呼吸道感染与气象因素的关系

呼吸道感染是呼吸系统常见病、多发病。利用杭州地我１９９０年１月－１９９２年１２月气象资料作了统计分析，并对同期来海军杭州疗养院门诊就诊的呼吸道感染病人进行了调查。结果为１－３、１１、１２月发病率高，与５－９月相比有非常显著差异。呼吸道感染与气温低，湿度高，温差大，天气骤变等气象因素密切相关。潮冷天气，频敏降温大幅度降温三种气象因素共同存在情况下可导致呼吸道感染性疾病的高发。同时从气象学角度提出了预     

温州地区住院儿童下呼吸道腺病毒感染的流行特征及与气象因素的相关性

目的：研究温州地区住院儿童下呼吸道腺病毒（HAdV）感染的流行病学特点及与气象因素的相关性。方法：回顾性分析2008年1月至2017年12月因急性下呼吸道感染在温州医科大学附属第二医院育英儿童医院住院儿童的呼吸道病毒抗原检测数据,分析呼吸道HAdV感染的流行特征;同时提取2008年1月至2017年12月温州地区气象资料,包括每旬平均气温、平均湿度、总降雨量、降雨天数、平均风速。采用广义相加模型（GAM）进行单因素和多因素回归分析HAdV流行与气候因素的相关性。结果：2008年1月至2017年12月进行呼吸道病毒抗原检测的鼻咽吸取物和痰液标本89 898份,HAdV阳性1 974例（2.2%）,其中＜1岁339例;1～3岁615例;3～5岁597例;5～18岁423例。儿童HAdV感染检出例数和检出率都是5～7月达到峰值。基于GAM模型分析发现：气温越高,HAdV检出率越高（P=0.015）。而风速越低,检出率越高。随风速增高,检出率降低的幅度逐渐减小（P=0.003）。结论：温州地区下呼吸道感染住院儿童HAdV感染高峰季节在春末、夏初。气温和风速是影响下呼吸道HAdV感染的主要气象因素。     

洛阳地区婴幼儿支原体流行活性与气候因素的相关性探讨

目的：探讨洛阳地区婴幼儿支原体流行活性与气候因素的相关性。方法：对2012年因呼吸道感染而住院256例婴幼儿进行支原体病原学监测。运用培养基检测呼吸道分泌物中支原体抗体。同时收集2012年洛阳地区月平均气温、平均湿度、总日照、总雨量、平均风速等有关气象资料。采用直线回归和逐步回归法研究支原体活性与气候因素的相关性。结果：2012年呼吸道支原体检出率为37.8%（97/256）。呼吸道支原体感染有明显的季节性,1~3月及11~12月是呼吸道支原体感染高发月份,1月份阳性率高达54.5%。呼吸道支原体阳性率与月平均气温、日照总数和以及风速呈负相关（r=-0.96,P〈0.001;r=-0.68,P=0.014;r=-0.58,P=0.014）,尤其与气温关系最为密切。其余气象因素与呼吸道支原体阳性率无相关性（P〈0.05）。结论：呼吸道支原体是婴幼儿呼吸道感染的重要病原之一,其流行活性与气候相关,尤其是气温对呼吸道支原体的流行活性影响最大。     

银川地区几种气象因子对儿童呼吸道感染发生影响的探讨

目的：探讨银川地区几种气象因子对儿童呼吸道感染发生的影响，为预防这类疾病提供依据。方法：将四种气象因子气温，相对湿度，扬沙，浮尘分别同呼吸道感染发病率做单项回归分析和相关检验。结果：扬沙，浮尘对呼吸道感染发生的呈正相关（Ｐ〈０．０５）。气温，相对湿度对呼吸道感染发生的影响呈负相关（Ｐ〈０．０１），结论：证明呼吸系统疾病与气象因子有关，不同地区同一种气象因子对呼吸道感染的影响也不同。     

2008—2012年深圳市盐田区流感样病例比例与气象因素关系研究

目的探讨流感样病例比例（ILI％）与气象因素的关系。方法对深圳市盐田区2008年1月至2011年12月流感样病例比例监测数据与气象因素数据进行Spearman相关及多元线性回归分析。探讨影响流感样病例比例的主要气象因素。结果研究期间日均ILI％5．65,每年6—7月为ILI％高峰;流感高峰时月均气温26．64℃～27．74℃,月均相对湿度76．4％～85．6％,气压均处于年低谷990～998hpa,日降雨量处于每年的高峰;ILI％与日均气温、日均相对湿度、降雨量呈正相关,与日均气压、风速呈负相关,与日温差无显著性相关。结论气温、气压、相对湿度、风速是影响盐田区ILI％的主要气象因素。     

防治小儿反复呼吸道感染之中药散剂外用研究

资料与方法 根据1987年4月全国小儿呼吸道疾病学术会议修订的反复呼吸道感染（RRTI）诊断标准：年龄0～2岁，上呼吸道感染7次／年，下呼吸道感染3次／年；年龄3～5岁，上呼吸道感染6次／年，下呼吸道感染2次／年；年龄6～14岁，上呼吸道感染5次／年，下呼吸道感染2次／年。上呼吸道感染第2次距离第1次至少7天以上。若上呼吸道感染次数不够，可以加下呼吸道感染次数，反之则不成。需观察1年。检测治疗前后的生长发育情况（身高、体重）、呼吸道感染的次数、主要症状和体征、血红蛋白、免疫球蛋白、补体C3，并与对照组比较。     

大连地区气象因素与脑出血发病的相关性研究

目的 探讨大连市气象因素与同期脑出血发病的相关性,为易感、高危人群预防脑出血提供参考依据。方法 回顾性收集2013年1月1日—2015年12月31日大连市3家综合性三级甲等医院首发的脑出血2?560例,并收集同期气象资料。对各气象因素变化与脑出血发病进行相关回归分析,以脑出血日发病例数作为因变量,以每日气象因素变化作为自变量,对大连地区脑出血发病例数与气象因素进行相关性检验,分析各气象因素与脑出血发病间相关性;并进一步对各气象因素变化与脑出血发病进行相关回归分析,建立气象因素相关脑出血发病预报模型。结果 ①大连市脑出血患者的发病趋势呈现季节趋势,即冬季高发,夏季低发,其中12月至次年1月份发病率最高,7～8月份最低。②大连市脑出血发病例数与日均气温呈负相关（r?= -0.292,P?<0.05）、日最高气温呈负相关（r?=-0.284,P?<0.05）、日最低气温呈负相关（r?=-0.293,P?<0.05）,与日均气压呈正相关（r?=0.266,P?<0.05）、日最大风速呈正相关（r?=0.073,P?<0.05）。③对各气象因素进行回归分析,建立回归模型：Y日（发病例数）=2.719～0.042×日最低气温（℃）。结论 冬季脑出血发病率升高,且气温下降、气压升高、风速增大时脑出血发生率更高。     

温州地区气象因素与川崎病发病的相关性

目的：探讨气象因素与川崎病（KD）发病的相关性。方法：收集2005年1月至2015年12月温州地区住院的KD患儿资料及该地区气象资料,对每月KD发病人数与同时期该地区气象因素,包括降雨量、风速、日照时长、气温及气压进行相关性分析。结果：2005年1月至2015年12月温州地区约1 956例KD住院患儿纳入本研究,KD发病率以春夏季为高,冬季发病率较低。降雨量与KD发病率成正相关（r=0.217,P＜0.05）,气压、风速与KD发病率成负相关（r=-0.209、-0.652,P＜0.05）,气温、日照时数与KD发病率相关性不显著（P＞ 0.05）。结论：KD的发病与气象因素具有一定相关性。     

下呼吸道医院感染210例的危险因素分析

目的探讨下呼吸道医院感染的危险因素，加强预防，降低发病率。方法对我院2003年1月至12月22863例出院病人进行调查分析。结果医院感染人数689例，医院感染率3．01％，其中下呼吸道感染210例，占全院医院感染病例的30．49％，居全院医院感染部位的首位，其中儿童、年老（60岁以上）体弱、接受过呼吸道侵入性操作以及长期使用抗生素等病人感染率较高。结论年老体弱、接受过呼吸道侵入性操作及长期使用抗生素等病人是引起下呼吸道医院感染的危险因素。     

2001年至2008年苏州地区儿童急性呼吸道感染中腺病毒感染的流行趋势

目的了解近8年来苏州地区儿童急性呼吸道感染中腺病毒（ADV）的感染流行趋势。方法用直接免疫荧光（DFA）法对2001年1月至2008年12月共22607份急性呼吸道感染患儿鼻咽分泌物标本进行ADV等7种呼吸道病毒抗原检测;用酶联免疫吸附法（ELISA）对145例确诊ADV感染患儿血清进行肺炎支原体（MP）、肺炎衣原体（CP）抗体定量测定;同时用逆转录-聚合酶链反应（RT-PCR）对上述145例ADV感染患儿鼻咽分泌物标本进行人类偏肺病毒（hMPV）RNA抗原定性测定。结果 （1）22607份标本中共检出ADV312份,阳性检出率为1.38%;2001—2008年ADV全年阳性检出率依次为2.72%、0.88%、1.13%、1.19%、0.99%、1.53%、0.79%和1.47%。（2）自2006年起的145例ADV感染患儿同时检出MP感染47例（32.41%）,同时检出hMPV感染6例（4.14%）,未检出ADV与CP混合感染;312例ADV患儿同时检出流感病毒B型2例（0.64%）,同时检出呼吸道合胞病毒1例（0.32%）,未检出ADV与流感病毒A型及副流感病毒的混合感染。（3）ADV感染四季均可发生,相对高发季节在每年的4～8月份;3岁以上儿童阳性检出率显著高于3岁以下儿童,差异有高度统计学意义（P﹤0.01）。（4）ADV所致疾病分布：3岁以上儿童以咽扁桃体炎高发（P﹤0.01）,3岁以内儿童以下呼吸道感染高发（P﹤0.01）。结论苏州地区儿童ADV检出率不高,感染相对高峰季节为每年的春夏季;3～8岁儿童为ADV高发年龄。     

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.