The healthy urinary microbiome in asymptomatic participants in the MAPP Network Study: Relation to gender,age, and menopausal status

IntroductionTo understand the role of the urinary microbiome in disease states and interpret non-culture-based diagnostic urine testing of midstream urine specimens, we must have a better understanding of the urinary microbiome in asymptomatic, healthy individuals. We examined the impact of gender, age, and menopausal status on the healthy human urinary microbiome in asymptomatic control subjects enrolled in the multi-institution National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Multidisciplinary Approach to the Study of Chronic Pelvic Pain Network (MAPP) study.MethodsAsymptomatic, healthy controls, recruited to be ageand sex-matched to patients in the Trans-MAPP Epidemiology and Phenotyping Study, provided midstream urine collection for polymerase chain reaction (PCR)-electrospray ionization mass spectrometry identification of urinary microbiota. The microbiomes of male and female participants were described and analyzed for differences in composition and diversity at the species and genus level by sex, age, and, in females, by menopausal status.ResultsSixty-six total species were detected with a mean of 1.2 species (standard deviation [SD] 1.1) per male (n=97; mean age=43) and 2.3 (SD 1.3) per female (n=110, mean age=38) in asymptomatic, healthy controls. Species and genera diversity analyses showed significantly greater richness and diversity in females. With regard to species, Bifidobacterium subtile, Lactobacillus crispatus, and Lactobacillus johnsonii were more predominant in females. The genera Bifidobacterium, Staphylococcus, Lactobacillus, and Corynebacterium were more predominant in females, while for males the most prevalent organisms included Staphylococcus and Propionibacterium; only Propionibacterium approached a significant difference between genders. No significant difference in the presence and/or diversity of micro-organisms with menopausal status could be observed. Sex-specific age trends, particularly diversity, were larger for females than males.ConclusionsThese results suggest the urinary microbiome of healthy, asymptomatic subjects differed between genders and age in females, but not menopausal status. Gender differences may be attributable to the detection of urethral/vaginal organisms in females and prostate organisms in males. These findings will better allow us to interpret the results of microbiome reports in the midstream urine specimens of patients with urinary symptoms.     

Digitalization of routine health information systems: Bangladesh,Indonesia, Pakistan

ObjectiveTo describe a systematic process of transforming paper registers into a digital system optimized to enhance service provision and fulfil reporting requirements.MethodsWe designed a formative study around primary health workers providing reproductive, maternal, newborn and child health services in three countries in Bangladesh, Indonesia and Pakistan. The study ran from November 2014 to June 2018. We developed a prototype digital application after conducting a needs assessment of health workers’ responsibilities, workflows, routine data requirements and service delivery needs. Methods included desk reviews, focus group discussions, in-depth interviews; data mapping of paper registers; observations of health workers; co-design workshops with health workers; and usability testing. Finally, we conducted an observational feasibility assessment to monitor uptake of the application.FindingsResearchers reviewed a total of 17 paper registers across the sites, which we transformed into seven modules within a digital application running on mobile devices. Modules corresponded to the services provided, including household enumeration, antenatal care, family planning, immunization, nutrition and child health. A total of 65 health workers used the modules during the feasibility assessment, and average weekly form submissions ranged from 8 to 234, depending on the health worker and their responsibilities. We also observed variability in the use of modules, requiring consistent monitoring support for health workers.ConclusionLessons learnt from this study shaped key global initiatives and resulted in a software global good. The deployment of digital systems requires well-designed applications, change management and strengthening human resources to realize and sustain health system gains.     

幽门螺杆菌感染对功能性消化不良患者的自主神经功能和降钙素基因相关肽的影响

目的探讨幽门螺杆菌(H.pylori)感染对功能性消化不良(FD)患者自主神经功能和降钙素基因相关肽的影响。方法以符合罗马Ⅳ诊断标准的31例FD患者为研究对象,根据是否感染H.pylori将FD患者分为H.pylori+组和H.pylori-组,分别对两组患者进行消化不良症状指数(SID)、尼平消化不良指数(NDI)和医院焦虑抑郁量表的测评,并检测患者的心率变异性(HRV)及降钙素基因相关肽(CGRP)的表达。结果两组患者在SID(Z=-0.858,P=0.858)、NDI(Z=-1.464,P=0.143)和医院抑郁评分(Z=0.699,P=0.485)方面差异无统计学意义,但H.pylori+组患者的医院焦虑评分明显高于H.pylori-组(Z=-2.470,P=0.014)。H.pylori+组的CGRP水平为(0.999±0.274)ng/ml,明显高于H.pylori-组的(0.812±0.172)ng/ml(t=2.238,P=0.033)。两组患者的HRV在极低频率(t=-1.210,P=0.236)、低频功率(LF)(t=0.419,P=0.678)、高频功率(HF)(...     

银杏叶提取物对血管性痴呆小鼠大脑皮层生长抑素及胆囊收缩素表达的影响

目的 观察银杏叶提取物(EGB)对血管性痴呆(VD)小鼠大脑皮层生长抑素(SS)和胆囊收缩素(CCK)表达的影响,探讨EGB对VD的改善作用.方法 复制VD小鼠模型,利用Y-迷宫检测VD模型小鼠学习记忆能力及不同剂量EGB治疗组的改善作用,实时定量聚合酶链式反应(PCR)方法检测各组动物大脑皮层中生长抑素和胆囊收缩素mRNA的变化,免疫组织化学方法研究不同剂量EGB对VD小鼠大脑皮层生长抑素和胆囊收缩素阳性神经元数量的影响.结果 各试验组小鼠均比对照组小鼠Y-迷宫学习记忆训练次数明显增多(P＜0.05),高低剂量EGB治疗组迷宫学会次数与模型组相比明显减少,且高剂量治疗组减少更明显(P＜0.05).VD模型组小鼠大脑皮层生长抑素和胆囊收缩素mRNA转录水平与对照组相比显著下调,高低剂量EGB治疗组与VD模型组相比显著上调(P ＜0.05);VD模型组小鼠大脑皮层生长抑素和胆囊收缩素阳性神经元数量与对照组相比显著减少,高低剂量EGB治疗组与VD模型组相比显著增多(P＜0.05).结论 EGB通过增加大脑皮层中生长抑素和胆囊收缩素的表达,对VD小鼠的学习记忆能力可起到一定的改善作用.     

姜芡止泻汤治疗抗生素相关性腹泻脾肾阳虚证疗效及对肠道菌群结构的影响

目的 观察姜芡止泻汤治疗抗生素相关性腹泻(AAD)脾肾阳虚证的疗效及对肠道菌群结构的影响.方法 采用随机数字表法将120例患者分为治疗组及对照组各60例.治疗组予姜芡止泻汤,每日1剂,每日2次,口服或鼻饲;对照组予甲硝唑片+双歧杆菌三联活菌,每日3次,口服或鼻饲.2组均连续治疗7 d.观察2组临床疗效、中医症状评分、西...     

疏肝健脾法治疗2型糖尿病30例

目的观察疏肝健脾法治疗肝郁脾虚型2型糖尿病的临床疗效。方法选择符合标准的肝郁脾虚型2型糖尿病患者60例,随机分为治疗组30例（中西药结合组）和对照组30例（西药组）,记录治疗前后的血糖、血脂、胰岛素水平、体重指数、胰岛素抵抗指数及中医证候积分,进行统计学分析。结果治疗组和对照组在治疗前后的血糖、血脂、体重指数、胰岛素抵抗指数和中医证候积分方面均有明显改善,在改善餐后2小时血糖、甘油三酯、胰岛素抵抗指数、中医证候积分方面,治疗组明显优于对照组（P〈0．05）。结论疏肝健脾法可明显改善临床症状、体征,改善2型糖尿病患者的胰岛素抵抗,降低胰岛素、血糖、血脂水平。疏肝健脾法对于治疗2型糖尿病具有良好的效果。     

Sexual victimization and completed suicide among danish female adults

Although sexual victimization has been associated with suicidal behaviors, its association with completed suicide has not been examined. We investigated this association among Danish women using longitudinal data and a conservative definition of victimization. This population-based case-control study included 476 suicide cases and 12,010 matched controls. Seven cases (1.5%) and 5 controls (0.04%) experienced sexual victimization that was reported to the police and resulted in a conviction. Sexual victimization was associated with a 14-fold increased rate of suicide, controlling for confounders and matching (95% CI: [3.4, 59]). Completed suicide is an important potential outcome of sexual victimization, warranting further examination.     

喉鳞状细胞癌的转录组数据分析及生物标志物筛选

目的 通过数据挖掘分析长链非编码RNA(lncRNA)、微小RNA(miRNA)和信使RNA(mRNA)在喉鳞状细胞癌中的相互作用机制.方法 从肿瘤基因图谱(TCGA)中获取喉鳞状细胞癌的lncRNA、miRNA、mRNA表达谱数据及相关临床数据,从TCGA和GEO数据库中获取喉鳞状细胞癌的DNA甲基化数据.进行蛋白相...     

线上线下混合式信息素养教学模式构建

介绍国内慕课环境下信息素养课程研究现状,结合广州医科大学图书馆教学实践,阐述慕课融合项目教学法嵌入信息素养课程教学设计与实践、实施方案调整情况,讨论慕课平台选择等问题,为相关研究提供参考。