组蛋白甲基化修饰与哺乳动物生殖

组蛋白甲基化是表观遗传学研究的热点和难点,研究表明,组蛋白甲基化修饰在哺乳动物配子的发生、胚胎着床和发育以及胎盘的发育过程中有着特殊作用,这些修饰可影响基因的表达,从而动态调节哺乳动物生殖过程中许多生物学进程。但目前研究的组蛋白甲基化修饰相关基因位点多而杂,且多停留在广泛的探索和描述这一层面,这些甲基化修饰发生动态变化的机制,以及相互作用等一系列过程还有待深入研究。     

国产重组人促卵泡激素在辅助生殖技术控制性超促排卵的临床应用

目的评价国产重组人促卵泡激素(recombinant human follicle-stimulating hormone,rhFSH)用于辅助生殖技术(assisted reproductive technology,ART)控制性超促排卵(controlled ovarian hyperstimulation,COH)的有效性及安全性。方法本试验采用多中心、随机、双盲、阳性平行对照、非劣效研究方法,于2017年7月至2019年6月间选取6家生殖医学中心纳入卵巢储备正常的不孕女性进行ART的COH治疗。受试者随机分为试验组(国产rhFSH,n=134)和对照组(进口rhFSH,n=133),研究过程中因各种因素排除受试者共8例,试验组7例,对照组1例,最终依照研究方案完成试验的受试者试验组127例,对照组132例。比较两组受试者COH周期中获得的卵母细胞总数、rhFSH用药情况、卵母细胞受精率、优质胚胎数、临床妊娠率、活产率、新生儿情况及不良反应发生率等指标。结果试验组和对照组在COH周期中获得的卵母细胞总数分别为(13.0±5.8)枚和(12.9±5.7)枚,差异无统计学意义(P>0.05);在82例卵胞质内单精子显微注射(intracytoplasmic sperm injection,ICSI)受试者中,试验组(39例)获得MII卵母细胞数[(9.9±3.9)枚]显著高于对照组(43例)[(7.5±3.0)枚,P=0.003];卵母细胞受精率试验组[63.82%(1048/1642)]显著高于对照组[56.19%(958/1705),P<0.001]。rhFSH用药时间和总量、优质胚胎数、临床妊娠率、早产率、活产率、新生儿异常发生率、新生儿体质量、Apgar评分等两组间差异无统计学意义(P均>0.05);治疗期间卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)和其他不良反应发生率差异无统计学意义(P均>0.05),且均为进口rhFSH已知的不良反应。结论在卵巢储备正常的不孕女性中使用相同卵巢刺激治疗方案,国产rhFSH有效性及安全性与进口rhFSH相当。     

广州市外籍人员网络社交特征及临时性行为的相关因素分析

目的 分析广州市外籍人员的社会支持、网络社交、性行为特征及相关因素,为有效开展外籍人员干预活动提供参考依据。方法 采用横断面调查研究设计,在2019年11月至2020年1月,对符合标准的研究对象采用线下和线上相结合的方式开展调查,收集人口学特征、社会支持、网络社交行为、性行为等信息。采用统计学方法对可能影响临时性行为的因素进行分析。结果 纳入研究的434名外籍人员中,线下调查241人,线上调查193人。男性占68.4%（297/434）;年龄（31.0±8.8）岁;来源地为非洲地区的占79.0%（343/434）;经商占46.5%（202/434）,学生占48.2%（209/434）;在中国有生意伙伴、家人陪伴的比例分别为59.4%（258/434）和28.1%（122/434）;在中国有关系密切的朋友<10人的比例为57.1%（248/434）;每日使用社交软件时间为1~3 h的占43.3%（188/434）;最近3个月发生临时性行为占15.2%（55/363）。Logistic多元回归分析结果显示,与每日使用社交软件时间<1 h者相比,>6 h者更有可能最近3个月发生临时性行为（OR=3.63,95%CI：1.31~10.08）。结论 广州市外籍人员中每日使用社交软件时间较长者更有可能发生临时性行为。合理运用社交软件进行艾滋病宣传教育可促进外籍人员的健康意识。     

调强放疗联合周剂量顺铂治疗老年人食管癌临床疗效观察

目的：观察调强放疗联合周剂量顺铂治疗老年人食管癌的近期疗效和毒副反应。方法将60例局部晚期老年食管癌患者采用数字表法随机分为同步放化疗组（ CRT组）30例和单纯放疗组（ RT组）30例,两组均采用6MV－X射线调强放疗,放疗剂量：DT 60 Gy／30次／6周。 CRT组在放疗第2天开始给予顺铂20～25 mg／m^2,1次／周,共6次。结果 CRT组、RT组近期有效率分别为80．0％、63．3％,差异有统计学意义（χ^2＝5．934,P＜0．05）。不良反应主要为骨髓抑制、放射性食管炎,基本为Ⅰ～Ⅱ级,两组不良反应差异无统计学意义（P＞0．05）。结论调强放疗联合周剂量顺铂治疗老年人食管癌近期疗效显著,不良反应轻,患者耐受性好,值得临床推广。     

Metabolism studies on hydroxygenkwanin and genkwanin in human liver microsomes by UHPLC-Q-TOF-MS

Hydroxygenkwanin (HYGN) and genkwanin (GN) are major constituents of Genkwa Flos for the treatment of edema, ascites, cough, asthma and cancer. This is a report about the investigation of the metabolic fate of HYGN and GN in human liver microsomes and the recombinant UDP-glucuronosyltransferase (UGT) enzymes by using ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS). An on-line data acquisition method multiple mass defect filter (MMDF) combined with dynamic background subtraction (DBS) was developed to trace all probable metabolites. Based on this analytical strategy, three phase I metabolites and seven glucuronide conjugation metabolites of HYGN, seven phase I metabolites and 12 glucuronide conjugation metabolites of GN were identified in the incubation samples of human liver microsomes. The results indicated that demethylation, hydroxylation and o-glucuronidation were main metabolic pathways of HYGN and GN. The specific UGT enzymes responsible for HYGN and GN glucuronidation metabolites were identified using recombinant UGT enzymes. The results indicated that UGT1A1, UGT1A3, UGT1A9, UGT1A10 and UGT2B7 might play major roles in the glucuronidation reactions. Overall, this study may be useful for the investigation of metabolic mechanism of HYGN and GN, and it can provide reference and evidence for further experiments.     

佛手化学成分研究

从佛手(Citrus medica L.var.sarcodactylis)乙醇提取物中分得3个化合物,经理化鉴定和光谱法确定其化学结构分别为柠檬内酯(Ⅰ),△~(5,22)-豆甾烯醇(Ⅱ)和棕榈酸(Ⅲ)。其中△~(5,22)-豆甾烯醇为首次从佛手中分离得到。     

Demonstration of two types of fatigue in subjects with chronic liver disease using factor analysis

Purpose

The purpose of this investigation was to determine if it was possible to separate fatigue self-reports into two distinct types of fatigue symptom clusters in research subjects with chronic liver disease (CLD). It was hypothesized that when items from the Medical Outcomes Study Short-Form (SF-36v2) are combined with items from the Fatigue Severity Scale (FSS), these distinct factors will emerge.

Methods

Confirmatory and exploratory factor analyses from data collected in a prospective, natural history study of CLD patients were conducted. Items were selected from the SF-36v2 and the FSS for entry into the factor analyses. In order to establish convergent and discriminant validity, derived factor scores were correlated with subscale scores of the Human Activity Profile (HAP), Mental Component Score (MCS) from the SF-36v2, and the Emotional Functioning Subscale of the Chronic Liver Disease Questionnaire (CLDQ-EF).

Results

106 participants with CLD were included (50% female; age: 51?±?10). Two factors were identified. The factors included one that clustered around questions addressing fatigue related to physical activity (peripheral fatigue) and the other to the questions addressing generalized fatigue that did not require physical tasks to produce the fatigue (central fatigue). The standardized factor loadings of all items were greater than 0.6 on their underlying constructs. Moreover, all factor loadings are significant at p?<?0.01. Peripheral fatigue was related to HAP (r?=?0.26, r?=?0.24, p?<?0.01), as was central fatigue (r?=??0.34, r?=??0.33, p?<?0.01). Central fatigue was related to MCS and CLDQ-EF (r?=??0.60; r?=??0.63, p?<?0.01), whereas peripheral fatigue was not (r?=?0.07, p?>?0.40). We then tested the original scales to determine if the newly created factors correlated better with the validity measures. The full FSS did not correlate as well as the newly created central fatigue scale, while the original peripheral fatigue scale (the SF-36v2 physical functioning) was more related to HAP than the newly created scale.

Conclusions

In individuals with CLD, two separate factors pertaining to fatigue were identified. This recognition of the multifaceted nature of fatigue may help increase the specificity of self-reports of fatigue and lead to treatments that can specifically address the underlying factors contributing to fatigue.

     

医疗卫生单位的后勤社会化管理与改革

相对于我国企业改革的发展,医疗卫生单位后勤管理与改革不仅起步较晚,而且力度不大,步伐不快。以往的医疗卫生单位后勤往往面面俱到,造成了严重的经济负担和社会资源的浪费。因此,医疗卫生单位后勤改革势在必行。     

电针内关对缺血再灌注损伤大鼠心肌肌浆网钙泵活性及mRNA表达的影响

目的：观察电针内关对缺血再灌注损伤大鼠心肌SERCA活性及其基因表达的影响,并以神门穴、合谷穴作对比研究。方法：实验分为假手术组、心肌缺血再灌注模型组（模型组）、电针内关组、电针神门组、电针合谷组,用无机磷比色法测定SERCA活性、RT-PCR法分析SERCA基因表达。结果：与假手术组比,模型组SERCA活性及其基因表达均有非常显著性差异（P〈0.01）,电针内关组、电针神门组与模型组比较差异有显著性（P〈0.05,P〈0.01）,电针内关组优于电针神门组（P〈0.05,P〈0.01）。结论：电针内关上调心肌SERCA基因表达,增强SERCA活性是实现对再灌注损伤心肌组织保护作用的途径之一。电针内关与电针神门两组疗效差异说明经穴对靶器官机制调节作用与经脉（穴）脏腑间的特异联系密不可分。     

预防性光照疗法和综合护理干预对早产儿高胆红素血症的影响

目的：探讨预防性光照疗法和综合护理干预对早产儿高胆红素血症的影响。方法：将160例早产儿随机分为两组各80例。对照组接受常规治疗和护理,干预组无论有无黄疸都进行预防性光疗,并在此基础上给予包括灌肠、抚触、腹部按摩和营养支持在内的综合护理干预。结论：对早产儿给予预防性光疗和综合护理干预可阻止高胆红素血症及胆红素脑病的出现,减少后遗症的发生。