目的 了解疫情期间医护人员代谢综合征(MS)、高同型半胱氨酸血症(HHcy)的患病率、二者关系及靶器官损害。方法 选取2020年1月—2021年11月在天津市某三级综合医院的1 544名医护人员作为研究对象。测量人体指标,测定血液生化、免疫等指标。分析MS及其组分的患病率、HHcy的患病率及靶器官损害。采用χ²检验,比较MS组、HHcy组与对照组靶器官损害的差异。采用Logistic回归模型分析MS与HHcy的关系。结果 三级综合医院医护人员疫情期间MS患病率为23.7%,MS组分:中心性肥胖、高血压/高血压病、高甘油三酯、低高密度脂蛋白和高空腹葡萄糖/糖尿病的患病率分别为49.4%、19.3%、24.3%、0.5%和37%。HHcy的患病率为29.7%。MS组、HHcy组与对照组靶器官损害程度差异有统计学意义(P<0.001)。HHcy与MS无直接相关性。结论 疫情期间医护人员MS和HHcy患病率较高,与对照组相比有明显的靶器官损害,HHcy不是MS的独立危险因素。

Objective To explore the prevalence of metabolic syndrome (MS) and hyperhomocysteinemia (HHcy), their relationship and target organ damage among medical staff during the pandemic. Methods A total of 1 544 medical staff in a third-class general hospital in Tianjin from January 2020 to November 2021 were selected as the object of study. The indexes of human body were measured, and the indexes of blood biochemistry and immunity were detected. The prevalence of MS and its components, the prevalence of HHcy and target organ damage were analyzed. χ² test was used to analyze the difference of target organ damage among MS group, HHcy group and control group. The relationship between HHcy and MS was analyzed by Logistic regression model. Results The prevalence of MS among medical staff in the third-class general hospital during the pandemic was 23.7%. The prevalence of central obesity, hypertension / hypertension disease, high triglyceride, low high density lipoprotein cholesterol and high fasting plasma glucose/diabetes were 49.4%, 19.3%, 24.3%, 0.5% and 37%, respectively. The prevalence of HHcy was 29.7%. There was significant difference in target organ damage among MS group, HHcy group and control group (P<0.001). There was no direct correlation between HHcy and MS. Conclusions During the pandemic period, the prevalence of MS and HHcy in medical staff were high, and there was obvious target organ damage in those staff compared with the control staff. HHcy is not an independent risk factor of MS.

目的 探讨一次不明原因流产与精子DNA损伤的关系。方法 收集有一次不明原因流产史的患者作为实验组,同时以有正常妊娠史的患者为对照组,分别比较两组男方年龄、精子密度、精子活力、精液量和精子DNA断裂指数有无差异。以SPSS 16.0为统计软件,进行独立样本的t检验。结果 两组的精液量、精子密度及活力均无差异,实验组男方年龄小于对照组(P<0.05),但实验组的DFI要高于对照组(P<0.01)。结论 本研究对照组年龄高于实验组,而DFI正好相反。这说明不明原因的自发流产与男方精子DFI密切相关,随着DFI的增加,流产风险增加。

Objective To investigate the relationship between unexplained abortion and sperm DNA damage. Methods Patients with a history of unexplained abortion were enrolled as an experimental group, and patients with a normal pregnancy history were used as a control group. The differences in age, sperm density, sperm motility, semen volume, and sperm DNA break index were compared between the two groups. The independent sample t test was performed using the statistical software of SPSS 16.0. Results There was no significant difference in semen volume, sperm density and motility between the two groups. The age of the male group in the experimental group was lower than that in the control group (P<0.05), but the DFI of the experimental group was higher than that of the control group, and the difference was statistical significance (P<0.01). Conclusion The age of the study control group was higher than that of the experimental group, while DNA fragmentation index DFI was the opposite, which indicated that unexplained spontaneous abortion was closely related to the male sperm DFI, and the risk of miscarriage may increase with the increase of DFI.

目的 本研究以ICSI后未成熟卵母细胞为研究对象,分析比较卵母细胞不同发育阶段冷冻对其后续效果的影响,评估ICSI后未成熟卵母细胞的利用价值。方法 未成熟卵母细胞直接成熟培养(新鲜组)与玻璃化冷冻后成熟培养(冷冻组)的成熟率,并利用孤雌激活的方法比较卵母细胞的发育潜力。结果 发现新鲜组与冷冻组体外培养卵母细胞成熟率、受精率、卵裂率、优质胚胎率和囊胚率均无差异(P>0.05)。但两组的GV期卵母细胞成熟率低于MI期(P<0.05),且冷冻组的GV期卵母细胞受精率低于MI期(P<0.05)。不过裸卵体外成熟培养效果欠佳,特别是对GV期卵母细胞,体外成熟培养后的卵母细胞发育潜力低下,无囊胚形成。结论 ICSI后未成熟卵母细胞的冷冻对卵母细胞的发育潜力没有明显影响,但体外成熟培养的卵母细胞发育潜力低下,有待进一步提高体外成熟培养技术。

Objective In this study, the immature oocytes after ICSI were used to analyze the effects of freezing on the subsequent development of oocytes at different developmental stages, and to evaluate the utilization value of immature oocytes after ICSI(intracytoplasmic sperm injection). Methods The immature oocytes was directly cultured (fresh group) and matured after vitrification (frozen group), and the development potential of the oocytes was compared by parthenogenetic activation. Results There was no significant difference in the oocyte maturation rate, fertilization rate, embryo cleavage rate, high quality embryo rate and blastocyst rate between the fresh and frozen groups (P>0.05). However, the maturation rate of GV oocytes in the two groups was lower than MI oocytes (P<0.05), and the fertilization rate of GV oocytes in the frozen group was lower than MI oocytes (P<0.05). However, the in vitro maturation of naked oocytes was not effective, especially for GV oocytes, the oocyte development potential after in vitro maturation was low, there was no blastocyst formation. Conclusion The freezing of immature oocytes after ICSI has no significant effect on the development potential, but the development potential of naked oocytes matured in vitro was low, and the in vitro maturation culture technology of naked oocyte needs to be further improved.

目的 观察家庭病床的癌症患者临终关怀对患者和家属的生活质量的影响,为提升癌症患者和家属生活质量提供参考。方法 我院于2014年3月—2016年3月对50例癌症晚期家庭病床患者实施临终关怀治疗,设为观察组,另选择同期在我院住院治疗但未接受我院临终关怀治疗的50名癌症晚期患者作为对照组,比较两组患者入组后1月、3月的疼痛评分、接受死亡率及患者照护家属的生活质量评分变化。结果 两组患者年龄、性别、癌症类型、分期、入组前疼痛评分、对死亡接受率比较差异无统计学意义(P>0.05)。观察组和对照组患者入组后1月、3月疼痛评分比较,观察组明显低于对照组患者,组间比较差异有统计学意义(P＜0.05);观察组患者1个月后死亡接受率明显高于对照组,组间差异有统计学意义(P＜0.05);观察组患者照护家属入组1月、3月后的生活质量评分明显高于对照组患者照护家属,组间比较差异有统计学意义(P＜0.05)。结论 对家庭病床的癌症患者实施临终关怀,可有效减轻患者临床症状痛苦,提高患者死亡接受率,给予患者精神抚慰和心理支持,维持患者临终尊严,提高患者照护家属的生活质量,具有较高的临床价值,值得进一步推广应用。