G-Force眩晕诊疗系统治疗老年良性阵发性位置性眩晕的临床疗效分析

目的 探讨G-Force眩晕诊疗系统治疗老年良性阵发性位置性眩晕(BPPV)的临床疗效.方法 回顾分析2018年1月-2019年12月复旦大学附属华东医院诊治的141例老年BPPV患者的临床资料,按患者年龄分为A组和B组,60岁～74岁的老年患者为A组,75岁～ 89岁的老年患者为B组.2组均采用G-Force眩晕诊疗...     

急性非淋巴细胞白血病Th1/Th2极化改变

目的探讨急性非淋巴细胞白血病(ANLL)患者Th1/Th2极化改变的临床意义。方法采用流式细胞仪检测26例ANLL患者起病时及治疗缓解后外周血CD3 CD8-细胞内IFN-γ和IL-4水平,并与同期28例对照组比较。结果ANLL患者治疗前Th0、Th1细胞和Th1/Th2比值较对照组显著降低(P<0.01),Th2细胞升高(P<0.05),治疗后Th0、Th1细胞和Th1/Th2比值较治疗前显著增高(P<0.01),Th2减低(P<0.05)。结论ANLL的发病可能与Th1/Th2失调有关。     

297例乳母膳食对乳汁成分的影响

目的 了解膳食成分与乳汁成分的相关性,了解不同的膳食结构对乳汁成分的影响.方法 通过方便取样的方法在城区及农村选取研究对象共297例,分为城区组和农村组.在两组生长过程中从初乳到成熟乳共取乳汁7次(初乳、过渡乳、2月乳、4月乳、6月乳、8月乳、10月乳),应用膳食回顾法调查采集母乳前24h乳母膳食信息.使用数字化超声波精密测量技术检测乳汁中的蛋白质、脂肪、乳糖、能量、水分、密度,采用统计软件对结果进行分析,比较两组的乳汁成分、膳食成分及膳食结构,同时比较各个时期的乳汁与膳食的相关性.结果 通过比较各期乳汁发现:初乳中蛋白质及乳糖含量农村组高于城区组,差异有统计学意义(t=2.77,P<0.05);过渡乳中脂肪含量城区组高于农村组,差异有统计学意义(t=2.64,P<0.05);成熟乳中蛋白质、脂肪及能量含量农村组高于城区组,差异有统计学意义(t值分别为2.16、4.73、4.46,均P<0.05);晚期乳中脂肪及能量含量农村组高于城区组,差异有统计学意义(t值分别为3.65、3.74,均P<0.05);城区组在初乳、过渡乳、2月、4月时乳母蛋白质摄入量高于农村组,差异有统计学意义(t值分别为2.39、3.44、2.10、2.64,均P<0.05);在过渡乳及6月时乳母脂肪摄入量城区组高于农村组,差异有统计学意义(t值分别为2.20、2.93,均P<0.05);在6月、8月及10月时乳母碳水化合物的摄入量农村组高于城区组,差异有统计学意义(t值分别为2.21、2.32、2.43,均P<0.05).通过相关性分析发现乳汁中蛋白质与膳食中脂肪在8月乳有相关性(r=-0.45,P<0.05),乳汁中蛋白质与膳食中蛋白质在过渡乳、4月乳和10月乳时有相关性(r值分别为0.38、0.45、0.47,均P<0.05),乳汁中的乳糖和膳食中的脂肪在4月乳和8月乳时有相关性(r值分别为-0.42、-0.43,均P<0.05),与膳食中的碳水化合物在6月乳时有相关性(r=0.39,P<0.05),乳汁中的能量和膳食中的脂肪在过渡乳和6月乳时有相关性(r值分别为0.89、0.43,均P<0.05),乳汁中的矿物质与膳食中脂肪在2月乳和4月乳时有相关性(r值分别为-0.42、-0.39,均P<0.05),乳汁中的脂肪与膳食中的脂肪在8月乳时有相关性(r=0.40,P<0.05)、与膳食中的碳水化合物在初乳及6月乳有相关性(r值分别为0.39、0.40,均P<0.05)、与膳食中的蛋白质在初乳时有相关性(r=0.39,P<0.05).结论 膳食成分及乳母的膳食与乳汁营养成分密切相关.     

2型糖尿病相关认知障碍与血糖管理

认知功能障碍包括轻度认知障碍、阿尔兹海默症和痴呆症,越来越被认为是2型糖尿病的一种重要的共病或并发症,影响血糖管理。本文旨在综述有关2型糖尿病与认知功能障碍、血糖控制之间的关系,危险因素的筛查和诊断,认知功能障碍患者的2型糖尿病管理(考虑高龄和老年人虚弱体质)以及新出现的预防疗法。良好的血糖控制与及早的认知测试是2型糖尿病管理的重要组成部分,对患者应当实施个性化策略,包括患者教育、血糖监测、根据日常情况(包括体育锻炼)适当调整饮食和药物。     

分次切除在皮肤病损治疗中的应用价值

目的探讨分次切除在皮肤病损治疗中的应用价值。方法通过10年来对498例皮肤病损患者接受分次切除治疗的观察和分析,评估了皮肤病损分次切除的疾病适应证、部位适应证、切口的合理安排和优缺点等。结果所有病例中切除次数为2次的病例457例,治疗时间5~13月,平均(8.06±3.45)月;3次及以上41例,平均(3.12±0.32)次,治疗时间12~21月,平均(13.76±1.34)月。术后随访6~13月,复发5例,其中色素痣3例,疤痕疙瘩2例。色素痣再次手术切除后无复发,疤痕疙瘩采取切除加放疗后无复发。结论分次切除在较大面积及特殊部位的皮肤病灶切除术中有其特有的优点和临床应用价值。     

二甲肼诱发大鼠大肠癌癌前病变模型的肠道双歧杆菌数量研究

目的:探讨二甲肼(DMH)诱发的大肠癌癌前病变模型大鼠的肠道内双歧杆菌数量与大肠癌癌前病变的关系。方法:应用双歧杆菌属特异性引物实时定量PCR,对实验第3与第9周8只模型组大鼠以及同年龄的7只正常对照组大鼠肠道中的双歧杆菌数量进行检测。结果:第9周的正常对照组大鼠未见明显异常隐窝灶(aberrant crypts foci,ACF),同年龄的模型组平均每只大鼠大肠可形成(37.7±2.6)个ACF。第3周正常对照组与同年龄的模型组大鼠肠道双歧杆菌数量差异无统计学意义,P=0.652;第9周模型组大鼠肠道双歧杆菌数量低于同年龄的正常对照组,但差异无统计学意义,P=0.090。结论:肠道内双歧杆菌的数量与大鼠大肠癌癌前病变没有明显相关性。     

Can Botulinum Toxin-A Contribute to Reconstructing the Physiological Homeostasis of the Masticatory Complex in Short-Faced Patients during Occlusal Therapy? A Prospective Pilot Study

The physiological homeostasis of the masticatory complex in short-faced patients is too robust to be disintegrated and reconstructed due to the powerful masseter muscle. This study innovatively introduced the botulinum toxin-A (BTX-A) into the field of dental occlusal treatment, providing a novel and minimally invasive therapy perspective for the two major clinical problems in these patients (low treatment efficiency and high rates of complications). In total, 10 adult patients with skeletal low angle seeking occlusal treatment (age: 27.0 ± 6.1 years; 4 males and 6 females) were administered 30–50 U of BTX-A in each masseter muscle and evaluated before and 3 months after injection based on cone-beam computed tomography (CBCT). We found a significant reduction in the thickness of the masseter muscle (MMT) (p < 0.0001). With regards to occlusion, we found a significant increase in the height of the maxillary second molar (U7-PP) (p < 0.05) with significantly flattened occlusal curves (the curve of Spee [COS] (p < 0.01), and the curve of Wilson [COW] (p < 0.05)). Furthermore, the variations in the temporomandibular joint exhibited a significant reduction in the anterior joint space (AJS) (p < 0.05) and superior joint space (SJS) (p < 0.05). In addition, the correlation analysis of the masticatory complex provided the basis for the following multiple regression equation: MMT = 10.08 − 0.11 COW + 2.73 AJS. The findings from our pilot study indicate that BTX-A, as a new adjuvant treatment attempt of occlusal therapy for short-faced patients, can provide a more favorable muscular environment for subsequent occlusal therapy through the adjustment of the biting force and may contribute to the reconstruction of healthier homeostasis of the masticatory complex. However, further research is required to establish the reliability and validity of these findings.     

Prevalence and related factors of hyperuricaemia in Chinese children and adolescents: a pooled analysis of 11 population-based studies

Background and aimsHyperuricaemia can lead to gout and is associated with an increased risk of cardiometabolic disease. We aimed to investigate the prevalence of hyperuricaemia and its related factors in Chinese children and adolescents.MethodsWe pooled data from 11 population-based studies comprising 54,580 participants aged 3–19 years. The sex- and age-standardized prevalence of hyperuricaemia was estimated overall and by sex, age, weight status, geographic region and survey year.ResultsSerum uric acid (SUA) increased gradually from 3 to 11 years with no significant sex difference, and then increased dramatically during 11–15 years. The estimated overall prevalence of hyperuricaemia was 23.3% (26.6% in boys and 19.8% in girls, p < .001). The prevalence increased with growing age (3.7, 9.8, 15.8, 35.5 and 31.7% among children aged 3–5, 6–8, 9–11, 12–15 and 16–19 years, respectively, p for trend < .001) and with increasing weight status (18.2, 37.6, 50.6 and 64.5% among children with non-overweight, overweight, obesity and extreme obesity, respectively, p for trend < .001). The prevalence was higher in North than in South (24.2 vs. 19.7%, p < .001), and increased markedly from 16.7% during 2009–2015 to 24.8% during 2016–2019. In multivariable regression analyses, sex, age, obesity, region and survey year were independently associated with odds of hyperuricaemia.ConclusionsThe prevalence of hyperuricaemia in Chinese children and adolescents is unexpectedly high. The findings suggest an urgent need to implement effective interventions to reduce risk of hyperuricaemia in Chinese youths.

KEY MESSAGES

• Question: What is the prevalence of hyperuricaemia in Chinese children and adolescents?
• Findings: In this large pooled cross-sectional study comprising >50,000 children and adolescents aged 3–19 years, we found that the prevalence of hyperuricaemia was high in overall population and subgroups of sex, age, obesity, region and survey year.
• Meaning: Our findings indicate that hyperuricaemia is an important health problem in Chinese children and adolescents, and effective intervention strategies are needed to reduce its burden.

     

中性粒细胞/淋巴细胞比值等4项指标对溃疡性结肠炎内镜活动度的判断价值

目的 探讨中性粒细胞/淋巴细胞比值(neutrophils-lymphocytes ratio,NLR)、单核细胞/淋巴细胞比值(monocyte-lymphocytes ratio,MLR)、C 反应蛋白(C-reactive protein,CRP)、红细胞沉降率(erythrocyte sedimentation...