risk factor for smooth muscle type of hyperplasia. Besides, rs2736100, rs10078761, and rs10069690 which are in linkage disequilibrium are associated with the severity of BPH.ConclusionsPolymorphism of the TERT gene determines the different disease development and pathological manifestations of BPH in the Chinese Han population the Northwest region.     

Gender Variance in Children and Adolescents with Neurodevelopmental and Psychiatric Conditions from Australia

Archives of Sexual Behavior - Gender variance is a broad term used to describe gender non-conforming behaviors. Past studies have used the parental response to Child Behavior Checklist (CBCL) Item...