传统与新型全氟化合物对育龄期女性生殖激素的影响

目的:探讨传统与新型全氟化合物(per-and polyfluoroalkyl substances,PFAS)在育龄女性中的暴露水平及对育龄期女性生殖激素的影响。方法:采用横断面调查研究设计,于2013~2015年间对433名正常育龄期女性进行问卷调查,收集其年龄、月经初潮年龄、产次、BMI、教育水平和家庭收入情况等信息,同时采集血液样本检测生殖激素水平,利用超高效液相色谱-串联质谱法测定血浆中PFAS浓度。采用多元线性回归和Quantile g-computation模型来评估PFAS混合暴露与生殖激素的关联。结果:研究人群血浆中全氟和多氟烷醚类化合物:6∶2全氟聚醚磺酸(6∶2 Cl-PFESA)、8∶2全氟聚醚磺酸(8∶2 Cl-PFESA)和六氟环氧丙烷二聚酸(HFPO-DA)的检出率分别为100%,99.8%和99.9%。且全氟和多氟烷醚类化合物的浓度:6∶2 Cl-PFESA(2.27 ng/mL)、8∶2 Cl-PFESA(0.07 ng/mL)和HFPO-DA(0.03 ng/mL)处于较高水平。多元线性回归结果发现支链PFAS异构体与孕酮成正相关:1m-PFOS(β=0.131,95%CI:0.021,0.242),br-PFOS(β=0.119,95%CI:0.005,0.234),混合暴露模型中发现PFAS与孕酮呈正相关(β=0.549,95%CI:0.323,0.774)。结论:本研究采用混合暴露模型的分析方法评估PFAS混合物的联合作用,反应了多种环境PFAS暴露与生殖激素的关联,发现了育龄期妇女新型PFAS浓度处于较高水平,证实PFAS暴露可能与育龄期女性生殖激素紊乱有关。

沙粒病毒的研究进展

沙粒病毒属于小RNA病毒科,可以通过多种方式感染人类并导致不同程度的疾病病死率。沙粒病毒主要以啮齿类动物为宿主,人类致病性沙粒病毒包括引起人类淋巴细胞脉络丛脑膜炎的淋巴细胞脉络丛脑膜炎病毒和导致人类出血性疾病的拉沙热病毒和塔卡里伯病毒群。啮齿动物约占哺乳动物种类的43%,目前在啮齿目动物体内发现30余种高致病性的病毒,其中就包括沙粒病毒。啮齿类动物主要受到沙粒病毒科的哺乳动物沙粒病毒属的感染。本文对沙粒病毒的基因蛋白结构、临床特点、流行病学情况和预防控制等做一综述,为沙粒病毒的研究和预防机制建立提供参考。

邻苯二甲酸酯对育龄人群及其子代生殖健康影响的研究进展

我国育龄妇女总生育率呈明显下降趋势。研究表明,年龄和遗传等因素与生育率有显著相关性,此外,环境内分泌干扰也可损害生育力。随着新型环境污染物的大量使用,其对育龄夫妇生育能力影响成为相关领域研究热点。邻苯二甲酸酯是一种常用塑料制品中的增塑剂,普遍存在于玩具、食品包装、建筑材料、电子与医疗部件、个人护理产品、办公学习用品等塑料包装产品中,是环境污染的主要物质。多项研究表明,邻苯二甲酸酯不仅能造成环境及水源的污染,还因其生殖毒性、遗传毒性、免疫毒性、神经毒性、致畸、致癌等多种毒性作用,对人类健康尤其是对育龄人群及其子代生殖健康的影响不容忽视。当前邻苯二甲酸酯及新型替代品在生殖健康的人群流行病学研究尚存在争议,毒性机制仍处于探索阶段。本文通过对邻苯二甲酸酯对亲本世代、子代(包括胚胎)的生殖发育及遗传毒性等影响的国内外研究进展做一综述,旨在推进邻苯二甲酸酯污染物有效控制措施的制定与其对生殖健康风险的预测,从而为邻苯二甲酸酯对育龄阶段人群不良生殖结局的精准防控提供科学依据和指导方案。

睡眠呼吸暂停综合征患者健康教育期望的质性研究

目的:探讨睡眠呼吸暂停综合征患者疾病认知及健康教育期望,为临床制定干预措施和健康教育模式提供参考。方法:采用现象学研究法对20例睡眠呼吸暂停综合征患者进行半结构式访谈,运用Colaizzi七步分析法对访谈资料进行整理、分析和主题归纳。结果:通过分析与总结共提炼出疾病认知、健康需求、健康教育模式3个主题。结论:护理人员应提高对睡眠呼吸暂停综合征患者健康教育的重视程度,给予患者提供网络化、个性化、延续化的健康指导,帮助患者进行疾病自我控制和管理,逐步提升健康教育质量。

A review of the epidemic and clinical study on scrub typhus in China(2010-2020)

Scrub typhus is an acute febrile vector-borne zoonotic disease caused by the obligate intracellular growth bacterium Orientia tsutsugamushi(Ot).Mites are the primary vectors and rodents play a pivotal role in the transmission of scrub typhus.Due to the climate warming,increased human activity and other factors,cases of scrub typhus have been increased sharply during the past decade in China,especially in the northern China.To understand the incidence trend,epidemic pattern,clinical sign,diagnosis and therapy of this diseases as well as genotype evolution of Orientia tsutsugamushi,we summarized and analyzed the current knowledge of scrub typhus in China from 2010 to 2020.The data indicated that the dominate genotypes of scrub typhus in China were Karp,Kato and Gilliam.Although the disease was distributed national wide,Yunnan,Guangzhou and Fujian showed the highest incidence rate.The main vector of scrub typhus in southwest,middle east and southeast of China appeared a geographic preference respectively.Seasonal timing,age and occupation were the key factors that relate to the peak incidence of scrub typhus.Notably,farmer was the occupation with the highest risk of Ot infection.Further study on the epidemic characteristics,risk factors,diagnosis and treatments of scrub typhus will be of benefit to a comprehensive guideline for prevention and control of this ancient disease.

Association of novel and legacy PFAS with reproductive hormones in women of child‑bearing age

Objective:To evaluate the legacy and novel per-and polyfluoroalkyl substances(PFAS)exposure in women of reproductive age,and to explore the effects on female reproductive hormones.Methods:We used cross-sectional data of 433 normal women of reproductive age from 2013 to 2015.Data of age,age at menarche,parity,BMI,education,and income were collected through questionnaires,serum samples were collected for reproductive hormones,and plasma samples for PFAS measurement by ultraperformance liquid chromatography-tandem mass spectrometer(UPLC-MS/MS).Multiple linear regression and quantile g-computation were adopted to analyze the association between PFAS and reproductive hormones.Results:The detection rates of 6:2 Cl-PFESA,8:2 Cl-PFESA and HFPO-DA in the plasma were 100%,99.8%and 99.9%,respectively.The median concentrations of these chemicals were 2.27 ng/mL,0.07 ng/mL and 0.03 ng/mL,respectively.Multiple linear regression analysis showed a positive association between branched PFOS[1m-PFOS(β=0.131,95%CI:0.021,0.242),br-PFOS(β=0.119,95%CI:0.005,0.234)]and progesterone.In addition,mixed exposure model suggested that PFAS had a positive association with progesterone(β=0.549,95%CI:0.323,0.774).Conclusion:In this study,a mixed exposure model was used to evaluate the combined effects of PFAS mixtures,reflecting the association between multiple environmental PFAS exposure and reproductive hormones,and a higher concentration of novel PFAS was found in women of reproductive age,confirming that PFAS exposure may be related to reproductive hormone disorders in women of reproductive age.

Research progress and prospects of arenavirus

Arenaviruses belong to the family of RNA viruses that can infect humans in various ways and cause different degrees of mortality.Rodents is the mainly hosts.Human pathogenic arenaviruses include lymphocytic choroid meningitis,Lassa virus group and Takarib virus group,which cause human lymphocytic choriomeningitis and human hemorrhagic diseases.Rodents account for about 43%of mammalian species.At present,more than 30 highly pathogenic viruses have been found in rodents,including arenaviruses.The arenaviridae that infects rodents are mainly mammalian arenaviruses.This article reviews the etiology,clinicopathology,epidemiology,prevention and control of arenavirus,and provides references for the research and prevention of arenavirus.

Research progress on the effects of phthalates on reproductive health of childbearing population and their offspring

The total fertility rate of women in childbearing age showed a downward trend in China.In addition to the age and genetic factors,environmental endocrine disruption can also impair fertility.The impact of increasing new environmental pollutants on the couples in childbearing age has become a research hotspot recently.Phthalate acid esters(PAEs)is a common plasticizer in plastic products,which is widely found in toys,food packaging,construction materials,electronic and medical components,personal care products,office and school supplies and other plastic packaging products,and is the main substance of environmental pollution.Multiple studies have shown that PAEs can not only cause environmental and water pollution,but also have a variety of toxic effects such as reproductive toxicity,genotoxicity,immunotoxicity,neurotoxicity,teratogenicity,and carcinogenesis.Therefore,its impact on human health,especially on reproductive health of people of reproductive age and their offspring,cannot be ignored.However,the current epidemiological study of PAEs and new alternatives in reproductive health population is still controversial,and the toxicity mechanism is still in the exploration stage.This article through to PAEs of parental generation,children(including embryo)of reproductive development and the influence of genetic toxicity research progress at home and abroad to do a review,aims to promote effective control measures for the establishment of PAEs pollutants rather than on reproductive health risk prediction,thus for PAEs of adverse reproductive outcomes of reproductive stage of people provide a scientific basis for precision control and guidance.

心房内心电图技术在乳腺癌患者输液港置管定位中的应用价值

目的探讨心房内心电图技术在乳腺癌患者输液港置管定位中的应用价值。方法选取2019年5月—2020年5月江西省肿瘤医院收治的需置入完全植入式静脉输液港(TIVAP)化疗的88例乳腺癌患者作为研究对象,采用随机数字表法分为试验组和对照组,每组各44例。对照组按常规方法进行TIVAP定位和置管,试验组则在心房内心电图技术辅助下进行TIVAP的定位和置管。比较两组的一次性置管成功率,以胸部X线片确定置管后导管尖端的位置,比较两组的导管尖端定位准确率,并统计置管相关并发症发生情况和患者置管满意度情况。结果试验组的一次性置管成功率和导管尖端定位准确率均高于对照组,差异有统计学意义(P<0.05)。试验组的并发症总发生率低于对照组,差异有统计学意义(P<0.05)。试验组的总满意度高于对照组,差异有统计学意义(P<0.05)。结论在乳腺癌患者输液港置管,应用心房内心电图技术引导下进行定位置管,能提高导管尖端位置定位的准确性,减少相关并发症,提高置管成功率和患者满意度。

9种传统中药提取成分体外抗人呼吸道合胞病毒作用研究

目的:对三叉苦水提物、黄皮叶水提物、路边青水提物、裸花紫珠水提物、胆木醇提物、胆木水提物、角花胡颓子醇提物、角花胡颓子水提物和竹叶椒醇提物共9种传统中药提取成分体外抗人呼吸道合胞病毒(human respiratory syncytial virus,HRSV)效果进行研究。方法:通过细胞培养技术评估药物对细胞的毒性作用,利用CCK-8法测定细胞存活率,选择细胞存活率大于50%的药物浓度,通过体外细胞感染模型评估药物抗HRSV的效果。结果:路边青水提物、裸花紫珠水提物和角花胡颓子水提物半数有效浓度(EC_(50))分别为0.05 mg/mL、0.03 mg/mL和0.05 mg/mL,治疗指数(therapeutic index,TI)分别为18.60、21.67和56.80。结论:路边青水提物、裸花紫珠水提物和角花胡颓子水提物具有较好的抗人呼吸道合胞病毒效果。

犬瘟热与犬副流感病毒双重一步法RT-PCR检测方法的建立

为建立可以同时检测犬瘟热病毒(CDV)和犬副流感病毒(CPIV)的检测方法,依据GenBank中登录的CDV的H基因和CPIV的NP基因保守序列,设计合成扩增序列分别为593 bp (CDV H基因)、1 530 bp (CPIV NP基因)的2对引物,通过优化反应条件,建立一种能够同时检测CDV和CPIV的双重一步法RT-PCR检测方法。特异性和敏感性试验显示,该方法能特异地检测CDV和CPIV,其最低检测限分别为3.58×10~6拷贝/μL和1.74×10~6拷贝/μL。对51份临床疑似病料样品进行检测,同时分别采用商品化的CDV和CPIV抗原检测试剂盒进行检测,结果二者符合率为100%。该结果表明本实验所建立的双重一步法RT-PCR方法的灵敏度及特异性均较好,可用于临床相关疫病的诊断。

海口市儿童肺炎患者呼吸道标本流感嗜血杆菌的耐药性与分子流行病学特征

目的调查海口市肺炎患儿分离的流感嗜血杆菌临床分布、耐药状况及克隆传播情况,为预防和治疗儿童流感嗜血杆菌性肺炎提供理论依据。方法收集2021年海口市妇幼保健院5342例住院肺炎患儿临床资料,分析患儿呼吸道标本流感嗜血杆菌阳性情况,检测菌株耐药性,并采用多位点序列分型(MLST)分析其同源性。结果5342例肺炎患儿共分离352株流感嗜血杆菌,检出率为6.59%;男患儿检出率为7.10%,女患儿检出率为5.82%;年龄<30 d检出率为0.30%,30 d~为8.45%,2岁~为11.62%,4岁~为12.88%,≥6岁为2.56%,各年龄段检出率比较差异有统计学意义(P<0.05);春季检出率为14.04%,夏季为4.48%,秋季为4.62%,冬季为4.40%,各季节检出率比较差异有统计学意义(P<0.001)。流感嗜血杆菌β-内酰胺酶阳性率为42.60%(141/331),对复方磺胺甲口恶唑、氨苄西林、头孢呋辛的耐药率分别为76.43%、69.19%、51.36%,对阿奇霉素、阿莫西林/克拉维酸、头孢他啶和头孢曲松的耐药率<30%,对美罗培南和左氧氟沙星的耐药率<1%。51株流感嗜血杆菌经MLST测序分成15个ST型;其中ST107包含11株(21.57%),主要分布在4个月~1岁患儿(9株)和3岁患儿(2株)。结论海口市肺炎患儿分离的流感嗜血杆菌具有遗传多样性,且发生社区克隆传播,以2~3岁幼儿感染多见。春季是感染高发季节,ST107是春季流行优势克隆型。经验治疗时须谨慎使用复方磺胺甲口恶唑、氨苄西林和头孢呋辛,阿莫西林/克拉维酸耐药率和β-内酰胺酶阴性菌株对氨苄西林耐药率升高,临床应引起重视。

高校智慧校园卡规划与实现

作为高校智慧校园的重要组成部分,校园一卡通系统应用广泛。校园卡技术飞速发展,迎来线上线下融合应用、有卡无卡场景并存、大数据支撑决策的智慧校园卡时代。在建设过程中,充分利用超融合、移动端微应用及大数据技术,搭建高可靠性、高延展性、高集成性的一卡通生态平台,实现一卡通智慧融合,开放共享,在实践中收到良好效果。在一定程度上达到了国家提出的,建设高水平大学办学目标相适应的信息化服务体系的目标。本文提出的方法已经在校园里得到普遍的应用。

腹腔镜胆道镜联合钬激光碎石技术在复杂嵌顿胆管结石治疗中的应用价值研究

目的:探讨腹腔镜胆道镜联合钬激光碎石技术在复杂嵌顿胆管结石治疗中的应用价值。方法:采用前瞻性随机对照研究,选取2018年1月至2019年12月郑州大学附属郑州中心医院肝胆胰外科收治的90例复杂嵌顿胆管结石合并胆囊结石患者,根据入组标准随机分为钬激光组(48例)和对照组(42例)。术后随访3~12个月,比较两组患者术前术中资料、术后恢复情况及并发症发生情况。结果:两组患者均完成手术并治愈出院,无围术期死亡。两组患者术前一般资料、术中出血量、术后进食时间比较,差异均无统计学意义(均P>0.05);钬激光组手术时间、术后住院时间、住院总费用均明显低于对照组,差异有统计学意义(P<0.05)。钬激光组术后发生结石残留率明显低于对照组(2.1%vs 16.7%),差异有统计学意义(χ^(2)=4.219,P<0.05);两组患者术后均无胆漏、胆道出血、胆管狭窄等并发症发生。钬激光组行胆管一期缝合术比例显著高于对照组(6.7%vs 0),差异有统计学意义(χ^(2)=5.763,P<0.05)。结论:腹腔镜胆道镜联合钬激光碎石技术可显著提高复杂嵌顿胆管结石的清除率,明显降低患者住院费用、缩短手术时间及术后住院时间,同时有利于胆管一期缝合术开展,值得临床推广应用。

The Theoretical Electrical Characteristics of Organic Thin Film Transistors Based on Capacitance Modulation

An electrical characteristic model of organic thin film transistors(OTFTs)is presented.The model is based on the capacitance modulation principle,i.e.the accumulated charges in the conductive channel are induced by the gate capacitance under an electric field.The current-voltage characteristics of the presented model are compared with the experimental data.According to the electrical characteristics of the model,it is explained that the operating process of OTFTs is actually modulated by the capacitance.The gate capacitance,the contact resistance,the contact barrier,and the field-effect mobility have a significant effect on the performance of OTFTs.

In vitro study on the antiviral activity of 9 extracts of traditional Chinese herbal medicine against the human respiratory syncytial virus

Objective:To study the in vitro virucidal activity of 9 extracts of traditional Chinese herbal medicine(the water extracts of Evodia lepta,Clausena lansium,Clerodendrum cyrtophyllum,Callicarpa nudiflora,Nauclea officinalis and Elaeagnus gonyanthes,the alcohol extracts of Nauclea officinalis,Elaeagnus gonyanthes and Zanthoxylumarmatum)on human respiratory syncytial virus(HRSV).Methods:The cytotoxic effect of the extracts on cells was evaluated by a cell viability assay using the CCK-8 method,a concentration of the extracts with cell viability greater than 50%was selected for the follow-up anti-HRSV effect assay,the 50%effective concentration(EC50)was assessed by an in vitro cell infection model.Results:The EC50s of the water extract from Clerodendrum cyrtophyllum,Callicarpa nudiflora and Elaeagnus gonyanthes were 0.05 mg/mL,0.03 mg/mL and 0.05 mg/mL,and the therapeutic index(TI)of them were 18.60,21.67 and 56.80 respectively.Conclusion:The water extracts of Clerodendrum cyrtophyllum,Callicarpa nudiflora and Elaeagnus gonyanthes possess the activity of anti-HRSV virus.

我国急诊科护士灾害准备度影响因素的Meta分析

目的了解可能影响急诊科护士灾害准备度的因素。方法检索PubMed、Web of Science、EMbase、CINAHL、中国知网、万方及维普数据库,检索时间为建库至2022年8月,纳入有关我国急诊科护士灾害准备度影响因素的相关文献,进行筛选、提取、评价文献,使用RevMan 5.3软件进行Meta分析。结果共纳入7篇文献,总样本量为2418例;Meta分析显示,灾害课程培训、救援经验、职称及学历是影响急诊科护士灾害准备度的因素。结论灾害课程培训、救援经验、职称以及学历是我国急诊科护士灾害准备度的影响因素,护理管理者应制定相应改进政策提升急诊科护士的备灾能力。

血清CRP、IL-6、PCT在支气管扩张症合并肺部感染中的表达水平及意义

目的探讨支气管扩张症合并肺部感染患者血清C-反应蛋白(C-reactive protein,CRP)、白细胞介素-6(Interleukin 6,IL-6)和降钙素原(Procalcitonin,PCT)的表达水平及意义。方法选取2017年1月-2019年5月海南医学院第一附属医院呼吸内科收治的支气管扩张症合并肺部感染患者90例为感染组,同期收治的未合并感染患者50例为未感染组。采集感染患者临床样本,进行病原菌分析。采集两组患者外周静脉血,检测血清CRP、IL-6、PCT的表达水平。结果90例支气管扩张症合并感染患者共送检标本90份,检出95株病原菌,其中以革兰阴性菌为主,占72.63%。感染组患者血清CRP、IL-6、PCT浓度分别为[(65.29±14.04)mg/L、(9.26±1.24)pg/ml、(5.65±1.42)ng/ml]显著高于未感染组[(13.56±1.01)mg/L、(7.36±1.67)pg/ml、(1.01±0.10)ng/ml],差异有统计学意义(P<0.05)。在感染组中,支气管扩张症病情越重,患者血清CRP、IL-6、PCT表达水平越高(P<0.05);感染越严重,患者血清CRP、IL-6、PCT表达水平越高(P<0.05)。革兰阴性菌感染患者血清CRP、IL-6、PCT水平均高于革兰阳性菌和真菌感染患者(P<0.05),而革兰阳性菌和真菌感染患者比较差异无统计学意义。结论支气管扩张症合并感染患者血清CRP、IL-6、PCT表达水平显著升高,有助于判断病情严重程度,并指导临床用药。

曼氏迭宫绦虫果糖-1,6-二磷酸酶的生物信息学分析、基因克隆及蛋白表达

目的通过生物信息学分析预测曼氏迭宫绦虫果糖-1,6-二磷酸酶(SmFBPase)的生物学特性,同时对SmFBPase进行基因克隆及蛋白原核表达。方法通过NCBI网站对SmFBPase基因序列进行开放阅读框分析和核苷酸序列同源性分析。通过ExPASy网站预测SmFBPase的理化性质、结构及表位等特性。构建pET-28α-SmFBPase重组质粒,并转化入~E.coli^BL21(DE3)菌株,用异丙基-β-D-硫代半乳糖苷对其诱导表达,用Western blot进行鉴定。结果SmFBPase由337个氨基酸组成,无信号肽、无跨膜区,理论相对分子质量约37×10~3,为稳定胞内蛋白。SmFBPase的氨基酸序列与人FBPase的氨基酸序列一致性为61.77%,且进化树中两者亲缘性较远,该蛋白含有13个B细胞表位。PCR、双酶切鉴定及测序分析,证明重组质粒构建成功。Western blot显示重组质粒转化BL21后成功诱导表达SmFBPase蛋白。结论生物信息学分析SmFBPase是一个具有潜在研究价值的药物靶点,原核表达的SmFBPase具有反应原性,为研究其糖代谢规律奠定了基础。

海南省琼中黎族苗族自治县2019年恙虫病东方体分子流行病学及遗传进化分析

目的通过分析海南省琼中黎族苗族自治县(简称“琼中”)98例不明原因发热患者的恙虫病流行特点,了解该地区恙虫病东方体菌株流行的情况,为该地区制定恙虫病防治策略和控制措施提供科学依据。方法收集2019年1月1日至2019年12月31日琼中黎族苗族自治县人民医院诊断为疑似恙虫病和不明原因发热患者血液样本,利用胶体金免疫层析法和巢式PCR方法对样本进行恙虫病东方体特异性IgM、IgG抗体和恙虫病东方体56kD型特异性抗原基因检测,同时使用预先设计的样本信息表收集患者的临床表现及流行病学信息。针对巢式PCR检测结果为阳性的样本,进行克隆及Sanger测序。对获得的患者临床信息及检测结果进行流行病学分析,将测序得到的序列进行基因遗传进化分析。结果98例样本中,恙虫病IgM抗体阳性率为24.49%(24/98),恙虫病IgG抗体阳性率为46.94%(46/98),恙虫病PCR阳性率26.53%(26/98),焦痂或皮疹13.27%(13/98)。根据诊断标准,最终诊断为恙虫病的患者为33例。感染人群主要以31~50岁的青壮年为主,职业主要为农民。该地区恙虫病的流行以营根镇、长征镇和红毛镇为主并涉及9个乡镇。流行时间有明细的季节性,以7月和11月为主要高发期。流行的基因型主要为Karp型和Gilliam型。结论琼中为恙虫病的自然疫源地,该地区流行的恙虫病东方体基因型主要为Karp和Gilliam型,具有基因多态性。