2013年江苏省居民恶性肿瘤死亡和潜在减寿分析

目的:了解2013年江苏省恶性肿瘤死亡情况及其所致潜在寿命损失特征,为肿瘤的预防提供依据?方法:通过江苏省死因监测系统搜集2013年恶性肿瘤的死亡个案信息,利用从公安部门获取的人口学信息,计算死亡率?标化死亡率?潜在减寿年数(potential years of life lost,PYLL)和标化潜在减寿年数(standardized potential years of life lost,SPYLL)等指标,评价恶性肿瘤的死亡和早死负担及其人群分布特征?结果:2013年恶性肿瘤导致死亡135 236例,占2013年总死亡人数的29.38%,男?女分别为86 736?48 500例?恶性肿瘤死亡率和标化死亡率分别为196.80/10万和111.59/10万,死亡率男女比为1.77,城乡比为0.95?死亡率前5位依次为肺癌?胃癌?食管癌?肝癌和结直肠肛门癌,占全部恶性肿瘤的75.10%?恶性肿瘤所致PYLL和SPYLL分别为788 367和582 620.68人年,PYLLR男女比为1.78,城乡比为0.93,PYLL前5位依次为肝癌?肺癌?胃癌?食管癌和白血病,女性中乳腺癌取代食管癌处第4位?结论:导致全人群死亡和早死的主要恶性肿瘤为肺癌?胃癌?食管癌?肝癌?结直肠肛门癌和白血病,以及女性乳腺癌?对于恶性肿瘤死亡率和潜在减寿率,男性远高于女性?农村居民略高于城市居民?应针对重点癌种和人群,开展相关预防干预措施?     

湖南省恶性肿瘤减寿年数和减寿率分析

本文运用减寿年数和减寿率指标分析了湖南省恶性肿瘤死亡所致的寿命损失情况，全省１０个抽样县市１９９０－１９９２年三年合计减寿年数为１７０９６８，减寿率为８．７３‰，其中男、女性减寿率分别为１０．４４‰和６．８９‰。全省前四位恶性肿瘤依次为癌、白血病、胃癌、肺癌、肺癌、且在城市和农村中的排列位均在前四位。减寿率的分布显示男性同于女性，城市高于农村，３０岁以上年龄组减寿率较高水平，并随年龄增长快速升高，     

2002-2019年上海市浦东新区居民肝癌死亡特征及减寿率分析

背景　肝恶性肿瘤是全球常见的消化系统肿瘤之一,浦东新区居民肝恶性肿瘤死亡的流行病学资料依然缺乏。目的　了解2002-2019年浦东新区居民肝癌死亡特征与所导致的寿命损失,为制定针对性的干预措施提供依据。方法　以浦东新区户籍人口为对象,以户籍居民死因数据库为基础,从中筛选出死亡日期在2002-2019年的肝癌死亡资料进行分析。居民死因资料采用国际疾病分类第10版（ICD-10）进行编码与归类,肝癌的编码范围为C22。分别计算浦东新区居民肝癌粗死亡率、标化死亡率、潜在减寿年数（PYLL）、潜在减寿率（PYLLR）、平均减寿年数（AYLL）、标化潜在减寿年数（SPYLL）以及标化潜在减寿率（SPYLLR）,对浦东新区居民肝癌死亡情况以及肝癌导致的寿命损失情况进行分析。肝恶性肿瘤死亡率与寿命损失的变化趋势采用年均变化百分比（APC）进行分析。结果　2002-2019年浦东新区居民肝癌死亡12 522例,年均粗死亡率为25.38/10万,标化死亡率为12.29/10万。2002-2019年浦东新区居民肝癌粗死亡率、标化死亡率均呈逐年下降趋势（粗死亡率：APC=-1.88%,Z=-12.468,P<0.001;标化死亡率：APC=-4.71%,Z=-10.601,P<0.001）。男性、女性居民肝癌粗死亡率与标化死亡率均呈下降趋势（P<0.001）。2002-2019年15~59岁、60~79岁浦东新区居民肝癌粗死亡率总体呈下降趋势（P<0.001）,80岁以上浦东新区居民肝癌死亡率保持稳定（P=0.053）。2002-2019年浦东新区居民肝癌死亡PYLL为98 580年,PYLLR为2.00‰,AYLL为7.87年/人,SPYLL为61 767年,SPYLLR为1.25‰。2002-2019年浦东新区居民肝癌死亡PYLLR、SPYLLR、AYLL总体均呈逐年下降趋势（P<0.001）,除2002-2010年浦东新区居民肝癌死亡AYLL保持稳定（P=0.853）。男性居民肝癌死亡PYLL为81 126年,PYLLR为3.29‰,AYLL为9.20年/人,SPYLL为50 225年,SPYLLR为2.04‰。女性居民肝癌死亡PYLL为17 454年,PYLLR为0.71‰,AYLL为4.72年/人,SPYLL为10 942年,SPYLLR为0.44‰。浦东新区男性居民肝癌死亡PYLL、PYLLR、AYLL、SPYLL及SPYLLR均大于女性。结论　2002-2019年浦东新区居民肝癌粗死亡率与标化死亡率均逐年下降,但仍引起了严重的寿命损失,肝癌对于男性及80岁高龄老年人群的危害需进一步关注,需采取差异化的防控措施,对于男性人群以改善行为危险因素为重点,降低肝癌对该人群的危害;对于高龄肝癌患者,应注重临终关怀与支持治疗工作,改善该人群的生存状态。     

徐州市城区居民肺癌死亡情况及潜在寿命损失分析

目的　探讨徐州城区居民肺癌死亡特征、死亡趋势及造成的潜在寿命损失。方法　按ICD - 9分类方法对 1990～ 1999年城区居民肺癌死亡情况进行回顾性调查。结果　徐州市肺癌年平均死亡率为 2 6 13 / 10万 ,标化死亡率为 2 9 4 6/ 10万 ,居民肺癌死亡减寿年数 (PYLL)合计 16882人年 ,减寿率为 1 86‰ ,标化减寿率为 2 0 2‰ ,每例肺癌死亡造成潜在寿命损失 6 5 7岁 ;男、女肺癌死亡率间差别有显著性意义 ,男、女肺癌死亡率比值为 2 0 1,2 0岁以后男、女年龄别死亡专率与年龄之间的线性趋势有显著性意义 (P <0 0 1)。结论　肺癌是威胁徐州市居民生命健康最严重的恶性肿瘤之一 ,应积极启动对其预防和控制工作。     

1993-2007年甘肃省疾病监测点胃癌死亡监测数据分析

目的了解甘肃省疾病监测点胃癌死亡特征,为制定胃癌的防制策略提供科学依据。方法对甘肃省各监测点依据死亡医学证明书收集的胃癌死因数据进行核对,按照ICD标准进行死因编码,然后由甘肃省CDC进行分类汇总和统计分析。结果1993-2007年甘肃省疾病监测点胃癌死亡均处于肿瘤死亡的第一位。2007年胃癌的死亡率为36.73/10万,占所有肿瘤死亡的35.91%,胃癌死亡的潜在减寿年数(PYLL)为5 420人年,潜在减寿年数顺位处第一位,胃癌死亡的减寿率为3.38‰,胃癌平均死亡年龄为64.08岁,去胃癌死因预期寿命为72.83岁,延长寿命0.75岁。胃癌死亡男性显著高于女性。结论胃癌死亡率和减寿率均处甘肃省肿瘤死亡的第一位,并且男性死亡大于女性死亡,中老年男性是胃癌防治的重点人群。     

1999年至2001年贫困县农村居民主要死因及潜在减寿年数调查

目的：调查贫困县农村居民主要的死亡原因及潜在减寿年数(potential years of life lost，PYLL)。方法：采用整群抽样的方法抽取河南省睢县后台乡、尚屯乡和城隍乡，对其3a来死亡居民的情况进行回顾性调查。运用全死因和PYLL分析方法对死亡资料进行分析。结果：引起当地居民寿命损失的主要疾病为恶性肿瘤、脑血管病、呼吸系病、心脏病及损伤和中毒。其中损伤和中毒占死因构成的9．99％，占总PYLL的22．77％，恶性肿瘤、脑血管病、心脏病和呼吸系病这几种主要的慢性病的死亡率累积构成为65．07％，PYLL累计构成为36．95％。结论：以恶性肿瘤为主的慢性非传染性疾病成为当前贫困地区疾病控制工作的重点，损伤与中毒成为重要的公共卫生问题。     

河北省迁安县肿瘤减寿年数及减寿率分析

本文应用减寿年数（ＰＹＬＬ）和减寿率等减寿指标分析了迁安县常见恶性肿瘤在性别、年龄上的分布特征，并按照标化减寿率排列了死因顺位，揭示了各种恶性肿瘤对迁安县居民寿命损失影响的相对重要性。     

2010年南通市某县居民恶性肿瘤死因分析

目的通过对南通市某县居民恶性肿瘤状况及死亡原因的研究探讨,为制定预防措施提供依据。方法按国际疾病分类法(ICD-10)对2010年南通市某县居民的恶性肿瘤死亡状况资料进行编码以及统计分析,计算死亡率、构成比等。结果 2010年南通市某县居民恶性肿瘤死亡率为240.25/10万,占全部死亡原因的30.48%,仅次于循环系统疾病居全死因的第2位。除宫颈癌和乳腺癌外,其他恶性肿瘤的死亡率均为男性高于女性。占死因前3位恶性肿瘤为肺癌、肝癌、胃癌。其中肝癌主要危害青壮年男性,造成的男性潜在寿命损失远远大于其他恶性肿瘤。南通市某县2010年居民恶性肿瘤潜在减寿年数(PYLL)为68536.5人年,平均减寿年数(AYLL)为13.31人年。结论恶性肿瘤已对该县居民生命健康构成了严重威胁,重点应加强肺癌和肝癌防治力度。     

湖北省2006-2007年监测点居民伤害死因分析

目的:了解湖北省监测点居民伤害死因及潜在寿命损失状况,为预防控制提供科学依据。方法:采用死亡率与潜在减寿年数(PYLL)等指标对湖北省2006-2007年监测点居民伤害死亡资料进行分析。结果:监测点居民伤害死亡5994例,粗死亡率为61.45/10万（标化死亡率为58.26/10万）,其中男性3 725例、女性2 26...     

宁夏居民主要恶性肿瘤潜在寿命损失分析

目的 探讨恶性肿瘤对宁夏居民寿命的危害。方法应 用潜在寿命损失年数(YPLL)对1994—2000年宁夏死亡监测资料进行分析。结果 1994—2000年宁夏居民恶性肿瘤全死因YPLL率为8．93年／1000人口。男性YPLL率为10．78年／1000人口。女性YPLL率为7．01年／1000人口。男性高于女性。胃癌、肝癌、白血病和肺癌居YPLL的前四位。是危害宁夏居民长寿水平的主要恶性肿瘤；造成男性居民寿命损失的主要恶性肿瘤为：肝癌、胃癌、白血病和肺癌。女性为：胃癌、白血病、肝癌及子宫颈癌。恶性肿瘤潜在寿命损失的高峰年龄为45—60岁。结论 胃癌、肝癌、白血病和肺癌是危害宁夏居民健康的主要恶性肿瘤。导致男性与女性居民寿命损失的主要恶性肿瘤及其顺位不完全相同。肝癌、胃癌、白血病、肺癌及子宫颈癌是我区需要重点防治的恶性肿瘤。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.