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论著

女性医务人员月经改变的影响因素及与心理状态的相关性研究

Study on the influencing factors of menstrual changes of female medical staff and the correlation with psychological status

:486-493
 
       目的   探讨女性医务人员月经改变的影响因素及与心理状态的相关性。方法   对深圳市3家医院女性医护人员进行随机抽样得到869份问卷调查样本,均为知情自愿参与本项调查研究。统计女性医务人员出现女性月经改变的比率和月经改变的基本特征,并采用单因素和多因素分析的方法分析影响月经改变因素。并以抑郁症筛查量表(PHQ-9)评估女性医护人员的心理状态,分析女性医务人员月经改变与心理状态评分间相关性。结果  869名女性医护人员中有293例发生月经改变,改变率为33.72%,其中月经周期改变94例、经期时间改变86例、月经量改变68例、痛经改变45例。将869例女性医护人员分为月经正常组和月经改变组,经单因素分析,两组间的年龄、职业、值夜班频率、既往病史、新冠感染等比较差异无统计学意义(P>0.05)。月经改变组的护士占58.36%高于月经正常的24.48%,月经改变组的新冠一线抗疫人员占64.51%高于月经正常的27.08%,月经改变组合并妇科疾病史的占比20.82%(61例)高于月经正常组的占比11.98%(69例)。而月经改变组的护士、新冠一线抗疫人员、合并妇科疾病史、新冠感染的比较差异有统计学意义(P<0.05)。多因素分析显示,职业为护士、合并妇科疾病史、新冠一线抗疫人员的P值分别为0.001、0.004、<0.001,故而职业为护士、合并妇科疾病史、新冠一线抗疫人员是女性医务人员月经改变的危险因素。月经改变组PHQ-9评分为9.10±2.57,月经正常组PHQ-9评分为5.98±1.06,月经改变组PHQ-9评分高于月经正常组(P<0.001)。两组受试者PHQ-9评分比较差异具有统计学意义,月经改变组PHQ-9评分中0~4分受试者为26.3%,月经正常组为47.2%,月经改变组PHQ-9评分中0~4分者比例小于月经正常组,差异具有统计学意义(P<0.05)。结论   女性医务人员中职业为护士、合并妇科疾病史、新冠一线抗疫人员是月经改变的主要危险因素,且月经改变与心理状态有密切的相关性,需引起医疗机构的关注。
      Objective  To analyze the influencing factors of menstruation changes of female medical staff and the correlation with their psychological status.Methods  The female medical staff in three hospitals of Shenzhen were  randomly sampled to get 869 questionnaires,with informed and willing to participate in this research.The rate of female menstruation changes and the basic characteristics of menstruation changes in female medical staff were calculated,and the influencing factors of menstruation changes were analyzed by single factor and multi factor analysis.And the psychological status of female medical staff was using the Depression Screening Scale (PHQ-9),and the correlation between menstrual changes and psychological status scores of female medical staff were analyzed.Results  Among 869 female medical staff,293 had hemorrhagic menstrual disease,with a change rate of 33.72%.Among them,94 had changes in menstrual cycle,86 had changes in menstrual period days,68 had changes in menstrual volume,and 45 had changes in dysmenorrhea.These 869 female medical staff were divided into normal menstruation group and menstrual change group.Through single factor analysis,there was no statistical difference between the two groups in terms of age,careers,night shift frequency,previous medical history,COVID-19 infection (P>0.05).The percentage of nurses in the menstrual change group was 58.36%,higher than that of 24.48% in the normal menstruation group.The percentage of frontline medical staff combating COVID-19 in the menstrual change group was 64.51%,higher than that of 27.08% in the normal menstruation group.And the percentage of menstrual change group with a history of combined gynecological diseases was 20.82% (61 cases),higher than that of the normal menstruation group was 11.98% (69 cases).And the difference was statistically significant when comparing the ratio of nurses,the frontline medical staff combating COVID-19,the history of gynecological diseases,and COVID-19 infection in the menstrual change group (P<0.05).Multivariate analysis showed that the occupation of nurses,frontline medical staffs combating COVID-19,and history of gynecological diseases were the risk factors for menstrual changes.The PHQ-9  score of the menstrual change group was higher than that of the normal menstrual group,and the difference was statistically significant.Conclusions  The main risk factors for menstrual changes are nurses,frontline anti-epidemic staff,and women with gynecological disease history.Menstrual changes are closely related to mental status,attention from healthcare organizations.
专家述评

炎症性肠病相关易感基因及其作用机制的研究进展

Research progress on susceptibility genes and their mechanisms in inflammatory bowel disease

:300-309
 
       炎症性肠病(IBD)是一种以反复腹痛、腹泻、血便和体重降低为主要表现的慢性特发性性疾病,主要分为溃疡性结肠炎与克罗恩病两种类型。近年来,IBD的患病率随着城市化和工业化进展迅速升高,给中国和全球的公共健康带来沉重的负担。随着人类基因组技术的发展,越来越多的证据表明,遗传学因素在IBD发病过程中起着不可或缺的作用。在亚欧人群中,通过大规模全基因组关联研究现已明确了320个IBD易感基因位点。IBD易感基因在影响机体的细胞代谢、免疫功能调节、肠道上皮屏障和微生物清除等多个方面发挥着重要作用。本文就IBD相关易感基因及其多态性的研究进展进行综述,从基因层面揭示IBD发病的分子机制,并对探索IBD因人而异的个性化治疗方案提供帮助。
    Inflammatory bowel disease(IBD)is a chronic idiopathic disease characterized by recurrent abdominal pain,diarrhea,bloody stools,and weight loss.Ulcerative colitis and Crohn’s disease represent the two main types of IBD.In recent years,the prevalence of IBD has increased rapidly with the advancement of industrialization,imposing a heavy burden on public health in China and globally.Currently,with the development of genomics,a growing body of evidence suggests that genetic factors play an indispensable role in the pathogenesis of IBD.In the Eurasian population,320 IBD susceptibility gene loci have been identified through large-scale genome-wide association studies.IBD susceptibility genes play a crucial role in various aspects affecting cellular metabolism,immune function regulation,intestinal epithelial barrier,and microbial clearance.This article reviews the susceptibility genes and their polymorphisms associated with IBD,revealing the molecule mechanisms of IBD from gene perspectives and contributing to the development of personalized treatment strategies tailored to individual IBD patients.
专家述评

结直肠癌肝转移的分子机制及临床治疗的研究进展

Advances in the emerging mechanisms and treatment progress on liver metastasis of colorectal cancer

:288-299
 
       结直肠癌(CRC)是全球第三大最常见的癌症,也是癌症相关死亡的第二大常见原因。结直肠癌肝转移(CRLM)是导致CRC患者死亡的主要原因,根治性肝切除术是目前有望治愈CRLM的唯一途径,但大部分患者不能进行根治性肝切除术。通过早期发现并进行针对性干预,能够改善患者的治疗效果及预后。文章通过综述CRLM的发病机制、诊疗现状及最新纳米诊疗方法,为深入探索高效诊疗方法提供思路。
      Colorectal cancer(CRC)is the third most common cancer and the second most common cause of cancer-related death worldwide.Colorectal cancer liver metastases(CRLM)are the leading cause of death in patients with CRC.Radical hepatectomy is the only way to cure CRLM so far,while most patients cannot undergo radical hepatectomy.CRLM treatment efficacy and prognosis can be improved by early diagnosis and specialized intervention.This paper reviews the pathogenesis,diagnosis,and treatment status of CRLM and the latest nano-diagnosis and treatment methods so as to provide ideas for in-depth exploration of efficient diagnosis and treatment methods.
论著

基于网络药理学与分子对接技术研究白头翁汤治疗细菌性痢疾的潜在活性成分及作用机制

Research on potential active ingredients and mechanisms of Baitouweng Decoction in the treatment of bacterial dysentery through network pharmacology and molecular docking

:216-227
 
       目的  采用网络药理学方法与分子对接技术分析白头翁汤治疗细菌性痢疾(BD)的潜在活性成分与作用机制。方法  借助中药系统药理学数据库与分析平台(TCMSP)及PubChem数据库检索筛选白头翁汤方的化学成分和作用靶点,通过Uniprot数据库校正基因名,同时通过比较毒物基因组学数据库(CTD)、药物靶标数据库(TTD)、GeneCards数据库和药物和药物靶标数据库(DRUGBANK)获得BD相关疾病靶点。经在线绘图平台微生信分析“活性成分-疾病”交集靶点,使用Cyoscape 3.7.2软件构建可视化的中药-活性成分-靶点网络、蛋白质互作网络,筛选潜在的关键活性成分与核心靶点;通过Metascape数据库对进行靶点的基因本体(GO)功能分析和京都百科全书基因和基因组通路数据库(KEGG)通路富集分析,同时使用Cyoscape 3.7.2软件构建基因-通路网络,筛选潜在的通路及其作用机制。同时采用分子对接技术对白头翁汤中关键活性成分和BD核心靶点进行分析。结果  白头翁汤共筛选出266个潜在活性成分,其中,槲皮素、β-谷甾醇、异鼠李素、异延胡索单酚碱、小檗红碱、豆甾醇等66个关键活性成分可通过肿瘤坏死因子(TNF)、白细胞介素-6(IL-6)、前列腺素内过氧化物合酶2(PTGS2)、丝氨酸/苏氨酸蛋白激酶1(AKT1)、血管内皮生长因子A(VEGFA)、V-rel网状内皮细胞病毒癌基因同源物A(RELA)、半胱氨酸天冬氨酸蛋白酶3(CASP3)、白细胞介素-8(CXCL8)、白细胞介素-1B(IL-1B)、丝裂原活化蛋白激酶1(MAPK1)、白细胞介素-10(IL-10)等33个潜在交集靶点作用于BD。GO基因功能分析共得到生物过程(BP)条目20个、细胞组成(CC)条目6个、分子功能(MF)条目9个(P<0.01),主要涉及外部凋亡过程、细胞迁移正向调控、细胞因子受体结合、蛋白同源二聚活性、TNF受体超家族结合等生物进程。KEGG通路富集分析确定13条信号通路(P<0.01),主要涉及癌症信号通路、白细胞介素-17(IL-17)信号通路等关键通路。分子对接结果显示槲皮素、β-谷甾醇、异鼠李素、异延胡索单酚碱等核心活性成分与TNF、IL-6、PTGS2核心靶点具有良好的结合效应(结合能<-5 kJ/mol)。结论  白头翁汤主要通过槲皮素、β-谷甾醇等潜在的多种活性成分作用于TNF、IL-6、IL-1B、PTGS2、AKT1、VEGFA等潜在的关键靶点调控IL-17等信号通路,从而发挥治疗细菌性痢疾的作用,符合中药复方多成分、多靶标、多途径起效的显著特征。
      Objective To analyze the potential active ingredients and mechanism of Baitouweng Decoction in the treatment of bacillary dysentery(BD)by means of network pharmacology and molecular docking technology.Methods With the help of the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(Traditional Chinese Medicine Systems Pharmacology Database,TCMSP)and PubChem database to search and screen the chemical composition and target of Baitouweng Decoction,the gene name was corrected through the Uniprot database,and the CTD database,TTD database,GeneCards database and DRUGBANK database obtain BD-related disease targets.The intersection target was obtained through the online  drawing platform,and Cytoscape 3.7.2 was used to construct a network of Pulsatilla active ingredient-component disease intersection target.The protein-protein interaction analysis of the intersection target was performed through the String database,and the Cytoscape 3.7.2 software was used for visualization.The Metascape database platform performed GO function analysis and KEGG pathway enrichment analysis on the target to predict its mechanism of action.The  key active ingredient compounds in Baitouweng Decoction were molecularly docked with the core protein in the intersection target.Results A total of 266 potential active ingredients in Baitouweng Decoction were screened,of which 66 key active ingredients such as quercetin,β-sitosterol,isorhamnetin,Isocorypalmine,berberine,stigmasterol,etc.It acts on BD through 33 potential intersection targets such as TNF,IL-6,PTGS2,AKT1,VEGFA,RELA,CASP3,CXCL8,IL-1B,MAPK1,IL-10.GO gene function analysis yielded a total of 20 biological process(BP)entries,6 cell composition(CC)entries,and 9 molecular function(MF)entries(P<0.01),which mainly involve external apoptosis process and positive regulation of cell migration,Cytokine receptor binding,protein homodimerization activity,tumor necrosis factor receptor superfamily binding and other biological processes.KEGG pathway enrichment analysis identified 13 signal pathways(P<0.01),mainly related to key pathways such as cancer signal pathway and IL-17 signal pathway.The results of molecular docking showed that the core active ingredients such as quercetin,β-sitosterol,isorhamnetin,Isocorypalmine and TNF,IL-6,PTGS2 core targets have good binding effects(binding energy <-5 KJ /mol).Conclusions Baitouweng Decoction modulated signaling pathways involving IL-17 through its active constituents like quercetin and β-sitosterol,targeting key molecules such as TNF,IL-6,IL-1β,PTGS2,AKT1,and VEGFA,reflecting the multi-target therapeutic approach of traditional Chinese medicine.
眼科专题:近视防控

户外活动对近视防控作用及其机制的研究进展

Research progress on prevention and control effect and mechanism of outdoor activities on myopia LI Shukui,LENG Yunxia

:4-10
 
       近几十年来,全球近视患病率不断上升,已成为全世界主要的公共卫生问题之一。众多研究表明户外活动能有效控制近视的发生和发展。本文综述了户外活动对近视防控作用的研究进展及其作用机制,以期为近视防控提供新的思路。

     In recent decades, the prevalence of myopia has been increasing globally, becoming one of the major public health issues worldwide. Numerous studies indicate that outdoor activities can effectively control the onset and progression of myopia. This article reviews the research progress on prevention and control effect and mechanism of outdoor activities on myopia, hoping to provide new insights for myopia prevention and control. 
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