新时代公共卫生体系的思考与研究

在评价全国32个省会城市和计划单列市新发传染病预防控制能力的基础上,聚焦分析了武汉的优势和短板：具备依法防疫的法律基础,但未转化成有效的行动;具有应对疫情的组织基础,平战结合的协调机制未有效建立;管理机制齐备,但部门间职责分工不明确;监测网络已建立,但“预测预警”的作用并未发挥;“投入不足导致职能偏废”的现象开始回头。各地的新发传染病预防控制能力均是优势与短板并存,应当怀有警醒之心,“补短板、堵漏洞、强弱项”,亡羊补牢,为时未晚。     

Analysis of lumbar vertebrae fractures among inpatients in a primary hospital: A 10-year epidemiological study

Background:To analyze the epidemiological characteristics and changing trends of lumbar fractures in Xingtai Orthopedic Hospital in the past 10 years, and to improve the prevention and treatment of lumbar fractures.Methods:Using the hospital information system, data on patients with lumbar fractures in our hospital from 2009 to 2018 were collected regarding their age, gender, fracture time, injury mechanism, and the type of fracture. The epidemiological characteristics and trends of lumbar fractures for the period were summarized and analyzed.Results:The age of male patients with a high incidence of lumbar fractures was 61 to 70 years, followed by 51 to 60 years. The age of female patients with the highest incidence rate was 61 to 70 years, followed by 51 to 60 years (19.22%). Lumbar fractures in group A were predominantly of men. The majority of lumbar fractures in group B were of women. In group A, the incidence rate was higher in young men (21–50 years) than in women and higher in women >51 years. Most of the affected individuals were women. In group B, there were more middle-aged and young men (21–50 years) than women; however, there were more women than men aged ≥51 years. Car accident injury was the main cause of fractures, but in group B women, low-energy injuries were the main cause of fractures. The periods of high incidence in groups A and B were 4 to 6 years and 7 to 9 years, respectively. The number of injuries in group A was the highest and burst fracture was the main fracture type. In group B, the number of fall injuries was the highest, followed by car accident injuries, and compression fracture was the main fracture type.Conclusion:The number of lumbar fractures in women caused by low-energy injuries showed an increasing trend. The type of compression fracture increased, which might be related to osteoporosis caused by the decrease in the estrogen level after menopause.     

EGFR mutation types and abundance were associated with the overall survival of advanced lung adenocarcinoma patients receiving first-line tyrosine kinase inhibitors

BackgroundEpidermal growth factor receptor tyrosine kinases inhibitors (EGFR-TKIs) are currently recognized as the standard treatment for advanced non-small cell lung cancer (NSCLC) patients with EGFR mutations. Clinically found patients with different EGFR mutational status have different prognosis.MethodsA retrospective cohort study was performed to explore the relationship between EGFR mutations and abundance with patient survival by using patient data from the Affiliated Cancer Hospital of Zhengzhou University between January 2013 and November 2016. All patients involved in the present study had sensitive EGFR mutations [either exon 19 deletion (DEL) or exon 21 L858R] and treated by EGFR-TKIs. They were followed up every three months until lost or dead. Mutation abundance was calculated as the copies of EGFR mutation divided by copies of EGFR locus, and the cut-off values for 19DEL and L858R were 4.9% and 9.5%, respectively.ResultsTotal of 236 patients were included, comprising 116 (49.2%) patients with 19DEL mutation and 120 (50.8%) patients with L858R mutation. The median follow-up duration was 23.2 months (95% CI: 14.9–26.7 months). Overall survival (OS) was significantly longer in patients with 19DEL mutation (20.9 months, 95% CI: 17.7–24.1 months versus 17.0 months, 95% CI: 14.4–19.6 months in patients with L858R; P=0.008) and in patients with high mutation abundance (20.9 months, 95% CI: 18.3–23.5 months versus 13.0 months, 95% CI: 10.3–15.7 months in patients with low mutation abundance; P<0.001). Multivariate Cox regression including age, performance status and tumor stage revealed that longer OS was independently associated with 19DEL mutation (HR: 0.48, 95% CI: 0.39–0.67, P=0.033) and high mutation abundance (HR: 0.62, 95% CI: 0.50–0.79, P=0.027).ConclusionsEGFR mutation types and abundance was associated with the patients’ survival which might be used to predict the efficacy of targeted therapy by EGFR-TKIs.     

原发性局灶节段性肾小球硬化预后相关因素的研究进展

近年来局灶节段性肾小球硬化（FSGS）发病率增加,且治疗困难,预后较差,是导致终末期肾疾病的主要原因之一。肾脏病学家试图探索某些指标来拟诊和预测预后,该文简述了原发性FSGS预后相关因素如蛋白尿程度、血肌酐水平、肾小管间质病变、病理类型、治疗方法、治疗反应、基因、足细胞及足细胞蛋白等的研究进展。     

异搏定对培养角膜基质细胞分泌转移生长因子-β_1的影响

目的　探讨异搏定(Verapamil)对体外培养兔角膜基质细胞分泌TGFβ1的影响。为预防或减轻PRK后混浊(haze)形成提供线索。方法　将传代培养细胞,在加药培养后48h,应用TGFβ1EmaxTMImmunoAssaySystem试剂盒对培养上清中TGFβ1含量进行检测,根据标准曲线分别计算出各孔TGFβ1的浓度。结果　Verapamil浓度5μg/ml和10μg/ml,作用48h,培养上清中TGFβ1含量明显降低(P<0.05)。Verapamil浓度越高,培养上清中TGFβ1含量越少。结论　Verapamil能明显抑制角膜基质细胞分泌TGFβ1,可望成为预防或减轻PRK后haze形成的药物。     

Foreperiod effect on time estimation and simple reaction time in schizophrenia

Compared effects of foreperiod (FP) duration on time estimation (TE) and reaction time (RT). There was no difference between schizophrenics (N = 20) and nonschizophrenics (N = 20) with respect to the effect of FP duration or with respect to the effect of change in FP duration. Prior information about FP duration nullified these two effects on schizophrenics' TE and had a detrimental effect on their RT. Alcoholics' TE and RT were affected little by such prior information. Suppression of preparation by expectancy was shown to be a possible characteristic of schizophrenia.     

Cdk3在结肠癌变过程中的表达及其意义

目的:研究Cdk3在结肠息肉、结肠腺瘤、结肠癌组织中的表达,探讨Cdk3在结肠癌变过程中的演变规律及其意义.方法:用免疫组织化学和原位杂交的方法检测22例结肠癌组织、22例结肠腺瘤组织、24例结肠息肉组织中Cdk3蛋白和mRNA的表达.结果:Cdk3蛋白和mRNA在结肠息肉、结肠腺瘤、结肠癌组织中的表达呈核.质型,以质为主.图像分析结果显示,结肠癌组织中Cdk3蛋白表达平均光密度值(0.80±0.36)明显高于结肠腺瘤组织(0.48±0.22)和结肠息肉组织(0.25±0.13)(P<0.05),结肠腺瘤组织中Cdk3蛋白表达平均光密度值明显高于结肠息肉组织(P<0.05),结肠癌组织中的阳性细胞数(266.5±40.2)明显高于结肠腺瘤组织(132.0±37.4)和结肠息肉组织(129.3±26.7).结论:Cdk3在结肠癌变过程中表达逐步增强,在结肠癌组织中异常高表达,可能在结肠癌变过程中发挥重要作用.