HIV/结核双重感染患者营养风险状况及影响因素分析

目的 调查HIV/结核双重感染患者的营养风险及影响因素,为HIV/结核双重感染患者的营养管理提供参考.方法 采用营养风险筛查2002回顾性收集321例HIV/结核双重感染患者营养风险筛查结果,对营养风险的影响因素进行Logistic回归分析.结果 HIV/结核双重感染患者营养风险发生率为57.94％;回归分析结果显示,BMI、血红蛋白和HIV-RNA定量是HIV/结核双重感染患者营养风险的影响因素(均P＜0.01).结论 HIV/结核双重感染患者营养风险比例较高,应重点关注BMI较低、贫血和HIV-RNA定量较高患者,及时纠正营养风险.     

妇幼保健专业人员对母乳喂养障碍感知质性研究的Meta整合

目的 系统评价妇幼保健专业人员对母乳喂养障碍感知的质性研究,为母乳喂养促进措施提供参考.方法 检索PubMed、Cochrane Library、JBI循证卫生保健国际合作中心图书馆、CINAHL、Embase、Web of Science、Sinomed、中国知网、万方和维普数据库,自建库至2021年1月发表的关于妇幼保健专业人员对母乳喂养障碍感知的质性研究.使用澳大利亚JBI循证卫生保健中心质性研究质量评价标准评价文献质量,采用汇集性整合的方法进行结果整合.结果 共纳入17项原始研究,归纳组合成14个新的类别,并综合成4个主题:人员配置、环境和机构间支持协作对母乳喂养行为的限制;专业人员母乳喂养支持能力、认知以及团队间协作有待改善;家庭、社会文化和传统习俗对母乳喂养的压力;孕产妇个人因素、分娩因素和新生儿健康影响母乳喂养.结论 妇幼保健专业人员在促进母乳喂养过程中感知到存在多方面的障碍因素.建议改进培训方法和保健策略,促进妇幼保健专业人员母乳喂养措施的实施.     

A National Survey of Breast Surgeons and Radiation Oncologists on Contemporary Axillary Management in Mastectomy Patients

Annals of Surgical Oncology - Management of axillary lymph nodes in breast cancer has undergone significant change over the past decade through landmark clinical trials. This study aimed to assess...     

Clinicopathological characteristics,prognosis, and chemosensitivity in patients with metastatic upper tract urothelial carcinoma

PurposeTo investigate the clinical characteristics, chemosensitivity, and outcome of metastatic upper tract urothelial carcinoma (UTUC).Patients and MethodsRecords of patients with metastatic UTUC since January 2005 were retrieved from a database that included clinical and survival data. Statistical analyses including survival and multivariate analyses of factors were respectively performed by the Kaplan-Meier method and Cox proportional hazard model.ResultsA total of 250 consecutive UTUC cases were evaluated. There were 56 patients (22.4%) with initially diagnosed stage IV disease. The most common metastatic sites were lung (39.6%), distant lymph nodes (39.2%), bone (19.6%), liver (18.0%), and adrenal gland (7.2%), respectively, and the local recurrence rate was 10.4%. Two hundred thirteen patients received first-line chemotherapy. The overall response rate was only 28.7% and the median progression-free survival time was only 5.0 months. The overall survival time of the cohort was 18.0 months. Multivariate analyses showed that initially diagnosed stage IV disease, number of metastatic organs ≥3, no response to chemotherapy and cycles of chemotherapy ≤2 were adverse prognosticators for overall survival.ConclusionUTUC presented to be more prone to metastasize than locally recur and thought to have low chemosensitivity. Stage IV disease at initial diagnosis, number of metastatic organs, response and cycles of chemotherapy were independent prognosticators for metastatic UTUC.     

利用CT表现鉴别肾上腺隐匿型嗜铬细胞瘤和皮质腺瘤

目的探讨如何利用CT表现对肾上腺隐匿型嗜铬细胞瘤和肾上腺皮质腺瘤进行鉴别诊断。方法收集2010年1月至2020年1月期间中国医科大学附属第一医院收治的177例肾上腺肿瘤患者进行回顾性分析,对比各组患者之间的一般临床资料和CT表现。结果隐匿型嗜铬细胞瘤56例、皮质醇腺瘤32例、醛固酮腺瘤44例、无功能腺瘤45例,隐匿型嗜铬细胞瘤组在肿瘤侧别上与无功能腺瘤组差异有统计学意义,在肿瘤最大直径、平扫CT值、动脉期和延迟期增强CT值上均显著大于三组肾上腺腺瘤组。以肿瘤直径≥2.95 cm诊断隐匿型嗜铬细胞瘤,曲线下面积(AUC)为0.872,敏感度为87.5%,特异性为76.0%;当平扫CT值≥24.5 Hu时,AUC为0.929,敏感度为94.0%,特异性为82.5%;当动脉期增强CT值≥89.5 Hu时,AUC为0.886,敏感度为72.7%,特异性为90.6%;当延迟期增强CT值≥82.5 Hu时,AUC为0.937,敏感度为84.6%,特异性为95.3%;联合以上四个指标时,AUC为0.981,阈值为≥0.118,敏感度为100%,特异性为90.6%。结论以肿瘤直径2.95 cm、平扫CT值24.5 Hu、动脉期增强CT值89.5 Hu和延迟期增强CT值82.5 Hu为阈值对肾上腺隐匿型嗜铬细胞瘤有较好的鉴别诊断价值。     

Pseudotumor appearance in chronic hepatitis

A pseudotumor appearance of the liver has not been previously described in chronic hepatitis. We reviewed 81 charts with a biopsy diagnosis of "chronic hepatitis" and at least one radiologic liver scan, and found four cases with a pseudotumor appearance. They all had features on radiologic scans suggestive of space-occupying lesions. Histology showed chronic hepatitis in all four. Two were cirrhotic, one due to alcohol and the other due to hepatitis B. The other two patients had chronic active hepatitis with regenerative nodules but only limited fibrosis, one due to hepatitis B, the other probable non-A, non-B. None had any evidence of hepatic malignancy. We conclude that some patients with chronic hepatitis may present with a pseudotumor appearance on radiological scans, due to the presence of regenerative nodules. Space-occupying lesions on liver scans in chronic hepatitis may represent non-neoplastic liver disease.     

The role of mtDNA deletion in the sensitivity to aminoglycoside antibiotic induced deafness]

OBJECTIVE: To establish an animal model of mitochondrial DNA (mtDNA) deletion and investigate the possible role of mtDNA deletion in aminoglycoside antibiotic induced deafness. METHODS: Thirty wistar rats (4 months) were randomly divided into group A and B. Doxorubicin (DOX) was subcutaneously injected at doses of 2 mg/kg twice per week for 3 months in group A and then kanamycin (KM) was intraperitoneally injected 500 mg/kg per day for 10 consecutive days. The treatments of group B were identical to group A, except normal saline was substituted for DOX. The thresholds of auditory brainstem response (ABR) were measured before and after the drug administrations. The inner ear membranous labyrinthine tissue was harvested and mtDNA was amplified to identify 4,834 bp deletion by PCR technique. RESULTS: The elevation of the mean ABR thresholds in group A(67.08 +/- 8.59) dB peSPL was significantly higher than that in group B (12.71 +/- 4.42) dB peSPL after KM administration (P < 0.001). In group A, 9 of the 15 rats demonstrated 4,834 bp mtDNA deletion. However, mtDNA 4,834 bp deletion was negative in group B animals. CONCLUSION: DOX can induce mtDNA deletion in the inner ear tissue of the rat. mtDNA deletion in the inner ear may play an important role in the hypersensitivity to aminoglycoside antibiotic ototoxicity.     

铅对大鼠肠道神经元和血管平滑肌细胞NOS活性的影响

用β－ＮＡＤＰＨ组织化学方法研究铅对大鼠肠壁肌间神经佾内神经元和血管平滑肌一氧化氮合酶（ＮＯＳ）活性的影响。结果发现：腹腔注射醋酸铅（４０ｍｇ．ｋｇ＾－１）１５ｄ后,大鼠肠道ＮＯＳ阳性神经无元和阳性纤维数量减少,且阳性神经元的形态也有不同程度的改变,肠壁内血管平滑肌ＮＯＳ活性下降。上述变化提示ＮＯ的生成减少可能是铅中毒时腹能的机制之一。     

颈椎不同位置时椎管矢状径及截面积的解剖研究

为观察坐位颈椎不同位置时椎管内结构的变化,解剖颈椎标本８具。用灌石蜡的方法测量颈椎矢状径及截面积的变化。结果：颈椎轻度屈曲时,椎间盘、黄韧带、椎板、硬膜、脊髓的形态与位置发生变化,但对椎管容积影响不大,中立位和自然屈颈位时椎管矢状径和椎管截面积两者均无明显差异（ｐ＞０．０５）。提示：颈椎后路椎板成形椎管扩大手术时,坐位是值得推荐的一种体位。     

1981-1993年杭州口岸航空食品卫生细菌检测分析

本文报导了自1981年-1993年对杭州→香港中国民航航班及港龙航空公司航班,九大类供机食品卫生监督检验结果及分析.按不同年份,各类食品,不同检验项目以及不同航空公司配餐食品卫生质量分别作了比较.共检供机食品969份,合格535份,不合格434份,总合格率为55.21%.不同食品的合格率比较,合格率最高的是糕点为75.22%,其次为面饭为74.32%,合格率最低的是色拉为11.11%.