Baseline immune activation as a risk factor for the onset of depression during interferon-alpha treatment.

BACKGROUND: Major depression has been associated cross-sectionally with increased cell-mediated immune activation but causality has been difficult to establish. This study prospectively investigated the hypothesis that baseline level of immune activation predicts the development of depression during interferon-alpha (IFN-alpha) treatment. METHODS: Sixteen hepatitis C patients without psychiatric disorder underwent IFN-alpha treatment. Proinflammatory and anti-inflammatory cytokines were determined before starting treatment. Presence of a major depressive disorder (MDD) was assessed at baseline and several times during treatment. RESULTS: Baseline soluble interleukin-2 receptor (sIL-2r), interleukin-6 (IL-6), and interleukin-10 (IL-10) concentrations were significantly increased in the five subjects that developed MDD during treatment compared with those that did not, with standardized effect sizes of 1.08, 1.16, and 1.25, respectively, controlling for marijuana use, cigarette smoking, and baseline level of depressive symptoms. CONCLUSIONS: Results suggest that increased immune activation, rather than an epiphenomenon, is a causal risk factor for the development of MDD.     

肝移植术后糖尿病危险因素分析

目的 探讨肝移植术后糖尿病（PTDM）的发生及发展的危险因素。方法 回顾性分析98例肝移植受者的临床资料。根据其肝移植术后是否发生糖尿病，分为糖尿病组（36例）和非糖尿病组（62例）。以术前和术后可能的9个危险因素作为分析指标，进行这些指标的单因素分析和χ^2检验。结果 在对两组患者的年龄、乙型肝炎病毒（HBV）感染情况、有无肝硬化及肝硬化的程度、术前糖耐量情况、免疫抑制剂的选择及其血药浓度、激素的使用时间的比较分析中发现：术前肝硬化患者PTDM的发生率明显高于无肝硬化者；肝硬化失代偿期患者PTDM的发生率高于代偿期。术前糖耐量异常的患者PTDM的发生率明显高于糖耐量正常者。激素半年内撤离的患者PTDM的发生率明显低于半年内未撤离者。而两组患者的年龄、HBV的感染情况、免疫抑制剂的选择及其血药浓度相比较，差异均无统计学差异。结论 肝硬化、尤其是肝硬化失代偿期，糖耐量异常，长期使用激素是PTDM发生的危险因素。     

Framing the child at risk

Risk Assessment Reports are one form of accounting practice which delineate the space of risk considered in a child abuse neglect investigation. The paper analyses two Risk Assessment Reports, contrasting what is reported, what is directly observed and what is hypothesized and implied by child protection practitioners during the assessment of risk. From an analysis of these two reports (each 4 – 5 pages long), the paper identifies the rhetorical strategies and their realizations used by two practitioners in framing the child at risk. The paper problematizes the tension between the institutional need to constrain the exercise of professional judgement through Risk Assessment Models, and the extent to which practitioners actually localize the framing of risk to specific areas of investigation.     

城市血吸虫病综合防治措施的研究

目的探索快速控制城市血吸虫病流行的综合措施。方法在城市血吸虫病流行区选择3个试点现场,南津港、太平桥2个点采取以化疗为主的综合防治措施,小柳叶洲点采取以环境改造灭螺为主的综合防治措施。结果南津港点3年居民血吸虫感染率分别为2.80%、2.60%和2.24%,并发生急性血吸虫病2例;感染螺平均密度分别为0.0009、0.0027、0.0020只/0.1m2。小柳叶洲点3年无居民粪检阳性者,无急性血吸虫病例,哨鼠感染率为0,没有查到感染性钉螺。太平桥点3年居民感染率分别为1.18%、0.20%和0.26%,无急性血吸虫病例,家畜感染率分别为6.35%、3.57%和3.85%,2004年发现感染性钉螺,平均密度为0.0001只/0.1m2。结论在城市血吸虫病流行区,采取以环境改造灭螺为主、人群化疗、健康教育、药物灭螺灭蚴的综合防治措施能快速控制疫情。采取以化疗为主的综合防治措施,难以有效控制疫情。     

Low level of response to alcohol as associated with serotonin transporter genotype and high alcohol intake in adolescents.

BACKGROUND: A low level of response to alcohol has been associated with both the genetic constitution of the regulatory region (SLC6A4) of the human serotonin (5-hydroxytryptamine, 5-HT) transporter (5-HTT) and with future alcohol intake and an increased risk for alcoholism. To date, all studies of relevant polymorphisms have been carried out in populations in the United States. METHODS: Data were extracted from a subset (n = 243) of a cohort of children who have been observed since birth through evaluation of the family history of alcoholism and psychosocial risk influences. At age 16 years, the response to alcohol was assessed with the Self-Rating of the Effects of Alcohol (SRE) questionnaire, and the average amount of alcohol intake per month was assessed during the prior 6 months. Additional variables that were measured included the 5-HTT genotype, externalizing behavior, and sociodemographic variables, such as gender and age. RESULTS: The level of response to alcohol was significantly lower among carriers of two long alleles of the 5-HTT regulatory region compared with carriers of one or two short alleles (Mann-Whitney U = 5225.0, p = .005). In a multiple regression analysis, the level of response to alcohol and externalizing behavior but not psychosocial factors significantly predicted the average amount of alcohol intake per month. CONCLUSIONS: This study demonstrates that, independent of the assessed psychosocial variables, the 5-HTT genotype correlated with the level of response to alcohol and predicted alcohol intake among 16-year-old adolescents.     

颅内肿瘤切除术后颅内感染危险因素分析

目的 探讨颅内肿瘤切除术后颅内感染的危险因素和预防措施。方法 回顾性分析442例颅内肿瘤切除术患者的临床资料。结果 442例颅内肿瘤切除术患者发生颅内感染33例，感染率为7．47％。非脑膜瘤手术颅内感染率为10．04％，高于脑膜瘤术后颅内感染率3．83％（P〈0．05）；手术时间≥4h者颅内感染率为9．87％，高于手术时间〈4h者颅内感染率4．78％（P〈0．05）；有脑脊液漏者颅内感染率为15．00％，高于无脑脊液漏者颅内感染率6．28％（P〈0．05）；引流管留置≥24h者颅内感染率为11．58％，高于未留置或留置〈24h者颅内感染率5．03％（P〈0．05）。结论 手术时间≥4h、引流管留置时间≥24h、存在脑脊液漏是颅内肿瘤切除术后发生颅内感染的危险因素。     

腹腔镜胆囊切除术并发症的预防和治疗

目的 探讨腹腔镜胆囊切除术(LC)常见并发症的发生原因及预防措施.方法 回顾性分析本院1998至2007年完成的1126例腹腔镜胆囊切除术患者的临床资料,将患者分为实验组以及对照组,在实验组患者手术过程中采取一系列针对性的措施预防并发症的发生.而对照组采用传统的手术方式及围术期护理.将两组的并发症发生率进行比较.结果 实验组并发症发生率为1.62%,明显低于对照组的3.86%,两组比较,具有统计学意义.结论 腹腔镜胆囊切除术是胆囊切除的最佳选择,但仍存在较严重的并发症,遵循正规的手术原则,及时中转开腹,才能减少并发症,保证手术质量.     

4132名少年儿童血压状况调查分析

目的了解7～14岁少年儿童血压特点,为流行病学及预防成人高血压提供参考数据。方法用统一标准采集血压及有关数据,用概率单位法行正态性检验,确定血压95%参考值范围,对年龄与血压和体质指数进行相关性分析,行U检验、t检验。结果随年龄增大血压也逐渐上升,各年龄段男女之间血压差异无统计学意义。体质指数随年龄增大而增加。血压偏高者其体质指数高于同年龄段中值水平。结论年龄与血压和体质指数呈正相关。血压偏高者体质指数都具有较高中值水平。     

Statistical analysis of pathologic risk factors for intramyometrial lymphvascular space involvement in myoinvasive endometrial carcinoma

In a retrospective study using univariate analysis, we identified tumor type (nonendometrioid vs endometrioid), depth of myoinvasion (MI), mode of MI (infiltrative vs cohesive), and direct anatomic invasion of the cervical wall from the isthmus as significant positive risk factors for intramyometrial lymphvascular space involvement (LVSI). On multivariate analysis, tumor grade, depth of MI, and mode of MI retained their significance. We created a grid for the relative risks of LVSI with respect to these variables individually or in combination. We suggest that our indirect estimate of the risk of LVSI can help in assessing prognosis and determining the need for adjuvant therapy whenever LVSI is important in clinical decision making, but its pathologic diagnosis is uncertain.