2010—2019年新疆伊宁市初治涂阳肺结核患者流行特征及治疗转归分析

目的 了解2010—2019年新疆伊宁市初治涂阳肺结核流行特征,并分析影响其治疗结局的因素,为该地区的结核病疫情防控提供理论依据。方法 通过《中国结核病管理信息系统》收集伊宁市2010—2019年初治涂阳肺结核患者的基本信息、治疗及诊断信息。人口学信息来源于2010—2019年《伊犁州统计局统计年鉴》,流行特征分析采用描述性流行病学方法,并采用多因素logistic回归模型分析纳入患者治疗转归的影响因素。结果 2010—2019年新疆伊宁市共报道了4728例初治涂阳肺结核病患者,年均报告发病率为87.16/10万,各年度报告发病率范围为66.55/10万（391例）~127.29/10万（727例）,在4728例初治涂阳患者中,HIV检查阳性患者共665例,HIV-TB双重感染年均登记报告率为12.57/10万;男性2922例,女性1806例,男性与女性的比例为1.62∶1;16~45岁［66.96%(3166/4728)］、少数民族［84.40%（3973/4728）］人群多发;患者来源主要以转诊为主,占比为42.49%（2009/4728）;患者主要为Ⅲ型肺结核［94.20%（4454/4728）］;初治涂阳肺结核流行期集中在每年的3—5月;多因素logistic回归结果显示:强化期督导（OR=0.015,95%CI:0.003~0.077）、全程督导（OR=0.067,95%CI:0.014~0.314）、全程管理（OR=0.045,95%CI:0.004~0.526）、系统管理（OR<0.001,95%CI:0.000~0.001）的初治涂阳肺结核患者更易治疗成功。结论 2010—2019年伊宁市初治涂阳肺结核报告发病率总体上呈现先下降后上升的趋势,应重点关注男性、中年、少数民族人群,在3—5月期间对以上高危人群进行结核病筛查;加强初治涂阳肺结核患者治疗过程中的系统管理和督导工作。     

子宫内膜异位症不孕并发内膜息肉的病理特征及手术后复发分析

目的:分析子宫内膜异位症(EM)不孕患者发生内膜息肉情况及病理特征。方法:收集本院2016年1月-2017年1月收治的不孕患者,EM 67例为观察组,非EM 82例为对照组,比较两组内膜息肉发生率,观察组r-AFS不同分期内膜息肉发生率、治疗后临床妊娠率,分析发生内膜息肉的病理特征。结果:观察组内膜息肉发生率(31.3%)及息肉复发率(11.9%)高于对照组(12.2%、2.4%)(P<0.05);观察组EMⅠ期患者内膜息肉发生率17.7%、无复发,Ⅱ期内膜息肉发生率32.0%、复发率8.0%,Ⅲ期内膜息肉发生率40.0%、复发率20.0%,Ⅳ期内膜息肉发生率40.0%、复发率30.0%,各期发生率及复发率比较无差异(P>0.05);卵巢型内膜息肉发生率25.0%、复发率10.0%,腹膜型内膜息肉发生率29.0%、复发率9.7%,DIE型内膜息肉发生率43.8%、复发率18.8%,EM不同病理类型内膜息肉发生率及复发率无差异(P>0.05)。结论:EM不孕患者发生内膜息肉几率较大,及时手术切除息肉可提高妊娠率,临床应及早诊断和治疗。     

胆道结石术后继发急性胆管炎病原菌及sCD14-ST和IL-8的诊断价值

目的探讨胆道结石术后继发急性胆管炎病原菌及可溶性CD14亚型(sCD14-ST)、白细胞介素-8(IL-8)的诊断价值。方法选择海南医学院第一附属医院2017年1月-2019年6月收治的胆道结石术后继发急性胆管炎患者62例作为研究对象,纳入研究组,选择同期医院收治的胆道结石术后未继发急性胆管炎的患者60例设为对照组;对研究组患者病原菌进行统计;比较不同急性胆管炎程度、不同预后结局患者血清sCD14-ST、IL-8水平;采用受试者工作特征曲线评估血清sCD14-ST、IL-8水平对于患者不良预后的诊断价值。结果 62例患者共培养分离病原菌67株,其中革兰阴性菌43株占64.18%,革兰阳性菌21株占31.34%,真菌3株占4.48%,以大肠埃希菌为主;重度急性胆管炎患者血清sCD14-ST、IL-8分别为(91.38±25.67)pg/ml、(45.28±13.61)pg/ml高于中度患者分别为(74.34±19.65)pg/ml、(32.06±10.44)pg/ml及轻度患者(P均<0.001),中度患者血清sCD14-ST、IL-8水平高于轻度患者(P均<0.001);预后不良患者急性胆管炎血清sCD14-ST、IL-8分别为(89.84±25.09)pg/ml、(41.94±12.28)pg/ml高于预后良好患者(P<0.05);sCD14-ST、IL-8对胆道结石术后急性胆管炎患者预后的截断值分别为65.65、29.31 pg/ml,其曲线下面积分别为0.841、0.768。结论胆道结石术后继发急性胆管炎病原以革兰阴性菌为主;运用血清sCD14-ST、IL-8可较好区分疾病严重程度,且对患者预后具有一定预测价值。     

Natural frequency/damping coefficient relationship of the catheter-manometer system required for high-fidelity measurement of the pulmonary arterial pressure

Using a digital simulation method, we analyzed the relationship between natural frequency (f _n ) and damping coefficient () of the catheter-manometer system required for high-fidelity measurement of the pulmonary arterial pressure. The pulmonary artery pressure waveform was obtained with a catheter-tip transducer and it was fed into a dynamic simulator programmed on a computer. The original waveform and the output of the simulator were compared and judged visually for the fidelity. From this analysis, the combination of f _n and was obtained and was plotted on a f _n – diagram. It showed as an area, which was convex on the left side and open on the right side. The left-convex endpoint was located at a damping coefficient of about 0.7. At a lower heart rate, this area was extended to the lower frequency side, while, at a higher heart rate, this area was limited to the higher frequency side. The f _n – diagram was also constructed theoretically by calculating the relations between natural frequencies and damping coefficients of a second order system with the amplitude and phase error tolerance set at +/–5% respectively.(Kinefuchi Y, Suzuki T, Takiguchi M, et al.: Natural frequency/Damping coefficient relationship of the catheter-manometer system required for high-fidelity measurement of the pulmonary arterial pressure. J Anesth 7: 419--426, 1993)     

Characterization and phylogenetic analysis of a neurovirulent Zika virus isolated from Cambodia in 2019

The geographic range of Zika virus (ZIKV) has expanded from Asia to the Americas, leading to the 2015–2016 pandemic with enhanced neurovirulence. At present, ZIKV is continuously circulating in many Southeast Asian countries. Unfortunately, the persistent evolution of ZIKV in Southeast Asia and its influence on the biological characteristics of the virus remain incompletely understood. In this study, the in vitro and in vivo properties of a new ZIKV isolate obtained from Cambodia in 2019 (CAM/2019) were characterized and compared with those of the Cambodian strain (CAM/2010). Compared with CAM/2010, the CAM/2019 virus showed similar plaque morphology and growth curves in cell cultures and induced comparable viremia and organ viral loads profiles in both BALB/c and A129 (IFNAR1^−/−) mice upon intraperitoneal (i.p.) inoculation. Remarkably, the CAM/2019 virus exhibited enhanced neurovirulence in neonatal mice compared with CAM/2010, with a 74-fold reduction in the 50% lethal dose (LD₅₀). Consistently, CAM/2019 produced higher viral loads in the brains of BALB/c neonatal mice than CAM/2010 did. Sequence alignment showed that the CAM/2019 virus has acquired 12 amino acid substitutions, several of which were found to be associated with neurovirulence. In particular, the CAM/2019 virus shared an A1204T substitution in NS2A with the Thai isolate SI-BKK02 that was isolated from a microcephaly case. Taken together, our results indicate that a ZIKV strain isolated with specific mutations has emerged in Cambodia, highlighting the need for extensive molecular and disease surveillance in Cambodia and other Asian countries.     

The Effects of Race,Socioeconomic Status,and Household Structure on Injury Mortality in Children and Young Adults

Objectives: Injuries are the leading killer of young persons in the United States, yet significant gaps in our understanding of this cause of death remain. By examining the independent influences of race, education, income, household structure, and residential location on injury mortality in young persons, this study addresses these gaps. Method: Using data from the National Longitudinal Mortality Study, survival analysis is used to examine the injury mortality risk faced by 0 to 17 year olds over a nine-year follow-up period. Separate models are estimated for homicide, suicide, unintentional injury deaths, and all injury deaths. Results: Household head's education has an independent effect on youth homicide and unintentional injury mortality risk. By contrast, family income and household structure do not have independent effects on any of the injury outcomes. Finally, much of the excess homicide risk faced by young African-Americans is explained by underlying racial differentials in socioeco-nomic status, household structure, and residential location. Conclusions: By finding an independent effect of household head's education on youth mortality risk from homicide and unintentional injuries, this study adds to the large body of evidence linking socioeconomic differentials to inequality in life chances.     

云南富源县阿依村肺癌的流行病学特征及环境致癌因素研究

本文对富源县阿依村特定人群肺癌的流行病学特征及环境致癌因素进行调查研究。研究了该村1986～1996年肺癌调整死亡率的水平,变化趋势、死亡专率及性别比值。该村肺癌死亡率高、波动性大。男性肺癌调整死亡率高于宣威肺癌高发区1．9倍,女性肺癌调整死亡率接近宣威肺癌高发区的水平,男女合计肺癌调整死亡率高于我国重庆、上海、沈阳、大连、南京、天津、广州等工业城市9．7～12．0倍。男性高于女性2．4倍。死亡高峰年龄男女性均始于30～岁年龄组。以居民群体为暴露单位,采集了该村火塘燃烧室、地炉燃烧室、室外空气中颗粒物及有害气体样品,检测其TSP、IP、BaP、SO2浓度,结果显示上述4项污染物的浓度均是火塘燃烧室高于地炉燃烧室而室外最低。γ辐射火塘燃烧室显著高于地炉燃烧室。IP提取物的致突变活性,火塘燃烧室高于地炉燃烧室高于室外。对该村居民改炉改灶降低室内空气中污染物的浓度及致突变活性的效果进行了评定。     

不同单位保种的S180细胞核型及DNA含量的比较研究

对四个单位保种的S180 细胞经KM 小鼠腹腔传代,体外培养加秋水仙碱,涂片、染色后,显微镜下计数染色体数目:腹水传代的S180 细胞,用70 % 乙醇固定,流式细胞仪测DNA 含量。结果如下:本学部( 本部) ,中国医学科学院药物所( 药物所) ,武汉大学保种中心( 武汉大学) 和北京市肿瘤所( 肿瘤所) 保种的S180 细胞株,其染色体均数分别为62-8 ±22-8 ,69-1 ±21-2,39-9 ±8-26 ,58-7±9-75 条。四单位S180 细胞株染色体数做方差分析表明,除肿瘤所与本部外,其它两单位比较均有显著统计学差异(P< 0-01) 。直方图分析显示主流染色体范围分别为56 ～60 ,61 ～65,41 ～45,61 ～65 条。流式细胞术DNA 含量分析表明肿瘤所S180 DNA含量最多,武汉大学保种的S180 细胞的DNA含量最少。这些结果均证明四个单位的S180 细胞株在一些方面已出现显著差异。     

家庭环境因素对青少年精神分裂症的影响

目的 探讨精神分裂症和家庭环境的关系。方法 用自编“家庭环境调查问卷”、修订的父母养育方式评价量表（ＥＭＢＵ）对８２例青少年患者和８２个正常青少年家庭进行调查,用Ｃａｍｂｅｒｗｅｌｌ家庭会谈表（ＣＦＩ）评定患者亲属的情感表达（ＥＥ）水平。结果 （１）病例组父母关系、亲子关系差,父母有不良行为习惯者多（Ｐ〈０．０５）;家庭性患者父母文化水平低、经济收入低、健康状况差（Ｐ〈０．０１）。（２）病例组父母     

腭裂术后语音的实验研究

提供一种易被患者接受、无害、科学客观的腭裂术后语音缺陷的诊断方法。方法：随机选择各种腭裂类型的腭裂术后患者４７例,将其语音输入ＫＡＹ７８００语图仪,分析其语音特点和语图表现。结果：腭裂术后语音有３大语音特点和８类语图表现。３大语音特点是残缺、代偿和干扰;８类语图表现是辅音残缺、共振峰残缺、送气代偿、浊化代偿、喉塞代偿、鼻音干扰元音、鼻音干扰辅音和噪音干扰。结论：腭裂术后患者口腔内的能量不足是造成以上语音缺陷的主要原因。