高危风险因素管理在PICU医院感染防控中的应用

目的在日常监测和自查中及在临床工作中,确定PICU存在的院感高风险因素,给予针对性预防控制措施,提高工作质量,降低医院感染。方法采用回顾性调查与前瞻性监测的方法,将2014年5月~2015年4月未实施高危风险因素管理PICU收治的60例患儿作为对照组,并将2015年5月~2016年4月实施高危风险因素管理后PICU收治的62例患儿作为实验组,分析实施高危风险因素管理前后对医院感染率、护理质量、家长满意度的影响。结果实施高危风险因素管理后,医院感染率较前显著下降,两组比较差异有统计学意义(P<0.05);实验组护理质量评分、家长满意度评分均显著高于对照组,差异有统计学意义(均P<0.05)。结论对PICU进行医院感染的高危风险因素评估,并根据评估结果采取积极有效的干预措施,可有效降低院感发生率。     

Intracortical Synchronization of Epileptic Discharges at Different Stages of Ultrastructural Rearrangements in a Completely Neuronally Isolated Area of Rat Neocortex

Cross-correlation functions were used to study the time delay (a measure of synchronization) in the appearance of epileptic discharges in distant areas of the cortex in the intact cortex and in neuronally isolated cortical strips in Wistar rats. Experiments were performed at different stages of axon sprouting 30 and 90 days after isolation of cortical areas and in intact cortex. Significant increases in the number of synapses in layer V of isolated cortical strips at 30 days correlated with significant decreases in the time delay, while decreases in the number of synapses at 90 days correlated with a significant increase in the time delay. This is evidence that newly formed synapses increase the extent of synchronization and thus affect epileptogenesis. The data obtained here suggest that large pyramidal cells in layer V of the rat neocortex form a neural network in pathological conditions, this supporting intracortical synchronization of epileptic discharges.     

地震灾区中学特岗教师心理健康状况调查

目的探讨四川省地震1年后灾区中学特岗教师心理健康状况。方法采用症状自评量表(SCL-90)对四川省安县、江油市、都江堰市等地区64名中学特岗教师进行心理测评。结果1灾区中学特岗教师心理问题发生率为51.56%,特岗教师的得分与全国常模间差异有显著性;2男女特岗教师9个因子得分与全国男女常模因子分之间的差异有统计学意义;3特岗男女教师得分差异无统计学意义;4来自城市的特岗教师SCL-90量表总均分、总分及各因子得分均高于来自农村的特岗教师。结论灾区中学特岗教师的心理健康状况不容乐观,应及早进行心理干预。     

西部开发中的虫媒病传播问题

西部开发地区存在许多虫媒病 ,即昆虫和蜱螨传播的疾病 ,为了保障开发人群的健康 ,首先需要对这些疾病的传播 ,特别是有些疾病的自然疫源地或流行区有所了解。本文列述了 13种虫媒病及其在这个地区的分布 ,对其中值得我们更重视的 4类重要疾病 ,包括鼠疫、莱姆病、疟疾和登革热的病原体传播媒介或有的贮存宿主以及重要性等作了扼要的介绍。本文并提出了这类疾病在开发中和开发后可能产生的危害性 ,以及防止或减少它们危害的建议。作者认为从开发地区的长远利益出发 ,应该重视开发中自然环境改变对上述虫媒病传播影响的研究     

The human papillomavirus type 16 E5 oncoprotein synergizes with EGF-receptor signaling to enhance cell cycle progression and the down-regulation of p27

E5 oncoprotein activity from high risk human papillomaviruses (HPVs) is associated with growth factor receptor signaling, but the function of this protein is not well understood. In this study, we investigated the role of HPV-16 E5 on the cell cycle progression during EGF-stimulation. Wild-type and NIH 3T3 cells over-expressing human EGF-receptor were transfected with HPV-16 E5 gene and the cell cycle progression was characterized. This analysis showed that the E5-expressing cells increased DNA synthesis (S-phase) by around 40%. Cell cycle protein analysis of E5-expressing cells showed a reduction in the half-life of p27^Kip1 protein as compared to control cells (18.4 vs. 12.7 h), an effect that was enhanced in EGF-stimulated cells (12.8 vs. 3.6 h). Blockage of EGF-receptor activity abrogated E5 signals as well as p27^Kip1 down-regulation. These results suggest that E5 and the EGF-receptor cooperate to enhance cell cycle entry and progression through regulating p27^Kip1 expression at protein level.     

Low- and high-risk human papillomavirus E7 proteins regulate p130 differently

The E7 protein of high-risk human papillomaviruses (HR HPVs) targets pRb family members (pRb, p107 and p130) for degradation; low-risk (LR) HPV E7 only targets p130 for degradation. The effect of HR HPV 16 E7 and LR HPV 6 E7 on p130 intracellular localization and half-life was examined. Nuclear/cytoplasmic fractionation and immunofluorescence showed that, in contrast to control and HPV 6 E7-expressing cells, a greater amount of p130 was present in the cytoplasm in the presence of HPV 16 E7. The half-life of p130, relative to control cells, was decreased in the cytoplasm in the presence of HPV 6 E7 or HPV 16 E7, but only decreased by HPV 6 E7 in the nucleus. Inhibition of proteasomal degradation extended the half-life of p130, regardless of intracellular localization. These results suggest that there may be divergent mechanisms by which LR and HR HPV E7 target p130 for degradation.     

Human papillomavirus type 16 E6 and E7 oncoproteins act synergistically to cause head and neck cancer in mice

High-risk human papillomaviruses (HPVs) contribute to cervical and other anogenital cancers, and they are also linked etiologically to a subset of head and neck squamous cell carcinomas (HNSCC). We previously established a model for HPV-associated HNSCC in which we treated transgenic mice expressing the papillomaviral oncoproteins with the chemical carcinogen 4-nitroquinoline-1-oxide (4-NQO). We found that the HPV-16 E7 oncoprotein was highly potent in causing HNSCC, and its dominance masked any potential oncogenic contribution of E6, a second papillomaviral oncoprotein commonly expressed in human cancers. In the current study, we shortened the duration of treatment with 4-NQO to reduce the incidence of cancers and discovered a striking synergy between E6 and E7 in causing HNSCC. Comparing the oncogenic properties of wild-type versus mutant E6 genes in this model for HNSCC uncovered a role for some but not other cellular targets of E6 previously shown to contribute to cervical cancer.     

Managing uncertainty about treatment decision making in early stage prostate cancer: A randomized clinical trial

Objectives

Several new methods are available, but we know little about successful integration of contraceptive technologies into services. We investigated provider factors associated with the initiation of new hormonal methods among women at high risk of unintended pregnancy.

Methods

This cohort study enrolled 1387 women aged 15-24 starting hormonal contraception (vaginal ring, transdermal patch, oral contraceptive, or injectable) at four family planning clinics in low-income communities. We measured provider factors associated with method choice, using multinomial logistic regression.

Results

Ring and patch initiators were more likely than women starting oral contraceptives to report that they chose their method due to provider counseling (p < 0.001). Contraceptive knowledge in general was low, but initiation of a new method, the ring, was associated with higher knowledge about all methods after seeing the provider (p < 0.001). Method initiated varied with provider site (p < 0.001). These associations remained significant, controlling for demographics and factors describing the provider-patient relationship, including trust in provider and continuity of care.

Conclusion

Women's reports of provider counseling and of their own contraceptive knowledge after the visit was significantly associated with hormonal method initiated.

Practice implications

More extensive counseling and patient education should be expected for successful integration of new hormonal methods into clinical practice.     

农村突发公共卫生事件与公共卫生应急系统

近年来国内、外突发公共卫生事件频繁发生，全社会都在关注公共卫生应急系统的建设。农村医疗卫生机构是监测突发公共卫生事件的前哨，是控制突发公共卫生事件的前线，熟悉和掌握农村突发公共卫生事件的有关基本知识，对于有效预防和及时报告、正确应对和处理突发公共卫生事件具有至关重要的作用。农村突发公共卫生事件应急系统的建设和完善是我国公共卫生应急系统的重要部分。     

Eating as a neurodevelopmental process for high-risk newborns

Many high-risk and preterm infants have difficulty with successful feeding and subsequent optimal growth during their stay in the neonatal intensive care unit as well as in the months after discharge. Environmental, procedural, and medical issues necessary for treatment of the hospitalized infant present challenges for the development of successful eating skills. Emerging data describe eating as a predictable neurodevelopmental process that depends on the infant's organization of physiologic processes, motor tone and movement, level of arousal, and ability to simultaneously regulate these processes.