A Cross-Country Network Analysis of Adolescent Resilience

PurposeIn situations of adversity, young people draw on individual, relational, and contextual (community and cultural) resources to foster their resilience. Recent literature defines resilience as a capacity that is underpinned by a network of interrelated resources. Although empirical studies show evidence of the value of a network approach, little is known regarding how different country contexts influence which resources are most critical within a resource network and how resources interact for adolescent resilience.MethodsNetwork analysis was conducted with data from studies that had used the Child and Youth Resilience Measure. Regularized partial correlation networks of 17 resources were estimated for 14 countries (Botswana, Canada, China, Colombia, Equatorial Guinea, India, Indonesia, Italy, Jordan, New Zealand, the Philippines, Romania, South Africa, and Syrian refugees living in Jordan). The sample size was 18,914 (mean age = 15.70 years, 48.8% female).ResultsWe observed mostly positive associations between the resources of interest. The salience and strength of associations between resources varied by country. The most central resource across countries was having supportive caregivers during stressful times because this resource had the most and strongest positive associations with other resources.ConclusionsThis study gives first empirical evidence from multiple countries that an interplay of social–ecological resources (such as individual skills, peer, caregiver and community support, and educational aspirations and opportunities) matter for adolescent resilience. Across countries, caregiver support appears to be most central for adolescent resilience. Future resilience interventions might apply this network approach to identify important, contextually relevant resources that likely foster additional resources.     

老年性系统性红斑狼疮的特点(附48例临床分析)

目的　探讨老年性系统性红斑狼疮患者的临床特征。方法　总结 48例老年性系统性红斑狼疮患者临床表现及自身抗体分布特点 ,并与中青年患者对比分析。结果　老年组蝶形红斑、盘状红斑、光过敏、脱发、雷诺氏现象等皮肤表现及肾损害较中青年组明显少见 (P<0 .0 5 ) ,浆膜炎、肺部病变、肌痛和肌无力、疲乏、血液系统损害明显高于中青年组 ,而狼疮的两项特异性抗体 (抗ds-DNA和抗Sm抗体 )、非特异性抗体 (抗SS -A和抗SS -B抗体 )以及补体C3 下降的阳性率都低于中青年组 (P <0 .0 5 )。结论　老年性与中青年性系统性红斑狼疮相比在临床表现、免疫学检查等方面有其自身特点 ,在临床诊断中应给予足够重视。     

术前孤立性CRP升高与体外循环术后并发症的相关性

目的探讨无感染的、术前孤立性C-反应蛋白(CRP)增加,对于体外循环心脏术后的结果,是否有预测性价值。方法分术前孤立性CRP升高(10.5～70.2mg／L)50例(A组)与CRP正常(＜10mg／L)50例对照(B组),B组匹配A组在年龄、性别和疾病种类,两组均进行体外循环心脏手术。结果A组脓毒性并发症(20％)比对照组(2％)多(P＜0.01)。这些病人微生物学阳性仅10％。A组中需要儿茶酚胺支持的占28％,而B组仅12％(P＜0.05)。A组较B组术后需呼吸机支持的时间明显延长(25.2±6.2h比6.6±0.5h)(P＜0.01)、ICU滞留时间也较B组长(4.6±0.8d比2.6±0.3d)(P＜0.05)。结论术前孤立性CRP升高的病人,体外循环术后,发生脓毒性并发症的可能性明显增加。且大多数病例微生物学实验阴性,推测大多数脓毒性并发症是由于全身炎症反应综合征的原因。     

基于中西医临床病证特点的系统性红斑狼疮动物模型研究评述

基于系统性红斑狼疮（SLE）的中西医临床病证特点,参考国内外SLE动物模型研究文献,依据临床诊断标准,对现有模型的临床符合度进行评价,经对比分析发现,自发小鼠模型中的MRL/lpr小鼠模型与诱导模型中的姥鲛烷诱导模型中西医临床病证吻合度最高。但目前SLE动物模型多按照西医病因特点建模,缺乏中医病证结合模型,中医符合度低,因此在现有研究基础上增加中医干扰因素,彰显中医辨证优势,加强SLE中医辨证相关研究是今后努力的方向。     

Severe Granulomatous Rosacea with Cutaneous Lupus Erythematosus

Rosacea and cutaneous lupus erythematosus (CLE) are chronic inflammatory dermatoses. To our knowledge, no cases of granulomatous rosacea (GR) associated with CLE have been previously reported in the literature. We describe the case of a 38-year-old female patient who presented to our clinic with a diffuse scaly facial erythema, with the codiagnoses of GR and CLE later confirmed with clinicopathological correlation.     

Perception of contraceptive counseling and contraceptive use among systemic lupus erythematosus patients

Objectives(1) To evaluate the perception of contraceptive counseling and knowledge regarding the impact of unintended pregnancy and (2) examine the prevalence of, and predictors for contraceptive use among systemic lupus erythematosus (SLE) patients.Study designA cross-sectional survey was conducted at the Rheumatology Clinic of a university hospital. SLE patients who attended the clinic from April 2018 to January 2019 and at risk for unintended pregnancy and were invited to be interviewed. The structured interview guide consisted of three parts: personal and obstetric information, perception of contraceptive counseling and knowledge about the impact of unintended pregnancy, and contraceptive use.ResultsThe mean age of the 137 patients who gave informed consents was 34 ± 8 years, with 47 patients (34%) stating that they had received contraceptive counseling. Seventy-five patients (52%) reported practicing contraception. The intention to not become pregnant (Odds Ratio; 95% CI = 7.28; 1.75–30.27), perception of adequate contraceptive counseling (2.77; 1.06–7.20) and discussion with partners and physicians about contraception (3.95; 1.64–9.50) were predictors for contraceptive use (p < 0.05).ConclusionMost patients reported no contraceptive counseling with approximately half of the patients using contraceptive methods within the past three months. Desire to avoid pregnancy, perception of adequate contraceptive counseling, and the influence of partners and physicians were significant predictors for contraceptive use.ImplicationsContraceptive counseling should be routinely included in discussions about disease processes and treatment plans, including access issues. Best practices for contraceptive counseling and integrated, multi-disciplinary team services should be developed and provided in clinical settings.     

Ⅰ期双侧全髋关节置换治疗系统性红斑狼疮合并股骨头坏死的早中期疗效

目的分析Ⅰ期双侧全髋关节置换（THA）治疗系统性红斑狼疮（SLE）合并中晚期股骨头缺血性坏死（ANFH）的早中期疗效。方法中山大学附属第三医院骨科对17例SLE合并中晚期ANFH患者均行Ⅰ期双侧THA，按照ARCO分期分为ⅢB期7髋、ⅢC期12髋，Ⅳ期15髋，结合患者年龄与骨质条件选择股骨假体不同的固定方式。采用Harris评分结合SF-36评分方法进行疗效比较与随访，平均随访时间28个月。结果术后2例切口延迟愈合，1例假体脱位，1例大腿痛10月，1例急性肾衰，均经治疗后好转。6例经彩超发现无症状下肢深静脉血栓，无肺栓塞、假体深部感染发生，无肾上腺皮质危象表现，随访期间髋关节疼痛及活动度明显改善，无假体松动。Harris髋关节功能评分（平均91．6分）与术前（平均42．6分）相比差异有统计学意义（P〈0．01），SF-36评分（平均84．5分）与术前（平均51．4分）相比差异有统计学意义（P〈0．01）；不同ARCO分期病例术后Harris评分差异无统计学意义（P〉0．05）；不同假体固定方式术后Harris髋关节功能评分、SF-36评分均差异无统计学意义（P〉0．05）。结论Ⅰ期双侧人工髋关节置换术对SLE合并中晚期ANFH的早中期疗效良好，应严格掌握手术适应证和手术时机，加强围手术期处理，选择合适的假体固定方式。     

系统性红斑狼疮患者红细胞免疫功能的改变及与辨证分型关系的研究

目的：研究系统性红斑狼疮（SLE）患者红细胞免疫功能的变化并探讨其与中医辨证分型的关系。方法：81例患者予以狼疮活动积分,选用外周血红细胞C3b受体花环（C3bRR）率、免疫复合物花环（ICR）率、肿瘤红细胞花环（TER）率作为红细胞免疫功能的指标,常规检测血沉（ESR）、血清C3。结果：SLE患者C3bRR、TER率与健康人比较显著降低（P＜0．01）,ICR率则显著升高（P＜0．01）。C3bRR、TER率、血清C3水平依热毒炽盛、脾肾阳虚、肝肾阴虚、气阴两虚型递增,而ICR率、ESR水平依上述次序递减。结论：SLE患者红细胞免疫功能较健康人低下。C3bRR、ICR、TER率及ESR、C3水平可以作为辨证分型的辅助指标。     

Ku70和Ku80基因在系统性红斑狼疮患者皮肤上的表达

目的 :研究Ku70和Ku80基因在系统性红斑狼疮 (systemiclupuserythematosus,SLE)患者皮肤表达的变化及其与SLE发病的关系。方法 :利用Ku70、Ku80地高辛标记的cDNAs探针对皮损区、非皮损区及正常对照皮肤进行原位杂交。结果 :Ku70、Ku80mRNAs的表达量从高到低依次为SLE皮损区、SLE非皮损区、正常皮肤。另外还发现在皮肤的层次上真皮浅层单一核细胞Ku70、Ku80mRNAs表达量高于表皮基底层细胞、表皮棘细胞层和颗粒层细胞。结论 :Ku70、Ku80mRNAs的表达在SLE患者皮肤上发病区高于非发病区 ,更大于正常皮肤。Ku70、Ku80mRNAs表达的变化与SLE的发病有关 ,其机制有待进一步研究     

抗心磷脂抗体与系统性红斑狼疮患者病情活动性的相关性研究

为探讨系统性红斑狼疮(systemic lupus erythematosus, SLE)患者血清抗心磷脂抗体的阳性率及其与患者病情活动性关系,用酶联免疫吸附法的ACAIg含量测定药盒(ELISA)对87例SLE患者血清ACAIg含量进行了测定.结果:全组患者的 ACAIgG、A CAIgA和ACAIgM 阳性率分别为62.1%、52.9%和35.6% .ACAIgG、ACAIgM 测定值与代表SLE 活动性的病情积分呈正相关(r=0.2763,P=0.044;r=0.3294,P=0.018).AC AIgG 、ACAIgA、ACAIgM与补体C3呈负相关(r=-0.4737,P=0.000;r=-0.2990,P =0.017;r=-0.2758,P=0.029);ACAIgG与补体C4呈负相关(r=-0.40 79,P=0.005).并发血栓时,ACAIgA增高.并发狼疮脑病时,A CAIgG、ACAIgM 测定值的变化较无此并发症者明显增高.由此表明 ACA测定值的变化可以客观反映SLE患者的病情活动性.并发血栓时,ACAIgA增高.并发狼疮脑病时,ACAIgG、ACAIgM 测定值增高.