2013年某县慢性病现状及其危险因素监测的分析

目的掌握山东省东阿县城乡居民的慢性病现状及其相关危险因素特点,通过分析慢性病相关危险因素,找到东阿县疾病防控的重点,为制定适合东阿县的慢性病防控干预计划提供依据。方法采取随机抽样方法抽取1100个家庭,每户根据KISH表法确定1例18岁及以上常住居民作为调查对象。采用问卷调查、身体测量和实验室检测三种方法。结果东阿县城乡居民慢性病患病率为23.28%(291/1250)。居民的主要的慢性病为高血压(13.80%)及糖尿病(3.44%);东阿县18岁以上城乡居民普遍存在吸烟、饮酒、不合理膳食、体力活动不足、超重、肥胖是的主要危害因素,其中吸烟、饮酒在男性中的分布明显高于在女性中的分布。结论根据东阿县居民慢性病患病特点及相关危险因素现况,可结合一级"控制危险因素"、二级"治疗患者"、三级"促进康复"来控制和管理慢性病。     

Alterations in apoptotic caspases and antioxidant enzymes in arsenic exposed rat brain regions: Reversal effect of essential metals and a chelating agent

Arsenic (As) widely studied for its effects as a neurotoxicant. The present study was designed to evaluate the protective effect of calcium, zinc or monoisoamyl dimercaptosuccinic acid (MiADMSA), either individually or in combination on As induced oxidative stress and apoptosis in brain regions (cerebral cortex, hippocampus and cerebellum) of postnatal day (PND) 21, 28 and 3 months old rats. Arsenic exposure significantly decreased the activities of superoxide dismutase (SOD) isoforms, catalase (CAT), glutathione peroxidase (GPx) and glutathione reductase (GR) with increase in glutathione s transferase (GST) while lipid peroxidation (LPx), arsenic levels, mRNA expression of caspase 3 and 9 were significantly increased in different brain regions. Arsenic induced alterations in these parameters were greater in PND 28 and more pronounced in cerebral cortex. From the results it is evident that combined supplementation of calcium and zinc along with MiADMSA would be most effective compared to individual administration in reducing arsenic induced neurotoxicity.     

县级医院医务人员手卫生现状及影响因素的调查分析

目的：了解县级医院医务人员手卫生现状,分析其影响因素。方法在咨询专家的基础上自行设计调查问卷,采用横断面调查的方法,于2014年7月对本院424名医务人员进行调查。结果本院医务人员平均洗手执行率为96.43%,经多元线性回归模型分析显示,是否接受手卫生相关培训是医务人员洗手执行率的影响因素。本院医务人员手卫生知识平均知晓率为48.41%,职业是医务人员手卫生知识知晓率的影响因素。结论医务人员洗手意识还有待于提高,县级医院应结合医务人员迫切需要的知识内容,定期开展医院感染及手卫生知识的教育和培训,加大县级医院基础设施建设投入,提高医务人员手卫生的依从性。     

急性呼吸窘迫综合征患者下呼吸道重力依赖区气道关闭数值模拟

为了研究急性呼吸窘迫综合征（ARDS）患者下呼吸道重力依赖区气流特性的变化情况,基于CT影像建立真实人体下呼吸道三维模型,确定重力依赖区气道关闭位置,利用CFD技术对下呼吸道内气体进行瞬态数值模拟,得到了部分气道关闭后下呼吸道内空气流速、表面压力、壁面剪切应力等参数的变化趋势,理解了ARDS发生发展的病理生理变化,从而指导机械通气策略,避免呼吸机相关肺损伤的发生。     

Regional glucose andβ-Hydroxybutyrate use by developing rat brain

Rates of glucose andd--hydroxybutyrate use were determined in five brain regions of 20-day-old rats. The regions studied were cerebral cortex, thalamus, striatum, cerebellum, and brain stem. The tracers for determining rates of substrate use were [³H]fluorodeoxyglucose and [3-¹⁴C]-d--hydroxybutyrate. Two or five minutes after isotope administration the animals were sacrificed in a 6-kW, 2450-MHz focused microwave device. Ten minutes prior to isotope administration the animals were injected intraperitoneally with normal saline or DL--hydroxybutyrate (10mmol/kg). Bloodd--hydroxybutyrate levels averaged 0.21 mol/ml in saline-injected and 3.13 mol/ml in hyperketonemic rats. Rates of glucose utilization were significantly heterogeneous between regions in both groups: thalamus > cerebral cortex striatum > brain stem > cerebellum. These rates were 20–35% lower in hyperketonemic rats. Rates ofd--hydroxybutyrate use varied significantly between regions only in the saline group, with the brain stem rate being significantly lower than that in cortex or cerebellum. Regional rates ofd--hydroxybutyrate use did not correlate significantly with regional rates of glucose use in either the saline or the hyperketonemic groups. Regional rates of glucose use were strongly and positively correlated between conditions, as were regional rates ofd--hydroxybutyrate use. Thus, in 20-day-old rats, the regional heterogeneity of brain glucose use is similar to that in adult rats.d--Hydroxybutyrate use is much less regionally heterogeneous. When brain regional rates ofd--hydroxybutyrate use are increased seven- to ninefold in acute hyperketonemia, there are compensatory decreases in regional rates of glucose use sufficient to keep regional rates of energy production unchanged.     

Enzymatic cytochemistry,DNA ploidy and AgNOR quantitation in hepatocellular nodules of uncertain malignant potential in liver cirrhosis

Conventional histological examination of echo-guided biopsy specimens can be inconclusive in small nodular lesions in cirrhotic livers. We investigated the diagnostic potential of cytochemical analysis of dipeptidyl-peptidase IV (DPP IV), of image analysis of nuclear DNA content, and of interphase silver-stained nucleolar organizer regions (AgNORs) in 12 cases of small (13- to 29-mm in diameter) hepatic nodules visualized in cirrhotic patients by ultrasonography. All cases underwent an echo-guided liver biopsy at the time of detection and in none of them were histological signs of malignancy found. Characterization with the above-mentioned techniques was always done at the time of histological examination. These patients underwent a mean (±sd) follow-up of 27.0 (±11.2) months after biopsy, with repeated ultrasound (US) examinations. In the seven patients with subsequent neoplastic growth, DPP IV score was altered in five of six; the fraction of mononucleated polyploid cells was altered in six of seven; and the AgNOR quantity exceeded the cutoff value of 4 m² in five of five cases. Among the five lesions whose US appearance remained unchanged during the follow-up, only one abnormality (AgNORs) was found in one case. The combined cytochemical analysis of DPP IV, nuclear DNA content, and quantitative evaluation of interphase AgNORs in biopsy samples may contribute to the differential diagnosis of hepatocellular nodules of uncertain type in the cirrhotic liver.This work was supported by grants from the Ministero per l'Università e la Ricerca Scientifica (fondi 40% e 60%) andA.I.R.C. (Milano).     

一种新的HBeAg阴性慢性乙型肝炎病毒变异机制

Objective To investigate mutation patterns in core promoter(CP)region of hepatitis B virus(HBV).Methods HBV DNA was extracted from sera of patients with chronic HBV infection.The CP sequence was amplified by polymerase chain reaction(PCR)and cloned into pMD19 T vector.The positive clones were then sequenced.The sequences were compared with known HBV genome in GenBank to identify the mutation sites and patterns of patients with chronic HBV infection.Results There were 74 clones from 21 patients with chronic HBV infection which were sequenced.The sequence comparisons showed that there was a 234-nucleotide deletion in CP region of HBV genome in 54 clones and a 245-nucleotide deletion in one clone.These deletion regions included CP,HBeAg initiation codon and direct repeat sequence(DR)Ⅰ regions,which named CP deletion(CPD).A1585T replacement mutation was also found in HBV strain with CPD,which indicated that there was linkage between these two mutations.Conclusions A novel mechanism of HBeAg negative chronic hepatitis B is observed,which includes deletions of CP and HBeAg initiation codon.Meanwhile,a simple and useful PCR method is developed to detect CPD.     

同型号仪器不同地区血液流变学指标参考值的比较

目的：探讨同型号仪器不同地区血液流变学指标的差异性。方法：选择四个地区男女血液流变学指标,包括低切、中切、高切血液黏度,红细胞压积,血浆黏度,相互比较统计分析。结果：男性的血液流变学指标：粤西地区与广西地区的中切黏度、绍兴地区与广西地区的中切黏度、广西地区与深圳市低切黏度、高切黏度比较差异均无统计学意义（P〉0.05）,其余的血液流变学指标比较差异均有统计学意义（P〈0.05）。女性的血液流变学指标：粤西地区与绍兴地区的中切黏度、粤西地与广西地区的血浆黏度、粤西地区与深圳市的中切黏度、绍兴地区与广西地区的血浆黏度、绍兴地区与深圳市的中切黏度比较差异均无统计学意义（P〉0.05）,其余的血液流变学指标差异均有统计学意义（P〈0.05）。男性血液流变学指标86.66%有差异,女性的血液流变学指标83.33%有差异。结论：同型号仪器不同地区不能使用厂家或其他实验室的参考值,建立本地区本实验室、不同性别、不同年龄的参考值至关重要,只有这样才符合血液流变学检测规律和规范。