辽宁阜新农村居民心肌梗死的流行病学特征及危险因素调查

目的了解北方农村地区成年人群心肌梗死的流行病学特征和相关危险因素,为北方农村地区心肌梗死的防治和干预提供科学依据。方法采用随机分层整群抽样对辽宁省阜新地区的7个乡镇≥35岁30214名农村常驻(≥5年)成年人进行了调查。由培训过的医师对调查对象进行了血压测量和常见心肌梗死危险因素资料的收集。结果辽宁省农村居民心肌梗死患病率为0.29%,标化率为0.28%;男性患病率为0.26%(标化率0.25%),女性患病率为0.32%(标化率0.31%),性别间差异无显著性(χ2=0.90,P=0.342)。随着年龄和血压分级的增高,心肌梗死患病率呈明显增高趋势。多元Logistic逐步回归分析表明年龄、超重、肥胖、高血压家族史、高血压、吸烟和爱吃咸食等因素是心肌梗死患病的危险因素。其中肥胖人群患心肌梗死的调整优势比是体质正常人群的6.08倍(95%CI为2.84～13.03)。结论辽宁省农村居民心肌梗死患病率较高,肥胖、高血压是心肌梗死最显著的危险因素,而许多居民对心肌梗死危险因素的防治知识非常匮乏。应提高农村居民对心肌梗死危险因素和相关知识的认识度,以降低心肌梗死的患病危险性。     

辽宁阜新农村老年人群高血压患病率及危险因素调查

目的了解辽宁省农村地区老年人群高血压的流行病学特征和相关危险因素，为辽宁省农村地区高血压的防治和干预提供科学依据。方法采用分层整群随机抽样法对辽宁省农村地区7个乡镇年龄≥65岁4541名常住（≥5年）居民进行调查，由培训过的医师进行入户询问调查和相关的体格检查。结果辽宁农村地区老年人群高血压患病率为61．33％，标化患病率为61．18％。男性患病率为59．68％（标化率为59．50％），女性患病率为62、99％（标化率为63、07％），性别间差异有显著性（P〈0．05）。不同乡镇间高血压患病率差异较大，范围为45．15％-70．45％。随着年龄的增高，女性高血压患病率呈明显的增高趋势。高血压病人未知晓率高达68．01％。Logistic逐步回归显示年龄、性别、超重、肥胖、吸烟、家族史、饮食不良等因素是高血压患病的危险因素。结论辽宁省农村老年人高血压患病率高，知晓率低，应采取全面的高血压预防控制措施，提高农村居民对高血压危险因素和相关知识的认识度，以降低高血压的患病率。     

成都地区中老年人群单纯收缩期高血压流行特点及其影响因素

目的探讨成都城乡地区中老年人群单纯收缩期高血压流行状况及危险因素,为本地区中老年高血压防治工作提供理论依据。方法 2008年应用分层整群抽样方法调查成都城乡地区40~79岁中老年人5205人,经统一培训的30余名医护人员进行血压测量及资料收集。了解中老年单纯收缩期高血压的患病率,分析中老年单纯收缩期高血压的影响因素。结果成都城乡地区中老年人群单纯收缩期高血压患病率为16.64%,标化患病率为15.87%。城市居民患病率为17.18%,农村居民患病率为14.23%;城市高于农村(P0.01)。男性患病率为16.09%;女性患病率为16.99%(P=0.40)。随着年龄的增加,单纯收缩期高血压患病率呈明显的增高趋势。多元Logistic逐步回归分析发现,年龄、偏咸膳食、腹型肥胖为男性单纯收缩期高血压的危险因素。年龄、绝经、超重或肥胖、腹型肥胖、高胆固醇血症为女性单纯收缩期高血压的危险因素。文化程度高及适度的运动为女性单纯收缩期高血压的保护因素。结论成都地区中老年人单纯收缩期高血压患病率较高,与增龄关系密切。控制腰围、体质量、钠盐摄入,适度运动对中老年人单纯收缩期高血压防治工作有较为重要的意义。     

辽宁省阜新地区蒙、汉两族农村居民缺血性卒中的流行病学特征及危险因素比较

目的通过对农村地区蒙、汉两族成年人群缺血性卒中的流行病学特征和相关危险因素的调查，为缺血性卒中防治提供依据。方法制定统一的调查问卷，按标准化调查方法，由培训过的医师进行人户询问、血压测量及资料收集。采用随机分层整群抽样的方法，对辽宁省阜新农村地区的7个乡镇〉135岁30214名农村常驻（〉15年）成年人进行性别、民族、高血压、心脑血管疾病史、吸烟、嗜酒及饮食情况等方面调查。结果辽宁省农村蒙族居民缺血性卒中患病率为2．36％，标化率为2．48％；汉族为1．73％，标化率1、78％。随着年龄或高血压级数的增高，卒中患病率呈明显的增高趋势。多因素Logistic逐步回归显示年龄、性别、高血压及高血压家族史等因素是蒙、汉两族患病的相同危险因素，同时文化水平对汉族居民卒中的患病率也产生一定的影响。其中高血压人群患卒中的危险性是非高血压人群的5～8倍。结论辽宁省阜新农村蒙族居民患病率高于汉族居民，可能与其生活方式、遗传因素等有关。高血压患者对自己的保护意识较弱。应提高农村居民对高血压等危险因素和相关知识的认识，以减少卒中的患病率。     

福建省高血压患病情况及影响因素分析

目的了解福建省城乡居民高血压的患病情况和影响因素。方法 2014年8月至2016年7月,采用多阶段分层随机抽样的方法抽取福建省年龄15岁常驻居民15 176人,通过问卷调查和体格检查收集相关资料。结果福建省年龄15岁居民高血压患病率为30.3%,标化后为24.2%。其中,城市居民高血压患病率为29.4%(标化率23.5%),农村居民高血压患病率为31.2%(标化率25.1%),农村高于城市(χ~2=5.720,P0.05)。福建省城乡居民高血压的共同危险因素包括男性、年龄增长、文化程度低下、高血压家族史、高体质量指数、中心性肥胖。此外,饮酒的农村居民患高血压危险较高。结论福建省农村居民高血压患病率高于城市居民,城乡间高血压相关危险因素存在细微差异。     

河北省农村居民单纯收缩期高血压流行病学特征分析

目的了解河北省部分农村居民单纯收缩期高血压(ISH)的流行病学特征及影响因素。方法按照1999年WHO/ISH的ISH诊断标准(收缩压≥140mmHg和舒张压<90mmHg),分析2002年河北省农村居民营养与健康状况调查资料中的单纯收缩期高血压患病率及影响因素。结果1.河北省15岁以上农村居民单纯收缩期高血压(ISH)粗患病率为12.5%(标化率10.28%),其中男性为12.3%,女性为12.6%,35岁以前男性ISH患病率高于女性,45岁～54岁则女性高于男性;ISH总患病率随年龄增长而增长;45岁以后呈快速增长。2.ISH患病率随着体质指数(BMI)、腰围(WC)的增加而增高。3.影响ISH患病率的主要因素是年龄、BMI、性别。结论ISH患病率占高血压总患病率的33.3%,随年龄增长而迅速增高;预防控制ISH从早期开始并以控制肥胖为主,是降低人群高血压致残致死的重要措施。     

辽宁省阜新市农村男性人群高血压的患病情况及危险因素调查

目的了解辽宁省农村地区成年男性人群高血压的流行病学特征和相关危险因素，为其高血压的防治和干预提供科学依据。方法采用分层整群随机抽样对阜新市8个乡镇≥35岁的22747名农村常住（≥5年）成年男性进行调查。由培训过的医师对调查对象进行血压测量和资料的收集。结果辽宁省阜新市农村男性居民高血压患病率为37．0％。随着年龄的增长，高血压患病率呈明显增高趋势。男性高血压患者未知晓率高达74．1％，已明确为高血压的患者对自己的保护意识较弱。多元Logistic逐步回归显示年龄、超重、肥胖、吸烟、饮酒、家族史、饮食不良等因素是高血压患病的危险因素。结论辽宁省阜新市农村男性居民高血压患病率高，知晓率低，应注重加强高血压防治知识宣传及采取全面的高血压预防控制措施，提高农村居民对高血压危险因素和相关知识的认识度，减少高血压的患病率。     

闽北农村居民高血压危险因素流行病学研究

目的:研究分析闽北农村地区高血压流行现状及合并的心血管危险因素。方法:采用整群抽样的方法,按标准化调查方法于2013年6月～2014年3月间对闽北农村地区6个乡镇8个村≥35岁常住居民1784人进行流行病学调查问卷和体检。诊断标准依据《中国高血压防治指南2010》定义,多因素分析采用Logistic回归方法。结果:闽北农村地区人口高血压患病率17.43%(311/1784),标化后高血压患病率23.21%,其中男性为18.66%,女性为16.13%,任何年龄段男女性高血压患病率差异无统计学意义(P均0.05);多因素Logistic回归分析显示,年龄、超重(BMI≥24 kg/m~2)、高甘油三酯及空腹血糖是高血压的独立危险因素(OR=1.107～2.096,P0.05或0.01)。结论:闽北农村地区高血压患病率处于较高水平,年龄、超重、高甘油三酯及空腹血糖是高血压的主要危险因素。     

辽宁省农村男性人群血压的正常高值

目的了解辽宁省农村男性居民血压正常高值的流行病学特征及相关危险因素,为防治与其相关的高血压和心血管疾病提供依据。方法采用分层整群随机抽样对辽宁省阜新市7个乡镇≥35岁15 122名农村常住(≥5年)男性居民进行调查。由培训过的医师对调查对象进行血压测量和资料的收集。结果辽宁省农村男性居民血压正常高值率为51.2%,高血压患病率为35.8%。随着年龄的增高,血压正常高值率呈下降趋势,高血压患病率呈增高趋势。多元Logistic逐步回归分析发现,超重、肥胖、蒙古族、饮酒与血压正常高值患病率显著相关。结论辽宁省农村男性居民血压正常高值率高,存在多种危险因素,应积极开展宣教工作,改变当地居民的生活方式,如减轻体重、限酒等,以防止高血压和心脑血管疾病的发生。     

辽宁省阜新农村地区非治疗高血压人群高血压类型与多代谢异常的关系

目的了解辽宁省阜新农村地区非治疗高血压人群高血压类型与多代谢异常的关系。方法采用分层整群抽样方法对阜新农村≥35岁非治疗高血压人群进行流行病学调查及实验室检查。将高血压患者按不同类型高血压分成3组即单纯收缩期高血压组、单纯舒张期高血压组、收缩压舒张压均高组,使用SPSS11.5进行统计分析高血压类型与多代谢异常的关系。结果共入选4273人,平均年龄56.5±11.4岁。单纯收缩期高血压组代谢异常患病率分别为,超重(肥胖)31.4%、糖代谢异常19.9%和血脂异常46.9%;单纯舒张期高血压组代谢异常患病率分别为,超重(肥胖)41.9%、糖代谢异常11.7%、血脂异常44.3%;收缩压舒张压均高组代谢异常患病率分别为,超重(肥胖)45.6%、糖代谢异常19.0%和血脂异常53.3%。超重(肥胖)患病率全年龄组3组间不同,而糖代谢异常和血脂异常仅在<60岁组3组间差异具有显著性。单纯收缩期高血压组,非老年人群较老年人群糖脂代谢异常患病率低,而超重(肥胖)患病率则在非老年人群中较高。多数代谢异常合并患病率在收缩压和舒张压均高组为最高。结论辽宁省阜新农村地区非治疗高血压人群中不同高血压类型间合并多代谢异常患病情况不同,应针对具体情况进行综合干预,预防心脑血管病的发生。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.