突发公共卫生事件应急决策支持方法综述

采用文献分析方法,基于中国知网和Web of Science,从传统应急决策支持、基于大数据的应急决策支持两方面,详细阐述突发公共卫生事件应急决策支持方法、模型、系统和应用的国内外研究现状。     

多囊卵巢综合征患者个体化辅助生殖助孕策略与难点

多囊卵巢综合征（PCOS）是导致育龄期女性不孕的重大疾病之一,严重影响患者身心健康。PCOS患者往往存在下丘脑-垂体-卵巢轴功能异常和代谢紊乱,严重损害正常的生殖过程。辅助生殖技术是PCOS相关不孕症的重要治疗手段,但患者的卵巢高反应状态使卵巢过度刺激综合征（OHSS）的风险升高,增加患者的治疗风险与经济负担。为提高妊娠率、减少OHSS风险、改善辅助生殖助孕的临床结局,临床医生需要在辅助生殖助孕的全过程进行综合干预。如何全面优化PCOS患者辅助生育助孕过程的管理策略是近年来的研究热点。本文旨在结合本团队既往的研究结果和临床经验,从超促排卵前的预处理、卵巢刺激方案、促排药物类型和剂量、OHSS预防策略等方面对目前PCOS患者辅助生殖助孕策略的现状和难点进行评述,以期进一步推动PCOS患者个体化辅助生殖助孕策略的临床应用和科学研究     

上颌窦底黏膜增厚与牙槽骨高度及上颌窦解剖结构的关联性

目的 通过观测上颌后牙缺失患者的锥形束CT,研究上颌窦底黏膜增厚与缺牙区部分解剖结构的关系,为上颌窦底黏膜增厚患者的上颌窦提升术与缺失牙种植治疗提供临床参考。方法 收集2013年1月—2022年5月于天津医科大学附属口腔医院牙周科与广州医科大学附属口腔医院牙周科拍摄锥形束CT的患者资料,筛选出上颌单侧单颗后牙缺失的患者103例,通过CBCT三维重建,并以上颌窦底黏膜是否增厚（＞2 mm）作为分组标准,测量牙槽骨高度、宽度、上颌窦外侧壁血管至窦底距离、上颌窦外侧壁厚度,以同一患者自身两侧指标的差值为统计值,分析上颌窦底黏膜增厚是否对缺牙区部分解剖结构存在影响。结果 最终纳入上颌窦底黏膜增厚组56例,非上颌窦底黏膜增厚组47例。对其指标进行统计,其中两组患者的牙槽骨高度差值存在差异,上颌窦底黏膜增厚组大于非上颌窦底黏膜增厚组,差异有统计学意义（P＝0.0246）。两组间的牙槽骨宽度、上颌窦外侧壁厚度、上颌窦外侧壁血管至窦底距离的差值,差异无统计学意义（P＞0.05）。结论 持续存在的上颌窦底黏膜增厚可能与缺牙后牙槽骨高度的变化存在关联     

可溶性铀的内吞外排及对HK-2细胞的损伤研究

目的研究人肾近曲小管细胞(HK-2)对可溶性铀的内吞和外排情况,了解铀暴露后的细胞毒性效应。方法采用CCK-8法测定不同浓度铀染毒后细胞活性,分别在光镜和透射电子显微镜下观察细胞铀染毒后的变化;采用ICP-MS法测定细胞在不同时间对铀的内吞、外排情况;采用流式细胞仪检测铀染毒后细胞周期和细胞凋亡的变化。结果 HK-2细胞在铀暴露后出现剂量依赖性损伤,细胞周期阻滞在G1期,细胞发生凋亡和坏死,细胞增殖受到了抑制;细胞内吞的铀含量在24 h内逐渐增加,同时铀的内吞量存在阈值,细胞表面结合的铀含量分数较低(<0.2%),细胞内吞的铀1 h内40%以上都会排出胞外;铀在细胞内和细胞外均会形成针样状沉淀(300μM);结论细胞在铀染毒后出现周期阻滞、凋亡和细胞活性下降,可溶性铀的内吞、外排过程非常迅速,细胞可将可溶性铀转化为无毒性的沉淀。     

我市城区社区护理人力资源现状调查

目的分析我市城区社区护理人力资源现状,为合理配置社区护理人力资源提出建议。方法通过问卷调查、文献研究等方法调查我市城区社区护理人员数量、质量与结构。结果护理人员年龄、学历、职称、从事社区护理工作年限普遍偏低,从业范围较窄。结论护理人员素质偏低,严重影响了社区护理职能和护理质量,提高护理人员的整体素质和调整护理队伍结构是我市城区社区卫生服务全面发展的当务之急。     

探讨基于一带一路背景下中医药发展的有效途径

中医药文化是中华文化的瑰宝,也是传播中华文明的重要枢纽.近年来,由于国家大力推动"一带一路"的建设,中医药对外发展的趋势日益上升.本文通过分析一带一路下中医药的历史渊源和发展现状,思考科学发展中医药,提高传播软实力的方式方法;并围绕"一个中心,多个落脚点",以多个方向形式发展中医药文化,推动中医药进一步弘扬于外.     

下颌升支矢状劈开前移术对成年骨性Ⅱ类下颌后缩女性患者上气道影响的CBCT研究

目的:研究下颌升支矢状劈开前移术对成年骨性Ⅱ类下颌后缩女性患者上气道影响.方法:选取成年骨性Ⅱ类下颌后缩女性患者40例,根据采用不同的治疗方式分为两组:手术组20例采用双侧下颌升支矢状劈开截骨术前移下颌+正畸治疗,代偿组20例采用单纯正畸掩饰治疗.收集患者正畸治疗前和正畸治疗结束时的CBCT数据.分别测量正畸治疗前和正...     

牛磺熊去氧胆酸治疗胆石症有效性、安全性和经济性的卫生技术评估

目的:基于卫生技术评估(HTA)方法,系统评价牛磺熊去氧胆酸(TUDCA)治疗胆石症的有效性、安全性和经济性.方法:计算机系统检索PubMed,Embase,the Cochrane Library,CNKI和万方数据库,以及检索国内外HTA数据库与官方网站,纳入TUDCA治疗胆石症的HTA报告、系统评价、随机对照试验...     

星形细胞肿瘤中RCAS1的mRNA及蛋白表达的临床意义

目的:探讨RCAS1在人星形细胞肿瘤中的基因及蛋白表达,及其与肿瘤发生、发展的关系.方法:RT-PCR法检测59例新鲜星形细胞肿瘤组织及6例正常脑组织中RCAS1的mRNA表达.免疫组织化学法检测71例星形细胞肿瘤及6例正常脑组织病理切片中RCAS1的蛋白表达.结果:弥漫型星形细胞瘤(GradeⅡ)和间变型星形细胞瘤之间(Grade Ⅲ)、间变型星形细胞瘤和胶质母细胞瘤(Grade Ⅳ)之间RCAS1 mRNA的表达有统计学差异(P＜0.05),而RCAS1蛋白表达仅在间变型星形细胞瘤和胶质母细胞瘤之间存在统计学差异(P＜0.01),RCAS1蛋白表达与肿瘤级别呈正相关(r=0.573,P＜0.001).在正常脑组织中未检测到RCAS1蛋白.结论:RCAS1的表达与星形细胞肿瘤的病理分级有关.星形细胞肿瘤中RCAS1的表达在转录和转录后水平受到调节.     

New predictors of in-stent restenosis in patients with diabetes mellitus undergoing percutaneous coronary intervention with drug-eluting stent

Background Percutaneous coronary intervention (PCI) had become the major therapeutic procedure for coronary artery disease (CAD), but the high rate of in-stent restenosis (ISR) still remained an unsolved clinical problem in clinical practice. Increasing evidences suggested that diabetes mellitus (DM) was a major risk factor for ISR, but the risk predictors of ISR in CAD patients with DM had not been well characterized. The aim of this study was to investigate the clinical and angiographic characteristic predictors significantly associated with the occurrence of ISR in diabetic patients following coronary stenting with drug-eluting stent (DES). Methods A total of 920 patients with diabetes who diagnosed CAD and underwent coronary DES implantation at Beijing Anzhen Hospital in China were consecutively enrolled from January 2012 to December 2012. Of these, 440 patients underwent the second angiography within ≥ 6 months due to the progression of treated target lesions. Finally, 368 of these patients who met the inclusion and exclusion criteria were followed up by angiography after baseline PCI. According to whether ISR was detected at follow-up angiography, patients were divided into the ISR group (n = 74) and the non-ISR group (n = 294). The independent predictors of ISR in patients with DM were explored by multivariate Cox’s proportional hazards regression models. Results A total of 368 patients (260 women and 108 men) with a mean ages of 58.71 ± 10.25 years were finally enrolled in this study. Of these, ISR occurred in 74/368 diabetic patients (20.11%) by follow-up angiography. Univariate analysis showed that most baseline characteristics of the ISR and non-ISR group were similar. Patients in the ISR group had significantly higher serum very low density lipoprotein cholesterol (VLDL-C), triglyceride (TG) and uric acid (UA) levels, more numbers of target vessel lesions, higher prevalence of multi-vessel disease, higher SYNTAX score, higher rate of previous but lower rate of drinking compared with patients in the non-ISR group. The independent predictors of ISR in patients with DM after DES implantation included VLDL-C (HR = 1.85, 95% CI: 1.24–2.77, P = 0.002), UA (per 50 μmol/L increments, HR = 1.19, 95% CI: 1.05–1.34, P = 0.006), SYNTAX score (per 5 increments, HR = 1.34, 95% CI: 1.03–1.74, P = 0.031) and the history of PCI (HR = 3.43, 95% CI: 1.57–7.80, P = 0.003) by the multivariate Cox’s proportional hazards regression analysis. Conclusions The increased serum VLDL-C and UA level, higher SYNTAX score and the history of previous PCI were independent predictors of ISR in patients with DM after coronary DES implantation. It provided new evidence for physicians to take measures to lower the risk of ISR for the better management of diabetic patients after PCI.