医学生疑病现象的内在人格心理特征及应付方式分析

[目的]分析医学生疑病现象的人格心理特征及应付方式。[方法]以云南中医学院2006级（三年级）医学生为研究对象,以MMPI的疑病人格量表、90项症状清单（SCL-90）、应付方式问卷和卡氏十六种人格因素量表为主要测评工具,筛查疑病倾向医学生并对其内在人格心理特征及应付方式进行分析。[结果]疑病倾向医学生SCL-90的躯体化因子、强迫因子、抑郁因子、焦虑因子和偏执因子得分比非疑病倾向医学生均显著增高（P〈0．05）;应付方式的解决问题因子分显著低于非疑病倾向医学生（P〈0．01）,而自责和幻想因子分则显著高于非疑病倾向医学生（P〈0．05）;16-PF的乐群性和兴奋性因子分显著低于非疑病倾向医学生,而敏感性、怀疑性、幻想性、忧虑性、紧张性和自律性因子分均显著高于非疑病倾向医学生（P〈0．05）。[结论]疑病倾向医学生心理症状多表现为躯体化、强迫、抑郁、焦虑和偏执;低乐群、低兴奋、高敏感、高怀疑、高幻想、高忧虑、高紧张、高自律和不成熟的应付方式可能是疑病倾向医学生的人格行为特征。     

颗粒型生物膜反应器在污水处理中的应用

介绍了颗粒型生物膜反应器在污水处理中的应用情况,对比了不同反应器结构和技术特点.与传统的活性污泥法和静态生物膜反应器相比,颗粒型生物膜反应器具有沉降速度快、污泥浓度高、比表面积大等特点,可以达到很高的负荷,节省占地面积.另外,颗粒型生物膜反应器的污泥产率也非常低、不存在污泥膨胀的问题,日常维护也非常简单.并指出随着对该领域进一步的深入研究和新型反应器的开发,颗粒型生物膜反应器将得到更为广泛的应用.     

努力探索社区妇幼保健管理的新模式

上海市闸北区宝山地段医院经过 4年探索 ,在社区形成了妇幼保健管理和社区服务互相促进的发展机制。建立了社区妇幼保健协管员和志愿者队伍 ,这支队伍成为强有力的社区妇幼保健支持组织。同时 ,利用社区综合卫生服务点开展妇幼保健服务 ,结合保健保偿实行电脑化管理 ,开设妇幼保健特色门诊 ,加强人才培养 ,使社区妇幼保健工作上了一个新台阶。 4年实践及其取得的显著成效说明 ,积极争取政府的领导和支持 ,动员各部门和社区群众广泛参与 ,实行条块结合 ,这是推进社区妇幼保健事业的首要条件     

High‐dimensional propensity score algorithm in comparative effectiveness research with time‐varying interventions

The high‐dimensional propensity score (hdPS) algorithm was proposed for automation of confounding adjustment in problems involving large healthcare databases. It has been evaluated in comparative effectiveness research (CER) with point treatments to handle baseline confounding through matching or covariance adjustment on the hdPS. In observational studies with time‐varying interventions, such hdPS approaches are often inadequate to handle time‐dependent confounding and selection bias. Inverse probability weighting (IPW) estimation to fit marginal structural models can adequately handle these biases under the fundamental assumption of no unmeasured confounders. Upholding of this assumption relies on the selection of an adequate set of covariates for bias adjustment. We describe the application and performance of the hdPS algorithm to improve covariate selection in CER with time‐varying interventions based on IPW estimation and explore stabilization of the resulting estimates using Super Learning. The evaluation is based on both the analysis of electronic health records data in a real‐world CER study of adults with type 2 diabetes and a simulation study. This report (i) establishes the feasibility of IPW estimation with the hdPS algorithm based on large electronic health records databases, (ii) demonstrates little impact on inferences when supplementing the set of expert‐selected covariates using the hdPS algorithm in a setting with extensive background knowledge, (iii) supports the application of the hdPS algorithm in discovery settings with little background knowledge or limited data availability, and (iv) motivates the application of Super Learning to stabilize effect estimates based on the hdPS algorithm. Copyright © 2014 John Wiley & Sons, Ltd.     

Primary cilia in satellite cells are the mechanical sensors for muscle hypertrophy

Skeletal muscle atrophy is commonly associated with aging, immobilization, muscle unloading, and congenital myopathies. Generation of mature muscle cells from skeletal muscle satellite cells (SCs) is pivotal in repairing muscle tissue. Exercise therapy promotes muscle hypertrophy and strength. Primary cilium is implicated as the mechanical sensor in some mammalian cells, but its role in skeletal muscle cells remains vague. To determine mechanical sensors for exercise-induced muscle hypertrophy, we established three SC-specific cilium dysfunctional mouse models—Myogenic factor 5 (Myf5)-Arf-like Protein 3 (Arl3)^−/−, Paired box protein Pax-7 (Pax7)-Intraflagellar transport protein 88 homolog (Ift88)^−/−, and Pax7-Arl3^−/−—by specifically deleting a ciliary protein ARL3 in MYF5-expressing SCs, or IFT88 in PAX7-expressing SCs, or ARL3 in PAX7-expressing SCs, respectively. We show that the Myf5-Arl3^−/− mice develop grossly the same as WT mice. Intriguingly, mechanical stimulation-induced muscle hypertrophy or myoblast differentiation is abrogated in Myf5-Arl3^−/− and Pax7-Arl3^−/− mice or primary isolated Myf5-Arl3^−/− and Pax7-Ift88^−/− myoblasts, likely due to defective cilia-mediated Hedgehog (Hh) signaling. Collectively, we demonstrate SC cilia serve as mechanical sensors and promote exercise-induced muscle hypertrophy via Hh signaling pathway.

Exercise is considered as the primary intervention to improve muscle strength and to counteract muscle atrophy. While physical exercise training is considered a suitable intervention to improve muscle strength and endurance in healthy individuals, some people are resistant to the beneficial effects of exercise (1–3). It has been debated whether exercise is beneficial or harmful for patients with myopathic disorders (4) and type 2 diabetes (5). This so-called “exercise resistance” is considered congenital, and one recently identified causative factor involved in exercise resistance is hepatokine selenoprotein P (2, 6).Primary cilia have a mechanosensory function in bone cells (7), renal cells (8), and airway smooth muscle cells exert a role in sensing oscillatory fluid flow and transducing extracellular mechano-chemical signals into intracellular biochemical responses (9). Intriguingly, low muscle tone is a clinical feature often present in congenital ciliopathies with unclear underlying mechanisms (10). Arf-like Protein 3 (ARL3) is a highly conserved ciliary protein across ciliated organisms. ARL3, a regulator of intraflagellar transport in primary cilia, has been reported involving with various ciliary signaling functions (11, 12) and maintaining cell division polarity (13). Arl3 mutations cause Joubert syndrome (14, 15). Arl3^−/− knockout does not affect cilia structure but compromises ciliary function (16).Cells utilize primary cilia to convert environmental cues, mechanical or chemical, into various cellular signaling essential for development (17–21). During skeletal muscle development, Hedgehog (Hh) signaling helps to initiate the myogenic program (22). In myoblast cells, Fu et al. (23) showed that primary cilia are assembled during the initial stages of myogenic differentiation but disappear as cells progress through myogenesis. The ablation of primary cilia suppresses Hh signaling and myogenic differentiation while enhancing proliferation. However, there are still significant gaps in our understanding of how exercise and mechanical signals activate the Hh signaling pathway. In the present study, we hypothesize that primary cilia in satellite cells (SCs) transduce mechanical stimulation through activation of Hh signaling and promote muscle hypertrophy induced by exercise.Hypertrophy of skeletal muscle is a complex biological process that involves multiple cell types, including SCs, fibro-adipogenic precursors, endothelial cells, fibroblasts, pericytes, and immune cells. Removing cilia from fibro-adipogenic precursors can reduce intramuscular adipogenesis and increase myofibril size during muscle healing (24). SCs play an essential role in muscle hypertrophy and exercise adaptation (25, 26), especially in young mice (27). Mechanical signals can interrupt SC suppression in a skeletal muscle loss model induced by ovariectomy. Diminished SC number and elevated adipogenic gene expression in muscle caused by ovariectomy are averted by mechanical stimulation (28). Experiments in vitro indicate that mechanical stimulation enhances the fusion of SCs (29). SCs are a heterogeneous population of stem cells and committed progenitors (30). Paired box protein Pax-7 (Pax7) is a traditional marker of SCs and acts at different levels in a nonhierarchical regulatory network controlling SC-mediated muscle hypertrophy (31). A major target gene of Pax7 is Myogenic factor 5 (Myf5), and loss of Pax7 significantly decreases Myf5 expression in myoblasts (32). However, Myf5 is present in Pax3/Pax7 double mutants, indicating Myf5 activation occurs independently of Pax3/Pax7 (33). Furthermore, 10% of Pax7-expressing satellite cells have never expressed Myf5 (30). Parise et al. (34) observed an approximately sixfold increase in the number of Myf5-expressing cells by 48 h following exercise, which remained elevated until at least 96 h after exercise. We established three mouse models of Myf5-Arl3^−/−, Pax7-Intraflagellar transport protein 88 homolog (Ift88^−/−), and Pax7-Arl3^−/− to investigate the SC during mechanical stimulation and exercise. In the present study, we provide exciting evidence that SC cilia act as the key mechanical sensor for exercise-induced hypertrophy.     

Quantitative glycoproteomics of high-density lipoproteins

In this work, we developed a targeted glycoproteomic method to monitor the site-specific glycoprofiles and quantities of the most abundant HDL-associated proteins using Orbitrap LC-MS for (glyco)peptide target discovery and QqQ LC-MS for quantitative analysis. We conducted a pilot study using the workflow to determine whether HDL protein glycoprofiles are altered in healthy human participants in response to dietary glycan supplementation.

The optimized HDL glycoproteomics method was sensitive enough to detect the effects of dietary supplements on HDL protein glycoprofiles even in a small sample size.     

繁枝蜈蚣藻粗提物体外抗单纯疱疹病毒研究

目的：研究海藻繁枝蜈蚣藻抗单纯疱疹病毒Ⅰ型活性。方法：采用空斑减数实验测定5种不同提取方法所得蜈蚣藻粗提物抗HSV-1活性，计算空斑抑制率：郁ED50，并从药物对细胞的保护、对病毒增殖的影响及对病毒感染细胞的综合作用3个方面初探繁枝蜈蚣藻抗单纯疱疹病毒活性机理。结果：蜈蚣藻多糖能明显抑制HSV-1的致病变作用，ED。依次为8．72、12，16、8．93、8．49和805982．62μg／ml，药物住对细胞的保护及对病毒感染细胞的综合作用中均表现出明显活性。结论：繁枝蜈蚣藻有显著的抗HSV-1活性，且初步推测蜈蚣藻多糖抗HSV-1活性是作用在病毒和受体结合、侵入Vero细胞阶段。     

社区饮食和运动干预对代谢综合征患者糖脂代谢的影响

目的探讨社区饮食和运动干预对代谢综合征患者糖脂代谢的影响。方法对上海市某社区66名代谢综合征患者实施社区饮食和运动干预,饮食干预采用食品交换法,运动干预以步行为主,干预为期3个月,并随访3个月,同时将66名患者作为对照。结果干预组患者空腹血糖、果糖胺显著低于干预前和对照组,总胆固醇显著低于干预前,甘油三酯和高密度脂蛋白胆固醇无显著变化。结论社区饮食和运动干预能改善代谢综合征患者的糖代谢,对脂代谢效果不明显。     

农村外来务工人员的健康现状及相关知信行调查分析

目的了解农村外来务工人员的健康现状,评价其知信行水平,找出该人群的健康隐患以及采取有针对性的健康促进策略。方法采用二阶段随机抽样的方法,抽取192名15岁以上的外来务工人员进行问卷调查,问卷由宁波市健康教育所自行设计。结果外来务工人员以青壮年为主,且流出地集中,基本生活条件较差。知识得分的中位数为45.0分,不合格率为69.3%,优秀率仅为5.7%。高血压危险因素的知晓率只有7.3%,艾滋病的3个主要的传播途径的知晓率为46.4%。外来人员的吸烟率为23.6%,其中男性吸烟率为46.3%。6.8%的人经常喝生水,血压测量率和体检率都较低。结论外来务工人员预防和保健知识掌握情况较差,整体卫生意识淡薄,需要进行针对性的健康教育,并应制定有利于健康的相关公共政策。