目的:探讨基于高通量测序技术的低深度全基因组测序技术在复发性流产胚胎或绒毛组织染色体异常的应用价值.方法:选择2019年3月—2021年8月就诊于汕头大学医学院第一附属医院妇产科门诊并确诊为自然流产的患者,孕周为5～16周,留取流产组织,提取DNA,制备文库,进行流产物染色体低深度全基因组拷贝数变异测序,分析胚胎染色体数目和结构变异结果.结果:197例样本检测全部成功,检出染色体异常样本135例,染色体异常检出率为68.5%,其中检出染色体数目异常104例(77.0%),染色体部分重复/缺失26例(19.3%),染色体数目异常合并部分重复/缺失5例(3.7%),嵌合体10例(7.4%);染色体数目异常以16(11.85%)、X(9.63%)、22(96.67%)、21(5.93%)染色体高发.≥35岁患者的染色体数目异常率比<35岁患者的高(分别为70.0%和51.6%,P<0.05).共检出26例染色体部分重复/缺失,最短序列长度为0.12 Mb,最大片段94.54 Mb.在26例CNVs中,9例CNVs有明确致病性,2例CNVs提示可能致病.其中4个包含微缺失/微重复综合征.结论:低深度全基因组拷贝数变异测序技术能有效检测出流产胚胎绒毛组织染色体的非整倍体和部分重复/缺失情况,有助于明确复发性流产的病因,指导患者优生优育.

目的 调查新冠肺炎疫情暴发1年后医务人员心理健康情况及相关影响因素,以及时采取适当的心理干预措施,保护医务人员健康.方法 面对广东省各层级医疗机构医务人员发放线上问卷,内容包括社会人口学特征、一般健康问卷(GHQ-12)、简化版创伤后应激障碍症状清单(PCL-6).收集数据并对各项指标进行统计分析.结果 共发放问卷600份,回收有效问卷519份.基层医疗机构调查对象创伤后应激障碍(PTSD)检出率为39.24％(144/367),低于综合医院调查对象的51.32％(78/152),且差异具有统计学意义(x2=6.406,P=0.011).Logistic回归结果显示:家中是否有未成年孩子(OR=3.139;P=0.004)、医院层级(OR=3.902;P=0.009)是调查对象出现情绪困扰的影响因素;医院层级(OR=2.340;P=0.019)、工作年限为6～9年(相较于工作年限≤5年)(OR=0.396;P=0.021)、性别(OR=0.590;P=0.028)是调查对象出现PTSD的影响因素.结论 工作单位和政府机构可以为那些面临精神问题的高风险人员提供适当的心理支持来消除他们的不良情绪.

Objective:To investigate the research competence and training needs of young general practitioners (GPs) in Guangdong province.Methods:A questionnaire survey on research competence and training needs was conducted in December 2020 among GPs from one selected economically developed area and one selected less developed area in Guangdong Province.Results:A total of 172 young GPs were included in the study. The survey showed that 75.6% (130/172) and 76.2% (131/172) respondents thought that participation in scientific research and research literacy were important, but only 11.9% (21/172) had participated in research project, among whom 81.0% (17/21) undertook data collection. The basic score of evidence-based medicine was 24.00(21.00, 28.00), and 55.2% respondents (95/172) were able search literature when they encountered problems and 43.7% (77/172) used domestic databases. The self-assessment score of scientific research ability was 14.00(12.00, 17.00), the score of research training needs was 41.00(31.00, 49.50), and the scores of "scientific research topic selection, scientific research design, statistical analysis, organization and implementation, and paper writing" were generally high. There was significant difference in the total scores of the two scales of evidence-based medicine basis and scientific research ability self-assessment among respondents with different educational background ( P<0.05). The basic score of evidence-based medicine of orientation-trained GPs was higher than that of non-orientation-tranined GPs; the average score of research training needs in female respondents was higher than that in males ( P<0.05). Conclusions:The study suggests that young general practitioners have inadequate experience in research participation and organization, and low self-ratings of research competence, but generally high personal efficacy in research. It is recommended that appropriate training content and well-organized intervention should be developed for young GPs.

Objective: To investigate the relationship between body mass index and bone age advance based on propensity score matching. Methods: The clinical data of 404 children and adolescents from September 2016 to December 2020 in the Department of Child Growth and Development of the General Medicine Branch of the First Affiliated Hospital of Shantou University Medical College were retrospectively analyzed, including 171 males and233 females, aged 3-17 years old, mean age（8.09±2.83） years old. The subjects were divided into normal weight group（357 cases） and overweight and obesity group（47 cases）. After equalizing the confounding factors between the two groups by propensity score, logistic regression model was used to analyze the influencing factors of advanced bone age. Results: Before propensity score matching, except for father.s height and thyroid-stimulating hormone level, other factors were unevenly distributed between the two groups（all P＜0.05）. After matching, all covariates were balanced between the two groups（all P＞0.05）. Before propensity score matching, the risk of occurrence of bone age advancement in the overweight and obese group was 7.235 times higher than that in the normal weight group（OR=7.235, 95%CI: 3.770-13.883, P＜0.001）. After matching, the risk of occurrence of bone age advancement in the overweight and obese group was 4.789 times higher than that in the normal weight group（OR=4.789, 95%CI: 2.079-11.033, P＜0.001）. Conclusion: Overweight and obesity may be an independent risk factor for early bone age. Controlling weight gain is beneficial to prevent the occurrence of bone age advancement and improve adult height in children and adolescents.

Objective: To investigate the CT diagnostic criteria for lymph node metastasis of esophageal cancer.Methods: A database of 322 cases of esophageal cancer from the First Affiliated Hospital of Shantou University Medical College from 2009 to 2019 was selected for retrospective analysis. The location of lymph node metastasis,short diameter, long diameter and number of lymph nodes were examined by CT 1 week before surgery and compared with postoperative pathological findings. Results: Receiver operator characteristic（ROC） curve analysis showed that the area under the ROC curve was 0.862 and the Youden index was 0.633 when the short diameter of the lymph node ≥ 6.5 mm was used as the criterion for the diagnosis of lymph node metastasis in the supraclavicular fossa. When the diameter is ≥10 mm, the Youden index is 0.100. The area under the ROC curve was 0.778 and the Youden index was 0.411 when the short diameter of the lymph node was ≥ 7.5 mm, and the Youden index was 0.199 when the short diameter was ≥ 10 mm. The area under the ROC curve was 0.640 and the Youden index was 0.297 when the short diameter of the lymph node was ≥6.5 mm as the criterion for diagnosing lymph node metastasis in the non-recurrent laryngeal nerve area; when the short diameter was ≥10 mm, the Youden index was 0.048. The area under the ROC curve was 0.765 and the Youden index was 0.406 when the short diameter of lymph nodes was ≥6.5 mm as the criteria for the diagnosis of lymph node metastasis in the cardia and left gastric region; when the short diameter was ≥10 mm, the Youden index was 0.167. Conclusion: CT diagnostic criteria for lymph node metastasis of esophageal cancer may be more reasonable if the short diameter is less than 10 mm.

目的:编制新型冠状病毒肺炎疫情期间医务人员工作生活适应性量表.方法:经过文献回顾以及对目标受访者的线上半结构式访谈形成条目池,专家评议和小组讨论后形成量表初版,预调查后确定量表第二版用于正式调查.2021年3月采用方便抽样法,通过问卷星平台对汕头市3所医院和广东省医学教育协会的医务人员进行问卷调查.采用Cronbach'sα系数和分半信度评估量表的信度.采用探索性因子分析和Pearson相关系数评估量表的结构效度和内容效度.采用12项一般健康问卷(12-item General Health Questionnaire,GHQ-12)及简化版创伤后应激障碍检查表(Posttraumatic Stress Disorder Checklist,PCL-6)评估量表的效标关联效度.结果:医务人员工作生活适应性量表包括准备情况、工作影响、生活影响、担忧、受支持情况5个维度,共21个条目.Cronbach'sα系数为0.854,分半信度系数是0.693.总量表共提取5个公因子,累积方差贡献率为75.678％,21个条目的因子载荷均>0.50.各维度与总量表的Pearson相关系数分别为0.415～0.737,P值均<0.01.医务人员工作生活适应性量表总分与GHQ-12总分的相关系数为0.279(P<0.05),与PCL-6总分的相关系数为0.507(P<0.01).结论:医务人员工作生活适应性量表具有较好的信效度,可用于评估新冠肺炎疫情期间医务人员的工作生活受影响情况.

目的:探讨应用PSBH方法开展大学生营养教育及对不合理生活方式进行早期干预的作用.方法:应用"解决问题、促进健康"方法,通过举办营养教育讲座、发放营养知识和健康生活方式宣传手册、并采用KAP调查问卷对汕头大学200名不同专业本科学生进行营养教育干预前、后调查.结果:营养教育干预前,大学生的营养知识相对缺乏,部分营养知识的答题正确率不到50％.部分大学生存在一些不正确的饮食行为.实施PSBH项目后,大学生营养知识显著提高(P<0.05),营养态度明显改善(P<0.01)、不合理饮食行为也明显改变.结论:通过PSBH项目,对在校大学生的生活方式进行干预,可提升在校大学生对营养知识的了解,促进良好营养态度的形成,纠正不合理的饮食行为和生活习惯,对预防常见慢性病有积极意义.

目的：了解城镇生源、农村生源大学新生营养知识、态度及饮食行为现状，为开展大学营养健康教育提供依据。方法采用调查问卷的形式对汕头大学医学院2014级197名新生进行营养知识、态度及饮食行为的横断面调查。结果医学新生营养知识缺乏，平均（23.30±7.88）分，低分人数占32.0%，高分人数仅占29.4%；城镇生源学生营养知识平均得分高于农村生源学生（t=2.058，P<0.05）。67.0%的医学新生对饮食和营养状况具有良好的态度，不同生源学生比较，无显著性差异（P>0.05）。对于吃夜宵习惯，72.6%的城镇生源学生回答“有时吃”，明显高于农村生源学生的54.9%（χ2=6.474，P<0.05）。多元Logistic回归分析显示，营养知识得分与学生“吃夜宵习惯”呈负相关（P<0.05），“城镇生源”和“男性”与学生“有时吃夜宵”和“经常吃夜宵”呈正相关（P<0.05）。结论大学新生营养态度较为积极，但城乡生源大学新生营养知识、饮食行为存在显著差异，应注意结合城乡生源的差异特点开展大学生营养教育。