β-FIBRINOGEN PROMOTER-455 G／A （HaeⅢ） POLYMORPHISM PREDICTION OF PLASMA FIBRINOGEN BUT NOT OF ISCHEMIC CEREBROVASCULAR DISEASE

Objective The-455 G/A (HaeⅢ) polymorphism of β-fibrinogen gene influences levels of plasma fibrinogen. We further investigated whether it influences the risk of isehemie cerebrovaseular disease. Methods We accumulated 134 acute isehemic eerebrovaseular disease (ICVD) eases and compared their -455 G/A status with a control group (n=166). The β-fibrinogen gene -455 G/A polymorphism was analyzed for all subjects by PCR-RFLP with the restrictive enzyme HaeⅢ. Results Plasma fibrinogen was higher in AA homozygous participants (341mg/dL) than in participants carrying the G allele: GA (290mg/dL), GG (298mg/dL) in the control group. Plasma fibrinogen was also higher in AA homozygous patients (353mg/dL) than in eases carrying the G allele: GA (287mg/dL), GG (302mg/dL) in the ICVD group. However, there was no significant association between β-fibrinogen gene -455 G/A polymorphism and ICVD group. Conclusions Although a small effect cannot be excluded, β-fibrinogen gene -455 G/A polymorphism is an independent predictor of plasma fibrinogen, but not of isehemie cerebrovaacular disease.     

原发性高血压患者应用抗高血压药物不良事件原因分析

目的 探讨原发性高血压患者应用抗高血压药物不良事件及其原因。方法 将243例观察对象按照用药正确与否分3组，应用面对面横断面调查方法，分析比较组间不良事件发生率及其原因。结果 导致原发性高血压患者发生不良事件的主要原因是经常停药、他人介绍用药、媒介宣传用药、经济原因停药、配伍不合理、测量值不正确、用一种药物时间过长和药物个体适应性差等原因。结论 合理正确应用抗高血压药物对于保护高血压患者靶器官具有重要意义。     

583例小儿肺炎证候病机学关联规则分析

目的：通过数理分析探讨小儿肺炎的证候病机学。方法：运用关联规则分析583例小儿肺炎发病治疗前症状体征。结果：获得668项频繁项集，其中支持度大于80％者4项：肺部呼吸音粗糙、无恶寒、舌质红、咳嗽每咳数声，共获得关联规则6888条，最高支持度80％，最高置信度98％。结论：小儿肺炎48h内的主要症状体征为：咳嗽每咳数声、咳嗽阵作、气促、发热、多痰、舌质红、肺部呼吸音粗糙、无恶寒、无紫绀、无恶心呕吐等，并且咳嗽每咳数声与咳嗽阵作及发热、无恶寒、气促、多痰、舌质红等症状体征常常关联出现。在证候病机上表现：肺气郁阻是小儿肺炎最主要的病机病理。热邪入里，肺热壅盛，肺气郁阻，津蓄为痰为常见的病机病理改变，且热与郁与痰的病机密切关联。     

从脾肾论治化疗后潮热汗出症临床观察

目的:从脾肾论治肿瘤患者化疗后潮热汗出等症状.方法:选取浙江中医药大学附属第一医院肿瘤科门诊及病房化疗后出现潮热汗出症状者共103例,随机分为两组,对照组(48例)予西药调节免疫功能药物(乌苯美司)加改善自主神经功能药物(谷维素)治疗,治疗组(55例)在同对照组西药调节免疫功能基础上加用益气健脾补肾中药汤剂,对症状改善程度进行分析.结果:治疗组优于对照组,两组比较,差异有显著性(P<0.05).结果:从脾肾论治可以明显改善肿瘤病人化疗后潮热汗出症状,提高生活质量.     

肾盂输尿管癌细胞增殖与凋亡的相关性

目的探讨Ki-67和凋亡（Apoptosis）在肾盂输尿管癌中的表达及其与肿瘤细胞分级、病理分期及预后的关系。方法采用SABC法和TUNEL法对34例肾盂输尿管癌行Ki-67和凋亡检测。结果Ki-67和凋亡在肿瘤细胞分级间存在显著差异,Ki-67index：G2与G1比较P〈0.05,G3与G2比较P〈0.05,G3与G1比较P〈0.01;Apoptosis index：G2与G1比较P〈0.05,G3与G2比较P〈0.05,G3与G1比较P〈0.01。Ki-67和凋亡在肿瘤病理分期的T3与T1及T2与T1之间有显著差异,T2与T1比较P〈0.05,T3与T1比较P〈0.01,但T3与T2比较P〉0.05;Ki-67index以20%为界分为二组,Apoptosis index以3%为界分为二组,组间生存率有显著差异（P〈0.05）。Ki-67在肾盂输尿管癌中的表达与凋亡一致。结论肾盂输尿管癌细胞增殖与凋亡密切相关;凋亡可作为临床判断肾盂输尿管癌恶性程度、病理分期、细胞分级以及预后的一种客观量化指标。     

The Prevalence of Incidental Simple Ovarian Cysts ≥ 3 cm Detected by Transvaginal Sonography in Early Pregnancy

ObjectiveTo determine the prevalence of simple ovarian cysts of ≥ 3 cm diameter detected by transvaginal sonography (TVS) in a population of asymptomatic women in early pregnancy.MethodsWe conducted a retrospective review of 10 830 consecutive women presenting prior to 14 weeks’ gestational age (GA) for early dating TVS. The records of all women with simple cysts ≥ 3 cm in diameter were included. The study population was divided into five groups by GA: ≤ 6 weeks; 6.1–8 weeks; 8.1–10 weeks; 10.1–12 weeks; and 12.1–14 weeks.ResultsA simple cyst ≥ 3 cm in diameter was present in 4.9% of women at ≤ 6 weeks’ gestation, in 5.1% between 6.1 and 8 weeks, in 5.3% between 8.1 and 10 weeks, in 3.2% between 10.1. and 12 weeks, and in 1.5% between 12 and 14 weeks. Overall, a simple cyst ≥ 3 cm was present in 516 women (4.8%). Prior to 10 weeks, 5.1% had simple cysts ≥ 3 cm, dropping to 2.7% after 10 weeks, a statistically significant decrease (P < 0.0001). Between 10.1 weeks and 12 weeks, the prevalence dropped to 3.2%, and then to 1.5% in the 12.1–14 week group.ConclusionThis investigation provides reference data on the prevalence of detecting simple ovarian cysts ≥ 3 cm by TVS in an asymptomatic early pregnancy population. A progressive decline in the frequency of detecting simple ovarian cysts ≥ 3 cm begins after 10 weeks’ gestational age.     

Acupuncture Treatment for 34 Cases of Epiphora with Dysfunction of Lacrimal Duct

We have treated 34 cases of epiphora due to dysfunction of the lacrimal duct with a warm needle puncturing at the Jingming (UB 1) point. The effect was significantly better than that of the control group treated with lacrimal duct irrigation and norflaxacin eye drops (a total effective rate of 91.07% vs. 54.29%).     

奥地利维也纳医科大学医学考试形式介绍及启示

医学生需要具备不同层次的能力,所以需要不同的考试形式来衡量能力的高低。不同考试方法的选择对于反映所选课程的学习效果至关重要。本文主要介绍了维也纳医科大学的考试设计及其作用,以及对我国医学教育评估的启示。通过学习奥地利先进的教学评估理念和方法,可为我国医学教育评估方式改革、培养高素质医学人才提供借鉴。