Pre-vaccination vulnerability and suspected adverse events following HPV vaccination. A case-control study nested in the Danish national birth cohort

Previous studies have indicated that girls experiencing suspected adverse events (AE) following HPV vaccination were more vulnerable prior to vaccination. However, no study has previously investigated differences in vulnerability using prospectively collected self-reported measures of vulnerability. The objective of this study therefore was to describe the distribution of biological and psychosocial indicators of vulnerability in girls referred to a hospital setting due to suspected adverse events and compare it with a sample of non-referred HPV vaccinated girls.The study was conducted as a case control study based within the Danish National Birth Cohort. Cases were defined as HPV vaccinated girls referred to a hospital setting between 2015 and 2017 due to suspected adverse events (n = 80), and 5 controls were randomly selected from the remaining source population, matched to cases on age at vaccination, region of residence and year of vaccination. The final study population consisted of 480 girls. Prior exposures were based on information gathered from an 11 year follow up of the DNBC and included information on self-rated health, frequent health complaints, medication use, bullying, stressful life events and physical activity. Conditional logistic regression analysis was used to estimate the association between each exposure and referral.The percentage of individuals in the exposed category of each exposure was generally higher for cases than controls. Particularly, the odds of being referred were higher for those with low self-rated health compared to high (OR [95%-CI] 2.43 [1.07–5.5]1), those being bullied (OR 3.19 [1.17–8.73]), and those who had taken medication (OR 2.22 [1.32–3.67]).Overall, these results indicated that girls experiencing suspected AE following HPV vaccination were more vulnerable prior to vaccination.     

前列腺增生患者前列腺电切术后发生尿频的影响因素分析

目的 分析前列腺增生(BPH)患者前列腺电切术(TURP)术后发生尿频的影响因素.方法 选择2017年5月至2020年10月我院收治的80例BPH患者作为研究对象,收集患者的临床资料并分析TURP术后发生尿频的影响因素.结果 80例BPH患者TURP术后尿频发生率为10.00％.单因素和Logistic回归分析结果显示...     

呼出气一氧化氮测定在COPD频繁急性加重表型患者中的临床意义

目的 探讨中央和外周气道呼出气一氧化氮(FeNO)在慢性阻塞性肺病(COPD)频繁急性加重表型患者中的临床意义。方法 收集2019年1月至2021年6月安徽医科大学第四附属医院呼吸与危重症医学科收治的90例COPD患者作为研究对象,在一年内因急性加重次数≥2次的患者纳入频繁急性加重组(n=23),急性加重次数≤1次的患者纳入非频繁急性加重组(n=67)。测定两组中央气道一氧化氮(FeNO₅₀)浓度和外周气道呼出气一氧化氮(FeNO₂₀₀)浓度、肺泡气一氧化氮(CaNO)浓度并收集白细胞计数、血嗜酸粒细胞百分比、血清总免疫球蛋白E(IgE)、慢性阻塞性肺疾病评估测试(CAT)评分及肺功能等相关指标,对进行对比分析。结果 COPD频繁急性加重组FeNO₂₀₀、CaNO、C反应蛋白(CRP)、血清总IgE、CAT评分均高于非频繁急性加重组,第一秒用力呼气容积占预计值百分比(FEV1%)低于非频繁急性加重组(P＜0.05)。在COPD急性加重患者中,FeNO₂₀₀、CaNO与FEV1%呈负相关(r=-0.305、-0.439,P＜0.05),与血清总IgE呈正相关(r=0.523、0.514,P＜0.05),其中CaNO还与CRP呈正相关(r=0.321,P=0.023)。结论 COPD频繁急性加重表型患者中央和外周FeNO浓度存在差异,FeNO₂₀₀、CaNO均可作为COPD患者外周小气道炎症指标。     

基于隐结构模型和频繁项集的针刺治疗慢性前列腺炎辨证取穴规律

目的：探讨针刺治疗慢性前列腺炎的辨证取穴规律,为临床治疗慢性前列腺炎提供帮助。方法：检索国家知识基础设施数据库（CNKI）、中文科技期刊数据库（CCD）等数据库中关于针刺辨证论治慢性前列腺炎的文献,构建包含症状、证型、穴位处方的慢性前列腺炎病历数据库,运用隐结构模型分析、频繁项集等方法,分析针刺治疗慢性前列腺炎的辨证取穴规律。结果：共纳入文献64篇,涉及穴位91个,症状248项。高频穴位如三阴交、中极等;高频症状包括舌体瘀点瘀斑、苔黄腻、滴白、尿急等;构建隐结构模型,得出慢性前列腺炎主要证型有湿热下注、肾阳不足等;挖掘出症状-穴位频繁项集、症状-证型-穴位频繁项集各4项。症状-穴位频繁项集如“尿急+滴白+阳痿+早泄+肾俞+足三里”,症状-证型-穴位频繁项集如“尿频+尿急+苔黄腻+滴白+舌体瘀点瘀斑+湿热瘀阻+三阴交+会阴”,提示治疗时可根据相应症状判定证型及选择对应穴位。结论：针刺治疗慢性前列腺炎多以三阴交、中极、关元等为主要穴位,穴位配伍依据临床情况辨证选穴,此可为临床治疗慢性前列腺炎提供参考。     

全局频繁闭项目集挖掘算法研究

频繁闭项目集挖掘是数据挖掘研究中的一个重要研究课题.目前已有的频繁闭项目集挖掘算法主要针对单机环境,有关分布式环境下的全局频繁闭项目集挖掘算法的研究尚不多见.为此,本文提出了一种快速挖掘全局频繁闭项目集算法,并对其更新问题进行了研究;提出了一种相应的频繁闭项目集增量式更新算法,该算法将充分利用先前的挖掘结果来节省发现新的全局频繁闭项目集的时间开销.实验结果表明算法是有效的.     

Levamisole in steroid-sensitive nephrotic syndrome of childhood: the lost paradise?

Among the different drugs used for sparing steroids in steroid-sensitive nephrotic syndrome (SSNS) with frequent relapses and steroid dependency, levamisole is the least toxic and the least expensive. However, it is neither approved for this indication nor widely used in Europe. This may be explained by the difficulty in obtaining levamisole in some countries and the lack of good quality evidence for its effectiveness. Evidence is limited to three clinical trials that all suffered from methodological limitations. Statistical synthesis of these trials showed that levamisole reduces the risk of a relapse during treatment (relative risk 0.60, 95% confidence interval 0.45–0.79). From the available information, no conclusions can be drawn on the steroid-sparing effect, the long-term efficacy, and safety, as well as possible differences in efficacy in different subgroups of SSNS patients. The confirmation of a favorable effect of levamisole on the reduction of the frequency of relapses and on sparing steroids in an adequately powered, double-blind, placebo-controlled, randomized, multi-center clinical trial will promote consensus on the place of levamisole in the treatment of SSNS of childhood. Follow-up should be at least 1 year to evaluate long-term efficacy and side effects. If the results of such a clinical trial confirm the beneficial effects of levamisole in nephrotic syndrome, this may allow registration for this indication and interest companies other than Jansen-Cilag, which only recently has decided to stop its production.     

灵通胶囊治疗头痛的临床研究

目的:观察灵通胶囊对无先兆偏头痛(Migraine without aura)和高频发作性紧张型头痛(Fre-quent episodic tension-type headache,FETTH)的即时止痛疗效。方法:头痛患者共95例随机分配到灵通组和元胡组(对照组)。其中无先兆偏头痛入灵通组25例服药51例次,入元胡组28例服药53例次;FETTH入灵通组25例服药39例次,入元胡组17例服药27例次。分别于疼痛时即时服用灵通胶囊2粒和元胡止痛颗粒2包。将疼痛程度分级量化,由患者记录服药前和服药后2小时内每30分钟时的疼痛程度。以服药后2小时疼痛减轻程度≥50%作为有效。结果:无先兆偏头痛有效率在灵通组为68.6%,在元胡组为32.1%(P<0.001);FETTH有效率在灵通组为76.9%,在元胡组为59.3%(P>0.05);两种头痛的综合有效率在灵通组为72.2%,在元胡组为41.3%(P<0.001)。灵通组在服药30分钟后各时点的疼痛评分显著低于元胡组(P<0.001)。结论:灵通胶囊对两种头痛有明显的即时止痛疗效。     

交通频繁肇事驾驶员心理健康状况及其与生活事件、人格的关系

目的 明确频繁肇事驾驶员的心理健康状况及其与生活事件、人格的关系.方法 采取分层整群抽样抽取870名机动车驾驶员,并从中选出620名符合研究条件的驾驶员,采用自制一般情况调查表、生活事件量表、90项症状自评量表及艾森克人格问卷对其进行测试评估.结果 (1)频繁肇事驾驶员在SCL-90的总分及各因子分明显高于非肇事驾驶员[分别为(65.17±39.68)分,(18.65±13.85)分,(9.24±5.44)分,(3.48±2.84)分,(6.96±4.81)分,(1.83±2.11)分,(10.19±7.19)分,(2.53±2.74)分,(7.00±4.96)分,(1.48±1.77)分,(4.68±3.66)分,(1.24±1.48)分,(3.51±3.58)分,(0.62±1.29)分,(3.84±3.36)分,(1.00±1.33)分,(5.34±4.17)分,(1.27±1.72)分,(8.93±6.54)分,(2.96±2.97)分,(6.08±4.81)分,(2.11±2.18)分],均差异具有显著性(P＜0.01);(2)相关分析显示频繁肇事驾驶员SCL-90总分与生活事件量表中各因子及艾森克人格问卷中除掩饰性外的各因子均呈有统计学意义的正相关(r=0.146～0.393,P＜0.05);(3)回归分析显示生活事件和人格各因子对SCL-90总分及各因子影响不同,负性生活事件对频繁肇事驾驶员SCL-90总分最具预测性.结论 频繁肇事驾驶员存在较多心理问题,生活事件和人格中的情绪和精神质因子是影响其心理健康的重要因素.     

Characteristics of frequent attenders in different age and sex groups in primary health care

Objective. To explore depression from a gender perspective, by capturing depressed women's and men's formulations of their experiences and understanding of their situation. Design. Qualitative interview study. Setting. A healthcare centre in northern Sweden. Subjects. Eighteen patients who had been diagnosed with depression and treated for at least 6 months were interviewed in depth, both women and men of different ages and social status. Open questions were posed around the themes of Malterud's key questions, focusing especially on how the informants conveyed their experiences. Interviewing and qualitative data analysis went on simultaneously. Results. The experience of depression held similarities for men and women, but the outward manifestations differed by gender as well as socioeconomic status. Though experiences of high demands underlay the narratives of all informants, home or work had different priority. Men talked more easily about physical distress – often the heart – than about emotions. Women verbalized more readily emotional distress – shame and guilt – while physical symptoms often revolved around the stomach. Men dealt with insecurity by aggrandizing their previous competence, women by self-effacement. Conclusion. As clinicians we must listen attentively not only to the manifest but to the avoided or unarticulated. By doing so we might counteract normative gender patterns that highlight the depression of women and conceal that of men.     

Carto系统与常规方法指导消融频发右室流出道室性早搏的比较

目的通过对应用Carto电解剖标测系统(Carto系统)与常规方法指导射频消融治疗频发右室流出道室性早搏(RVOT-PVCs)的比较,评价其临床应用。方法 68例频发RVOT-PVCs患者,其中Carto组36例,运用Carto系统重建右室流出道三维电解剖图后行电解剖标测靶点并予冷盐水灌注电极进行消融;另32例在X线下常规标测和消融,为常规组。比较两组的手术时间、靶点标测时间、X线曝光时间、总放电次数及有效放电率、消融成功率、并发症和随访复发结果。结果手术时间、即时成功率两组无差别(P0.05)。与常规组相比,Carto组靶点标测时间明显缩短(50.8±10.2minvs71.9±20.9min),X线曝光时间缩短(15.5±3.8minvs27.0±7.1min),总放电次数减少(5.8±1.2次vs9.4±1.8次),有效放电率增高(48.1%±12.2%vs31.5%±7.9%),复发率降低(2.8%vs9.4%),P均0.05。两组均无并发症。结论两种标测方法消融频发RVOT-PVCs均有效,安全。但Carto系统对复杂的多源多形早搏有明显的优势。