• 【由p53-related转录因子协调的人胸腺髓质基质的细胞网络。】 复制标题 收藏 收藏
    DOI:10.1369/jhc.6A7028.2006 复制DOI
    作者列表:Ichimiya S,Kojima T
    BACKGROUND & AIMS: :The final elimination step of self-reactive T cells occurs in the medulla of the thymus where a complex framework provided by stromal cells supports an optimal milieu for their selection. Here we present evidence that tight junctions (TJs) widely join medullary stromal cells of the human thymus. Occludin (OCLN) and claudin-1 (CLDN-1) of TJ-associated molecules were dominantly expressed in medullary thymic epithelial cells (mTECs), and CLDN-4 and CLDN-7 were also localized in some mTECs near Hassall's corpuscles. Interestingly, p53-like transcription factors were found to upregulate OCLN and CLDN-1 in human TEC lines, as recently suggested in the regulation of mTEC function. Furthermore, dendritic cells (DCs) of the medulla, with a major role for selection of thymocytes, expressed CLDN-1 and OCLN as well, implying that the interposition of DCs within the mTEC scaffold is also helped by TJs. Analysis of freeze-fracture replicas of the thymus revealed TJ strand structures in the vicinity of gap junction plaques through which small molecules might move, as implied by dye-transfer analysis of a medullary cell line. Thus, it is thought that p53-like molecules regulate TJ-associated interactions of medullary stromal cells and that this mechanism might be associated with an intercellular communication network, probably for preserving the medullary niches.
    背景与目标: : 自反应性T细胞的最终消除步骤发生在胸腺的髓质中,其中基质细胞提供的复杂框架支持其选择的最佳环境。在这里,我们提供了证据,表明紧密连接 (TJs) 广泛地连接了人胸腺的髓质基质细胞。TJ相关分子的Occludin (OCLN) 和claudin-1 (CLDN-1) 在髓样胸腺上皮细胞 (mtec) 中主要表达,CLDN-4和CLDN-7也位于Hassall小体附近的一些mtec中。有趣的是,正如最近在mTEC功能的调节中所建议的那样,发现p53-like转录因子上调人TEC系中的OCLN和CLDN-1。此外,对胸腺细胞的选择具有主要作用的髓质树突状细胞 (dc) 也表达CLDN-1和OCLN,这意味着DCs在mTEC支架内的插入也受到TJs的帮助。胸腺的冷冻断裂复制品分析显示,TJ链结构位于缝隙连接斑块附近,小分子可能会穿过缝隙连接斑块移动,如髓质细胞系的染料转移分析所暗示的那样。因此,人们认为p53-like分子调节延髓基质细胞的TJ相关相互作用,并且该机制可能与细胞间通信网络有关,可能用于保护延髓壁。
  • 【阴道和子宫颈透明细胞腺癌。荷兰中部登记处的更新显示了双龄发病率的峰值。】 复制标题 收藏 收藏
    DOI:10.1002/(sici)1097-0142(19970601)79:11<2229::aid-c 复制DOI
    作者列表:Hanselaar A,van Loosbroek M,Schuurbiers O,Helmerhorst T,Bulten J,Bernhelm J
    BACKGROUND & AIMS: BACKGROUND:The objective of this study was to update the registry of women in the Netherlands with clear cell adenocarcinoma (CCAC) of the cervix or vagina with or without intrauterine exposure to diethylstilbestrol (DES). METHODS:From a nationwide search in PALGA, the automated pathology registry in the Netherlands, data were gathered on women with CCAC born after 1947. Information obtained from the clinical files of the patients included reported exposure to DES, patterns of complaints previous to diagnosis, the current status of the patients, and the results of cytopathologic examinations previous to histopathologic diagnosis. After review of the histopathologic slides, the specific pathologic characteristics of CCAC were determined. The age distribution of women born after 1947 was compared with that of women born before 1947. RESULTS:Information about possible exposure to DES during pregnancy was available for 73 of 88 women with CCAC born after 1947. Exposure to DES was reported for 47 (64%) of these women. The DES medication was most often reported as having started before the 18th week of pregnancy. Cytopathologic examination was informative in 81% of the cases of CCAC of the cervix, but only in 41% of the cases of CCAC of the vagina. Most patients had Stage I or II tumors at diagnosis. Tumor Stage III and IV and a high grade of nuclear atypia were related to unfavorable outcome. The age distribution of all patients with CCAC showed two distinct peaks; one at young age, (a mean age of 26 years), and one at older age (a mean age of 71 years). This bimodal age distribution still applied when the cases in which DES exposure was reported had been excluded. CONCLUSIONS:Despite the fact that DES has not been prescribed to pregnant women in the Netherlands in the last 20 years, CCAC is still relevant in our times. It is important to stay alert and periodically to update and evaluate the data of this registry, including data on women born outside the DES exposure period. The bimodal age distribution in this study of women without intrauterine exposure to DES suggests a carcinogenesis-promoting role of menarche and menopause and/ or the existence of a subpopulation with genetic risk factors or exogenous risk factors other than exposure to DES. Postmenopausal observation of women exposed to DES must be encouraged for clinical reasons and may help facilitate differentiation between these two hypotheses. If these risk factors of CCAC were better documented and their interrelationships better defined, CCAC could become an important model of multistep carcinogenesis in tissues sensitive to sex hormones.
    背景与目标:
  • 【全球女性人乳头瘤病毒患病率的年龄特异性曲线的变化。】 复制标题 收藏 收藏
    DOI:10.1002/ijc.22241 复制DOI
    作者列表:
    BACKGROUND & AIMS: :An inverse relationship between age and human papillomavirus (HPV) prevalence has been reported in many developed countries, but information on this relationship is scarce in many other parts of the world. We carried out a cross-sectional study of sexually active women from the general population of 15 areas in 4 continents. Similar standardised protocols for women's enrolment, cervical specimen collection and PCR-based assays for HPV testing were used. HPV prevalence in different age groups was compared by study area. 18,498 women aged 15-74 years were included. Age-standardised HPV prevalence varied more than 10-fold between populations, as did the shape of age-specific curves. HPV prevalence peaked below age 25 or 35, and declined with age in Italy, the Netherlands, Spain, Argentina, Korea and in Lampang, Thailand and Ho Chi Minh, Vietnam. This was not the case in Songkla, Thailand nor Hanoi, Vietnam, where HPV prevalence was low in all age groups. In Chile, Colombia and Mexico, a second peak of HPV prevalence was detected among older women. In the poorest study areas in Asia (Shanxi, China and Dindigul, India), and in Nigeria, HPV prevalence was high across all age groups. The substantial differences observed in age-specific curves of HPV prevalence between populations may have a variety of explanations. These differences, however, underline that great caution should be used in inferring the natural history of HPV from age-specific prevalences.
    背景与目标: : 在许多发达国家,已经报道了年龄与人乳头瘤病毒 (HPV) 患病率之间的反比关系,但是在世界许多其他地区,有关这种关系的信息很少。我们对来自4大洲15个地区的普通人群的性活跃女性进行了横断面研究。使用了类似的标准化方案,用于女性入组,宫颈标本收集和基于PCR的HPV检测方法。按研究区域比较了不同年龄组的HPV患病率。包括18,498名15-74岁的妇女。年龄标准化的HPV患病率在人群之间的变化超过10倍,年龄特定曲线的形状也是如此。HPV的患病率在25岁或35岁以下达到峰值,在意大利,荷兰,西班牙,阿根廷,韩国以及泰国南邦和越南胡志明市,随着年龄的增长而下降。泰国宋卡和越南河内的情况都不是这样,那里所有年龄组的HPV患病率都很低。在智利,哥伦比亚和墨西哥,在老年妇女中发现了HPV患病率的第二个高峰。在亚洲最贫困的研究地区 (中国山西和印度Dindigul) 和尼日利亚,HPV的患病率在所有年龄组中都很高。在人群之间HPV患病率的年龄特异性曲线中观察到的实质性差异可能有多种解释。然而,这些差异强调,在从年龄特异性患病率推断HPV的自然史时应格外小心。
  • 【[胎儿左右肺动脉的多普勒检查。与胎儿位置和胎龄的关系: 方法学研究]。】 复制标题 收藏 收藏
    DOI:10.1055/s-2007-1000509 复制DOI
    作者列表:Taddei F,Chaoui R,Lenz F,Bast C,Kalache K,Heling KS,Bollmann R
    BACKGROUND & AIMS: UNLABELLED:A Methodical Study:

    AIM OF THE STUDY:To analyse the feasibility of colour and spectral Doppler assessment of blood flow in the fetal right (RPA) and left (LPA) main pulmonary arteries in relation to fetal position and to gestational age.

    STUDY DESIGN:The fetal position was a priori divided into 3 types, depending on whether the fetal heart was visualised apically (Type 1), from the right side (Type 2) or from the left side (Type 3). Three groups A (19-25 weeks gestation), B (26-32) and C (33-39) including 33 consecutive pregnancies each, were examined to document the fetal position as well as the rate of the successful Doppler examinations of the RPA and/or LPA.

    RESULTS:The fetal position Type 2 was most common throughout gestation (in group A = 42%, B = 36%, C = 51%) followed by the type 3 and then type 1. The rate of successful Doppler records from the RPA and LPA depended on the fetal position: In Type 2 RPA in 98%; in Type 3, LPA in 100%; but the apical approach was not effective (< 40%). Depending on gestational age, the success rates for a Doppler examination of at least one vessel were high (> 85%), whereas successful examination of both vessels was unlikely (12%).

    CONCLUSIONS:In the second half of pregnancy, independent of fetal position, Doppler examination of at least one pulmonary artery is successful in most cases, whereas the assessment of both vessels is rather difficult.

    背景与目标: 未标记 : 有条不紊的研究:
    研究的目的 : 分析彩色和频谱多普勒评估胎儿右 (RPA) 和左 (LPA) 主肺动脉血流与胎儿位置和胎龄的可行性。
    研究设计 : 根据胎儿心脏是从右侧 (2型) 还是从左侧 (3型) 可视化,先验地将胎儿位置分为3种类型。A组 (妊娠19-25周),B组 (26-32) 和C组 (33-39),每组33次连续怀孕,检查以记录胎儿位置以及RPA和/或LPA的成功多普勒检查率。
    结果 : 2型胎儿位置在整个妊娠期间最常见 (A组 = 42%,B = 36%,C = 51%) 接着是类型3,然后是类型1。来自RPA和LPA的成功多普勒记录的速率取决于胎儿位置: 在2型RPA中98%; 在3型中,在100% 中LPA; 但是根尖方法无效 (< 40%)。根据胎龄的不同,对至少一个血管进行多普勒检查的成功率很高 (> 85%),而对两个血管的成功检查不太可能 (12%)。
    结论 : 在怀孕的后半段,在大多数情况下,独立于胎儿位置,对至少一条肺动脉进行多普勒检查是成功的,而对两条血管的评估相当困难。
  • 【鼠疫耶尔森氏菌的毒力因子被强烈的脂多糖反应所克服。】 复制标题 收藏 收藏
    DOI:10.1038/ni1386 复制DOI
    作者列表:Montminy SW,Khan N,McGrath S,Walkowicz MJ,Sharp F,Conlon JE,Fukase K,Kusumoto S,Sweet C,Miyake K,Akira S,Cotter RJ,Goguen JD,Lien E
    BACKGROUND & AIMS: :At mammalian body temperature, the plague bacillus Yersinia pestis synthesizes lipopolysaccharide (LPS)-lipid A with poor Toll-like receptor 4 (TLR4)-stimulating activity. To address the effect of weak TLR4 stimulation on virulence, we modified Y. pestis to produce a potent TLR4-stimulating LPS. Modified Y. pestis was completely avirulent after subcutaneous infection even at high challenge doses. Resistance to disease required TLR4, the adaptor protein MyD88 and coreceptor MD-2 and was considerably enhanced by CD14 and the adaptor Mal. Both innate and adaptive responses were required for sterilizing immunity against the modified strain, and convalescent mice were protected from both subcutaneous and respiratory challenge with wild-type Y. pestis. Despite the presence of other established immune evasion mechanisms, the modified Y. pestis was unable to cause systemic disease, demonstrating that the ability to evade the LPS-induced inflammatory response is critical for Y. pestis virulence. Evading TLR4 activation by lipid A alteration may contribute to the virulence of various Gram-negative bacteria.
    背景与目标: : 在哺乳动物体温下,鼠疫杆菌合成具有低Toll样受体4 (TLR4) 刺激活性的脂多糖 (LPS)-脂质A。为了解决弱TLR4刺激对毒力的影响,我们对鼠疫耶尔森氏菌进行了修饰,以产生有效的TLR4-stimulating LPS。即使在高攻击剂量下,改良的鼠疫耶尔森氏菌在皮下感染后也完全无毒。对疾病的抵抗力需要TLR4,衔接子蛋白MyD88和共受体MD-2,并且CD14和衔接子Mal显着增强。对于针对改良菌株的免疫灭菌,需要先天和适应性反应,并且可以保护恢复期小鼠免受野生型鼠疫耶尔森氏菌的皮下和呼吸攻击。尽管存在其他已建立的免疫逃避机制,但改良的鼠疫耶尔森氏菌无法引起全身性疾病,这表明逃避LPS诱导的炎症反应的能力对于鼠疫耶尔森氏菌的毒力至关重要。通过脂质A改变逃避TLR4激活可能有助于各种革兰氏阴性细菌的毒力。
  • 【公共卫生管理学院: 程序设计和关键成功因素。】 复制标题 收藏 收藏
    DOI:10.1097/00124784-200609000-00002 复制DOI
    作者列表:Orton S,Umble KE,Rosen B,McIver J,Menkens AJ
    BACKGROUND & AIMS: :The Management Academy for Public Health is a team-based training program jointly offered by the School of Public Health and the Kenan-Flagler Business School at the University of North Carolina at Chapel Hill. This 9-month program teaches public health managers how to better manage people, information, and finances. Participants learn how to work in teams with community partners, and how to think and behave as social entrepreneurs. To practice and blend their new skills, teams develop a business plan that addresses a local public health issue. This article describes the program and explains the findings of the process evaluation, which has examined how best to structure and deploy a team-based method to create more effective, more entrepreneurial public health managers. Findings indicate that recruitment and retention are strong, program elements are relevant to learners' needs, and learners are satisfied with and value the program. Several specific benefits of the program model are identified, as well as several elements that support business plan success and skills' application on the job. On the basis of these findings, four success factors critical for developing similar programs are identified.
    背景与目标: : 公共卫生管理学院是由公共卫生学院和北卡罗来纳大学教堂山分校的Kenan-Flagler商学院联合提供的基于团队的培训计划。这个为期9个月的计划教公共卫生经理如何更好地管理人员,信息和财务。参与者将学习如何与社区合作伙伴一起团队合作,以及如何作为社会企业家进行思考和行为。为了实践和融合他们的新技能,团队制定了解决当地公共卫生问题的商业计划。本文介绍了该计划并解释了过程评估的结果,该评估研究了如何最好地构建和部署基于团队的方法,以创建更有效,更具企业家精神的公共卫生经理。研究结果表明,招聘和保留能力很强,课程要素与学习者的需求相关,并且学习者对课程感到满意并重视。确定了计划模型的几个特定好处,以及支持业务计划成功和技能在工作中的应用的几个要素。根据这些发现,确定了开发类似计划的四个成功因素。
  • 【水痘短缺对社区人口中18和24个月大的儿童的近期和长期影响。】 复制标题 收藏 收藏
    DOI:10.1186/1471-2296-7-51 复制DOI
    作者列表:Yawn BP,Schroeder C,Wollan P,Rocca L,Zimmerman R,Bardenheier B
    BACKGROUND & AIMS: BACKGROUND:Little is known about the impact of the recent varicella vaccine shortage. To assess the temporal trend in varicella vaccine administration before 18 and 24 months of age in a community cohort of children prior to, during and after the recent varicella vaccine shortage. And to compare the temporal trends in varicella vaccinations to trends of an older, more widely accepted vaccine, the MMR. METHODS:Community population-based birth cohorts were identified who were eligible for the varicella vaccination before, during and after the 2001 to 2002 varicella vaccine shortage. Only children (84% of all) who remained in the community through their second birthday were included. For each child in the cohort, the medical records and immunization registry records from both medical facilities in the county were reviewed to identify the dates and sites for all varicella immunizations given. In addition to varicella immunizations, the dates of all MMR vaccinations were recorded. Additional data abstracted included the child's birth date, gender and dates of any recognized cases of chickenpox up through age 24 months. RESULTS:Of the 2,512 children in the birth cohorts, 50.8% were boys. In the three cohorts combined, 81.1% of the boys and 79.3% of the girls (p = 0.30) received the varicella vaccine by age 24 months. The pre-shortage community rate of varicella immunization was 79.7% by 24 months of age. During the varicella vaccine shortage, the rate of varicella immunization by 24 months fell to 77.2%. Only 6 additional children received a "catch-up" immunization by 36 months of age. In the post shortage period the community 24-month immunization rate rebounded to a level higher than the pre-shortage rate 84.0%. During the almost three years of observation, the MMR immunization rate by age 24 months was constant (87%). CONCLUSION:The varicella shortage was associated with an immediate drop in the 24-month varicella immunizations rate but rebounded quickly to above pre-shortage rates. In this community the only long term impact of the varicella vaccine shortage may be on the small number of children who still had not received catch-up varicella immunizations by 36 months of age.
    背景与目标:
  • 【代表性全科样本中晚年失眠的危险因素。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Morgan K,Clarke D
    BACKGROUND & AIMS: BACKGROUND:Insomnia is widely reported and widely treated in general practice, yet relatively little research has focused on the natural history of the condition in primary care settings. As a result, there is at present little information to enable clinicians to assess insomnia risk, or anticipate outcomes in older general practice populations.

    AIM:To estimate, using 8-year longitudinal data, the risk of insomnia onset associated with selected health and lifestyle factors.

    METHOD:Survivors from a nationally representative sample (n = 1042) of elderly people originally interviewed in 1985 were reassessed in 1989 (n = 690) and 1993 (n = 410). At the first follow up in 1989, 84 new cases of insomnia were identified (a weighted incidence rate per person per year at a risk of 3.1%; 95% CI = 2.7-3.5). In logistic regression analyses controlling for age and sex, the risk of insomnia onset was then assessed in relation to the selected factors.

    RESULTS:Three factors assessed in 1985 were significantly and independently related to incident insomnia: psychometric ratings consistent with depressed mood odds ratio (OR) = 4.41; 95% CI = 3.32-5.43); health index scores indicating lower physical health status (OR = 1.19; 95% CI = 1.06-1.31 per unit change in scale score); and moderate and low levels of physical activity (OR = 1.91 and 2.14; 95% CI = 1.91-3.62 and 2.14-3.64 respectively). However, although depressed mood represented a major risk factor, the most likely source of risk was physical rather than mental ill-health.

    CONCLUSIONS:Psychiatric, somatic and lifestyle factors significantly and independently increase the risk of insomnia in older general practice patients. In predicting incident sleep disturbance, these factors exceed in importance the age and sex of patients.

    背景与目标: 背景 : 失眠在一般实践中被广泛报道和广泛治疗,但针对初级保健机构中该病的自然史的研究相对较少。因此,目前几乎没有信息可以使临床医生评估失眠风险,或预测老年全科医生的结果。
    目标 : 使用8年的纵向数据进行估计,失眠发作的风险与选定的健康和生活方式因素有关。
    方法 : 1989年 (n = 690) 和1993 (n = 410) 重新评估了来自1985年最初接受采访的具有全国代表性的老年人样本 (n = 1042) 的幸存者。在第一次随访1989年,发现了84例新的失眠病例 (每人每年加权发病率,风险为3.1%; 95% CI = 2.7-3.5)。在控制年龄和性别的逻辑回归分析中,然后根据所选因素评估失眠发作的风险。
    结果 : 1985年评估的三个因素与失眠事件显着且独立相关: 符合抑郁情绪优势比 (OR) = 4.41; 95% CI = 3.32-5.43); 健康指数得分表明较低的身体健康状况 (OR = 1.19; 95% CI = 1.06-1.31每单位变化的量表得分); 和中等和低水平的体育活动 (OR = 1.91和2.14; 95% CI分别 = 1.91-3.62和2.14-3.64)。但是,尽管情绪低落是主要的危险因素,但最可能的危险来源是身体健康而不是精神健康不良。
    结论 : 精神病学,躯体和生活方式因素显着且独立地增加了老年全科患者的失眠风险。在预测事件睡眠障碍时,这些因素的重要性超过了患者的年龄和性别。
  • 【在口腔鳞状细胞癌的侵袭性肿瘤前沿评估的组织生物学因素 (恶性程度和AgNOR含量) 的预后价值。】 复制标题 收藏 收藏
    DOI:10.1038/bjc.1997.263 复制DOI
    作者列表:Piffkò J,Bànkfalvi A,Ofner D,Bryne M,Rasch D,Joos U,Böcker W,Schmid KW
    BACKGROUND & AIMS: Tumour cells at the invasive front of carcinomas have been found to differ substantially from the rest of tumour cells in a variety of human cancers. The present multivariate survival analysis of 94 oral squamous cell carcinomas (OSCCs) revealed that both the argyrophilic nucleolar organizer regions-associated protein (AgNOR) content of invading tumour cells and a multiparametric histopathological tumour front grade were significantly and independently associated with tumour-related death, irrespective of conventional Broders' grade and clinical stage of the tumours. High tumour front scores and AgNOR content at the invasive OSCC front thus seem to reflect increased malignant potential. Proliferative activity, assessed by standardized AgNOR analysis, most probably represents one of the biological features underlying the usefulness of evaluating the invasive tumour front.

    背景与目标: 在各种人类癌症中,已发现位于癌侵袭性前沿的肿瘤细胞与其他肿瘤细胞有很大不同。目前对94例口腔鳞状细胞癌 (oscc) 的多变量生存分析显示,侵袭性肿瘤细胞的嗜银核仁组织区相关蛋白 (AgNOR) 含量和多参数组织病理学肿瘤前等级均与肿瘤相关死亡显着且独立相关,与肿瘤的常规broders等级和临床分期无关。因此,侵袭性OSCC前沿的高肿瘤前沿得分和AgNOR含量似乎反映了恶性潜能的增加。通过标准化的AgNOR分析评估的增殖活性,很可能代表了评估侵袭性肿瘤前沿有用性的生物学特征之一。
  • 【肝移植受者巨细胞病毒感染危险因素的多变量分析。】 复制标题 收藏 收藏
    DOI:10.1016/0016-5085(90)90352-2 复制DOI
    作者列表:Gorensek MJ,Carey WD,Vogt D,Goormastic M
    BACKGROUND & AIMS: :Thirty-three consecutive liver-transplant recipients were prospectively studied over a 37-mo period for evidence of cytomegalovirus infection. Sixteen (48%) episodes of cytomegalovirus infection were identified; 9 were primary infections and 7 were recurrent infections. Beginning with patient 8, gamma-globulin prophylaxis was routinely administered to most patients. Twelve potential risk factors for cytomegalovirus infection were evaluated and included pretransplant cytomegalovirus serological status of donor and recipient; recipient's age, sex, race, and liver disease; number and type of blood products transfused; type and intensity of immunosuppression; and occurrence of rejection. The Cox proportional hazards model identified positive donor cytomegalovirus serology as the single most important risk factor for subsequent development of cytomegalovirus infection, regardless of recipient cytomegalovirus serological status. In addition, use of gamma-globulin prophylaxis seemed to be protective against the occurrence of disseminated cytomegalovirus disease.
    背景与目标: : 在37个月的时间内,对33位连续的肝移植受者进行了前瞻性研究,以寻找巨细胞病毒感染的证据。确定了16 (48%) 例巨细胞病毒感染; 9例为原发感染,7例为复发性感染。从患者8开始,大多数患者常规使用丙种球蛋白预防。评估了巨细胞病毒感染的十二个潜在危险因素,包括供体和受者的移植前巨细胞病毒血清学状态; 受者的年龄,性别,种族和肝脏疾病; 输血的血液制品的数量和类型; 免疫抑制的类型和强度; 和排斥的发生。Cox比例风险模型确定阳性供体巨细胞病毒血清学是随后发生巨细胞病毒感染的唯一最重要的危险因素,而与受体巨细胞病毒的血清学状况无关。此外,使用丙种球蛋白预防似乎可以预防弥漫性巨细胞病毒疾病的发生。
  • 【根据不同年龄组对首选唇部位置的评估。】 复制标题 收藏 收藏
    DOI:10.1016/j.ijom.2012.10.005 复制DOI
    作者列表:Park NS,Park JH,Bayome M,Mo SS,Kim Y,Kook YA
    BACKGROUND & AIMS: :The purpose of this study was to compare preferred facial profiles rated by different age groups. An average profile of each gender was constructed from subjects with normal occlusions. Each average profile was located in the centre, and then the lips were protruded or retruded in six 1mm increments in each direction. 70 lay people were divided into 3 groups: young adult (20-39 years); middle-aged (40-54 years); and senior (55-70 years). They were asked to rank their 3 most preferred profiles for each gender. The distribution of the most pleasing profile was compared according to age groups by the Kruskal-Wallis test and according to the rater's gender by the Mann-Whitney U-test. There was a significant difference between the three age groups regarding the preferred male and female profiles (P<0.001). Both the middle-aged and the senior groups tended to select a slightly more retruded lip/flat profile than the young adult group. There was no gender dimorphism in the selection of the preferred profile. The young adult group preferred the straight profile while the middle-aged and senior groups favoured the slightly retruded profile. This may provide useful information for treatment planning in orthodontics and orthognathic surgery.
    背景与目标: : 这项研究的目的是比较不同年龄段的首选面部特征。从正常闭塞的受试者中构建每个性别的平均特征。每个平均轮廓位于中心,然后在每个方向上以六个1毫米的增量突出或重放嘴唇。70名外行人分为3组: 年轻人 (20-39岁); 中年 (40-54岁); 和老年人 (55-70岁)。他们被要求对每个性别的3个最喜欢的个人资料进行排名。通过Kruskal-Wallis测试根据年龄组比较了最令人愉悦的个人资料的分布,并通过Mann-Whitney u- test根据评估者的性别进行了比较。三个年龄组在首选男性和女性特征方面存在显着差异 (P<0.001)。与年轻的成年组相比,中老年组和老年组都倾向于选择略胜一筹的嘴唇/扁平轮廓。在选择首选特征时没有性别二态性。年轻的成年组更喜欢直率的轮廓,而中老年组则更喜欢略微被重述的轮廓。这可能为正畸和正颌手术的治疗计划提供有用的信息。
  • 【神经性糖尿病足溃疡微生物组与临床因素有关。】 复制标题 收藏 收藏
    DOI:10.2337/db12-0771 复制DOI
    作者列表:Gardner SE,Hillis SL,Heilmann K,Segre JA,Grice EA
    BACKGROUND & AIMS: :Nonhealing diabetic foot ulcers (DFUs) are a common and costly complication of diabetes. Microbial burden, or "bioburden," is believed to underlie delayed healing, although little is known of those clinical factors that may influence microbial load, diversity, and/or pathogenicity. We profiled the microbiomes of neuropathic nonischemic DFUs without clinical evidence of infection in 52 individuals using high-throughput sequencing of the bacterial 16S ribosomal RNA gene. Comparatively, wound cultures, the standard diagnostic in the clinic, vastly underrepresent microbial load, microbial diversity, and the presence of potential pathogens. DFU microbiomes were heterogeneous, even in our tightly restricted study population, but partitioned into three clusters distinguished primarily by dominant bacteria and diversity. Ulcer depth was associated with ulcer cluster, positively correlated with abundance of anaerobic bacteria, and negatively correlated with abundance of Staphylococcus. Ulcer duration was positively correlated with bacterial diversity, species richness, and relative abundance of Proteobacteria, but was negatively correlated with relative abundance of Staphylococcus. Finally, poor glycemic control was associated with ulcer cluster, with poorest median glycemic control concentrating to Staphylococcus-rich and Streptococcus-rich ulcer clusters. Analyses of microbial community membership and structure may provide the most useful metrics in prospective studies to delineate problematic bioburden from benign colonization that can then be used to drive clinical treatment.
    背景与目标: : 无法愈合的糖尿病足溃疡 (DFUs) 是糖尿病的常见且昂贵的并发症。微生物负担或 “生物负荷” 被认为是延迟愈合的基础,尽管对可能影响微生物负荷,多样性和/或致病性的那些临床因素知之甚少。我们使用细菌16s核糖体RNA基因的高通量测序,对52例个体的神经性非缺血性DFUs的微生物群进行了分析,而没有感染的临床证据。相比之下,伤口培养物 (临床上的标准诊断) 大大低估了微生物负荷,微生物多样性和潜在病原体的存在。即使在我们严格限制的研究人群中,DFU微生物群也是异质的,但分为三个簇,主要由优势细菌和多样性区分。溃疡深度与溃疡簇有关,与厌氧菌的丰度呈正相关,与葡萄球菌的丰度呈负相关。溃疡持续时间与细菌多样性,物种丰富度和变形菌的相对丰度呈正相关,但与葡萄球菌的相对丰度呈负相关。最后,血糖控制不佳与溃疡群有关,中位血糖控制最差的集中于富含葡萄球菌和富链球菌的溃疡群。微生物群落成员和结构的分析可能会在前瞻性研究中提供最有用的指标,以从良性定植中描绘出有问题的生物负荷,然后将其用于推动临床治疗。
  • 【退伍军人同时发生自杀意念和暴力冲动的危险因素。】 复制标题 收藏 收藏
    DOI:10.1037/pas0000490 复制DOI
    作者列表:Elbogen EB,Wagner HR,Kimbrel NA,Brancu M,Naylor J,Graziano R,Crawford E,VA Mid-Atlantic MIRECC Workgroup.
    BACKGROUND & AIMS: :Suicide and violence are significant problems in a subset of Iraq/Afghanistan-era veterans. This study investigates how posttraumatic stress disorder (PTSD) and resilience in veterans are associated with suicidal ideation and violent impulses while controlling for known covariates of both adverse outcomes. Structured clinical interviews were conducted of N = 2,543 Iraq/Afghanistan-era U.S. veterans. Compared with veterans denying suicidal ideation or violent impulses (n = 1,927), veterans endorsing both (n = 171) were more likely to meet diagnostic criteria for PTSD, report childhood abuse, combat exposure, physical pain symptoms, and drug misuse, and less likely to endorse self-direction/life purpose. Veterans reporting concurrent suicidal ideation and violent impulses had higher odds of misusing drugs and reporting pain symptoms relative to veterans reporting suicidal ideation only (n = 186) and had lower odds of endorsing self-direction/life purpose compared with veterans reporting violent impulses only (n = 259). The findings underscore the importance of examining drug abuse, physical pain symptoms, and self-direction/life purpose, as well as PTSD and history of trauma, in the context of clinical assessment and empirical research aimed at optimizing risk management of suicide and violence in military veterans. (PsycINFO Database Record
    背景与目标: : 自杀和暴力是伊拉克/阿富汗时代退伍军人的一个重要问题。这项研究调查了退伍军人的创伤后应激障碍 (PTSD) 和韧性如何与自杀意念和暴力冲动相关,同时控制了两种不良结果的已知协变量。对N = 2,543伊拉克/阿富汗时代的美国退伍军人进行了结构化的临床访谈。与否认自杀意念或暴力冲动的退伍军人 (n = 1,927) 相比,支持这两者的退伍军人 (n = 171) 更有可能满足PTSD的诊断标准,报告儿童期虐待,战斗暴露,身体疼痛症状和药物滥用,并且不太可能认可自我指导/生活目标。与仅报告自杀意念的退伍军人相比,报告同时自杀意念和暴力冲动的退伍军人滥用药物和报告疼痛症状的几率更高 (n = 186),并且与仅报告暴力冲动的退伍军人相比,认可自我指导/生活目标的几率更低 (n = 259)。研究结果强调了在旨在优化自杀和暴力风险管理的临床评估和实证研究的背景下,检查药物滥用,身体疼痛症状,自我指导/生活目的以及PTSD和创伤史的重要性。退伍军人。(PsycINFO数据库记录
  • 【猫鼬粪便中碳和氮稳定同位素的判别因子。】 复制标题 收藏 收藏
    DOI:10.7717/peerj.3436 复制DOI
    作者列表:Montanari S
    BACKGROUND & AIMS: :Stable isotope analysis of feces can provide a non-invasive method for tracking the dietary habits of nearly any mammalian species. While fecal samples are often collected for macroscopic and genetic study, stable isotope analysis can also be applied to expand the knowledge of species-specific dietary ecology. It is somewhat unclear how digestion changes the isotope ratios of animals' diets, so more controlled diet studies are needed. To date, most diet-to-feces controlled stable isotope experiments have been performed on herbivores, so in this study I analyzed the carbon and nitrogen stable isotope ratios in the diet and feces of the meerkat (Suricata suricatta), a small omnivorous mammal. The carbon trophic discrimination factor between diet and feces (Δ13Cfeces) is calculated to be 0.1 ± 1.5‰, which is not significantly different from zero, and in turn, not different than the dietary input. On the other hand, the nitrogen trophic discrimination factor (Δ15Nfeces) is 1.5 ± 1.1‰, which is significantly different from zero, meaning it is different than the average dietary input. Based on data generated in this experiment and a review of the published literature, carbon isotopes of feces characterize diet, while nitrogen isotope ratios of feces are consistently higher than dietary inputs, meaning a discrimination factor needs to be taken into account. The carbon and nitrogen stable isotope values of feces are an excellent snapshot of diet that can be used in concert with other analytical methods to better understand ecology, diets, and habitat use of mammals.
    背景与目标: : 粪便的稳定同位素分析可以为追踪几乎任何哺乳动物物种的饮食习惯提供一种非侵入性方法。虽然通常收集粪便样本进行宏观和遗传研究,但稳定的同位素分析也可以用于扩展特定物种饮食生态学的知识。目前尚不清楚消化如何改变动物饮食的同位素比率,因此需要进行更多的饮食控制研究。迄今为止,大多数饮食控制的粪便稳定同位素实验都是在食草动物上进行的,因此在这项研究中,我分析了猫鼬 (Suricata suricatta) 的饮食和粪便中的碳和氮稳定同位素比。饮食和粪便之间的碳营养歧视因子 (Δ13Cfeces) 计算为0.1 ± 1.5 ‰,与零没有显着差异,并且反过来与饮食输入没有差异。另一方面,氮营养歧视因子 (Δ15Nfeces) 为1.5 ± 1.1 ‰,与零显着不同,这意味着它不同于平均饮食投入。根据该实验中产生的数据以及对已发表文献的回顾,粪便的碳同位素表征饮食,而粪便的氮同位素比率始终高于饮食投入,这意味着需要考虑歧视因素。粪便的碳和氮稳定同位素值是饮食的绝佳快照,可以与其他分析方法一起使用,以更好地了解哺乳动物的生态,饮食和栖息地使用。
  • 【全膝关节置换术后伤口感染的危险因素。】 复制标题 收藏 收藏
    DOI:10.1093/oxfordjournals.aje.a115580 复制DOI
    作者列表:Gordon SM,Culver DH,Simmons BP,Jarvis WR
    BACKGROUND & AIMS: :Wound infections are an infrequent but serious complication of total knee arthroplasty. Between January 1984 and November 1987, 20 of 243 (8.2%) patients at two affiliated hospitals developed surgical wound infections following 259 total knee arthroplasty procedures performed in clean-air operating rooms. Eighteen (90%) of the patients had deep infections; nine required removal of the prosthesis. A single surgeon (surgeon X) was associated with 18 of the procedures that had subsequent infection (risk ratio (RR) = 9.4, 95% confidence interval (CI) 2.2-39), and an investigation was carried out in an effort to explain the difference in infection rates between surgeon X and other surgeons. In a cohort study, stratified analyses identified a preoperative American Society of Anesthesiologists (ASA) physical status class greater than or equal to 3, surgeon X, and early postoperative use of a continuous passive motion device as risk factors associated with surgical wound infection following total knee arthroplasty procedures. Logistic regression analyses identified being a patient operated on by surgeon X with an ASA class greater than or equal to 3 as the only significant independent risk factor for total knee arthroplasty-associated surgical wound infections (RR = 9.3, 95% CI 2.8-31). The effect due to surgeon X could not be explained by receipt or timeliness of administration of antimicrobial prophylaxis, type of prosthesis inserted, duration of operation, postoperative use of continuous passive motion, or underlying etiology of joint disease. The authors conclude that surgical technique and patient's severity of illness were the primary determinants of surgical wound infection after total knee arthroplasty. This study demonstrates the complexity of epidemiologic investigation of surgical wound infections and the importance of considering patient severity of illness when interpreting surgeon-specific infection rates.
    背景与目标: : 伤口感染是全膝关节置换术的罕见但严重的并发症。在1984年1月和1987年11月之间,两家附属医院的243名患者中有20名 (8.2% 名) 在清洁空气手术室中进行了259次全膝关节置换术后发生了手术伤口感染。18 (90%) 名患者患有深部感染; 9名需要移除假体。单个外科医生 (外科医生X) 与18例随后感染的手术相关 (风险比 (RR) = 9.4,95% 置信区间 (CI) 2.2-39),并进行了一项调查,以解释外科医生X与其他外科医生之间感染率的差异。在一项队列研究中,分层分析确定术前美国麻醉医师协会 (ASA) 的身体状况等级大于或等于3,外科医生X,以及术后早期使用连续被动运动装置是与全膝关节置换术后手术伤口感染相关的危险因素。Logistic回归分析确定是由ASA等级大于或等于3的外科医生X手术的患者,是全膝关节置换相关手术伤口感染的唯一重要独立危险因素 (RR = 9.3,95% CI 2.8-31)。不能通过接受或及时施用抗菌药物,插入的假体类型,手术持续时间,术后使用连续被动运动或关节疾病的潜在病因来解释外科医生X的作用。作者得出结论,手术技术和患者的疾病严重程度是全膝关节置换术后手术伤口感染的主要决定因素。这项研究证明了外科伤口感染的流行病学调查的复杂性,以及在解释外科医生特定的感染率时考虑患者疾病严重程度的重要性。

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