中国老年人代谢综合征流行特征及其影响因素研究

目的 探讨我国≥ 60岁老年人群MS流行特征及其影响因素,为其防控工作提供科学依据。方法 数据来自2013年中国慢性病及其危险因素监测。采用多阶段分层整群抽样的方法对31个省（自治区、直辖市）的298个监测县（区）辖区内人群进行抽样,将其中50 497名≥ 60岁老年人作为研究对象。根据2017年中华医学会糖尿病分会提出的中国人的MS诊断标准,比较MS不同分组间患病率的差异,分析MS与主要影响因素的关联性。结果 我国老年人MS患病率为36.9%（95% CI：35.4~38.5）,城市高于农村,女性高于男性,东部地区高于西部地区。≥ 70岁老年人MS患病率低于60~69岁老年人。高文化程度、高家庭收入的老年人群MS患病率高于低社会经济水平的老年人群。MS各组分患病率比较显示,高血压的患病率最高,为72.8%,其次为高血糖和中心性肥胖。年龄、性别、文化程度、地区和城乡是MS的主要影响因素,吸烟、饮酒和身体活动水平与MS具有相关性。结论 我国老年人群中,女性MS患病风险高于男性,MS患病风险与社会经济水平和生活行为因素有关。建议对MS患病人群开展以增加运动和合理膳食为主的生活方式干预,高血压和高血糖患者在生活方式干预基础上需进行药物治疗,降低心血管疾病的发病和死亡风险。     

家庭参与式一体化照护对早产儿生长发育 及家庭照护能力的影响

目的 探讨基于家庭参与式护理模式的一体化照护对早产儿生长发育及家庭照护能力的影响。方法 选取74例早产儿及其家庭作为研究对象,随机分为干预组和对照组各37例。对照组接受早产儿常规护理;干预组接受基于家庭参与式护理模式的一体化照护方案,由专业照护团队在早产儿出生时、出生后及出院后提供全程一体化照护支持服务。比较两组早产儿的生长发育、母乳喂养情况及早产儿家庭照护能力。结果 两组各36例完成全程随访。两组早产儿在出生时、1月龄、3月龄身长、体质量、头围比较,差异无统计学意义(均P>0.05)。干预组早产儿在出院前、1月龄、3月龄的纯母乳喂养率显著高于对照组,且干预组父母在出院时家庭照护能力评分显著高于对照组(均P<0.05)。结论 基于家庭参与式护理模式的一体化照护能够有效促进早产儿纯母乳喂养、提高早产儿家庭照护能力,为早产儿顺利过渡至家庭照护提供有利保障。     

“中医适宜技术干预包”治疗阿片类药物相关性便秘的多中心临床观察研究

目的：通过多中心的临床研究,评价“中医适宜技术干预包”治疗阿片类药物相关性便秘的临床疗效。方法：选取2021年7月～2022年10月,在上海中医药大学附属岳阳中西医结合医院肿瘤科病房、利群医院安宁疗护病房、长征社区卫生服务中心安宁疗护病房进行住院治疗,符合阿片类药物相关性便秘诊断标准及便秘津亏肠燥证辨证标准的患者为纳入对象,采用随机数字表法随机分为对照组及干预组各164例。两组患者均参照《阿片类药物相关性便秘中西医结合护理方案》开展常规护理工作,对照组在常规护理的基础上,给予患者乳果糖口服液,每日３次,空腹服用,每次10ml,给予患者相应的用药指导;干预组在常规护理的基础上,采用“中医适宜技术干预包”,即中药贴敷、中药离子导入、耳穴压豆三项中医护理适宜技术联合治疗阿片类药物相关性便秘。两组患者干预疗程均为14天。比较干预后两组患者的日均排便人次数、平均排便间隔时间、干预前后两组患者的便秘症状评分及干预后的评分差值,便秘相关生活质量评分及干预后的评分差值、干预前后两组患者的疼痛评分。结果：治疗后两组患者在日均排便人次数（Z=-1.07,P=0.284）、平均排便间隔时间（Z=-1.06,P=0.286）两方面无明显差异。治疗后,干预组患者的便秘症状评分低于对照组（Z=-3.237,P=0.001）,两组患者的便秘相关生活质量评分差异无统计学意义（Z=-0.042,P=0.966）;干预组的便秘症状评分改善程度（（Z=-2.076,P=0.038）、便秘相关生活质量评分提高均比对照组患者更为明显（Z=-2.235,P=0.025）。治疗前后两组患者的疼痛评分均无显著差异（干预前：Z=-0.35,P=0.727;干预后：Z=-0.883,P=0.377）。结论：“中医护理干预包”可改善阿片类药物相关性便秘患者的便秘情况,同时可有效缓解患者的便秘不适症状,提高患者的生活质量,符合晚期肿瘤患者安宁疗护的理念,具有临床推广意义。     

Quantitative Distribution Characterization and Correlation Study of Composition,Structure and Hardness of Rim Region in Railway Wheel

The railway wheel is the key component of high-speed railway train. To assure the safety in service, higher requirements are put forward in this study for the composition, microstructure uniformity, and comprehensive properties of wheel materials. In this paper, the high throughput quantitative distribution characterization methods of composition, microstructure, inclusions and Vickers hardness of high-speed railway wheel materials based on the spark source original position analysis technique, high throughput scanning electron microscope (SEM) combined with image batch processing technology, and automatic two-dimensional quantitative distribution analysis technique of inclusions and micro hardness have been studied. The distribution trend of the content of nine elements, size and quantity of sulfides and oxides, ferrite area fraction, and Vickers hardness from the wheel tread surface to the radial depth of about 50 mm below the surface has been discussed. The influence of inclusions distribution on the element segregation and the effect of rim-chilling process with different water spraying angle on the distribution of microstructure and micro hardness have been investigated. It was found that unsynchronized cooling on both sides of the rim altered the phase behavior of ferrite and pearlite and obvious inhomogeneity distribution of ferrite appeared, which led to the asymmetrical Vickers hardness in areas near or away from the flange. Based on the quantitative characterization of area fraction and micro hardness on the same location of wheel rim, a statistical mapping relationship between ferrite area fraction and Vickers hardness was established.     

减肥类保健食品中非法添加盐酸西布曲明和酚酞的定性定量检测

目的建立准确检测减肥类保健食品中非法添加盐酸西布曲明和酚酞的定性定量方法。方法采用超高效液相色谱-串联质谱(UPLC-MS/MS)法,以0.1%甲酸的甲醇溶液和水溶液为流动相,通过分子离子峰、二级质谱的碎片离子、多反应检测模式的色谱峰等信息,对盐酸西布曲明和酚酞进行定性鉴别和定量测定。结果 4批保健食品中均检出盐酸西布曲明和酚酞。结论该方法准确可靠、专属性强、灵敏度高,可作为检测减肥类保健食品中非法添加盐酸西布曲明和酚酞的有效方法。     

免疫亲和柱净化光化学衍生高效液相色谱-荧光检测法测定动物类药材中黄曲霉毒素

目的建立动物类药材中黄曲霉毒素B1,B2,G1,G2的免疫亲和柱净化光化学衍生高效液相色谱-荧光检测(HPLC-FLD)法。方法样品经甲醇-水(80∶20)提取后,通过免疫亲和柱净化、柱后光化学衍生、高效液相色谱-荧光检测器测定。结果在优化条件下,黄曲霉毒素G2,G1,B2,B1的检出限分别为0.15,0.25,0.1,0.2μg/kg,回收率为78.8%～106.7%,RSD均低于7.1%。结论所用方法简便快速、灵敏度高、重现性好,可满足动物类药材中黄曲霉毒素检测的需要。     

Effectiveness of a double-carbapenem combinations against carbapenem-resistant Gram-negative bacteria

The emergence of carbapenem-resistant organisms posed considerable threat to global health while only limited treatment options are available and led to efforts to discover a novel way to treat them. To evaluate in vitro synergistic activity of meropenem plus ertapenem, a total of 203 carbapenem-resistant strains, collected from 12 provinces and municipalities in China, were examined with a dual carbapenem combination therapy. The statistical software R was used for analysis. Two hundred and one (201) of carbapenem-resistant strains mainly produced four types of carbapenemase: KPC-2 (n = 142, 69.95%), OXA-232 (n = 7, 3.45%), NDM (n = 38, 18.72%; 36 NDM-1, 1 NDM-4, 1 NDM-5), and IMP (n = 15, 7.39%; 1 IMP-26, 10 IMP-30, 4 IMP-4). Fifty-one out of two hundred and three (51/203 or 25.12%) of the examined strains showed a synergistic effect for the meropenem plus ertapenem combination throughout the checkerboard method, while only three isolates showed potential clinically relevant synergy (3/203, 1.48%). An additive effect was observed in 55/203 (27.09%) of the examined strains. Ninety-seven of the examined isolates (47.78%) showed fractional inhibitory concentration (FIC) greater or equal to 2 (indicating antagonism). The synergistic activity of meropenem plus ertapenem combination suggests this combination can be a possible way to treat the infection caused by the carbapenem-resistant organisms, especially for IMP or NDM producer with a lesser minimum inhibitory concentration (MIC) and the infected individual who was not recommended to use colistin or tigecycline.     

青年近视人群视网膜劈裂的OCT特征

目的：:通过频域光学相干断层扫描（SD-OCT）观察青年近视人群视网膜劈裂的类型、患病率、组成比例、分布规律及临床特征,探讨青年近视人群视网膜劈裂的SD-OCT影像学特点。方法：:横断面研究。收集2020年7—12月于河北医科大学第二医院眼科近视激光手术门诊就诊的近视患者523例（1 046眼）,其中低度近视（-3.0...