1705例嗅觉功能障碍临床与疗效分析

目的探讨不同病因与不同等级嗅觉功能障碍之间的关系,以及药物、手术治疗不同病因引起的嗅觉功能障碍的疗效分析。方法以1705例不同病因就诊的嗅觉功能障碍患者及鼻科住院患者为研究对象,采用T&T标准试嗅法检测,结果分为嗅觉正常(Ⅰ级)、轻度嗅觉损害(Ⅱ级)、中度嗅觉损害(Ⅲ级)、重度嗅觉损害(Ⅳ级)、嗅觉丧失(Ⅴ级)五级。五级患者的变量因素比较采用卡方检验;嗅觉功能障碍与变量因素关系采用多变量logistic回归模型进行分析。采用卡方检验、t检验和fisher确切概率法分析单/双侧嗅觉丧失与不同病因的关系,采用t检验分析药物与手术治疗不同病因导致的嗅觉功能障碍的疗效。结果不同嗅觉功能障碍等级之间的年龄分布不同,嗅觉功能越差,其分布的年龄段越高。男、女之间发病率差异无统计学意义。多变量logistic回归分析提示:慢性鼻窦炎鼻息肉、鼻中隔偏曲、头外伤、上呼吸道感染、慢性鼻窦炎、腺样体肥大、鼻骨骨折、不明原因是导致嗅觉功能障碍的独立风险因素。在嗅觉功能障碍(Ⅱ级到Ⅴ级)的患者中,慢性鼻窦炎鼻息肉的发病率最高(12.0%),其次为鼻腔肿物(6.4%)、慢性鼻窦炎(5.9%)、不明原因(5.8%)、上呼吸道感染(5.0%)。其中慢性鼻窦炎鼻息肉(10.2%)、头外伤(3.0%)、上呼吸道感染(3.9%)所致嗅觉完全丧失的比例最高。鼻中隔偏曲、鼻骨骨折所致的嗅觉丧失以单侧为主,头外伤所致的嗅觉丧失以双侧为主。鼻出血、慢性鼻窦炎所致的嗅觉功能障碍,药物治疗的效果优于手术治疗。腺样体肥大、鼻骨骨折所致的嗅觉功能障碍,手术治疗后嗅觉功能改善大于药物治疗。慢性鼻窦炎鼻息肉所致的嗅觉功能障碍,手术与药物治疗的效果无明显差别。结论慢性鼻窦炎鼻息肉、鼻中隔偏曲、头外伤、上呼吸道感染、慢性鼻窦炎、腺样体肥大、鼻骨骨折是引起嗅觉功能障碍的独立危险因素。鼻中隔偏曲、鼻骨骨折多引起单侧嗅觉丧失,头外伤多引起双侧嗅觉丧失。鼻出血、慢性鼻窦炎所致的嗅觉功能障碍用药物治疗效果优于手术治疗;相较于药物治疗,腺样体肥大、鼻骨骨折所致的嗅觉功能障碍以手术治疗疗效更为显著。

火龙果组织培养技术研究进展

火龙果(Hylocereus undulatus Britt.)属于热带亚热带水果,其果实营养丰富,有巨大的商业价值和经济价值。利用组织培养技术可以方便快捷地获得大量健康的火龙果无菌苗。为建立火龙果高效组织培养体系,推动火龙果的研究应用,文章对火龙果组织培养中外植体的选择、外植体的消毒方式、组培再生途径以及生根培养等方面的研究进展进行了综述,分析影响火龙果组织培养的相关因素,并对火龙果组织培养所存在的问题提出合理建议。

人员密集型场所细菌真菌气溶胶冬季分布特征及健康影响分析

地铁、超市、电子市场、医院挂号大厅等都属于人员数量多且活动多的密集型场所,其室内空气中的细菌真菌污染不容忽视。为了解这些人多场所内的细菌真菌气溶胶浓度及不同粒径段微生物的分布,于2019年冬季首先对四类场所内的细菌和真菌气溶胶进行了现场采样和实验分析,并测试了其它环境参数;然后分析了不同场所内细菌真菌气溶胶的浓度水平及分布特征;最后,评估了不同场所微生物气溶胶的浓度水平及可能产生的健康风险。结果表明:1)细菌气溶胶浓度均值为电子市场>超市>医院>地铁,其中电子城内细菌气溶胶浓度为838 cfu/m^(3),地铁内细菌为449 cfu/m^(3);真菌气溶胶浓度均值为超市>电子市场>医院>地铁,其中超市内真菌气溶胶浓度为558 cfu/m^(3),地铁内真菌为282 cfu/m^(3);2)细菌气溶胶中值直径为医院>地铁>电子市场>超市,真菌气溶胶中值直径为电子市场>医院>地铁>超市,且场所内细菌、真菌气溶胶中值直径均小于室外细菌真菌气溶胶中值直径;3)地铁、超市、电子市场内空气中的细菌主要集中在第Ⅰ级(>7μm)、第Ⅳ级(2.1~3.3μm)和第Ⅴ级(1.1~2.1μm)粒径段,医院空气中细菌主要集中在第Ⅰ级、第Ⅱ级(4.7~7μm)和第Ⅳ级粒径段;真菌气溶胶主要分布在第Ⅲ级(3.3~4.7μm)、第Ⅳ级和第Ⅴ级粒径段;4)测试区域内电子市场配件区细菌气溶胶浓度最高,地铁站台最低,分别为1 074 cfu/m^(3)、194 cfu/m^(3);真菌气溶胶浓度最高和最低的分别为超市蔬菜区和地铁站台,分别为614 cfu/m^(3)和113 cfu/m^(3);5)4类场所细菌气溶胶水平均为较清洁,真菌在超市中为较清洁,在地铁、医院大厅和电子市场内为清洁;6)所有场所微生物气溶胶的健康影响系数均显著小于1,健康风险较低。

北京地区医院建筑冬季室内微生物气溶胶浓度水平及暴露评价

为深入分析不同功能建筑室内微生物气溶胶的污染情况、分布特征及暴露水平。在对学校不同建筑冬季室内外细菌和真菌气溶胶的浓度水平分析的基础上,本文对医院不同功能场所室内细菌和真菌气溶胶的浓度大小、粒径分布和暴露水平进行了研究。结果表明:1)医院各场所冬季室内细菌气溶胶浓度为(82~841) cfu/m^3,真菌为(60~354) cfu/m^3,细菌与真菌浓度比B/F为1.91~5.10。2)医院室内细菌气溶胶的中值直径为(2.33~3.75)μm,真菌为(2.43~2.69)μm。且室内微生物气溶胶的中值直径均小于室外。3)医院室内细菌和真菌气溶胶对医务人员的日均潜在暴露量为(1 406~4 183)cfu/d和(485~1 601) cfu/d,对就诊人员的日均潜在暴露量为(144~1 101) cfu/d和(50~400) cfu/d。4)医院室内微生物气溶胶对医务人员的日均暴露量和潜在暴露量明显高于就诊人员,且测试医院门诊大厅内细菌和真菌气溶胶对医院人群的暴露量均高于呼吸科候诊厅、儿科候诊厅和口腔诊室的暴露量。

International Association of Diabetes and Pregnancy Study Group criteria is suitable for gestational diabetes mellitus diagnosis： further evidence from China

Background The International Association of Diabetes and Pregnancy Study Group （IADPSG） recommended new diagnostic criteria for gestational diabetes mellitus （GDM） after extensive analyses of the Hyperglycemia and Adverse Pregnancy Outcomes （HAPO） study. Unfortunately, there was no data from mainland of China in this study. We evaluated the feasibility of IADPSG criteria for GDM diagnosis in China. Methods A large prospective study was conducted. We reviewed medical records of a total of 25 674 pregnant women who underwent GDM screening and diagnosis between January 1, 2005 and December 31, 2012 in the Peking University First Hospital. The prevalence of gestational glucose metabolism abnormalities was calculated according to different cut off values defined by the National Diabetes Data Group （NDDG） or the IADPSG, and the incidence of adverse pregnancy outcomes related to GDM was analyzed. Results According to the cut off values of NDDG and IADPSG criteria, the prevalence of gestational glucose metabolism abnormalities was 8.4% and 18.9% （P 〈0.01） respectively, and the prevalence of cesarean section （52.5% vs. 46.0%, P 〈0.01）, macrosomia （7.5% vs. 6.3%, P 〈0.05）, neonatal hypoglycemia （1.6% vs. 1.0%, P 〈0.01）, and perinatal death （0.5% vs. 0.2%, P 〈0.01）; the prevalence was significantly lower when IADPSG criteria were applied. The prevalence of macrosomia, cesarean section, neonatal hypoglycemia, pregnancy induced hypertension, etc. was also higher in the GDM group than in the normal group. The prevalence of cesarean section （62.3%） and macrosomia （14.8%） was the highest in untreated mild GDM patients. Conclusions Our results indicated that treatment/intervention of women with GDM identified by IADPSG criteria was related to significantly lower risk of multiple adverse pregnancy outcomes. Such findings provide support for applying IADPSG criteria in China.

Freeze-drying-assisted Synthesis of Mesoporous CoMoO4 Nanosheets as Anode Electrode Material for Enhanced Lithium Batteries

A facile and green freeze-drying-assisted method was proposed to synthesize C0MoO4 mesoporous nano-sheets(MPNSs).The resulting product exhibits a Mgh specific capacity and good rate perfomance when evalimte an anode material for lithium-ion batteries(LIBs).The reversible specific capacity can be kept at 1105.2 mA·h·g^-1 after 100 cycles at a current density of 0.2 A/g.Even at the current densities of 1 and 4 A/gs the CoMoO4 MPNSs electrode can still retain the reversible capacities of 1148.7 and 540 mA·h·g^-1,respectively.Furthermore,the full cell(LiPePO4 catliode/CoMoO4 MPNSs anode)displays a stable discharge capacity of 146.7 mA·h·g^-1 at 0.1 C(1 C=170 mA/g)together with an initial coulombic efficiency of 98.2%.In addition,the CoMoO4 crystal structure is destroyed and reduced into Co^0 and Mo^0 in the first discharge process.In the subsequent cycles,the attractive Li storage properties come from the reversible conversions between Co/Co^2+and Mo/Mo^6+.The improved electroche-mical performance of CoMoO4 MPNSs is mainly attributed to their unique porous structures,which not only possess a good ion diffusion and electronic conduction pathway,but also provide many cavities to alleviate the volume changes during repeated cycling.This work offers a new perspective to the design of other porous electrode materials with a good energy storage performance.