食管癌遗传流行病学病例对照研究

应用遗传流行病学和病例对照研究方法，对淮安市１６３个乡食管癌高危人群中的２４９例食管癌病例进行遗传度分析以及１∶１配比病例对照研究。结果表明：食管癌一级血缘亲属的遗传度为３６．６９％，明显高于二级血缘亲属的遗传度（７．１６％）；各级亲属的加权平均遗传度达３３．６５％；一、二级血缘亲属的预期率为７．５７％和４．２７％；与实际率（８．２８％和３．８９％）比较均无显著差异（Ｐ＞０．０５），提示食管癌可能     

山西省阳泉市部分人口食管癌遗传流行学病调查

目的了解遗传因素在食管癌病因中的作用。方法在山西省阳泉市进行了１／１０人口,６个乡、共１３万人的食管癌家族遗传流行学调查,对得到的２２８个食管癌高发家系和同等数量的对照家系进行了１：１病例－对照研究。结果（１）食管癌一级亲属的遗传度为５２．６％,二级亲属遗传度为３１．２％,一、二级亲属加权平均遗传度为４９．２％;（２）食管癌病例在各家族中不按二项式分布,呈家族聚集趋势;（３）分离比Ｐ＝１７．６％±３．３％,小于２５％,提示食管癌不是按单基因遗传的;（４）男性一级亲属相对风险为１０．４９,女性一级亲属ＲＲ为７．６９,合计一级亲属ＲＲ为９．１７;（５）男性一级亲属归因风险（ＡＲ）为６２．１３／１０万,女性一级亲属ＡＲ为９９．９４／１０万,合计一级亲属ＡＲ为７５．１５／１０万,均高于一般居民的４０．１７／１０万。结论遗传因素在阳泉食管癌发病中起到较为重要的作用。     

胃癌遗传流行病学病例对照研究

目的：通过遗传流行病学病例对照研究，揭示胃癌发病与遗传因素的关系。方法：采用整群抽样的方法，对金坛市1998年5月1日至1999年4月30日发生的全部101例胃癌病例和按年龄、性别1：1匹配的对照，进行分离比、遗传度估算和配比病例对照研究。结果：病例组一级亲属总的患病率为4．81％，高于对照组的3．02％，但统计学检验无显差异；分离比为0．0057％，明显低于0．25％，表明胃癌属多基因遗传方式；遗传度估算显示，该病一级亲属中，遗传度为18．6％，女性（23．0％）明显高于男性（18．8％）。结论：在胃癌的病因中，遗传因素起一定作用，且为多基因遗传疾病。     

吸烟和遗传因素与西安地区食管癌关系的病例对照研究

目的：研究吸烟和遗传因素在西安地区非农业人口食管癌发生中的作用。方法：采用病例对照研究方法，于１９９４年８月至１９９５年１月，对８９例病例和９７例对照进行了调查。结果：食管癌患者中有吸烟和食管癌家族史的比例显著高于对照（Ｐ＝０．００００），单因素分析表明，吸烟（ＯＲ＝３．３）和食管癌家族史（ＯＲ＝１０．４）是引起西安地区非农业人口食管癌的主要危险因素。分层分析表明二者间存在交互作用，在食管癌的发生     

山东半岛原发性肝癌279例家系调查对照分析

对２７９例原发性肝癌患者的家系进行调查对照分析，结果Ⅰ级、Ⅱ级、Ⅲ级亲属肝癌患病率显著高于对照组，Ｐ＜０．００１。肝硬变患病情况亦然。有阳性家族史研究组３１．１８％，对照组４．４３％，机会比（ＯＲ）是９．８。多元逐步回归分析，Ｒ（复相关系数）＝０．４０６２７，提示肝癌发病与年龄、性别相关。肝癌发病具有家族倾向性。     

胆石症的遗传方式和遗传度研究

目的：探讨遗传方式和遗传因素在胆石症发生中的地位与作用。方法；对１２８个胆石症先证家系和１５１个非胆石症对照家系进行胆石症家族史的分离比和遗传度研究，并相互比较。结果；胆石症患病率，病例组一级亲属高于对照组，有显著差异；遗传度，病例组一要属遗传度２１．９２％，其中男性高于女性；胆石症的分离比０．００２６８，低于０．２５。结论；胆石症是一种多基因遗传病；遗传因素在胆石症发生中作用显著，对男性更为明显     

成人阻塞性睡眠呼吸暂停低通气综合征遗传流行病学研究

目的：探讨成人阻塞性睡眠呼吸暂停低通气综合征（OSAHS）发病的遗传流行病学模式和特征。方法：应用Li-Mantel-Gart法、Falconer回归法及SAGE-REGTL软件对OSAHS患者进行分离比、遗传度计算及复合分离分析。结果：OSAHS的分离比为0.168,95%可信区间为0.127-0.209。成人OSAHS先证者Ⅰ、Ⅱ级亲属遗传度分别为56.138%和25.007%,两者的加权遗传度为37.469%。复合分离分析显示孟德尔显性、隐性、加性和主基因模型假设均被接受（P〉0.05）,环境和无传递模型被拒绝（P〈0.05）;以AIC值判断,显性模型拟合程度最好。结论：遗传因素在成人OSAHS发病中占有重要作用。OS-AHS符合多基因遗传模式,存在主基因效应。     

2型糖尿病的遗传和环境病因及其相互关系的流行病学研究

对江苏省１９９７年糖尿病流行病学调查中，筛选出的糖尿病患者１８３例及与其性别、年龄构成相近的正常人对照１６４例，进行了２型糖尿病遗传和环境危险因素的病例对照研究。结果显示：病例组和对照组具有良好的均衡可比性，病例组一级亲属总的累积发病率为３．７６％，与对照组的１．１０％相比，差异有非常显著性（Ｐ＜０．００５）；２型糖尿病的遗传度为３６．２％；Ｌｏｇｉｓｔｉｃ回归分析表明，遗传因素与肥胖、高血压等危险因素共同存在时，糖尿病的发病危险性（ＯＲ）将显著增加，进一步说明２型糖尿病是遗传和环境危险因素共同作用的结果     

抑郁症自杀行为遗传度及相关危险因素研究

目的了解抑郁症自杀行为的遗传度及其危险因素.方法应用个体匹配病例对照研究方法对103例有自杀行为抑郁症患者(先证者)和103例非精神病患者以及他们的亲属资料进行研究,并对抑郁症自杀行为相关危险因素Logistic回归分析.结果先证者Ⅰ级亲属自杀行为发生率为4.56%,高于Ⅱ级亲属的1.60%(P <0.01),二者均高于非精神病患Ⅰ级亲属的0.26%(P <0.01);抑郁症自杀行为加权平均遗传度为(57.23±5.70)%;抑郁症自杀行为与阳性自杀家族史、绝望、自责、负性生活事件及妄想等因素有关.结论遗传因素在抑郁症自杀行为中起主导作用,社会心理因素是促发因素.     

牡丹江地区汉族人群原发性高血压遗传特征分析

目的：分析黑龙江省牡丹江地区汉族居民原发性高血压的遗传特征,为预防和干预高纬地区原发性高血压提供参考依据。方法：采用病例对照研究方法对394例原发性高血压患者及同期体检的300名非高血压健康人群进行问卷调查。结果：汉族原发性高血压患者遗传度为61.1%,其中男57.6%,女65.8%;病例组家系一级亲属、家系男性一级亲属和家系女性一级亲属的患病率分别为37.39%、30.07%和43.25%,均高于对照组的9.65%、9.92%和11.24%,差异有统计学意义（P〈0.05）;原发性高血压患者分离比为0.22（分离比〈0.25）。结论：牡丹江地区汉族人群的原发性高血压符合多基因遗传病特征。     

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.     

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.     

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…     

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.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.