Joint trajectory analysis of treated adolescents' alcohol use and symptoms over 1 year

OBJECTIVE: This study characterized treated adolescents' alcohol use and symptom trajectories over 1 year to describe the form of use trajectories and symptom trajectories, and the joint probability of membership in alcohol use and symptom trajectory groups. METHOD: 109 teens (age 14-18, 66% male, 94% white), recruited from addictions treatment, with a lifetime DSM-IV alcohol diagnosis, reported on daily alcohol use and symptoms in monthly phone contacts using the Time Line Follow-Back method. A group-based modeling method jointly estimated trajectories of use and symptoms. RESULTS: Four alcohol use trajectories were identified: "Abstinent" (31%), Low (36%), Increasing (28%), and High Use (5%). Three alcohol symptom trajectories were identified: Very Low severity (44%), Mild (44%), and High severity (12%). The most frequent joint outcome was "Abstinent" and Very Low symptom severity (32%). CONCLUSIONS: Symptom severity was moderately related to alcohol use pattern over 1 year. Findings have implications for moving beyond relapse defined as a return to "any use" to consideration of treatment outcome in terms of a broader pattern of alcohol use and problems.     

急性缺血性脑卒中患者低密度脂蛋白胆固醇/淋巴细胞比值与颈动脉斑块稳定性及狭窄程度的相关性

目的 探讨急性缺血性脑卒中(AIS)患者低密度脂蛋白胆固醇/淋巴细胞(LDL-C/LYM)与颈动脉斑块稳定性及狭窄程度的相关性。方法 选取2021年4月至2022年4月就诊于青海省人民医院神经内科的336例AIS患者为研究对象,根据超声结果将患者分为无斑块组(42例)、稳定斑块组(63例)和易损斑块组(231例);根据狭窄度将患者分为无狭窄组(42例)、轻度狭窄组(177例)、中度狭窄组(67例)和重度狭窄组(50例),比较各组之间一般资料、低密度脂蛋白胆固醇、淋巴细胞计数、LDL-C/LYM等差异。采用SPSS 23.0统计软件进行数据分析。根据数据类型,分别采用t检验、Kruskal-Wallis H检验或χ²检验进行组间比较。采用Spearman相关分析LDL-C/LYM值与颈动脉狭窄程度的相关性。采用多因素logistic回归分析颈动脉斑块易损性的危险因素。结果 稳定斑块组和易损斑块组年龄、高血压病与糖尿病史、D-二聚体和LDL-C/LYM值均高于无斑块组(均P＜0.05)。易损斑块组糖尿病史、总胆固醇、低密度脂蛋白胆固醇和LDL-C/LYM值的水平高于稳定斑块组,而淋巴细胞水平降低 (均P＜0.001)。多因素logistic回归分析显示,糖尿病史与LDL-C/LYM值是颈动脉斑块易损性的独立危险因素(OR=1.948,95%CI 1.01~3.77,P=0.048;OR=4.543,95%CI 1.10~18.69,P=0.036)。受试者工作特征(ROC)曲线分析显示,LDL-C/LYM值对诊断斑块稳定性的曲线下面积(AUC)为0.676(95%CI 0.605～0.748;P＜0.001),最佳临界值为1.54,灵敏度为61.5%,特异度为69.8%。Spearman相关性分析显示,LDL-C/LYM值与斑块的狭窄程度呈正相关(r=0.654;P＜0.001)。结论 LDL-C/LYM值增高是AIS患者颈动脉斑块易损性的独立危险因素,与颈动脉斑块狭窄程度呈正相关。     

不同病程2型糖尿病患者胰岛α及β细胞功能评价

目的 了解不同病程2型糖尿病（T2DM）患者胰岛α、β细胞功能状况.方法 对283例T2DM患者（病程≤1年者40例,＞1年～≤5年者85例,＞5年～≤10年者90例,＞10年者68例）及30例正常对照者,行口服葡萄糖耐量试验（OGTT）及胰岛素、胰高糖素释放试验,比较各组间胰高糖素、胰高糖素/胰岛素比值等的变化,对胰高糖素行相关及回归性分析.结果 ①糖尿病组空腹及餐后各时相胰高糖素、胰高糖素/胰岛素比值及胰高糖素曲线下面积（AUC）,均高于正常对照者,且随病程延长各项指标相应升高,其中病程≤1年组0、30、60、120和180 min胰高糖素水平分别为[（71±20）、（106±36）、（143±54）、（133 ±68）和（87±55） ng/L],且随病程延长胰高糖素水平明显升高,病程＞10年组分别为[（80±19）、（125±36）、（167±47）、（178±64）和（129 ±65） ng/L].②不同病程T2DM患者间稳态模型胰岛素抵抗指数（HOMA-IR）及胰岛素敏感指数（ISI）差异无统计学意义,随病程延长,HOMA-β、糖负荷后30 min胰岛素和血糖净增值的比值（△I30/△G30）及胰岛素AUC均明显降低,差异有统计学意义（F值分别为3.75、3.77和3.07,均P＜0.05）,以△I30/△G30最明显.③多元逐步回归分析显示,胰高糖素与空腹血糖、血糖AUC呈正相关（t值分别为6.23、3.41,均P＜0.05）,与△I30/△G30呈负相关（t值为-2.13,P＜0.05）.结论 糖尿病早期在保护β细胞功能的同时应及早关注胰高糖素的调控,从而使血糖更易达标.     

在德育中融人中医药优秀传统文化的实践与思考

中医药优秀传统文化蕴藏着丰富的人文知识底蕴,是德育的重要精神资源,对德育中有强大的教化功能。黑龙江中医药大学充分发挥中医药优秀传统文化在高等中医药院校德育工作中的作用,将中医药优秀传统文化融入德育,创新德育方式和途径,拓展德育发展的空间。     

吉林省某高等医学院校交互式电子白板在人体解剖学课程中的应用研究

人体解剖学课程内容繁杂、医学生学习难度大,多媒体呈现形式单一、交互性不足,对此将交互式电子白板这一新型智能操作平台引人人体解剖学课程教学中,并融入创设情境、互动交流、总结提高等教学环节中,实现将白板各功能与解剖学教学无缝对接,通过实践发现交互式电子白板能有效地提高医学生的认知能力、学习效率、师生交互性。     

CT影像与X线影像对肺结核合并糖尿病疗程判定的对比研究

目的:对比分析CT影像与X线影像对肺结核合并糖尿病疗程的判定。方法:选择肺结核合并糖尿病患者126例,所有患者均应用统一标准治疗方案,强化期:异福酰胺胶囊和乙胺丁醇,顿服,2个月。巩固期异福胶囊,顿服,4个月。标准疗程为6～8个月,延长疗程为4～12个月,标准疗程结束应用CT、X线检查,根据影像学价差结果延长疗程全部疗程结束后做X线及CT对比。结果:在标准疗程结束后,CT检查后需要延长疗程患者的占比明显高于X线检查,差异有统计学意义(P<0.05);全疗程结束后,CT检查对患者的病灶情况较X线检查更为准确。结论:糖尿病合并肺结核患者采用CT检查以了解治疗进程,较X线检查对患者的治疗更为有利。     

The course of maternal depressive symptomatology during the first 18 months postpartum in an Italian sample

Postnatal depression (PND) affects about 10-15% of women and can last more than a year in chronic cases. The Edinburgh Postnatal Depression Scale (EPDS) is a well-known questionnaire for screening PND symptomatology during the first weeks after birth, but its use in later periods is rare, reflecting a tendency to pay more attention to the onset of PND instead of its course. The study aimed to explore stability of PND symptomatology at 3, 9 and 18 months after birth, using the EPDS. Depression rate decreased from 3 to 18 months postpartum. Onset of symptoms was mainly within the first 3 months; 23.4% of 167 women showed an EPDS score > or =13 on at least one of the assessments, and 7.2% of women did so on at least two assessments. Over the 18-month period, the number of women who had recovered in the period from one assessment to the following was not significantly different from the number of women becoming depressed. Our findings underline the need to consider the existence of different courses of depressive symptomatology in research and clinical practice; women with persistent or recurrent depressive symptoms need forms of preventive intervention that cover at least the first postpartum year.     

The rating of perceived exertion during competitive running scales with time

This study assessed the relationship of the rating of perceived exertion (RPE) with heart rate and pacing strategy during competitive running races of differing distance and course elevation. Nine men and women competed in a 7-mile road race (7-MR) and the Great West Run half marathon (GWR; 13.1 miles). Heart rate, split mile time, and RPE were recorded throughout the races. The RPE was regressed against time and %time to complete the 7-MR and GWR. Although the rate of increase in RPE was greater in the 7-MR, there were no differences when expressed against %time (inferring that the brain uses a scalar timing mechanism). As the course elevation, distance, pacing strategy, and heart rate response varied between conditions, this study has provided evidence that the perceptual response may have distinct temporal characteristics during distance running. The results provide further evidence that RPE scales with the proportion of exercise time that remains.     

中医院校《医学机能实验学》课程建设研究与实践

突破传统按阶段分科实验教学的格局,对医学基础与中医药学相关课程进行改造和优化,重组生理学、药理学、生物化学、中药药理学、针灸学实验课,减少验证性实验,保留经典实验,增加多学科综合性实验,将5门学科知识有机融合,相互贯通、相互渗透,使之成为一门跨学科、多层次、综合性的实验教学课——《医学机能实验学》。7年的实践证明,机能实验课程的改革不但优化了投资,更重要的是培养了学生的综合能力和创新能力,呈现了教学相长的良好局面。     

糖尿病患者病程及血清胱抑素C水平与糖尿病肾病的关系

目的探讨糖尿病患者在尿白蛋白排泄率正常时病程与血清胱抑素C水平的关系及各不同病程组与糖尿病肾病Ⅲ期组血清胱抑素c水平的关系。方法对160例糖尿病患者进行血清胱抑素C水平测定,将其中120例尿白蛋白排泄率正常糖尿病患者依病程分三组：A组40例,病程〈5年;B组40例,病程5～10年;C组40例,病程〉10年。余40例糖尿病肾病Ⅲ期患者为D组。结果A、B、C三组血清胱抑素c水平依次为（0．73±0．20）、（O．84±0．19）、（0．96±0．18）mg／L,各组间比较差异有统计学意义（P〈0．05）,A、B组与D组（0．99±0．21）mg／L相比差异亦有统计学意义,而C组与D组相比血清胱抑素c水平差异无统计学意义（P〉0．05）.结论糖尿病患者肾脏损害程度随糖尿病病程的延长不断加重,病程超过10年时肾脏损害程度已与糖尿病肾病Ⅲ期相当.