果糖和双酚A联合暴露对发育早期雄性大鼠摄食饮水和体重的影响

目的探讨双酚A(bisphenol A,BPA)和果糖单独或联合暴露对发育早期雄性大鼠摄食量、饮水量和体重的影响。方法将50只清洁级初断乳的Wistar雄性大鼠按体重随机分为5组,分别为对照组、13%果糖组、20%果糖组、BPA(1μg/ml)组和BPA(1μg/ml)+果糖(13%)组,每组10只,每笼3~4只饲养。采用自由饮水方式进行染毒,连续染毒8周,每天新鲜配制饮水。测定各组大鼠摄食量、饮水量和体重,并计算能量和蛋白质摄入量。结果与对照组比较,13%果糖组和20%果糖组大鼠的摄食量和蛋白质摄入量均明显减少,差异均有统计学意义(P0.05);13%果糖组和BPA+果糖组大鼠的饮水量明显增加,总热能摄入量也明显增高,差异均有统计学意义(P0.05);20%果糖组和BPA组大鼠的饮水量和总热能摄入量间比较,差异无统计学意义(P0.05);BPA+果糖组大鼠的饮水量和总能量摄入均明显高于BPA组,差异均有统计学意义(P0.05)。实验期间,各实验组大鼠体重与对照组比较,没有明显差异(P0.05)。结论 1μg/ml BPA和13%果糖单独或联合暴露对发育期雄性大鼠的体重没有明显影响;联合暴露组大鼠的摄食量和饮水量与13%果糖组一致,没有受到BPA的影响。     

沈阳市初中生超重肥胖和含糖饮料摄入关联性分析

了解青少年超重肥胖、含糖饮料(sugar-sweetened beverages,SSBs)摄入情况及其相互关系,为采取针对性的肥胖防治措施提供住依据.方法 分层随机整群抽取沈阳市某区12所中学2 788名14~15岁初中生进行营养状况评价,收集1 928份血液样品,实验室检测三酰甘油(triglyceride,TG)、总胆固醇(cholesterol,TCHO)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、血糖(blood glucose,GLU)、尿酸(uric acid,UA)、载脂蛋白A-1(Apolipoprotein A-1,ApoA-1)、载脂蛋白B类(ApolipoproteinsB,Apo-B)和脂蛋白(A){ lipoprotein (a),Lp[a]},问卷调查了解近1周的SSBs摄入情况.结果 33.9%的受调查对象为超重或肥胖.超重肥胖青少年TG、LDL-C、GLU、UA、Apo-B和冠状动脉粥样硬化风险指数均高于正常组,HDL-C低于正常组(P值均<0.01);超重肥胖男生的TCHO高于正常组,超重及肥胖女生的ApoA-1低于正常组(P值均<0.01).69.4%的青少年平时有喝SSBs的习惯,男生(75.5%)高于女生(64.0%) (x2=42.73,P<0.01).随着含糖饮料摄入的增加,收缩压和UA呈升高趋势;不同摄入频率组间TCHO、HDL-C和LDL-C及冠状动脉粥样硬化风险指数差异均有统计学意义(P值均<0.01).正常和超重肥胖女生组间SSBs摄入频率差异有统计学意义(x2=23.72,P<0.01),每周喝1~3瓶与肥胖之间关联有统计学意义(OR=1.27,95%CI=1.06~ 1.53).结论 初中生超重肥胖情况不容乐观,且含糖饮料摄入与超重肥胖存在一定关联.建议加强青少年健康教育,适当减少SSBs的消费.     

A combined anti-thrombotic therapy for thrombosis of mitral prosthetic valves

Background For patients with prosthetic heart valves, thrombosis of the valves is dangerous. A second surgery for re-replacing the thrombosed valve is quite traumatic. There have been some researches on noninvasive therapies for thrombosis of prosthetic heart valves. But the combined anti-thrombotic therapy including anti-coagulants and anti-platelet agents was seldom studied. Methods Fourteen patients suffered from thrombosis of the mitral prosthetic valve with stable hemodynamics were studied retrospectively. Thrombosis of the valves was demonstrated by transesophageal echocardiography. All the patients were given a combined antithrombotic therapy with clopidogrel and warfarin during the whole treatment with close monitoring. Low molecular weight heparin (LMWH) was given twice a day during the first 5 days of further treatment in four inpatients. Transthoracic echocardiography was performed repeatedly to observe the function of the mitral prosthetic valves and changes of the thrombus. Results This study included 4 males and 10 females. In these patients, 13 suffered from thrombosis of the mechanical mitral valves, and one patient had thrombosis of the bioprosthetic mitral valve. After an average of 32.0 ± 20.4 days’ treatment, eleven (78.6%) patients’ thrombi disappeared thoroughly with normalized valvular function, only three (21.4%) patients’ thrombi still existed, but no deterioration of valvular functions. For the patients with successful treatment , sizes of the left atriums decreased after treatment (P = 0.01). No significant changes of other chambers and left ventricular ejection fraction were observed (P > 0.05). None experienced major bleeding except for two cases of mild subcutaneous hemorrhage. Conclusions The combined anti-thrombotic therapy based on clopidogrel and warfarin (plus LMWH) is a feasible treatment of thrombosis of prosthetic heart valves under a close monitoring , for both inpatients and outpatients.     

儿童孤独症的病因学研究进展

孤独症（autistic disorder,AD）最早于1943年由Kanner报道,以认知障碍、语言障碍及刻板行为为主要临床表现。孤独症的病因不清,大多数学者认为孤独症是具有基因易感性的个     

COVID-19患者嗅觉和味觉功能障碍研究进展

<正>自2019年12月报告首例新型冠状病毒(COVID-19)感染患者以来,全球已有6亿多人口被COVID-19感染,并有650万人死亡^[1]。其中嗅觉功能障碍(olfactory dysfunction)和味觉功能障碍(gustatory dysfunction)是COVID-19常见的相关症状之一,其发生率明显高于流行性感冒等其他上呼吸道感染疾病,并且可通过嗅觉和味觉障碍来预测和诊断COVID-19。大多数研究^[2-3]报告,嗅觉和味觉障碍在发病后1个月内康复,但症状也可持续至2年甚至更久,且转阴后仍持续存在。     

经肛门塞入消炎痛栓用于高热病人降温

经肛门塞入消炎痛栓用于高热病人降温@谷建梅$中国医科大学第一临床学院感染科!沈阳110001 @魏薇$中国医科大学第一临床学院感染科!沈阳110001 @巩英凤$中国医科大学第一临床学院感染科!沈阳110001     

带管芯导管经鼻气管插管术

目的探讨带管芯的经鼻气管插管术的可行性。方法ASAⅠ~Ⅱ级患者60例,择期行上颌或下颌手术,随机分为实验组、对照组,每组30例。实验组以带管芯的气管导管行盲探经鼻气管插管术,对照组则不带管芯。结果实验组盲探经鼻气管插管成功率为86.7%,较对照组63.3%高(P<0.01),实验组鼻腔出血1例,远低于对照组6例(P<0.01)。结论带管芯的经鼻气管插管术较不带管芯的传统方法插管成功率高,发生鼻腔损伤率低,可推广用于临床。     

光动力学治疗及其在妇科应用的进展

光动力学治疗中,光敏剂选择性地聚集在组织中,给予合适波长的激光,产生光化学效应,造成被选择治疗组织的损伤.随着光敏剂和激光技术的发展,其应用日趋广泛.妇科领域已用于妇科恶性肿瘤、癌前病变和良性疾病的诊断和治疗.