目的调查广东省翁源县妇女孕期 抑郁的水平并分析其影响因素，为孕期心理保健提供重要依据。方法采用单纯随机抽样的方法，抽取在广东省翁源县妇幼保健院住院分娩的产妇进行问卷调查。结果 206名调查对象中，抑郁量表平均得分为(40.75±9.42)分，孕期抑郁症的患病率为14.56%。多因素分析表明，年龄≥35岁、家庭人均收入 2000元/月、主观支持得分低的孕妇孕期抑郁水平高。结论年龄、家庭经济状况、主观支持情况对妇女孕期抑郁水平有影响，应有针对性地开展心理卫生健康教 育和心理咨询工作。
目的 了解广东省翁源县恶性肿瘤死亡的流行特征，为防制工作提供科学依据.方法 按照全国第3次死因回顾性调查方案，对2004-2005年翁源县主要死因进行回顾性调查，分析主要恶性肿瘤死亡率、标化率及对预期寿命的影响.结果 2004-2005年翁源县恶性肿瘤的粗死亡率为141.9/10万，标化率为138.3/10万，死亡数居全死因的第2位;男女标化率分别为183.5 /10万和98.0/10万，男性明显高于女性(x2=26.163，P=0.000)，肝癌、胃癌和肺癌的男性标化率也显著性高于女性;且无论在男性和 女性还是总体，胃癌的标化率均显著高于广东省农村地区.恶性肿瘤死亡率随年龄增大而增高(x2 =3 375.0，P=0.000)，75岁～组的死亡率最高.居前5位的恶性肿瘤依次为肝癌、胃癌、肺癌、食道癌和其他恶性肿瘤;对期望寿命影响前3位的是肝 癌、胃癌和肺癌.结论 翁源县的恶性肿瘤、肝癌、胃癌和肺癌死亡水平男性高于女性，且胃癌显著高于广东省农村地区.因此，恶性肿瘤仍是危害居民健康的常见病和多发病，尤其是胃癌 和肝癌等消化系统肿瘤在该地区死亡率较高，应有针对性地开展综合防制工作.
目的调查广东省翁源县新生儿脐 带血铅的含量，分析其影响因素，为当地优生优育政策提供科学依据。方法选取广东省韶关市翁源县妇幼保健院和新江镇卫生院作为研究现场，对所有在2011年 9月1日-2012年8月31日分娩的576名孕妇进行问卷调查，同时采集新生儿脐带血标本。结果 576名新生儿脐带血铅含量为12.77~253.63μg/L，中位数和四分位数间距分别为31.96和18.37μg/L;44名(7.64%)新生 儿脐带血铅含量100μg/L;单因素分析显示，孕期住房距公路距离50 m(OR=0.39，95%CI=0.19~0.78)、孕妇孕期平均每天走公路时间30 min(OR=2.51，95%CI=1.30~4.84)、孕期喝咖啡(OR=4.47，95%CI=2.38~8.39)、孕期饮茶 (OR=3.00，95%CI=1.60~5.62)和孕期补钙(OR=0.26，95%CI=0.13~0.52)与新生儿脐带血铅含量有关;多因素分 析显示，孕期喝咖啡(OR=3.58，95%CI=1.11~11.57)和补钙(OR=0.31，95%CI=0.10~0.97)与新生儿脐带血铅含 量有关。结论当地新生儿脐带血铅含量水平较高，孕妇妊娠期住宅距公路距离及其生活习惯与之相关。
患者男，63岁， 韶关市翁源县人，因"下腹痛10余天"于2015年2月3日入院. 患者10余天前无明显诱因出现下腹阵发性闷痛，无放射，伴大便难解，每2~3天解1次，无发热、乏力、恶心、呕吐、腹胀、腹泻、便血. 在翁源县人民医院行肠镜检查发现乙状结肠肿物， 活检提示乙状结肠高分化腺癌;上腹CT显示胃癌术后改变，肝实质未见占位病灶， 腹主动脉周围小淋巴结.诊断"乙状结肠腺癌"，建议患者到上级医院诊治，遂入住我院消化科. 自发病以来，患者睡眠、精神、胃纳稍差，大便同上述， 小便正常， 体重无明显下降.
A rapid method of impregnating endotracheal tubes and urinary catheters with gendine: a novel antiseptic agent.
OBJECTIVES： To test the efficacy of gendine， a novel antiseptic， containing Gentian Violet and chlorhexidine， in coating different medical devices， including endotracheal tubes (ETT) and urinary catheters (UC). METHODS： We determined the antimicrobial efficacy and cytotoxicity of ETT and UC segments coated， through an instant dip method， with gendine. Using the modified Kirby-Bauer method， gendine-coated devices showed zones of inhibition of >/=15 mm against methicillin-resistant Staphylococcus aureus (MRSA)， Pseudomonas aeruginosa， Escherichia coli and Candida parapsilosis. RESULTS： Gendine-coated endotracheal tubes (GND-ETT) soaked in bronchoalveolar fluid (BAL) and incubated at 37 degrees C maintained a zone of inhibition of >/=15 mm against MRSA and P. aeruginosa for at least 3 weeks. Similarly， gendine-coated urinary catheters (GND-UC)， soaked in urine， maintained a zone of inhibition of >/=15 mm against E. coli for 8 weeks. Using the minimum essential media elution method in mouse fibroblast cells， GND-ETT and GND-UC were found to be non-cytotoxic. Gendine-coated UC significantly reduced the amount of viable MRSA， E. coli or C. parapsilosis organisms adhering to their surfaces when compared with silver/hydrogel-coated urinary catheters or control uncoated catheters (P < 0.01). Similarly GND-ETT significantly reduced the adherence of the same organisms as well as P. aeruginosa when compared with control (P = 0.02). CONCLUSIONS： GND-ETT and GND-UC impregnated using an instantaneous dip method， were shown to have broad-spectrum activity， prolonged antimicrobial durability and high efficacy in inhibiting adherence of organisms commonly causing nosocomial pneumonia and urinary tract infection. Furthermore， these coated devices were shown to be non-cytotoxic.
Identification and genetic characterization of PmrA-regulated genes and genes involved in polymyxin B resistance in Salmonella enterica serovar typhimurium.
Salmonella enterica serovar Typhimurium encounters antimicrobial peptides (AP) within the phagosomes of professional phagocytes and at intestinal mucosal surfaces. Salmonella serovar Typhimurium utilizes the two-component regulatory system PmrA-PmrB， which is activated in response to the environmental conditions encountered in vivo， to regulate resistance to several AP， including polymyxin B (PM). Random MudJ transposon mutagenesis was used to identify PmrA-PmrB-regulated genes， as well as genetic loci necessary for PM resistance. Three different phenotypic classes of genes were identified： those necessary for PM resistance and regulated by PmrA， those necessary for PM resistance and not regulated by PmrA， and PmrA-regulated genes not required for PM resistance. Loci identified as necessary for PM resistance showed between 6- and 192-fold increased sensitivities to PM， and transposon insertion sites include surA， tolB， and gnd. PmrA-regulated loci identified included dgoA and yibD and demonstrated 500- and 2，500-fold activation by PmrA， respectively. The role of the identified loci in aminoarabinose modification of lipid A was determined by paper chromatography. The gnd mutant demonstrated a loss of aminoarabinose from lipid A， which was suggested to be due to a polar effect on the downstream gene pmrE. The remaining PM(s) mutants (surA and tolB)， as well as the two PmrA-regulated gene (yibD and dgoA) mutants， retained aminoarabinose on lipid A. yibD， dgoA， and gnd (likely affecting pmrE) played no role in PmrA-regulated resistance to high iron concentrations， while surA and tolB mutations grew poorly on high iron media. All PM(s) mutants identified in this study demonstrated a defect in virulence compared to wild-type Salmonella serovar Typhimurium when administered orally to mice， while the PmrA-regulated gene (yibD and dgoA) mutants showed normal virulence in mice. These data broaden our understanding of in vivo gene regulation， lipopolysaccharide modification， and mechanisms of resistance to AP in enteric bacteria.
Ultrashort flare GnRH agonist with GnRH antagonist (MDA/Ant) results in a lower cancellation rate compared with clomiphene citrate/ gonadotropins (CC/Gnd) for poor responder (PR) patients
Retinol (ROL) and its biologically active metabolite， all-trans retinoic acid (ATRA)， are essential for a number of reproductive processes. However， there is a paucity of information regarding their roles in ovarian folliculogenesis， oocyte maturation， and early embryogenesis. The objectives of this study were to quantify and compare peripheral plasma (PP) and follicular fluid (FF) retinoid levels， including ATRA in women undergoing in vitro fertilization (IVF) and to investigate the relationship between retinoid levels and embryo quality. Retinoid levels were evaluated in PP and FF from 79 women undergoing IVF at the time of oocyte retrieval and corresponding embryo quality assessed on a daily basis after retrieval for 3 days until uterine transfer. Analysis compared the retinoid levels with day 3 embryo grades and between endometriosis versus control patients. Results demonstrated distinctive levels of retinoid metabolites and isomers in FF versus PP. There was a significantly larger percentage of high-quality grade I embryos derived from the largest versus smallest follicles. An increase in follicle size also correlated with a >50% increase in FF ROL and ATRA concentrations. Independent of follicle size， FF yielding grade I versus nongrade I embryos showed higher mean levels of ATRA but not ROL. In a nested case-control analysis， control participants had 50% higher mean levels of ATRA in their FF and PP than women with endometriosis. These findings strongly support the proposition that ATRA plays a fundamental role in oocyte development and quality， and that reduced ATRA synthesis may contribute to decreased fecundity of participants with endometriosis.
Expression of Putative Virulence Factors of Escherichia coli O157:H7 Differs in Bovine and Human Infections
Abstract Escherichia coli O157：H7 is a commensal organism in cattle， but it is a pathogen in humans. This differential expression of virulence suggests that specific virulence factors are regulated differently in human and bovine hosts. To test this hypothesis， relative real-time reverse transcription-PCR was used to relate the expression of several putative virulence genes (eae， espA， stx(2)， rfbE， ehxA， and iha) to that of the "housekeeping" gene gnd during natural human and experimental bovine infection with E. coli O157：H7. We examined these genes in fecal samples from eight humans and four calves. iha and espA were significantly more expressed in bovine infections. rfbE and ehxA appeared to be more highly expressed in human infections， though these differences did not achieve statistical significance. Our results support the hypothesis that some virulence-associated genes of O157：H7 are differentially expressed in a host-specific manner.
摘 要： 翁源县人民医院是一问二级甲等综合医院。内设分院一问，临床科室11个，医技科室6个，职能科室9个，两个门诊部。开放病床250张。全院在岗在编、借用、人事代理、聘用人员共523人，其中：专业技术人员431人，占全院在岗人员的82.4％；副高职称9人，中级职称92人，初级职称330人，副高与中级、初级职称人员的比例为1：12：14。是一个知识密集、专业结构复杂，人员来自五湖四海的医疗机构。近年来，该院领导班子紧紧围绕“政治上关心，事业上支持，生活上关怀，感情上关爱”加强人才队伍建设，在以院长杨荣全为首的医院取得了显著的成绩，促进了该院三个文明建设的协调发展。