Influence of early-life factors on the development of endometriosis

Objective: Our aim was to study the association between early-life factors and the development of endometriosis.

Methods: This case–control study included 440 women with surgically confirmed endometriosis (cases) and 880 women without endometriosis (controls). Information on early-life factors was ascertained retrospectively by in-person interviews with participants and their mothers. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between endometriosis and maternal and paternal characteristics and foetal and infant exposures were estimated using unconditional logistic regression, adjusting for frequency matching and confounding variables.

Results: We observed that women who were not breastfed as infants had twice the risk of endometriosis compared with women who were breastfed (adjusted OR 2.0; 95% CI 1.6, 4.5). Our data suggested an increased endometriosis risk with neonatal vaginal bleeding (adjusted OR 1.9; 95% CI 1.2, 4.3) and paternal smoking (adjusted OR 1.8; 95% CI 1.1, 4.9). Although the CIs included the null hypothesis value, caesarean section (adjusted OR 1.7; 95% CI 1.0, 3.5) and prematurity (adjusted OR 1.4; 95% CI 0.8, 3.7) were probably associated with the incidence of endometriosis.

Conclusions: Some early-life factors including breastfeeding, neonatal vaginal bleeding and paternal smoking were associated with subsequent, surgically confirmed endometriosis in this cohort of Chinese women.     

特应质与儿童肺炎支原体肺炎严重程度及肺外表现相关性研究

目的探讨特应质在肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)儿童病情严重程度和肺外并发症中的作用,并阐明IL-17在其中的作用机制。方法回顾性纳入了2017年2月至2019年2月期间就诊于本院的221例MPP儿童,所有患者均行过敏原检测。采用相关性分析探索特应质和IL-17与病情及肺外并发症等相关性。结果221例MPP患儿中71例合并特应质,44例出现肺外并发症,其中以皮肤表现(36.4%)最为常见。有特应质MPP患者哮喘发作(P<0.001)和既往哮喘病史(P<0.001)比例、总IgE(P<0.001)显著高于无特应质患者,而IL-17(P<0.001)显著低于无特应质患者。有特应质MPP患者中更易出现重症肺炎(48/71 vs 17/150,P<0.001)。有特应质MPP患者出现胸腔积液(P=0.045)、呼吸急促(P<0.001)的比例、需氧疗(P<0.001)、糖皮质激素治疗的比例(P=0.008)以及糖皮质激素治疗时间(P=0.002)显著高于无特应质患者。合并肺外并发症MPP患者血浆IL-17(P=0.009)显著低于无肺外并发症患者,而总IgE水平(P=0.009)和特应质比例(P<0.001)显著高于无肺外并发症患者。结论特应质是导致MPP患儿病情严重和肺外并发症的危险因素之一,可能与IgE释放和IL-17降低相关。     

116例急性卒中患者院前流行病学特征

目的探讨镇江市急救中心救治的116例急性卒中患者的临床特征。 方法回顾性分析2019年1月1日至3月31日镇江市急救中心收治的116例脑卒中患者的病历资料，其中男性73例，女性43例；年龄23～96岁，平均(55.1±14.0)岁。分析内容包括患者基本特征、格拉斯哥昏迷量表(GCS)评分、美国国立卫生研究院卒中量表(NIHSS)评分、送达医院时的生命体征等。 结果青年脑卒中(年龄<45岁)占全部患者的22.4%，65岁以下患者占78.4%。卒中患者以男性居多(62.9%)，城市居多(72.4%)。从卒中症状开始到到达医院的时间平均为27 h(范围为0.5～72 h)。40例患者(34.5%)在症状出现后4.5 h内(窗口期)到达有溶栓能力的医院。患者总体NIHSS为(15.71±7.52)分，出血性卒中患者[(17.54±7.54)分]高于缺血性卒中患者[(14±7.15)分](P<0.05)。所有脑卒中患者入院平均GCS评分为(12.12±3.35)分，缺血性卒中为(13.07±2.56)分，出血性卒中为[(11.11±3.80)分](P<0.05)。 结论镇江市急救中心院前救治的卒中患者以65岁以下患者为主，男性居多，尽管患者意识水平尚可，但普遍病情较重，而且仅约1/3患者能短时间到达医院。因此，社会、媒体和医疗机构应积极的宣传，使人们提高对危险因素和卒中的认识。急救中心也应进一步提升相应的救治能力。     

Protein Quantity on the Air–Solid Interface Determines Degradation Rates of Human Growth Hormone in Lyophilized Samples

Recombinant human growth hormone (rhGH) was lyophilized with various glass-forming stabilizers, employing cycles that incorporated various freezing and annealing procedures to manipulate glass formation kinetics, associated relaxation processes, and glass-specific surface areas (SSAs). The secondary structure in the cake was monitored by infrared and in reconstituted samples by circular dichroism. The rhGH concentrations on the surface of lyophilized powders were determined from electron spectroscopy for chemical analysis. Glass transition temperature (T_g), SSAs, and water contents were determined immediately after lyophilization. Lyophilized samples were incubated at 323 K for 16 weeks, and the resulting extents of rhGH aggregation, oxidation, and deamidation were determined after rehydration. Water contents and T_g were independent of lyophilization process parameters. Compared with samples lyophilized after rapid freezing, rhGH in samples that had been annealed in frozen solids prior to drying, or annealed in glassy solids after secondary drying retained more native-like protein secondary structure, had a smaller fraction of the protein on the surface of the cake, and exhibited lower levels of degradation during incubation. A simple kinetic model suggested that the differences in the extent of rhGH degradation during storage in the dried state between different formulations and processing methods could largely be ascribed to the associated levels of rhGH at the solid–air interface after lyophilization. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.     

Evaluation of the toxicological safety of erinacine A-enriched Hericium erinaceus in a 28-day oral feeding study in Sprague–Dawley rats

Natural products have attained great importance as they are believed to be the new alternative medicines for conventional therapy. As numerous studies have proved the tremendous medicinal values of Hericium erinaceus, it is necessary to take into account its safety as well as its risk for the recipient. However, mushroom mycelium has an identity distinct from mushrooms, as two specific classes of compounds, hericenones and erinacines, can only be extracted from both the fruit body and the cultured mycelium, respectively. Therefore, this is the first report on the evaluation of the toxicity of H. erinaceus mycelium, enriched with 5 mg/g erinacine A, by a 28-day repeated oral administration study in Sprague–Dawley rats. Three doses of 1 (Low), 2 (Mid) and 3 (High) g/kg body weight/day were selected for the study while distilled water served as control. All animals survived to the end of the study. No abnormal changes were observed in clinical signs. No adverse or test article-related differences were found in urinalysis, haematology and serum biochemistry parameters, between the treatment and control groups. No gross pathological findings and histopathological differences were seen. Therefore, the no-observed-adverse-effect level of erinacine A-enriched H. erinaceus is greater than 3 g/kg body weight/day.     

Epidemiology,pathophysiology, and treatment of traumatic cervical vascular injury

Operative techniques to treat traumatic cervical instability have evolved with the development of techniques such as occipital segmental plating, C1 lateral mass screws, a variety of C2 fixation techniques, and C1/C2 transarticular screw fixation, in addition to lateral mass and pedicle screws in the subaxial cervical spine. These advances have led to benefits, such as improved construct strength and enhanced biomechanical stability. In the current era, it is essential to have a good familiarity with the types of instrumentation available and a comprehensive understanding of the regional anatomy to avoid complications and optimize clinical outcomes.     

综合护理干预对老年股骨颈骨折患者术后首次排便的影响

目的探讨综合护理干预对老年股骨颈骨折患者术后首次排便的影响。方法便利抽样法选择2010年11月至2011年11月在镇江市第二人民医院住院治疗的84例老年股骨颈骨折需手术的患者为研究对象,按随机数字表法将其分为观察组和对照组,每组42例。观察组患者采用综合护理干预措施,对照组采用骨科常规护理措施,观察比较两组患者术后自觉肠鸣音时间、肛门排气时间、首次排便时间以及首次大便通畅度情况。结果观察组患者术后自觉肠鸣音时间、肛门排气时间、首次排便时间均早于对照组,且首次大便通畅度优于对照组,差异均有统计学意义(均P<0.01)。对照组有24例术后96h仍未排便,给予通便药物或灌肠干预,而观察组仅有1例患者需灌肠干预。结论综合干预措施能明显缩短老年股骨颈骨折患者术后肠功能恢复时间。     

婴幼儿接种乙肝疫苗预防乙型肝炎的临床观察

目的:观察婴幼儿接种乙肝疫苗的临床效果。方法:对近年来在我社区进行乙肝疫苗接种的婴幼儿进行临床追踪观察。结果:325例婴幼儿中抗-HBs阳性者320例,阳性率达98.5%;出现不良反应者10例,发生率3.1%,反应较轻,不需要特殊治疗,短时间内可消退。结论:婴幼儿接种乙肝疫苗可有效预防乙型肝炎,具有社会学意义和流行病学意义。