武汉市中学生饮酒状况及其影响因素调查

为了解武汉市中学生饮酒状况及其影响因素,对武汉市部分中学生进行封闭式问卷调查。结果：武汉市中学生饮酒率为21．0％,男生为31．3％,女生为10．9％;随着年级的上升饮酒率逐步上升;中学生饮酒与家庭环境、朋友关系等因素密切相关。影响中学生饮酒的主要因素有对饮酒的态度、性别、性别、年龄、家庭状况、父母及朋友的饮酒行为、父母的文化程度等,故控制中学生饮酒应从家庭入手,与家长配合进行,并注意中学生伙伴行为的影响。     

BT—BAK细胞和BCG膀胱腔内过继免疫治疗对膀胱癌患者全身免疫功能影响的比较

目的：观察BT-BAK细胞与BCG膀胱腔内灌注治疗对患者全身免疫功能的影响。方法：由手术切除的膀胱瘤标本制备膀胱肿瘤可溶性抗原,以BCG为佐剂,从PBMNC中诱导出抗膀胱肿瘤特异性细胞毒性BT-BAK细胞,临床选择72例浅表性膀胱癌术后患者随机平均分成2组分别进行BT-BAK和BCG的膀胱腔内灌注治疗。于不同阶段采用ELISA法测定患者外周血中IL-2、TNF-α及IFN-γ的含量;观察治疗后患者PBMNC对T24膀胱肿瘤细胞株杀伤活性的变化。结果：BT-BAK组患者血清中IL-2、TNF-α及IFN-γ的水平均较治疗前明显提高（P＜0.01);患者PBMNC对T24膀胱肿瘤细胞株的杀伤活性显著增强（P＜0.01)。BT-BAK组上述指标均高于BCG组（P＜0.05)。平均随访18.16个月,两组的复发率分别为2.7%和11.11%。结论：BT-BAK细胞及其培养上清进行膀胱腔内灌注治疗,能够有效提高膀胱癌术后患者的全身免疫水平,降低膀胱癌的术后复发率。     

脑血管痉挛大鼠血和脑组织ET—1、NO含量动脉变化的研究

目的：探讨内皮素（ET）－1和一氧化氮（NO）在蛛网膜下腔出血（SAH）后脑血管痉挛（CVS）及脑缺血性损害中的作用。方法：采用非开颅法大鼠SAH模型,检测24h内血及脑组织中NO和ET－1含量,并测定脑微区血流（rCBF）和基底动脉管径。结果：大鼠SAH后30min基底动脉管径缩小,rCBF持续下降;血NO减少,ET－1增多;脑组织NO和ET－1均增加。结论：血NO减少,ET增多系SAH后CVS发生的原因之一;脑组织NO和ET增多则加重脑损伤。     

64例狼疮性肾炎大剂量环磷酰胺冲击治疗的研究

目的　观察大剂量环磷酰胺冲击治疗狼疮性肾炎的疗效。方法　对 6 4例狼疮肾炎 ( L N ,其尿红细胞 >10个 /高倍视野 ,2 4小时尿蛋白 >1g,血肌酐 >133μmol/ L )进行大剂量环磷酰胺 ( CTX)冲击治疗 (每月 1次 ,共 6次 ,其后每 3月 1次 ,共 6次 )。结果　 49例 L N患者达到肾脏损害缓解 ( 2 4小时尿蛋白 <1g;血肌酐 <133μmol/ L ;尿沉渣内红细胞 <10个 /高倍视野 ;尿管型消失 )。达到肾脏病变缓解所需冲击次数平均为 3.6次 ( 1～8次 )。每次用 CTX剂量均数 1.1g( 0 .6～ 1.6 g)。副作用有闭经 (发生率 33% ) ;带状疱疹 (发生率 13% ) ;出血性膀胱炎 1例。结论　此治疗方案治疗 L N有效 ,安全 ,副作用小     

DNA拓扑异构酶I与肿瘤化疗

DNA拓扑异构酶 (topoisomerase ,TOPO )是一种基本的核酶 ,催化超螺旋结构的双链 DNA中某一条链的断裂和再接反应 ,从而改变 DNA的拓扑学状态 ,参与细胞DNA的复制和转录。TOPO 抑制剂是一类以 TOPO 为靶点的抗肿瘤药物 ,肿瘤细胞对 TOPO 抑制剂的耐药机制是复杂多样的 ,其中最主要的是 TOPO 基因突变和 TOPO 表达水平下降以及 TOPO 酶活性降低。笔者就近年来关于这方面的研究作一文献综述。1　 TOPO 及其抑制剂的作用机制人的 TOPO 是由 2 0号染色体上单拷贝基因编码的、分子量为 10 0 k Da的蛋白质。TOPO 催化 DN…     

The prognostic value of platelet-to-lymphocyte ratio on the long-term renal survival in patients with IgA nephropathy

Purpose

Platelet-to-lymphocyte ratio (PLR) was established showing the poor prognosis in several diseases, such as malignancies and cardiovascular diseases. But limited study has been conducted about the prognostic value of PLR on the long-term renal survival of patients with Immunoglobulin A nephropathy (IgAN).

Methods

We performed an observational cohort study enrolling patients with biopsy-proven IgAN recorded from November 2011 to March 2016. The definition of composite endpoint was eGFR decrease by 50%, eGFR?<?15 mL/min/1.73 m², initiation of dialysis, or renal transplantation. Patients were categorized by the magnitude of PLR tertiles into three groups. The Kaplan–Meier curves and multivariate Cox models were performed to determine the association of PLR with the renal survival of IgAN patients.

Results

330 patients with a median age of 34.0 years were followed for a median of 47.4 months, and 27 patients (8.2%) had reached the composite endpoints. There were no differences among the three groups (PLR?<?106, 106?≤?PLR?≤?137, and PLR?>?137) in demographic characteristics, mean arterial pressure (MAP), proteinuria, and estimated glomerular filtration rate (eGFR) at baseline. The Kaplan–Meier curves showed that the PLR?>?137 group was significantly more likely to poor renal outcomes than the other two groups. Using univariate and multivariate cox regression analyses, we found that PLR?>?137 was an independent prognostic factor for poor renal survival in patients with IgAN. Subgroup analysis revealed that the PLR remained the prognostic value for female patients or patients with eGFR less than 60 mL/min/1.73 m².

Conclusions

Our results underscored that baseline PLR was an independent prognostic factor for poor renal survival in patients with IgAN, especially for female patients or those patients with baseline eGFR less than 60 mL/min/1.73 m².

     

护士组织承诺对医院磁性水平影响的机制研究

目的 探究护士组织承诺、心理韧性对医院磁性水平的影响,为临床护理人力资源管理提供依据.方法 采用护士心理韧性量表、中国职工组织承诺量表、医院磁性要素量表对新疆地区4所三甲综合医院的3047名临床护士开展调查,并建立三者之间的关系模型.结果 护士心理韧性得分64.93士15.73,护士组织承诺得分81.53±16.66,护士感知医院磁性水平得分97.31土21.38.护士心理韧性与组织承诺、护士感知医院磁性水平呈正相关(r=0.492、0.483,均P＜0.01),护士组织承诺与感知医院磁性水平呈正相关(r=0.561,P＜0.01),组织承诺是心理韧性与医院磁性环境的中介变量,中介效应占总效应的55.40％.结论 护士心理韧性、组织承诺处于中等水平,护士感知医院磁性水平处于中等偏低水平,组织承诺在心理韧性与工作环境间起中介作用.医院管理者应重视护士组织承诺的建立和维护,稳定护士队伍,提高护士满意度,从而提高护理质量.     

新疆地区三甲医院磁性水平现状及影响因素研究

目的 调查新疆地区综合三甲医院磁性水平现状,分析其影响因素,为稳定护理队伍提供参考.方法 采用医院磁性要素量表、组织承诺量表、护士心理契约量表及心理韧性量表,整群抽取新疆地区4所综合三甲医院的3 047名临床护士进行调查.结果 医院磁性水平得分为(97.31±21.38)分,得分率54.06％.Logistic回归分析显示,护士组织承诺、心理韧性、心理契约、学历、用工性质、年龄是影响医院磁性水平的重要因素(P＜0.05,P＜0.01).结论 新疆地区三甲医院磁性水平有待提高,影响因素较多,应采取针对性措施提高医院磁性水平,稳定护理队伍.     

Overview and update on molecular testing in non-small cell lung carcinoma utilizing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) samples

Lung carcinoma remains one of the most frequent and aggressive human neoplasms. Fortunately, in the last decades, the increasing knowledge of the molecular mechanisms leading to cancer development has allowed the use of targeted therapies with improvement of prognosis in many patients. Clinical management has also changed after the introduction of endobronchialultrasonographic bronchoscopy that allows a conservative staging of lung tumors, avoiding the need of mediastinoscopy for lymph node staging. Lung pathologists and cytopathologists are facing the challenge of giving the more comprehensive prognostic and predictive information with ever smaller tissue or cytological samples. The aim of this review is to summarize the molecular testing for non-small cell lung carcinoma and how pathologists can contribute to the patient's outcome with a conscious management of biological samples.     

Sampling‐based estimation for massive survival data with additive hazards model

For massive survival data, we propose a subsampling algorithm to efficiently approximate the estimates of regression parameters in the additive hazards model. We establish consistency and asymptotic normality of the subsample‐based estimator given the full data. The optimal subsampling probabilities are obtained via minimizing asymptotic variance of the resulting estimator. The subsample‐based procedure can largely reduce the computational cost compared with the full data method. In numerical simulations, our method has low bias and satisfactory coverage probabilities. We provide an illustrative example on the survival analysis of patients with lymphoma cancer from the Surveillance, Epidemiology, and End Results Program.