无创心输出量监测在暴发性心肌炎患儿中的应用

目的 探讨无创心输出量监测系统(non-invasive cardiac system, NICaS)在暴发性心肌炎(fulminant myocarditis, FM)患儿中的应用价值。方法 纳入FM患儿39例作为试验组,同期住院的肺炎患儿47例作为对照组。2组均行NICaS和经胸超声心动图(transthoracic echocardiography, TTE)检查,监测心脏指数(cardiac index, CI)、△CI、格兰夫-高尔指数(Granov Goor index, GGI)及左心室射血分数(left ventricular ejection fraction, LVEF)等参数,比较试验组患儿NICaS和TTE参数的差异及相关性;试验组随机分为A1组(n=21,参照NICaS制定治疗方案)和A2组(n=18,参照TTE制定治疗方案),比较2组预后。结果 试验组TTE和NICaS测得的CI均小于对照组,试验组NICaS测得的CI小于TTE,差异有统计学意义(P<0.05)。Pearson相关性分析显示,试验组和对照组NICaS与TTE测得的CI呈显著正相关(r=...     

羧酸酯酶1和羧酸酯酶2基因表达量与体质量指数的关系及其基因多态性分析

目的 通过检测健康志愿者的羧酸酯酶1 (carboxylesterase 1,CES1)和羧酸酯酶2 (carboxylesterase 2,CES2)的基因多态性和基因表达水平,探索CES1和CES2在代谢中的作用。方法 从48例健康志愿者获得血样并提取DNA,对DNA进行二代基因测序,并提取总RNA检测基因表达量。使用多元线性回归分析CES1和CES2基因表达量与性别、年龄、体质量指数(body mass index, BMI)的关系。结果 CES1的基因表达量为141.8(72.7,237.8),CES2的基因表达量为74.4(30.8,133.6)。多元线性回归分析中,BMI与CES2的基因表达有关,性别、年龄和BMI与CES1的基因表达无关。发现CES1 20个基因变异,其中10个会引起氨基酸序列改变;发现CES2 6个基因变异,其中2个引起氨基酸序列改变。结论 发现CES2的表达水平与BMI相关,CES1的表达水平与BMI无明显相关,基因预测结果提示CES1的遗传变异可能影响其功能表达。     

我国中央层面家庭医生签约服务政策量化评价：基于PMC指数模型

背景 我国人口老龄化形势日益严重,家庭医生签约服务对助推分级诊疗制度建设、建立合理有序就医秩序发挥着重要作用,目前学者对家庭医生签约服务政策的研究主要集中于定性评价,较少有学者利用工具聚焦代表性政策对各篇进行定量评价。目的 定量评价我国中央层面的6篇家庭医生签约服务相关政策,分析政策优劣,在此基础上,提出促进我国家庭医生签约服务高质量发展的对策和措施,助力健康中国战略实施。方法 于2022-04-30,以“家庭医生”为关键词在北大法宝数据库进行全文检索,并在国务院网站进行相关内容检索,检索时限为2015-01-01至今。采用ROSTCM 6.0软件进行文本挖掘,然后以其结果为依据选择其中具有代表性的中央层面家庭医生签约服务相关政策,并基于政策一致性评价（PMC）指数模型对其进行量化评价。结果 依据纳入与排除标准检索获得相关政策32篇,家庭医生签约服务领域排名前5位的高频关键词为“签约服务”（274次）、“健康”（272次）、“医疗”（264次）、“家庭医生”（225次）、“签约”（180次）,以其为依据共选择中央层面有代表性的家庭医生签约服务相关政策6篇,分别标记为P1～P6。政策量化...     

低频脉冲电刺激联合摄食-吞咽训练在AIS后吞咽障碍的应用及疗效

探讨低频脉冲电刺激联合摄食-吞咽训练在急性缺血性脑卒中（AIS）后吞咽障碍的应用及对呼吸能力、吞咽功能、营养指标的影响。方法 选取本院2019年6月—2021年8月107例AIS后吞咽功能障碍患者,随机分为观察组（n=54）和对照组（n=53）,对照组给予摄食-吞咽训练,观察组在对照组的基础上使用低频脉冲电刺激治疗,两组均持续治疗1个月,比较两组治疗前后吞咽功能、舌骨喉复合体动度、喉镜吞咽功能(FEES)评估结果、呼吸功能、营养指标以及并发症发生情况。结果 观察组治疗后洼田饮水试验评定、标准吞咽功能评价量表（SSA）评分、吞咽功能初筛量表（EAT-10）评分低于对照组（P＜0.05）;观察组治疗后舌骨喉复合体动度包括舌骨向前、上移以及喉向前、喉上移最大幅度均大于对照组（P＜0.05）;观察组治疗后FEES评价中声带麻痹、食物渗漏、食物潴留、误吸比例低于对照组（P＜0.05）;观察组治疗后肺功能指标最长呼气时间、第一秒用力呼气容积（FEV1）、用力肺活量（FVC）以及最大吸气压（PImax）均大于对照组（P＜0.05）;观察组治疗后营养指标BMI指数、血清总蛋白（TP）、白蛋白（ALB）、转铁蛋白（TRF）、前白蛋白（PALB）水平均高于对照组（P＜0.05）;观察组吸入性肺炎发生率低于对照组,营养不良发生率为低于对照组（均P＜0.05）。结论 低频脉冲电刺激联合摄食-吞咽训练治疗AIS后吞咽障碍,可有效促进吞咽功能恢复,改善舌骨喉复合体动度,增强呼吸功能,提高营养状态,降低并发症发生风险     

阻塞性睡眠呼吸暂停与甘油三酯葡萄糖指数的相关性

目的 探讨阻塞性睡眠呼吸暂停（OSA）与甘油三酯葡萄糖（TyG）指数的相关性。方法 选取2021年1月—2022年12月中南大学湘雅二医院行睡眠呼吸监测的270例OSA患者。根据甘油三酯和空腹血糖计算TyG指数,根据TyG指数的三分位数将患者分为Q1组、Q2组、Q3组,根据睡眠呼吸暂停低通气指数（AHI）将患者分为轻度组、中度组、重度组。采用多元线性分析评估TyG指数与AHI之间的关系,有序Logistic回归分析TyG指数与OSA严重程度之间的关系。结果 TyG指数越高的患者AHI、体质量指数（BMI）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖越高,而血清高密度脂蛋白胆固醇（HDL-C）水平则越低（P <0.05）。TyG指数越高的患者肥胖和糖尿病、冠心病比例越高,男性比例越高,年龄更低（P <0.05）。随着患者AHI的增加,TyG指数、BMI增加,TG、空腹血糖上升,最低血氧饱和度下降（P <0.05）,OSA越严重的患者肥胖、高血压和冠心病比例越高（P <0.05）。Pearson相关性分析结果显示,TyG指数与AHI水平呈正相关（r =0.282,P <0.05）。多元线性回归分析结果显示,AHI（b =0.002）、BMI（b =0.017）、TG（b =0.361）、空腹血糖（b =0.109）和性别（b =0.083）是TyG的影响因素（P <0.05）。有序Logistic模型结果显示：轻度OSA［O^R=0.396（95% CI：0.207,0.757）］和中度OSA［O^R=0.281（95% CI：0.163,0.484）］患者的TyG等级较重度OSA低,说明OSA严重程度增加是TyG指数升高的影响因素。非肥胖患者［O^R=0.424（95% CI：0.253,0.710）］、不吸烟患者［O^R=0.506（95% CI：0.283,0.904）］、非糖尿病患者［O^R=0.268（95% CI：0.156,0.460）］、非冠心病患者［O^R=0.452（95% CI：0.253,0.807）］、女性［O^R=0.409（95% CI：0.221,0.760）］的TyG等级较低,故吸烟、肥胖、糖尿病、冠心病、男性是TyG指数升高的影响因素（P <0.05）。结论 TyG指数与OSA严重程度相关,可以考虑将TyG指数用于OSA患者胰岛素抵抗的观察,从而进行干预,使患者获益。     

AN ARTERIAL PERFORMANCE INDEX

INTRODUCTIONWhenpulsatingbloodflowsthroughtheartery,thearterialwallwilldilateandcontractperiodicallybecauseoftheelasticityofarterialwallandtheperipheralresistance'Thisensuresthecontinuityofbloodflowandthelocalbloodpressurenotchangingtoomuch.Ifthearterialwallispathologicallychanged,causingthechangeoftheelasticityofarterialwall,theperformanceofarterywillbeaffected'Atpresent,thecomplianceiswidelyusedtoevaluatethedistensibilityofarterialwass[1],butitcannotevaluatethetotalperformanceofartery'T…     

Studies on the Level of Natural Antibodies Reactive with Various Tumor Cells during Urethane Carcinogenesis in BALB/c Mice

Serum from young normal BALB/c mice was found to contain IgM antibodies able tomediate complement-dependent lysis of certain syngeneic or allogeneic tumor target cells. The titer of such naturally occurring antitumor antibodies (NATA) was found to increase with aging.A longitudinal serological study comparing the cytotoxicity potential of NATA fromnormal and from urethan-treated BALB/c mice was performed. It was found that urethan-treated mice that did not develop primary lung-adenomas within the duration of the experi-ment had significantly lower NATA titers, against one out of 4 target cells assayed, than urethan-treated animals that developed lung adenomas. This difference was evident in two independent experiments. The results suggested that the lower NATA activity of the urethan-treated mice that did not develop tumors existed even before exposure to the carcinogenic insult. This raises the possibility that certain populations could be segregated according to their natural antibody profile into those individuals which will develop primary tumors within a certain period if exposed to a subthreshold amount of carcinogen, and those which will not.     

Effect of nociceptive stimulation on mitotic activity of epithelial cells in skin surrounding a wound at different age periods

Wounds 1 cm long, down to the cutaneous muscle, were inflicted on rats aged 11 days, 2 months, and 2.5 months in the subscapular region. Nociceptive stimulation was applied to the animals by means of an electric current 48 h after the operation. Mitotic activity was determined in cells of the stratum basale of the skin epithelium adjacent to the wound. Nociceptive stimulation was found to reduce the mitotic index of the cutaneous epithelial cells of the animals of all age groups studied by a considerable degree (by several times). An increase in the mitotic index was observed from the early to the later stages of postnatal ontogeny.Laboratory of Age and Evolutionary Physiology, Voroshilovgrad Pedagogic Institute. Laboratory of Growth and Development, Institute of Human Morphology, Academy of Medical Sciences of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR A. P. Avtsyn.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 84, No. 11, pp. 605–606, November, 1977.     

Serological studies of monoclonal RH1(D) antibodies with RH1(D) variants

In this paper we chose to emphasize three aspects of our work. First we underlined that “low grade and high grade” D weak red blood cells studied at the DNA level could, when monoclonal antibodies were used, give patterns of positive and negative reactions like partial RH1(D) cells. Secondly, we showed the importance of the technical conditions of the study which are essential for establishing a pattern of reactivity defining an epitope. It appears that the use of papain treated cells at room temperature can be misleading for the definition of epitope especially with IgM antibodies. Lastly we pointed out the interest of Rh variant cells, defined at the gene level, to study the expression of RH1(D) epitopes on the external part of the membrane.     

A comparison of three bioelectrical impedance analyses for predicting lean body mass in a population with a large difference in muscularity

This study tested the hypothesis that, as compared to whole-body bioelectrical impedance (BI) analysis, segmental BI analysis can estimate lean body mass (LBM) more accurately in a population with a large difference in muscularity. In addition to whole-body BI, which determines impedance (Z) between the wrist and ankle, two segmental BI analyses which determine the Z value of every body segment in each of (1) the arms, legs and trunk (distal BI) and (2) the upper arms, upper legs and trunk (proximal BI) were applied to a group of 125 male athletes and 75 non-athletes. The subjects were divided into validation and cross-validation groups. Simple and multiple regression analyses were applied to (length)²/Z (BI index) values for the whole-body and each body segment, to develop the prediction equations of LBM measured using air-displacement plethysmography. In the validation group, the SE of estimation was similar in the whole-body (3.4 kg, 5.4%), distal (3.4 kg, 5.5%) and proximal BI (3.3 kg, 5.2%) analyses. However, the whole-body and distal BI analyses produced systematical errors in the estimates of LBM. Moreover, the residuals in the two methods significantly (P<0.05) correlated with the ratios of BI indices of the upper arms and upper legs to those of the arms and legs, respectively, calculated as variables approximating the relative development of lean tissues at the proximal area of limbs. On the other hand, the proximal BI analysis was validated and cross-validated. Thus, the accuracy of estimating LBM was similar in the whole-body and the two segmental BI analyses. However, the prediction equations derived from the use of the whole-body BI index and a combination of the arms, legs and trunk BI indices produced a systematical error relating to the difference between the limb segments in lean tissue development.