子宫结合带的调节因素与相关疾病

子宫结合带（JZ）是MRI上显示的子宫壁正常结构,JZ在MRI上呈低信号。妊娠期以外的子宫结合带是依赖雌激素的周期性调控来控制子宫的收缩运动的,除此之外,许多生物因子都参与了JZ的调节,如CX43、干扰素因子IFNγ、细胞活素和生长因子等。JZ与子宫肌瘤、子宫内膜异位症、子宫腺肌症、妊娠期并发症、不孕、胚胎植入等的发生均有关,其相关研究现在主要聚集在MRI方面的研究,本文综述了子宫结合带的调节因素及相关疾病。     

Occupational voice demands and their impact on the call-centre industry

Background  

Within the last decade there has been a growth in the call-centre industry in the UK, with a growing awareness of the voice as an important tool for successful communication. Occupational voice problems such as occupational dysphonia, in a business which relies on healthy, effective voice as the primary professional communication tool, may threaten working ability and occupational health and safety of workers. While previous studies of telephone call-agents have reported a range of voice symptoms and functional vocal health problems, there have been no studies investigating the use and impact of vocal performance in the communication industry within the UK. This study aims to address a significant gap in the evidence-base of occupational health and safety research. The objectives of the study are: 1. to investigate the work context and vocal communication demands for call-agents; 2. to evaluate call-agents' vocal health, awareness and performance; and 3. to identify key risks and training needs for employees and employers within call-centres.     

Selective effects of CPAP on sleep apnoea-associated manifestations

Background   Visceral adiposity and obstructive sleep apnoea (OSA) may be independently associated with daytime sleepiness/low performance, insulin resistance, hypercytokinaemia, and/or hypertension. The objectives of this study are to simultaneously test these associations at baseline and after 3 months of continuous positive airway pressure (CPAP) therapy.
Materials and methods   Sixteen obese men with OSA; 13 non-apnoeic, obese controls, and 15 non-obese controls were monitored in the sleep laboratory for four consecutive nights. Objective measures of daytime sleepiness and performance, serial 24 h plasma measures of interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), TNF receptor 1 (TNF-r1) and adiponectin, fasting blood glucose and insulin, visceral adiposity and blood pressure were obtained. Sleep apnoeics were re-assessed using the same protocol after 3 months of CPAP.
Results   At baseline, IL-6, TNF-r1, and insulin resistance were highest in OSA patients, intermediate in obese controls, and lowest in non-obese controls ( P  < 0·05). Visceral fat was significantly greater in sleep apnoeics than obese controls and predicted insulin resistance and IL-6 levels, whereas OSA predicted TNF-r1 levels ( P  < 0·05). CPAP decreased daytime sleepiness and blood pressure ( P  < 0·05), but did not affect fasting glucose or insulin or around the clock adiponectin, IL-6, TNF-α, or TNF-r1 levels.
Conclusions   In obese sleep apnoeics, visceral fat is strongly associated with insulin resistance and inflammation. CPAP decreases sleepiness and moderates hypertension but does not affect visceral adiposity, insulin resistance, hypoadiponectinaemia or hypercytokinaemia, all of which are independent risk factors for cardiovascular disease and diabetes.     

西安市50岁以上居民食物频率问卷准确性及重现性研究

目的对用于评价西安城区居民膳食营养状况的西安食物频率问卷(FFQ)的重现性和准确性进行食物组的研究。方法在西安城区随机抽取出125名50～80岁当地居民,共完成6轮的食物摄入情况的调查,其中4轮24小时膳食回顾调查(24HDRs)的结果作为参考,通过第一轮FFQ结果与第二轮FFQ以及4轮24HDRs结果之间的比较分别进行FFQ的重现性和准确性研究。结果各个食物组在两轮FFQ间的Spearman相关系数在0.38(糕点类)～0.74(茶类)。第二轮FFQ与4轮24HDRs均值间的相关系数在0.12～0.74之间,经过个体内方差校正后,相关系数均有所提高。结论西安食物频率问卷可以相对准确、可靠地评价西安城区50岁以上居民的膳食营养状况。     

直视下尿道内切开术的再认识

目的：观察直视下尿道内切开术（DVIU）的长期疗效,重新评价DVIU的临床应用价值。方法：回顾性分析2003年1月～2007年1月收治的65例尿道狭窄或闭锁患者行DVIU及术后随访的临床资料：狭窄长度0．5～2．0cm,平均1．2cm。其中≤1．0cm者25例,1．1～2．0cm者40例。30例行尿道超声检查测量尿道瘢痕厚度,其中瘢痕厚度≤1cm者10例,〉1cm者20例,瘢痕长度和厚度均≤1cm者9例。结果：65例共行DVIU72例次,72例次内切开手术均获得成功。63例获得随访,随访时间24～60个月,平均40．5个月。48例（76．2％）因狭窄复发而最终接受开放手术。尿道超声显示瘢痕厚度≤1cm的10例中,只有1例接受手术;瘢痕厚度〉1cm的20例中,18例接受手术;瘢痕长度和厚度均≤1cm的9例均未行手术。结论：DVIU适合于狭窄段和瘢痕厚度均〈1cm的患者,切开次数以1次为宜,手术疗效与严格掌握适应证密切相关。     

尿道狭窄患者围手术期尿液TGF-β1变化的分析研究

目的:探讨尿道狭窄患者围手术期尿液TGF-β1浓度变化情况以及影响该浓度的相关因素.方法:使用ELISA试剂盒对29例尿道狭窄患者术前1个月及术后1个月尿液中TGF-β1进行测定及记录.同期取泌尿系统其他手术的14例患者作为对照组,测定其术后1个月尿液中TGF-β1浓度.结果:检测结果显示实验组在接受手术治疗后尿液中TGF-β1含最较对照组有显著增高(P＜0.05).同时实验组患者术前和术后尿液TGF-β1浓度也存在明显差异(P＜0.05).在相关性因素的分析中,前尿道狭窄患者术后尿液中TGF-β1含量的变化幅度较后尿道狭窄患者更为显著(P＜0.05),同时采用自体组织替代技术较传统端端吻合技术以及内镜切开技术更能引起尿液中TGF-β1的明显变化(P＜0.05).但年龄、既往手术次数均未能引起患者术后TGF-β1的变化.结论:狭窄部位、手术方式都与患者尿液中 TGF-β1的含量存在一定的联系,而年龄及既往手术史等因素未发现与患者体内TGF-β1含量有较大的联系.     

Utilization of supplemental iron by premature infants fed fortified human milk

We measured red blood cell iron incorporation (RBC-inc) in 13 human milk-fed premature infants (birthweight 1037 +/- 289 g, gestational age 27 +/- 2 wk, weight at start of study 1571 +/- 426 g) who were receiving full tube-feedings of human milk fortified with a commercial human milk fortifier (FortHM). The relative RBC-inc of supplemental iron (2 mg/kg/d of ferrous sulfate) was assessed using 57Fe sulfate mixed directly into a 24-h volume of FortHM, and 54Fe sulfate given as a bolus between two FortHM feedings the next day. RBC-inc was similar between the two methods of supplemental iron administration (4.7 +/- 2.5% vs 4.6 +/- 1.5%, respectively). Although these values are lower than RBC-inc expected from iron native to human milk, the relatively large amount of iron in the supplements contributed most of the iron incorporated into RBC by the infants. There was a significant positive correlation between the reticulocyte count and RBC-inc. As the high nutrient (especially calcium) content of the FortHM did not interfere with iron utilization, adding iron directly to FortHM, or incorporating it into commercial fortifiers, may be a practical method to provide iron to premature infants.     

The Immunohistochemical Analysis of RCAS1, HLA‐G,and B7H4‐Positive Macrophages in Partial and Complete Hydatidiform Mole in Both Applied Therapeutic Surgery and Surgery Followed by Chemotherapy

Citation Basta P, Galazka K, Mach P, Jozwicki W, Walentowicz M, Wicherek L. The immunohistochemical analysis of RCAS1, HLA‐G, and B7H4‐positive macrophages in partial and complete hydatidiform mole in both applied therapeutic surgery and surgery followed by chemotherapy. Am J Reprod Immunol 2011; 65: 164–172 Introduction The suppressive microenvironment developing around the implantating ovum in normal pregnant women may correlate with the development in cancer patients of a suppressive microenvironment of neoplasmatic cells derived from trophoblasts, such as occurs in molar lesions. Macrophages are suitable candidates for mediating not only the balance of the maternal defensive immune responses to external antigens, but also a tolerance to tumor cells. The aim of our study has been to gain information about the expression of RCAS1, B7H4, and HLA‐G within the macrophages present in the microenvironment of the molar lesion. Methods We analyzed the immunoreactivity of such antigens as B7H4, RCAS1, and HLA‐G on the macrophages present in tissue samples derived from patients on whom curettage was performed after a diagnosis of molar pregnancy. These patients were then divided into two subgroups according to whether or not they required chemotherapy after the surgical procedure. Results We observed a statistically significant increase in the RCAS1‐positive macrophage infiltration within the microenvironment of the molar lesions in patients with partial hydatidiform mole in comparison with those patients who exhibited complete hydatidiform mole. There were no such differences, however, in the infiltration of HLA‐G‐ and B7H4‐positive macrophages between the two groups of patients. Additionally, we showed that RCAS1‐ and HLA‐G‐positive macrophages are more distinct in those cases of complete molar pregnancy where chemotherapy was necessary after surgical treatment while no such differences with respect to B7H4‐positive macrophages were observed. Conclusion The immune‐suppressive endometrial microenvironment represented by suppressive macrophages may have an influence on the clinical course of hydatidiform mole.