四川省绵阳市2013—2019年60岁以上人群肺结核流行特征

目的分析四川省绵阳市60岁以上人群活动性肺结核患者的流行特征,为老年结核病防治提供参考依据。方法采用描述性研究方法,对2013—2019年绵阳市60岁以上老年肺结核登记发病情况进行分析。结果2013—2019年绵阳市老年人活动性肺结核登记发病率(91.00/10万)高于全人群(68.77/10万),差异有统计学意义(χ~2=375.71,P0.01);病原学阳性肺结核登记发病率(29.74/10万)高于全人群(18.99/10万),差异有统计学意义(χ~2=306.61,P0.01);七年间,绵阳市60岁以上老年肺结核呈下降趋势(χ~2_(趋势)=175.33,P0.01);60岁以上老年肺结核病原学阳性患者的登记发病率呈上升趋势(χ~2_(趋势)=11.11,P0.01);60岁以上老年肺结核患者在全人群患者中占比呈上升趋势(χ~2_(趋势)=96.94,P0.01);老年肺结核患者数和登记发病率均以60~65岁组最多和最高;老年肺结核患者复治比例高于其他人群(χ~2=44.39,P0.01);老年肺结核人群重症比例高于其他人群重症比例(χ~2=14.77,P0.001)。结论绵阳市60岁以上老年肺结核登记发病率有所下降,但老年肺结核病原学阳性登记率呈上升趋势,且在全人群患者中占比增加,老年肺结核疫情仍然严峻,应加强对老年人群的结核病防治宣传,及早发现患者,切断传播途径,有效控制老年肺结核的传播流行。     

湖北省咸宁市2011—2021年65岁及以上老年肺结核流行病学特征

目的 分析咸宁市2011—2021年老年(≥65岁)肺结核的感染情况，为制定老年结核病防治策略和措施提供科学依据。方法 采用描述性流行病学研究方法，分析2011—2021年湖北省咸宁市老年(本文研究的是65岁及以上的老年人)肺结核疫情特征。结果 2011—2021年，湖北省咸宁市老年肺结核患者年平均登记率为211.52/10万(5 289/2 500 496)，整体呈下降趋势(χ²_趋势=58.06,P<0.05)，且高于全人群肺结核患者年平均登记率96.04/10万(26 463/27 554 195，χ²=2 896.69,P<0.05)；老年肺结核患者登记数占全人群肺结核患者登记数的平均构成比为19.99%(5 289/26 463)，整体呈上升趋势(χ²_趋势=272.05,P<0.05)；老年肺结核患者平均病原学阳性率为51.86%(2 743/5 289)，高于全人群肺结核患者平均病原学阳性率46.41%(12 282/26 463，χ²     

2002—2013年广西肺结核病疫情变化趋势分析

目的 分析2002—2013年广西肺结核病疫情态势,评价广西结核病发现工作质量。方法 利用2002—2013年广西结核病网络专报系统及对容县、兴业县、富川县、昭平县、苍梧县、藤县等6县结核病防治工作现场督导资料,统计分析各年活动性肺结核登记率、新涂阳登记率及其占同期活动性肺结核登记率的比例和各年发现率,现场抽检6县结核患者痰检率、痰检阳性率、痰检合格率等,采用SPSS19.0统计软件进行统计,应用Cox-Stuart显著性检验进行变化趋势的统计学处理,分析疫情变化趋势及原因。结果 2004—2013年活动性肺结核患者登记率呈下降趋势,新涂阳患者登记率无升降趋势;新涂阳肺结核患者占活动性肺结核的比例范围为22.75%～37.00%,无升降趋势;各年新涂阳发现率无升降趋势。2011—2013年,活动性肺结核患者登记率年均下降3.7%,新涂阳患者登记率年均下降24.4%;新涂阳肺结核患者占活动性肺结核的比例范围年均递降21.58%;新涂阳发现率年均递降24.4%;新涂阳患者构成比年均递降1.3%,复治涂阳患者构成比年均递升13.9%。6县总痰检率为72.62%,痰涂片不合格率44.94%,初诊涂阳患者检出率为7.96%。结论 2004—2013年广西活动性肺结核疫情持续缓慢下降,但10年来新涂阳疫情依旧。2011年以来,新涂阳患者发现急剧下滑,下行压力加大,治疗管理质量滑坡。对结核病防控行政推动减弱,对痰涂片检查工作督查不力,是导致质量下降的主因。     

重庆市2009—2018年65岁及以上老年人肺结核疫情分析

目的 分析重庆市2009—2018年老年肺结核疫情,为探讨和制定老年肺结核疫情控制策略提供科学依据。方法 收集重庆市2009—2018年在结核病信息管理系统中登记的年龄≥65岁肺结核病例数据,采用描述性统计学方法对数据进行分析。结果 2009年全市活动性肺结核患者和病原学阳性患者登记率分别为91.31/10万和53.45/10万,2018年分别为61.03/10万和22.68/10万,年递降率分别为4.38%和9.09%。2009年老年活动性肺结核患者和病原学阳性患者登记率分别为112.59/10万和68.79/10万,2018年分别为105.48/10万和48.21/10万,年递降率分别为0.72%和3.87%。全人群患者登记率和病原学阳性患者登记率递降幅度分别达到老年患者的6倍和2倍。老年患者在全人群患者中的年平均比例为17.47%,且渝东南地区最高,为20.33%。登记的老年患者中,男女性别比为3.3∶1,职业以农民为主（80.76%）。10年间,年平均就诊延迟比例为79.15%,明显高于全人群患者（P< 0.05）,其中渝东南地区最高（84.77%）。治疗成功率由2009年的90.24%降至2017年的80.79%,年递降率为1.22%,其中主城地区最低（85.41%）,渝东南地区次之（87.65%）。结论 重庆市≥65岁老年人群肺结核疫情严峻,特别是渝东南地区,应通过强化宣传教育工作,加大患者筛查力度,强化患者系统管理,有效控制老年肺结核疫情。     

武威市2001-2010年各县肺结核就诊率及新涂阳登记率分析

目的分析少数民族县和非少数民族县肺结核就诊率及新涂阳登记率存在差异的现状,探索少数民族县肺结核防治工作策略。方法收集武威市年肺结核可疑者就诊率和新涂阳登记率,使用EXCEL2003和SPSS13.0软件进行处理分析。结果少数民族县10年平均就诊率显著高于非少数民族县,新涂阳登记率2001-2005年少数民族县高于非少数民族县,而2006年后和非少数民族县持平,逐渐缩小差距。结论结核病防治工作要结合少数民族的风俗习惯开展有针对性的宣传,提高结核病防治知识知晓率和患者治疗的依从性,以降低少数民族县结核病疫情。     

福建福鼎市2005～2008年涂阳肺结核病人发现与治疗转归分析

目的分析福鼎市涂阳肺结核病人发现与治疗转归情况,为结核病防治工作提供参考。方法根据2005～2008年结核信息管理报表数据,运用队列研究分析。结果在登记的涂阳肺结核病例中,初治涂阳登记率保持在较高水平并相对稳定,复治涂阳与总体涂阳登记率登记率呈下降趋势,初、复治涂阳病人比例为1：0.11。2个月与3个月痰检阴转率较高,满疗程治愈率达到85%以上,未治愈的病人中,其他（毒副反应停药、拒治）所占比例高于其他原因未治愈病人。结论结核病防治规划实施已步入正轨,涂阳肺结核病人的发现率和治愈率均达到较高水平,直接面视下短程化学疗法（DOTS）疗效显著可靠。     

2006～2008年新涂阳肺结核流行特征

①目的探讨常州市新北区肺结核病的流行特征,为制定防治策略提供依据。方法收集常州市新北区2006～2008年新涂阳肺结核病疫情资料,进行统计分析。结果 2006～2008年常州市新北区共报告新涂阳肺结核450例,登记率为31～39/10万左右;男性例数为女性的2.95倍;〉60岁者占28%;农民、民工和工人分别占50.89%,16.00%与15.11%。结论常州市新北区新涂阳肺结核患者登记率呈逐年下降趋势,且肺结核病的发生男性高于女性,其中老年和青年、农民是高发群体。因此对该部分重点人群肺结核防控工作将成为将来的主要方向。     

2012—2017年扬州市结核病流行特征与患者治疗转归分析

目的：了解2012—2017年扬州市结核病疫情特征,为控制结核病疫情提供依据。方法：收集“中国疾病预防控制信息系统”中,扬州市登记报告肺结核患者信息,进行数据汇总及统计分析。结果：2012—2017年登记肺结核患者12 689例,患者登记率由53.44/10万下降至41.08/10万,新涂阳患者登记率由15.24/10万下降至13.02/10万,各年份患者登记率及新涂阳患者登记率差异均有统计学意义(均P<0.001);报告发病率从53.82/10万下降至40.19/10万,差异有统计学意义(P<0.001);江都区肺结核登记率最高：67.94/10万,仪征市最低：31.97/10万,各地区肺结核登记率差异有统计学意义(P<0.001);35~44岁及≥55岁年龄段人群登记率逐年降低(P<0.001);新涂阳与复治涂阳患者治愈率分别为93.06%、76.65%,差异有统计学意义(P<0.001)。结论：扬州市结核病疫情呈下降趋势,应关注农村地区、重点人群疫情,采取综合措施防控。     

结核病控制中现代结核病控制策略应用的效果研究

目的 探讨现代结核病控制策略的实施对肺结核病人发现登记和结核病疫情的影响.方法 对1994-2009年荆州市肺结核病人发现登记数据进行动态数列分析.结果 1994-2009年共发现和登记各类肺结核病人49 950例,其中涂阳肺结核38 107例,肺结核病人年平均增长15.92%,涂阳肺结核病人登记率年平均增长14.51%.其中1994-2004年涂阳登记率年平均增长速度为26.32%,2004-2009年涂阳登记率年平均递降率为5.90%.结论 随着现代结核病控制策略在我市广泛推广和应用,完善了疫情报告和监测系统,降低了结核病疫情,使传染性肺结核病的发现率和治愈率明显提高,加快了我市结核病控制工作的进程.     

银川市2004-2013年老年活动性肺结核监测患病情况分析

目的分析银川市老年活动性肺结核患病情况及其流行病学特点,探讨老年活动性肺结核病防治对策。方法对银川市辖区2004-2013年10年结核病疫情动态相关资料行描述性流行病学分析。结果2004-2013年银川市发现活动性肺结核病例10929例,其中老年活动性肺结核患者4837例,占44.26%;老年涂阳病例1880例,占所有涂阳肺结核病例的42.62%;全人群活动性肺结核患病率由2004年的70.9/10万下降到2013年的30/10万;但老年肺结核患者占全人群发病比例在逐年增大,由2004年的44.11%增长到2013年的49.53%,老年肺结核病例男性高于女性,男女之比为1.43∶1。结论银川市肺结核10年来控制效果显著,但老年肺结核所占比例较大,应加大对老年肺结核的防控工作力度。     

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.