Contribution of cost to treatment nonadherence in the US breast cancer survivors: a population-based analysis

Breast Cancer Research and Treatment - Breast cancer survivors are often prescribed medications for at least 5 years to reduce recurrence risk, yet some forego this treatment due to cost....     

髓核摘除单侧内固定椎间融合术治疗腰椎间盘突出症早期疗效

目的:比较单侧及双侧内固定联合髓核摘除椎间融合术治疗腰椎间盘突出症的初期临床疗效,探讨单侧内固定的可行性。方法:2008年3月～2009年6月在我科行髓核摘除椎体间融合固定术治疗的单间隙腰椎间盘突出症患者共54例,其中行单侧内固定22例,平均随访20.3个月;双侧内固定32例,平均随访19.5个月。对比分析两组患者一般资料、手术时间、出血量、住院天数、住院费用、疼痛视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)、融合率及并发症情况。结果:两组患者的术前一般资料(性别、年龄、手术节段)无统计学差异,术前VAS评分及ODI评分单侧组分别为7.23分和42.36分,双侧组分别为6.96分和41.88分,两组无统计学差异(P>0.05);末次随访时VAS评分及ODI评分单侧组分别为2.77分和16.82分,双侧组分别为2.91分和18.75分,与术前比较均具有统计学差异(P<0.05),但两组间比较无显著性差异(P>0.05)。单侧组手术时间比双侧组平均减少22min,出血量平均减少57ml,住院费用平均减少6007元,两组住院天数无差异。结论:单侧内固定椎间融合治疗单间隙腰椎间盘突出症能够达到双侧内固定同样的疗效,且具有手术时间短、出血量少、费用低等优点。     

幼儿的性与性别意识

本文通过对弗洛伊德幼儿性欲理论进行的简单的阐述与幼儿性别社会化过程相比教，区分了幼儿的性教育与性别意识培养之间的差别，并说明在教育中不能将刻板化的性别意识的教育当作幼儿的性教育。     

江苏汉族青少年维生素D受体基因多态性分析

目的 检测江苏地区青少年维生素D受体(VDR)基因型分布情况,建立正常青少年VDR基因多态性分布谱.方法 应用聚合酶链反应-限制性片断长度多态性技术(PCR-RFLP)对139名江苏地区汉族健康青少年VDR基因型进行检测分析.结果 139名青少年中,VDR基因AA、Aa和aa基因型分别为8(5.76%)名、55(39.57%)名和76(54.67%)名,BB、Bb和bb基因型分别为7(5.04%)、34(24.46%)和98(70.50%).结论 江苏地区汉族健康青少年VDR基因型分布男女性别之间趋于一致,与文献报道的国人、日本人没有显著性差异,与韩国人、欧洲人差异明显.     

单耳听力损失对不同年龄段儿童影响的初步观察

目的:探讨单耳听力损失对儿童语言、智商、学习等的影响.方法:回顾性分析2008-10-2009-12期间101例单耳听力损失患儿的听力资料及各项相关检查,并电话随访95例患儿目前的语言发育、学习等情况.结果:重度、极重度单耳听力损失学龄儿童的总智商、言语智商、操作智商较双耳听力正常者低(P<0.05),中重度单耳听力损失儿童与双耳听力正常儿童的智商差异无统计学意义(P>0.05).结论:单耳听力损失对幼儿的语言发育、学龄儿童的智商及学习成绩等有一定的影响,及早、正确干预可弥补听力损失导致的不良影响.     

ACE基因多态性与贵州布依族、汉族原发性高血压及患者血清PⅢNT、MMP-9及 hs-CRP的相关性研究

目的：探讨血管紧张素转化酶（angiotensin converting enzymegene,ACE）基因I/D位点多态性与贵州布依族、汉族原发性高血压及患者血清Ⅲ型前胶原氨基端肽（procollagen Ⅲ N-terminal peptide,PⅢNT）、基质金属蛋白酶-9（matrix metallopro－teinase-9,MMP-9）及高敏C反应蛋白（hypersensitive C-reactive protein,hs-CRP）的相关性。方法：入选贵州黔南地区原发性高血压患者302例（布依族154例,汉族148例）为高血压组,健康者299例（布依族143例,汉族156例）为正常对照组,应用聚合酶链反应-限制性片段长度多态性技术检测ACE I/D位点各基因型及等位基因,采用酶联免疫吸附试验检测血清PⅢNT、MMP-9及hs-CRP水平。结果：①ACE基因ID基因型及D等位基因分布频率在高血压组和正常对照组间（ ?字2=13.50,P=0.001）、在布依族高血压组和布依族正常对照组间（ ?字2=28.28,P=0.000）差异均有统计学意义。②PⅢNT、MMP-9与hs-CRP水平在布依族与汉族间、在高血压组与正常对照组间、在布依族高血压组与对照组间,以及在汉族高血压组与对照组间差异均有统计学意义（P<0.01）;PⅢNT、MMP-9与hs-CRP水平在ACE I/D位点不同基因型间差异均有统计学意义（P<0.01）。结论：①ACE基因ID基因型及D等位基因可能与布依族高血压有关;在布依族正常人群中,具有ID基因型及D等位基因者可能比具有Ⅱ、DD基因型及I等位基因者患高血压的风险高;ACE基因 I/D多态性可能是贵州黔南布依族高血压的致病因素之一。②布依族高血压患者及具有ID基因型的患者可能更易出现血管壁胶原积累、炎症反应、细胞外基质沉积及血管重塑。     

Synthetic B- and T-cell epitope peptides of porcine reproductive and respiratory syndrome virus with Gp96 as adjuvant induced humoral and cell-mediated immunity

Highly pathogenic porcine reproductive and respiratory syndrome virus (HP-PRRSV) has recently caused huge economic losses in the pig industry worldwide. Commercial vaccines, including inactivated vaccines and attenuated live vaccines, are available but fail to provide sustainable protection, especially against genetically heterologous strains. Thus several approaches have been used to develop more effective PRRSV vaccines and/or immune modulators to accelerate and magnify immune responses to PRRSV vaccines. Heat shock protein Gp96 is one such modulator that enhances both the innate and adaptive immune responses. In the present study, two B-cell epitopes and seven T-cell epitopes from PRRSV and a Pan DR T-helper cell epitope were synthesized and mixed with the N-terminal 22–355 aa of Gp96 (Gp96N) as an adjuvant, and immune responses were evaluated. Our results show that Gp96N activated PRRSV-specific humoral immune responses elicited by BCE-peptides and promoted the PRRSV-specific cellular immunity induced by TCE-peptides. Moreover, higher levels of IL-12 and TNF-α and lower levels of IL-4 and IL-10 were observed in the serum of Gp96N-vaccinated piglets compared to piglets immunized with no Gp96N, displaying a predominant Th1 type of immune response induced by Gp96N. Following challenge with the virulent HP-PRRSV isolate JXwn06, piglets vaccinated with the mixture of peptides and Gp96N presented with milder clinical symptoms, lower viremia, and less pathological lesions in their lungs, however, this vaccine could not provide lasting and effective protection against HP-PRRSV infection. These data provide important bases for the development of PRRSV epitope-based synthetic peptide vaccines combined with Gp96N as attractive immunomodulators in swine.     

Pure tone hearing profiles in children with otitis media with effusion

Introduction: Otitis media with effusion (OME) is a common middle ear disease in children. The associated conductive hearing loss is a major concern for hearing health professionals. The aim of the present study was to describe the configuration of pure tone audiograms of children with OME and to design a statistical stratification algorithm to facilitate hearing loss profiling in children with OME.

Methods: School age children with OME were recruited. Bone and air conduction thresholds were obtained using standard procedures. Hierarchical cluster analysis was employed to determine audiometric profile groups. The Mandarin Hearing in Noise Test was used to measure sentence perception in children for cluster analysis validity assessment.

Results: Ninety-seven children (164 ears) aged between 72 months and 153 months were examined. Air conduction thresholds averaged for 500?Hz, 1000?Hz and 2000?Hz were in the range of 8.3–53.3?dB HL with a mean of 26.8?dB HL. Bone conduction thresholds were found to be influenced by middle ear pathology with a maximal elevation at 2000?Hz of 25?dB HL. Four audiometric profiles were identified. Cluster 1 contained 54 ears (32.9%) with normal or near normal hearing, Clusters 2 contained 37 ears (22.6%) with mild hearing loss, Cluster 3 included 48 ears (29.3%) and Cluster 4 included 25 ears (15.2%) with moderate hearing loss. Stability and validity of the four-cluster profiling procedure was examined and established with satisfactory results.

Conclusions: OME in children is associated with pure tone hearing thresholds ranging from normal to moderate hearing loss. The hierarchical clustering algorithm proved useful as a novel means of profiling hearing loss in children with OME and may assist in identifying affected children at greater risk of auditory disadvantage.

• Implications for rehabilitation

• A hierarchical cluster analysis method can be used to determine audiometric profiles in children with OME.

• This algorithm assists to identify children at greater risk of auditory disadvantage.

• Cluster groups with more elevated pure tone thresholds may be targeted for priority in clinical surveillance and medical/surgical intervention.

     

建筑卫生陶瓷企业粉尘检测结果的分析

目的 了解建筑卫生陶瓷企业粉尘危害现状,为制定预防控制粉尘危害措施提供科学依据.方法 对19家建筑卫生陶瓷企业进行现场卫生学调查和工作场所粉尘浓度及粉尘中游离二氧化硅(SiO2)含量检测.结果 检测121份工作场所沉积粉尘中游离SiO2含量为(29.0±15.4)％,建筑陶瓷企业粉尘中游离SiO2含量[(33.2±13.2)％]与卫生陶瓷企业[(28.9±13.0)％]相比,差异无统计学意义(P＞0.05).总粉尘时间加权平均容许浓度(总尘CTwA)为0.08～29.70 mg/m3,超标率19.6％(170/868),最高的超过职业接触限值28.7倍;建筑陶瓷企业总尘CTWA超标率(22.6％)明显高于卫生陶瓷企业(8.5％),差异有统计学意义(P＜0.001).呼吸性粉尘时间加权平均容许浓度(呼尘CTWA)为0.04～5.00 mg/m3,超标率为9.5％(77/811),最高的超过职业接触限值6.1倍.建筑陶瓷企业呼尘CTWA超标率(1 1.1％)显著高于卫生陶瓷企业(2.6％),差异有统计学意义(P＜0.05).结论 陶瓷粉尘中游离SiO2含量高、总尘和呼尘CTWA超标率高,对作业工人健康危害较大,应进一步采取有效干预措施,控制陶瓷粉尘危害.     

Potent antitumoral effects of targeted promoter-driven oncolytic adenovirus armed with Dm-dNK for breast cancer in vitro and in vivo

Currently, no curative treatments are available for late-stage metastatic or recurrent breast cancer, because the cancer tolerates both chemotherapy and endocrine therapy. In this study, we investigated the feasibility of a dual-regulated oncolytic adenoviral vector with a novel suicide gene to treat breast cancer. Following targeted gene virotherapy of conditionally replicating adenoviruses (CRAds), the novel suicide gene of multisubstrate deoxyribonucleoside kinase of Drosophila melanogaster (Dm-DNK) was inserted into the double-regulated oncolytic adenovirus SG500 to ensure more safety and enhanced antitumor activity against breast cancer both in vitro and in vivo. Selective replication, cell-killing efficacy, and cytotoxicity, combined with chemotherapeutics were investigated in several breast cell lines (MDA-MB-231 and MCF-7), normal cells (WI-38 and MRC-5), and human (MDA-MB-231) tumor models in vivo. The double-regulated SG500-dNK had high cell-killing activity in breast cancer. Replication was similar to wild-type in breast cells and was attenuated in normal cells. SG500-dNK combined with the chemotherapeutics (E)-5-(2-bromovinyl)-2′-deoxyuridine (Bvdu) and 2′,2′-difluoro-deoxycytidine (dFdC) resulted in synergistically enhanced cell killing and greatly improved antitumor efficacy in vitro or in breast xenografts in vivo. These data suggest that the novel oncolytic variant SG500-dNK is a promising candidate for targeting breast tumors specifically when combined with chemotherapeutics.