影响妇幼卫生服务提供的因素分析

目的:对“计划生育/生殖健康“项目资料进行分析,以探讨妇幼卫生服务提供的主要影响因素,为改善妇幼卫生服务提供依据.方法:资料来源于“生殖健康/计划生育“项目终期评估,统计方法采用主成分分析法分析资料.结果:将原始资料经过处理,建立指标体系;运用主成分分析法从18个指标中提取了6个主成分,方差累积贡献率为79.66%.影响妇幼卫生服务提供的因素主要有产后访视率、住院分娩率、高危孕产妇住院分娩率、卫技人员占全院人数的比例等.结论:运用主成分分析,可综合反映影响妇幼卫生服务提供的因素.     

Immune Dysregulation Is Associated with Neurodevelopment and Neurocognitive Performance in HIV Pediatric Populations—A Scoping Review

HIV-1 is known for its complex interaction with the dysregulated immune system and is responsible for the development of neurocognitive deficits and neurodevelopmental delays in pediatric HIV populations. Considering that HIV-1-induced immune dysregulation and its association with neurodevelopmental and neurocognitive impairments in pediatric populations are not well understood, we conducted a scoping review on this topic. The study aimed to systematically review the association of blood and cerebrospinal fluid (CSF) immune markers with neurocognitive deficits and neurodevelopmental delays in pediatric HIV populations. PubMed, Scopus, and Web of Science databases were searched using a search protocol designed specifically for this study. Studies were selected based on a set eligibility criterion. Titles, abstracts, and full texts were assessed by two independent reviewers. Data from the selected studies were extracted and analyzed by two independent reviewers. Seven studies were considered eligible for use in this context, which included four cross-sectional and three longitudinal studies. An average of 130 (±70.61) children living with HIV, 138 (±65.37) children exposed to HIV but uninfected and 90 (±86.66) HIV-negative participants were included across the seven studies. Results indicate that blood and CSF immune markers are associated with neurocognitive development/performance in pediatric HIV populations. Only seven studies met the inclusion criteria, therefore, these limited the number of significant conclusions which could have been made by using such an approach. All considered, the evidence suggests that immune dysregulation, as in the case of adult HIV populations, also has a significant association with neurocognitive performance in pediatric HIV populations.     

On-Demand Hydrogen Generation by the Hydrolysis of Ball-Milled Aluminum–Bismuth–Zinc Composites

In this investigation, ternary Al-Bi-Zn composites were prepared through mechanochemical activation to determine the combined effects of low-cost Bi and Zn on the morphology change and reactivity of the Al composite during the hydrolysis reaction. Specifically, Zn was considered as a means to slow the hydrogen generation rate while preserving a high hydrogen yield. A steady hydrogen generation rate is preferred when coupled with a proton exchange membrane fuel cell (PEMFC). Scanning electron microscopy (SEM) analysis indicated that Bi and Zn were distributed relatively uniformly in Al particles. By doing so, galvanic coupling between anodic Al and the cathodic Bi/Zn sustains the hydrolysis reaction until the entire Al particle is consumed. X-ray diffraction analysis (XRD) showed no intermetallic phases between Al, Bi, and/or Zn formed. A composite containing 7.5 wt% Bi and 2.5 wt% Zn had a hydrogen yield of 99.5%, which was completed after approximately 2300 s. It was further found that the water quality used during hydrolysis could further slow the hydrogen generation rate.     

HLA alleles and sustained peanut consumption promote IgG4 responses in subjects protected from peanut allergy

We investigated the interplay between genetics and oral peanut protein exposure in the determination of the immunological response to peanut using the targeted intervention in the LEAP clinical trial. We identified an association between peanut-specific IgG4 and HLA-DQA1*01:02 that was only observed in the presence of sustained oral peanut protein exposure. The association between IgG4 and HLA-DQA1*01:02 was driven by IgG4 specific for the Ara h 2 component. Once peanut consumption ceased, the association between IgG4-specific Ara h 2 and HLA-DQA1*01:02 was attenuated. The association was validated by observing expanded IgG4-specific epitopes in people who carried HLA-DQA1*01:02. Notably, we confirmed the previously reported associations with HLA-DQA1*01:02 and peanut allergy risk in the absence of oral peanut protein exposure. Interaction between HLA and presence or absence of exposure to peanut in an allergen- and epitope-specific manner implicates a mechanism of antigen recognition that is fundamental to driving immune responses related to allergy risk or protection.     

Different cytokine profiles in cryptogenic fibrosing alveolitis and fibrosing alveolitis associated with systemic sclerosis: a quantitative study of open lung biopsies.

Differences in the inflammatory response and prognosis of cryptogenic fibrosing alveolitis (CFA) and that associated with systemic sclerosis (FASSc) are beginning to emerge. It is hypothesized that these differences may be reflected in a distinct pattern of T-helper (Th)-1 and Th-2-type cytokines. Open lung biopsies were obtained from clinically well-documented cases of CFA and FASSc and, as a control, compared with grossly and histologically normal parenchyma obtained from smokers whose lungs were resected for cancer (n=5 in each group). In situ hybridization (ISH) was applied to the samples using anti-sense and sense 35S-labelled riboprobes to detect messenger ribonucleic acid (mRNA) for interleukins (IL)-2, IL-4, IL-5 and interferon (IFN)-gamma. Between 52-91% of cells expressing the cytokines studied were present in the alveolar interstitium rather than in lumenal cells or the alveolar epithelial lining. The highest values for all four cytokines were present in the patients with FASSc, i.e., 22-39 ISH positive cells x mm(-2) alveolar tissue compared with 1-19 cells x mm(-2) and 4-5 cell x mm(-2) in CFA and control subjects, respectively. Whereas the proportions of the four cytokines in FASSc were similar to the control subjects, IL-4 and IL-5 predominated significantly in CFA (p<0.001). For example, the ratio of IL-5 to IFN-gamma was 22:1 in CFA, significantly higher than in the cases with FASSc (2:1) or the control subjects (4:1) (p<0.05). In conclusion, cryptogenic fibrosing alveolitis is an inflammatory condition which is characterized, like asthma, by a predominance of gene expression for T-helper-2-type regulatory cytokines, whereas cryptogenic fibrosing alveolitis associated with systemic sclerosis appears to have a distinct mixed T-helper-1/T-helper-2 functional phenotype and a greater number of cells expressing each of these pro-inflammatory cytokines.     

Hydrocephalus associated with glycogen storage disease type II (Pompe's disease).

The authors describe a case of hydrocephalus in an 8-month, 2-week-old infant who had been previously diagnosed with glycogen storage disease type II. Cranial imaging revealed no evidence of obstruction within the ventricular system. This case adds to the central nervous system complications associated with this disorder. Several possible mechanisms for the hydrocephalus observed in this infant are discussed.     

羽毛作业工人变应疾病诊断结果评价

为探讨职业性接触羽毛尘引起变应性疾病的诊断方法 ,对 12 5名接尘工人和 97名非接尘人员作了流行病学调查 ,以 3种抗原皮内试验 ,结合血清 Ig E测定 ,进行变应性疾病的诊断。采用卡方检验 ,相关分析结果显示 ,接尘组变应疾病的发病率显著高于对照组 (P<0 .0 1) ,其中 ,变应性支气管炎与变应性眼结膜炎的发生与接尘时间及粉尘浓度呈正相关 (P<0 .0 1和 P<0 .0 5 )。认为职业性接触羽毛尘所损害的靶器官 ,主要为呼吸系统的变态反应。皮肤试验可做为职业性变应疾病的诊断指标。     

Mechanisms of brain injury during infant cardiac surgery

Neurological injury is a major and often debilitating complication of congenital heart disease and open-heart surgery. Paradoxically, the full impact of this complication has been underscored by the marked decrease in mortality and the rescue of infants with desperate and previously lethal heart conditions. Although recent focus has been on mechanisms of brain injury originating during open-heart surgery, this article also emphasizes the importance of mechanisms initiated or perpetuated during the preoperative and postoperative periods. In addition to the usually implicated mechanism of hypoxia-ischemia, recent genetic advances suggest an important role for genetic deletion syndromes. Inflammatory cascades have been implicated in the end-organ injury seen after cardiopulmonary bypass and might play a role in neurological dysfunction. These mechanisms are reviewed, with an emphasis on recent developments in our understanding of brain injury in this population.