Socioeconomic status dependent medical complexities in children with sickle cell disease in Saudi Arabia

A look into the associations of socioeconomic status (SES) with prevalence of various complications in sickle cell disease (SCD) is necessary, for an improvement of societal norms, governmental health policies and strategies. We therefore studied the influence of SES indices on certain hematological and clinical parameters in children with SCD in Saudi Arabia. We included 32 female and 33 male patients aged 5–16 years, who were classified based upon their family income. Family monthly income was divided into 4 categories from lowest to highest, with socioeconomic class1 having low earnings of <5000 SAR; the middle income class divided further into class 2 with earnings >5000–10,000 SAR, and class 3 with earnings >10,000–15,000 SAR; and the higher income class 4 with earnings of >15,000 SAR. The assessment indices used were, the frequency of vaso-occlusive crisis (VOC), adverse events, and hematological parameters. A higher percentage of children affected with the disease were from class1, which is the low socio-economic class. It was found that the percentage of frequency of VOC pain crisis, and adverse events was higher in social class 1 patients than in the classes 2, 3, and 4. Also, the age group 5–10 years appeared more susceptible to adverse events and VOC. Our findings suggest the need to conduct future larger studies, to deduce the modifying influence of disparity in SES on certain clinical and hematological indices in children with SCD.     

2004-2016年贵州省石漠化状况及动态演变特征

石漠化是制约我国西南地区社会、经济、生态发展的重要因素之一,及时监测评估其演变状况,对区域石漠化防治及生态环境建设具有重要科学意义。选取2004-2016年间4期TM影像,研究贵州省域尺度上、石漠化时空演变特征和未来发展趋势。结果显示：1）2004-2016年间,贵州省78.3%的区域植被覆盖度上升,平均增加了19.1%,达到63.4%,有55.4%的区域岩石裸露率下降;2）贵州省石漠化空间分布呈现从东北到西南渐次加重的特征,西部毕节市中、重度石漠化面积占该区域面积仍达62.0%-86.4%,而东部黔东南州约为18.4%-33.0%;3）2004-2016年间,贵州省石漠化状况呈现总体持续好转态势,以轻、中度石漠化转入为主体的无石漠化面积增加了1.1倍,轻度石漠化增加了20.0%左右,中度和重度石漠化面积分别减少了40.0%左右;4）截止到2016年,贵州省无石漠化、轻、中、重度石漠化区域分别占比约42.0%、24.1%、23.5%、10.4%;5）未来2020年及2024年,贵州省石漠化仍将持续改善,石漠化面积占比将分别减少8.9%和12.2%。过去十多年间,贵州省石漠化状况得到基本遏制,但局部区域仍存在高度的不稳定性,或趋于恶化的风险,未来在各类政策措施的支持下,贵州省石漠化状况仍将继续好转,但部分重度石漠化区域的治理将更为复杂而艰难。     

Correlation between chronological age and skeletal age using cvmi and modified MP3 methods

Chronological age conveys only a rough approximation of the maturational status of a person whereas skeletal maturity indicators give a more accurate estimation. Therefore, it is of interest to document the correlation between chronological and skeletal age using CVMI and modified MP3 methods. A total of 39 subjects between the age ranges of 9-16 years were selected for this study. Pre-treatment lateral cephalograms and hand-wrist radiographs of the subjects were used. The skeletal age was analyzed by the Cervical Vertebrae Maturity Index (CVMI) and modified MP3 methods. The data was analyzed with SPSS software version 23.00. Kendall''s Tau correlation test was performed to estimate the correlation between chronological age and skeletal age among the subjects and a linear regression test was also performed. Positive correlation was found between chronological age and skeletal age assessed by CVMI method (r= 0.398) and modified MP3 method (r=0.382) with p value >0.003. Thus it can be concluded that there was a positive correlation between chronological age and skeletal age among all the subjects.     

精准营养联合生长抑素对胃癌根治术患者的临床疗效

目的探讨生长抑素联合精准营养疗法对胃癌根治术患者术后营养指标水平和肠道菌群的影响。方法选取我院2017年10月至2019年1月收治并拟行胃癌根治术治疗的92例胃癌患者为研究对象,随机分为对照组(46例)和观察组(46例)。两组患者术后均给予常规处理。对照组患者同时给予生长抑素+常规肠外营养支持,观察组患者同时给予生长抑素+精准营养支持。于营养干预前后统计两组患者营养相关指标[体质量、血清白蛋白(ALB)、前白蛋白(PA)、淋巴细胞计数(LC)、肌酐(Ct)以及尿素氮(UN)]水平;对肠道菌群进行alpha分析,并计算肠杆菌、肠球菌、乳杆菌和双歧杆菌数量。结果营养干预前,两组患者营养相关指标水平以及肠道菌群相关指标水平之间差异无统计学意义(均P>0.05)。营养干预后,(1)观察组患者平均体质量以及血清ALB、PA、LC水平分别为(56.98±5.34)kg、(29.98±6.03)mg/L、(137.14±35.17)g/L、(1.15±0.26)×10⁹,对照组分别为(53.29±5.18)kg、(26.12±5.29)mg/L、(104.53±27.66)g/L、(0.82±0.18)×10⁹,两组之间差异有统计学意义(均P<0.05);(2)观察组患者肠道菌群Chao指数和Ace指数水平分别为(397.84±75.23)、(408.26±78.34),对照组分别为(362.13±66.23)、(371.19±70.09),两组之间差异有统计学意义(均P<0.05);(3)观察组患者肠道肠杆菌、肠球菌数量明显低于对照组,而乳杆菌、双歧杆菌数量明显高于对照组(均P<0.05)。结论胃癌根治术患者术后联合生长抑素和精准营养疗法能够显著改善患者的营养状况,保持肠道菌群丰度,平衡肠道菌群分布,值得临床研究和应用。     

Trait‐based diatom functional diversity as an appropriate tool for understanding the effects of environmental changes in soda pans

Saline lakes, among the most seriously endangered ecosystems, are threatened due to climate change and human activities. One valuable feature of these environments is that they constitute areas of high biodiversity. Ecologists are, therefore, under great pressure to improve their understanding of the effects of natural and anthropogenic disturbances on the biodiversity of saline lakes. In this study, a total of 257 samples from 32 soda pans in Central Europe between 2006 and 2015 were examined. The effects of environmental variables and of geographical and limnoecological factors on functional diversity were analyzed. Furthermore, the explanatory power of the trait‐based approach was assessed, and the applicability of the indices for biomonitoring purposes was determined. It was found that low habitat heterogeneity and harsh environments lead to the selection of a small number of suitable traits, and consequently, to a naturally low level of functional diversity. Anthropogenic activities enhance diversity at functional level due to the shift toward freshwater characteristics. On the regional scale, the effects of the region and status (natural, degraded, reconstructed) on diatom functional diversity were significant and more pronounced than that of the environmental and other limnoecological factors. The degree of variance found in functional diversity ascribed to environmental variables is five times greater in the case of the application of a trait‐based approach, than when a taxonomic one is employed in the literature. Each of the tested functional diversity indices was sensitive to the most important environmental variables. Furthermore, these were type‐specific and proved to be more complex indicators than taxonomic metrics. It is possible to suggest four functional diversity indices (FGR, FRic, FDis, and FDiv) which emphasize their independence from substrate and seasonal variations for ecological status assessment and conservation planning.     

稀有鮈鲫对不同生境的选择性偏好

对不同生境的识别和选择性偏好是保障鱼类生存和繁衍的重要能力之一。以稀有鮈鲫（Gobiocypris rarus）为研究对象,使用沙、水草和石块在观测水缸中进行多种排列组合以构建不同的生境类型,基于在各区域的停留时长和中线跨越次数两项参数,测试稀有鮈鲫对不同生境类型的偏好以及营养状态、生境组成物数量、环境照度对该行为影响。结果表明,稀有鮈鲫对不同的生境类型具有明显的选择性偏好,对仅水草生境偏好程度最高,对仅石块生境的偏好程度最低。该偏好行为在24 h的禁食后变化不显著（P > 0.05）,但生境组成物数量和环境照度对该行为具有显著影响（P < 0.05）,其偏好程度随水草数量和照度的增加而增加,在包含8棵水草及1 000 lx的照度下最高。     

微血管减压术联合感觉根部分切断术对原发性三叉神经痛患者疼痛评分、生活质量及睡眠状况的影响

目的:探讨微血管减压术(MVD)联合感觉根部分切断术(PSR)对原发性三叉神经痛(TN)患者疼痛评分、生活质量及睡眠状况的影响。方法:回顾性分析2015年2月~2019年3月期间我院收治的80例原发性TN患者的临床资料,根据手术方式的不同将患者分为对照组(n=40,MVD治疗)和研究组(n=40,MVD联合PSR治疗),比较两组患者疼痛评分、生活质量、围术期指标、睡眠状况、并发症发生情况以及复发率。结果:两组患者治疗后视觉疼痛模拟量表(VAS)评分均较治疗前下降,且研究组低于对照组(P<0.05)。两组患者治疗后生活质量量表(SF-36)各维度评分均较治疗前升高,且研究组高于对照组(P<0.05)。两组患者治疗后匹兹堡睡眠质量指数表(PSQI)各项目评分均较治疗前升高,且研究组高于对照组(P<0.05)。研究组住院时间短于对照组,手术时间长于对照组(P<0.05);两组术中出血量比较无统计学差异(P>0.05)。研究组的并发症总发生率低于对照组(P<0.05)。两组随访期间复发率比较差异无统计学意义(P>0.05)。结论:MVD联合PSR治疗原发性TN,虽然手术时间较长,但是在减轻患者疼痛、改善患者生活质量及睡眠状况等方面效果显著,能够降低并发症发生率。     

生殖道感染类型分布及其对女性血清炎症因子、性功能和心理状态的影响

摘要 目的：了解女性生殖道感染类型分布情况,分析生殖道感染对女性血清炎症因子、性功能和心理状态的影响。方法：选择2016年5月～2018年8月到我院就诊的生殖道感染女性患者60例（研究组）,另选取同期到我院进行健康体检的健康女性60例（对照组）。统计研究组患者生殖道感染的感染类型,并比较两组血清炎症因子、性功能和心理状态情况。结果：60例生殖道感染患者感染类型以宫颈炎（33.33%）、非特异性阴道炎（26.67%）居多。研究组血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）以及白细胞介素-8（IL-8）水平分别为（144.38±31.85）ng/mL、（73.85±15.73）ng/mL、（218.64±43.28）ng/mL,均高于对照组的（99.01±22.25）ng/mL、（40.27±10.52）ng/mL、（113.82±26.08）ng/mL,差异有统计学意义（均P＜0.05）。研究组性欲、高潮频数、性满意度、性焦虑、配偶高潮频数、配偶性满意度评分分别为（3.08±0.92）分、（4.38±1.01）分、（2.71±1.07）分、（3.66±1.30）分、（2.68±1.01）分、（2.95±1.04）分,均低于对照组的（3.84±0.51）分、（4.92±0.32）分、（3.87±0.47）分、（4.18±0.54）分、（3.82±0.38）分、（3.97±0.41）分,差异有统计学意义（均P＜0.05）。研究组健康问卷抑郁量表（PHQ-9）与广泛性焦虑评定量表（GAD-7）评分分别为（16.35±5.88）分、（13.87±3.73）分,均高于对照组的（5.15±1.76）分、（5.89±1.39）分,差异有统计学意义（均P＜0.05）。结论：女性生殖道感染以宫颈炎和非特异性阴道炎为主,生殖道感染会导致女性患者血清炎症因子水平显著升高,性功能降低,同时对患者心理状态也存在一定影响,因此,在临床工作中应予以患者及时有效的干预,从而改善患者性功能以及心理状态。     

不同预后脓毒症患者血清降钙素原、C反应蛋白与凝血功能指标和APACHE Ⅱ评分的关系分析

目的:探讨不同预后脓毒症患者血清降钙素原(PCT)、C反应蛋白(CRP)与凝血功能指标和急性生理和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分的关系。方法:回顾性分析2015年1月至2019年1月期间深圳市第二人民医院重症医学科收治的160例脓毒症患者(脓毒症组)与在深圳市第二人民医院接受住院治疗的160例非脓毒症患者(非脓毒症组)的临床资料,根据脓毒症组患者住院28d后的预后情况分为存活组118例和死亡组42例,比较脓毒症组和非脓毒症组以及死亡组和存活组患者血清PCT和CRP水平、APACHE II评分以及凝血功能指标,采用Pearson相关性回归分析脓毒症患者血清降钙素原和CRP水平与APACHEⅡ评分以及凝血功能指标相关性。结果:与非脓毒症组相比,脓毒症组的血清PCT和CRP水平以及APACHEⅡ评分明显升高,凝血酶原时间(PT)和部分凝血活酶时间(APTT)明显延长(均P<0.05)。与存活组相比,死亡组的血清PCT和CRP水平以及APACHEⅡ评分明显升高,而PT和APTT均明显延长(均P<0.05)。Pearson相关性回归分析结果显示,血清PCT和CRP水平与APACHEⅡ评分、PT及APTT均呈正相关(均P<0.05)。结论:脓毒症患者血清PCT和CRP水平异常升高,APACHEⅡ评分及凝血功能指标均与血清PCT和CRP水平呈正相关,检测血清PCT和CRP水平有助于评估脓毒症患者的预后。     

老年肺炎患者血清Apelin-13水平与疾病严重程度和预后的相关性研究

摘要 目的：探讨与研究老年肺炎患者血清Apelin-13水平与疾病严重程度和预后的相关性。方法：采用回顾性研究方法,2018年3月到2021年2月选择在延安大学咸阳医院住院诊治的老年肺炎患者78例作为研究对象,检测血清Apelin-13水平,使用急性生理学及慢性健康状况评分系统（APACHEⅡ）、CT严重程度指数（CTSI）、序贯性器官功能衰竭评分（SOFA）评定患者的疾病严重程度,随访患者的预后并进行相关性分析。结果：所有患者随访到2021年7月1日,平均随访时间为18.47±2.82个月,死亡18例（死亡组）,占比23.1 %。死亡组的性别、年龄、生活行为、体重指数、病程、合并疾病等与非死亡组对比无差异（P>0.05）,但血清Apelin-13表达水平具有差异,且死亡组较非死亡组低（P<0.05）。死亡组的APACHEⅡ评分、SOFA评分、CTSI评分高于非死亡组（P<0.05）。在78例患者中,Pearson分析显示血清Apelin-13水平与APACHEⅡ评分、SOFA评分、CTSI评分存在负相关性（P<0.05）。多因素logistic回归分析显示：血清Apelin-13水平（OR=3.770）、APACHEⅡ评分（OR=3.624）、SOFA评分（OR=2.422）、CTSI评分（OR=1.842）都为影响患者预后死亡的重要因素（P<0.05）。结论：老年肺炎患者血清Apelin-13水平呈现低表达状况,与患者的APACHEⅡ评分、SOFA评分、CTSI评分等疾病严重程度指标存在相关性,也是影响患者预后死亡的重要因素。