目的 调查研究白银市汉族女性叶酸代谢关键酶5,10-亚甲基四氢叶酸还原酶(MTHFR)和甲硫氨酸合成酶还原酶(MTRR)的基因多态性分布特征.方法 选取2017-2020年在白银市妇幼保健院进行孕期保健的331例汉族健康女性为研究对象,采集口腔黏膜上皮细胞,提取基因组DNA,通过荧光定量PCR分型检测MTHFRC677T、A1298C及MTRR A66G基因位点情况,并进行分析.结果 入组对象的基因多态性分布符合遗传平衡.汉族女性MTHFR 677CC、CT及TT的基因型频率分别为27.5％、45.0％及27.5％,C、T等位基因频率分别为50.0％、50.0％;MTHFR 1298AA、AC及CC的基因型频率分别为71.0％、26.6％及2.4％,A、C等位基因频率分别为84.3％、15.7％;MTRR 66AA、AG及GG的基因型频率分别为56.5％、38.4％及5.1％,A、G等位基因频率分别为75.7％、24.3％.汉族女性MTHFR C677T和A1298C两位点连锁有6种组合,频率最高的是CT/AA(31.4％),没有CT/CC、TT/AC及TI/CC组合.两位点间存在完全连锁不平衡(D'=1.0,r2=0.186).结论 获取白银市汉族女性MTHFR和MTRR基因多态性的群体遗传学特征,其中关键基因位点MTHFR C677T的高风险TT基因型比例为27.5％,低于已报道的山东淄博、河南新乡等地,高于新疆阿克苏、浙江丽水及广东佛山等地,说明叶酸利用能力中等,对于高风险人群应加强孕期管理,同时此研究也可为白银地区育龄女性进行个体化增补叶酸提供理论依据.

目的 探讨高危型HPV联合TCT检查在宫颈癌早期诊断中的作用.方法 回顾性分析高危型人类乳头瘤病毒(HPV)和薄层液基细胞学检查(TCT)对1 535例宫颈癌的筛查结果,比较两种方法及联合应用对宫颈癌早期诊断的临床意义.结果 CIN-Ⅰ-Ⅲ期和宫颈癌患者高危型HPV感染率均高于正常炎症患者(P＜0.05),且随着病情加重高危型HPV感染率越高(P＜0.05);CIN-Ⅰ-Ⅲ期和宫颈癌患者TCT阳性率均高于正常炎症患者(P＜0.05),且随着病情加重TCT阳性率越高(P＜0.05);联合应用组的灵敏度(92.13％)、特异度(80.24％)、正确诊断指数(0.73％)、阳性预测值(40.31％)和阴性预测值(99.45％)均高于其他两种方法,但差异不显著(P＞0.05).结论 高危型HPV联合TCT检查对宫颈癌的早期诊断和治疗具有敏感性和特异度高的特点,将两种方法有机结合可以提高宫颈癌筛查的准确性和宫颈癌的早期确诊率.

Objective:To analyze drug dependency of 50 inpatients with diabetes mellitus (DM). Methods:Questionnaire for drug dependency of T2DM patients was designed by reading literature and taken as the survey tool through interviewing. The contents included general conditions of the patients, treatment (the sorts of the drugs, dose, quantity and times), and the dependency was assessed by the above indexes. Results: There were 20 cases (36.4%) of DM patients with good drug dependency, but 35 patients (63.6%) with poor drug dependency. The pa-tients with good dependency could grasp the advantages of healthy behaviours well, the perception rate reached 80.00%(16/20); while the ones with poor drug dependency couldn’t understand the advantages of healthy be-haviours, and the perception rate was 48.57% (17/35), the difference was significant (P<0.05). The patients with good dependency presented strong economic affordability, the ones with poor drug dependency showed weak eco-nomic affordability, the difference was remarkable (P<0.05). 90.00%of the patients with good dependency were able into sick role(18/20), and 65.71%of the ones with poor dependency were able into sick role(23/35), the differ-ence was significant (P<0.05). Conclusion:The patients should take the medicine by following the doctor′s advice, at the same time, we should enhance health education, help the patients establish right and positive healthy belief, transform the belief into spontaneous action and improve life quality.

目的:分析水资源与5岁以下儿童死亡率的关系,探讨影响因素,提出干预措施。方法:将白银市辖区各乡镇根据地理位置及水资源情况划分为山区、黄河灌区、黄河沿岸三组,分别统计2007-2010年各组5岁以下儿童、婴儿、新生儿死亡率并进行比较,分析其影响因素。结果:2007-2010年白银市5岁以下儿童、婴儿、新生儿死亡率黄河沿岸与黄河灌区及山区有显著差异。结论:为降低5岁以下儿童死亡率,除加强对边远、贫困地区的卫生投入,改善卫生及交通条件,加强医疗保健专业技术人员的培训等措施外,还应加强饮用水管理及清洁卫生,加强黄河沿岸儿童管理及教育,减少和避免意外死亡的发生。