社区护理人员开展健康教育的调查分析

目的 通过了解新疆石河子市社区卫生服务机构护理人员开展健康教育的现状,分析影响因素,为社区护士科学有效地开展健康教育提供依据.方法 采用问卷调查,对本市社区卫生服务机构的151名护理人员进行了调查.结果 社区护士普遍开展了健康教育,主要是通过健康咨询的方式宣传健康的生活方式和慢性病的防治知识,护士在健康教育过程中面临的最大困难依次是缺少资金、社区居民观念跟不上和缺少社区护士.结论 社区健康教育的对象主要为服务站的就诊者,内容和形式单一,且不够深入,社区护士缺乏健康教育的理论与技能,在健康教育与健康促进方面没有发挥应有的作用,应引起社区护理管理者的重视,制定切实可行的措施,发挥社区护士在健康教育中的作用.     

肢带型肌营养不良的MRI表现

目的 观察肢带型肌营养不良的MRI表现。方法 回顾性分析7例经临床及病理检查确诊为肢带型肌营养不良患者的MRI资料,观察双侧大腿肌群脂肪沉积与炎性水肿情况,采用4分法进行评价。并进行统计学分析。结果 肢带型肌营养不良患者大腿肌群MRI均可见脂质沉积和炎性水肿性改变。不同肌肉间脂肪沉积(χ²=75.596,P<0.01)与炎性水肿差异均有统计学意义(χ²=41.368,P<0.01),双侧大腿肌群间脂肪沉积与炎性水肿差异均无统计学意义(P均>0.05)。结论 肢带型肌营养不良患者大腿肌群MRI信号特点及分布具有一定特征,MR检查有助于疾病的诊断。     

48例规律透析患者甲状旁腺病理形态分析及8例电镜下超微结构观察

目的 探讨继发性甲状旁腺功能亢进症（secondary hyperparathyroidism,SHPT）患者甲状旁腺组织病理形态改变与甲状旁腺激素水平、透析龄等因素的关系.方法 通过形态学观察比较,研究48例规律透析患者因SHPT切除的甲状旁腺病理学形态特征.结果 甲状旁腺激素水平与增生甲状旁腺的细胞类型无相关性,与患者性别、继发陈旧性出血及钙化程度无相关性（P＞0.05）,48例规律透析患者SHPT （95.8％,46/48）以甲状旁腺结节状增生为主,甲状旁腺继发性出血（70.8％,34/48）及钙化（62.5％,30/48）在SHPT的规律透析患者中广泛存在,透析龄的延长对钙化的程度及范围影响较大（P＜0.05）.电镜下可见增生的甲状旁腺细胞内含丰富的线粒体及核蛋白体.结论 长期规律透析患者形成SHPT时甲状旁腺内钙化灶形成及反复的出血是常见的继发性改变,结节状增生是难治性继发性甲状旁腺增生的病理形态基础.电镜下所见提示增生的甲状旁腺细胞呈高活性状态.     

基因芯片筛选尿道下裂雌激素敏感基因的研究

目的 寻找与尿道下裂发病密切相关的基因,探讨尿道下裂形成机制.方法 ①实验组为12例尿道下裂患儿,年龄6～12个月,平均8个月.尿道下裂中度5例,重度7例.组织标本取自尿道成形手术时切取的尿道板组织.②对照组为6例年龄匹配的男性患儿,留取包皮环切时的正常表皮组织.用Tri-Reagent分别提取总RNA,与含22 000个人类基因的寡核苷酸基因芯片杂交、洗脱、染色、扫描,基因强度变化行方差分析(ANOVA,P＜0.01)和Tukey分析,基因表达强度变化＞2倍作为有意义的基因,比较尿道下裂和正常组织之间基因表达差异.从上调表达的基因中选择雌激素敏感基因行RT-PCR,标本除上述患儿RNA外,再增加年龄配对的3例中度、1例重度尿道下裂和2例年龄配对的RNA作为对照,即对照、中度和重度尿道下裂患者RNA标本各8例,验证芯片结果.结果 尿道下裂组织与正常组织之间存在明显的基因表达差异,共筛选出表达强度变化＞2倍的基因94个,其中中度尿道下裂与正常比较,47个基因上调表达(P＜0.01);重度尿道下裂与正常比较,68个基因上调表达(P＜0.001);重度与中度比较,17个基因上调表达(P＞0.05).上调表达的基因中发现了4个雌激素敏感基因CYR61、结缔组织生长因子、ATF3和GADD45β,基因芯片和RT-PCR均证实其在尿道下裂组织中的表达明显高于正常对照.结论 异常表达的基因与尿道下裂的发生有关,尿道下裂组织中雌激素敏感基因上调表达参与了尿道下裂的发病机制.     

Relative efficacy of phenytoin and phenobarbital for the prevention of theophylline-induced seizures in mice

We evaluated the efficacy of pretreatment with phenytoin and phenobarbital to prevent seizures in mice given convulsive doses of theophylline. The control LD50 for theophylline was determined in 48 mice by intraperitoneal injections of increasing doses without anticonvulsant treatment. Anticonvulsant effects were determined in 105 additional mice pretreated with either phenytoin 30 mg/kg (n = 35), phenobarbital 35 mg/kg (n = 30), or phenobarbital 60 mg/kg (n = 40) one hour before theophylline administration. The theophylline LD50 (95% confidence interval) was 239 mg/kg (range, 229 to 248 mg/kg) for controls, 204 mg/kg (range, 194 to 214 mg/kg) for phenytoin, 305 mg/kg (range, 288 to 323 mg/kg) for low-dose phenobarbital, and 319 mg/kg (range, 307 to 331 mg/kg) for high-dose phenobarbital. Each LD50 differed significantly from control (P less than .05). The phenobarbital groups were significantly different from phenytoin (P less than .05) but not from each other. Theophylline serum concentrations were not significantly different among groups after adjustment for different doses. The mean +/- SEM time to seizure in minutes after adjustment for theophylline dose was 23.5 +/- 4.0 minutes for controls, 5.7 +/- 7.5 minutes for phenytoin, 44.1 +/- 7.1 minutes for low-dose phenobarbital, and 63.7 +/- 6.5 minutes for high-dose phenobarbital.(ABSTRACT TRUNCATED AT 250 WORDS)     

喉鳞状细胞癌中PTEN蛋白表达与微血管密度的相关性

目的 研究喉鳞癌（LSCC）组织中抑癌基因PTEN蛋白（PTEN）的表达与肿瘤微血管密度（MVD）之间的相关性。方法 采用免疫组化SP法检测10例正常喉组织、20例癌旁组织和60例LSCC组织中PTEN基因和MVD的表达情况。结果 PTEN在LSCC、癌旁喉组织及正常组织中阳性表达率分别为70．00％、95．00％、100．00％,差异有显著性（P〈0．01）。LSCC组织中PTEN蛋白表达在TNM分期Ⅰ～Ⅱ期、高中分化癌、无转移、生存率〉3年的患者中表达水平较Ⅲ～Ⅳ期、低分化和有转移、生存率〈3年的患者高,差异有显著性（P〈0．05）。在不同恶性程度、分化程度、预后及有无转移的LSCC组织中,PTEN蛋白表达与MVD呈显著负相关（P〈0．05）。结论 PTEN基因突变和／或缺失可能在LSCC的发生、发展和血管形成中发挥重要作用。PTEN、MVD是反映LSCC生物学行为的重要指标。     

Prevalence of Candida spp., xerostomia,and hyposalivation in oral lichen planus – A controlled study

Objective

To determine the frequency of Candida spp., xerostomia, and salivary flow rate (SFR) in three different groups: patients with OLP (OLP group), patients with oral mucosal lesions other than OLP (non‐OLP group), and subjects without oral mucosal lesions (control group).

Material and methods

Xerostomia as well as SFR was investigated in the three groups. Samples for isolation of Candida spp. were collected from OLP lesions (38 patients), non‐OLP lesions (28 patients), and healthy subjects (32 subjects).

Results

There was no statistically significant difference regarding the frequency of xerostomia and hyposalivation among the three groups (P > 0.05). A higher prevalence for colonization by Candida spp. was found in the healthy subject as compared to that of patients with OLP (P = 0.03) and non‐OLP (P = 0.02) groups. Low SFR was not a factor for colonization by Candida spp.

Conclusions

Xerostomia and hyposalivation occur with similar frequency in subjects with and without oral lesions; also, the presence of oral lesions does not increase the susceptibility to colonization by Candida spp. It seems that any study implicating Candida spp. in the malignant transformation of oral lesions should be carried out mostly on a biochemical basis, that is, by testing the capability of Candida spp. to produce carcinogenic enzyme.     

Molar incisor hypomineralization: prevalence,severity and clinical consequences in Brazilian children

International Journal of Paediatric Dentistry 2010; 20: 426–434 Background. The prevalence of molar incisor hypomineralization (MIH) varies considerably around the world; however, few studies have examined MIH in South American countries. Objective. To evaluate the prevalence, severity, and clinical consequences of MIH in Brazilian children residing in rural and urban areas of the municipality of Botelhos, Minas Gerais, Brazil. Methods. Children aged 6 to 12 years (n = 918) with all four‐first permanent molars erupted had these teeth evaluated according to the European Academy of Paediatric Dentistry (EAPD) criteria. The examinations were conducted by two previously trained examiners, and the dental impact caused by MIH was evaluated with the Decayed, Missing and Filled Teeth (DMFT) index (WHO). Results. Molar incisor hypomineralization was present in 19.8% of the 918 children, with a higher prevalence in rural areas. The majority of the defects presented were demarcated opacities without post‐eruptive structural loss, which has been considered as mild defects. Children with MIH had higher DMFT values. Conclusion. Despite the high prevalence of MIH, the severity of the defects was mild. The results indicate a positive association between MIH and the presence of dental caries.     

Loss of function,missense, and intronic variants in NOTCH1 confer different risks for left ventricular outflow tract obstructive heart defects in two European cohorts

Loss of function variants in NOTCH1 cause left ventricular outflow tract obstructive defects (LVOTO). However, the risk conferred by rare and noncoding variants in NOTCH1 for LVOTO remains largely uncharacterized. In a cohort of 49 families affected by hypoplastic left heart syndrome, a severe form of LVOTO, we discovered predicted loss of function NOTCH1 variants in 6% of individuals. Rare or low-frequency missense variants were found in 16% of families. To make a quantitative estimate of the genetic risk posed by variants in NOTCH1 for LVOTO, we studied associations of 400 coding and noncoding variants in NOTCH1 in 1,085 cases and 332,788 controls from the UK Biobank. Two rare intronic variants in strong linkage disequilibrium displayed significant association with risk for LVOTO amongst European-ancestry individuals. This result was replicated in an independent analysis of 210 cases and 68,762 controls of non-European and mixed ancestry. In conclusion, carrying rare predicted loss of function variants in NOTCH1 confer significant risk for LVOTO. In addition, the two intronic variants seem to be associated with an increased risk for these defects. Our approach demonstrates the utility of population-based data sets in quantifying the specific risk of individual variants for disease-related phenotypes.