Effectiveness of Community Intervention in Improving Bone Health Behaviors in Older Adults

An 8-week, bone-health community program addressed risks/lifestyle changes within the Health Belief Model and Theory of Reasoned Action frameworks in a randomized format (treatment group n = 35; control group n = 34). Median week 1 values for calcium (control, 963 mg; treatment, 1023 mg) and vitamin D (81 IU both groups) were below recommendations, increasing throughout the program for both control (1023 mg calcium, 128 IU vitamin D) and treatment (1005 mg calcium, 122 IU vitamin D) groups. There was limited response to the exercise outcome variables, with many not participating in that section of the program. Psychosocial variables were positive for both control and treatment groups at week 1, with no significant difference at postintervention. Regression analysis indicated that those with a positive attitude about calcium intake and belief that they could choose calcium-fortified foods were more likely to have higher calcium intake. Intention to exercise was modified by peer and family support. Community-based programs can translate and use clinical trial key topics and outcomes, but participation bias makes impact results difficult to interpret the effectiveness of the program.     

Balloon Retrograde Transvenous Obliteration Versus Endoscopic Cyanoacrylate in Bleeding Gastric Varices: Comparison of Rebleeding and Mortality with Extended Follow-up

Purpose

To assess short- and long-term mortality and rebleeding with endoscopic cyanoacrylate (EC) versus balloon-occluded retrograde transvenous obliteration (BRTO).

Multi-Center Analysis of Liver Transplantation for Combined Hepatocellular Carcinoma-Cholangiocarcinoma Liver Tumors

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Gallbladder Cryoablation for Chronic Cholecystitis in High-Risk Surgical Patients: 1-Year Clinical Experience with Imaging Follow-up

PurposeTo assess the short-term safety and efficacy of gallbladder cryoablation in high-risk patients.Materials and MethodsA single-center, retrospective review of clinical and imaging follow-up from patients who were referred for gallbladder cryoablation between August 2018 and July 2019 was performed. All patients had serious pre-procedural comorbidities and were unacceptable surgical candidates (mean age, 52.5 years; mean American Society of Anesthesiologists score, 3.67). Primary efficacy measures included technical success, absence of symptoms after cholecystostomy tube removal, and imaging evidence of cystic duct obstruction and gallbladder involution. The primary safety measure was the absence of Society of Interventional Radiology moderate or greater adverse events.ResultsTechnical success was 86%, with 1 of 7 patients unable to undergo cryoablation because of adhesions preventing hydrodissection of the colon away from the gallbladder. Mean duration of clinical follow-up after discharge was 278 days (range, 59–498 days). Abdominal pain was absent in all patients after ablation. Cholecystostomy tubes were removed immediately after ablation (n = 5) or on post-procedure day 11 (n = 1). Computed tomography or magnetic resonance imaging was obtained at 1–3 months (n = 6), 4–6 months (n = 4), and 6–12 months (n = 5) after the procedure and demonstrated gallbladder involution in 5 of 6 patients. One patient had asymptomatic distention of the gallbladder on follow-up imaging. Hepatobiliary iminodiacetic acid scans were completed in 5 of 6 patients 1 month after ablation and demonstrated cystic duct occlusion in all 5 patients. One moderate adverse event (infection) and 1 life-threatening adverse event (hemorrhage) occurred.ConclusionsGallbladder cryoablation might be a viable treatment option for high-risk patients with gallbladder disease and warrants further investigation.     

成年小鼠颈5脊髓钳夹损伤模型的制备与评价

目的 :制备小鼠C5脊髓背侧及背外侧束钳夹损伤模型,评价损伤后动物的行为学和组织学表现。方法:采用C57/BL成年小鼠为实验对象,将16只动物随机分为损伤组和对照组,每组8只。动物麻醉后,切开背侧颈部皮肤,显露并切除小鼠C5椎板,损伤组采用自制改良FST DUMONT 5号手术钳分别钳夹背侧皮质脊髓束(dCST)和脊髓背外侧束两次;对照组仅切除椎板不做脊髓钳夹损伤。分别在术前和术后3d、2周、4周、6周、8周时采用圆筒实验、水平楼梯实验和食物抓取实验评价动物的行为学表现;术后8周时采用BDA顺行示踪观察皮质脊髓束(CST)和红核脊髓束(RST)在损伤后的情况。结果:钳夹损伤后,小鼠后肢步行功能正常但肢体的精细活动能力受到明显影响。在圆筒实验中,损伤组小鼠伤侧前肢的使用频率下降,前肢梳洗动作幅度受限,伤后各时间点与对照组相比差异均有统计学意义(P0.05);在水平楼梯实验中,损伤组小鼠对横梁的抓握精确性降低,伤后各时间点与对照组相比差异有统计学意义(P0.05);在食物抓取实验中,损伤组小鼠的食物抓取能力也出现了明显受限,伤后各时间点与对照组相比差异有统计学意义(P0.05)。以上行为学结果在伤后3d达高峰,2周后逐渐恢复,但直至8周仍不达正常水平。术后8周顺行示踪结果显示对照组小鼠CST和RST均显露清晰,纤维束呈纵行排列;损伤组小鼠CST和RST在损伤处大量断裂、逆向崩解,且无再生迹象。结论:成年小鼠C5脊髓钳夹损伤模型能够方便观察动物随意运动的控制情况及评价轴突的再生状况,适合作为轴突再生的研究模型。     

成对数据的主客体互依调节模型在公共卫生领域的应用与SPSS软件实现

目的 介绍主客体互依调节效应模型（Actor–Partner Interdependence Moderation Model，APIMoM）的基本理论，基于多层次模型实现，为APIMoM的实际应用提供方法学参考。方法 介绍APIMoM在不同类型的成对数据以及调节变量中的构建方法，并结合实例提供在SPSS中实现的语句。结果 本文介绍了5种不同类型的成对数据和调节变量组合的APIMoM构建方法，对于可区分的成对数据，可进一步使用二截距模型分别估计对子内两个成员的效应。结论 APIMoM多应用于心理和行为等方面，使用该模型前要考虑清楚变量间的因果关系和调节变量的选择，才能有效地将APIMoM应用于公共卫生领域成对数据的研究。     

江海交汇处区域经济空间结构的重构

运用克里斯塔勒中心地理论和引力模型等分析方法，以长江与南黄海交汇处的南通市为例，分析了以淤泥质海岸为主体江海交会处区域经济空间结构及内部差异形成的要素，以及此类地区沿海区域经济社会发展滞后的动力机制。论证了新一轮沿海开发和空间结构重构中，该类地区以沿江沿路经济轴带为基础，实施陆海统筹、江海陆协同发展的必然性。提出要充分利用原有基础，在不同区域利用各自优势，因地制宜实施发展战略，打造区域经济空间网络结构，实现区域空间均衡发展。力图从一个侧面探讨大的江河与淤泥质海岸交汇处区域发展问题的研究范式。