Motivational factors in discussing sexual health with young people with chronic conditions or disabilities

The objective of this study was to identify determinants of professionals’ intention to use the new board game SeCZ TaLK to facilitate sexual health discussions with young people with chronic health conditions and disabilities, and to gauge whether intention led to actual use. A cross-sectional web-based survey of 336 professionals before they received the game sought to measure their intention to use SeCZ TaLK, their attitudes towards discussing sexuality, social professional environment, self-efficacy, opinion on the feasibility of using the game and experience discussing sexuality. Actual use of SeCZ TaLK was assessed at follow-up (N = 105). Professionals with higher self-efficacy and more experience in discussing sexual health were more likely to intend to use the game. At follow-up, intention to use explained 21% of the variance in actual use. SeCZ TaLK fits easily into the daily practice of professionals working in assisted-living and day-care facilities; other professionals experienced greater difficulty integrating the game into their practice. Despite this, SeCZ TaLk was also used across a wide range of settings including in psycho-educational groups, group consultations in hospitals and group therapy in rehabilitation centres. Professionals appreciated the board game SeCZ TaLK, but actual use depended on their own motivation and skills and compatibility with work routines.     

二尖瓣病变合并冠心病13例外科治疗体会

目的总结二尖瓣病变合并冠心病的外科治疗体会。方法对13例二尖瓣病变合并冠心病患者同期行二尖瓣置换或成型及冠脉搭桥术,回顾性分析,临床资料。结果术后1例死于严重心律失常,其余均存活。随访3—36个月,心功能恢复至Ⅰ-Ⅱ级9例,Ⅲ级3例,未出现心肌缺血症状。结论术前明确诊断,充分准备,术中加强心肌保护,提高手术水平,缩短手术时间,加强围手术期治疗是手术成功的关键。     

亨廷顿舞蹈症、氧化应激与胶质细胞

氧化应激的产生与胞浆内活性氧簇的升高密切相关,过多生成的活性氧簇能够造成脂质过氧化,损伤蛋白质甚至DNA,而这些物质的受损与疾病发生相关,尤其是神经退行性疾病.神经退行性疾病经常被描述为进行性的神经元丢失,伴随神经元或者胶质细胞中出现标志性寡聚体.在神经退行性疾病中,胶质细胞可能以一种抗氧化应激的方式在神经元功能维持以及生存上发挥重要作用.反之,神经元也能够通过不同途径反馈调节胶质细胞.该文主要探讨在亨廷顿舞蹈症中胶质细胞的特点和功能,阐明氧化应激与亨廷顿舞蹈症的关系,概括这三者之间的关系进而论证胶质细胞在亨廷顿舞蹈症中的抗氧化应激保护作用.     

一种新型的抗老年痴呆剂：左旋黄皮酰胺的化学、生物学活性和作用机制研究

从芸香科植物黄皮叶中分离出具有五种不同骨架的七个新酰胺类化合物,其中之一的黄皮酰胺的γ-内酰胺与具有促智作用的脑复康（piracetam）呈现相同的骨架,其分子中有4个不对称中心,应有16个对映体。在鉴定出16个对映体的绝对构型之后,用黄量教授设计的仿生路线先后完成了16个对映体和光活黄皮酰胺的不对称合成,在这一研究中解决了立体化学和合成中的一些难点,大大缩短了合成步骤,提高了总得率,生产工艺日趋成熟,其合成规模可满足临床试用和日后治疗疾病的需要。使用多项模型和指标也已证明（一）黄皮酰胺是有效对映体,（＋）黄皮酰胺为劣对映体。黄皮酰胺对映体的代谢（血药浓度、吸收、分布、排泄、血浆蛋白结合、肝脏首过效应）和酶促动力学也都存在立体选择性差异。（一）黄皮酰胺的主要药理作用是改善认知功能和抑制Ap毒性。药理作用的显著特点是提高突触效能和结构的可塑性,为国际上近年提出的“突触丢失是老年痴呆的主要原因”的新学说提供了有力的支持,也为当前AD治疗的新策略提供了有良好前景的新药。     

面向在线医疗社区的慢病知识服务模型构建

[目的/意义]实现"全覆盖、长周期、细粒度、高质量"的全民慢病健康管理与服务目标,完成在精准性、用户满意度等层面慢病有效管理的新突破。[方法/过程]在对国内外主要在线医疗社区服务内容进行比较分析和有效提取社区用户群体需求特征的基础上,复用和优化已有的通用疾病本体模型,在多维视阈下构建起了面向用户的慢病知识服务模型,并以冠心病为例进行了本体构建以及慢病知识服务平台的开发与实践。[结果/结论]该知识服务模型能够为用户提供多样性信息资源、细粒度知识、强导向性的智能化个性化的慢病健康知识服务,同时为个体和社会层面的慢病一体化、周期化、综合化的管理与服务提供支持。[局限]由于平台限制,获取的在线医疗社区数据样本有限。     

High-resolution mapping of brain vasculature and its impairment in the hippocampus of Alzheimer's disease mice

Accumulating evidence indicates the critical importance of cerebrovascular dysfunction in the pathogenesis of Alzheimer''s disease (AD). However, systematic comparative studies on the precise brain vasculature of wild-type and AD model mice are still rare. Using an image-optimization method for analysing Micro-Optical Sectioning Tomography (MOST) data, we generated cross-scale whole-brain 3D atlases that cover the entire vascular system from large vessels down to smallest capillaries at submicron resolution, for both wild-type mice and a transgenic (APP/PS1) mouse model of AD. In addition to distinct vascular patterns in different brain regions, we found that the main vessels of the molecular layer of the hippocampal dentate gyrus (DG-ml) undergo abrupt changes in both diameter and branch angle, spreading a unique comb-like pattern of capillaries. By using a quantitative analysis workflow, we identified in the hippocampus of AD mice an overall reduction of the mean vascular diameter, volume fraction and branch angle, with most significant impairment in the DG-ml. In addition, virtual endoscopy revealed irregular morphological features in the vessel lumen of the AD mice, potentially contributing to the impairment of blood flow. Our results demonstrate the capability of high-resolution cross-scale evaluation of brain vasculature and underscore the importance of studying hippocampal microcirculation for understanding AD pathogenesis.     

Myeloperoxidase in Chronic Kidney Disease

Numerous lines of evidence implicate a role of myeloperoxidase (MPO) in the pathogenesis of cardiovascular disease (CVD). It is a well accepted fact that patients with chronic kidney disease (CKD) are at an increased risk for CVD. MPO is a pro-oxidant enzyme which could be involved in the increased susceptibility of these patients to CVD. Hence, the levels of plasma MPO was determined in healthy controls as well as in patients with CKD [stratified with the level of their kidney failure as CKD stages II–V (end stage renal disease)]. Plasma MPO was assayed by a spectrophotometric method. Serum urea and creatinine were estimated on a clinical chemistry analyzer using standard laboratory procedures. The mean plasma MPO levels were significantly lower with advancing stages of renal failure (P < 0.001). There was a positive correlation between MPO and GFR (r = +0.89, P < 0.001) and a negative correlation with urea (r = −0.85, P < 0.001) and creatinine (r = −0.82, P < 0.001). While an inverse association was observed between plasma MPO and urea in CKD patients, such an association was not observed in control subjects (P = 0.43). In conclusion, the decline in plasma MPO levels may be due to the inhibitory effect of uraemic toxins on the enzyme.     

Efficacy of Tumor Necrosis Factor and Interleukin-10 Analysis in the Follow-up of Nonalcoholic Fatty Liver Disease Progression

Tumor necrosis factor (TNF-α) is a cytokine involved in systemic inflammation during acute phase reactions. The current study was designed to investigate the levels of pro-inflammatory cytokine (TNF-α) along with the anti-inflammatory cytokine (IL-10) during progression of non-alcoholic fatty liver disease (NAFLD) from simple steatosis to non-alcoholic steatohepatitis (NASH) and fibrosis in diabetic patients, and correlate the levels of cytokines with the progression of NAFLD. Fifty-two diabetic patients compared to 18 healthy controls were participated in this study. Based on clinical diagnosis, patients were divided into three groups: simple steatosis, NASH and fibrosis. Serum liver function tests, fasting blood glucose, bilirubin, ALT, AST, TNF-α, IL-10 and lipid profile were measured. TNF-α levels were significantly higher in NAFLD patients compared to control subjects with a significant positive correlation with body mass index and fasting blood glucose (FBG) but with negative correlation with IL-10. Serum IL-10 levels were significantly lower in NAFLD patients compared with controls. A positive correlation between IL-10 and HDL-C with concomitant negative correlation between IL-10 and FBG and triacylglycerides was found. Cytokine analyses showed that there was a prominent imbalance between TNF-α and IL-10 in patients with NAFLD, and this imbalance increase by increasing the progression of NAFLD especially in obese diabetic patients. TNF-α and IL-10 could be used in diagnosis and follow-up of NAFLD stages in a way to avoid liver biopsies in greater proportion of patients.     

运动:健康促进的积极方式

运用文献综述、归纳演绎等研究方法，从医学、社会学等视觉阐述了健康促进运动的发展，健康的概念及影响因素，身体运动与健康的关系，并提出了当前中国健康促进的问题及对策。旨在进一步加深运动健康促进理念，增强健康促进意识，提高国民的健康状况和生活质量。     

毕淑敏与贾平凹疾病叙事比较分析

疾病是生活中人们较为回避的话题,但它对人的生活的影响却并不因我们的回避而消失。在文学作品中,越来越多的作家对疾病话题进行了探讨。从不同的角度展现出不同的疾病叙事,引进了社会对疾病问题的审视。本文着重分析“文学界的白衣天使”毕淑敏和“文坛病人”贾平凹作品中的疾病叙事特征。