中孕期孕妇的碘营养状态对心脏电信号的影响

目的探讨中孕期孕妇碘营养状态对其心脏电信号的影响。 方法2015年7月至2017年7月，采取方便抽样法，于山东省海阳市某2家二级医院，选取1 600例中孕期孕妇为研究对象，纳入观察组。按照年龄匹配原则，采取同样的方法，选择同期在这2家医院进行健康体检，碘含量检测结果正常的非妊娠女性800例，纳入对照组(C组)。对观察组受试者进行尿碘含量检测，同时对观察组及C组受试者进行心电图检查。根据观察组中孕期孕妇碘含量检测结果，将其分为碘营养缺乏亚组(G1亚组)，碘营养过量亚组(G2亚组)和碘营养正常亚组(G3亚组)。对于观察组3个亚组与C组的心电图检查结果正常和大致正常率、窦性心律不齐等异常结果发生率的比较，采用χ²检验，进一步两两比较，采用调整检验水准后进行比较。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》的要求。本研究分组，均征得受试者本人的知情同意，并签署临床研究知情同意书。 结果①观察组进一步分组及组间一般临床资料比较结果：观察组中，G1、G2及G3亚组孕妇分别为502、179及919例。观察组3个亚组孕妇的年龄、孕龄分别总体比较，差异均无统计学意义(P>0.05)。这3个亚组孕妇与C组受试者年龄总体比较，差异亦无统计学意义(P>0.05)。②心电图检查结果正常和大致正常率比较：观察组3个亚组与C组总体比较，差异有统计学意义(χ²＝79.889，P<0.001)；G1与G2亚组孕妇心电图正常和大致正常率分别为72.71%(365/502)与70.95%(127/179)，均显著低于G3亚组(86.51%，795/919)与C组(88.25%，706/800)，并且差异均有统计学意义(均为P<0.001)。③G1、G2及G3亚组孕妇心电图检查异常结果中，窦性心律不齐发生率最高。G1、G2及G3亚组与C组窦性心动过缓、窦性心动过速、窦性心律不齐、室性早搏、短P-R间期、ST-T改变发生率分别整体比较，差异均有统计学意义(χ²＝38.423、37.687、296.887、20.933、50.112、30.783，均为P<0.001)；而电轴左偏或右偏、QRS低电压、传导阻滞分别总体比较，差异均无统计学意义(P>0.05)。④G1、G2及G3亚组与C组心电图检查异常结果两两比较，差异有统计学意义的为窦性心动过缓(G1亚组vs C组：χ²＝19.659，G2亚组vs C组：χ²＝17.409，G1亚组vs G3亚组：χ²＝20.592，G2亚组vs G3亚组：χ²＝17.703，均为P<0.001)；窦性心动过速(G1亚组vs C组：χ²＝17.433，G2亚组vs C组：χ²＝35.622，G2亚组vs G3亚组：χ²＝16.992，均为P<0.001)；窦性心律不齐(G1亚组vs C组：χ²＝178.673，G2亚组vs C组：χ²＝110.717，G1亚组vs G3亚组：χ²＝168.011，G2亚组vs G3亚组：χ²＝93.579，均为P<0.001)；室性早搏(G1亚组vs C组：χ²＝14.593，G1亚组vs G3亚组：χ²＝13.472，均为P<0.001)；短P-R间期(G1亚组vs C组：χ²＝43.563，G2亚组vs C组：χ²＝19.291，G1亚组vs G3亚组：χ²＝20.191，均为P<0.001)；ST-T改变(G1亚组vs C组：χ²＝19.796，G2亚组vs C组：χ²＝23.314，G2亚组vs G3亚组：χ²＝10.630，均为P≤0.001)。 结论中孕期孕妇体内碘营养状态失衡，可增加异常心电图的发生。     

三级甲等医院甲状腺疾病住院患者的临床特征分析

目的分析三级甲等医院甲状腺疾病住院患者的临床特征,为评估抗菌药物的合理应用提供参考数据。方法采用随机抽样的方法选取沈阳市某三级甲等医院,抽取2009年1月-2010年12月甲状腺疾病手术患者400例,提取病历中临床特征的相应信息。结果手术患者平均年龄（50.85±10.62）岁,游离甲状腺素T4（15.90±2.36）pmol/L,甲状腺过氧化物酶抗体（24.52±4.39）IU/mL。结论该三级甲等医院甲状腺疾病住院患者的临床特征为进一步评估该医院甲状腺疾病患者抗菌药物的合理应用提供了基础数据。     

碘缺乏和甲状腺功能减退对大鼠仔鼠小脑细胞外信号调节激酶1/2蛋白表达的影响

Objective To study the effects of iodine deficiency and hypothyroidism on protein expression of extracellular signal-regulate kinase(ERK1/2) in the cerebellum of rots. Methods Twenty-eight healthy Wistar rots, female, 60 days old, were randomly divided according to their body weight into control group, iodine deficient group and hypothyroidism groups. Hypothyroidism groups in accordance with drinking water containing propylthiouracil(PTU) were divided into doses of 5 mg/L and 15 mg/L groups, 7 rats in each group. Rats after pregnancy, iodine deficient rats were administered with iodine-deficient diet and hypothyroid rats were administered with PTU in drinking water. Pup's cerebellum in each group were weighed on day 14,21,28 and 42. Cerebellum tissue was observed for cerebellar morphology using silver staining and detected for ERK1/2 protein using immunohistochemistry on day 7,14,21,28 and 42. Results On day 14,21,28 and 42, cerebellum weight of pups from iodine-deficient[(0.0945±0.0233), (0.1347±0.0046), (0.1542±0.0094), (0.1949±0.0048)g]were significantly lighter than control[(0.1856±0.0123), (0.2049±0.0098), (0.2268±0.0065), (0.2606±0.0086)g, all P < 0.05]and hypothyroidism groups [for 5 mg/L group: (0.1741±0.0172), (0.1927±0.0103), (0.2181±0.0064), (0.2583±0.0054)g, all P<0.05; for 15 mg/L group: (0.1604±0.0083), (0.1682±0.0103), (0.1996±0.0073) and (0.2579±0.0067)g, all P< 0.05]the difference had statistical significance(F=6.325,8.870, 16.191 and 21.574, all P<0.05). Compared to the controls on day 7, iodine-deficient group didn't have clear layers; on day 21, disappearance of external granule cells from iodine-deficient and 15 mg/L groups was delayed, still two or three layer external granule cells remained; on day 28 and 42, molecular layer from 5, 15 mg/L and iodine-deficient groups and became thinner. Immunohistochemistry showed that on day 7, there was no statistical difference of integrated optical density average of ERK1/2, in all the groups(F=1.102, P>0.05); on day 14,21,28 and 42, integrated optical density average of ERK1/2 in iodine-deficient group[(7.3245±0.5070), (8.3606±1.0683), (9.1217±1.0402), (12.1587±0.7581), all P<0.01]and hypothyroidism groups [for 5 mg/L group: (11.4307±1.5200), (14.919±0.8497), (16.0082±1.1130), (15.7721±0.8293), all P< 0.01; for 15 mg/L group: (7.8538±0.9775), (11.2461±0.8138),(12.78±1.3783), (13.0871±1.1450), all P < 0.01]was significantly lower than those of controls [(16.2831±0.5143), (20.2653±0.9551), (22.7485±1.0267), (22.1725±0.9939), all P < 0.01], the difference having a statistical signifieance(F=16.131,13.543,26.953,41.583, all P<0.01). Conclusions Iodine deficiency and hypothyroidism during critical periods of brain development may change eerebellar morphology and down regulate the protein expression of ERK1/2, which may result in damage of cerebellum development.     

碘缺乏和甲状腺功能减退对大鼠仔鼠小脑细胞外信号调节激酶1/2蛋白表达的影响

Objective To study the effects of iodine deficiency and hypothyroidism on protein expression of extracellular signal-regulate kinase(ERK1/2) in the cerebellum of rots. Methods Twenty-eight healthy Wistar rots, female, 60 days old, were randomly divided according to their body weight into control group, iodine deficient group and hypothyroidism groups. Hypothyroidism groups in accordance with drinking water containing propylthiouracil(PTU) were divided into doses of 5 mg/L and 15 mg/L groups, 7 rats in each group. Rats after pregnancy, iodine deficient rats were administered with iodine-deficient diet and hypothyroid rats were administered with PTU in drinking water. Pup's cerebellum in each group were weighed on day 14,21,28 and 42. Cerebellum tissue was observed for cerebellar morphology using silver staining and detected for ERK1/2 protein using immunohistochemistry on day 7,14,21,28 and 42. Results On day 14,21,28 and 42, cerebellum weight of pups from iodine-deficient[(0.0945±0.0233), (0.1347±0.0046), (0.1542±0.0094), (0.1949±0.0048)g]were significantly lighter than control[(0.1856±0.0123), (0.2049±0.0098), (0.2268±0.0065), (0.2606±0.0086)g, all P < 0.05]and hypothyroidism groups [for 5 mg/L group: (0.1741±0.0172), (0.1927±0.0103), (0.2181±0.0064), (0.2583±0.0054)g, all P<0.05; for 15 mg/L group: (0.1604±0.0083), (0.1682±0.0103), (0.1996±0.0073) and (0.2579±0.0067)g, all P< 0.05]the difference had statistical significance(F=6.325,8.870, 16.191 and 21.574, all P<0.05). Compared to the controls on day 7, iodine-deficient group didn't have clear layers; on day 21, disappearance of external granule cells from iodine-deficient and 15 mg/L groups was delayed, still two or three layer external granule cells remained; on day 28 and 42, molecular layer from 5, 15 mg/L and iodine-deficient groups and became thinner. Immunohistochemistry showed that on day 7, there was no statistical difference of integrated optical density average of ERK1/2, in all the groups(F=1.102, P>0.05); on day 14,21,28 and 42, integrated optical density average of ERK1/2 in iodine-deficient group[(7.3245±0.5070), (8.3606±1.0683), (9.1217±1.0402), (12.1587±0.7581), all P<0.01]and hypothyroidism groups [for 5 mg/L group: (11.4307±1.5200), (14.919±0.8497), (16.0082±1.1130), (15.7721±0.8293), all P< 0.01; for 15 mg/L group: (7.8538±0.9775), (11.2461±0.8138),(12.78±1.3783), (13.0871±1.1450), all P < 0.01]was significantly lower than those of controls [(16.2831±0.5143), (20.2653±0.9551), (22.7485±1.0267), (22.1725±0.9939), all P < 0.01], the difference having a statistical signifieance(F=16.131,13.543,26.953,41.583, all P<0.01). Conclusions Iodine deficiency and hypothyroidism during critical periods of brain development may change eerebellar morphology and down regulate the protein expression of ERK1/2, which may result in damage of cerebellum development.     

“证据”在临床药学研究领域的可视化引文分析

目的:针对临床药学研究领域"证据"开展可视化引文分析。方法:借助可视化引文分析工具Hist Cite,以Web of Science核心合集的科学引文索引数据库扩展版为数据源,综合运用文献计量分析、引文分析和可视化技术,分析临床药学研究"证据"的数量和年代分布、国家地区和研究机构分布和核心作者。结果:2002~2013年,临床药学领域的"证据"呈现逐年上升的趋势,主要涉及到62个国家和地区,以美国的研究文献最多,研究机构主要为大学的药学院。结论:近十年来,临床药学研究领域"证据"发展迅速,Hist Cite能够快速、直观的展现临床药学研究领域的发展轨迹。     

海淀区2011-2014年度从业人员健康体检结果分析

目的为了解海淀区从业人员健康状况,为卫生监督提供参考依据。方法对2011-2014年海淀区从业人员健康体检资料进行回顾性分析。结果 416 080名从业人员体检合格率为96.75%,不合格人数13 521名,HAVIgm阳性29例(0.7■)、HEVIgm阳性30例(0.72■)、ALT异常13 443例(3.2%)、结核阳性19例(0.46■)。结论海淀区从业人员健康体检合格率较高,从业人员健康体检工作需要常抓不懈,对从业人员每年要进行定期健康检查,及时发现异常,确保公众健康安全。     

碘缺乏和甲状腺功能减退对大鼠仔鼠小脑细胞外信号调节激酶1/2蛋白表达的影响

Objective To study the effects of iodine deficiency and hypothyroidism on protein expression of extracellular signal-regulate kinase(ERK1/2) in the cerebellum of rots. Methods Twenty-eight healthy Wistar rots, female, 60 days old, were randomly divided according to their body weight into control group, iodine deficient group and hypothyroidism groups. Hypothyroidism groups in accordance with drinking water containing propylthiouracil(PTU) were divided into doses of 5 mg/L and 15 mg/L groups, 7 rats in each group. Rats after pregnancy, iodine deficient rats were administered with iodine-deficient diet and hypothyroid rats were administered with PTU in drinking water. Pup's cerebellum in each group were weighed on day 14,21,28 and 42. Cerebellum tissue was observed for cerebellar morphology using silver staining and detected for ERK1/2 protein using immunohistochemistry on day 7,14,21,28 and 42. Results On day 14,21,28 and 42, cerebellum weight of pups from iodine-deficient[(0.0945±0.0233), (0.1347±0.0046), (0.1542±0.0094), (0.1949±0.0048)g]were significantly lighter than control[(0.1856±0.0123), (0.2049±0.0098), (0.2268±0.0065), (0.2606±0.0086)g, all P < 0.05]and hypothyroidism groups [for 5 mg/L group: (0.1741±0.0172), (0.1927±0.0103), (0.2181±0.0064), (0.2583±0.0054)g, all P<0.05; for 15 mg/L group: (0.1604±0.0083), (0.1682±0.0103), (0.1996±0.0073) and (0.2579±0.0067)g, all P< 0.05]the difference had statistical significance(F=6.325,8.870, 16.191 and 21.574, all P<0.05). Compared to the controls on day 7, iodine-deficient group didn't have clear layers; on day 21, disappearance of external granule cells from iodine-deficient and 15 mg/L groups was delayed, still two or three layer external granule cells remained; on day 28 and 42, molecular layer from 5, 15 mg/L and iodine-deficient groups and became thinner. Immunohistochemistry showed that on day 7, there was no statistical difference of integrated optical density average of ERK1/2, in all the groups(F=1.102, P>0.05); on day 14,21,28 and 42, integrated optical density average of ERK1/2 in iodine-deficient group[(7.3245±0.5070), (8.3606±1.0683), (9.1217±1.0402), (12.1587±0.7581), all P<0.01]and hypothyroidism groups [for 5 mg/L group: (11.4307±1.5200), (14.919±0.8497), (16.0082±1.1130), (15.7721±0.8293), all P< 0.01; for 15 mg/L group: (7.8538±0.9775), (11.2461±0.8138),(12.78±1.3783), (13.0871±1.1450), all P < 0.01]was significantly lower than those of controls [(16.2831±0.5143), (20.2653±0.9551), (22.7485±1.0267), (22.1725±0.9939), all P < 0.01], the difference having a statistical signifieance(F=16.131,13.543,26.953,41.583, all P<0.01). Conclusions Iodine deficiency and hypothyroidism during critical periods of brain development may change eerebellar morphology and down regulate the protein expression of ERK1/2, which may result in damage of cerebellum development.     

碘缺乏和甲状腺功能减退对大鼠仔鼠小脑细胞外信号调节激酶1/2蛋白表达的影响

Objective To study the effects of iodine deficiency and hypothyroidism on protein expression of extracellular signal-regulate kinase(ERK1/2) in the cerebellum of rots. Methods Twenty-eight healthy Wistar rots, female, 60 days old, were randomly divided according to their body weight into control group, iodine deficient group and hypothyroidism groups. Hypothyroidism groups in accordance with drinking water containing propylthiouracil(PTU) were divided into doses of 5 mg/L and 15 mg/L groups, 7 rats in each group. Rats after pregnancy, iodine deficient rats were administered with iodine-deficient diet and hypothyroid rats were administered with PTU in drinking water. Pup's cerebellum in each group were weighed on day 14,21,28 and 42. Cerebellum tissue was observed for cerebellar morphology using silver staining and detected for ERK1/2 protein using immunohistochemistry on day 7,14,21,28 and 42. Results On day 14,21,28 and 42, cerebellum weight of pups from iodine-deficient[(0.0945±0.0233), (0.1347±0.0046), (0.1542±0.0094), (0.1949±0.0048)g]were significantly lighter than control[(0.1856±0.0123), (0.2049±0.0098), (0.2268±0.0065), (0.2606±0.0086)g, all P < 0.05]and hypothyroidism groups [for 5 mg/L group: (0.1741±0.0172), (0.1927±0.0103), (0.2181±0.0064), (0.2583±0.0054)g, all P<0.05; for 15 mg/L group: (0.1604±0.0083), (0.1682±0.0103), (0.1996±0.0073) and (0.2579±0.0067)g, all P< 0.05]the difference had statistical significance(F=6.325,8.870, 16.191 and 21.574, all P<0.05). Compared to the controls on day 7, iodine-deficient group didn't have clear layers; on day 21, disappearance of external granule cells from iodine-deficient and 15 mg/L groups was delayed, still two or three layer external granule cells remained; on day 28 and 42, molecular layer from 5, 15 mg/L and iodine-deficient groups and became thinner. Immunohistochemistry showed that on day 7, there was no statistical difference of integrated optical density average of ERK1/2, in all the groups(F=1.102, P>0.05); on day 14,21,28 and 42, integrated optical density average of ERK1/2 in iodine-deficient group[(7.3245±0.5070), (8.3606±1.0683), (9.1217±1.0402), (12.1587±0.7581), all P<0.01]and hypothyroidism groups [for 5 mg/L group: (11.4307±1.5200), (14.919±0.8497), (16.0082±1.1130), (15.7721±0.8293), all P< 0.01; for 15 mg/L group: (7.8538±0.9775), (11.2461±0.8138),(12.78±1.3783), (13.0871±1.1450), all P < 0.01]was significantly lower than those of controls [(16.2831±0.5143), (20.2653±0.9551), (22.7485±1.0267), (22.1725±0.9939), all P < 0.01], the difference having a statistical signifieance(F=16.131,13.543,26.953,41.583, all P<0.01). Conclusions Iodine deficiency and hypothyroidism during critical periods of brain development may change eerebellar morphology and down regulate the protein expression of ERK1/2, which may result in damage of cerebellum development.     

临床药学专业医学统计学教学模式实例分析

临床药学是连接医学和药学的新兴学科,医学统计学是医学中重要的基础课之一,该文采用实例分析探讨临床药学专业医学统计学的教学模式问题,分析临床药学与医学统计学的特点,结果表明实例分析教学有助于临床药学专业学生认清医学统计学的学科特点,培养学生解决实际问题的能力,提高教师的引导能力。实例分析是适应临床药学专业需求的教学模式。     

沈阳市3岁儿童婴幼儿龋患病特点分析

目的探讨沈阳市3岁儿童婴幼儿龋患病特点,为探查沈阳市儿童婴幼儿龋影响因素、防控措施提供依据。方法采用多阶段分层随机抽样方法抽取沈阳市9区1080名3岁儿童进行检查,发放调查问卷,并进行统计分析。结果问卷回收有效率为84．70％,受检儿童婴幼儿龋患病率为44．48％,龋均为1．96,龋面均3．82,龋蚀严重度指数为9．41,婴幼儿龋充填率为5．44％,对照组受检儿童家长对儿童口腔卫生知晓程度明显高于婴幼儿龋组家长（P〈0．01）。结论沈阳市3岁儿童婴幼儿龋患病状况严重,应加强对婴幼儿龋的早期干预。