深圳市1983～1999年性病艾滋病流行趋势分析

目的　了解深圳市1983～1999年性病、艾滋病流行动态特征，为政府制订预防控制措施提供科学依据。方法　对深圳市1983～1999年性病年报资料及人口数据进行统计分析。结果　①1985年以前，深圳市性病年发病率保持在10.53/10万以下，1986年后以平均2.53倍的速度急骤上升，至1989年达到339.44/10万的最高水平，1990年回落至158.46/10万后，一直维持在158.46/10万～327.76/10万的高发病率水平；②深圳市各年度性病报告发病率均高于全国平均发病水平，并与全国性病发病率保持同步发展的态势；③各年度性病的性别发病率均为男性高于女性，年龄别发病率以20～40岁性活跃年龄段最高，婚姻状况分布以已婚为主，文化程度以中学文化程度居多，职业构成以工人、干部、无业、饮服、个体列前五位；④淋病为优势病种，梅毒发病率及构成增长最快，艾滋病毒感染者近年呈快速上升趋势；⑤患者来源外地人群平均占57.93%，传播方式以非婚性接触占大多数。结论　深圳市性病艾滋病流行仍呈上升趋势，预防和控制工作力度仍应加强。     

林口县1971年—1993年流行性出血热流行情况调查分析

林口县出血热发病历史较早、七十年代全县累计发病51例，曾于1971年和1978年分别发生两次流行。1971年发病12例，发病率3．92／10万；1978年发病16例，发病率4．13／10万。198Q年后疫区逐步扩大，出现新疫区，老疫区亦有发病。有的乡镇出现了局灶性爆发，并向城镇蔓延。八十年代全县发病158例，分布于全县所有16个乡镇中的153个村屯。发病率较高的年份是：1981年5．53／10万；1982年557／10万；1987年6．49／10万，1988年5．53／10万。（图1）一人群分布1．性别：1971－1993年全县发病265例，其中男性205例，女性60例。男女之比为3．4。1，…     

海南省澄迈县1994～2001年梅毒流行特征分析

目的：对1994－2001年澄迈县梅毒流行趋势及其特征进行流行病学分析。为控制澄迈县梅毒流行提供科学依据。方法： 采用澄迈县皮肤性病防治所梅毒疫情上报资料分为4年段（1994－1997年和1998－2001年）进行统计分析。结果：澄迈县梅毒发病率呈逐年上升趋势。前4年共检出梅毒242例，平均年发病率为13．2／10万，后4年共确诊梅毒患406例。平均年发病率为21．9／10万。后4年比前4年增长幅度为67．8％。结论：澄迈县梅毒流行已进入快速增长期，为控制澄迈县梅毒流行态势，应及时制订性病防治规划，加大开展性病防治、健康教育等宣传工作的力度，是当前性病防治工作中的重点。     

肇庆市1955—1999年麻风流行病学分析

目的：全面了解肇庆市麻风病流行状况及评价防治效果。方法：对1995－1999年来肇庆市6，867例麻风病患者进行流行病学分析。结果：年均发病率，年均发现率，患病均率由50年代的34．48／10万，26．64／10万，0．95‰分别下降对90年代的0．17／10万，0．15／10万，0．018‰，呈大幅度下降；发病儿童由50年代1．49／10万降至90年代0．01／10万；型比（MB／PB）及畸残率呈“U”字型演变；平均确诊延迟期最高是70年代的5．28年，最低是90年代的2．35年；患病男女比例平均2．54：1；高要市是肇庆市唯一末达标地区，其麻风病流行情况是端州区相比，有明显差异（P＜0．05）。结论：肇庆市麻风病流行呈明显下降趋势，全市六县（市）二区中只有高要市是唯一未达标的县（市）。     

大庆市1999～2007年性传播疾病流行病学分析

目的：探讨大庆市性传播疾病（STD）的流行特征，为今后制定防治策略提供依据。方法：收集大庆市1999～2007年的性传播疾病疫情资料，并进行统计分析。结果：1999～2007年大庆市共报告性传播疾病11855例。卫生部规定上报的8种性病中，除了性病性淋巴肉芽肿（LGV）外均有报告。发病率从1999年的66．10／10万下降到2007年的17．59／10万。其中淋病（GV）始终位居STD发病率之首。性病性淋巴肉芽肿没有报告，AIDS／HIV近3年来有报告。结论：1999～2007年STD总数呈下降趋势，STD从性活跃年龄组向非性活跃年龄组扩散，因此必须加强STD的防治工作，同时加强对普通人群的宣传教育和监测。     

桂林市秀峰区2005～2007年性病发病情况分析

目的：了解桂林市秀峰区2005～2007年性病发病情况。方法：收集我院2005～2007年性病传染报告卡共计1330例。结果：3年性病报病共1330例,发病率呈逐年上升趋势。艾滋病、淋病、梅毒的平均发病率分别为37．45／10万、43．75／10万、283．16／10万,年平均发病率为121．45／10万。性病以梅毒为主,发病以农民和家务及待业人员为主,女性性病病例呈现逐年增多趋势。结论：性病防治形势仍十分严峻,应推广安全套使用和持续进行健康教育、咨询及行为干预策略和医疗干预策略结合起来,控制性病的传播、流行。     

兴宁市1998～2003年狂犬病流行病学分析

目的：为探讨兴宁市狂犬病发病趋势与流行规律，以制定更加有效的防制对策。方法：用流行病学分析方法对兴市1998～2003年狂犬病发病疫情资料和个案凋查进行分析。结果：6年来共发病30例，发病率波动在0．09／10万～0．79／10万之间。1998年发病率0．54／10万，1999年发病率为0．79／10万，上升了46．3％；2000年发病率为0．54／10万，下降了31．6％；2001年发病率为0，2002年发病率为0．62／10万，2003年发病率为0．09／10万，下降了85．5％。1998、1999、2000、2002年发病率均超出省颁指标。结论：狂犬病的发生、流行与犬等动物传染源有关，通过免疫犬只，彻底净化疫区和被犬伤后及时处理伤口，使用狂犬疫苗、血清等综合措施，疫情是可以得到有效控制的。     

深圳市2004年性传播疾病流行病学分析

目的 了解深圳市2004年性传播疾病流行特征，为政府制订预防控制措施提供科学依据。方法 对深圳市2004年性传播疾病年报资料及人口数据进行统计分析。结果 深圳市2004年性传播疾病报告病例数为18371例。较2003年增长了33．34％，年报告总发病率329．61／10万。非淋菌性尿道炎（NGU）发病率最高，且位居性病构成比第一位；尖锐湿疣列第二位，淋病排第三位，仍是性病优势病种，但构成比继续下降。结论 HIV／AIDS、NGU的增长呈明显上升趋势，先天梅毒依然是儿童性病中的优势病种，应加强对孕产妇的产前性病查检工作。     

海口市2006年性病艾滋病流行病学分析

目的了解和掌握海口市性病艾滋病流行规律和变化趋势，为制定海口市性病艾滋病防治策略提供依据。方法收集全市各医疗机构皮肤科开展性劳诊疗业务的医疗机构上报性病疫情报告卡，进行整理分析。结果全市共报告8种性病（卫生部《性病防治管理办法》规定监测报告）2311例，比2005年减少127例，减少幅为5．2％（127／2438），发病率为13．51／10万，与2005年比较有高度显著性差异。结论2006年性病疫情明显下降是海口市开展性病控制、性病及艾滋病广泛宣传及安全套的推广使用的重要结果。     

GM(1,1)模型在预测流脑流行趋势中的应用

目的 建立远安县流脑流行趋势模型，对流脑流行进行预测预报，掌握流行动态，为该病的综合防治提供科学依据；方法 应用灰色系统理论分别对远安县1982－1999、1984－1999、1986－1999年三组流脑疫情资料进行分析，分别建立GM（1，1）预测模型，并选择最优GM（1，1）模型进行流脑发病预测；结果 流脑流行趋势GM（1，1）模型以1986－1999年组为优，其模型为Y＝－4.8474e^-0.4696t 8.6506，精度检验结果显示：C＝0.04,P=1.00，平均误差率为4.06%，模型判为优，可用于流脑流行趋势预测；应用该模型预测我县2000－、2002－、2004－、2006－年流脑发病率将分别降至0.1085/10万、0.0679/10万、0.0424/10万、0.0265/10万；结论 我县长期采取以预防接种为主的综合防治措施取得了良好效果，在今后几年里流脑发病率将持续下降，但我们绝不能放松对流脑的预防控制工作，否则有可能在未来几年大幅度上升；建模资料的选择与GM（1，1）模型预测精度和效果密切相关。     

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.     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

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.