妇科肿瘤患者化疗期症状群与生活质量的动态变化及其相关性研究

目的 分析妇科肿瘤患者化疗期不同时间点的症状群与生活质量的动态变化,并探讨两者间的相关性.方法 采用前瞻性研究方法,以137例妇科肿瘤化疗患者为研究对象,使用一般资料问卷、中文版安德森症状评估量表(MDASI-C)和欧洲癌症研究与治疗组织(EORTC)生活质量问卷(QLQ-C30)量表在化疗后即刻(T1)、化疗后1个月(T2)、化疗后3个月(T3)及化疗后6个月(T4)4个不同时间点进行动态调查.结果 妇科肿瘤患者在化疗期4个时间点的症状严重程度(F=76.31,P=0.00)、生活质量(F=117.65,P=0.00)均有差异.T3时间点的症状最严重、生活质量最差.T1时间点提取出4个症状群,分别为:病感症状群、消化道症状群、神经系统症状群及疼痛相关症状群,与生活质量多个领域得分呈正相关(P<0.05);T3时间点提取出5个症状群,分别为:神经系统症状群、病感症状群、疼痛相关症状群、情感症状群及消化道症状群.以上症状群与QLQ-C30量表多个领域得分呈正相关(P<0.05).结论 在化疗后即刻至化疗后3个月,妇科肿瘤患者化疗期间的症状群越来越严重,生活质量越来越差.     

盆底超声参数与SUI患者肌纤维疲劳度和病情程度的相关性分析

目的 探讨盆底超声参数与压力性尿失禁(SUI)患者病情程度、肌纤维疲劳度的相关性.方法 选取2018年10月至2020年3月该院SUI患者146例为研究对象,均接受盆底超声检查并给予盆底肌训练.分析盆底超声参数[膀胱颈旋转角度(θ)、膀胱颈下移距离(X)、膀胱颈移动度(Mu)、膀胱尿道后角(α)]与SUI问卷评分(SS)、肌纤维疲劳度的相关性,以及分析其预测SUI疗效不佳的价值.结果 不同病情程度患者年龄、受教育程度、年收入、分娩方式、会阴情况、流产次数和X比较差异无统计学意义(P>0.05),BMI、既往分娩次数、新生儿体重、θ、Mu、α比较差异有统计学意义(P<0.05).SUI患者X与SS、盆底肌纤维疲劳度无显著相关性(P>0.05),θ、Mu、α与SS评分、盆底肌纤维疲劳度呈正相关(P<0.05).疗效良好者θ、Mu、α低于疗效不佳者(P<0.05);θ预测的曲线下面积(AUC)最大,临界值37.35°时,其灵敏度、特异度分别为94.74％、59.84％.结论 盆底超声参数中θ、Mu、α与SUI患者肌纤维疲劳度、病情程度存在良好线性关系.     

Effects of Chinese Medicine on Symptoms, Syndrome Evolution, and Lung Inflammation Absorption in COVID-19 Convalescent Patients during 84-Day Follow-Up after Hospital Discharge: A Prospective Cohort and Nested Case-Control Study

Objective:To observe the changes of symptoms,Chinese medicine(CM)syndrome,and lung inflammation absorption during convalescence in patients with coronavirus disease 2019(COVID-19)who had not totally recovered after hospital discharge and whether CM could promote the improvement process.Methods:This study was designed as a prospective cohort and nested case-control study.A total of 96 eligible patients with COVID-19 in convalescence were enrolled from Beijing Youan Hospital and Beijing Huimin Hospital and followed up from the hospital discharged day.Patients were divided into the CM(64 cases)and the control groups(32 cases)based on the treatment with or without CM and followed up at 14,28,56,and 84 days after discharge.In the CM group,patients received the 28-day CM treatment according to two types of CM syndrome.Improvements in clinical symptoms,CM syndrome,and absorption of lung inflammation were observed.Results:All the 96 patients completed the 84-day follow-up from January 21 to March 28,2020.By the 84th day of follow-up,respiratory symptoms were less than 5%.There was no significant difference in the improvement rates of symptoms,including fatigue,sputum,cough,dry throat,thirst,and upset,between the two groups(P>0.05).Totally 82 patients(85.42%)showed complete lung inflammation absorption at the 84-day follow-up.On day 14,the CM group had a significantly higher absorption rate than the control group(P<0.05)and the relative risk of absorption for CM vs.control group was 3.029(95%confidence interval:1.026-8.940).The proportions of CM syndrome types changed with time prolonging:the proportion of the pathogen residue syndrome gradually decreased,and the proportion of both qi and yin deficiency syndrome gradually increased.Conclusions:Patients with COVID-19 in convalescence had symptoms and lung inflammation after hospital discharge and recovered with time prolonging.CM could improve lung inflammation for early recovery.The types of CM syndrome can be transformed with time prolonging.     

高密度高分辨标测下外科术后房性心动过速的电生理特征

观察在高密度、高分辨率视觉下的心外科术后房性心动过速（房速）的电生理特点及消融效果。     

新型冠状病毒肺炎期间皮肤科医务人员的焦虑情绪分析

目的 调查新型冠状病毒肺炎疫情下皮肤科医务人员的焦虑情绪,以期为今后的心理疏导和临床工作提供依据。方法 采用随机抽样方法选取笔者医院皮肤科医务人员为研究对象,采用焦虑自评量表(SAS)评定患者焦虑程度,并对于检出的焦虑者进行综合心理干预。结果 皮肤科医务人员SAS评分为(40.66±7.84)分,焦虑症状检出率为14.93%,其中女性SAS评分高于男性,女性焦虑情绪检出率高于男性,护士SAS评分高于医生。检出焦虑的医务人员平均SAS评分在接受综合心理干预后由59.45±6.97降低至40.32±7.88(P＜0.001)。结论 基于新型冠状病毒肺炎疫情环境,皮肤科医务人员的心理健康也会受到一定程度的负面影响,女性和护士的焦虑检出率较高。以呼吸放松训练,正念疗法及音乐聆听三位一体的综合心理干预是应对焦虑,促进心理健康的可靠方法。     

急性ST段抬高型心肌梗死患者PCI术后无复流现象的研究进展

冠状动脉粥样硬化性心脏病是全球范围内心血管疾病患者死亡的主要原因,其中以急性ST段抬高型心肌梗死(STEMI)最为凶险。及时经皮冠状动脉介入治疗(PCI)是目前急性STEMI患者最主流的再灌注策略。而部分患者在PCI术后仍不能得到充分的血液灌注,即出现无复流现象(NRP),与随后的不良临床预后密切相关。因此,为了有效恢复再灌注后冠状动脉微循环的血流,防治冠状动脉NRP的发生就显得尤为重要。本文回顾NRP的定义、诊断和临床表现,以病理生理机制为桥梁,提出通过相关预测因子来选择防治策略从而提高PCI疗效。     

20例ABO血型抗原表达异常样本的血型基因分析

目的 探讨20例样本ABO血型抗原表达减弱的分子生物学机制。方法 采用微柱凝集法及盐水试管法进行ABO血型血清学鉴定;对ABO基因第1-7外显子及其上游启动子区域PCR产物直接测序进行基因分型。结果 11例样本通过家系分析可以确定其基因型（1例ABO*A2.01/ABO*B.01,1例ABO*A2.01/ABO*O01.01,1例A1.02/B3.04,2例B3.04/O.01.01、2例B3.02/O.01.02,4例Bw.12/O.01.01）;3例样本在ABO基因启动子区域发生-35_-18位的碱基缺失,通过家系分析,提示该变异发生在B等位基因;1例样本在ABO基因启动子区域发生-119位C>T变异;1例样本发生第7外显子1054位点缺失碱基C;4例样本在ABO血型基因1-7外显子及其调控区域未发现变异。结论 启动子区域-119位C>T变异及Exon7 1054del变异可能是导致ABO血型抗原异常表达的新变异;部分ABO亚型可能与内含子异常或mRNA合成异常有关;本地区B亚型明显多于A亚型。     

Inverted U-Shaped Associations between Glycemic Indices and Serum Uric Acid Levels in the General Chinese Population: Findings from the China Cardiometabolic Disease and Cancer Cohort (4C) Study

Objective The relationship between serum uric acid(SUA)levels and glycemic indices,including plasma glucose(FPG),2-hour postload glucose(2 h-PG),and glycated hemoglobin(HbA1 c),remains inconclusive.We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.Methods The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study.A total of 105,922 community-dwelling adults aged≥40 years underwent the oral glucose tolerance test and uric acid assessment.The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.Results A total of 30,941 men and 62,361 women were eligible for the current analysis.Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels,but with different inflection points in men and women.The thresholds for FPG,2 h-PG,and HbA1 c for men and women were 6.5/8.0 mmol/L,11.0/14.0 mmol/L,and 6.1/6.5,respectively(SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes,while the inflection points were reached earlier in men than in women.     

中国第9次北极科学考察期间科考队员睡眠质量分析

目的 了解北极特殊环境对科考队员睡眠质量的影响.方法 应用匹兹堡睡眠质量指数(PSQI)量表对参加我国第9次北极科学考察的科考队员(131人)在出行前、北极考察期间、考察结束后的睡眠情况进行调查,并记录队员的入睡时间点、晨起时间点、入睡时间、睡眠时间.结果 共发放问卷131份,回收有效问卷88份.88名队员中男77名、女11名,年龄为22～50(48.1±17.9)岁,包括船员18人、科考队员70人.考察期间队员的中位晨起时间点比出行前早180 min,入睡时间长于出行前及考察结束3个月后[(45.23±25.84)min vs(18.45±14.34)min、(19.50±12.57)min,P均<0.01],夜晚睡眠时间短于出行前及考察结束3个月后[(6.83±2.24)h vs(8.36±1.45)h、(8.14±1.45)h,P均<0.01].根据PSQI量表评分,考察期间队员的睡眠质量下降、入睡时间延长、睡眠时间缩短、睡眠效率下降、催眠药物使用增加,与出行前相比差异均有统计学意义(P均<0.01).结论 极地极昼及低温环境显著影响北极科学考察时科考队员的睡眠节律,导致入睡时间延长、睡眠时间缩短、助眠药物使用增加,这可能影响到队员的工作状态.     

Early Changes in Serologic Markers in Workers Exposed to Indium Compounds

Case reports of lung disease among indiumexposed workers in Japan,the USA,and China over the past two decades have raised public concern about the toxicity of indium and indium compounds.Occupational exposure to indium compounds can result in potentially fatal indium lung disease,which is characterized by pulmonary alveolar proteinosis(PAP)and may progress to fibrosis,with or without emphysema[1].