保留左结肠动脉的腹腔镜直肠癌D3根治术对中晚期直肠癌患者的临床效果分析

目的探讨保留左结肠动脉的腹腔镜直肠癌D3根治术(Dixon)对中晚期直肠癌患者的临床效果分析。方法选取2015年12月至2018年1月60例中晚期直肠癌患者资料,根据术式不同分为保留组和未保留组,其中保留组(n=32)采用保留左结肠动脉的Dixon术,未保留组(n=28)采用高位结扎的Dixon术。采用SPSS 22.00软件对数据资料进行处理,围术期各项指标用(x±s)表示,采用独立t检验;术后并发症发生率、淋巴结清扫情况采用χ^2或Fisher检验,P<0.05表示差异有统计学意义。结果保留组肛门排气时间、边缘动脉弓压力显著少于未保留组(P<0.05),其余围术期指标比较均无统计学意义(P>0.05);两组清扫淋巴总数、转移淋巴结数及阳性淋巴结总数差异均无统计学意义(P>0.05),但保留组清扫第253组淋巴结数目显著大于未保留组(P<0.05);保留组吻合口漏发生率3.1%(1/32)显著少于未保留组10.7%(3/28),(P<0.05);两组患者术后1年肿瘤复发、转移发生率差异无统计学意义(P<0.05)。结论相比于高位结扎的Dixon术,保留左结肠动脉不增加术后肿瘤复发转移概率,并且可有效降低吻合口漏的发生率,具有良好的应用前景。     

低氧环境对椎间盘自发性吸收的影响及其作用机制

目的探讨低氧环境对椎间盘自发性吸收的影响及其作用机制。方法取SPF级成年日本大耳兔9只,雌雄不限,平均体质量2 kg。将兔处死后取脊柱髓核组织,经消化、分离、培养后获得传代髓核细胞,将生长良好的髓核细胞制成细胞悬液。根据不同时效的低氧环境将细胞分为5组对照组(常氧浓度下培养6 h)、低氧6 h组(2%O2浓度下培养6 h)、低氧12 h组(2%O2浓度下培养12 h)、低氧24 h组(2%O2浓度下培养24 h)和低氧48 h组(2%O2浓度下培养48 h)。采用实时聚合酶链反应法检测缺氧诱导因子(HIF)-1α、3型酸敏感离子通道(ASIC3)及水通道蛋白3(AQP3)mRNA表达水平,采用流式细胞仪检测各组髓核细胞凋亡情况。采用SPSS 24.0软件对数据进行分析。结果与对照组比较,低氧各组细胞凋亡率均明显升高,差异均有统计学意义(均P<0.01);与低氧12、24和48 h组比较,低氧6 h组细胞凋亡率最高,差异均有统计学意义(均P<0.01)。与对照组比较,低氧各组细胞HIF-1α和ASIC3 mRNA表达水平均明显上升,AQP3 mRNA表达水平均明显下降,差异均有统计学意义(均P<0.01);与低氧12、24和48 h组比较,低氧6 h组HIF-1α和ASIC3 mRNA表达水平最高,差异均有统计学意义(均P<0.01)。结论短时间低氧环境可以促进髓核细胞凋亡,从而加速椎间盘突出组织自发性吸收进程,其机制可能与HIF-1α和ASIC3的表达增加及AQP3的表达下降有关。     

The association between metabolic syndrome and lower urinary tract symptoms suggestive of benign prostatic hyperplasia in aging males: evidence based on propensity score matching

BackgroundTo investigate the association between lower urinary tract symptoms suggestive of benign prostate hyperplasia (LUTS/BPH) and metabolic syndrome (MetS) in aging Chinese males.MethodsA dataset that included 3,568 non-MetS cases and 1,020 MetS cases (after data cleansing) was downloaded from the China Health and Retirement Longitudinal Study (CHARLS). To balance the intergroup covariates, propensity score matching (PSM) was employed in the analyses. Univariate logistic regression and multivariate logistic regression were then performed to investigate the relationship between LUTS/BPH and MetS in aging Chinese males.ResultsBefore PSM, multivariate logistic regression showed that participants with MetS had a 1.47 times higher risk of LUTS/BPH compared to non-MetS cases in the final model (P<0.001). It also revealed that participants with low high-density lipoprotein (HDL), abdominal adiposity, or high triglycerides had a higher probability of LUTS/BPH [odds ratio (OR) =1.56 for low HDL; OR =1.50 for abdominal adiposity; and OR =1.48 for high triglyceride, P<0.001], while participants with hyperglycemia or hypertension had identical odds of LUTS/BPH (P>0.05). After PSM, 1,000 pairs were successfully matched. It was also found that MetS cases had a 1.60 times higher risk of LUTS/BPH compared to non-MetS cases (P<0.001), and participants with low HDL, abdominal adiposity, high triglycerides, or hyperglycemia had a higher likelihood of LUTS/BPH than their counterparts (P<0.001). However, the probability of LUTS/BPH in hypertensive patients remained similar to that in non-hypertensive patients (P>0.05).ConclusionsAging Chinese males with MetS had a higher probability of LUTS/BPH. Also, patients with low HDL, abdominal obesity, high triglycerides, or hyperglycemia had an increased risk of LUTS/BPH; however, this was not the case for hypertensive patients.     

中国9个长寿地区65岁及以上人群氧化应激水平与高甘油三酯血症的关联研究

目的探讨我国长寿地区65岁及以上老年人氧化应激水平与高甘油三酯血症的关系。方法研究对象来源于2017-2018年“老年健康生物标志物队列研究”,最终将我国9个长寿地区2393名65岁及以上老年人群纳入研究。通过问卷调查和体格检测,收集调查对象的人口学特征、生活方式及健康状况等信息,同时采集调查对象的静脉血以检测丙二醛(MDA)、超氧化物歧化酶(SOD)及甘油三酯水平。采用限制性立方样条拟合多重线性回归模型分析MDA、SOD与甘油三酯的关联,采用广义线性混合效应模型分析氧化应激与高甘油三酯血症的关联。结果2393例调查对象年龄为(84.6±11.3)岁,最小65岁,最大112岁;男性1145名(47.9%);甘油三酯水平为(1.4±0.8)mmol/L,高甘油三酯血症检出率为9.99%(239名)。限制性立方样条拟合多重线性回归模型分析结果显示,MDA水平与甘油三酯水平呈线性关联;SOD水平与与甘油三酯水平呈非线性关联。广义线性混合效应模型分析结果显示,调整相关混杂因素后,MDA每升高1 nmol/ml,高甘油三酯血症检出风险增加[OR(95%CI)值为1.063(1.046,1.081)];SOD每升高1 U/ml,高甘油三酯血症检出风险降低[OR(95%CI)值分别为0.986(0.983,0.989)]。结论我国9个长寿地区65岁及以上老年人MDA和SOD水平与高甘油三酯血症发生风险有关联。     

深圳市学龄儿童接种流感疫苗对缺课预防效果的实证研究

目的 评估深圳市采用入校接种方式以及学龄儿童流感疫苗接种率高低对缺课的影响。方法 以深圳市小学学龄儿童为研究对象,利用2017年12月至2020年6月深圳市286所小学缺课数据以及学龄儿童流感疫苗接种政策实施后深圳市9个区疫苗接种率和组织方式（入校接种与非入校接种）数据,以缺课人数作为被解释变量,分别以组织方式和区接种率作为分组变量,构建双重差分模型,采用泊松回归进行分析,并对回归结果进行稳健性检验。结果 相比于非入校接种和低接种率,入校接种和高接种率可有效降低缺课的发生风险,对缺课的预防效果分别为32.6%（95%CI： 17.0%~45.3%,P<0.01）和53.0%（95%CI：42.1%~61.8%,P<0.01）。结论 深圳市实施学龄儿童流感疫苗免费接种政策并优先采用入校接种的方式,可有效降低学生缺课的发生风险。     

中国9个长寿地区65岁及以上人群血铅浓度与认知功能受损的关联研究

目的探讨65岁及以上人群血铅水平与认知功能受损的关联。方法研究对象来自2017-2018年在我国9个长寿地区开展的“老年健康生物标志物队列研究”,最终将1684名血铅和认知功能数据完整的65岁及以上人群纳入本研究。通过问卷调查和体格检测,收集调查对象的人口学特征、生活方式、健康状况及认知功能评分等信息;同时采集调查对象的静脉血以检测血铅水平。根据血铅水平的四分位数将调查对象分为4组(Q₁-Q₄组),采用多因素logistic回归模型分析血铅浓度与认知功能受损的关系,采用限制性三次样条检验血铅浓度与认知受损之间是否存在非线性关联。结果1684名研究对象年龄为(83.1±11.1)岁,其中女性843名(50.1%);认知功能受损者191名(11.3%)。调整相关混杂因素后,老年人血铅浓度每升高10μg/L,认知功能受损患病风险OR(95%CI)值为1.05(1.01~1.10);与血铅浓度Q1组老年人相比,血铅浓度较高者认知功能受损的患病风险较高,Q₂,Q₃,Q₄组的OR(95%CI)值分别为1.19(0.69~2.05)、1.45(0.84~2.51)和1.92(1.13~3.27)。结论我国9个长寿地区65岁及以上老年人血铅水平与认知功能受损患病风险存在关联。     

Dental Care Utilization of Hospitalized Persons Living with HIV and Substance Use

Journal of Community Health - People living with HIV (PLWH) who use drugs experience worse health outcomes than their non-using counterparts. Little is known about how often they seek dental care...     

Mycobacterium ulcerans-specific immune response after immunisation with bacillus Calmette-Guérin (BCG) vaccine

BackgroundBacillus Calmette–Guérin (BCG) vaccine provides partial protection against Buruli ulcer caused by Mycobacterium ulcerans in epidemiological studies. This study aimed to quantify M. ulcerans-specific immune responses induced by BCG immunisation.MethodsIntracellular cytokine analysis of in-vitro experiments done 10 weeks after BCG immunisation in 130 Australian infants randomised to one of three BCG vaccine strains given either at birth (BCG-Denmark, BCG-Japan, or BCG-Russia) or at two months of age (BCG-Denmark).ResultsProportions of polyfunctional CD4⁺ T-cells were higher in M. ulcerans-stimulated compared to unstimulated control samples. These proportions were not influenced by the vaccine strain or timing of the immunisation. The M. ulcerans-specific immune responses showed similar patterns to those observed in M. tuberculosis-stimulated samples, although they were of lower magnitude.ConclusionsOur data show that BCG immunisation induces M. ulcerans-specific immune responses in infants, likely explaining the cross-protective effect observed in epidemiological studies. (ACTRN12608000227392)     

Immunogenicity,safety and reactogenicity of ROTAVAC® in healthy infants aged 6–8 weeks in Vietnam

BackgroundROTAVAC® is derived from human 116E rotavirus (RV) neonatal strain. In this study, we evaluated the immunogenicity, safety and reactogenicity of ROTAVAC® in Vietnam.MethodWe conducted a phase IV clinical trial in healthy infants aged 6–8 weeks using the complete regimen of ROTAVAC® with three doses. Serum anti-RV IgA was measured by enzyme-linked immunosorbent assay to assess the geometric mean concentration in infants who received the complete regimen of the vaccine.ResultsA total of 360 participants were enrolled in this clinical trial. The mean age ± standard deviation at enrollment was 6.9 ± 0.6 weeks. The anti-RV IgA titer was 4.01 ± 3.74 mg/ml pre-vaccination and substantially increased to 29.27 ± 80.64 mg/ml post-vaccination. The value of logIgA significantly increased (p = 0.003) from 0.28 ± 0.79 to 1.03 ± 0.54. The proportion of participants with equal to and greater than 3-fold and 4-fold shifts in pre- to post-vaccination antibody titer (IgA) were 55.4% and 48.3%, respectively. No adverse events or serious adverse events were recorded immediately within 30 min after the administration of each dose. The most common adverse events within 14 days after each visit were fever, unusual crying and irritability. Other adverse events occurred at a low rate, and no case of intussusception was noted.ConclusionsThe complete regimen of ROTAVAC® demonstrated an immunological response with clinically acceptable safety profile. Post-completion of this study, ROTAVAC® is now a WHO-prequalified vaccine and available in Vietnam.