国外个人健康信息安全与隐私保护法制建设及启示

随着信息技术的快速发展,个人健康信息安全与隐私保护所面临的严峻挑战已成为卫生信息化建设中亟待解决的重要议题。欧美等部分发达国家均十分关注个人健康信息的安全与隐私保护,相继制定了一系列相关的法律法规以规范个人健康信息的存储、传输和利用。通过介绍国外个人健康信息安全与隐私保护法制建设情况,为我国个人健康信息安全与隐私保护法律的制定提供借鉴作用。     

SPINK1 contributes to proliferation and clonal formation of HT29 cells through Beclin1 associated enhanced autophagy

We aimed to explore the molecular mechanism that were involved in SPINK1-induced proliferation and clonogenic survival of human colorectal carcinoma (CRC) HT29 cells. Initially, we generated HT29 cells either permanently silencing or overexpressing SPINK1 protein. The results showed that SPINK1 overexpression (OE) significantly stimulated the proliferation and clonal formation of HT29 cells at the varied time points. Secondly, we found SPINK1 OE enhanced the ratio of LC3II/LC3I and the level of autophagy-related gene 5 (ATG5), whereas SPINK1 knockdown (Kd) reversed the above outcome under normal culturing and/or fasting condition in the cells, indicating its role in autophagy enhancement. Moreover, LC3-GFP-transfected SPINK1-OE HT29 cells strengthened the fluorescence intensity compared with the untransfected control. Chloroquine (CQ) significantly decreased the level of autophagy in both control and SPINK1-OE HT29 cells. The autophagy inhibitors, CQ and 3-Methyladenine (3-MA), remarkably inhibited the proliferation and colony formation of SPINK1-OE HT29 cells, while ATG5 upregulation resulted in the growth of the cells, suggesting the important function of autophagy in cell’s growth. Thirdly, SPINK1-induced autophagy was independently of mTOR signaling as p-RPS6 and p-4EBP1 were activated in SPINK1-OE HT29 cells. Instead, Beclin1 up and down regulation were clearly observed in SPINK1-OE and SPINK1 Kd HT29 cells, respectively. Moreover, Beclin1 silencing apparently reduced autophagy in SPINK1-OE HT29 cells, indicating that SPINK1-induced autophagy was closely associated with Beclin1. Collectively, SPINK1-promoted proliferation and clonal formation of HT29 cells were closely associated with Beclin1 associated enhanced autophagy. The above findings would open a new window for probing the role of SPINK1-related autophagic signaling in the pathogenesis of CRC.     

纳米炭在甲状腺乳头状癌淋巴结清扫中的价值及对术后甲状旁腺激素的影响

目的　探讨纳米炭在甲状腺乳头状癌淋巴结清扫中的价值及对术后甲状旁腺激素的影响。方法　回顾性收集2017年1月~2018年12月北京市平谷区医院收治的甲状腺乳头状癌需行甲状腺全切除手术的216例患者临床资料,根据患者术式分为纳米炭组112例和对照组104例。两组患者均接受甲状腺全切除手术及双侧中央淋巴区清扫,纳米炭组在术中接受纳米炭混悬液注射,对照组接受常规手术。对中央区清扫组织进行病理检查,统计两组检出淋巴结总数、淋巴结转移率、甲状旁腺显露数、甲状旁腺误切数、术后血钙和甲状旁腺激素水平,并记录术后并发症发生情况。术后随访1年。结果　纳米炭组检出淋巴结2150枚,每例检出（9.59±2.42）枚;对照组检出1659枚,每例检出（7.98±2.18）枚,纳米炭组淋巴结检出显著高于对照组（P＜0.05）。纳米炭组转移淋巴结为923枚,每例转移（4.12±1.02）枚;对照组转移淋巴结为733枚,每例转移（3.52±0.94）枚,纳米炭组转移淋巴结检出明显高于对照组（P＜0.05）。纳米炭组黑染淋巴结2045枚,总染黑率为95.12%;黑染转移淋巴结2016枚,黑染淋巴结总转移率为93.77%。纳米炭组有2例患者清扫淋巴组织病理检查中发现甲状旁腺组织,误切率为1.79%;对照组有10例患者淋巴组织中发现甲状旁腺组织,误切率为9.62%,纳米炭组甲状旁腺误切率显著低于对照组（P＜0.05）。两组患者术前血钙和血甲状旁腺激素水平相当（P＞0.05）;纳米炭组手术前后血钙和血甲状旁腺激素水平无明显变化（P＞0.05）;术后3天,对照组患者血钙和甲状旁腺激素水平显著低于术前（P＜0.05）,且均显著低于纳米炭组（P＜0.05）。术后1个月、3个月两组患者的血钙和血甲状旁腺激素水平均恢复至术前正常水平（P＞0.05）。两组患者均未出现永久性并发症,暂时性喉上神经损伤、喉返神经损伤、低钙血症的发生率相当,无显著差异（P 均＞0.05）,纳米炭组暂时性甲状旁腺功能减低发生率显著低于对照组（P＜0.05）。结论　纳米炭有助于在甲状腺乳头状癌中央区淋巴结清扫术中提高转移淋巴结检出,并能够保护甲状旁腺,降低手术对甲状旁腺激素水平的影响。     

医技人员国货意识、消费行为倾向与国产医疗器械使用意愿关系调查研究

目的通过对辽宁省医疗器械医生的调查,实证定量分析该群体国产医疗器械的使用意愿、消费行为倾向以及国货意识之间的关系,填补该领域的空白。方法对辽宁省9个示范区的医疗器械操作医生进行问卷调查,共回收有效问卷1092份,运用SPSS 23.0统计软件整理、分析数据。结果医疗器械操作医生不同类别国产器械选择意愿在10%~20%,低端设备高于高端设备,基层医疗机构高于二、三级医院。国货意识评分为(5.29±1.53)分,二级医院高于其他级别医院。国产器械消费倾向评分为(10.39±3.19)分,其中品牌维度为(2.72±1.67)分,溢价维度为(2.90±1.71)分,重购倾向维度为(4.76±1.62)分,农村高于城市,随职称升高而降低,大专学历高于其他学历,随着医院级别降低而升高。国货意识总分与消费行为倾向总分无显著相关。器械医生选择国产器械使用意愿与消费行为倾向评分相一致,选择国产器械的医生国产器械行为倾向评分高于选择进口。选择进口心电图机的国货意识显著低于选择国产品牌的医生。结论本研究在国内首次调查了医疗器械操作医生国货意识、消费行为倾向以及国产医疗器械使用意愿的水平和之间的关系,表明国产器械要占领国内市场并走向世界,既要提升产品质量和服务,也需要培养国民国货意识,形成支持、利用的政策环境和消费环境。     

身体活动、静坐行为的时间分布与肥胖的关系

目的 综合探究乌海市成年居民身体活动(physical activity, PA)、静坐行为(sedentary behavior, SB)的时间分布与肥胖的关系。方法 采用多阶段整群随机抽样,以乌海市18~79岁常住居民为研究对象进行横断面调查。通过问卷调查、体格检查收集研究对象的社会人口学信息、PA和SB时间、饮食摄入、慢性病控制情况、身高、体质量、腰围及其他协变量。成分线性回归分析PA、SB的时间分布与肥胖的关系,以及时间重新分配后对肥胖的影响。结果 成分线性回归结果显示,控制混杂因素后,职业与非职业人群PA、SB的时间占比与体重指数(body mass index, BMI)、腰围身高比(waist to height ratio, WHtR)的负自然对数(-lnWHtR)的关系均有统计学意义(P均<0.001)。职业人群中,中高强度PA的时间占比与-lnWHtR呈负相关(β=-0.008, P=0.022),而SB时间占比与BMI、-lnWHtR呈正相关(β=0.117, P=0.003; β=0.007, P=0.005)。非职业人群中,中高强度PA的时间占比与BMI呈负相关(β=-0.079, P=0.041)。职业与非职业人群中,低强度PA的时间占比与BMI、-lnWHtR 关系无统计学意义。时间重新分配结果显示,10 min的中高强度PA代替低强度PA和SB对肥胖的影响更大。结论 在运动指南的制定以及健康管理的实践中,综合考虑不同人群PA、SB的时间分布对健康的影响,而非简单地增减PA或SB的绝对时间,将取得更长远的健康效果。     

FAAS法测定钙尔奇小添佳咀嚼片中钙、铁、锌和铜的含量

目的建立钙尔奇小添佳咀嚼片中钙、铁、锌、铜的含量测定方法。方法用硝酸和过氧化氢微波消解样品,火焰原子吸收标准曲线法测定钙、铁、锌、铜4种元素含量。结果钙、铁、锌、铜4种元素的回收率在97.0%¹02.5%之间;RSD≤2.5%(n=5)。结论实验建立的方法快速、简便,结果准确,适用于钙尔奇小添佳咀嚼片中钙、铁、锌、铜的含量测定。     

医学生物化学实验教学方法的探讨

医学生物化学是医药学各专业的必修课程,其中理论教学非常重要,实验教学也是教学的重要组成部分.实验教学的质量是用来衡量学生掌握医学生物化学理论知识的一个指标,在实验教学中,教师通过改进实验教学方法和手段、设计新型实验和完善考核体系等充分发挥教学的主导作用;同时教师在教学中要增加与学生互动交流、培养学生的学习兴趣和创新意识,进而使学生发挥教学的主体作用.     

Fresh embryo transfer versus freeze-only after in vitro maturation with a pre-maturation step in women with high antral follicle count: a randomized controlled pilot study

Journal of Assisted Reproduction and Genetics - In vitro maturation (IVM) is an alternative to in vitro fertilization (IVF) for women at high risk of developing ovarian hyperstimulation syndrome...     

Intravenous parecoxib sodium as an analgesic alternative to morphine in acute trauma pain in the emergency department

Background

Parecoxib sodium is the first parenteral COX-2 inhibitor used for pain management licensed for postoperative pain. However, no study has assessed the usage of parecoxib for acute traumatic pain in the emergency department (ED). The objective of this study was to investigate a potential alternative analgesic agent in the ED by determining the mean reduction of pain score between acute traumatic pain patients who were administered with intravenous (IV) parecoxib sodium versus IV morphine sulfate. The onset of perceptible analgesic effect and side effects were also evaluated.

Methods

A randomized, double-blinded study comparing IV parecoxib 40 mg versus IV morphine at 0.10 mg/kg was conducted in adult patients presented with acute traumatic pain with numeric rating scale (NRS) of 6 or more within 6 hours of injury. Patients were randomized using a computer-generated randomization plan. Drug preparation and dispensing were performed by a pharmacist. Periodic assessment of blood pressure, pulse rate, oxygen saturation, and NRS were taken at 0, 5, 15, and 30 minute intervals after the administration of the study drug. The primary outcome was the reduction of NRS. Side effect and drug evaluation was conducted within 30 minutes of drug administration.

Results

There was no statistically significant difference in the reduction of mean NRS between patients in the IV parecoxib group or IV morphine group (P?=?0.095). The mean NRS for patients treated with IV morphine were 7.1 at 0 minutes, 4.5 at 5 minutes, 3.1 at 15 minutes, and 2.0 at 30 minutes. Whereas mean NRS for patients who received IV parecoxib were 7.8 at 0 minutes, 5.7 at 5 minutes, 4.7 at 15 minutes, and 3.9 at 30 minutes. The onset of perceptible analgesic effects could be seen as early as 5 minutes. Dizziness was experienced in 42.9% of patients who received IV morphine compared to none in the parecoxib group.

Conclusions

There was non-significant trend toward superiority of IV morphine over IV parecoxib. Looking at its effectiveness and the lack of opioid-related side-effects, the usage of IV parecoxib sodium may be extended further to a variety of cases in the ED.