A rare case of unicondylar medial Hoffa fracture associated with ipsilateral vertical patella fracture

An 18 year old male patient was hit by a car to his motorcycle causing a unicondylar Hoffa fracture and an ipsilateral patella fracture. Hoffa fracture is a rare lesion and this association of injury has not been reported before.     

High perceived social standing is associated with better health in HIV-infected Ugandan adults on highly active antiretroviral therapy

Perceived social standing (PSS) was evaluated as a determinant of differences in health outcomes among Ugandan HIV-infected adults from Kampala using cross-sectional study design. PSS was defined using the MacArthur scale of subjective social status translated and adapted for the study setting. Socio-demographic and psychosocial correlates of PSS ranking at enrollment were determined using linear regression models. High versus low PSS was defined based on the median PSS score and evaluated as a determinant of body mass index, hemoglobin, quality of life (QOL) and frailty-related phenotype via linear regression. A log-binomial regression model estimated the relative-risk of good, very good or excellent versus fair or poor self-rated health (SRH) in relation to PSS. Older age, increasing social support and material wealth were correlated with high PSS ranking, whereas female sex, experience of multiple stigmas and multiple depressive symptoms were correlated with low PSS ranking. High PSS participants were on average 1.1 kg/m² heavier, had 4.7 % lower frailty scores and 3.6 % higher QOL scores compared to low PSS patients (all p < 0.05); they were also more likely to self-classify as high SRH (RR 1.4, 95 % confidence interval 1.1, 1.7) but had comparable hemoglobin levels (p = 0.634). Low PSS correlated with poor physical and psychosocial wellbeing in HIV-positive Ugandan adults. The assessment of PSS as part of clinical management, combined with efforts to reduce stigma and improve social support, may identify and possibly reduce PSS-associated health inequality in Ugandan adults with HIV.     

鞍山市铁东区公共场所卫生基层问题及解决建议

笔者作为基层卫生监督工作人员经过十多年的公共场所卫生监督工作,通过对鞍山市铁东区公共场所卫生监督情况进行分析。发现当前存在许多公共场所卫生监督执法困难和难题,主要表现为卫生监督队伍薄弱,新兴公共场所剧增,公共场所执法依据不确定性（无法可依）等问题。笔者提出相应的解决建议,应转变卫生监督观念,提高监督管理质量。     

不同程度铅中毒大鼠模型的制备

目的：建立不同程度大鼠铅中毒模型。方法：Wistar大鼠分别自由饮用不同浓度的醋酸铅1、3、6个月,以原子吸收法测定全血和脑匀浆液的铅水平。结果：实验组全血和脑匀浆中的铅水平均明显高于对照组（P〈0．01）,且二者的铅水平随染铅时问的延长、浓度的增加均明显升高（P〈0．05）。结论：以不同时间、不同浓度染铅均成功地建立了大鼠铅中毒模型。     

Effect of Multivitamin Supplementation on Measles Vaccine Response among HIV-Exposed Uninfected Tanzanian Infants

Immunization and nutritional interventions are mainstays of child health programs in sub-Saharan Africa, yet few published data exist on their interactions. HIV-exposed (but uninfected) infants enrolled in a randomized placebo-controlled trial of multivitamin supplements (vitamins B complex, C, and E) conducted in Tanzania were sampled for an assessment of measles IgG quantity and avidity at 15 to 18 months. Infants were vaccinated between 8.5 and 12 months of age, and all mothers received high-dose multivitamins as the standard of care. Of 201 HIV-exposed infants who were enrolled, 138 (68.7%) were seropositive for measles. There were no effects of infant multivitamin supplementation on measles seroconversion proportions, IgG concentrations, or IgG avidity (P > 0.05). The measles seroconversion proportion was greater for HIV-exposed infants vaccinated at 10 to 11 months of age than for those vaccinated at 8.5 to 10 months (P = 0.032) and greater for infants whose mothers had a CD4 T-cell count of <200 cells/μl than for infants whose mothers had a CD4 T-cell count of >350 cells/μl (P = 0.039). Stunted infants had a significantly decreased IgG quantity compared to nonstunted infants (P = 0.012). As for measles avidity, HIV-exposed infants vaccinated at 10 to 11 months had increased antibody avidity compared to those vaccinated at 8.5 to 10 months (P = 0.031). Maternal CD4 T-cell counts of <200 cells/μl were associated with decreased avidity compared to counts of >350 cells/μl (P = 0.047), as were lower infant height-for-age z-scores (P = 0.016). Supplementation with multivitamins containing B complex, C, and E does not appear to improve measles vaccine responses for HIV-exposed infants. Studies are needed to better characterize the impact of maternal HIV disease severity on the immune system development of HIV-exposed infants and the effect of malnutrition interventions on vaccine responses. (This study has been registered at ClinicalTrials.gov under registration no. NCT00197730.)     

Knowledge and attitudes towards emergency contraception of health-care providers in a region with a high birth rate

Objective?To assess the knowledge of, attitude towards and practices of emergency contraception among health-care providers at a university hospital located in a region with a high birth rate.

Methods?The survey was conducted among 214 health-care providers working at a university hospital located in eastern Turkey.

Results?Two hundred participants completed the questionnaire. Of the respondents, 26.0% said that they did not know anything about emergency contraception, while the remaining 74.0% said that they knew about at least one of the methods of emergency contraception. But among these, the knowledge of 38.5% of the participants about emergency contraception was accurate and that of 61.5% was inaccurate. Thirty-four percent of the respondents stated that they had previously required personally to use emergency contraceptive methods. The most commonly used emergency contraceptive methods were oral contraceptives (69.1%) and intrauterine device (14.7%). None of the respondents knew anything about mifepristone and levonorgestrel.

Conclusion?There is a knowledge deficit among health-care providers who play a significant role in the dissemination of the information about emergency contraception.     

顺铂为基础的联合化疗对非小细胞肺癌患者血糖影响的临床观察

目的:探讨顺铂(DDP)为基础的联合化疗在非小细胞性肺癌(NSCLC)治疗中对血糖变化的影响.方法:以顺铂为基础的联合化疗患者150例,回顾性分析化疗前后的血糖变化情况及相关临床资料.结果:150例患者中,化疗期间6例(4.00%)确诊为糖尿病(DM),6例(4.00%)出现糖耐量减低(IGT),10例(6.67%)出现空腹血糖受损(IFG),8例(5.33%)一过性血糖升高,继发DM患者化疗前后的平均血糖值分别为(5.08±0.18)和(10.79±2.80)mmol/L,化疗前后空腹血糖水平差异有统计学意义,t=5.200,P=0.003.继发DM多发生在化疗的第3.5个周期,DDP的累积量约280 mg/m2.结论:常规剂量顺铂化疗能引起DM、IGT、IFG及一过性血糖升高,化疗期间应密切监测血糖.     

血清miR-200a-3p与miR-30a-5p表达在心力衰竭诊断及预后评估中的价值

分析血清中微小核糖核酸200a-3p（miR-200a-3p）和微小核糖核酸30a-5p（miR-30a-5p）表达在心力衰竭（HF）诊断以及HF患者预后评估中的价值。 前瞻性选取内蒙古医科大学附属医院2018年4月～2020年4月期间收治的HF患者131例为研究对象（HF组）,同时期健康体检志愿者131例为对照组;采用实时荧光定量PCR（qRT-PCR）测定血清中miR-200a-3p和miR-30a-5p表达水平;采用Spearman相关分析血清中miR-200a-3p和miR-30a-5p水平与HF患者病情严重程度的相关性;采用ROC曲线分析血清miR-200a-3p和miR-30a-5p对HF的诊断价值;采用Logistic回归分析HF患者预后的影响因素;采用Kaplan-Meier生存分析血清miR-200a-3p和miR-30a-5p表达水平与HF患者预后的关系。 与对照组相比,HF组血清中miR-200a-3p和miR-30a-5p表达水平显著升高,差异具有统计学意义（P<0.05）;轻度HF、中度HF和重度HF患者血清中miR-200a-3p和miR-30a-5p表达水平依次升高,差异具有统计学意义（P<0.05）;Spearman相关分析显示,血清中miR-200a-3p和miR-30a-5p表达水平与HF患者病情严重程度呈正相关（r_s=0.442,r_s=0.564,均P<0.05）;ROC曲线分析结果显示,miR-200a-3p和miR-30a-5p联合诊断HF较miR-200a-3p和miR-30a-5p单一指标诊断效果更好（P<0.05）;Logistic回归分析结果发现,NT-proBNP、LVEF、LVEDD、miR-200a-3p和miR-30a-5p是HF患者预后的影响因素（Wald χ²=4.321～128.193,P<0.05）;Kaplan-Meier生存分析结果显示,血清中miR-200a-3p和miR-30a-5p高表达患者3年生存率低于miR-200a-3p和miR-30a-5p低表达患者（均P<0.05）。 HF患者血清中miR-200a-3p和miR-30a-5p表达水平显著升高,二者与HF的发生及患者预后相关。