以原发性胆汁性肝硬化为主要表现的成人Wilson病1例

患者,女性,43岁,因“反复双下肢水肿2月,乏力、纳差1周“于2008年8月28日入院。患者于2008年6月底无明显诱因出现双下肢水肿,就诊当地诊所,静脉滴注人血白蛋白治疗好转1周后再次出现双下肢水肿,未行进一步检查及治疗,

Association of quantitative analysis of intratumoral reduced E-cadherin expression with lymph node metastasis and prognosis in patients with breast cancer

長崎大学学位論文 [学位記番号]博（医歯薬）甲第1544号 [学位授与年月日]令和5年9月6日(2023-09-06

Association of quantitative analysis of intratumoral reduced E-cadherin expression with lymph node metastasis and prognosis in patients with breast cancer

Loss of E-cadherin expression is a poor prognostic factor in patients with breast cancer. Breast cancer cells co-cultured with adipocytes reportedly promote E-cadherin attenuation and tumor progression. The current study aimed to investigate the association of reduced E-cadherin expression with adipose tissue invasion (ATI) and prognosis in breast cancer. Surgical specimens were collected from 188 women with invasive ductal carcinoma of the breast who had undergone surgery without neoadjuvant treatment. We compared E-cadherin expression in ATI and invasive front (IF) using immunohistochemistry with ImageJ. Reduced E-cadherin expression was detected not only in the ATI area but also in the IF, and the degree of reduced E-cadherin expression was positively correlated with both areas. In patients with lymph node metastasis compared to those without, E-cadherin expression was reduced and this reduction was associated with poor recurrence-free survival. We concluded that E-cadherin expression is reduced not only at the ATI area but also at the IF of the tumor. Reduced E-cadherin expression is a clear prognostic factor for breast cancer. Hence, future research is warranted for establishing an objective and quantitative E-cadherin staining assay that will allow clinical use of E-cadherin as a prognostic factor.長崎大学学位論文 学位記番号:博(医歯薬)甲第1544号 学位授与年月日:令和5年9月6日Author: Xiangyue Meng, Michi Morita, Sayaka Kuba, Hiroko Hayashi, Ryota Otsubo, Megumi Matsumoto, Kosho Yamanouchi, Kazuma Kobayashi, Akihiko Soyama, Masaaki Hidaka, Kengo Kanetaka, Takeshi Nagayasu & Susumu EguchiCitation: Scientific Reports, 13, art. no. 10434; 2023Nagasaki University (長崎大学), 博士(医学) (2023-09-06

Factors influencing parents' decision on their children's vaccination against seasonal influenza : a systematic review

Introduction: Seasonal influenza is believed to be a common attribution of morbidity and mortality in the children population, and it causes huge disease burden worldwide. Although seasonal influenza vaccination is recommended as the most effective prevention by the World Health Organization and vaccination programs for children have been introduced in many countries, vaccination coverage remains low. Parents are primary decision makers for their children's immunization, therefore it is important to understand the determinants that influence parents' decision-making to provide important information for promoting vaccination uptake against seasonal influenza among children. Objective: To synthesize factors that influence parental decision on children's vaccination against seasonal influenza from published literature. Method: Literature reported factors that influenced parental decision on children's vaccination against seasonal influenza published before/on 31th May, 2013 were searched in PubMed and Web of Science databases. Manual searching was also performed for the citations of the retrieved papers. Both qualitative and quantitative articles consistent with the objective were searched from PubMed and Web of Science databases on 31th May, 2013. Records were screened in the sequence of title, abstract and full text to identify eligible studies, and references of eligible studies were also scrutinized to avoid missing important articles. Influencing factors were extracted from included papers, and the identified factors that influenced parental decision making were then discussed based on theoretical behavioral models. Results: Totally 32 articles met the inclusion criteria. Factors associated with parental decision included demographic factors, which consisted of parental and children’s age, parental gender, ethnicity, household income, residence, insurance status, family characters, parental education level, and children’s health history; psychological factors, including attitudes towards influenza vaccination, knowledge of influenza and vaccination, perceived risk of seasonal influenza, and emotional factors; past behaviors comprising previous frequency of using health care services, children’s seasonal influenza vaccination history, previous absenteeism from school or work, social norm referring cues to action and subjective norms; and environmental factors, meaning access to vaccination facilities. Discussion: An integrated framework based on the Health Belief Model, Triandis’ Theory of Interpersonal Behavior and the Theory of Reasoned Action was constructed to explain the findings. The framework proposes that the parents’ intention to vaccinate their children against seasonal influenza is influenced by demographic variables, attitude towards seasonal influenza vaccination, knowledge and perception of influenza/influenza vaccine, social norms (cues to action and subjective norms), emotion, and past behavior/experience; easy access to vaccination providers as a facilitating condition additionally determine the possibility of turning intention into actual behavior. Interventions such as providing positive knowledge relevant to seasonal influenza vaccination, targeting less intended and more influential decision-makers, ensuring sufficient access to vaccination, and creating action cues may be implemented to promote uptake of seasonal influenza vaccination among children.published_or_final_versionPublic HealthMasterMaster of Public Healt

Influence of mindfulness level on the severity of obstructive sleep apnea hypopnea syndrome patients and its mediating effect.

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS) 患者正念水平与负性情绪的关系以及正念水平在睡眠呼吸暂停指数(AHI) 与体重指数(BMI) 和颈围之间的中介作用。方法 选取2016 年5 月至2017 年8 月在 解放军总医院睡眠医学研究中心就诊的OSAHS 患者130 例，根据AHI 将患者分为轻度42 例、中度43 例和重度45 例。记录患者一般资料，采用便携式睡眠仪(PM) 监测患者AHI、夜间最低血氧饱和度(LSaO2) 及夜间平均血氧饱和度(MSaO2)，并进行抑郁焦虑压力量表(DASS)、正念注意觉知量表(MAAS) 评分。结果 OSAHS 患者随着病情程度加重，DASS 各维度得分升高，MAAS 得分减少。重度组OSAHS 患者MAAS 得分为(36.78&plusmn;10.76)，低于中度(53.26&plusmn;9.18) 和轻度组(69.45&plusmn;11.21)。重度组DASS 各维度得分(23.44&plusmn;8.599)、(26.22&plusmn;7.65)、(24.51&plusmn;8.30) 高于中、轻度组[(13.47&plusmn;4.53)、(15.19&plusmn;4.79)、(14.37&plusmn;5.86)]、[(5.83&plusmn;4.52)、(7.45&plusmn;5.26)、(7.05&plusmn;5.25)]，差异均有统计学意义(P &lt;0.05)。MAAS 在AHI 与BMI 和颈围之间具有完全中介效应，中介效应占总效应41.1%、43.4%。结论 在OSAHS 患者中，重度OSAHS 患者的正念水平低于中、轻度患者，焦虑抑郁压力水平高于中、轻度患者。正念水平在AHI 与BMI、颈围之间具有中介效应。</p

两种介质模型啁啾长周期光纤光栅的色散分析

为了更加准确地研究薄包层CLPFG（啁啾长周期光纤光栅）的传输与色散特性,仿真分析了单轴晶体光纤的二、三层介质模型所得纤芯模有效折射率的差别以及中心波长的差别,并基于该差别,采用数值分析的方法研究不同包层半径、包层模序对CLPFG色散性能的影响。结果表明,当单轴晶体光纤包层半径与包层模序较小时,两种光纤介质模型的纤芯模有效折射率有较大差别。对于两种介质模型的光纤光栅,降低包层半径或增大包层模序数都有利于增大色散。文章的分析方法和结论为CLPFG的分析和设计提供了理论依据

Macrobenthos feeding functional groups in the intertidal flats of the Liaohe Estuary

In the spring and autumn of 2020, we collected macrobenthos from 46 sampling sites in the intertidal flats of the Liaohe Estuary to analyze the characteristics and distribution of macrobenthic functional feeding groups. We identified 46 species which were classified mainly as mollusks, polychaetes, and crustaceans. The carnivorous group contained the largest number of species and mainly included polychaetes, while the planktophagous group was dominant in terms of abundance and biomass and mainly included mollusks. In spring, abundance and biomass levels of all macrobenthic functional feeding groups (except the carnivorous group) were higher when compared with the autumn period. We also observed no significant differences in abundance and biomass levels between sections for all macrobenthic functional feeding groups. However, the planktophagous group abundance and biomass levels were dominant in sections B and C. Two-factor analysis of variance indicated insignificant differences in species number, abundance, and biomass levels in different functional feeding groups between spring and autumn periods. These results help us better understand macrobenthic functional feeding group characteristics in intertidal flats in estuarine areas and may facilitate improved biodiversity management programs with a view to restoring marine fishery resources

Nursing interventions based on the theory of syndrome differentiation in the treatment of herpes zoster (以辨证施护理论为导向的护理模式在带状疱疹中的应用)

Herpes zoster, known as "snake sore", "waist sore" and "spider sore" in Traditional Chinese Medicine, seriously affects the quality of life and health status of patients. This paper reviews the application progress of Traditional Chinese Medicine and theory of syndrome differentiation in clinical nursing of herpes zoster in recent years, and provides reference for improvement of integrative treatment of herpes zoster. (带状疱疹属中医学“蛇缠疮”“缠腰火丹”“蜘蛛疮”范畴, 严重影响患者的生活质量及健康状态。本研究就以辨证施护理论为导向的护理模式在带状疱疹的应用现状进行综述, 旨在为进一步完善该病的中西医结合疗法提供参考。