外环境中布雷图指数和诱蚊诱卵器指数的差异研究

目的 对外环境布雷图指数法和诱蚊诱卵器法的平行对照研究,比较布雷图指数和诱蚊诱卵器指数的差异,以便明确自然积水对诱蚊诱卵器法监测的影响,为蚊虫及蚊媒传染病防控提供科学依据。方法 2020年5—10月期间每月中旬在上海市静安区各街道（镇）居民区外环境中采用布雷图指数法和诱蚊诱卵器法开展相同区域内的平行对照研究,比较不同监测环境中两监测方法的差异。结果 不同月份中,诱蚊诱卵器指数最高为8月6.86,其次为7月6.74;布雷图指数最高为8月16.24,其次为7月14.56。两监测方法在时间趋势上高度相关（r=0.965,P<0.05）,诱蚊诱卵器指数各月均低于布雷图指数,指数月间分布趋于平缓。诱蚊诱卵器指数老旧公房为5.73,商品房为4.91,差异有统计学意义（Z=12.530,P<0.05）;布雷图指数老旧公房为13.58,商品房为7.14,差异有统计学意义（Z=-4.013,P<0.05）。老旧公房布雷图指数和诱蚊诱卵器指数均高于商品房,老旧公房的布雷图指数为13.58,高于同一地区的诱蚊诱卵器指数5.73,差异有统计学意义（Z=-3.608,P<0.05）。两类型居民区积水构成相近,两类型居民区最多的积水种类依次为盆景、水生植物、闲置容器和储水容器,数量上老旧公房自然积水平均66.43处/居民区,商品房平均49.27处/居民区,随自然积水数量增加,布雷图指数上升。结论 布雷图指数和诱蚊诱卵器指数有较高的一致性,诱蚊诱卵器指数相较于布雷图指数更趋于平缓,不同类型居民区中环境积水数是影响诱蚊诱卵器指数的主要因素,在自然积水较多的环境中,布雷图指数法相较于诱蚊诱卵器指数敏感性更高。     

Negative affective stress reactivity: The dampening effect of snacking

The present study sets out to further elucidate the complex relationship between daily hassles, snacking, and negative affect (NA). The aim of the present study was to examine whether or not moment‐to‐moment energy intake from snacks moderates the association between momentary stress and NA. And, if so, can this moderating effect be replicated by using the amount of macronutrient intake (i.e., carbohydrates, fat, and protein) as moderator on the association between momentary stress and NA? Adults (N = 269), aged 20–50 years, participated in this study. Stress, NA, and snack intake were assessed 10 times a day for 7 consecutive days in daily life with an experience sampling smartphone application. Multilevel regression analyses were performed to assess the hypothesized associations. Our study revealed a dampening effect of snacking on negative affective stress reactivity. However, this dampening effect could not be replicated by the amount of macronutrient intake from snacks. On the contrary, the amount of carbohydrates has an enhancing effect on negative affective stress reactivity. In the end, our study suggests that the critical question is which mechanisms are decisive in the dampening role of snacking on stress reactivity. A multidisciplinary approach may provide a full perspective.     

计算机辅助测量青少年特发性脊柱侧凸脊柱长度的方法及可行性分析

目的 :提出一种新的计算机辅助测量青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)脊柱长度的方法,评价其准确性和可重复性。方法:在前后站立位脊柱全长正位X线片上选取每个椎体的四个顶点,基于Matlab 6.5软件,设定程序确定L4下终板至T1上终板的中线,将中线上点的距离和作为脊柱长度。由1名医师采用计算机辅助测量方法和2名医师采用手工测量方法,随机选取5例AIS患者并对每例患者进行5次重复测量,计算两种方法测量结果的均值和标准差,评价计算机辅助测量脊柱长度方法的准确性和可重复性。选取45例AIS患者,其中女38例,男7例,年龄10～16岁(13.5±1.5岁);Cobb角10°～45°(32.5°±8.7°)。由同一骨科医师在前后站立位脊柱全长正位X线片上分别采用手工测量方法和计算机辅助测量方法获得T1～L4脊柱长度,计算均值和标准差,比较两种测量方法的结果是否存在差异。应用计算机辅助测量方法测量计算出45例AIS患者L4～T1的脊柱长度,对同一医师应用该测量方法间隔4周的两次测量结果做比较,分析同一观察者在不同时间的可重复性;对3名不同医师分别应用该测量方法的测量结果做比较,分析该方法不同观察者间的可重复性。结果:应用计算机辅助测量方法测量5例AIS患者的脊柱长度(±s)分别为325.8±0.46mm、391.3±0.43mm、476.7±0.04mm、441.3±0.79mm和432.8±0.50mm,2名医师应用手工测量方法测量5例AIS患者的脊柱长度分别为325.7±8.3mm、390.9±7.6mm、476.7±6.0mm、441.5±8.2mm、433.1±6.0mm和326.2±5.9mm、391.4±7.5mm、476.1±5.8mm、441.6±8.2mm、432.9±5.8mm,应用计算机辅助测量方法多次测量脊柱长度测得结果的标准差较手工测量结果低得多。采用计算机辅助测量方法与手工测量方法测量45例AIS患者的脊柱长度(±s)分别为404.7±43.2mm和405.1±45.5mm,两组均数比较差异无显著性(P0.05),采用计算机辅助测量方法测量AIS脊柱长度的同一观察者间隔4周的组内相关系数为0.995(P0.05),不同观察者间的组内相关系数为0.942(P0.05)。结论:计算机辅助测量AIS患者脊柱长度的方法较传统的手工测量方法操作简单,并且其准确性和可重复性均较好。     

中药干预对急性心肌梗死远期预后影响的回顾性研究

目的回顾性分析早期使用中药对首次急性心肌梗死(AMI)患者远期预后的影响。方法以1996年1月~2002年4月因AMI在北京中医药大学附属东直门医院、东方医院心内科住院并渡过急性期(28d)且资料完整的所有患者(共162例)为研究对象;随访患者发生联合终点事件(死亡和重大心脑血管事件)的情况;单因素分析采用Kaplan-Meier法描绘生存曲线,用log-rank法进行比较检验,多因素分析采用Cox回归分析。结果单因素分析显示使用中药汤剂患者无事件生存率高于未使用者(P<0.01);多因素分析显示年龄、前壁梗死、心功能减低、心律失常和糖尿病史与联合终点事件的风险呈正相关,而使用血管紧张素转化酶抑制剂(ACEI)和中药汤剂呈负相关,其中中药汤剂的相对危险度RR为0.093(95%CI=0.029~0.294,P<0.001)。结论年龄、心力衰竭、前壁梗死、梗死后心律失常、糖尿病史是AMI远期预后的危险因素,而早期应用中药汤剂和ACEI制剂是AMI远期预后的保护因素,初步从回顾性研究的角度为中医药治疗AMI提供了基于循证医学的证据。     

Human Temporal Bone Removal: The Skull Base Block Method

Objectives To describe a technique for harvesting larger temporal bone specimens from human cadavers for the training of otolaryngology residents and fellows on the various approaches to the lateral and posterolateral skull base. Design Human cadaveric anatomical study. The calvarium was excised 6 cm above the superior aspect of the ear canal. The brain and cerebellum were carefully removed, and the cranial nerves were cut sharply. Two bony cuts were performed, one in the midsagittal plane and the other in the coronal plane at the level of the optic foramen. Setting Medical school anatomy laboratory. Participants Human cadavers. Main Outcome Measures Anatomical contents of specimens and technical effort required. Results Larger temporal bone specimens containing portions of the parietal, occipital, and sphenoidal bones were consistently obtained using this technique of two bone cuts. All specimens were inspected and contained pertinent surface and skull base landmarks. Conclusions The skull base block method allows for larger temporal bone specimens using a two bone cut technique that is efficient and reproducible. These specimens have the necessary anatomical bony landmarks for studying the complexity, utility, and limitations of lateral and posterolateral approaches to the skull base, important for the education of otolaryngology residents and fellows.     

Percutaneous epiphysiodesis using transphyseal screws for limb-length discrepancies: high variability among growth predictor models

Purpose

Percutaneous epiphysiodesis using transphyseal screws (PETS) was developed as a minimally invasive outpatient procedure to address limb-length discrepancy (LLD) that allowed immediate postoperative weight bearing and was potentially reversible by removing the screws. The aims of our study were to report our results using PETS for LLD and evaluate the accuracy of three growth predictor models.

Methods

Sixteen patients with an average age of 14 years were treated for LLD using PETS. Thirteen patients had screws inserted in a parallel fashion and 3 had crossed screws. We compared the predicted LLD at skeletal maturity using the three growth predictor methods with the actual LLD at skeletal maturity and preoperative LLD with the final LLD at skeletal maturity.

Results

The mean LLD at skeletal maturity between the predicted and final measurements was 0.2 cm using the Green−Anderson method, 1.4 cm using the Moseley method, and −0.1 cm using the Paley method. The mean preoperative LLD of 3.1 cm was corrected to 1.7 cm at skeletal maturity (p < 0.001). Six patients complained of pain over the screw heads; however, no patient developed an infection or angular deformity.

Conclusions

The three growth predictor methods predicted the final LLD within an average of 1.4 cm, but there was high variability. Although PETS improved the LLD by a mean of 1.4 cm, we believe the results would have been better if PETS was performed at an earlier skeletal age.     

Mechanisms and biomarkers of immune quiescence in kidney transplantation

This review discusses the current understanding of biomarkers of immune quiescence based on reviews of published literature in kidney transplant operational tolerance and mechanistic studies based on a better characterization of the stable, well-functioning renal allograft.     

Characterizing alleles with large deletions using region specific extraction

Two novel HLA class II alleles, DRB4*03:01N and DQB1*03:276N, containing large deletions were identified during routine typing. Extraction of DNA encompassing the deletions was carried out with a panel of capture oligonucleotides followed by whole genome amplification. Next generation DNA sequencing was then used to characterize the sequences. DRB4*03:01N has a 16 kilobase pair deletion stretching upstream from intron 2 toward centromeric DRB8. DQB1*03:276N has two deletions separated by 844 nucleotides. The first deletion (3.7 kilobase pairs) is upstream of intron 1 and the second deletion removes 3.3 kilobase pairs further upstream towards centromeric DQA2.