NAFLD患者肝功能与血脂的相关性研究

目的:探讨非酒精性脂肪肝性肝病(NAFLD)患者肝功能与血脂间的关系。方法:选取某医院健康体检人群中NAFLD患者116例,对照组94例,测量身高、体重,计算体质指数;检查血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酸转移酶(GGT)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C),并进行对比分析。结果:NAFLD组ALT、AST、GGT及TG均高于对照组,而HDL-C则低于对照组,差异有统计学意义(P<0.01,P<0.05),Pearson相关分析结果显示:ALT、AST分别与TG呈正相关,与HDL-C呈负相关(相关系数r依次为0.423、0.324、-0.328、-0.282,P<0.01)。结论:NAFLD患者肝功能损害与脂代谢紊乱尤其是高TG血症及低HDL-C血症存在一定的相关性。     

Heart failure and orthostatic hypotension

Orthostatic hypotension (OH) is traditionally defined as a fall of ≥20 mmHg in systolic and/or ≥10 mmHg in diastolic blood pressure within 3 min of active standing. OH is a common comorbidity among patients with heart failure (HF). A comprehensive review regarding the relationship between OH and HF has not been published in the English literature. Here we provide current information about concomitant HF and OH, including: pathophysiology, methods of evaluation, prevalence, risk factors, prognosis and management of OH in HF patients, as well as the incidence of HF among patients with OH. The prevalence of OH in HF ranges from 8 % among community-living individuals to 83 % in elderly hospitalized patients. Dizziness and palpitations are the most frequent OH symptoms. Main predisposing factors for OH are HF severity, non-ischemic HF etiology, prolonged bed rest, hypertension and polypharmacy. OH in HF is generally managed according to recommendations for treatment of OH in the non-HF population. However, since acceptable pharmacotherapy with fludrocortisone and midodrine is problematic in HF due to adverse effects, the management of OH is based mainly on non-pharmacologic interventions. Several prospective epidemiological studies reported that OH is independently associated with an increased risk of developing HF. Since OH is a common and frequently symptomatic condition in HF patients, its clinical implications should be emphasized. Longitudinal studies should be conducted to investigate the prognostic significance and optimal management of OH in the HF population.     

甘肃省卫生资源配置状况综合评价研究

目的：了解甘肃省2009年14个地市州医疗卫生资源配置与利用情况,为甘肃省区域卫生规划提供基础数据。方法：结合该省资源配置标准描述医疗卫生资源配置的数量状况,利用基尼系数分析其公平性。结果：该省医疗卫生资源结构不太合理,区域间不平衡,没有按照地域进行配置卫生资源。结论：各级政府应该按照资源配置标准和居民卫生服务需求调整卫生资源的数量和结构,优化配置各种卫生资源,使有限的卫生资源得到最大程度的利用。     

国外食品安全质量监管模式对我国的启示

通过比较分析美国、英国、法国、欧盟、加拿大、日本等国家食品质量安全法律体系和配套的管理监督体系,提出我国的食品安全质量监管应从健全和完善食品安全法规、条例和标准,加快推行并完善食品安全质量管理体系,建立国家食品安全监测和预警系统,建立食品安全信息发布和食品安全事件通报处理制度,提高食品安全领域的科技水平和人才队伍建设等方面进行改进。     

Bone age in the 21st century: is Greulich and Pyle’s atlas accurate for Israeli children?

Background  

The applicability today of Greulich and Pyle's Radiographic Atlas of Skeletal Development of the Hand and Wrist (G&P) is uncertain.     

Does bariatric surgery improve ovarian stimulation characteristics,oocyte yield,or embryo quality?

Background

Obesity is a major global health concern associated with multiple co-morbidities. Bariatric surgery has been considered a good treatment option in cases of morbid obesity. This preliminary study aims to investigate the effect of bariatric surgery on ovarian stimulation characteristics and IVF treatment cycle outcome.

Methods

A retrospective study that was performed in a tertiary, university-affiliated medical center and included all patients who underwent IVF treatment both before and after bariatric surgery. Data on ovarian stimulation variables of IVF treatment cycle prior and following the bariatric surgery were reviewed and compared.

Results

From January 2005 to June 2014, seven women fulfilled the inclusion criteria. After the operation, BMI was significantly reduced (mean?±?SD) (43.1?±?3.3 vs. 29.6?±?7.33, p?=?0.018), as was the number of gonadotropin ampoules required during stimulation (69.3?±?10.5 vs. 44.5?±?17, p?=?0.043). No between-cycle differences were observed in peak estradiol level, the number of oocytes retrieved, and percentage of mature oocytes.

Conclusions

To the best of our knowledge, this preliminary case series is the first comparison of IVF cycle characteristics prior to and following bariatric surgery. The operation seems to reduce treatment costs without affecting oocyte or embryo quality. Further large studies are required to establish the surgery’s effect on IVF outcome among infertile women.

     

Interleukin-2 and SOCS-1 proteins involvement in the pathophysiology of severe ovarian hyperstimulation syndrome-a preliminary proof of concept

Background

Ovarian hyperstimulation syndrome (OHSS), is characterized by marked ovarian enlargement and acute third space fluid sequestration that almost always develops after hCG administration or in early pregnancy. OHSS is similar to vascular leak syndrome (VLS), which may be attributable to the massive increase in systemic inflammatory cytokines. In the present pilot exploratory case series, we sought to evaluate interleukin (IL)-2 and suppressor of cytokine signaling (SOCS)-1 expressions in the peripheral blood mononuclear cells (PBMCs) of patients suffering from severe ovarian hypertimulation syndrome (OHSS), and to examine whether their expressions differ when compared to PBMCs originated from normal early pregnant women (without OHSS).

Methods

Interleukin-2 and SOCS-1 mRNA expressions were examined in PBMCs of 5 women who were hospitalized due to severe OHSS (OHSS group) and 5 women with early IVF pregnancies and without OHSS (control group).

Results

Interleukin-2 mRNA levels in PBMCs were significantly higher in the OHSS as compared to the control groups. Moreover, while SOCS-1 mRNA levels were non-significantly lower, the ratio between IL-2 and SOCS-1 mRNA levels was significantly higher in the OHSS, as compared to the control group.

Conclusions

The inflammatory response to hCG, leading to dysregulation of Il-2 expression and SOCS activation, might be the culprit of OHSS. Additional large prospective studies are required to elucidate the effect of hCG on patients’ inherited inflammatory cascades, which may help discriminating those at risk to develop severe OHSS from those who are not.

     

消化性溃疡病人医嘱依从性的行为干预研究

为探讨医嘱依从性在消化性溃疡治疗中的作用,我们对确诊消化性溃疡的病人,进行医嘱依从性研究,尝试用行为干预来提高临床疗效。材料与方法一、随机抽取１９９７年门诊病人１１８例为样本人群,均经胃镜确诊为消化性溃疡,且无并发症和其它重要脏器的病变。二、医嘱依从性评价包括：（１）按医嘱服药;（２）要求病人从治疗开始的第２、４、８周来院复诊;（３）第８周同时复查胃镜等。依随机性原则对样本人群分为：Ａ组４４例,为“常规治疗（无行为干预）组”;Ｂ组３４例,为“常规治疗＋对病人行为干预”;Ｃ组２９例,为“常规治疗＋…     

婴幼儿RDW参考值及对缺铁诊断的探讨

目的 应用ＲＯＷ诊断婴幼儿缺铁。方法 以ＺＰＰ为指标，将不同年龄组的３０６例婴幼儿分为正常组和缺铁组，分别计算ＲＤＷ的分布及敏感性、特异性、ＲＯＣ曲线和拟然比。结果 缺铁和非缺铁之间的ＲＤＷ分布差异具有显著意义，推荐参考值为４２天组〈０．１４８；６月组≤０．１３７；１岁以上≤０．１４０，３个年龄组的阳性拟然比为２．４、５．６、９．１，阴性拟然比为０．６８、０．３９、０．１７。结论 ＲＤＷ对６个月以