心理评估量表结合Procam评分对非特异性胸痛患者的预测效应

目的 探讨心理评估量表和Procam评分对非特异性胸痛(NSCP)的预测效应.方法 对2019年7月至2020年12月该院87例胸痛患者进行冠状动脉造影(CAG)检查,按检查结果分为NSCP和缺血性胸痛(ICP).比较两组临床资料、Procam评分、躯体化症状自评量表(SSS)评分、综合医院焦虑与抑郁量表(HADS)评分,分析各评分与NSCP的相关性.结果 两组年龄、性别、吸烟史、糖尿病史、高血压病史、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、左心室舒张末直径(LV)、射血分数(EF)比较,差异无统计学意义(P>0.05).NSCP组Procam评分较ICP组低,SSS评分、HADS-a评分、HADS-d评分较ICP组高,差异有统计学意义(P<0.05).Procam评分、HADS-a评分是NSCP的独立危险因素[HR:1.107(1.039～1.179),P=0.002;HR:0.641(0.469～0.875),P=0.005].Pro-cam评分联合HADS-a评分检验效能曲线下面积(AUC)及约登指数均高于Procam评分及HADS-a评分单项评估.结论 Procam评分联合HADS-a评分预测NSCP价值更优.     

Inverted U-Shaped Associations between Glycemic Indices and Serum Uric Acid Levels in the General Chinese Population: Findings from the China Cardiometabolic Disease and Cancer Cohort (4C) Study

Objective The relationship between serum uric acid(SUA)levels and glycemic indices,including plasma glucose(FPG),2-hour postload glucose(2 h-PG),and glycated hemoglobin(HbA1 c),remains inconclusive.We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.Methods The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study.A total of 105,922 community-dwelling adults aged≥40 years underwent the oral glucose tolerance test and uric acid assessment.The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.Results A total of 30,941 men and 62,361 women were eligible for the current analysis.Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels,but with different inflection points in men and women.The thresholds for FPG,2 h-PG,and HbA1 c for men and women were 6.5/8.0 mmol/L,11.0/14.0 mmol/L,and 6.1/6.5,respectively(SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes,while the inflection points were reached earlier in men than in women.     

Combined Effect of Smoking and Obesity on Coronary Heart Disease Mortality in Male Veterans: A 30-year Cohort Study

Objective Evidence is lacking regarding the combined effects of smoking and obesity on mortality from coronary heart disease in male veterans.This study aimed to explore the combined effect of smoking and obesity on coronary heart disease mortality in male veterans in China.Methods A cohort of 1,268 male veterans from 22 veteran centers in Xi’an(Shaanxi Province,China)were followed up once every 2 years from February 1,1987 to October 30,2016.The endpoint was death from any cause.The hazard ratio(HR)of each risk factor and the 95%confidence interval(CI)were calculated using a multivariate Cox proportional hazard model.Results The total follow-up was 24394.21 person-years;each subject was followed up for a mean duration of 19.24 years.By the end of the study,of the 1,268 veterans,889 had died,363 were alive,and 16 were lost to follow-up.Cox regression analysis results revealed that current smoking(HR:1.552,95%CI:1.074–2.243),obesity(HR:1.625,95%CI:1.024–2.581),and the combined effect of the two factors(HR:2.828,95%CI:1.520–5.262)were associated with coronary heart disease mortality.Conclusion Our results suggest that obese veterans who smoke might be an important target population for coronary heart disease mortality control.     

Full-Length Genome Sequencing of SARS-CoV-2 Directly from Clinical and Environmental Samples Based on the Multiplex Polymerase Chain Reaction Method

The new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading worldwide with the number of confirmed cases increasing dramatically[1,2]. Coronaviruses have the largest genome among RNA viruses and have caused two major outbreaks[3,4]. The new coronavirus (SARS-CoV-2) is the third coronavirus spread globally in the past 17 years. According to the World Health Organization, SARS-CoV-2 has affected more than 155.6 millon patients in 222 countries as of 6 May 2021 and has become a major global health concern (https://www.who.int/emergencies/diseases/novel-coronavirus-2019).     

National Nutrition and Health Systematic Survey for Children 0-17 Years of Age in China

The main purpose of the National Nutrition and Health Systematic Survey for children 0-17 years of age in China (CNHSC) was to collect basic data on the nutrition, development, and health status for children in different regions across China using evidence-based, reliable, and cost-effective approaches. Children and their parents or guardians from seven regions (south, southwest, north, northwest, eastern, central, and northeast China) in China were recruited. A multi-stage stratified randomized sampling method was used. Two provinces were randomly sampled from each of the seven regions, from which one urban district and one rural country were also randomly sampled, resulting in a total of 28 survey counties/districts. Dietary surveys, health examinations, laboratory testing, and questionnaires were used to collect dietary intake, nutritional status, child development, and health status information. Nutrition, health, and lifestyle assessment of children and their parents was determined using the Knowledge Attitude Practice (KAP) survey. Greater than 100,000 children (38,000 children < 6 years of age and 66,000 children 6-17 years of age) completed the survey. The survey provided comprehensive data on child nutrition and health status for future studies and will serve as the basis for an integrated nutrition and health improvement strategies proposal for children in China.     

Physical Activity and Sedentary Behaviors among Chinese Children: Recent Trends and Correlates

Objective This study was aimed at examining the trends and correlates of physical activity (PA) and sedentary behaviors among Chinese children. Methods A total of 4,341 subjects (6,936 observations) aged 6–17 years who participated in the China Health and Nutrition Survey (2004–2015) were included. Of the subjects, 41％ participated in the survey twice or more. Random-effects ordinal regression models and repeated-measures mixed-effects models were used to examine the PA trends. Quantile regression models were applied to examine the factors influencing PA and sedentary behaviors. Results From 2004 to 2015, the prevalence of physical inactivity among Chinese children aged 6–17 years increased by 5.5％ [odds ratio (OR), 1.51; 95％ confidence interval (CI), 1.19–1.90; P < 0.001]. The PA volume declined by 5.8 metabolic equivalent of task-hr/week (P < 0.001), and the time spent in sedentary behaviors increased by 1.8 hr/week (P < 0.001). Age, ethnicity, and region showed significant effects on the PA volume across the quartiles (P < 0.001). Across the quartiles, sedentary time was significantly higher in the children residing in urban areas (P < 0.001) or areas with high urbanization levels (P ≤ 0.005) than in their counterparts. Conclusions A declining PA trend among Chinese children aged 6–17 years was observed from 2004 to 2015, and certain subgroups and geographical areas are at higher risk of physical inactivity.     

Local inhibition of GABA affects precedence effect in the inferior colliculus

The precedence effect is a prerequisite for faithful sound localization in a complex auditory environment, and is a physiological phenomenon in which the auditory system selectively suppresses the directional information from echoes. Here we investigated how neurons in the inferior colliculus respond to the paired sounds that produce precedence-effect illusions, and whether their firing behavior can be modulated through inhibition with gamma-aminobutyric acid （GABA）. We recorded extracellularly from 36 neurons in rat inferior colliculus under three conditions： no injection, injection with saline, and injection with gamma-aminobutyric acid. The paired sounds that produced precedence effects were two identical 4-ms noise bursts, which were delivered contralaterally or ipsilaterally to the recording site. The normalized neural responses were measured as a function of different inter-stimulus delays and half-maximal interstimulus delays were acquired. Neuronal responses to the lagging sounds were weak when the inter-stimulus delay was short, but increased gradually as the delay was lengthened. Saline injection produced no changes in neural responses, but after local gamma-arninobutyric acid application, responses to the lagging stimulus were suppressed. Application of gamma-aminobutyric acid affected the normalized response to lagging sounds, independently of whether they or the paired sounds were contralateral or ipsilateral to the recording site. These observations suggest that local inhibition by gamma-aminobutyric acid in the rat inferior colliculus shapes the neural responses to lagging sounds, and modulates the precedence effect.     

股骨头负重区松质骨的压缩力学特性

背景松质骨力学特性在代谢性疾病、骨折、关节退行性变的内在发生规律中具有意义.目的了解松质骨的生物力学特性.设计以股骨标本为单一样本的实验观察.单位上海第二医科大学附属第九人民医院骨科生物力学实验室.对象2001-05/07完成于在上海第九人民医院骨科生物力学实验室,选取19具男性尸体股骨头.方法取19具新鲜青年(30岁左右)尸体股骨.对股骨头负重区的松质骨进行压缩测试.主要观察指标标本的屈服载荷、极限应力、极限应变、能量值、弹性模量.结果测算松质骨各项压缩数据,其中屈服载荷的平均值为(410.64±190.29)N,极限应力为(8.69±3.75)MPa,极限应变为(10.84±6.58)%,能量值为(2.54±1.89)J,弹性模量为(40.77±32.12)MPa.加载初期松质骨呈弹性变形,此后横截面增大抗压能力增强.结论试验表明松质骨力学性能主要是缓解外力冲击加压.     

急性大出血患者介入治疗的护理

笔报道急性大出血患介入治疗的护理，治疗前做好术前准备及局部麻醉的护理，术中密切配合术完成股动脉穿刺，保持呼吸道及输液通畅，监测生命体征等；术后观察穿刺点，穿刺侧肢体的皮肤颜色，足背动脉搏动及有无误栓重要脏器，做好相应的护理。