Using aggregated mobile phone location data to compare the realised foodscapes of different socio-economic groups.

The foodscape (the built food environment) is considered one of the driving factors of the higher burden of obesity and chronic disease observed in low socio-economic status (SES) groups. Traditional data collection methods struggle to accurately capture actual access and exposure to the foodscape (realised foodscape). We assess the use of anonymised mobile phone location data (location data) in foodscape studies by applying them to a case study in Perth, Western Australia to test the hypothesis that lower SES groups have poorer realised foodscapes than high SES groups. Kernel density estimation was used to calculate realised foodscapes of different SES groups and home foodscape typologies, which were compared to home foodscapes of the different groups. The location data enabled us to measure realised foodscapes of multiple groups over an extended period and at the city scale. Low SES groups had poor availability of food outlets, including unhealthy outlets, in their home and realised foodscapes and may be more susceptible to a poor home foodscape because of low mobility.     

CTCs与结直肠癌病理特征及术后复发的关系研究

目的通过检测结直肠癌患者术前外周血循环肿瘤细胞(CTCs),探讨结直肠癌患者术前CTCs检出水平与临床病理特征及预后的关系。方法收集2017年3月1日-2019年6月30日的40例结直肠癌患者及36例良性疾病患者的外周血,采用FISH法检测CTCs,比较两组患者的CTCs检出水平、癌胚抗原(carcinoembryonic antigen,CEA)、TNM分期(T是原发灶,N是淋巴结,M是远处转移)、肿瘤分化程度、脉管癌栓之间的关系,并进行统计学分析。结果 (1)结直肠癌组中CTCs阳性率为62.5%,良性肿瘤对照组中阳性率为5.6%,差异具有统计学意义(P <0.05)。(2)结直肠癌患者组术前CTCs阳性率高于CEA(P <0.05)。(3)CTCs术前阴性组患者术后复发的风险低于CTCs阳性组(P <0.05)。(4)术前CTCs阳性患者的术后病理结果中,脉管癌栓阳性率高于CTCs阴性组(P <0.05)。结论 CTCs在恶性肿瘤中表达比良性肿瘤高,对恶性肿瘤的诊断有较大的指导意义。CTCs敏感性高于CEA,两者结合可提高结直肠癌的检出率。CTCs阳性的结直肠癌患者出现脉管癌栓率较高,复发危险度较高,可作为结直肠癌预后的重要指标。     

超声清创联合重组人表皮生长因子治疗肛周脓肿合并感染的效果

目的探讨超声清创联合重组人表皮生长因子对肛周脓肿合并感染患者表皮细胞生长因子(Epidermal growth factor,EGF)、激活素A(Activin A,ACTA)水平及创面血流量的影响。方法选取2018年2月-2020年1月承德医学院附属医院肛周脓肿合并感染患者117例,依据随机数字表法分为对照A组(n=39)、对照B组(n=39)、联合组(n=39)。常规干预基础上对照A组采取超声清创,对照B组采取重组人表皮生长因子,联合组采取超声清创及重组人表皮生长因子。统计三组治疗情况、治疗前后疼痛程度评分、创面血流量及经皮氧分压、EGF、转化生长因子-β(Transforming growth factor-β,TGF-β)、ACTA、C-反应蛋白(C-reactive protein,CRP)水平及临床疗效。结果联合组创面愈合时间、感染控制时间、住院时间分别为(12.39±2.01)d、(5.22±1.56)d、(13.91±2.51)d短于对照A组、对照B组,创面细菌清除率为(89.13±4.64)%高于对照A组、对照B组(P<0.001);治疗后1 d、3 d、7 d、14 d三组VAS评分较治疗前降低,且联合组低于对照A组、对照B组(P<0.05);治疗后1 d联合组创面血流量及经皮氧分压分别为(0.92±0.25)PU、(35.69±3.20)mmHg大于对照A组、对照B组(P<0.05);治疗后1 d联合组血清EGF、TGF-β分别为(0.70±0.11)μg/L、(0.68±0.12)μg/L高于对照A组、对照B组(P<0.05);治疗后1 d联合组血清ACTA、CRP分别为(9.45±3.58)μg/L、(5.71±2.68)mg/L低于对照A组、对照B组(P<0.05);联合组疗效优于A组和B组(P<0.05)。结论联合采取超声清创及重组人表皮生长因子治疗肛周脓肿合并感染,可改善创面愈合及感染控制情况,缓解疼痛程度,增加创面血流量及经皮氧分压,调节EGF、ACTA等水平,提高整体治疗效果。     

SPECT在癫*诊断中的价值

目的：探讨单光子断层扫描（SPECT）对颅内非局灶性病变致癫痫的无创性定位诊断的作用和临床意义,并与EEG,MRI进行比较,方法：对88例癫痫病人分别在1－2周内行SPECT,EEG,MRI检查,比较3种方法的检出率,准确度,特异度,敏感度,阳性及阴性预测值,结果：SPECT的检出率,准确率,敏感度,阴性预测值显著高于MRI（P＜0．05）,其特异度显著低于MRI（P＜0．05）,SPECT的检出率,准确度,特异度,敏感度,阳性及阴性预测值与EEG比较,均无显著性差异（P＞0．05）,结论：SPECT检查在癫痫定位中优于MRI,其对单一癫痫灶的检出亦优于EEG。     

超声骨刀与高速磨钻应用于颈椎后路单开门椎管扩大成形术的有效性及安全性的Meta分析

目的 :通过Meta分析评价应用超声骨刀(ultrasonic bone curette,UBC)与高速磨钻(high-speed drill,HSD)在颈椎后路单开门椎管扩大成形术(cervical expansive open-door laminoplasty,CEOL)中的有效性及安全性。方法:计算机检索PubMed、Embase、Web of Science、万方数据库(Wanfang Data)、中国期刊全文数据库(CNKI),搜集关于比较应用超声骨刀和高速磨钻在颈椎后路单开门椎管扩大成形术中有效性及安全性的临床对照研究,检索时限为建库至2021年3月。2名研究人员分别筛选文献、提取数据并评价纳入研究的偏倚风险后,采用Cochrane Library提供的Revman 5.3软件进行Meta分析。结果:最终纳入8个临床研究,包括4个随机对照试验(randomized controlled trial,RCT)和4个队列研究(cohort study,CS),共计631例患者,其中超声骨刀组314例,高速磨钻组317例。Meta分析结果显示,两组间术前、术后早期及末次随访时JOA评分、VAS评分、手术相关总并发症发生率、术后轴性症状和C5神经根麻痹发生率均无统计学差异(P0.05)。然而,与高速磨钻组相比,超声骨刀组手术时间[均数差(mean difference,MD)=-24.78,95%置信区间(confidence interval,CI)为(-36.80,-12.76),P0.0001]、术中出血量[MD=-69.94,95%CI为(-115.40,-24.47),P=0.003]、术后引流量[MD=-53.21,95%CI为(-86.95,-19.46),P=0.002]、硬脊膜撕裂发生率[优势比(odds ratio,OR)=0.30,95%CI为(0.09,0.95),P=0.04]和脑脊液漏发生率[OR=0.30,95%CI为(0.09,0.95),P=0.04]均明显低于高速磨钻组。结论:在颈椎后路单开门椎管扩大成形术中应用超声骨刀安全有效,可以节约手术时间、减少术中出血量和术后引流量、降低硬脊膜撕裂和脑脊液漏的风险。     

Who receives influenza vaccinations at the Pharmacy? An analysis of the Texas Behavioral Risk Factor Surveillance System

IntroductionVaccination helps to prevent influenza infection and reduce associated costs but the influenza vaccination rate in Texas for adults between the ages of 18 to 64 years old is the lowest in the US. Pharmacies and alternative locations have been shown to help increase vaccination rates but many adults still go unvaccinated.ObjectiveThis research aims to determine the factors associated with obtaining influenza vaccination at the pharmacy compared to non-pharmacy locations in Texas.MethodThis study used pooled Texas Behavior Risk Factor Surveillance System datasets (2014 to 2018) for this assessment. The main outcome variable was categorized into pharmacy and non-pharmacy vaccination locations and analyzed using a logistic regression analysis. Further statistical analysis was done using a multinomial logistic regression after re-categorizing the outcome variable into pharmacy, doctor office, and other locations.ResultBlacks were 63% (AOR 0.37, C.I. 0.26, 0.50) and Hispanics were 38% (AOR 0.62, C.I. 0.48, 0.80) less likely to receive influenza vaccinations at the pharmacy respectively when compared to Whites. Furthermore, those who did not live in a Metropolitan Statistical Area (MSA) were 33% (AOR 0.67, C.I 0.53, 0.84) less likely to receive influenza vaccinations at the pharmacy compared to those who lived in an MSA. While there was no observed difference in the likelihood of receiving influenza vaccination, the unemployed population were 40% (AOR 1.40, C.I 1.15, 1.71) more likely to be vaccinated in the pharmacy compared to the employed population.ConclusionThere is potential for increased utilization of pharmacies as a source of influenza vaccination in Texas. Racial differences exist both for receiving influenza vaccinations and being vaccinated in the pharmacy. Influenza vaccination advocacy and education efforts may be necessary to improve pharmacy-based vaccination in Texas, especially for minorities and rural-dwelling Texans.     

超声刀在MED治疗腰椎间盘突出症中的应用

目的 探讨超声刀应用于后路脊柱显微内窥镜椎间盘摘除术(Microendoscopic Discectomy MED)治疗腰椎间盘突出症中的优势与疗效.方法 我院自2005年1月～11月将根据患者症状、体征、体查、CT和或MRI确诊的腰椎间盘突出症患者97例随机分为两组,超声刀 MED组45例,采用超声刀处理椎板下缘等骨性结构;而常规MED手术组52例采用枪钳或电动磨钻处理.结果 超声刀 MED组与常规MED组平均手术时间分别为42 min和75 min,平均术中失血量分别为29 ml和61 ml,平均术后引流量分别为13 ml和29 ml,差异均有显著性(P＜0.05);两组所有病例获得13月(6～17月)随访,按Macnnab标准,优良率分别为95.6%和92.3%,差异无显著性(P＞0.05).结论 超声刀切割骨骼的同时不损伤软组织,且有同步止血功能,操作安全方便,能缩短MED手术时间,不失为脊柱手术一种理想的辅助工具.     

经颅多普勒超声对原发性帕金森病和血管性帕金森综合征检查的临床意义

目的探讨经颅多普勒超声(TCD)对原发性帕金森病(IPD)和血管性帕金森综合征(VPS)的临床应用价值和意义。方法对81例IPD和32例VPS患者的TCD和颅脑CT的检查结果进行比较研究。结果IPD组81例中总异常血管支数为223支(30．59％);VPS组32例中总异常血管支数为163支(56．60％);异常形式两组均以左侧大脑中、后动脉血流速度减慢为主要特点。结论IPD和VPS患者均伴有脑部血流动力学改变,VPS组的异常率高于IPD组,异常特点是左侧血流速度显著慢于右侧。     

Determination of microviscosity and location of 1,3-Di(1-pyrenyl)propane in brain membranes

We determined the microviscosity of synaptosomal plasma membrane vesicles (SPMV) isolated from bovine cerebral cortex and liposomes of total lipids (SPMTL) and phospholipids (SPMPL) extracted from SPMV. Changes in the microviscosity induced by the range and rate of lateral diffusion were measured by the intramolecular excimerization of 1,3-di(1-pyrenyl)-propane (Py-3-Py). The microviscosity values of the direct probe environment in SPMV, SPMTL and SPMPL were 38.17, 31.11 and 27.64 cP, respectively, at 37°C and the activation energies (E_a) of the excimer formation of Py-3-Py in SPMV, SPMTL and SPMPL were 8.236, 7.448 amd 7.025 kcal/mol, respectively. Probe location was measured by polarity and polarizability parameters of the probe Py-3-Py and probe analogues, pyrene, 1-pyrenenonanol and 1-pyrenemethyl-3β-hydroxy-22,23-bisnor-5-cholenate (PMC), incorporated into membranes or solubilized in reference solvents. There existed a good linear relationship between the first absorption peak of the¹L_a band and the polarizability parameter (n ²−1)/(2n ²+1). The calculated refractive index values for SPMV, SPMTL and SPMPL were close to 1.50, which is higher than that of liquid paraffin (n=1.475). The probe location was also determined by using a polarity parameter (f−1/2f¹). Here f=(ε−1)/(2ε+1) is the dielectric constant function and f'=(n ²−1)/(2n ²+1) is the refractive index function. A correlation existed between the monomer fluorescence intensity ratio and the solvent polarity parameter. The probes incorporated in SPMV, SPMTL, and SPMPL report a polarity value close to that of 1-hexanol (ε=13.29). In conclusion, Py-3-Py is located completely inside the membrane, not in the very hydrophobic core, but displaced toward the polar head groups of phospholipid molecules, e.g., central methylene region of aliphatic chains of phospholipid molecules.     

Aversive properties of theκ opioid agonist U50,488 in the week-old rat pup

Opioids have been shown to produce analgesia and to be reinforcing during the first week of life in the rat. Opioids also have analgesic actions in both the infant and adult, but can be aversive in the mature animal. We examined the aversive effects of the opioid agonist U50,488 during the first postnatal week in the rat pup in three ways. In the first experiment, U50,488, injected peripherally (1.0–30.0 mg/kg), was paired with an odor and pups were tested 8 h later for positional preference for avoidance of that odor. This task is similar to conditioned preference/aversion tests used with adult animals. Both 3- and 7-day-old pups learned to avoid the odor adulterated side at the two higher doses. When exposed to odors previously associated with U50,488, pups at both ages decreased locomotor activity. In a second experiment, acute treatment with U50,488 increased ultrasonic distress vocalizations (USV) equally at 3 and 7 days of age, increased locomotor activity, and decreased rectal temperature. Neither of the latter two effects was correlated with the increase in USV production. The third experiment showed that conditioned odor cues increased USV 8 h later in 3- and 7-day-old pups at 1.0–10.0 mg/kg without changes in activity or rectal temperature. The results from these studies suggest that U50,488 can produce aversions in the neonatal rat pup as it does in the adult.Supported by U.S.P.H.S. grant DA-06600