慢性乙型肝炎患者生存质量测量与影响因素分析

目的 测量并评价慢性乙型肝炎患者生存质量（QOL）,分析其主要影响因素。方法 采用生存质量SF－36表,对200例慢性乙型肝炎患者及200例正常对照进行生存质量（QOL）测量,并对QOL的影响因素进行单因素分析和多因素逐步回归分析,寻找其中主要影响因素。结果 慢性乙型肝炎患者组的SF－36总评分及生理机能、角色生理状况、心理健康状况、社会机能、机体活力、躯体不适和主观健康状部的平均评分与对照组相比显著降低（P＜0．01）;影响慢性乙肝患者QOL的主要因素是病程、并发症、谷丙转氨酶（ALT）、乏力、黄疸等。结论 慢性乙型肝炎患者的生存质量全面下降,有效的治疗以缩短病程、减少并发症及心理治疗和护理将有利于改善患者的生存质量。     

SF-36量表在慢性乙型肝炎患者生存质量中的应用研究

目的测量并评价慢性乙型肝炎患者的生存质量（QOL）。方法采用SF-36量表,对66例慢性乙型肝炎患者和60例正常对照进行QOL测量与评价,并对QOL的影响因素进行单因素分析和多因素逐步回归分析。结果慢性乙型肝炎患者的平均SF-36总评分及生理机能、角色生理状况、心理健康状况、角色心理状况、社会机能、活力、躯体疼痛和主观健康状况的平均评分分别为56±17、65±24、21±30、62±18、28±34、55±28、57±2、68±25和52±16,与对照组相比,差异有统计学意义（P均〈0.001）。慢性乙型肝炎患者的平均生存质量指数评分（7.2±2.2）与对照组相比,差异有统计学意义（P〈0.01）。慢性乙型肝炎患者SF-36总评分及其8个分项目相互之间相关系数均具有统计学意义（P〈0.01）。SF-36总评分与生存质量指数评分呈极显著性正相关（r=0.7841,P均〈0.01） 影响慢性乙型肝炎患者QOL的主要因素是临床分型、乏力、腹水、黄疸、脾肿大、血清ALT与总胆红素升高、血浆白蛋白或（A/G）降低以及HbeAg、HBV-DNA持续阳性等。结论SF-36适用于我国慢性乙型肝炎患者QOL的测量。     

乙型肝炎、肝硬化患者生存质量评价及相关因素研究

目的测量并评价慢性乙型肝炎、肝硬化患者的生存质量（QOL）,以了解乙型肝炎、肝硬化患者生存质量状况,并探讨可能影响其生存质量的主要因素,为提高肝炎、肝硬化患者生存质量进行有效干预提供理论依据。方法采用SF-36量表,对50例慢性乙型肝炎、肝硬化患者和100例正常对照进行生存质量的测量与评价,并对生存质量的影响因素进行单因素分析和多因素逐步回归分析。结果与正常对照组相比,慢性乙型肝炎、肝硬化患者组的SF-36总评分及其八个纬度（躯体健康、躯体角色功能、躯体疼痛、总体健康、精力、社会功能、情绪角色功能、心理健康）的评分均降低,差异有统计学意义（P〈0．05）;影响慢性乙型肝炎肝硬化患者QOL的因素主要有经济收入、乏力、病程。结论乙型肝炎肝硬化患者的生存质量全面下降,影响慢性乙型肝炎肝硬化患者QOL的诸多因素中经济收入、乏力和病程是主要因素。     

老年慢性乙肝患者生存质量的影响因素调查

目的探讨老年慢性乙肝患者生存质量的影响因素。方法采用国内外通用的生存质量量表对慢性乙肝患者生存质量(QOL)进行测量，筛选影响老年患者QOL的主要因素。结果婚姻不满意、肝炎反复发作、有并发症、经济状况差和总胆红素升高是影响其QOL得分的主要因素。结论在慢性乙肝患者病程中，采取相应干预手段，对有效提高老年慢性乙肝患者的生存质量具有一定的现实意义。     

肺结核患者生存质量影响因素的研究

目的：为探讨结核患者生存质量（QOL）及其影响因素。方法：采用SF－36、QL－index,KPS等量表,对228例患者和正常对照进行QOL多终点平行测量,通过t检验、方差分析和多元逐频回归分析探讨影响因素。结果：肺结核患者各终点QOL绵显著低于对照组（P＜0．01）;其影响因素是病灶大小、白细胞数、并发症、转氨酶和病程,结论：加强全程导化疗、合理营养、功能康复、心理关怀、社会支持,以提高肺结核患者的QOL。     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与氯氮平对精神分裂症患者生活质量的影响。方法:采用生活质量问卷(QOL),阳性与阴性症状量表(PANSS),副反应量表(TESS),健康状况问卷(SP-36)进行疗效、不良反应和生活质量评估,并对影响生活质量的某些因素进行多元逐步回归分析。结果:两组PANSS评分治疗前后均有极显著差异,而两组同期相比差异无显著性,治疗结束后,阿立哌唑组在生理机能,生理职能,生活活力,社会功能4个因子分及生存质量总评分均明显高于氯氮平组。多因素逐步回归分析显示影响患者生存质量的主要因素依次为精神症状,药物,不良反应,病程。结论:阿立哌唑与氯氮平对精神分裂症疗效相当,生活质量影响优于氯氮平。     

肝炎后肝硬化患者生存质量调查与影响因素分析

目的 测量并评价肝炎后肝硬化患者生存质量(QOL)以及影响因素.方法 采用SF-36量表,对220例肝炎后肝硬化患者和220例正常对照者进行QOL测量与评价,并对其影响因素进行单因素分析和多因素逐步回归分析.结果 肝炎后肝硬化患者SF-36总评分与对照组相比差异有统计学意义.影响肝炎后肝硬化患者QOL的主要因素是性别、Child-Pugh分级、血小板计数(P=0.004、0.013、0.011).结论 肝炎后肝硬化患者生存质量全面下降,Child-Pugh分级、性别与血小板计数为肝硬化患者生存质量的主要影响因素.     

利培酮与氯丙嗪对精神分裂症患者生存质量的影响

目的比较利培酮与氯丙嗪对精神分裂症患者生存质量的影响。方法采用阳性与阴性症状量表 (PANSS) ,副反应量表 (TESS)、健康状况问卷 (SF 3 6)进行疗效 ,副反应和生存质量评估 ,并对影响生存质量的某些因素进行多元逐步回归分析。结果两组PANSS评分治疗前 ( 71.6± 17.49,66.0 2± 14 .12 ) ,治疗后 ( 4 1.2 6± 9.3 7,3 8.93± 7.67)均有显著性差异 (P <0 .0 1) ,而两组同期相互比较 ,则无显著性差异。治疗结束后 ,利培酮组在生理机能、生理职能、生活活力、社会功能、情感职能 5个因子分及生存质量总评分均明显高于氯丙嗪组 (P <0 .0 5 ) ,且治疗前后评分有显著差异。多因素逐步回归分析显示影响患者生存质量的主要因素依次为精神症状、药物、副反应、病程。结论利培酮与氯丙嗪对精神分裂症疗效相当 ,生存质量优于氯丙嗪。     

慢性盆腔疼痛疾病患者生存质量及影响因素分析

目的评估慢性盆腔疼痛(CPP)患者的生存质量及其影响因素。方法收集117例慢性盆腔疼痛患者的年龄、婚姻状况、病程、视觉模拟评分(VAS评分)等,采用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)对患者生存质量进行评估,并以多元逐步回归分析筛选慢性盆腔疼痛患者生存质量的影响因素。结果患者的生存质量生理领域评分与全国常模相比偏低,差异有统计学意义,视觉模拟评分与生存质量的生理领域及心理领域评分存在负相关关系,年龄、病程与生存质量无相关关系。结论慢性盆腔疼痛患者生存质量的生理领域评分较全国常模明显下降,未显示年龄、病程和视觉模拟评分与生存质量的相关性。     

影响风湿病患者生活质量因素的多元Logistic回归分析及护理对策研究

目的 探讨影响风湿病患者生活质量因素的多元Logistic回归分析及护理对策.方法 选择该院89例风湿病患者及56例健康体检者,采用SF-36生活量表对其生活质量进行评分,并采用Pearson单因素与多元Logistic回归分析的方法对影响患者生活质量的因素进行分析,然而提出具体的护理对策.结果 ①观察组SF-36生活量表各维度[生理机能(PF)、生理职能(RP)、躯体疼痛(BP)、活力(VT)、社会功能(SF)、情感职能(RE)、精神健康(MH)]评分均显著低于健康对照组(P＜0.05,P＜0.01);②经Pearson单因素及多元Logistic回归分析,最终筛选出影响风湿病患者生活质量的相关因素:病程、并发症、ESR及hs-CRP.结论 影响风湿病患者生活质量因素较多,应在治疗的同时提供一定的护理措施,以改善患者病情及预后.     

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.