招收飞行学员听力检查标准探讨

目的 探讨修改空军招收飞行学员听力检查标准的可行性. 方法 ①收集招收飞行学员听力检查资料5673份,按现行的空军招收飞行学员听力检查标准(标准1)统计听力合格例数及合格率.②将低中频(0.25、0.5、1、2、3 kHz)听力损失不超标准1且双耳高频(4、6、8 kHz)听力损失总和≤270 dB者,按双耳高频听力损失之和的大小分为3组:A组(≤210 dB),B组(＞210 dB且≤240 dB)及C组(＞240 dB且≤270 dB).按5 dB档差统计A组听力较差耳4 kHz听力损失＞45 dB的例数,以及B组和C组听力较差耳4 kHz听力损失≤45 dB的例数.③将标准1高频部分修改为4 kHz听力损失≤45 dB,且双耳高频听力损失总和≤240 dB(标准2),或4 kHz听力损失≤45 dB且双耳高频听力损失总和≤270 dB(标准3).按标准2和标准3统计合格例数及合格率;分别统计符合3个标准的合格者中的0.5、1、2、4 kHz平均听阈＞25 dB的例数及所占百分比.比较3个标准的合格率及合格者中有听力障碍的百分比. 结果 ①按标准1统计,合格5310例.②A组4 kHz听力损失＞45 dB的63例,B组4 kHz听力损失≤45 dB的30例,C组4 kHz听力损失≤45 dB的25例.③按标准1、标准2及标准3统计的合格率分别为93.60％(5310/5673)、93.02％(5277/5673)及93.46％(5302/5673),差异无统计学意义;按标准1、标准2及标准3统计的合格者中0.5、1、2、4 kHz平均听阈＞25 dB的比率分别是2.56％(136/5310)、1.57％(83/5277)及1.77％(94/5302),按标准1统计的比率比标准2、标准3统计均高(x2=12.76、7.77,P＜0.01),而标准2与标准3之间差异无统计学意义. 结论 将现行空军招收飞行学员听力检查标准的高频修改为4 kHz听力损失≤45 dB,双耳高频听力损失之和≤240 dB是科学合理的,既降低了合格者中轻度听力障碍的比例,又对合格率没有明显影响.     

中国9省区1991-2009年7~17岁儿童青少年膳食脂肪和胆固醇入状况及变化趋势

目的 研究1991-2009年中国9省区儿童青少年膳食脂肪和胆固醇摄人状况及变化趋势+为合理膳食指导提供基础性资料。方法以“中国健康与营养调查”(ClaNS)1991—2009年7轮调查数据为基础.选择连续72 h有完整膳食数据的7～17岁的健康儿童青少年作为研究对象。计算该人群13均脂肪和胆周醇摄人量、脂肪供能比及脂肪食物来源,并与中同居民膳食脂肪适宜摄人量进行比较。结果 调查人群的脂肪和胆同醇摄入量增加,脂肪供能比不断提高.至2009午已分别达到65.8 g/d、240.0me/d和32.O%;脂肪供能比超过30%的人群比例显著增加,至2009年已达到57.0%。结论 中国9省7～17岁儿童青少年膳食结构发生显著变化.脂肪供能比已超过中国居民膳食脂肪参考摄入量的要求,应适当控制高脂肪和胆固醇食物的摄人量。     

Cost-effectiveness of maternal immunization against neonatal invasive Group B Streptococcus in the Netherlands

BackgroundNeonatal invasive Group B Streptococcus (GBS) infection causes considerable disease burden in the Netherlands. Intrapartum antibiotic prophylaxis (IAP) prevents early-onset disease (EOD), but has no effect on late-onset disease (LOD). A potential maternal GBS vaccine could prevent both EOD and LOD by conferring immunity in neonates.ObjectiveExplore under which circumstances maternal vaccination against GBS would be cost-effective as an addition to, or replacement for the current risk factor-based IAP prevention strategy in the Netherlands.MethodsWe assessed the maximum cost-effective price per dose of a trivalent (serotypes Ia, Ib, and III) and hexavalent (additional serotypes II, IV, and V) GBS vaccine in addition to, or as a replacement for IAP. To project the prevented costs and disease burden, a decision tree model was developed to reflect neonatal GBS disease and long-term health outcomes among a cohort based on 169,836 live births in the Netherlands in 2017.ResultsUnder base-case conditions, maternal immunization with a trivalent vaccine would gain 186 QALYs and prevent more than €3.1 million in health care costs when implemented in addition to IAP. Immunization implemented as a replacement for IAP would gain 88 QALYs compared to the current prevention strategy, prevent €1.5 million in health care costs, and avoid potentially ~ 30,000 IAP administrations. The base-case results correspond to a maximum price of €58 per dose (vaccine + administration costs; using a threshold of €20,000/QALY). Expanding the serotype coverage to a hexavalent vaccine would only have a limited additional impact on the cost-effectiveness in the Netherlands.ConclusionsA maternal GBS vaccine could be cost-effective when implemented in addition to the current risk factor-based IAP prevention strategy in the Netherlands. Discontinuation of IAP would save costs and prevent antibiotic use, however, is projected to lead to a lower health gain compared to vaccination in addition to IAP.     

A benchmark dose study of prenatal exposure to di(2-ethylhexyl) phthalate and behavioral problems in children

IntroductionPrenatal exposure to di(2-ethylhexyl) phthalate (DEHP) has been reported to be associated with adverse effects on neurodevelopment that yield behavior syndromes in young children with an estimated median exposure lower than the currently recommended tolerable daily intake (TDI) and reference dose (RfD).ObjectivesOur aim was to derive the benchmark dose for prenatal exposure to DEHP for the neurodevelopmental health in children.MethodsA total of 122 mother-child pairs from the Taiwan Maternal and Infant Cohort Study were analyzed for the dose-response relationship between maternal exposure to DEHP and children's behavioral syndromes evaluated at 8 years (n = 122, 2009), 11 years (n = 96, 2012), and 14 years (n = 78, 2015) of age. We employed a multivariate regression model to assess the statistical associations between the estimated maternal average daily intake of DEHP and child's individual CBCL scores for boys and girls at each separate age, followed by a mixed model for all the children across three ages accounting for individual variations. We then employed structural equation models by combining the children's specific behavioral problem scores at different ages and obtained a simulated overall latent score in relation to maternal exposure. Based on the established dose-response relationship, we derived the benchmark dose (BMD) and the lower limit (BMDL).ResultsAssociations of maternal DEHP exposure (median 4.54$\mu g/kg\_bw/day$) with the Child Behavior Checklist (CBCL) scores were all significant, except for somatic complaints, adjusting for child's age, gender, IQ, and family income. The BMDL, given a benchmark response of 0.10 (0.05) and a background response of 0.05, was 6.01 (2.16) $\mu g/kg\_bw/day$for an integrated CBCL score.ConclusionsThe current TDI (RfD) of 50 (20) $\mu g/kg\_bw/day$ for DEHP might not protect pregnant women for their children from behavioral problems. There remains the lack of comparable toxicological data. Further investigations are needed.     

Membrane-associated mucins of the ocular surface: New genes,new protein functions and new biological roles in human and mouse

The mucosal glycocalyx of the ocular surface constitutes the point of interaction between the tear film and the apical epithelial cells. Membrane-associated mucins (MAMs) are the defining molecules of the glycocalyx in all mucosal epithelia. Long recognized for their biophysical properties of hydration, lubrication, anti-adhesion and repulsion, MAMs maintain the wet ocular surface, lubricate the blink, stabilize the tear film and create a physical barrier to the outside world. However, it is increasingly appreciated that MAMs also function as cell surface receptors that transduce information from the outside to the inside of the cell. A number of excellent review articles have provided perspective on the field as it has progressed since 1987, when molecular cloning of the first MAM was reported. The current article provides an update for the ocular surface, placing it into the broad context of findings made in other organ systems, and including new genes, new protein functions and new biological roles. We discuss the epithelial tissue-equivalent with mucosal differentiation, the key model system making these advances possible. In addition, we make the first systematic comparison of MAMs in human and mouse, establishing the basis for using knockout mice for investigations with the complexity of an in vivo system. Lastly, we discuss findings from human genetics/genomics, which are providing clues to new MAM roles previously unimagined. Taken together, this information allows us to generate hypotheses for the next stage of investigation to expand our knowledge of MAM function in intracellular signaling and roles unique to the ocular surface.     

MRI评估女性盆腔器官脱垂研究进展

胶质瘤是中枢神经系统最常见的原发性肿瘤,术后复发率及病死率较高。MRI纹理分析可无创量化肿瘤的异质性特征,用于胶质瘤术前分级、放射治疗后假性进展与复发的鉴别及疗效监测等,为胶质瘤患者个体化诊疗提供客观依据。本文就MRI纹理分析法原理及其在胶质瘤诊治中的应用进行综述。     

European reference values for Doppler indices of left ventricular diastolic filling

The European Study Group on diastolic heart failure requires objective evidence of abnormal left ventricular diastolic function to establish the diagnosis of diastolic heart failure, which is common in older people. Reference values for Doppler indices of transmitral flow, used to assess left ventricular diastolic function, have not been reported for people 70 years and over in Europe. The aim of this study was to establish reference values for these Doppler indices of transmitral flow in older people. A random sample of 355 subjects aged 70 and over, living in the community underwent clinical assessment and echocardiography. Asymptomatic subjects with no cardiovascular disease and cardiovascular risk factors were identified. Measurements of five commonly used Doppler indices of transmitral flow from these subjects were obtained and reference range expressed as mean+/-2 standard deviations and as percentiles. We have therefore generated reference Doppler values of transmitral flow for people aged over 70 in a British population.     

Influenza vaccine effectiveness against laboratory confirmed influenza in Greece during the 2013–2014 season: A test-negative study

BackgroundIn 2013–2014 Greece experienced a resurgence of severe influenza cases, coincidental with a shift to H1N1pdm09 predominance. We sought to estimate Vaccine Effectiveness (VE) for this season using available surveillance data from hospitals (including both inpatients and outpatients).MethodsSwab samples were sent by hospital physicians to one of three laboratories, covering the entire country, to be tested for influenza using RT-PCR. The test-negative design was employed, with patients testing positive serving as cases and those testing negative serving as controls. VE was estimated using logistic regression, adjusted for age group, sex, region and calendar time, with further adjustment for unknown vaccination status using inverse response propensity weights. Additional age group stratified estimates and subgroup estimates of VE against H1N1pdm09 and H3N2 were calculated.ResultsOut of 1310 patients with known vaccination status, 124 (9.5%) were vaccinated, and 543 patients (41.5%) tested positive for influenza. Adjusted VE was 34.5% (95% CI: 4.1–55.3%) against any influenza, and 56.7% (95% CI: 22.8–75.7%) against H1N1pdm09. VE estimates appeared to be higher for people aged 60 and older, while in those under 60 there was limited evidence of effectiveness. Isolated circulating strains were genetically close to the vaccine strain, with limited evidence of antigenic drift.ConclusionsThese results suggest a moderate protective effect of the 2013–2014 influenza vaccine, mainly against H1N1pdm09 and in people aged 60 and over. Vaccine coverage was very low in Greece, even among groups targeted for vaccination, and substantial efforts should be made to improve it. VE can and should be routinely monitored, and the results taken into account when deciding on influenza vaccine composition for next season.     

图书馆参考咨询服务现状及应注意的问题

参考咨询是图书馆的一项中心任务。从读者应用需求的角度分析了对图书馆参考咨询服务的现状及其存在的问题,并从便利性与时效性出发提出了参考咨询服务应注意的问题。     

湖北省健康青少年及成人外周血T淋巴细胞正常值研究

目的建立湖北省健康青少年及成人外周血T淋巴细胞正常参考值。方法用MultiTEST 4色荧光抗体对342例10~59岁湖北健康青少年及成人外周血进行标记,用BD公司FACSCalibur流式细胞仪检测并分析结果,SPSS 13.0软件进行统计学处理。结果湖北10~59岁健康青少年及成人外周血CD3 、CD4 CD3 和CD8 CD3 绝对数及CD4 /CD8 比值均值分别为(1 427.94±481.93)/mm3,(865.73±289.97)/mm3,(556.64±249.70)/mm3,1.72±0.65;CD3 、CD4 CD3 和CD8 CD3 百分率分别为(67.88±8.56)%,(41.40±6.53)%,(26.48±7.15)%。T淋巴细胞绝对数在不同性别间差异无统计学意义,但CD3 和CD4 CD3 百分率差异有统计学意义。10~18岁青少年T淋巴细胞正常值与19~59岁成人的相比较有统计学意义。结论初步建立了湖北省健康青少年及成人外周血T淋巴细胞正常参考值。应分别建立青少年和成人的T淋巴细胞正常参考值及抗病毒治疗标准,为艾滋病防治工作提供参考。