阿尔茨海默病遗传学研究进展

阿尔茨海默病(Alzheimer's disease,AD),以65岁为界可分为早发性(early-onset Alzheimer's disease,EOAD)和晚发性(late-onset Alzheimer's disease,LOAD)两种,其中LOAD占90%以上。两者均是遗传因素和环境因素相互作用的结果,其中LOAD的遗传度高达80%。随着人类基因组计划的完成,全基因组关联研究和二代基因测序技术的进展,一系列基因(BIN1、CLU、ABCA7、CR1、PICALM、MS4A4A/MS4A6A/MS4A4E、EPHA1、CD2AP、CD33)被发现与LOAD的易感性相关。本文综述了与LOAD发病相关的易感基因研究进展。     

哲里木盟地区猪病发生和流行的基本趋势及其对策

哲里木盟地区自1980年到1998年猪病的发生和传播出现如下特征：新的传染病（如猪呼吸—综合症）不断增多,旧的传染病以并发、非典型性为主。细菌性传染病、遗传性疾病及代谢性疾病是增多趋势。因此,猪病的防治是一个系统工程,应统筹规划,重点防治,制定科学的免疫程序,科学地使用抗菌药物,并深入研究和利用中草药及各类生物制剂,为防治猪病提供新的手段。     

重大疾病保险的保险需求与最优免赔额的确定

随着重载运输的不断发展，铁路钢桥病害日益凸显。以朔黄铁路64 m下承式钢桁梁为对象，对其出现的典型支座病害的成因、处理方法和病害对桥梁运营的影响进行了系统的分析研究。研究结果表明：由于4个支座之间存在高低不平，且支座表面存在一定程度的不平整，支座部位构件产生了一定程度的初始应力，在重载列车的反复作用下，导致支座联接构件出现疲劳断裂破坏，进而引起桥跨结构跨中横向加速度、竖向振幅的急剧增大和主桁杆件受力的显著变化，危及行车安全。通过更换结构部件和改变支座高程的方法能够消除支座病害影响，整治效果显著。     

Don't Let Your Disease Define You

Vivian Stephenson directed information technology systems at numerous companies, including Target Corporation, as Executive Vice President and Chief Information Officer, and Williams-Sonoma, as Chief Operating Officer and Chief Information Officer. In 1994, Vivian was a recipient of the “Oscar” of information technology—the Smithsonian Institution and Computerworld Award—for developing the Planned Store Inventory System at Mervyn's Corporation. Vivian is a former chair of the Board of Trustees at Mills College, from which she received a Doctor of Humane Letters Honorary Degree in 2005 for her “ethical and compassionate leadership” and for serving as “an inspired, unwavering advocate for women and the power of education to transform women's lives and society as a whole.” Vivian survived two different types of breast cancer, diagnosed in 1980 and 1996. In 2009, she was diagnosed with stage IV ovarian cancer.     

Erectile dysfunction,loss of libido and low sexual frequency increase the risk of cardiovascular disease in men with low testosterone

Introduction: Testosterone deficiency increases the cardiovascular disease (CVD) risk.

Aim: To evaluate the effect of erectile dysfunction (ED), sexual frequency and hypogonadal symptoms on CVD risk.

Methods: A total of 395 hypogonadal men aged 45–74 years were surveyed using the Androgen Deficiency in the Aging Male and the International Index of Erectile Function.

Main outcome measures: The 10-year CVD risk was measured with the Framingham Risk Score. Logistic regression was performed to obtain the odds ratios of sexual function and hypogonadal symptoms for a 10-year CVD risk ≥20% (high risk).

Results: The mean age was 56.1?±?6.7 years. The mean 10-year CVD risk of the whole cohort was 18.1%?±?11.4%, while 131 subjects (33.2%) were classified as high risk. Logistic regression revealed that ED severity was associated with CVD risk [OR?=?2.37 (CI 1.24–4.51) for mild-to-moderate ED, OR?=?4.39 (1.78–8.43) for moderate ED and OR?=?12.81 (4.65–26.11) for severe ED]. Compared to sexual frequency <1 per month, sexual frequency?≥4 decreased the risk of high CVD risk [OR?=?0.35 (0.23–0.780)]. Loss of libido [OR?=?2.95 (1.91–4.12)] and less strong erection [OR?=?3.87 (CI 2.11–4.95)] increased the risk of high CVD risk. All remained significant after adjustment for age and testosterone.

Conclusions: ED, decreased sexual frequency and loss of libido predict a high 10-year CVD risk in hypogonadal men.     

Enhancing Palliative Care for Low-Income Elders with Chronic Disease: Feasibility of a Hospice Consultation Model

Challenges exist in assimilating palliative care within community-based services for nursing home eligible low-income elders with complex chronic illness as they approach the end of life (EOL). This study assessed the feasibility of a consultation model, with hospice clinicians working with three Care Wisconsin Partnership Program teams. Consults occurred primarily during team meetings and also informally and on joint patient visits and were primarily with the palliative care nurse addressing physical issues. Fifty-seven percent of consultant recommendations were implemented. Benefits of consultation were identified with focus groups of clinical staff as were opportunities and barriers to the implementation. Models of integration are proposed.     

浅论近代日本“存娼”“废娼”之争

日本近代公娼制度确立之后,在“国家否定人身买卖”的大义名分之下,确立了强制性的性病检查制度,国家权力公然涉足性交易.围绕公娼制度的存废,日本国内展开了激烈的论战.透过这一论战,可以发现,双方均首肯公娼存在的所谓基本前提——男性本能的要求和悠久的历史,并缺乏在社会伦理层面上对公娼制度的严肃探讨;比起娼妓的人权来,双方均更多地考虑所谓的“国家体面”;双方均从社会卫生的视角出发,将娼妓定为“病毒的传播者”.归根到底,双方的立足点,更多的不是“文明开化”,而是“富国强兵”,在本质上均是大日本帝国的“爱国者”.     

血清胆固醇与炎症因子和冠心病斑块稳定性的相关性分析

目的:探讨血清胆固醇?炎症因子和冠心病斑块稳定性的相关关系?方法:2013年7月~2014年5月南京医科大学第一附属医院收治的冠心病患者107例,其中55例稳定性心绞痛(stable angina pectoris,SAP)患者为SAP组,52例急性冠状动脉综合征(acute coronary syndrome,ACS)患者为ACS组,并选取相同时期非冠心病患者96例为对照组?主要观察总胆固醇(total cholesterol,TC)?低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)?总胆红素(total bilirubin,TBil)?超敏C反应蛋白(high sensitive C reactive protein,hs-CRP)?肿瘤坏死因子(tumor necrosis factor,TNF)-α?白介素(interleukin,IL)-6等炎症因子和斑块稳定性的相关关系?结果:ACS组TC和LDL-C分别为(6.38 ± 1.17)mmol/L和(5.63±1.12)mmol/L,均高于SAP组[TC(4.51 ± 1.06)mmol/L?LDL-C(4.42 ± 1.05)mmol/L],且均高于对照组,差异具有统计学意义(P < 0.05);ACS组TBil为(6.28 ± 0.74)μmol/L,SAP组TBil为(9.96 ± 1.02)μmol/L,均低于对照组,差异具有统计学意义(P < 0.05)?ACS组Hs-CRP?IL-6和TNF-α分别为(19.06 ± 3.72)mg/L?(57.35 ± 4.14)pg/L和(38.11 ± 2.64)pg/L,均高于SAP组[hs-CRP(11.31 ± 2.15)mg/L?IL-6(29.60 ± 3.08)pg/L和TNF-α(26.82 ± 2.13)pg/L],且均高于对照组,差异具有统计学意义(P < 0.05)?结论:冠心病患者血中TC?LDL-C?IL-6?TNF-α和Hs-CRP等明显增高,并与斑块稳定性呈正相关?     

老年人慢性病健康教育方式需求分析

通过调查南京市中老年人慢性病相关状况、健康养生方式、健康教育投入费用支出等情况,分析目前慢性病健康教育的效果及需求,探讨有效可行的健康教育推广方式。问卷调查及分析。中老年人基本生活方式较健康,健康投入愿望强烈,但健康养生途径比较单一,缺乏科学指导。不同医保形式的人群健康教育需求差异很大。健康教育可以有效防止慢性病健康费用开支,预防和减少慢性病的危害,目前中老年人获得健康养生途径单一,这显现出以专业医学工作者为指导和以政府为主要推动力量的社区健康教育方式的稀缺,而中老年居民普遍关注自身健康,且有增加自身健康投入的愿望,但缺乏科学合理的投入渠道与正确引导,国家相关部门应为健康教育的实施提供财力、物力和政策等方面的保障,可根据不同人群的性别、收入、居住状况、职业背景等差异方面,实施有针对性的、梯度定价方式设计的健康教育产品。