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简介：AbstractMucormycosis is a lethal human disease caused by fungi of the order Mucorales. Mucormycosis is caused by fungi mainly belonging to the genera Mucor, Rhizopus, and Lichtheimia, all of which belong to the order Mucorales. The number of individuals with mucormycosis-causing disorders has increased in recent years, hence, leading to the spread of mucormycosis. Throughout the coronavirus disease 2019 (COVID-19) pandemic, numerous cases of mucormycosis in COVID-19-infected patients have been reported worldwide, and the illness is now recognized as COVID-19-associated mucormycosis, with most of the cases being reported from India. Immunocompromised patients such as those with bone marrow sickness and uncontrolled diabetes are at a greater risk of developing mucormycosis. Genes, pathways, and other mechanisms have been studied in Mucorales, demonstrating a direct link between virulence and prospective therapeutic and diagnostic targets. This review discusses several proteins such as high-affinity iron permease (FTR1), calcineurin, spore coat protein (CotH), and ADP-ribosylation factors involved in the pathogenesis of mucormycosis that might prove to be viable target(s) for the development of novel diagnostic and therapeutic methods.

简介：AbstractIn order to effectively implement the Tianjin Biosecurity Guidelines for Codes of Conduct for Scientists, biosecurity awareness-raising and education are essential because if these are not in place scientists will not understand the need for biosecurity codes of conduct. In an effort to assist in the implementation of the guidelines, a small-scale survey was carried out in early 2022 of biosecurity awareness-raising and education projects that have been developed over the last two decades to discover what resources and experience have been accumulated. It is argued that the survey demonstrates that much of what is needed to implement the guidelines effectively has been developed, but that there are specific deficiencies that need to be remedied quickly. In particular, an updated teaching resource covering the core issues related to the Biological and Toxin Weapons Convention (BTWC) and the problem of dual use in scientific research needs to be made widely available and translated into at least the six official United Nations (UN) languages. Additionally, more specialists from the Humanities with expertise in ethics need to become involved in biosecurity awareness-raising and education activities. While advantage should be taken now of the available national, regional and international networks of people involved in related activities, it is suggested that in the longer term cooperation in biosecurity awareness-raising and education will benefit from the development of an equivalent organisation to the International Nuclear Security Education Network (INSEN) organised through the International Atomic Energy Agency (IAEA).

简介：AbstractBackground:Zoonoses are public health threats that cause severe damage worldwide. Zoonoses constitute a key indicator of One Health (OH) and the OH approach is being applied for zoonosis control programmes of zoonotic diseases. In a very recent study, we developed an evaluation system for OH performance through the global OH index (GOHI). This study applied the GOHI to evaluate OH performance for zoonoses in sub-Saharan Africa.Methods:The framework for the OH index on zoonoses (OHIZ) was constructed including five indicators, 15 subindicators and 28 datasets. Publicly available data were referenced to generate the OHIZ database which included both qualitative and quantitative indicators for all sub-Sahara African countries (n = 48). The GOHI algorithm was used to estimate scores for OHIZ. Indicator weights were calculated by adopting the fuzzy analytical hierarchy process.Results:Overall, five indicators associated with weights were generated as follows: source of infection (23.70%), route of transmission (25.31%), targeted population (19.09%), capacity building (16.77%), and outcomes/case studies (15.13%). Following the indicators, a total of 37 sub-Sahara African countries aligned with OHIZ validation, while 11 territories were excluded for unfit or missing data. The OHIZ average score of sub-Saharan Africa was estimated at 53.67/100. The highest score was 71.99 from South Africa, while the lowest score was 40.51 from Benin. It is also worth mentioning that Sub-Sahara African countries had high performance in many subindicators associated with zoonoses, e.g., surveillance and response, vector and reservoir interventions, and natural protected areas, which suggests that this region had a certain capacity in control and prevention or responses to zoonotic events.Conclusions:This study reveals that it is possible to perform OH evaluation for zoonoses in sub-Saharan Africa by OHIZ. Findings from this study provide preliminary research information in advancing knowledge of the evidenced risks to strengthen strategies for effective control of zoonoses and to support the prevention of zoonotic events.

简介：AbstractBackground:Being able to predict with confidence the early onset of type 2 diabetes from a suite of signs and symptoms (features) displayed by potential sufferers is desirable to commence treatment promptly. Late or inconclusive diagnosis can result in more serious health consequences for sufferers and higher costs for health care services in the long run.Methods:A novel integrated methodology is proposed involving correlation, statistical analysis, machine learning, multi-K-fold cross-validation, and confusion matrices to provide a reliable classification of diabetes-positive and -negative individuals from a substantial suite of features. The method also identifies the relative influence of each feature on the diabetes diagnosis and highlights the most important ones. Ten statistical and machine learning methods are utilized to conduct the analysis.Results:A published data set involving 520 individuals (Sylthet Diabetes Hospital, Bangladesh) is modeled revealing that a support vector classifier generates the most accurate early-onset type 2 diabetes status predictions with just 11 misclassifications (2.1% error). Polydipsia and polyuria are among the most influential features, whereas obesity and age are assigned low weights by the prediction models.Conclusion:The proposed methodology can rapidly predict early-onset type 2 diabetes with high confidence while providing valuable insight into the key influential features involved in such predictions.

简介：摘要Pedro Delgado及其同事阐述了如何通过改善人群合作方式，达到缩小医疗公平差距的问题。

简介：摘要部分射血分数减低的心力衰竭（心衰）患者经治疗后左心室射血分数改善，甚至恢复正常，被称为射血分数改善的心衰。左心室逆重构是其中重要的病生理基础，与临床预后改善相关。本文从射血分数改善的心衰的定义、发生机制、临床特征、评估、治疗及随访等几个方面进行介绍。

简介：摘要目的探讨环孢素A（cyclosporin A，CsA）是否可以改善滋养细胞轻度受损的小鼠胚胎的着床。方法①将30只ICR小鼠腹腔注射CsA 5 mg/kg，采用化学发光法检测注射后1 h、3 h、4 h、6 h、8 h、10 h、13 h、14 h、16 h、20 h鼠体内CsA血药浓度变化情况；②将36只小鼠随机分为对照组和实验组，实验组腹腔注射CsA 5 mg/kg，对照组相同体质量下注射同等剂量橄榄油，根据Gardner评分结合实验需要将移植胚胎分为A、B、C三类，分类后胚胎分别移植至两组小鼠子宫，于交配后（days postcoitum，dpc）5.5 d时采用实时荧光定量PCR技术检测小鼠胚胎着床率及着床部位白血病抑制因子（leukemia inhibitory factor，LIF）mRNA的表达情况。结果①小鼠体内CsA血药浓度在给药后6~10 h达到高峰；②B类胚胎在实验组小鼠中着床率［73.9%（34/46）］高于对照组［50.0%（23/46），P=0.018］；③两组小鼠着床部位LIF mRNA的表达差异无统计学意义（P>0.05）。结论CsA给药剂量为5 mg/kg时，CsA可以改善滋养细胞形态上存在轻度受损的小鼠胚胎的着床；CsA可能成为提高IVF成功率的潜在药物。

简介：摘要抑郁症是一种以情绪低落为主要表现的常见精神障碍，其病理生理机制复杂且药物治疗效果欠佳。丰富环境(environmental enrichment，EE)是实验室常用的改善大脑功能的干预措施之一，通过将实验室动物暴露于较标准饲养环境更为丰富的感官、运动和/或社会刺激中，而使其获得积极的可塑性和适应性变化。大量研究表明，EE对多种抑郁动物模型都有明显的改善作用，但至今尚未能全面了解其机制，且行为学结果存在差异。由于EE的多维性和复杂性，目前还没有统一的范式标准，因此有必要整合现有的数据，通过理解EE的作用机制，对EE的各结构组成和实施步骤进行完善。文章结合近年来对抑郁动物模型的研究，从促进海马神经发生、减轻神经炎症、调节神经内分泌和影响表观遗传修饰等方面对EE的抗抑郁作用机制进行综述，以期为抑郁症机制研究和治疗提供新思路。随着精准医学和个体化医疗的兴起，人们对探索抑郁个体间差异和群体内效应的来源和机制越来越感兴趣，所以如何根据现有研究发现的作用机制将EE合理翻译至人类社会，是未来将要面临的挑战。

简介：摘要脓毒症存活患者出院后仍然面临较高的二次感染和死亡风险，并且长期遗留认知功能、精神和肢体运动功能障碍，严重影响患者的长期预后和生活质量。本文浅析脓毒症预后不良的主要因素，进而从心理干预、早期活动、营养支持和免疫调理等方面阐述有利于改善脓毒症患者长期预后的康复治疗对策。

简介：摘要目的研究生酮饮食(KD)对db/db小鼠胰岛β细胞去分化的影响。方法选用8周龄2型糖尿病小鼠模型db/db雄性小鼠，适应性喂养3周后，分为正常喂养组(ND)、生酮饮食组(KD)、75%热量限制组(CR)，另将8周龄C57BL/6雄性小鼠作为正常对照组(C)，以标准饲料喂养。C、ND组自由进食标准饲料，KD组自由进食生酮饲料，CR组作为阳性对照组，每日以ND组75%的热量进食标准饲料。不同饮食干预4周后，检测各组小鼠体重、空腹血糖、空腹胰岛素、糖耐量及血β-羟丁酸水平；苏木精-伊红染色观察小鼠胰腺组织内胰岛的形态和结构；免疫荧光共染观察小鼠胰岛β细胞特异性转录因子的表达。结果饮食干预4周后，与ND组相比，KD组小鼠空腹血糖、胰岛素和葡萄糖曲线下面积显著降低(P<0.05)；KD组胰岛形态和结构较规整，胰岛细胞数量增加；胰腺免疫荧光共染显示KD恢复胰岛β细胞的数量和排列及胰岛β/α细胞比例，恢复胰腺十二指肠同源盒-1等β细胞特异性转录因子的表达。结论KD可降低db/db小鼠的空腹血糖和胰岛素，改善糖耐量，可能与其能够恢复β细胞特异性转录因子的表达，逆转胰岛β细胞去(转)分化有关。

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简介：摘要目的探讨深度学习重建（DLR）较混合迭代重建（Hybrid IR）在改善胸部低剂量CT（LDCT）图像质量方面的效果。方法回顾性分析2020年10月至2021年3月在北京协和医院行胸部LDCT体检或因肺内结节定期复查的77例患者。对所有入组患者的影像资料进行不同算法重建，获得标准级别Hybrid IR图像、标准和强级别DLR图像。在3种图像的肺实质、主动脉、肩胛下肌及腋下脂肪内选取感兴趣区并测量其CT值和标准差，用于计算信噪比（SNR）和对比噪声比（CNR）。同时，由2名影像医师按照Likert 5分量表法对图像质量进行主观评分，且记录肺磨玻璃结节（GGN）的数量，并对其显示情况进行评分。2名医师评分不一致时由第3名医师评分决定。采用Kruskal-Wallis非参数检验对3种图像的主观和客观评分进行分析，若总体存在差异，则用Bonferroni校正检验进行组内两两比较。结果3种图像在肺实质、主动脉、肩胛下肌及腋下脂肪处的CT值差异均无统计学意义（P均>0.05），而图像噪声、SNR和图像的CNR差异均有统计学意义（P均<0.05）。其中标准级别Hybrid IR图像、标准和强级别DLR图像的CNR分别为0.71（0.49，0.88）、1.06（0.78，1.32）和1.14（0.84，1.48）。标准级别和强级别DLR图像均较标准级别Hybrid IR图像的主观和客观噪声低及SNR和CNR高，差异均有统计学意义（P均<0.05）。在对主要解剖结构（肺裂、肺血管、气管和支气管、淋巴结、胸膜和心包）和GGN的显示上，标准级别和强级别DLR图像评分明显优于Hybrid IR图像，差异均有统计学意义（P均<0.05）。结论与Hybrid IR相比，DLR可以明显降低LDCT图像的噪声，且对GGN的显示良好，有助于在较低辐射剂量水平时保证图像质量，从而改善采用CT行肺癌筛查及肺结节随访的安全性。

简介：摘要目的探讨复合发酵乳改善便秘小鼠的作用及其对肠道菌群、短链脂肪酸(short chain fatty acid, SCFA)、肠动力、肠黏膜屏障的影响。方法C57BL/6JNifdc小鼠27只，随机平均分为对照组、模型组及干预组。模型组及干预组连续给予洛哌丁胺灌胃2周，从第2周开始，干预组灌胃洛哌丁胺后加灌复合发酵乳连续治疗7 d。对照组给予生理盐水灌胃。测定各组小鼠摄食量、饮水量、体重变化、粪便含水率、首粒黑便时间及小肠推进率。检测小鼠结肠五羟色胺2C受体(serotonin C receptor，5-HTR2C)、闭锁小带蛋白-1(zona occludins-1 ，ZO-1)、组织黏蛋白-2(mucin-2，MUC-2)mRNA的表达量；Western blot检测Raf/ERK/MAPK相关蛋白质；气相色谱法检测肠道内SCFA水平；高通量测序分析肠道菌群变化。结果与对照组相比，模型组小鼠首粒黑便排出时间显著延长(P<0.01)，粪便含水率、小肠推进率、结肠5-HTR2C、ZO-1 mRNA表达显著降低(P<0.01)。与模型组相比，干预组的首粒黑便排出时间显著缩短，粪便含水率、小肠推进率显著增加(P<0.05)，结肠5-HTR2C、ZO-1 mRNA表达上调(P<0.05)，结肠Raf/ERK/MAPK通路磷酸化增加，肠道产SCFA菌增加且肠道内SCFA含量增加。结论复合发酵乳可能通过调节肠道菌群多样性，增加产SCFA细菌丰度，并提高SCFA含量，增强结肠中Raf/ERK/MAPK通路的磷酸化上调5-HTR2C mRNA的表达，同时增加结肠中ZO-1 mRNA的表达，从而促进肠道蠕动并增强肠黏膜屏障功能，起到改善便秘的作用。

简介：摘要选取在兴城特勤疗养中心疗养的飞行员200例，按照入院顺序分为试验组和对照组（各100例）。对照组进行常规疗养，试验组在常规疗养的基础上进行森林疗法。干预后试验组飞行员的匹兹堡睡眠质量指数量表（Pittsburgh Sleep Quality Index，PSQI）评分较对照组低，差异有统计学意义（t=4.23，P<0.001）；两组飞行员干预前后PSQI总分差异均有统计学意义（t=22.58、17.41，P值均<0.001）。两组飞行员随访时PSQI总分均低于干预前，差异有统计学意义（t=17.85、13.25，P值均<0.001）。试验组飞行员的总有效率高于对照组，差异有统计学意义（χ2=5.11，P=0.024）。结果表明森林疗法可有效改善飞行员的睡眠质量。航卫保障工作中还应进一步持续开展森林疗法。

简介：摘要轻度认知障碍(mild cognitive impairment，MCI)被认为是阿尔茨海默病(Alzheimer′s disease，AD)发病的前驱期阶段，因此及早对MCI患者进行诊断和治疗对于预防和延缓恶化成各种痴呆具有重要意义。目前，没有明确的药物治疗可以明显延缓或改变AD发展的病程。膳食作为生活方式的主要内容，已有大量研究证实特定的营养素、膳食模式与认知功能及大脑形态或功能有关，且能够降低AD的风险，减少MCI向AD的转化。随着影像学技术的发展，认知障碍患者膳食因素与影像学的联系及膳食改善后神经影像学的改变已逐渐成为国内外研究热点。本文就膳食改善认知障碍的神经影像学最新进展做出综述，期望为膳食干预改善认知障碍的神经影像学机制和其临床应用提供有力的依据。

简介：摘要目的评估有创动脉血压（Invasive blood pressure，IBP）监测对脓毒症患者预后的影响。方法收集MIMIC-Ⅳ数据库中脓毒症患者，根据是否行IBP监测分为IBP组和无创血压监测（NIBP）组。运用单因素分析和临床相关性筛选变量进行多元logistic回归模型，倾向性匹配评分（PSM）和逆概率加权（IPTW）调整组间混杂因素并稳健研究结论，logistic回归分析IBP和结局的关系。亚组分析评价IBP开始时间和持续时间的不同对结局的影响。结果IBP组和NIBP组相比28 d病死率低（OR=0.54，95%CI 0.46~0.62，P<0.001），经过PSM和IPTW后结论稳健。对IBP开始时间<24 h，24 h~48 h，>48 h进行logistic回归分析提示IBP开始时间<24 h组与主要研究结论一致（OR=0.42，95%CI：0.36~0.49，P<0.001），经PSM和IPTW后关系依旧稳健。IBP持续时间不同（≤1 d，≤2 d，≤3 d，≤4 d，>4 d）均显示IBP组与下降的28 d病死率相关，具有统计学意义。结论IBP与脓毒症患者28 d病死率下降具有相关性，且最佳IBP时间是24 h内。

简介：摘要目的观察射频导入左旋维生素C精华液改善黄褐斑的效果与安全性。方法2019年3—6月，解放军总医院第七医学中心皮肤科就诊的20例黄褐斑患者，男1例、女19例，年龄30~60岁，平均43.5岁。20例患者每周接受1次22%左旋维生素C精华液射频导入治疗，共8周，治疗后随访至12周。根据临床照片、VISIA皮肤图像分析仪、CK多功能皮肤测试仪、患者自我评估来判定结果，并记录不良反应。结果医师评估和患者自我评估均显示黄褐斑皮损得到改善，随访至12周时，18例(90%)患者认为皮肤色斑、水润度、细纹、光泽度均得到明显改善。治疗1、4周后与治疗前比较，VISIA皮肤图像分析仪检测指标中，皮肤纹理、紫外线色斑、棕色斑均有改善，差异有统计学意义(P<0.05)。CK多功能皮肤测试仪检测显示，皮肤光泽度明显改善，皮肤含水量增加，黑色素指数下降，差异均有统计学意义(均P<0.05)，经皮失水量和红色素指数差异无统计学意义(P>0.05)。2例在治疗中出现局部轻微红肿反应并自行消退，其余未见明显不良反应。结论射频导入22%左旋维生素C精华液可改善面部黄褐斑，无明显不良反应，不影响皮肤屏障功能。

简介：摘要老年衰弱已成为社会关注的焦点，提高老年人生活质量迫在眉睫，机能的恢复以及改善可延缓衰老，功能锻炼包括平衡能力以及步行能力的锻炼，可有效改善身体机能，提高老年人的生活质量，对于控制老年人运动量和度同样重要。将运动性的功能锻炼与科学技术及理念结合，为老年人制定科学的、多层次、个性化的功能锻炼模式，可以延缓衰弱，促进老年人身体健康

简介：摘要肠道吻合口愈合是消化道手术术后面临的重要问题，处理不当易造成吻合口漏，进而诱发脓毒血症及感染性休克，甚至危及生命。富血小板血浆(PRP)由自体全血浓缩得到，其血小板浓度高于全血基线水平且包含多种生长因子，可使复杂性创口快速愈合，减少患者住院时间，因而被广泛应用在皮肤、肩关节等领域。近年来，PRP在消化道手术中的应用受到广泛关注。然而，目前关于PRP改善吻合口愈合的研究多集中于动物实验，缺乏统一标准，效果不完全统一，尚未应用于临床。本文以PRP改善肠道吻合口愈合为切入点，系统阐述PRP改善肠道吻合口愈合的研究进展，为其临床应用提供参考。