深圳市外来劳务工与户籍人口结核病治疗影响因素的对比研究

目的 调查影响劳务工结核病管理、治疗效果的因素,为制定我国流动人口结核病防治策略提供依据.方法 用自行设计的问卷,调查深圳市6个区经结核病防治机构确诊的外来劳务工结核病患者1364例(研究组)和当地户籍结核病患者436例(对照组).结果结核病患者发现与首诊医疗单位、工作流动性、经济状况等有关,个体诊所首诊怀疑结核病比例(39.0%)偏低.有58.4%(796例)的劳务工患者就诊延迟,其中以患者自身不重视(55.9%,445例)、自觉症状轻(19.3%,154例)、医院远不方便(10.2%,81例)为主;而户籍人口有68.1%(297例)患者就诊延迟,其中以不重视(177,59.6%)和不方便(47,15.8%)为主.二者相比延迟因素分布差异有统计学意义(χ2=21.49,P<0.01).有39.9%(544例)的劳务工患者与49.1%(214例)的户籍人口患者诊断延误,二者相比延误因素差异无统计学意义(χ2=7.31,P=0.293).17.6%(240例)的劳务工患者与13.1%(57例)的户籍人口患者有药物漏服现象,二者相比药物漏服原因差异无统计学意义(χ2=6.66,P>0.05);77.5%(1057例)的劳务工患者与31.8%(138例)的户籍患者认为督导点服药对工作、生活有影响,两者相比服药点给患者带来困难的原因差异有统计学意义(χ2=9.71,P<0.05);79.2%(1080例)的劳务工患者与63.3%(276例)的户籍人I=I患者曾未按医生处方要求取药,二者相比未按医嘱取药的原因差异具有统计学意义(χ2=24.84,P<0.01);51.2%(699例)的劳务工患者与46.1%(201例)的户籍人口患者曾未按医生要求及时化验,二者相比其主要原因差异无统计学意义(χ2=3.26,P>0.05).结论 影响深圳劳务工结核病管理、治疗效果的因素较多,必须加强宣传,提高患者的就诊意识,健全转诊机制,减轻劳务工经济负担,以降低区域结核病的发病率.     

某高校女大学生月经病症状及其影响因素分析

目的 探讨女大学生月经病相关症状的流行特征及其影响因素,为女大学生生殖健康保健和教育提供参考.方法 采用整群随机抽样方法,对某高校266名女大学生进行自填问卷调查,并对结果进行非条件Logistic回归分析.结果 女生平均初潮年龄为(13.37±1.31)岁.月经病症状自报患病率为79.3%,其中痛经为67.3%,其次为经期不规则(37.0%)、月经稀发(7.1%).月经病症状就诊率最高的是闭经(100.0%)和月经间期出血(100.0%),就诊率最低的是痛经(26.8%).初潮年龄、贫血、母亲有痛经史、经期运动情况、经期洗冷水澡都对月经病的发生有不同程度的影响.结论 女大学生月经病症状普遍存在.有必要加强学校生殖健康教育和提供相关服务,提高女大学生身心健康水平.     

高血压患者的生命质量及影响因素研究

采用世界卫生组织生命质量测定量表简表(WHOQOL-BREF),对大庆市275名高血压患者的生命质量及影响因素进行了访谈式的调查。结果表明,影响高血压患者生命质量的因素是多方面的,包括年龄、文化程度、职业、病情分期、并发证、家庭支持、经济收入等;提高高血压患者的生命质量,关键在于健康教育和健康促进。     

新疆4个民族健康人凝血因子V Leiden突变的检测

目的 分析新疆4个民族健康人中凝血因子V(FV)Leiden突变的发生状况,为从分子水平诊断静脉血栓的形成提供一种快速简便的方法.方法 应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)分析,对新疆地区60名维吾尔族、57名哈萨克族、50名蒙古族和82名汉族健康人进行FV Leiden基因突变检测.结果 新疆维吾尔族、哈萨克族、蒙古族和汉族健康个体均未检出FV Leicien基因突变类型.结论 Fv Leiden突变可能不是新疆地区维吾尔族、哈萨克族、蒙古族和汉族健康人静脉血栓发病的主要危险因素.     

PEA3和GDNF在小鼠纹状体的表达

目的:观察多瘤促活化因子(PEA3)和胶质细胞源性神经生长因子(GDNF)蛋白在出生后小鼠纹状体神经纤维中的表达变化及相关性,为进一步探讨多巴胺能神经元疾病的治疗方法提供实验依据。方法:分别取正常鼠龄为1,5,10,20,30,40 d昆明小鼠各5只,断头处死,迅速取出大脑,冠状面切取纹状体所在部位1 cm厚的组织块。常规固定、脱水、石蜡包埋,连续切片,免疫组织化学SABC方法,DAB染色。结果:本实验观察到PEA3免疫阳性反应纤维数目在出生后1,5,10,20 d持续上升,在30,40 d下降并保持在一定水平,GDNF蛋白免疫反应阳性纤维数目在出生后1,5,10,20 d保持在一定水平,在30,40 d下降,各组间的表达差异具有统计学意义(P<0.05)。结论:出生后,GDNF在纹状体多巴胺能神经纤维发育过程中发挥作用,并且可能以PEA3作为其下游作用靶。这种作用方式在第20天以前可能是GDNF作用于纹状体神经纤维发育过程的主要途径。     

Quantitative multifocal fMRI shows active suppression in human V1

Multifocal functional magnetic resonance imaging has recently been introduced as an alternative method for retinotopic mapping, and it enables effective functional localization of multiple regions-of-interest in the visual cortex. In this study we characterized interactions in V1 with spatially and temporally identical stimuli presented alone, or as a part of a nine-region multifocal stimulus. We compared stimuli at different contrasts, collinear and orthogonal orientations and spatial frequencies one octave apart. Results show clear attenuation of BOLD signal from the central region in the multifocal condition. The observed modulation in BOLD signal could be produced either by neural suppression resulting from stimulation of adjacent regions of visual field, or alternatively by hemodynamic saturation or stealing effects in V1. However, we find that attenuation of the central response persists through a range of contrasts, and that its strength varies with relative orientation and spatial frequency of the central and surrounding stimulus regions, indicating active suppression mechanisms of neural origin. Our results also demonstrate that the extent of the signal spreading is commensurate with the extent of the horizontal connections in primate V1.     

Sensitivity to activated protein C during the menstrual cycle in women with and without factor VLeiden

Introduction

Activated protein C (APC) resistance is associated with an increased risk of venous thrombosis. High levels of estradiol and progesterone, e.g. during ovarian stimulation and pregnancy, as well as exogenously administered estrogens and progestagens during oral contraceptive use, induce an acquired form of APC resistance. Several coagulation factors display a cyclic pattern during the menstrual cycle due to the fluctuation of estradiol and progesterone. The aim of the study was to evaluate whether varying levels of estradiol and progesterone during the menstrual cycle are associated with differences in sensitivity to APC.

Materials and methods

Normalized APC sensitivity ratios (nAPCsr) were determined with the thrombin generation-based APC-resistance test at six different time points during the menstrual cycle in thirteen wildtype women and six women with factor V_Leiden.

Results

Mean nAPCsr varied slightly during the menstrual cycle. Women without factor V_Leiden were more likely to have lower nAPCsr at the beginning of the cycle than later on in the cycle (1.34 versus 1.54 and 1.58, Friedman ranking test p = 0.009).

Conclusions

The sensitivity to APC differs between the different phases of the menstrual cycle. This cyclic variability could be useful in improving studies on APC resistance in women.     

Anti-apoptotic actions of vasopressin in H32 neurons involve MAP kinase transactivation and Bad phosphorylation

Vasopressin (VP) secreted within the brain modulates neuronal function acting as a neurotransmitter. Based on the observation that VP prevented serum deprivation-induced cell death in the neuronal cell line, H32, which expresses endogenous V1 receptors, we tested the hypothesis that VP has anti-apoptotic properties. Flow cytometry experiments showed that 10 nM VP prevented serum deprivation-induced cell death and annexin V binding. Serum deprivation increased caspase-3 activity in a time and serum concentration dependent manner, and VP prevented these effects through interaction with receptors of V1 subtype. The signaling pathways mediating the anti-apoptotic effect of VP involve mitogen activated protein (MAP) kinase and extracellular signal-regulated kinases (ERK), Ca²⁺/calmodulin dependent kinase (CaMK) and protein kinase C (PKC). Western blot analyses revealed time-dependent decreases of Bad phosphorylation and increases in cytosolic levels of cytochrome c following serum deprivation, effects which were prevented by 10 nM VP. These data demonstrate that activation of endogenous V1 VP receptors prevents serum deprivation-induced apoptosis, through phosphorylation-inactivation of the pro-apoptotic protein, Bad, and consequent decreases in cytosolic cytochrome c and caspase-3 activation. The data suggest that VP has anti-apoptotic activity in neurons and that VP may act as a neuroprotective agent in the brain.     

The feasibility of using V.A.C. Therapy in home care patients with surgical and traumatic wounds in the Netherlands

The aim of this study was to review the feasibility of using vacuum-assisted closure (V.A.C.) Therapy for the management of surgical and traumatic wounds in the home care settings in the Netherlands. De-identified patient data were collected from a health insurance database in the Netherlands. All patients with complete records, including indication, age, duration of therapy and defined treatment goal between January and November 2006 were included. Data from 338 patients were analysed. On average, wounds had been present for 2 months before start of V.A.C. Therapy. Overall, 74% of patients reached the pre-defined therapy goal (77% for dehisced wounds, 68% for abdominal wounds, 73% for traumatic wounds and 91% for sternal wounds) with approximately 1 month of V.A.C. Therapy. There was a negative association between the wound duration prior to V.A.C. Therapy and the treatment success rate (r = -0.162, P = 0.003). Wounds with shorter duration (6 months prior to V.A.C. Therapy. V.A.C. Therapy is a feasible and effective treatment for surgical and traumatic wounds in home care patients with over 70% of patients treated in this sample achieving pre-defined treatment goals. The success rate of V.A.C. Therapy is negatively associated with the duration of the wound before V.A.C. Therapy is commenced.