教师体检人群肺结节检出结果及影响因素分析

目的:分析教师人群肺结节检出结果和影响因素。方法:回顾性搜集我院体检中心3 068名教职工（包括离退休人员）胸部低剂量CT（low-dose computed tomography,LDCT）结果,和相关年龄、性别、生活史及部分检查资料进行整理分析,并建立体检后肺结节精准健康管理流程。结果:本次检出患有肺结节1 849例,总患病率60.27%,其中直径＜6 mm结节为89.89%,6~7 mm结节为6.81%,≥8 mm为3.30%;实性肺结节90.21%,亚实性结节9.79%;孤立性肺结节43.97%,多发性肺结节56.03%,其中高校教师组肺结节检出率达79.81%,男性为63.41%,吸烟者为93.37%,40岁以下为70.86%,每天运动＜60分钟为79.73%。其他方面以血脂异常和甲状腺疾病检出率较高。多因素Logistic回归分析显示,性别、吸烟、运动少和教师组别是肺结节发生的独立易感因素（OR=0.334、22.869、0.384、2.549,均P＜0.05)。结论:肺结节以＜6 mm、实性结节为主,正确认识肺结节,在体检中更应重视对运动少、青年女性、高校教师的筛查,加强长期规律随访。     

原发性肝癌术后发生静脉血栓栓塞症的危险因素及Caprini风险预测模型的应用

目的:研究原发性肝癌术后发生静脉血栓栓塞症（venous thromboembolism,VTE）的危险因素,并验证和改良Caprini模型对肝癌术后患者VTE发生的预测能力。方法:对我院收治的452例肝癌患者进行回顾性分析,根据术后1月内是否发生VTE而分为VTE组和非VTE组。采用多因素Logistic回归以用来筛选VTE发生的独立危险因素。采用受试者操作特征曲线（receiver operating characteristic,ROC）和曲线下面积（area under ROC curve,AUC）来描述和比较传统Caprini模型和改良Caprini模型对VTE发生预测的准确性。结果:共有41例原发性肝癌患者术后出现VTE,整体发生率为9.07%。单因素分析示BMI、糖尿病患病率、门静脉癌栓发生率、手术时间、二次手术率、以及Caprini评分可能与VTE的发生有关。多因素分析示BMI（OR=1.14,P=0.01）、手术时间（OR=10.91,P=0.001）、有门静脉癌栓（OR=4.98,P=0.001）、二次手术（OR=7.85,P=0.01）和Caprini评分（OR=2.63,P=0.001）是VTE发生的独立危险因素。改良后的Caprini模型和一般Caprini模型在预测VTE时的AUC分别为0.912和0.811;当取最大约登指数时,二者敏感度分别为85.37%和63.41%,特异度分别为85.64%和87.59%。结论:BMI、手术时间、门静脉癌栓、二次手术是原发性肝癌患者术后VTE发生的独立影响因素,联合上述四种指标可以显著提高Caprini模型对VTE的预测能力。     

结直肠癌术后肝转移的危险因素分析及预测模型构建

目的:分析结直肠癌术后肝转移的危险因素并构建预测模型.方法:选取2011年1月至2015年12月于苏州市第九人民医院行根治性手术切除的247例结直肠癌患者作为观察对象,依据随访是否出现肝转移分为转移组、非转移组.对两组各项指标进行单因素筛选,再行Logistic多因素回归分析,并建立预测模型,应用受试者工作特征(rec...     

The incidence of preterm deliveries decreases in Finland

Objective  We examined the trends and risk factors of preterm delivery.
Design  Register-based retrospective cohort study from Finland.
Setting  National Medical Birth Register data during 1987–2005.
Population  The study population consisted of 1 137 515 deliveries, of which 59 025 were preterm (5.2%).
Methods  We calculated the population attributable risks for using the risk factor prevalence rates in the population. We further calculated odds ratios with 95% CI by multivariate logistic regression to adjust for confounders.
Main outcome measures  Preterm delivery rate subclassified into moderately preterm (32–36 weeks), very preterm (28–31 weeks) and extremely preterm (less than 28 weeks).
Results  Preterm delivery rates increased from 5.1% in the late 1980s to 5.4% in the late 1990s but then decreased to 5.2% for 2001–05. The proportion of extremely preterm deliveries decreased substantially by 12% ( P < 0.01). The greatest risk factors were multiplicity (OR 13.72, 95% CI 13.26–14.19), followed by elective delivery (OR 1.86, 95% CI 1.82–1.89), primiparity (OR 1.47, 95% CI 1.45–1.50), in vitro fertilisation treatment (OR 1.39, 95% CI 1.31–1.47), maternal smoking (OR 1.31, 95% CI 1.29–1.34) and advanced maternal age (OR 1.02, 95% CI 1.02–1.03 for each additional year of age). Prematurity rates decreased by 1.8% after adjusting for risk variables.
Conclusions  The rate of preterm delivery has not increased from 1987 to 2005 in Finland, while the risk for extremely preterm delivery has decreased. This finding is in contrast with recent trends in other countries.     

Animal models to test drugs with potential antidiabetic activity

Although medicinal plants have been historically used for diabetes treatment throughout the world, few of them have been validated by scientific criteria. Recently, a large diversity of animal models has been developed to better understand the pathogenesis of diabetes mellitus and new drugs have been introduced in the market to treat this disease. The aim of this work was to review the available animal models of diabetes and some in vitro models which have been used as tools to investigate the mechanism of action of drugs with potential antidiabetic properties. In addition, a MEDLINE/PUBMED search for articles on natural products, pancreatectomy and diabetes mellitus treatment published between 1996 and 2006 was done. In the majority of the studies, natural products mainly derived from plants have been tested in diabetes models induced by chemical agents. This review contributes to the researcher in the ethnopharmacology field to designs new strategies for the development of novel drugs to treat this serious condition that constitutes a global public health.     

Temporal effect of Guanxin No. 2 on cardiac function, blood viscosity and angiogenesis in rats after long-term occlusion of the left anterior descending coronary artery

AIM: Cardiac infarction is one of the main causes of death in both developing and developed countries over past decades. Currently available approaches for treating patients with this disease are not satisfactory. Traditional Chinese medicines have been increasingly paid attention to. The aim of this study was to characterize the dynamic protective effects of Guanxin No. 2 decoction (GX II) on cardiac dysfunction combined with the blood viscosity and myocardial hypertrophy parameters in myocardial infarction (MI) rats. METHODS: Male Sprague-Dawley rats (180-200 g) were randomly divided into three groups: sham-operated, coronary artery ligation (CAL), and CAL plus GX II (GX II, 10.0 g raw materials/kg/d, bid, p.o.). The experiment was carried out at 4 time points as the 3rd, 7th, 14th, and 28th day after ligation. RESULT: It was found that on the one hand, GX II could significantly improve the heart function, and remarkably decrease infarct size and inhibit ventricular remodeling. On the other hand, GX II showed some unique effects such as angiogenesis which was induced in the left ventricular tissue. This result was consistent with the finding of an augmented vascular endothelial growth factor (VEGF) expression in this area. CONCLUSIONS: The studies demonstrated that GX II exerted extensively beneficial cardioprotective effect on CAL rats, it might stimulate angiogenesis of ischemic region to compensate blood supply to the heart via upregulated VEGF expression.     

淫羊藿对哮喘大鼠肺组织RANTES及MCP-3表达的影响

目的 观察补肾中药淫羊藿对哮喘大鼠肺组织调节激活正常T细胞表达和分泌因子(regulated on activation, normal T cell expressed and secreted,RANTES)、单核细胞趋化蛋白3（monocyte chemotactic protein-3,MCP-3）表达的影响,进一步探讨淫羊藿防治哮喘的作用机制。 方法 将挪威大鼠随机分成6组：正常组、模型组、阳性药组（给地塞米松）、淫羊藿低、中、高剂量组（分别给淫羊藿0.125、0.5、2.0 g/mL)。用Real-time PCR法检测肺组织RANTES、MCP-3 mRNA的表达,ELISA法检测各组血清中肿瘤坏死因子α（TNF-α）、白细胞介素（IL）4、5的含量。结果 与模型组比较,各用药组大鼠肺组织RANTES、MCP-3 mRNA的表达下调（P＜0.05或P＜0.01）,TNF-α水平均明显降低（P=0.000）,阳性药组和淫羊藿中、高剂量组IL-4水平均明显下降（P=0.007,P=0.047,P=0.033）, IL-5水平仅见阳性药组和淫羊藿高剂量组显著下降（P=0.003,P=0.005）。结论 哮喘发作期给予淫羊藿可减轻哮喘气道炎症,并且其与抑制肺组织RANTES、MCP-3表达有关。     

Embryotoxicity of serum from women smoking cocaine base paste (CBP)

OBJECTIVE: Using a mouse embryo bioassay, we examined the embryotoxic properties of serum obtained from eight women who had ingested cocaine base paste (CBP) for a period of 1-3 years. STUDY DESIGN: Two-cell stage mouse embryos were cultured in the presence of serum extracted from eight CBP-smoking or control women. After 48h, embryos were evaluated to determine their developmental stage and then processed by Tarkoswki's technique to determine the proportion of embryos with micronuclei, in order to establish the number of micronuclei/embryo. RESULTS: Serum from CBP patients diminished the percentage of embryos progressing to the compacted morula stage, while increasing the proportion of embryos with micronuclei and the corresponding micronuclei/embryo ratio. CONCLUSION: These findings provide the first experimental evidence of embryotoxic compounds in the serum of CBP-smoking women. This study highlights the reproductive risk of chronically ingested CBP and demonstrates the need for further studies.     

Predictors of wheezing in prematurely born children

OBJECTIVE: To examine the degree to which neonatal illness severity, postneonatal health problems, child characteristics, parenting quality as measured by the HOME Inventory, and maternal characteristics are related to the development of wheezing in prematurely born children over the first 27 months after term. DESIGN: Longitudinal predictive study. SETTING: Infants were recruited from two neonatal intensive care units, one in southeast and one in Midwest. PARTICIPANTS: One hundred thirteen preterm infants who weighed less than 1,500 g or required mechanical ventilation and their mothers. MAIN OUTCOME MEASURES: The presence of wheezing was obtained from maternal report at 2, 6, 9, 13, 18, 22, and 27 months. Wheezing was considered to be medically significant if the child was using bronchodilators or pulmonary antiinflammatory medications. RESULTS: Sixty-eight percent of the children had wheezing at least one or more ages; 47% of the children were also taking bronchodilators or pulmonary antiinflammatory medications and thus had medically significant wheezing. CONCLUSION: Postneonatal health problems and the social environment appear to be more important in developing wheezing in prematurely born children than neonatal medical complications.