Obstacles to the Integrated Care of Children Aged 6 to 59 Months Suffering from Acute and Severe Malnutrition at the Chu-Me and HATC of N’Djamena/Chad

Introduction: the problem of Severe Acute Malnutrition (SAM) and its consequences concern and challenge all social actors worldwide. The objective of the study was to identify the real obstacles that actors face in the integrated management of children aged 6 - 59 months suffering from SAM at the University Hospital of Mother and Child (CHUME) and the Chad-China Friendship Hospital (HATC) of N’Djamena. Methodology: this is a cross-sectional descriptive and interpretative study conducted from January to October 2023 at the CHUME and HATC of N’Djamena. It is based on questionnaires and direct observation of two hundred and thirty-six (236) parents or guardians of malnourished children admitted to these health facilities. All 236 agreed to participate freely in this study. Results: it appears from this study that the obstacles to the integrated management of malnourished children were: poor care-care relationship (26.7%) permanent product breaks (22.9%), the direct costs of services ranged from 30,000 to 60,000 FCFA (41.53%), drugs used for the treatment of patients came from the street (66.10%), malaria and anemia occupy an important place (27.5%), 57.2% respondents had monthly income below 60,000 CFAF. Conclusion: the present study carried out has identified the real bottlenecks to the integrated management of children suffering from SAM in the therapeutic nutritional units of the city of N’Djamena. .

PD-1抑制剂治疗肝癌患者的临床疗效及ECOG-PS评分联合Child-Pugh分级对肿瘤超进展的预测价值

目的探讨程序性死亡受体1(PD-1)抑制剂治疗肝癌患者的临床疗效,以及美国东部肿瘤协作组体力状况(ECOG-PS)评分联合Child-Pugh分级对肿瘤超进展的预测价值。方法选择100例肝癌患者,所有患者接受PD-1抑制剂治疗。根据治疗后是否出现肿瘤超进展将患者分为超进展组(n=18)和未超进展组(n=82),分析PD-1抑制剂治疗肝癌患者的临床疗效。采用受试者工作特征曲线评价Child-Pugh分级、ECOG-PS评分对肝癌患者发生肿瘤超进展的预测价值。采用多因素Logistic回归模型分析肝癌患者发生肿瘤超进展的独立影响因素,构建列线图预测模型并进行验证。结果PD-1抑制剂治疗后肝癌患者的疾病控制率为42.00%,肿瘤超进展发生率为18.00%。未超进展组与超进展组患者的年龄、饮酒史、肝炎病史、肿瘤直径、血管侵犯情况、远处转移情况、转移部位数量、甲胎蛋白水平、中性粒细胞与淋巴细胞比值(NLR)、Child-Pugh分级、ECOG-PS评分的差异有统计学意义(P<0.05)。Child-Pugh分级联合ECOG-PS评分预测肝癌患者发生肿瘤超进展的受试者工作特征曲线下面积、敏感度、特异度、阳性预测值、阴性预测值高于Child-Pugh分级、ECOG-PS评分单独预测(P<0.05)。多因素Logistic回归分析结果显示,年龄、远处转移情况、甲胎蛋白水平、NLR、Child-Pugh分级、ECOG-PS评分是肝癌患者出现肿瘤超进展的独立影响因素(P<0.05),根据上述影响因素构建的列线图预测模型预测肝癌患者出现肿瘤超进展具有良好的区分度和校准度。结论PD-1抑制剂治疗肝癌患者的疗效显著。ECOG-PS评分联合Child-Pugh分级对肝癌患者PD-1抑制剂治疗后发生肿瘤超进展具有较好的预测价值。年龄、远处转移情况、甲胎蛋白水平、NLR、Child-Pugh分级、ECOG-PS评分是肝癌患者发生肿瘤超进展的独立影响因素,基于上述因素所构建的列线图预测模型可为临床评估肝癌患者发生肿瘤超进展提供参考。

Literature Review on Support for Children and Families Experiencing Parental Bereavement

Purpose: This study aimed to understand the actual nursing support in a wide perspective by reviewing overseas literature on support for children who have experienced parental bereavement and their families. The goal was to identify future challenges in nursing support in clinical practice in Japan. Method: Literature searchable as of May 2023 was retrieved using PubMed, resulting in 11 relevant articles. Result: The results revealed the following: 1) For support provided to children, 13 codes were condensed into 5 subcategories and 4 categories. 2) For support provided to families, 36 codes were condensed into 11 subcategories and 4 categories. Conclusion: Open communication was found to be essential for supporting children and their families who have experienced parental bereavement. Moreover, involvement of multiple professions facilitated the provision of specialized support to address diverse needs of children and families, playing a crucial role in overcoming grief. Additionally, the effectiveness of support systems for bereaved families highlighted the need for nursing professionals in Japan to gain knowledge through learning opportunities and to establish a multi-disciplinary approach to support, thus indicating future challenges in nursing support.

The Effect of Human Immunodeficiency Virus-1 Infection on Low Birth Weight, Mother to Child HIV Transmission and Infants’ Death in African Area

Background: It is yet a controversy subject whether low birth weight and infant death are associated to human immunodeficiency virus-1 infection. Objective: To appreciate association between low birth weights, mother to child HIV transmission and infant mortality in HIV-1 infected pregnant women delivering between 2011 and 2016. Materials: We conducted 6 years cohort study in urban Mali. Outcome included preterm delivery, small for gestational age, infant survival status and HIV transmission. Comparison concerned women clinical WHO stage, mother viro-immunological status, and newborn anthropometric parameters. Results: HIV-1 infected women who delivered low birth weight newborn were 20.9% (111/531) versus 16.5% (1910/11.546) in HIV negative patients (p = 0.016). CD4 T cell counts low than 350 T cells count were strongly associated to LBW (p = 0.000;RR = 3.03;95% CI [1.89 - 3.16]). There is no significant association between ART that was initiated during pregnancy (p = 0.061, RR = 0.02;CI 95% (1.02 - 1.99)) or during delivery (p = 0.571;RR = 1.01;CI 95% (0.10 - 3.02)) and LBW delivery. In multivariate analysis ART regimens containing protease inhibitor (PI) were lone regimens associated with LBW ((p = 0.030;RR = 1.001;95% confidence interval [1.28 - 3.80]). Very low birth weight was statistically associated to women HIV infection (adjusted relative risk, 2.02;p = 0.000;95% confidence interval (2.17 - 4.10)). There is no significant difference between mother to child HIV transmission rate in the two HIV-infected pregnant women (10 infected children in group 2: MTCT rate 4.5%) and 3 infected children in group 1 (MTCT rate: 2.7%) (p = 0.56;RR, 0.59;CI 95% (0.18 - 4.39)). In multivariate analysis, LBW was associated with infant death (p = 0.001;RR = 2.04;CI 95% [1.04 - 5.05]). The median weight of infant at the moment of death in group 1 was 851 g (IQR: 520 - 1833 g). Significant relationship was found between infant death among LBW newborn with mother WHO stage 2 (p = 0.004;adjusted RR = 3.22;CI 95% [2.25 - 6.00]), CD4 T cells count 3 (p = 0.005;RR = 2.81;CI 95% [1.20 - 4.11]), PI regimens (p = 0.030;RR = 1.00;CI 95% [1.28 - 3.80]). Conclusion: We confirm increased risk of low birth weight and mother HIV-1 infection and we identified strongest association between mortality in infant born to HIV-1 infected mother and LBW.

Child-Pugh分级和MELD评分对死亡的肝硬化患者的回顾性分析

目的:通过回顾性分析大出血死亡和非大出血死亡肝硬化患者中的Child-Pugh分级(CP分级)和终末期肝病评估模型(MELD)评分,以了解这两种评分方法对肝硬化患者病情判断及预后预测的价值。方法:选择160例肝硬化患者为研究对象,包括72例已死亡的肝硬化病例组,并且根据最终死亡主要原因是否与消化道大出血有直接关系进一步分为大出血死亡组和非大出血死亡组,以及88例肝硬化住院并好转出院的患者作为好转组,记录他们入院首次的临床资料,均进行MELD和CP评分和比较。结果:死亡组CP分值为10.264±2.028,MELD评分为22.230±13.451,好转组CP分值9.318±1.644,MELD评分15.37±6.201,两组之间两种评分差异均有统计学意义(P<0.05或P=0.001)。与好转组比较,大出血死亡组的两种评分差异均无统计学意义(P>0.05),而非大出血死亡组的差异均有统计学意义(P<0.05)。死亡组中CP分级为C级和高MELD评分(≥30分)的患者所占比例均高于好转组。死亡组中低MELD评分(<20分)和CP分级A级的患者中上消化道大出血致死的占70%以上。ROC曲线分析显示剔除大出血死亡因素后,MELD评分系统和CP分级短期死亡风险预测精确度明显提高。结论:MELD评分和CP分级系统对肝硬化患者预后预测均有一定价值,分值越高死亡的风险越大。在排除大出血死亡的前提下,MELD评分系统和CP分级系统均对肝硬化患者的短期生存预测更准确。MELD和CP分级评分系统存在不足,尤其对低MELD(<20分)和CP分级A级者的预后判断准确性不高,需要联合食道胃底静脉曲张情况共同评估患者的预后。

肝功能Child-Turcotte-Pugh评分在住院心力衰竭患者风险评估中的应用

目的:心力衰竭(心衰)患者常伴有肝功能损害,Child-Turcotte-Pugh(CTP)评分可用于评估肝脏功能,但其在心衰患者的应用尚不清楚。本研究旨在评估CTP评分在预测住院心衰患者死亡的价值。方法:连续入选1180例因心衰住院的患者,根据患者入院时肝功能情况进行CTP评分并按照CTP评分由小到大将患者分为3组:CTP A级组(n=951)、CTP B级组(n=206)及CTP C级组(n=23),终点事件为全因死亡。结果:随访1年后,有180例患者发生死亡,CTPA、B、C级心衰患者住院死亡率及1年死亡率均随着CTP等级的升高而增加(住院死亡率0.8%,11.7%,56.5%,P<0.001;1年死亡率9.6%,34.5%,78.3%,P<0.001)。多因素Cox回归分析显示CTP等级越高患者住院及1年死亡风险越高。CTP评分对住院死亡及1年全死亡判断的受试者工作特征曲线下面积分别为0.88与0.74。Kaplane Meier生存曲线显示出院时由CTP B或C级改善为CTP A级的患者1年生存率明显高于未改善的患者(P=0.028)。结论:CTP评分可以独立预测住院心衰患者的死亡风险,其住院期间的变化可用于评估患者住院期间的治疗效果。

血清对氧磷酯酶-1活性与肝硬化Child-Pugh分级的关系

目的探讨血清对氧磷酯酶-1(PON1)酶活性与肝硬化Child-Pugh分级的关系。方法以对氧磷(paraoxon)为底物测定76例正常、26例急性肝炎、45例慢性肝炎和72例肝硬化患者血清基础PON-1活性和1mol/L NaCl刺激后PON1活性;PCR扩增PON1基因,Alw I酶切PCR产物,对PON1基因192位多态性进行分型。结果正常对照组、急性肝炎、慢性肝炎和肝硬化患者血清PON-1基础活性水平分别为403±145,312±83,201±114,137±99 U/ml;1mol/L NaCl刺激后PON-1活性分别为673±232,509±139,335±151,233±162 U/ml。与正常对照比较,急性肝炎、慢性肝炎和肝硬化患者血清PON-1活性基础水平和1mol/LNaCl刺激后PON1活性均显著下降(P<0.01),肝硬化组下降最明显。肝硬化Child A,Child B和Child C组患者血清PON-1活性基础水平分别为185.5±98.6,141.6±93.6,86.7±51.2 U/ml;1mol/L NaCl刺激后PON-1活性分别为308.9±161.3,227.1±116.3,124.9±78.1 U/ml。Child B组比A组PON1酶活性显著下降(P<0.05),而Child C组又比B组PON1酶活性显著下降(P<0.01)。在肝硬化Child A,Child B和Child C组患者PON1的192位R-Q多态性分布频率无显著性差异(P>0.05)。结论血清PON1活性下降与肝硬化Child-Pugh分级相关,可反应肝硬化的严重程度,且PON1基因192位多态性不影响肝硬化各组的PON1酶活性。

Pivotal role of long non-coding ribonucleic acid-X-inactive specific transcript in regulating immune checkpoint programmed death ligand 1 through a shared pathway between miR-194-5p and miR-155-5p in hepatocellular carcinoma

BACKGROUND Anti-programmed death therapy has thrust immunotherapy into the spotlight.However,such therapy has a modest response in hepatocellular carcinoma(HCC).Epigenetic immunomodulation is a suggestive combinatorial therapy with immune checkpoint blockade.Non-coding ribonucleic acid(ncRNA)driven regulation is a major mechanism of epigenetic modulation.Given the wide range of ncRNAs that co-opt in programmed cell-death protein 1(PD-1)/programmed death ligand 1(PD-L1)regulation,and based on the literature,we hypothesized that miR-155-5p,miR-194-5p and long non-coding RNAs(lncRNAs)X-inactive specific transcript(XIST)and MALAT-1 are involved in a regulatory upstream pathway for PD-1/PD-L1.Recently,nutraceutical therapeutics in cancers have received increasing attention.Thus,it is interesting to study the impact of oleuropein on the respective study key players.AIM To explore potential upstream regulatory ncRNAs for the immune checkpoint PD-1/PD-L1.METHODS Bioinformatics tools including microrna.org and lnCeDB software were adopted to detect targeting of miR-155-5p,miR-194-5p and lncRNAs XIST and MALAT-1 to PD-L1 mRNA,respectively.In addition,Diana tool was used to predict targeting of both aforementioned miRNAs to lncRNAs XIST and MALAT-1.HCC and normal tissue samples were collected for scanning of PD-L1,XIST and MALAT-1 expression.To study the interaction among miR-155-5p,miR-194-5p,lncRNAs XIST and MALAT-1,as well as PD-L1 mRNA,a series of transfections of the Huh-7 cell line was carried out.RESULTS Bioinformatics software predicted that miR-155-5p and miR-194-5p can target PDL1,MALAT-1 and XIST.MALAT-1 and XIST were predicted to target PD-L1 mRNA.PD-L1 and XIST were significantly upregulated in 23 HCC biopsies compared to healthy controls;however,MALAT-1 was barely detected.MiR-194 induced expression elevated the expression of PD-L1,XIST and MALAT-1.However,overexpression of miR-155-5p induced the upregulation of PD-L1 and XIST,while it had a negative impact on MALAT-1 expression.Knockdown of XIST did have an impact on PD-L1 expression;however,following knockdown of the negative regulator of X-inactive specific transcript(TSIX),PD-L1 expression was elevated,and abolished MALAT-1 activity.Upon co-transfection of miR-194-5p with siMALAT-1,PD-L1 expression was elevated.Co-transfection of miR-194-5p with siXIST did not have an impact on PD-L1 expression.Upon co-transfection of miR-194 with siTSIX,PD-L1 expression was upregulated.Interestingly,the same PD-L1 expression pattern was observed following miR-155-5p cotransfections.Oleuropein treatment of Huh-7 cells reduced the expression profile of PD-L1,XIST,and miR-155-5p,upregulated the expression of miR-194-5p and had no significant impact on the MALAT-1 expression profile.CONCLUSION This study reported a novel finding revealing that opposing acting miRNAs in HCC,have the same impact on PD-1/PD-L1 immune checkpoint by sharing a common signaling pathway.

The Potential Role of a Health and Demographic Surveillance System in Rural Northern Nigeria to Reduce Maternal and Child Deaths

There exist a huge gap between generation of evidence-based research findings and its use to inform policies in most developing countries. Further, it is evident that most developing countries are lagging behind in formulating appropriate policies aimed at improving people’s lives due to lack of evidence-based research findings. We describe the potential of a Health and Demographic Surveillance System (HDSS) in informing appropriate health interventions towards reducing the high maternal and child deaths in rural communities of north western Nigeria through the Verbal Autopsy (VA) data collection. VA data collection involves the use of VA questionnaires—set of open ended and closed ended questions adapted from the World Health Organization (WHO) module— administered to the caregivers, parents or family members of a deceased person to elicit information on signs and symptoms and their durations, and other pertinent information about the deceased in the period before death. VA interviews were conducted by trained VA enumerators on all 2100 deaths reported during the update round 4 of routine data collection (July-December, 2012) and returned forms were checked for consistencies and completeness by a trained research officer. The forms were later coded by trained medical doctors for possible cause of death using the WHO International Classification of Diseases (ICD 10) codes. Fifty cases of neonatal deaths, 1650 cases of infant and child deaths, and 400 cases of adult deaths were reported during the update round 4 data collection. Neonatal sepsis was reported as the leading cause of neonatal deaths (58%) while malaria and intestinal infectious diseases were reported as the leading cause of infant and child deaths and adult deaths respectively (45% and 17%, respectively). The study provides documented evidence of high neonatal deaths due to neonatal sepsis in an area with low hygiene and high home delivery rates. The findings from the VA data collection at Nahuche HDSS inform the intervention study on home distribution of chlorhexidine to pregnant women. The findings from this study call on government and other stakeholders to strengthen research capacity to generate timely data and findings returned to policy makers within the shortest period of time for decision making.

儿童急性早幼粒细胞白血病早期死亡危险因素分析

目的分析初诊急性早幼粒细胞白血病(APL)早期死亡患儿的临床特点,探讨直接死亡原因和导致早期死亡的危险因素。方法回顾性分析2013年1月至2020年12月连续收治的初诊APL患儿的临床资料。结果纳入103例APL患儿,男56例、女47例,中位发病年龄9.0(7.0~13.0)岁,低、中、高危组患儿分别为24例、41例、38例,早期死亡13例。与生存组比较,早期死亡组初诊白细胞计数(WBC)≥100×109/L、凝血酶原时间(PT)延长≥3 s、D-二聚体≥9 mg/L、骨髓早幼粒细胞≥90%、危险度为高危的比例较高,差异均有统计学意义(P<0.05)。发生早期死亡的13例患儿中,男10例、女3例,从诊断至死亡的中位时间为4.0(2.0~7.0)d。13例患儿均死于出血,其中颅内出血13例,颅内出血合并肺出血5例。多因素logistic回归分析显示,初诊WBC≥10×109/L(OR=17.27,SE=1.12,95%CI:1.92~155.04)是发生早期死亡的独立危险因素。结论儿童APL早期病死率高,初诊WBC≥10×109/L是APL患儿发生早期死亡的重要预测因子。

贵阳市2002-2004年0-14岁儿童死亡原因分析

目的 了解贵阳市儿童少年死亡原因,提出对应预防措施,以有效降低儿童少年死亡率。方法 以街道办事处（乡、镇）为抽样单位,对2002-2004年贵阳市0-14岁儿童死因进行回顾性调查。结果 贵阳市0-14岁儿童少年死亡率为1.66‰,婴儿死亡率为12.42%,新生儿死亡占婴儿死亡的60.48%。伤害是0-14岁儿童的首要死因,其中溺水、交通事故、跌坠是伤害死亡的前3位原因。结论 贵阳市儿童死亡率较高。婴儿死亡率降低可降低儿童少年死亡率,有效控制伤害可降低儿童少年死亡率。

应用捕获-再捕获法估计5岁以下儿童死亡漏报率及死亡率

目的 探索用捕获 再捕获方法 (CRM )估计 5岁以下儿童死亡漏报率和死亡率 ,评价卫生部门收集 5岁以下儿童死亡资料的准确程度。方法 利用内蒙古喀喇沁旗卫生和计生两部门 1997～ 2 0 0 0年的 5岁以下儿童死亡登记资料通过核对、入户核查 ,用CRM估计儿童死亡率。结果 用CRM估计研究地区 1997～ 2 0 0 0年 5岁以下儿童死亡数为3 99人 ,卫生部门的漏报率为 2 4 8%,并且存在死亡儿童年龄越低死亡漏报率越高的现象 ;卫生部门 1997～ 2 0 0 0年报表登记的 5岁以下儿童平均死亡率为 2 2 97‰ ,估计 5岁以下儿童死亡率为 3 0 5 5‰ ,高于将两部门资料合并得到的儿童死亡率 2 8 5 6‰。结论 可以利用卫生和计生部门现有的信息依靠CRM校正因漏报而造成的数值误差 ,获得较准确的儿童死亡率。但在使用时必须注意其使用的前提条件 ,不能盲目地套用公式。

Ferroptosis mechanism and Alzheimer's disease

Regulated cell death is a genetically determined form of programmed cell death that commonly occurs during the development of living organisms.This process plays a crucial role in modulating homeostasis and is evolutionarily conserved across a diverse range of living organisms.Ferroptosis is a classic regulatory mode of cell death.Extensive studies of regulatory cell death in Alzheimer’s disease have yielded increasing evidence that fe rroptosis is closely related to the occurrence,development,and prognosis of Alzheimer’s disease.This review summarizes the molecular mechanisms of ferroptosis and recent research advances in the role of ferro ptosis in Alzheimer’s disease.Our findings are expected to serve as a theoretical and experimental foundation for clinical research and targeted therapy for Alzheimer’s disease.

肝硬化患者血清PGⅠ、PGⅡ及G-17水平变化及临床意义

目的探索肝硬化患者血清中胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)及胃泌素-17(G-17)的水平变化及临床意义。方法选取自2013年7月至2014年11月我院接收的肝硬化患者97例,作为观察组;另选取同期未患胃病的肝硬化患者92例,作为对照组。采用ELISA法分析肝硬化患者血清中PGⅠ、PGⅡ及G-17的水平变化。结果与对照组相比,观察组患者血清中PGⅠ、PGⅡ和G-17水平明显高于对照组,且差异具有统计学意义(P<0.05)。另外,与Child-Paugh A级相比,Child-Paugh C级患者血清中PGⅠ、PGⅡ和G-17的水平显著升高;Child-Paugh B级患者血清中PGⅠ和G-17的水平明显升高,差异具有统计学意义(P<0.05)。结论肝硬化患者血清中PGⅠ、PGⅡ及G-17可以作为指标来表征胃部疾病,且三个指标的水平与Child-Paugh分级有一定的联系。

肝硬化患者血清中γ-谷氨酰转移酶、胆碱酯酶、总胆汁酸水平及凝血功能对肝功能分级的价值评价

目的探讨肝硬化患者γ-谷氨酰转移酶(GGT)、胆碱酯酶(CHE)、总胆汁酸(TBA)水平及凝血功能的变化在Child-Pugh分级中的价值。方法测定40例肝硬化患者血清GGT、CHE、TBA及血浆中凝血酶原时间(PT)、激活部分凝血激酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(FIB)含量。与对照组30例比较。同时比较在肝硬化不同Child-Pugh分级状态时这7项指标的差异。结果与对照组比较,肝硬化组GGT、TBA血清含量明显升高,PT、APTT、TT时间延长,而CHE、FIB血清含量明显下降,差异均有显著性(P<0.001),且在不同肝功能分级时,各项指标均有统计学意义(P<0.05或P<0.01或P<0.001)。结论肝硬化患者GGT、CHE、TBA、PT、APTT、FIB、TT值与正常对照组比较存在明显差异,且不同肝功能分级的上述指标变化相异,故联合检测上述各值可为临床评价肝硬化患者的肝功能及预后提供客观依据。

PD-1/PD-L1抑制剂在儿童复发难治淋巴瘤中的免疫治疗进展

一些临床研究中显示,以程序性细胞凋亡蛋白-1(PD-1)或程序性凋亡配体-1(PD-L1)为靶点的免疫检查点抑制剂对于难治复发儿童恶性血液疾病及肿瘤有一定疗效,对难治复发霍奇金淋巴瘤、原发性纵隔B细胞淋巴瘤有一定抗肿瘤作用,儿童和青少年耐受性相对良好。PD-1/PD-L1抑制剂似乎并未增加感染率,但对于补充糖皮质激素和/或TNF-α靶向药物免疫抑制治疗者建议使用卡氏肺囊虫预防措施。与其他类型免疫检查点抑制剂、化疗药物及组蛋白脱乙酰酶抑制剂的联合应用,目前仍处于临床研究阶段。PD-1/PD-L1抑制剂的儿童使用剂量、疗程及方案还需要多中心的进一步研究,是否能够达到持久抗肿瘤作用亦需要更深入的研究。

2001-2010年河北省5岁以下儿童死亡趋势分析

目的分析全省2001-2010年5岁以下儿童死亡率及死因构成变化趋势,为政策制定提供理论依据。方法对河北省具有代表性的32个监测市、县、区5岁以下儿童死亡监测数据进行分析。结果 2001-2010年河北省婴儿和5岁以下儿童死亡率呈逐年下降趋势,农村婴儿死亡率和5岁以下儿童死亡率均明显高于城市。十年来河北省5岁以下儿童前五位疾病死因顺位发生较大变化,2010年依次为早产和/或低出生体重、先天性心脏病、出生窒息、其他先天异常、肺炎。

2006-2015年重庆市5岁以下儿童先天异常死亡情况分析

目的了解2006-2015年重庆市5岁以下儿童先天异常死亡的变化趋势。方法采用重庆市5岁以下儿童死亡监测网收集的2006-2015年以人群为基础的监测资料,计算5岁以下儿童先天异常死亡专率、构成比和年龄分布情况。结果重庆市5岁以下儿童先天异常死亡率由2006年的185.1/10万下降至2015年的145.1/10万。5岁以下儿童先天性心脏病、神经管畸形和先天愚型死亡率均明显下降。先天异常死亡占5岁以下儿童死亡的比例由2006年的14.3%上升至2010年的20.1%。5岁以下儿童先天异常死亡主要发生在婴儿期,尤其是新儿期。结论先天异常占5岁以下儿童死亡比例逐年上升,应继续加强出生缺陷三级预防,进一步减少5岁以下儿童先天异常死亡。

5-氮杂胞苷对胃癌裸鼠移植瘤死亡受体DR4和DR5表达的影响

【目的】研究5-氮杂胞苷(5-Aza-CdR)对胃癌裸鼠移植瘤中死亡受体4(DR4)和死亡受体5(DR5)表达的影响。【方法】利用RT-PCR方法检测5-Aza-CdR处理后的胃癌裸鼠移植瘤内DR4和DR5的RNA表达水平、用MS-PCR检测5-Aza-CdR处理后的胃癌裸鼠抑制瘤内DR4和DR5启动子区甲基化水平。【结果】5-Aza-CdR能够抑制胃癌裸鼠移植瘤的生长。5-Aza-CdR能够逆转胃癌裸鼠移植瘤中DR4和DR5的启动子甲基化水平,并上调DR4和DR5的表达水平。【结论】去甲基化药物5-Aza-CdR能够抑制裸鼠胃癌移植瘤生长,提示该药物有治疗作用且能够诱导DR4和DR5的启动子区去甲基化从而使DR4和DR5的表达水平升高。

成都市锦江区2008-2017年5岁以下儿童死亡监测分析

目的分析成都市锦江区2008-2017年5岁以下儿童死亡率和死因构成及其变化趋势。方法收集锦江区2008-2017年5岁以下儿童死亡监测数据,采用描述性分析、卡方检验等进行统计分析。结果 2008-2017年锦江区新生儿死亡率和5岁以下儿童死亡率呈下降趋势,不同性别5岁以下儿童死亡率差异无统计学意义(P> 0. 05)。儿童死亡的前五位死因依次为:早产或低出生体重、肺炎、其他先天性异常、先天性心脏病、其他新生儿疾病。省(市)级医疗保健机构是死亡儿童最主要的诊治机构。结论锦江区2008-2017年5岁以下儿童死亡率显著下降,降低新生儿及婴儿死亡率是降低5岁以下儿童死亡的关键环节,早产、肺炎和先天性心脏病是主要死因。