持续性特发性耳鸣严重程度的相关因素分析

目的 探讨导致持续性特发性耳鸣严重程度的相关因素.方法 分析870例持续性特发性主观性耳鸣患者的一般资料、病史、听力学结果、耳鸣匹配实验、耳鸣残疾量表、匹兹堡睡眠质量指数量表和焦虑自评量表,应用多因素Logistic回归分析研究与患者耳鸣严重程度相关的因素.结果 ①性别(P＜0.001)、年龄(P=0.010)、耳鸣主...     

提高医院感染诊断相关病原学送检率的干预措施及效果评价

目的 探讨二级综合医院提高医院感染诊断相关病原学送检率的干预措施及效果。 方法 选取2021—2022年某二级综合医院的所有住院患者中上报的医院感染病例作为研究对象,2021年为干预前组,2022为干预后组,比较实施干预改进措施前后医院感染诊断相关病原学送检率指标。 结果 2021年全年医院感染诊断相关病原学送检率为66.07%,实施干预改进措施后,2022年全年送检率达91.55%,符合规范要求的≥90%,干预前后比较差异有统计学意义(χ²=12.85,P＜0.01)。实施干预改进措施后,医院住院患者抗菌药物使用率,限制级、特殊级抗菌药物使用构成比比较,差异均有统计学意义(均P < 0.05)。 结论 实施有效的干预改进措施可以提高医院感染诊断相关病原学送检率,但质控指标还有待改进和完善之处。     

Potential for Collider Bias in Studies Examining the Association of Central Corneal Thickness With Glaucoma

PurposeCentral corneal thickness (CCT) may be biologically related to glaucoma or observed as associated with glaucoma simply due to its effect on intraocular pressure (IOP) measurement. We aimed to determine if the previously reported CCT-glaucoma associations, in which the analyses were adjusted for IOP or participants were selected on IOP, could be explained by collider bias.MethodsWe simulated datasets mimicking a longitudinal population-based study (Los Angeles Latino Eye Study) and a trial (Ocular Hypertension Treatment Study) such that: (i) CCT was not truly associated with glaucoma, (ii) CCT and true IOP both contribute to measured IOP, and (iii) true IOP contributes to glaucoma risk. We then tested whether an association between CCT and glaucoma could be spuriously induced simply by adjusting for or selecting on measured IOP.ResultsA thinner CCT was significantly associated with higher glaucoma incidence in the simulated longitudinal population-based study when adjusted for measured IOP, but not crudely (unadjusted). A thinner CCT was crudely associated with glaucoma incidence in the simulated trial in which the participants were selected for high measured IOP. Effect sizes in the simulations were similar to those observed in the original studies.ConclusionsOur findings question whether CCT is biologically associated with glaucoma and suggest that current evidence may be due to collider bias. This indicates that CCT alone cannot be used as a factor to identify people at high risk of glaucoma in the general population. Using CCT in combination with IOP may be superior to using IOP alone.     

Educational attainment polygenic scores,socioeconomic factors,and cortical structure in children and adolescents

Genome‐wide polygenic scores for educational attainment (PGS‐EA) and socioeconomic factors, which are correlated with each other, have been consistently associated with academic achievement and general cognitive ability in children and adolescents. Yet, the independent associations of PGS‐EA and socioeconomic factors with specific underlying factors at the neural and neurocognitive levels are not well understood. The main goals of this study were to examine the unique contributions of PGS‐EA and parental education to cortical structure and neurocognitive skills in children and adolescents, and the associations among PGS‐EA, cortical structure, and neurocognitive skills. Participants were typically developing 3‐ to 21‐year‐olds (53% male; N = 391). High‐resolution, T1‐weighted magnetic resonance imaging data were acquired, and cortical thickness (CT) and surface area (SA) were measured. PGS‐EA were computed based on the EA3 genome‐wide association study of educational attainment. Participants completed executive function, vocabulary, and episodic memory tasks. Higher PGS‐EA and parental education were independently and significantly associated with greater total SA and vocabulary. Higher PGS‐EA was significantly associated with greater SA in the left medial orbitofrontal gyrus and inferior frontal gyrus, which was associated with higher executive function. Higher parental education was significantly associated with greater SA in the left parahippocampal gyrus after accounting for PGS‐EA and total brain volume. These findings suggest that education‐linked genetics may influence SA in frontal regions, leading to variability in executive function. Associations of parental education with cortical structure in children and adolescents remained significant after controlling for PGS‐EA, a source of genetic confounding.     

“清宣理肺、舒风解痉”法对60例支气管哮喘急性发作期热哮患者肺功能、ACT评分及气道炎症因子影响

目的初步评价"清宣理肺、疏风解痉"中药复方治疗支气管哮喘急性发作期热哮患者的肺功能、ACT评分及气道炎症关键指标及免疫失衡相关炎症因子的影响,探讨中药治疗支气管哮喘急性发作中气道慢性炎症的演变,阐释中药作用机制,为中医药防治支气管哮喘提供研究思路和有效方剂。方法遵循随机、平行对照临床试验设计原则,将60例支气管哮喘发作期热哮患者随机分为两组,其中,中药组30例,西药组30例。中药组予"清宣理肺、疏风解痉"中药复方,1剂/d,分2次温服,西药组根据病情严重程度属于轻度持续者(哮喘控制水平第2级):普米克气雾剂,2喷/d,早晚各1次。病情严重程度属于中度持续者(哮喘控制水平第3级):舒利迭2吸/d,早晚各1次,疗程4周。观察比较治疗前后两组患者肺功能、ACT评分及气道关键炎性指标IL-8、IL-10、Ig E、ECP、IL-17、IL-33的变化。结果肺功能:中药组FVC、FEV1、PEF治疗前后比较,差异有统计学意义(P <0. 05),治疗后明显改善; FEV1/FVC治疗前后比较差异无统计学意义(P> 0. 05),治疗后无明显改变;西药组PEF比值治疗前后比较差异有统计...     

阻塞性睡眠呼吸暂停患者血清甲状腺功能指标变化及其影响因素

目的:探讨阻塞性睡眠呼吸暂停患者,血清甲状腺功能指标变化情况,以及相关影响因素。方法:选取2017年6月至2020年6月江门市第二人民医院收治的阻塞性睡眠呼吸暂停患者60例作为研究对象,根据患者的病情,将其分为轻度组(n=20)、中度组(n=21)和重度组(n=19),同时选取非阻塞性睡眠呼吸暂停患者25例作为对照组,了解每组患者的血清甲状腺功能指标情况。结果:中度、重度非阻塞性睡眠呼吸暂停患者的BMI、TSH等指标,明显高于轻度组与对照组。结论:阻塞性睡眠呼吸暂停患者的间歇性缺氧可导致甲状腺激素水平下降。     

极低/超低出生体质量儿晚发型败血症死亡相关因素分析

目的 探讨极低/超低出生体质量儿并发晚发型败血症死亡的高危因素.方法 选取2016年9月—2019年12月收治的血培养确诊晚发型败血症的极低/超低出生体质量儿,分析临床资料,找出死亡相关及独立危险因素.结果 538例极低/超低出生体质量儿发生晚发型败血症66例,发病率12.27％,死亡15例,病死率22.73％.胎龄小...     

宜昌夷陵地区儿童肥胖合并哮喘调查及影响因素

目的 探究宜昌市夷陵地区儿童肥胖合并哮喘患儿调查及影响因素.方法 采用分层随机整群抽样方法选取2018-2019年夷陵地区肥胖合并哮喘患儿379例,同期210例体检健康儿童作为对照组.通过问卷调查方式获取患儿一般资料,并进行单因素及多因素logistic分析.结果 肥胖伴哮喘患儿男性、居住在城市、存在哮喘家族史、二手烟...     

右归丸对膝骨关节炎模型鼠软骨组织显微结构及热休克蛋白90α蛋白表达的影响

目的:观察右归丸对膝骨关节炎(knee osteoarthritis,KOA)模型大鼠软骨组织显微结构和热休克蛋白90α(heat shock protein 90α,Hsp90α)蛋白表达的影响,进一步揭示右归丸防治KOA的机制。方法:将大鼠随机分为假手术对照组、KOA模型组、硫酸氨基葡萄糖组和右归丸(高、中、低剂量)组,每组10只。采用改良Hulth法制备大鼠KOA模型,分别予相应药物灌胃8周。HE染色法观察软骨组织的形态学变化,并进行Makin评分;应用免疫组化法检测各组大鼠软骨组织Hsp90α、纤连蛋白(fibronectin,Fn)和Ⅱ型胶原(collagen typeⅡ,COL-Ⅱ)的表达;RT-qPCR法检测各组大鼠软骨组织Hsp90α、白细胞介素1β(interleukin-1β,IL-1β)、基质金属蛋白酶3(matrix metalloproteinase-3,MMP-3)和MMP-13的mRNA表达水平,应用Western blot法检测各组大鼠软骨组织Hsp90α和COL-Ⅱ的表达。结果:与假手术组比较,KOA模型组大鼠软骨组织Makin评分明显升高,软骨组织H...     

慢加急性乙型肝炎肝衰竭患者死亡危险因素和预后评分模型的构建

目的 分析慢加急性乙型肝炎肝衰竭(HBV-ACLF)患者死亡的危险因素,建立预后评分预测模型.方法 2016年1月～2019年9月我院收治的126例HBV-ACLF患者,记录临床资料,将各指标纳入多因素Logistic回归分析,并建立预后评分预测模型,采用Hosmer-Lemeshow检验评估模型拟合度,采用ROC检验...