中国10个地区成年人共病流行特征分析

目的 描述中国成年人的共病流行情况及其长期变化,以及常见的共病模式。方法 本研究纳入参与中国慢性病前瞻性研究第二次重复调查的25 033人,利用研究对象参加2004-2008年基线调查和2013-2014年第二次重复调查时采集的信息进行分析。根据自报疾病史、现场体格检查及血液样本检测等信息定义了13种慢性病或健康问题,将共病定义为同时患有≥2种慢性病或健康问题。采用系统聚类分析法描述共病模式。结果 研究对象在基线调查时的年龄为（51.5±10.1）岁,第二次重复调查时为（59.5±10.2）岁。2次调查平均间隔时间（8.0±0.8）年,共病率由33.5%上升至58.1%,人均患病数由1.15个增加至1.82个,平均每5年增长0.42个患病数。年长者、城市人群、文化程度低者的共病率较高,且患病数量随年龄的增速更快。吸烟及过量饮酒者的患病数量随年龄增速也更快。该人群中最常见的共病组合为：超重肥胖、高血压、糖尿病、中风和冠心病。结论 我国成年人群共病率较高,且随年龄增长而增加。共病情况在不同地区、文化程度水平和不同生活方式人群中存在差异。     

食管癌筛查队列操作流程与建设标准方案探讨

癌症防治工作的重点在于一级预防和二级预防,通过健康教育引起人们对疾病的重视、自觉改变不良行为习惯、主动参加定期体检是防治癌症性价比最高的措施之一。食管癌作为我国疾病负担较重的恶性肿瘤之一,定期筛查和早诊早治是该病防治工作的重点。而队列研究有助于了解食管癌的自然史和危险因素、识别食管癌高危人群。本研究拟从危险因素调查、疾病监测、生物样本信息搜集等方面对食管癌多维动态随访共享队列的建设规范进行探讨,为今后建立规范统一的食管癌筛查队列研究操作流程和建设标准提供参考。     

A nationwide post-marketing survey of knowledge,attitude and practice toward human papillomavirus vaccine in general population: Implications for vaccine roll-out in mainland China

BackgroundHuman papillomavirus (HPV) vaccine has been increasingly discussed in mainland China since its first approval in 2016. To date, nearly all studies assessing HPV vaccine perceptions and attitudes were implemented during pre-licensure period. Therefore, the nationwide post-marketing survey was conducted to update knowledge, attitudes and practice on HPV vaccine among general population in mainland China.MethodsParticipants aged 18–45 years living in mainland China were recruited in April 2019 by multi-stage non-randomized sampling. Sociodemographic factors, HPV and HPV vaccine related awareness, knowledge, attitudes, vaccine uptake and potential obstacles were assessed in questionnaires. Bivariate analysis and multivariate regression were used to identify disparity among subgroups with different sociodemographic characteristics.Results4,000 women (32.1 ± 7.81y) and 1,000 men (31.8 ± 7.96y) were included in final analysis. Less than one third of participants had heard of HPV (female: 31%; male: 22%) and HPV vaccine (female: 34%; male: 23%). Knowledge score was also unfavorable on HPV (female: 3 out of 13; male: 1.8 out of 13) and HPV vaccine (female: 3 out of 6; male: 2 out of 5). Only 3% females had been vaccinated three years after HPV licensure in China, although willingness to get vaccinated among those unvaccinated were high (mean willingness score ± SD: female: 3.3 ± 0.97; male: 3.0 ± 0.98). Industry of employment and household income were the major factors related to awareness and knowledge of vaccine, whereas HPV and HPV vaccine awareness were key influential factors for willingness. The main obstacles of vaccination were safety concerns, lack of knowledge, and high price of HPV vaccines.ConclusionsFindings highlight a lack of vaccine awareness, knowledge, and poor uptake in mainland China and underscore the necessity of health education campaigns. The identified priority groups, contents to be delivered and practical obstacles could furthermore provide insight into health education to reduce disparities and accelerate HPV vaccine roll-out in China.     

四种无胃真骨鱼肠道L细胞的免疫组织化学研究

应用免疫组织化学ＡＢＣ技术，用高血糖素抗血清对鲢，鳙，团头鲂，银鲫的肠道内分泌细胞进行了免疫组织化学研究。４种鱼肠道中均显示出Ｌ细胞，分布密度各不相同，鲢肠只发布最多，银鲫肠中最少，Ｌ细胞位于肠褶各部，染色深褐，细胞以两端皆具突起的梭形细胞为主，多位于肠上皮细胞之间并与之平行，亦有少数末见突起的椭圆形细胞，多分布于上皮基部近基膜处，部分Ｌ细胞横卧于上皮基部与基膜贴近，突起伸向相邻细胞。少数Ｌ细胞位     

穿心莲内酯对TBHP诱导的椎间盘髓核细胞凋亡的作用及机制研究

目的：探讨穿心莲内酯（andrographolide,ANDRO）对叔丁基过氧化氢（tert-butyl hydroperoxide,TBHP）诱导的椎间盘髓核细胞（nucleus pulposus cells,NPC）凋亡的作用及其机制。方法：用TBHP诱导NPC建立细胞模型。将NPC分为5组：对照组、模型组（100μmol/L TBHP）、ANDRO低剂量组（100μmol/L TBHP+9μmol/L ANDRO）、ANDRO中剂量组（100μmol/L TBHP+18μmol/L ANDRO）和ANDRO高剂量组（100μmol/L TBHP+36μmol/L ANDRO）。流式细胞术检测细胞凋亡和活性氧（reactive oxygen species,ROS）水平,ELISA试剂盒检测氧化应激相关指标超氧化物歧化酶（superoxide dismutase,SOD）、谷胱甘肽过氧化物酶（glutathione peroxidase,GSH-PX）和过氧化氢酶（catalase,CAT）水平,JC-1探针法检测线粒体膜电位,Western blot检测动力相关蛋白1(dynam...     

Ca2+ channel actions of the non-dihydropyridine Ca2+ channel antagonist Ro 40-5967 in vascular muscle cells cultured from dog coronary and saphenous arteries

Summary We studied the membrane effects of (1S,2S)-2-(2-[[3-2(benzimidazolyl) propyllmethylamino]ethyl)-6-fluoro-1,2,3,4-tetrahydro-l-isopropyl-2-naphthyl-methoxy-acetate dihydrochloride, Ro 40-5967, a new non-dihydropyridine (DHP) Ca²⁺ channel antagonist, on dog coronary and saphenous arterial vascular muscle cells using the whole-cell patch-clamp method. Long-lasting (L-type) inward currents in 20 mM Ba²⁺ were measured over a range of test potentials (300 ms) from –50 mV to + 90 mV from a holding potential of –80 mV in the presence of 1 M Bay k8644 (a DHP Ca²⁺ agonist). Ro 40-5967 caused a concentration-dependent suppression of Ca²⁺ channel currents in muscle cells from both arteries, with greater potency on coronary than saphenous arterial cells. The concentration of Ro 40-5967 which inhibited the magnitude of peak inward currents by 50% (IC₅₀) was estimated to be 1 M (n = 5) in muscle cells from coronary artery and 10 M (n = 4) in saphenous artery. Ro 40-5967 (1 M) decreased the amplitude of the activation current-voltage relationship for coronary L-type Ca²⁺ channel currents over a wider range of membrane potentials than verapamil, diltiazem, or nifedipine. In contrast, block of Ca²⁺ channel currents in saphenous artery cells by 1 M Ro 40-5967 was only observed at command potentials positive to 0 mV. Ro 40-5967 (1 M) significantly shifted the voltage-inactivation curve downward by 40% in coronary (n = 4), but only by 18% in saphenous arterial muscle cells (n = 3). The non-parallel shift of the coronary artery inactivation curve suggests that pronounced resting channel block is a notable feature of Ro 40-5967. The marked inhibition of Ba²⁺ current by 1 M Ro 40-5967 in the inactivation protocol in coronary arterial muscle cells was found over the entire range of membrane holding potentials tested, while inhibition in the saphenous artery inactivation curve occurred only from holding potentials more positive than –40 mV. Therefore, Ro 40-5967 is unique: 1) in acting over a wider range of voltages, on both instantaneous and resting Ca²⁺ currents, than other Ca²⁺ antagonists; 2) in producing more significant resting state block; and 3) in acting with selectivity for coronary over saphenous arteries.This research was supported by National Institutes of Health grants HL38537, HL38645, and by F. Hoffmann-La Roche, Basel, Switzerland     

Optimal management of postpartum hemorrhage

目的　讨论产后出血干预治疗的合理方案。方法　回顾性分析 15例行干预性治疗的严重产后出血的病人的临床特点及方法。结果　 15例患者中子宫切除者 9例 ,行动脉栓塞治疗 7例 (2例切除子宫后又行栓塞治疗 ) ,行病灶挖除术 1例。需行干预性治疗的产后出血的原因依次为 :DIC ,子宫动 -静脉瘘及血管畸形 ,胎盘异常 ,子宫肌瘤及子宫裂伤。结论　应针对产后出血的不同原因、部位及性质选择合理有效的干预治疗。合理的治疗方案是抢救病人生命 ,保留生育功能 ,尽可能减少创伤的关键。     

移动平均数质控法在凝血试验中的应用

目的：建立凝血试验移动平均数质控法。方法：用移动平均数代替算术平均数,选择凝血验凝血酶原时间（ＰＴ）,活化的部分凝血激酶时间和纤维蛋白原３个项目,比较两种质控方法,同时用标准血浆作为质控。结果：当用适当的移动平滑系数时,移动平均数质控法既能排除病人标本非随机必的干扰,又能很好地反映试验前因素的影响。结论 ;移动平均数空法可用于凝血试验的实验室质控。     

透析中的终末期肾脏病可逆性探讨

透析中的终末期肾脏病 (ＥＳＲＤ) ,有不少医师认为已属不可治性 ,只能靠透析或肾移植维持生存。但也有人报道ＥＳＲＤ在透析治疗后有一定可逆缓解率〔1 ,2〕,部分患者肾功能可能恢复至氮质血症期甚至更低水平 ,并能脱离透析 ,避免肾移植或使之延后。本文回顾性分析本院 3 52例透析的ＥＳＲＤ病例 ,对ＥＳＲＤ的可逆缓解率及相关因素作初步探讨。对象与方法一、病例来源1992年 5月～ 1999年 9月曾在本院行血透治疗的所有慢性肾功能不全病例 ,符合下述条件者入选 :①患者有尿毒症的临床表现 (消化道症状及贫血为必备条件 ) ,肌酐清除率Ｃｃｒ…