Checklists for Assessing Skills of Children With Type 1 Diabetes on Insulin Injection Technique

Background:School-aged children often participate in type 1 diabetes (T1D) self-care tasks. Despite widespread discussion about the importance of developing self-care skills in childhood, few explain how the health care team should assess the skills of children with T1D when performing insulin injections.Objective:We sought to assess content validity evidence in two checklists regarding injection technique performed by children.Methods:Two checklists were designed based on a systematic review of the insulin injection technique. Experts in pediatric diabetes, health literacy, and diabetes education assessed the checklists regarding their clarity, objectivity, and relevance. Content validity was assessed using the content validity ratio (CVR).Results:Eleven providers (72% nurses or physicians, professional experience 19.4 ± 10.1 years, 45% of specialists in endocrinology, and 18% in pediatrics) participated in the assessment. Experts considered items containing the word homogeneity inappropriate. Items related to the needle insertion angle and the skin fold did not reach the CVR critical value. The final version of the checklist for syringe injection comprised 22 items with CVR = 0.91, and the checklist for pen injection comprised 18 items with CVR = 0.87.Conclusions:The checklists presented clear, objective, and relevant content that assesses the skills of children with T1D for insulin injection. The checklists formally present the order of the technique and all the steps for insulin injection and allow a quantitative assessment of the operational skills of children. The developed instruments offer providers the possibility of continuous assessment of the progress of the pediatric clientele until they reach independence in diabetes self-care.     

Sex-Dependent Effects of the Intake of NOVA Classified Ultra-Processed Foods on Syndrome Metabolic Components in Brazilian Adults

Longitudinal studies evaluating the relationship between UPF consumption and the incidence of Metabolic Syndrome (MetS) and its components are still scarce. This study aimed to evaluate the effect of UPF consumption on the incidence of MetS and its components in adults. A prospective study was conducted with 896 participants from the 1978/79 Ribeirão Preto cohort, São Paulo, Brazil. UPF consumption was evaluated in %kcal and %g at ages 23–25 years. Incidence of MetS and its components were estimated at ages 37–39 years, according to the Joint Interim Statement criteria. Poisson regression was used to assess associations, and interactions with sex were investigated. UPF consumption had no association with MetS (%kcal Adjusted PR: 1.00; 95% CI: 0.99–1.01; %g Adjusted PR: 1.00; 95% CI: 0.99–1.01). However, women with higher UPF consumption, in %kcal and %g, had a higher risk of abdominal obesity (%kcal: p = 0.030; %g: p = 0.003); and women with higher UPF consumption, in %g, had a higher risk of low HDL-cholesterol (p = 0.041). For the other components of MetS, no significant associations were observed in either sex. These findings suggest evidence of no association between UPF consumption and MetS; however, consumption of UPF was associated with increased WC and low HDL-c, but only in women.     

鼻咽癌四野面颈联合野适形放疗可行性研究及近期疗效分析

目的本研究采用四野面颈联合野放疗治疗鼻咽癌患者,分析急性放射性反应和近期疗效。方法101例初治鼻咽癌患者进行四野面颈联合野适形放疗,其中90例接受FP方案同步化疗及辅助性化疗。结果患者在7周内完成治疗计划,四野面颈联合野适形放疗获得了满意的剂量分布。鼻咽癌病灶完全缓解(completeremission,CR)为95.0%(96/101),部分缓解(partial remission,PR)5.0%(5/101),总有效率达100.0%,淋巴结病灶CR 90.1%(91/101),PR 6.9%(7/101),总有效率为97.0%,1年总生存率、无瘤生存率分别为100.0%、97.0%,不良反应主要为Ⅰ～Ⅱ级放射性黏膜炎、白细胞下降。结论四野面颈联合野适形放疗剂量分布满意,近期疗效满意,急性放射反应可耐受,远期疗效及组织损伤尚有待长期随访观察。     

不完全型P450 17α酶缺乏症六例报道及分析

目的 探讨不完全型P45017α酶（17α羟化爵每／17,20裂解酶）缺乏症（17OHD）的临床特征、鉴别诊断和处理方法。方法 回顾性分析北京协和医院6例不完全型17OHD的临床特征,并通过文献复习讨论该病的发病机制和典型的临床特征。结果 6例中4例为46,XX不完全型17OHD患者,其临床特征包括女性表型、不同程度的乳房发育、阴毛少、月经稀发或继发闭经、反复发作的卵巢囊肿、性腺功能低下伴持续性血清孕酮和（或）17α羟孕酮水平升高、合并或不合并低钾性高血压;另2例为46,XY不完全型17OHD患者,伴有不同程度的外生殖器性别不清和低钾性高血压。结论 不完全型17OHD是一种极为罕见的先天性甾体合成酶缺乏,临床上出现月经异常、性发育幼稚、反复发作的卵巢囊肿或外生殖器性别不清时应考虑此病。     

存活5年以上老年胃癌22例临床分析

本文总结我院1972年以来追随观察生存五年以上老年胃癌22例。早期胃癌占45%(10/22),进展期胃癌占55%(12/22)。腺癌占95%(21/22)。淋巴结转移32%(7/22)。全部经根治性手术。术后接受化疗14人占64%,其中进展期胃癌占86%(12/14)。提示手术及术后化疗对延长生命都起着重要作用。尤其对进展期胃癌伴淋巴结转移者更重要。对腺癌效果较好,胃体癌预后较佳。小剂量多疗程化疗是一种安全、稳妥、可靠的方法,尤其适用于老年患者。     

皮肤粘膜淋巴结综合征57例临床分析

对５７例川崎病患者的临床分析及随访表明，该病好发于４岁以下小儿，常并有心血管损害（６６．７％），其中以冠状动脉扩张及瘤样改变最为多见。对３８例有心血管损害者随访１个月至４年，发现心电图异常于热退后１月内恢复者居多，冠状动脉扩张于病后１月至１年内消失者居多。说明长期随访很有必要。     

青少年自虐行为发生诱因的病例对照研究

目的 探讨青少年自虐行为的发生诱因，为青春期心理教育提供依据。方法 采用问卷调查的形式，调查某市年龄在18～19岁男生1032人，女生980人，共计2012人。结果 自虐行为发生率为12．77％，自虐行为2次或2次以上占74．32％，青少年自虐行为重复发生的可能性大；男、女生自虐行为的发生诱因有差异。结论 家庭和学校应给予正确的引导，提高他们的社会适应性及对困难和挫折的心理承受能力。     

临床拟诊机化性肺炎31例诊疗的回顾性分析

目的 探讨临床拟诊机化性肺炎的诊断与治疗.方法 回顾性分析31例临床拟诊为机化性肺炎患者的临床资料、影像资料和治疗方法.结果 31例经抗生素治疗无效的患者,通过支气管镜肺活检病理或经皮肺穿刺病理除外结核、真菌、化脓性炎、肺癌而拟诊机化性肺炎24例,无病理检查结果而经激素治疗有效拟诊7例.21例患者具有典型机化性肺炎CT表现,所有病例均经短期（6～14d）激素治疗后影像学结果明显改善.随访6～25个月,复发6例,均发生在激素减量过快或停药患者中.结论 临床上经抗生素治疗无效、结合临床影像学特点、病理检查除外其他疾病是拟诊机化性肺炎的重要指标;对于无病理检查患者短期激素治疗有效有助于诊断.过早激素减量容易导致复发.     

2011-2015年河北省手足口病流行特征及病原特征分析

目的 分析河北省手足口病（hand foot and mouth disease,HFMD）的流行特征及病原学构成,为手足口病的防控提供科学依据。方法 利用描述流行病学方法对河北省2011-2015年疾病监测信息报告系统上报的手足口病病例和实验室检测结果进行统计分析。结果 2011-2015年累计报告手足口病病例349 113例,年均发病率为95.91/10万,其中2012年和2014年报告发病率最高,呈现隔年高水平流行的现象。高发期集中在5~7月,10~12月间又出现一个次高峰或“拖尾”峰,患者主要为≤5岁儿童,尤其以1~3岁组婴幼儿为主。各地区发病水平存在差异,以发病率和重症率为分类指标对各地市进行聚类分析和赋值评价,得到重点防控地区为廊坊市、沧州市、衡水市、石家庄市、保定市和承德市。不同年份病原构成亦不同,在2013年和2015年其他肠道病毒分别取代柯萨奇病毒A组16型（coxsachievirus A16,CoxA16）、肠道病毒71型（enterovirus 71,EV71）成为当年主要病原体,构成比高达44.89%和66.23%。结论 河北省手足口病呈现明显的季节、人群以及一定的地区分布规律,应进一步关注手足口病病原谱的变化,加强重点地区防控。     

营养素摄入水平与前列腺癌发病因素的相关分析

目的:探讨营养素摄入水平与前列腺癌发病危险的关系。方法:对经病理组织学确诊的96例前列腺癌新发病例实施1∶3配比的病例-对照研究。三类对照共计288例(其中医院癌对照96例,医院非癌对照96例,正常对照96例)。配比条件为同性别、同民族和年龄相差≤±5岁。结果:经条件Logistic回归分析结果显示,总热量(OR值1.22~2.06,P值分别为0.78、0.04和0.032)、总脂肪(OR值1.06~1.89,P值分别为0.98、0.021和0.019)、饱和脂肪酸(OR值1.08~1.79,P值分别为0.92、0.023和0.032)、不饱和脂肪酸(OR值1.07~2.81,P值分别为0.88、0.027和0.007 1)以及动物脂肪(OR值1.14~2.56,P值分别为0.87、0.047和0.008)与前列腺癌发病危险呈正相关;硒与前列腺癌发病危险呈负相关(OR值0.57~0.84,P值分别为0.84、0.031和0.030)。总热量、总脂肪、饱和脂肪酸、动物脂肪与前列腺癌发病存在一定的剂量反应关系。结论:营养素摄入过程中的高脂和微量元素硒缺乏与前列腺癌发病危险存在关联。