Decreased cortical thickness of left premotor cortex as a treatment predictor in major depressive disorder

Brain Imaging and Behavior - This study aimed to examine the cerebral cortex characteristics (thickness, surface area, and curvature) in patients with major depressive disorder (MDD), and explore...     

基于文献计量学的近10年我国男护士群体的研究现状及热点分析

目的通过文献计量分析,了解2009—2019年我国男护士群体的研究热点及发展趋势,为相关研究提供参考。方法通过万方、CNKI、维普及中国生物医学文献等数据库检索2009—2019年我国男护士相关文献,对纳入文献进行内容分析并使用bicomb 2.0软件和gCLUTO 1.0软件对关键词进行词频分析和双向聚类分析。结果共纳入931篇期刊文献,获得高频关键词25个,通过聚类分析获得3个研究热点,分别为男护士的工作优势与管理、男护士的心理健康以及男护生的护理教育。结论男护士群体的受关注程度日益提高,核心期刊论坛已初具雏形,但整体研究质量不佳,未来需强化科研设计及研究实施的科学性和严谨性,从而提高文献对临床实践的指导价值。     

慢性心力衰竭患者和家庭照顾者相依关系对双方正性情绪及积极应对方式的影响

目的:基于主客体互倚模型(APIM)分析慢性心力衰竭(CHF)患者和家庭照顾者的相依关系对双方正性情绪及积极应对方式的影响。方法:本研究为横断面研究。采用便利抽样法,选取2020年1—7月于南京医科大学第一附属医院心内科住院的101对CHF患者及其家庭照顾者作为调查对象。采用自制一般资料调查表、相依关系量表、中文版正负情绪量表和中文版简易应对方式量表对CHF患者及其家庭照顾者进行横断面调查,并建立相依关系对正性情绪及积极应对方式的APIM。结果:在主体效应方面,CHF患者及其家庭照顾者的相依关系均可影响自身的正性情绪(回归系数分别为3.922、3.427;P<0.01)和积极应对方式(回归系数分别为2.936、2.828;P<0.01);在客体效应方面,家庭照顾者的相依关系可影响CHF患者的正性情绪(回归系数为2.744,P<0.01)和积极应对方式(回归系数为2.198,P<0.05)。结论:CHF患者的情绪和应对行为受到自身和家庭照顾者所感知相依关系的正向影响,提示临床工作者应重视CHF家庭照护中相依关系的评估,积极探索以相依关系为焦点的干预方案。     

成人危重患者低体温复温管理的证据总结

目的 总结成人危重低体温患者复温管理的相关证据,为临床实践提供指导。方法 根据循证护理方法确立循证问题,根据证据的“6S”模型,从“证据金字塔”上层开始检索国内外有关成人危重患者低体温复温管理的相关证据,证据资源类型包括临床决策、推荐实践、证据总结、指南、专家共识。由2名研究人员独立进行文献质量评价,并对符合质量标准的文献进行证据内容提取。结果 共纳入8篇文献,包括2篇临床决策,1篇推荐意见,3篇证据总结,2篇专家共识。共提取出涉及体温监测（3条证据）、复温目标（2条证据）、复温措施选择（5条证据）、复温风险管理（7条证据）、复温并发症监测（5条证据）的22条证据,证据等级1~5级。结论 本研究从5个维度汇总了成人危重患者低体温复温管理证据,为临床实践提供了理论指导。但本研究汇总的证据来源多为国外研究,建议研究者在使用本次汇总的证据时,要充分评估每条证据在临床的可行性、适宜性、临床意义和有效性,并评估证据在临床应用的障碍与促进因素,以确保证据在临床的顺利应用。     

Body mass index,waist‐to‐hip ratio,waist circumference and waist‐to‐height ratio cannot predict male semen quality: a report of 1231 subfertile Chinese men

There were controversial results between obesity‐associated markers and semen quality. In this study, we investigated the correlations between age, obesity‐associated markers including body mass index (BMI), waist‐to‐hip ratio (WHR), waist‐to‐height ratio (WHtR) and waist circumference (WC), the combination of age and obesity‐associated markers, semen parameters and serum reproductive hormone levels in 1231 subfertile men. The results showed that BMI, WC, WHR and WHtR were positively related to age, and there were also positive relations between BMI, WHR, WC and WHtR and between sperm concentration (SC), total sperm count (TSC), progressive motility (PR), sperm motility and per cent of normal sperm morphology (NSM). However, age, each of obesity‐associated markers and the combination of obesity‐associated markers and age were unrelated to any of semen parameters including total normal‐progressively motile sperm count (TNPMS). Age, BMI, WHR, WC and WHtR were negatively related to serum testosterone and SHBG levels. However, only serum LH and FSH levels were negatively related to sperm concentration, NSM and sperm motility. In a conclusion, although age and obesity have significant impacts on reproductive hormones such as testosterone, SHBG and oestradiol, semen parameters related to FSH and LH could not be influenced, indicating that obesity‐associated markers could not predict male semen quality.     

多维度评估对特发性脊柱侧凸进展高峰期的预测价值

目的:通过多维度评估特发性脊柱侧凸(idiopathic scoliosis,IS)患儿侧凸进展高峰期(peak angle velocity,PAV)的相应成熟度指标,探讨其对PAV的预测价值。方法:选取初诊时月经未至、Risser征0级,Y三角软骨未闭、以半年为周期随访至少5次且进展超过5°的女性IS患儿30例,初诊年龄为10.8±1.5岁(7.8~12.1岁)。随访时收集及测量的指标包括实足年龄、Y三角软骨闭合状态、Risser征、身高、主弯Cobb角和骨龄(digital skeletal age,DSA)评分。计算每个随访周期内的身高增长速度(height velocity,HV)和Cobb角增长速度(angle velocity,AV)。采用逻辑回归分析各维度指标对PAV的预测价值。结果:30例患儿的PAV年龄为11.8±1.3岁(10~15岁),PAV时的身高为150.7±4.8cm,DSA评分为479.4±56.5,主弯Cobb角为26.5°±7.2°,HV为8.3±3.7cm/年,AV为7.8°±5.2°/年。PAV主要发生于Risser征0级(80.0%)和1级(20.0%)。逻辑回归分析结果显示PAV的发生与实足年龄介于11~13岁之间(OR=3.166,P=0.032)、Y软骨闭合(OR=6.365,P0.01)、Risser征0级(OR=12.963,P0.01)、DSA评分介于400~500之间(OR=10.758,P=0.011)、HV6cm/年(OR=4.346,P=0.025)、Cobb角30°(OR=9.535,P=0.013)呈显著相关。结论:年龄介于11~13岁之间、Risser征0级伴Y软骨闭合、DSA评分介于400~500之间、HV6cm/年和Cobb角30°为女性IS患儿侧凸PAV的高危因素,可用于预测PAV的发生,评估侧凸进展风险。     

RANK基因多态性与女性青少年特发性脊柱侧凸的相关性

目的 :探讨核因子κB受体活化子(receptor activator of nuclear factor-κB,RANK)基因多态性与女性青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)之间的相关性。方法:2009年2月~2013年7月在我院行支具或手术治疗的450例主弯Cobb角大于20°的女性AIS患儿为观察组(AIS组),年龄14.8±2.9岁(10~18岁)。对照组为例行健康体检的我院周围地区无血缘关系的健康青少年女性400名,年龄15.1±2.3岁(10~17岁)。所有AIS患儿均有身高、体重及体重指数(body mass index,BMI)等资料。AIS组和对照组每例取肘静脉血2ml,提取外周血白细胞基因组DNA。rs1805034和rs35211496作为RANK的目标位点,应用Taqman探针技术行荧光定量PCR,全部反应结束后在荧光定量PCR仪上读取终点荧光,确定各样本的基因分型结果。采用R×C表χ~2检验比较AIS组和对照组单核苷酸多态性(single nucleotide polymorphism,SNP)位点基因型及等位基因频率分布的差异。采用单因素方差分析比较AIS组患儿主弯Cobb角及BMI在不同基因型之间的差异。结果:rs1805034和rs35211496的基因型在AIS组和对照组中的分布均符合Hardy-Weinberg遗传平衡定律。rs1805034和rs35211496的基因型及等位基因频率两组间无统计学差异(P0.05)。单因素方差分析示AIS组内rs1805034和rs35211496的不同基因型患儿间的主弯Cobb角及BMI均无统计学差异(P0.05)。结论:RANK基因可能不是女性AIS的易感基因,女性AIS组内rs1805034和rs35211496的不同基因型患儿间的主弯Cobb角及BMI均无统计学差异。     

The association between the genetic polymorphism of HLA-DQA1, DQB1, and DRB1 and serum alanine aminotransferase levels in chronic hepatitis C in the Chinese population

Background and Aim:  To investigate a possible association between HLA genes with serum alanine aminotransferase (ALT) levels and evaluate whether the HLA-DQA1, DQB1, and DRB1 genes could influence the development of liver damage in chronic hepatitis C.
Methods:  A total of 145 patients with chronic hepatitis C virus (HCV) infection (36 patients with persistently normal ALT values; 109 patients with elevated ALT levels) and 160 uninfected healthy controls were examined for HLA-DQA1, DQB1, and DRB1 molecules by using polymerase chain reaction–sequencing based typing (PCR-SBT).
Results:  Among the patients chronically infected with HCV, the frequencies of DQA1*0501, DQB1*0301, and DRB1*0401 alleles were significantly increased in the normal ALT group compared with those with abnormal ALT levels, whereas that of DQB1*0201 was significantly lower. As compared to uninfected healthy controls, DQA1*0501, DQB1*0301, and DRB1*0401 allele frequencies were also statistically higher in the normal ALT group, whereas that of DQB1*0201 was the inverse. The haplotype frequencies of DQA1*0301-DQB1*0301, DQA1*0501-DQB1*0301, and DRB1*1101-DQB1*0301 were found to be significantly higher in the normal ALT group. Multivariate logistic regression indicated that female sex, and the DQB1*0301 allele and DRB1*0401 allele were independently associated with normal ALT values, whereas DQB1*0201 allele was the inverse.
Conclusions:  These results suggest that particular HLA alleles may have an influence on the serum ALT level of chronic HCV infection as a host genetic factor in the Chinese population. The DQA1*0501, DQB1*0301, and DRB1*0401 alleles, and the DQA1*0301-DQB1*0301, DQA1*0501-DQB1*0301, and DRB1*1101-DQB1*0301 haplotypes seem to be associated with low hepatitis activity; whereas DQB1*0201 allele is closely correlated with the progression of liver injury in chronic HCV infection.     

Occult infection with HBV intergenotypic A2/G recombinant following acute hepatitis B caused by an HBV/A2 isolate

Viral and host factors leading to occult hepatitis B virus (HBV) infection (OBI) are not fully understood. Whether HBV genotype may influence the occurrence and course of OBIs is unknown. Here, we describe the case of a patient infected with HBV genotype A2 who developed symptomatic acute hepatitis and did not seroconvert after loss of HBsAg and HBeAg. The acute phase of hepatitis B was followed by a period of more than 2 years during which the DNA of an intergenotypic HBV/A2/G recombinant was intermittently detected in serum.