综合心理干预模式对奥运驾驶员志愿者心理健康状况干预效果研究

目的研究综合心理干预模式对奥运驾驶员志愿者心理健康状况的干预效果。方法使用综合心理干预模式对1 000名奥运驾驶员志愿者进行心理干预2.5月,并比较干预前后驾驶员SCL-90分值变化情况。结果与干预前相比,SCL-90总分明显下降（117.50±26.92 vs.107.93±20.59,P〈0.01）;强迫、人际关系敏感、恐怖、偏执、精神病5个因子分显著下降;筛选阳性人数显著下降（227 vs.115,χ2=44.49,P〈0.01）。结论综合心理干预模式对提高奥运驾驶员志愿者的心理健康水平有实际的效果。     

Genome‐wide analysis of somatic copy number alterations and chromosomal breakages in osteosarcoma

Osteosarcoma (OS) is the most common primary malignant bone tumor in children and adolescents. It is characterized by highly complex karyotypes with structural and numerical chromosomal alterations. The observed OS‐specific characteristics in localization and frequencies of chromosomal breakages strongly implicate a specific set of responsible driver genes or a specific mechanism of fragility induction. In this study, a comprehensive assessment of somatic copy number alterations (SCNAs) was performed in 160 OS samples using whole‐genome CytoScan High Density arrays (Affymetrix, Santa Clara, CA). Genes or regions frequently targeted by SCNAs were identified. Breakage analysis revealed OS specific unstable regions in which well‐known OS tumor suppressor genes, including TP53, RB1, WWOX, DLG2 and LSAMP are located. Certain genomic features, such as transposable elements and non‐B DNA‐forming motifs were found to be significantly enriched in the vicinity of chromosomal breakage sites. A complex breakage pattern—chromothripsis—has been suggested as a widespread phenomenon in OS. It was further demonstrated that hyperploidy and in particular chromothripsis were strongly correlated with OS patient clinical outcome. The revealed OS‐specific fragility pattern provides novel clues for understanding the biology of OS.     

Spatial distribution of EGFR and KRAS mutation frequencies correlates with histological growth patterns of lung adenocarcinomas

Multiregional analysis provided first indications for morphological and molecular heterogeneity in lung adenocarcinomas (ADCs), but comprehensive morpho‐molecular comparisons are still lacking. The purpose of our study was to investigate the spatial distribution of EGFR and KRAS alterations systematically throughout whole tumor cross‐sections in correlation with the tumor cell content and the histopathological patterns. Central sections of 19 ADCs were subdivided into 467 segments of 5 mm × 5 mm. We determined the predominant histological growth pattern and the allele frequencies of driver gene mutations by digital PCR in every segment. We further quantified the absolute cell counts and proportions of tumor and non‐neoplastic cells in all segments to normalize the mutant allele frequencies. Driver gene mutations could be detected in >99% of the tumor containing segments, with high levels of inter‐ and intratumor heterogeneity regarding the mutant allele frequency (range: 0.04–19.36). Different patterns for the distribution of the variant allele frequency within a tumor were recognizable. While some cases showed ubiquitously low or high levels, others revealed regions with focally elevated frequencies. Differences between KRAS and EGFR alterations were not significant. The great majority of the analyzed tumor sections (16/19) exhibited two or more morphological growth patterns. Mutant allele frequencies were significantly higher in segments with a predominant solid pattern compared to all other histologies (p < 0.01). Our data indicate that driver gene mutations are present with high levels of inter‐ and intratumor heterogeneity throughout the whole tumor, with a correlation between the allele frequencies and histological growth patterns.     

Atrial fibrillation driver mechanisms: Insight from the isolated human heart

Although there have been great technological advances in the treatment of atrial fibrillation (AF), current therapies remain limited due to a narrow understanding of AF mechanisms in the human heart. This review will highlight our recent studies on explanted human hearts where we developed and employed a novel functional-structural mapping approach by integrating high-resolution simultaneous endo-epicardial and panoramic optical mapping with 3D gadolinium-enhanced MRI to define the spatiotemporal characteristics of AF drivers and their structural substrates. The results allow us to postulate that the primary mechanism of AF maintenance in human hearts is a limited number of localized intramural microanatomic reentrant AF drivers anchored to heart-specific 3D fibrotically insulated myobundle tracks, which may remain hidden to clinical single-surface electrode mapping. We suggest that ex vivo human heart studies, by using an integrated 3D functional and structural mapping approach, will help to reveal defining features of AF drivers as well as validate and improve clinical approaches to detect and target these AF drivers in patients with cardiac diseases.     

Driver licensing: descriptive epidemiology of a social determinant of Aboriginal and Torres Strait Islander health

Objective : Education, employment and equitable access to services are commonly accepted as important underlying social determinants of health. For most Australians, access to health, education and other services is facilitated by private transport and a driver licence. This study aimed to examine licensing rates and predictors of licensing in a sample of Aboriginal and Torres Strait Islander people, as these have previously been poorly described. Methods : Interviewer‐administered surveys were conducted with 625 people 16 years or older in four Aboriginal Community Controlled Health Services in New South Wales and South Australia over a two‐week period in 2012–2013. Results : Licensing rates varied from 51% to 77% by site. Compared to not having a licence, having a driver licence was significantly associated with higher odds of full‐time employment (adjusted OR 4.0, 95%CI 2.5–6.3) and educational attainment (adjusted OR 1.9, 95%CI 1.2–2.8 for trade or certificate; adjusted OR 4.0, 95%CI 1.6–9.5 for degree qualification). Conclusions : Variation in driver licensing rates suggests different yet pervasive barriers to access. There is a strong association between driver licensing, education and employment. Implications : Licensing inequality has far‐reaching impacts on the broader health and wellbeing of Aboriginal and Torres Strait Islander people, reinforcing the need for appropriate and accessible pathways to achieving and maintaining driver licensing.     

Safety and efficacy of targeted agents monotherapy in advanced NSCLC

The emergence of targetted therapy has revolutionised the treatment of advanced NSCLC. Increasing numbers of driver genes and related targetted agents have supplied more powerful weapons for conquering NSCLC. Depending on whether there are clear targets and therapeutic effects, we can now rank targetted agents into three categories: agents with explicit targets and pure effects, agents with theoretical targets but with no effective biomarkers, agents with vague targets and lower effects. The latest clinical data on the safety and efficacy of monotherapy with three kinds of agents will be reviewed respectively in this article.     

肺癌驱动基因及相关靶向治疗研究进展

肺癌是全球范围内发病率和死亡率最高的恶性肿瘤之一。传统化疗为主的治疗手段使肺癌的疗效难以获得突破性的进展。随着分子生物学研究的深入,发现一些基因的突变在肿瘤的发生发展中起驱动作用,靶向这些基因的治疗措施使患者获益显著。全文就近年来肺癌驱动基因的发现及其相关靶向治疗药物的研究进展做一综述。     

1826名公交司机血脂水平调查

目的分析1826名公交司机的血脂情况,探讨该公司司机的血脂水平分布情况。方法以来我院参加健康体检的一公交公司1826名司机作为研究对象,空腹抽血4.0 ml尽快分离血清于岛津CL8000全自动生化分析仪上进行血脂四项(CHOL、HDL、LDL、TRIG)检测,记录所有检测结果并进行统计学分析。结果研究显示血脂总异常检出率为48.2%,其中CHOL平均值为5.48±0.86 mmol/L,异常检出率为61.5%,HDL平均值为(1.20±0.42)mmol/L,异常检出率为22.0%,LDL平均值为(2.82±0.64)mmol/L,异常检出率为26.0%,TRIG平均值为(2.16±0.58)mmol/L,异常检出率为41.0%。与以往文献研究报道相比较,其中血脂总异常检出率、CHOL异常检出率和TRIG异常检出率差异均有统计学意义(P<0.01);而HDL和LDL异常检出率的差异无统计学意义(P>0.05)。结论应当加强相关的健康教育和心、脑血管性疾病的重点防范。     

广西柳州市机动车驾驶人酒后驾驶知识、态度、信念和行为调查

目的了解广西柳州市机动车驾驶人酒后驾驶的知识、态度、信念和行为（knowledge, attitude, belief and practice, KABP）。方法采用横断面调查,随机抽取的有代表性的路口,对被随机拦截的机动车驾驶人进行问卷调查。结果共调查5592名,有效问卷5569份,其中84.26%的驾驶人不了解国家有酒后驾驶的BAC值法律限制;2年内,仅有24.70%的驾驶人被警察拦截检查酒后驾驶行为,0.45%的人受到警告或处罚,15.68%的人认为若有酒后驾驶行为将有可能被警察发现;与被调查驾驶人有关系的社会成员中,仅有22.06%的人会劝告饮酒后的驾驶人不要驾车;有32.57%的人每周会饮酒1次以上。结论柳州市机动车驾驶人、社会公众对酒后驾驶相关法律、法规和执法以及对酒后驾驶引发的风险认知程度还很不足,必须采取广泛而有效的干预措施来降低酒后驾驶的发生率。     

Factors Associated with Drug Use Among Male Motorbike Taxi Drivers in Urban Vietnam

A cross-sectional study was conducted on a sample of 291 male motorbike taxi drivers (MMTDs) recruited through social mapping technique in Hanoi, Vietnam, for face-to-face interviews to examine factors associated with drug use among MMTDs using Information-Motivation-Behavioral skills (IMB) model. Among 291 MMTDs, 17.18% reported drug use sometime in their lives, 96% of whom were drug injectors. Being depressed, being originally borne in urban cities, currently residing in rural areas, having a longer time living apart from their wives/lovers, using alcohol, following Buddhism, and reporting lower motivation of HIV prevention predict significantly higher odds of uptaking drugs.