止血药对膀胱肿瘤患者术后凝血状态的影响

目的 探讨止血药对膀胱肿瘤患者术后凝血状态的影响.方法 选择进行住院治疗的膀胱肿瘤患者82例,按随机数字表法分为观察组和对照组,每组41例.观察组患者应用止血药,对照组患者不使用止血药.比较两组患者术后的凝血状态.结果 两组患者术前凝血指标比较差异无统计学意义(P＞0.05)；与术前比较,观察组和对照组患者术后1、2d的APTT和PT延长,PAI-1、t-PA、D-D显著增高,PLT减少,TT缩短,差异均有统计学意义(P＜0.05)；术后1、2d比较,观察组患者的TT短于对照组[(14.36±0.17)s比(15.42±0.18)s和(14.36±0.28)s比(15.29±0.27)s],PAI-1、t-PA、D-D显著高于对照组[(98.19±2.32) μg/L比(82.19±2.38)μg/L和(84.52±2.25) μg/L比(72.94±2.26)μg/L,(27.06±1.69) μg/L比(21.63±1.16) μg/L和(27.28±1.37) μg/L比(21.69±1.19) μg/L,(7.06±0.08) μg/L比(1.89±0.28)μg/L和(12.83±1.05) μg/L比(1.96±0.18)μg/L],差异均有统计学意义(P＜0.05),两组PLT、APTT、PT比较差异均无统计学意义(P＞0.05)；观察组患者下肢深静脉血栓形成发生率为7.32％(3/41),对照组为2.44％(1/41),两组比较差异无统计学意义(P＞0.05).结论 应用止血药可以加重膀胱肿瘤患者术后的高凝状态.因此,应慎重应用预防性止血药.     

男性和女性类风湿关节炎临床特点对比研究

目的 对比男性和女性类风湿关节炎(RA)的临床特点,分析二者的差异,指导临床决策.方法 采用回顾性分析方法,对95例男性和248例女性RA患者的临床特点进行对比研究.结果 男性RA患者发病年龄为18～79(51.40±15.55)岁,明显晚于女性RA患者的18～75(43.54±15.46)岁(P=0.0002);男性RA患者晨僵时间[(1.58±1.34)h]明显短于女性RA患者[(2.10±1.51)h](P=0.0357);男性与女性RA患者首发受累关节发生率比较差异有统计学意义(P=0.0170),且膝、跖趾、肩及踝等负重关节男性发生率明显高于女性,而腕关节发生率女性高于男性.男性RA患者继发性干燥综合征发生率13.68%(13/95),明显低于女性RA患者的35.08%(87/248),差异有统计学意义(P=0.0007).男性RA患者抗核抗体(ANA)阳性率[2.11%(2/95)]和IgM值[(1.42±0.75)g/L]较女性RA患者[10.48%(26/248)和(1.69±0.86)g/L]偏低,差异有统计学意义(P<0.05).男性与女性RA患者其他关节X线表现、关节外表现及实验室检查指标比较差异无统计学意义(P>0.05).结论 男性RA患者发病年龄晚,关节症状较女性轻.男性RA更易受累负重关节.男性与女性RA的严重程度基本相似.女性RA患者更易继发干燥综合征.

Abstract：

Objective To compare and analyze the different clinical features between male and female patients with rheumatoid arthritis (RA), by detecting the gender difference to make clinical decisions. Method The clinical features of 95 male RA patients(MRA) were analyzed and compared with those of 248 female RA patients (FRA) by retrospective analysis method. Results The mean onset age of MRA [18-79 (51.40±15.55) years old] was older than that of FRA[18-75(43.54 ±15.46) years old](P=0.0002). The morning stiffness time of MRA [(1.58 ±1.34) h] was shorter than that of FRA [(2.10 ±1.51) h](P = 0.0357). There was statistical difference in the first involved joint between MRA and FRA (P=0.0170), the prevalence of knee,metatarsonphalangeal joint,shoulder and ankle of MRA was higher than those of FRA, ' but conversely the wrist prevalence of FRA was higher than that of MRA.The prevalence of secondary Sj(o)gren syndrome of MRA(13.68%, 13/95) was rather lower than that of FRA(35.08%, 87/248)(P = 0.0007). MRA had lower positive rate of ANA (2.11% ,2/95) and lower value of IgM [(1.42 ±0.75) g/L] than FRA [(10.48% ,26/248), (1.69 ±0.86) g/L] (P < 0.05). There was no statistical difference between MRA and FRA in articular radiographic changes, most extraarticular manifestations and lab results (P >0.05). Conclusions MRA patients have older onset age and milder articular symptom than FRA patients. The disease severity of MRA is similar to that of FRA. Weighted joints are more involved in MRA. FRA is more inclined to have secondary Sj(o)gren syndrome.     

甲状腺功能亢进症伴周期性麻痹患者血睾酮水平的变化及意义

目的 探讨甲状腺功能亢进症伴周期性麻痹(TPP)患者血睾酮(T)水平的变化及意义.方法 选择男性甲状腺功能亢进症患者50例,按是否伴周期性麻痹分为TPP组和单纯甲状腺功能亢进症组(对照组),每组25例,比较两组治疗前后游离甲状腺素(FT4)、游离三碘甲腺原氨酸(FT3)、高敏促甲状腺素(sTSH)、T、促黄体生成素(LH)、促卵泡生成素(FSH).结果 两组治疗前sTSH、LH、FSH比较差异无统计学意义(P＞0.05).TPP组治疗前FT3、FT4低于对照组[(18.04±7.22)pmol/L比(25.06±14.15) pmol/L,(48.68±19.06) pmol/L比(62.23±27.42) pmol/L],T高于对照组[(12.17±2.09) μg/L比(8.62±2.76) μg/L],差异有统计学意义(P＜0.05).TPP组治疗前FT3、FT4、sTSH、T与治疗后比较差异有统计学意义(P＜0.05),治疗前LH、FSH与治疗后比较差异无统计学意义(P＞0.05).对照组治疗前FT3、FT4、sTSH、T与治疗后比较差异有统计学意义(P＜0.05),治疗前LH、FSH与治疗后比较差异无统计学意义(P＞0.05).两组治疗后FT3、FT4、sTSH、LH、FSH比较差异无统计学意义(P＞0.05).TPP组治疗后T高于对照组[(7.25±1.37) μg/L比(6.17±1.35)μg/L],差异有统计学意义(P＜0.05).结论 TPP患者存在血T水平升高,血T水平升高可能为甲状腺功能亢进症患者发生周期性麻痹的原因之一.     

帕金森病患者血尿酸水平及其对认知功能影响的观察

目的 观察帕金森病患者血尿酸水平及与认知功能障碍的关系.方法 观察组帕金森病患者113例,按照认知功能评估分为有无认知功能障碍组.同期体检中心113例健康体检者为对照组.测定血尿酸值,对结果进行分析.结果 观察组与对照组血尿酸水平:男性PD患者尿酸水平为(301.0±82.8)μmol/L,低于男性对照组(341.3±103.1)μmol/L,比较差异有统计学意义(P＜0.05),女性PD患者血尿酸水平为(215.9±73.3)μmol/L低于对照组(260.2±71.5)μmol/L,比较差异有统计学意义(P＜0.05).不同性别PD患者尿酸水平:女性PD患者尿酸水平为(215.9±73.3)μmol/L低于男性PD患者水平(301.0±82.8)μmol/L,比较差异有统计学意义(P＜0.05).正常对照组中,男性尿酸水平(341.3±103.1) μmol/L,女性(260.2 ±71.5) μmol/L,比较差异有统计学意义(P＜0.05).不同性别认知功能障碍发病率的比较:男性为53.45％,女性为54.55％,比较差异无统计学意义(P＞0.05).男性PD患者中,有认知功能障碍组的血尿酸水平为(278.3±84.8)μmol/L低于无认知功能障碍组(326.8±73.2)μmol/L,比较差异有统计学意义(P＜0.05),在女性PD患者中,有认知功能障碍组的血尿酸水平为(193.8±59.7) μmol/L低于无认知功能障碍组(289.7±72.9)μ mol/L,比较差异有统计学意义(P＜0.05).结论 帕金森病患者血尿酸水平降低,低尿酸水平可能与帕金森病患者的认知功能障碍有关.     

基质金属蛋白酶3和脂联素在膝关节炎关节滑液中的表达及临床意义

目的 探讨基质金属蛋白酶3(MMP-3)和脂联素在膝关节骨关节炎(OA)病变过程中的作用及临床价值.方法 选择90例膝关节OA患者作为OA组,另选择40例单纯膝关节半月板损伤患者作为对照组.膝关节OA患者按Kellgren-Lawrence (KL)标准分为Ⅰ～Ⅳ级,Ⅰ级21例,Ⅱ级27例,Ⅲ级23例,Ⅳ级19例.采用酶联免疫吸附法检测两组患者关节滑液中MMP-3和脂联素水平并进行比较.结果 OA组关节滑液中MMP-3和脂联素水平分别为(27.57±16.53)、(144.04±48.01) ng/L,均高于对照组的(11.27±3.76)、(86.05±28.52) ng/L,差异有统计学意义(t=6.153、8.638,P＜ 0.05).Ⅰ～Ⅳ级膝关节OA患者关节滑液中MMP-3和脂联素水平与对照组比较均上升,Ⅰ、Ⅱ级MMP-3和脂联素水平与对照组比较差异无统计学意义(P＞0.05);Ⅲ、Ⅳ级MMP-3和脂联素水平与对照组比较差异有统计学意义(P＜0.05);Ⅳ级MMP-3和脂联素水平与Ⅲ级比较差异有统计学意义(P＜0.05).膝关节OA患者关节滑液中MMP-3水平和脂联素水平呈正相关(r=0.506,P＜0.05).结论 MMP-3和脂联素在膝关节OA患者关节滑液中呈高表达,并且与膝关节OA的病变和进展有关.     

神经元特异性烯醇化酶、基质金属蛋白酶-9、腺苷脱氨酶及肿瘤坏死因子-α在结核性脑膜炎诊断中的应用

目的 研究脑脊液中神经元特异性烯醇化酶(NSE)、基质金属蛋白酶-9(MMP-9)、腺苷脱氨酶(ADA)及肿瘤坏死因子-α(TNF-α)水平对结核性脑膜炎(TBM)的临床诊断价值.方法 选取57例临床确诊的TBM患者作为TBM组,选取同期住院的非TBM患者49例(包括病毒性脑膜炎31例,非结核性细菌性脑膜炎18例)作为对照组,比较两组患者的临床表现和入院后24h内及治疗后恢复期脑脊液中NSE、MMP-9、ADA及TNF-α水平.结果 TBM组头痛、发热、脑膜刺激征、意识障碍发生率分别为89.5％(51/57)、93.0％(53/57)、86.0％(49/57)和56.1％(32/57),对照组分别为91.8％(45/49)、95.9％(47/49)、85.7％(42/49)和59.2％(29/49),两组比较差异无统计学意义(P＞0.05).入院后24h内TBM组脑脊液中NSE、MMP-9、ADA及TNF-α水平分别为(17.2±6.3) μg/L、(82.3±14.5) μg/L、(14.5±5.4) U/L和(87.9±16.1) μg/L,均显著高于对照组的(11.7±4.2)μg/L、(42.9±11.3) μg/L、(4.3±2.0) U/L和(79.3±14.6) μg/L,差异有统计学意义(P＜0.05);治疗后恢复期TBM组脑脊液中NSE、MMP-9、ADA及TNF-α水平分别为(6.5±2.1)μg/L、(16.7±4.1) μg/L、(6.1±2.3) U/L和(41.7±12.8) μg/L,对照组分别为(6.3±2.3) μg/L、(12.1±3.2) μg/L、(4.1±2.1)U/L和(32.9±11.3)μg/L,TBM组治疗后恢复期脑脊液中NSE水平与对照组比较差异无统计学意义(P＞0.05),MMP-9、ADA及TNF-α水平仍高于对照组,差异有统计学意义(P＜0.05);两组治疗后恢复期脑脊液中NSE、MMP-9、ADA及TNF-α水平均较入院后24h内显著下降,差异有统计学意义(P＜0.05).TBM组中急性起病者(38例)入院后24h内脑脊液中NSE、MMP-9、ADA水平分别为(19.5±6.7) μg/L、(87.9±16.1) μg/L、(17.2±6.3) U/L,均显著高于亚急性起病者(19例)的(14.9±5.1) μg/L、(76.7±13.5) μg/L、(11.8±5.1) U/L,差异有统计学意义(P＜ 0.05或＜0.01),TNF-α水平比较差异无统计学意义(P＞0.05).结论 脑脊液中NSE、MMP-9、ADA及TNF-α水平可为TBM的早期诊断及鉴别诊断提供依据.     

不同营养支持方式对食管切除术后体液免疫及结局的影响

目的 探讨不同营养支持方式对食管切除术后体液免疫及结局的影响.方法 46例行Ivor-Lewis食管切除术的食管鳞癌患者按抽签随机法分为肠内营养(EN)组和肠内+肠外营养(EN+PN)组,于术前1d、术后第18小时、术后第3、7天检测血清免疫球蛋白IgG、IgA、IgM、IgE、κ和λ轻链、补体C3、C4的含量.比较两组围手术期感染相关性并发症及住院时间.结果 手术前后各时点两组患者血清中IgG、IgA、IgM、IgE、κ和λ轻链、补体C3、C4的含量差异均无统计学意义(均P＞0.05).术后18h、术后第3天EN和EN+ PN组IgG[(8.90±1.75)、(7.53±1.41) g/L和(8.64±2.44)、(7.48±2.16) g/L]、κ轻链[(2.14±0.46)、(1.78±0.41) g/L和(2.15±0.63)、(1.86±0.62) g/L]和λ轻链[(1.34±0.45)、(1.11 ±0.31) g/L和(1.20±0.32)、(1.08±0.35) g/L]的含量均较术前1d[(12.15±2.86)和(11.11±2.96) g/L、(2.90±0.77)和(2.77±0.79) g/L、(1.79±0.57)和(1.56±0.41) g/L]明显降低(P=0.000,P=0.000; P=0.004,P=0.000; P=0.000,P=0.000; P=0.011,P=0.000;P=0.004,P=0.000;P=0.008,P=0.000),除EN组患者中κ轻链术后第7天[(2.42±0.69) g/L]仍明显低于术前[(2.90±0.77) g/L] (P=0.027)外,其他指标均在术后第7天接近术前水平(均P＞0.05);在手术前后各时点,两组患者血清中IgA、IgE和C3的含量差异均无统计学意义(均P＞0.05);EN组患者血清中IgM的含量手术前后各时点差异无统计学意义(P＞0.05),EN+ PN组患者术后第3天[(1.00±0.53) g/L]明显低于术前[(1.47±0.76) g/L](P =0.031),其余各时点与术前相比差异无统计学意义(均P＞0.05);EN组患者血清中C4的含量在术后18 h[(0.24±0.08) g/L]明显低于术前[(0.37±0.36) g/L] (P=0.030),其余各时点与术前比较差异均无统计学意义(均P＞0.05),而EN+ PN组患者手术前后各时点差异均无统计学意义(P＞0.05).两组患者感染相关性并发症发生率和住院时间的差异均无统计学意义(P =0.300,P=0.371).结论 EN和EN+ PN支持方式对食管切除术后体液免疫及结局的影响无差异.两种营养支持方式均不能完全改善术后体液免疫损害,EN方式更经济.     

丙氨酰谷氨酰胺在食管癌患者术后的应用

目的 研究丙氨酰谷氨酰胺对食管癌患者术后营养状况和免疫功能的影响.方法 将110例食管癌患者按随机数字表法分为对照组和试验组,每组55例.术后两组连续行6d肠外营养支持治疗,胃肠功能恢复后同时予流质饮食.试验组加用丙氨酰谷氨酰胺0.6 g/(kg·d).分别于术前和术后1、7d检测外周血IgA、IgG、IgM体液免疫指标和白蛋白(Alb)、前白蛋白(PA)、转铁蛋白(TFN)和淋巴细胞(LYM)营养状况指标.结果 两组患者术后ld体液免疫指标和营养状况指标比较差异均无统计学意义(P＞ 0.05);但IgG、Alb、PA、TFN和LYM均显著低于术前,差异有统计学意义(P＜0.05).术后7d,试验组的PA、TFN和LYM分别为(187.90±65.58) mg/L、(2.45±0.58) g/L、(1.96±0.33)×109/L,明显高于对照组的(162.40±55.43) mg/L、(2.1820.59)g/L、(1.54±0.31)×109/L,差异有统计学意义(P＜0.05);对照组的IgG仍显著低于术前(P＜0.05);试验组的IgA、IgG分别为(2.6±2.3)、(14.6±4.1) g/L,显著高于对照组的(2.2±2.5)、(10.3±3.5) g/L,差异有统计学意义(P＜0.05).结论 丙氨酰谷氨酰胺可以改善食管癌患者术后营养状况并提高患者的免疫功能.     

慢性阻塞性肺疾病急性加重期患者血清降钙素原、超敏C反应蛋白的变化及临床意义

目的 探讨血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)在慢性阻塞性肺疾病急性加重期(AECOPD)患者中的变化及临床意义.方法 分别采用化学发光法和免疫比浊法测定20例AECOPD患者(AECOPD组,其中脓痰8例、非脓痰12例)和15例健康体检者(健康对照组)血清PCT、hs-CRP浓度,并比较.结果 AECOPD组血清PCT浓度为(2.07±5.57)μg/L,健康对照组为(0.21±0.17)μg/L,两组比较差异有统计学意义(P＜ 0.05)；AECOPD组血清hs-CRP浓度为(3.66±3.95) mg/L,健康对照组为(0.49±0.17) mg/L,两组比较差异有统计学意义(P＜0.01).AECOPD组脓痰患者血清PCT、hs-CRP浓度与非脓痰患者比较差异无统计学意义(P＞0.05).在AECOPD诊断上,PCT、hs-CRP、白细胞计数的灵敏度分别为75％( 15/20)、40％(8/20)、40％(8/20),特异度分别为80％(12/15)、100％( 15/15)、100％( 15/15).与hs-CRP、白细胞计数比较,PCT具有更高的灵敏度(P＜0.05),而特异度差异无统计学意义(P＞0.05).结论 血清PCT、hs-CRP浓度可作为AECOPD的辅助诊断指标,PCT在诊断AECOPD方面优于hs-CRP和白细胞计数.     

缬沙坦联合激素治疗2～3期慢性肾脏病疗效观察

目的 观察缬沙坦联合激素治疗2～3期慢性肾脏病的疗效.方法 15例慢性肾脏病伴有肾功能损害患者,病理以活动、增殖性病变为主,给予缬沙坦联合激素治疗,检测治疗前及治疗后尿蛋白定量(Pro)、血尿素氮(BUN)、血肌酐(SCr)、血钾变化.结果 治疗后1个月Pro由治疗前(2.32±0.94) g/24 h降至(1.85±0.66) g/24 h(P＜0.05),SCr由(203.33±51.11)μmol/L降至( 169.45±41.79)μmol/L(P＜ 0.01),并随着时间延长进一步下降,至治疗12个月时Pro及SCr分别降至(0.44±0.52) g/24 h及(124.06±50.84)μmol/L,与治疗前比较差异均有统计学意义(P＜0.01).BUN治疗后1、3个月与治疗前比较差异无统计学意义(P＞ 0.05),治疗后6个月时由(13.53±5.04)mmol/L降至(9.65±2.30) mmol/L (P＜ 0.05),治疗后12个月时降至(7.53士2.52)mmol/L(P＜0.01).血钾治疗前后比较差异无统计学意义(P＞0.05).治疗后1、3、6、12个月时有效率分别为13.33％(2/15)、53.33％(8/15)、71.43％(10/14)、85.71％(12/14).结论 缬沙坦联合激素治疗Pro＞ 1.0 g/24h、病理变化为活动、增殖性病变的2～3期慢性肾脏病患者可有效延缓肾功能进展、降低蛋白尿,且对血钾无明显影响.     

企业职工高尿酸血症与血压、血脂、血糖的相关性研究

目的探讨企业职工高尿酸血症（HUA）与血压、血脂、血糖的相关性,为企业进行健康管理提供依据。方法以中国石油长庆油田公司各下属企业为抽样单位,整群随机抽取2个单位,每个单位中所有的HUA者作为HUA组,共720人;同时在尿酸水平正常者中随机选取620人为正常组。通过Logistic回归分析HUA与年龄、性别、血压、血脂、血糖的关系。结果HUA合并高血压、高血脂、空腹m糖受损任意一项、两项、三项的比例均远高于正常组（OR值分别为：4．036,2．562,4．174）。多因素Logistic回归发现：男性、收缩压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇是HUA的危险因素（OR值分别为7．736,2．309,1．721,2．761,1．411）;高密度脂蛋白胆固醇为HUA的保护因素（OR值为0．211）。结论HUA存在性别差异,且与血压、血脂密切相关。企业对职工的健康管理应充分考虑多危险因素的综合作用,全面的进行健康教育及干预。     

Continuity and change in neighborhood disadvantage and adolescent depression and anxiety

We used data from the Fragile Families and Child Wellbeing Study which includes a sample of adolescents of age 15 at the most recent wave (between 2014 and 2017) from mainly low-income urban families in the United States, to examine the association between neighborhood poverty entries and exits and adolescent depression and anxiety. In addition, we examined whether these associations differed by gender. Adolescents who consistently lived in disadvantaged neighborhoods had the highest level of depression and anxiety. Those who entered poor neighborhoods were more depressed than those who never lived in poor neighborhoods. Those who exited poor neighborhoods showed no significant difference in depression and anxiety compared to those never lived in poor neighborhoods. Furthermore, these associations applied to adolescent girls only and were not statistically significant for boys. The results suggest that neighborhood poverty has cumulative negative impacts on adolescent mental health and disproportionally affects adolescent girls. Reducing neighborhood poverty would substantially improve the health of adolescents, especially girls, which would reduce health disparities.     

Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights

At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described – fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.     

儿童青少年超重肥胖评价方法及SPSS和SAS实现

超重肥胖已成为世界各国儿童青少年面临的重大公共卫生问题之一。现行的儿童青少年超重肥胖筛查标准不统一,逐条评价或自行编写程序容易出错且效率较低。本研究以中国学龄儿童青少年超重与肥胖筛查标准为例,详细介绍了国际和中国共四种评价儿童青少年超重肥胖的方法和步骤,结合具体案例详细介绍其应用方法,同时编制SPSS和SAS程序包和解...     

癌缺氧病因及预防和治疗

目的 探讨癌及安阳林州市食管癌高发原因及癌病因预防和治疗措施.方法 对林州市食管癌等疾病现场进行调查,在进行10余年统计分析基础上,综合分析了全国156篇文献成果.结果 提出癌缺氧病因学说,使用制氧机、按摩器、饮用纯净水治疗恶性肿瘤,取得良好效果,改水能够大幅降低林州市居民食管癌发病率、死亡率.结论 癌可能是由于机体长...     

Recruitment and retention challenges and successes

Objective: Addressing health disparities requires well designed, culturally adapted research. However, recruiting/retaining minority participants has often been challenging. We present strategies used to successfully recruit and retain rural Hispanic women during a breastfeeding education intervention.

Design: This study involved a two-group repeated measures quasi-experimental design with assessments at seven intervals between enrollment and 6 months postpartum. Participants (Hispanic women?≥?15 years old) were recruited through a regional hospital.

Results: We successfully met our recruitment goals, most women contacted were enrolled (46 of 58), and 100% completed the study.

Discussion: Research staff with ties within the community helped establish trust. Using bilingual study materials, simple language, and an interpreter addressed language/literacy concerns. Phone assessments facilitated participation as transportation was an issue. Accommodating requests to deliver or mail study materials and providing incentives were important. Extra effort was needed to maintain contact when phone service was disrupted or participants moved. Keys to success were persistence, flexibility, and alleviating barriers to participation.     

骨钙素与儿童生长发育

骨钙素是成骨细胞分泌的骨蛋白 ,骨钙素水平与成骨细胞活性成正相关 ,是一项很好的反映骨形成与骨转化的生化指标。小儿骨生长发育有自身特点 ,骨钙素水平的改变类似儿童身高生长曲线 ,可以很好地应用于评价儿童生长发育及监测生长障碍患儿对治疗的反应     

初产妇与经产妇焦虑抑郁状态分析及干预

目的：分析初产妇、经产妇心理状态特点,以便采取更有效的干预措施。方法筛选2014年6月至2015年1月在咸阳市旬邑县妇幼保健院产科门诊产前检查的健康初产和经产妇各60名,孕周为28~40周。入组时用焦虑自评量表( SAS)、抑郁自评量表(SDS)对两组孕妇进行心理评定,并给1次支持性心理干预(40~60分钟),1周后再次用SAS、SDS对两组孕妇进行评定分析。结果经产妇干预前SAS(50.73±3.45)、SDS(49.13±3.86)评分明显高于初产妇SAS(42.45±2.08)、SDS(41.77±2.21),差异均有统计学意义(t值分别为-15.921、-12.817,均P<0.01);干预后两组SAS、SDS评分均比干预前明显降低,差异均有统计学意义(t值分别为14.999、15.413;15.724、15.832,均P<0.01);干预后经产妇 SAS(38.61±5.02)、SDS(39.10±3.03)评分明显高于初产妇SAS(34.88±3.31)、SDS(32.01±4.27),差异均有统计学意义(t值分别为-4.805、-10.489,均P<0.01)。结论初产妇和经产妇均伴有焦虑、抑郁情绪,干预前后经产妇抑郁、焦虑情绪均较初产妇明显,支持性心理干预能有效改善孕妇的不良情绪。     

Cholesterol and Egg Intakes with Cardiometabolic and All-Cause Mortality among Chinese and Low-Income Black and White Americans

We examined the associations of dietary cholesterol and egg intakes with cardiometabolic and all-cause mortality among Chinese and low-income Black and White Americans. Included were 47,789 Blacks, 20,360 Whites, and 134,280 Chinese aged 40–79 years at enrollment. Multivariable Cox models with restricted cubic splines were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality outcomes using intakes of 150 mg cholesterol/day and 1 egg/week as the references. Cholesterol intake showed a nonlinear association with increased all-cause mortality and a linear association with increased cardiometabolic mortality among Black Americans: HRs (95% CIs) associated with 300 and 600 mg/day vs. 150 mg/day were 1.07 (1.03–1.11) and 1.13 (1.05–1.21) for all-cause mortality (P-linearity = 0.04, P-nonlinearity = 0.002, and P-overall < 0.001) and 1.10 (1.03–1.16) and 1.21 (1.08–1.36) for cardiometabolic mortality (P-linearity = 0.007, P-nonlinearity = 0.07, and P-overall = 0.005). Null associations with all-cause or cardiometabolic mortality were noted for White Americans (P-linearity ≥ 0.13, P-nonlinearity ≥ 0.06, and P-overall ≥ 0.05 for both). Nonlinear inverse associations were observed among Chinese: HR (95% CI) for 300 vs. 150 mg/day was 0.94 (0.92–0.97) for all-cause mortality and 0.91 (0.87–0.95) for cardiometabolic mortality, but the inverse associations disappeared with cholesterol intake > 500 mg/day (P-linearity ≥ 0.12; P-nonlinearity ≤ 0.001; P-overall < 0.001 for both). Similarly, we observed a positive association of egg intake with all-cause mortality in Black Americans, but a null association in White Americans and a nonlinear inverse association in Chinese. In conclusion, the associations of cholesterol and egg intakes with cardiometabolic and all-cause mortality may differ across ethnicities who have different dietary patterns and cardiometabolic risk profiles. However, residual confounding remains possible.