重庆市主城居民恶性肿瘤死亡的流行病学特征及趋势分析

目的 了解重庆市主城区居民的恶性肿瘤死亡的流行病学特征及变化趋势,为恶性肿瘤的防治工作提供参考依据.方法 按照全国第3次死因回顾抽样调查方案,对2004～2005年重庆市渝中区以恶性肿瘤为主的死因进行回顾性抽样调查,分析主要恶性肿瘤死亡率、标化死亡率、死亡构成、截缩率、累积率等指标,并与全国和历史水平进行比较.结果 渝中区居民恶性肿瘤2年平均粗死亡率和标化死亡率分别为145.28/10万和78.84/10万,截缩率和累积率分剐为126.29/10万和11.24%;是总死亡原因的第1位死因,占总死亡的23.13%.居前5位的恶性肿瘤死亡依次为肺癌、肝癌、结直肠癌、胃癌和食管癌;男性和女性标化死亡率分别为105.20/10万和52.03/10万,男性标化率明显高于女性(u=10.73,P＜0.01).肺癌是重庆市城市居民恶性肿瘤的首要死因,它占恶性肿瘤死亡的37.17%,是第2位死因肝癌的2.59倍.渝中区恶性肿瘤的死亡率、标化死亡率低于全国平均水平,与该区全国第2次死因调查(1990～1992年)的173.85/10万比较有所下降,主要恶性肿瘤肺癌的死亡率低于第2次死因调查的58.74/10万,低于1991～2000年间的63.44/10万.结论 重庆市主城居民以肺癌为主的恶性肿瘤死亡水平呈逐步下降趋势,可能与环境污染治理等措施初见成效有关,建立完善的监测系统是制订相关策略和措施的依据,也是进行评估的基础.     

2000～2010年平罗县居民恶性肿瘤死亡原因分析

目的 了解2000～2010年平罗县居民恶性肿瘤死亡病因和死亡率变化趋势.方法 对平罗县疾病预防控制中心2000～2010年死亡原因年报表按照ICD-10编码,计算11年间恶性肿瘤的死亡率、标化死亡率、死因构成和死因顺位.结果 2000～2010年恶性肿瘤平均死亡率为84.13/10万,标化死亡率为90.38/10万.男性粗死亡率是女性的1.84倍,差异有统计学意义(χ2=34.22,P＜0.05).居前5位的恶性肿瘤分别是胃癌、肝癌、肺癌、食管癌、肠癌,占全部恶性肿瘤死亡人数的79.52%.肠癌死亡率上升较明显,2010年与2000年比较,男性上升了522.67%,女性上升了432.91%;胃癌死亡率一直居恶性肿瘤死亡首位,平均死亡率为23.39/10万,占全部恶性肿瘤死亡人数的27.84%.结论 恶性肿瘤始终居平罗县居民死因的第2位,男性恶性肿瘤死亡率高于女性.胃癌位于恶性肿瘤死亡的首位,肠癌死亡率上升较明显.     

楚雄市2015年居民死因监测结果分析

目的：收集分析楚雄市人口死亡原因及其变动规律,为政府和卫生行政部门科学制定疾病防控提供决策依据。方法：采用描述流行病学方法对2015年楚雄市死因监测资料进行分析。结果：2015年监测报告死亡个案3792例,其中男2337例（61.63％）;女1455例（38.37％）,全市人口死亡率为6.25‰,男性死亡率为7.61‰,女性为4.85‰;男性前5位死因依次为呼吸系统疾病、心脏病、脑血管病、恶性肿瘤、伤害;女性前5位死因依次为呼吸系统疾病、脑血管病、心脏病、恶性肿瘤、伤害。结论：呼吸系统疾病、心脏病、脑血管疾病、恶性肿瘤、伤害是楚雄市2015年居民死亡的主要原因。而伤害和呼吸系统疾病是楚雄市居民“早死”及青壮年死亡的主要原因。     

甘肃省榆中县2006年居民死亡监测分析

2006年榆中县居民死亡率543.62/10万,标化死亡丰498.77/10万;男性死亡率明显高于女性,性别比为1.25:1.前5位死因依次为呼吸系病、恶性肿瘤、损伤中毒、心脏病和脑血管病,占全死因死亡率的62.81%;新生儿死亡率和5岁以下儿童死亡率分别为14.67‰和21.47‰;平均期望寿命为73.72岁,女性高于男性.     

乌鲁木齐市人口1991和1992年主要死因分析

作者对乌鲁木齐市1991和1992两年的人口死亡率及主要死因进行了1/10人口的抽样调查。结果表明:人口粗死亡率为2.33‰,调整死亡率为2.48‰;男女死亡率分别为2.76‰和1.88‰,调整死亡率分别为2.50‰和2.10‰,男女死亡率比为1.23∶1。主要死因中,恶性肿瘤死亡率居第1位,第2位是心脏病,笫3位是脑血管疾病,而后依次为意外死亡、呼吸系疾病、新生儿死亡、消化系疾病、神经系疾病、泌尿系疾病和传染病。     

宁夏恶性肿瘤死亡率及人口死亡抽样调查研究

按照全国统一方法，宁夏回族自治区选择银川、吴忠、惠农、泾源四市（县）作为调查点，调查了１９９０～１９９２年恶性肿瘤及人口死因。结果为：四市、县三年度共死亡９６７３人，死亡率４．２‰，标化死亡率３．８６‰。其中婴儿死亡９５８人，死亡率２６．６５‰。人口中死亡的高峰在婴儿期及７０～岁年龄组。测算人口平均寿命男性６７．６７岁，女性７３．３岁。四市、县居民前五位死因依次为：循环系统疾病、恶性肿瘤、呼吸系统疾病、损伤与中毒及意外，以及新生儿疾病。四市、县三个年度共有１８３１人死于恶性肿瘤，平均年度死亡率为８４．５／１０万，占死亡总数的１９．３３％（男性死亡人口中恶性肿瘤占首位）；主要恶性肿瘤死亡位次为：胃癌、肺癌、肝癌、食管癌。与７０年代调查结果比较，人口死亡率及婴儿死亡率均下降，人口平均寿命延长。呼吸系统疾病及传染病的死亡率均下降，循环系统疾病及恶性肿瘤的死亡率分别上升至第一、二位。     

扶绥县1974～2005年恶性肿瘤死亡率分析

目的探讨扶绥县32年来恶性肿瘤死亡率变化趋势。方法利用扶绥县肿瘤防治研究所登记处肿瘤登记资料,分别计算1974~2005年各年度粗死亡率、中国人口标化率、世界人口标化率。结果扶绥县1974~2005年恶性肿瘤死亡病例为10 156例,粗死亡率84.47/10万,中国标化率80.04/10万,世界标化率102.59/10万。前5位恶性肿瘤为肝、胃、肺、鼻咽、结直肠癌,占全部恶性肿瘤86.00%。男女死亡率性比例为3.09∶1。结论扶绥县恶性肿瘤死亡率一直处于高水平状态,尤其是肝癌死亡,进一步加强肿瘤防治工作具有深远意义。     

云南省肺癌死亡趋势及疾病负担分析

目的 分析1973～2005年云南省居民肺癌的死亡趋势和疾病负担情况,为制定云南省相应的肺癌防治对策提供科学依据.方法 对全国三次死因调查资料进行动态分析,全部数据采用EXCEL进行处理.评价指标主要有标化死亡率和DALYs等.结果 三次死因调查,云南省居民肺癌标化死亡率分别为13.31/10万、33.88/10万和40.07/10万,DALYs分别为15.91‰、81.91‰和117.33‰.肺癌一直高居云南省恶性肿瘤死亡顺位的首位.且各个年龄组男性标化死亡率均高于女性,并呈现逐年上升趋势.结论 肺癌在今后一段时间内仍将是威胁云南省居民健康和生命危害的主要恶性肿瘤和主要死亡原因之一,应加强一级预防,普及防癌知识,提高群众自我保健和防癌意识.     

海南定安县2004～2005年恶性肿瘤死亡调查

目的调查全县居民以恶性肿瘤为主死因,了解癌症死亡率的人群分布特征。方法对2004～2005年全县居民以恶性肿瘤为主死因进行回顾性调查,分析恶性肿瘤死亡率及其死亡构成。结果定安县恶性肿瘤的平均粗死亡率和标化死亡率分别为123.39/10万和113.48/10万,占总死因比例19.6%。恶性肿瘤的死因顺位前五位分别为肝癌、胃癌、肺癌、肠癌及鼻咽癌,前三位恶性肿瘤死亡率男性均高于女性。结论定安县恶性肿瘤死亡情况接近全国农村地区水平,应提高三级农村保健网,加强恶性肿瘤的早诊早治以及登记报告工作。     

上海县居民死亡模式分析

用平均期望寿命、死亡率、标化死亡率和减寿年数等指标分析近30年来上海县居民的死亡模式发现,人口结构日趋老龄化,平均期望寿命1990年男、女分别达71.92岁和74.55岁。总死亡率明显下降,标化死亡率1970年后一直保持平稳,减寿年数从1960年的64942.5年下降为12554.0年。1950年婴儿、新生儿和1～4岁儿童死亡率分别为9.3‰、6.8‰和0.94‰。死因谱分析发现,上海县居民1988～1990年前三位死因为恶性肿瘤、呼吸系病和脑血管病,标化死亡率分别为98.25/10万、73.36/10万和56.46/10万。减寿年数分析显示,1990年前三位死因为恶性肿瘤、意外死亡和传染病,其值为4017.0年、3805.5年和643.0年。     

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.