2型糖尿病患者抑郁症发病风险预测及验证

目的：探讨2型糖尿病合并抑郁症的发病比例及相关的危险因素。方法：选择530例2型糖尿病并抑郁症患者填写问卷调查表,对调查表进行分析。结果：530例参与调查的患者中,合并抑郁症者183例（34．5％）,未合并抑郁症者347（65．5％）。单因素分析发现体重指数、糖化血红蛋白、胰岛素敏感指数、病程、并发症数量、家庭人均月收入、职业、情绪类型、社会关系在糖尿病伴抑郁症组和单纯糖尿病组之间差异有统计学意义（P〈0．05）。结论：2型糖尿病患者抑郁症的患病率较高,病程的长短、血糖的控制情况及并发症的多少是抑郁症发病的主要风险。     

高血压患者脑卒中后并发抑郁症的影响因素分析

目的:探讨高血压患者脑卒中后并发抑郁症的影响因素。方法:采用方便抽样法选取本院高血压合并脑卒中患者113例,问卷调查临床资料,采用单因素与多因素Logistic回归分析高血压患者脑卒中后并发抑郁症的影响因素。结果:高血压患者脑卒中后并发抑郁症(抑郁症组)43例,所占比例为38.05%,其中轻度抑郁症29例(25.66%),中度抑郁症10例(8.85%),重度抑郁症4例(3.54%)。单因素分析显示:女性、合并高血脂、冠心病、糖尿病、高血压病程15年、自费医疗、无配偶、人均月收入≤2000元、高中或以上文化程度的患者抑郁症发生率明显增高,比较差异均有统计学意义(P0.05)。经多因素Logistic回归分析显示,自费医疗、无配偶、人均月收入≤2000元是高血压患者脑卒中后并发抑郁症的独立危险因素(OR=10.698、4.215、7.245,P0.05)。结论:高血压患者脑卒中后并发抑郁症是性别、合并症、病程、医疗费用支付方式、婚姻状况、经济收入、文化程度等多种因素共同作用的结果。     

糖尿病及其合并视网膜病变者特质应对方式分析

目的了解糖尿病及其合并视网膜病变患者的特质应对方式及其影响因素。方法采用特质应对方式问卷(TCSQ)和自编的基本情况问卷对51例正常对照者和331例糖尿病及其合并视网膜病变者进行调查。了解患者特质应对得分情况,通过广义线性回归分析其影响因素。结果糖尿病及其合并视网膜病变者消极应对得分均高于正常对照者(P<0.05)。广义线性回归分析显示,年龄越大、文化程度和家庭人均月收入越高、病情越轻的患者易采取积极应对(P均<0.05);年龄越小、文化程度和家庭人均月收入越低、病情越重的患者则倾向于采取消极应对(P均<0.05)。结论年龄、文化程度、家庭人均月收入、病情是影响患者特质应对的主要因素。应根据患者的不同特点,有针对性地指导其积极应对疾病,从而提高生存质量。     

耳鼻喉疾病手术患者伴发精神抑郁的观察

目的：观察拟手术治疗的耳鼻喉疾病患者伴发抑郁症的情况，分析可能的影响因素。方法：运用ZUNG抑郁自评量表调查156例患耳鼻喉疾病拟手术患者伴发抑郁症的情况，依据患者的年龄、性别、文化程度、罹患疾病的性质，拟手术的规模大小等因素进行分组研究，应用SPSS10．0统计软件进行统计学处理。结果：40．4％的耳鼻喉疾病患者合并有不同程度的抑郁症。伴发中、重度抑郁症者占14．74％；女性患者，大学或大学以上文化程度的患者，小学文化程度和文盲患者，罹惠肿瘤性疾病的患者伴发抑郁症的比例较高；手术规模、患者是否明确进一步治疗的方案则不影响是否合并抑郁症。结论：耳鼻喉疾病拟手术患者伴发抑郁症的比例较高，性别、文化程度、疾病性质是主要的影响因素。     

2型糖尿病共病抑郁症的危险因素分析

目的 探讨2 型糖尿病共病抑郁症的临床特点及相关的危险因素.方法 选取120例2型糖尿病患者,均进行抑郁自评量表(SDS)评定,根据结果分为糖尿病伴抑郁症组和单纯糖尿病组,对两组患者的社会人口学资料和病情资料进行比较,采用Logistic回归分析探讨糖尿病并发抑郁症的危险因素.结果 120例糖尿病患者中,合并抑郁症者52例(43.3%),未合并抑郁症者68例.单因素分析发现婚姻状况、糖尿病病程、合并躯体疾病、空腹血糖和糖化血红蛋白(HbA1c)在糖尿病伴抑郁症组和单纯糖尿病组之间差异有统计学意义(P＜0.05).Logistic回归分析显示,婚姻状况、合并躯体疾病和HbA1c是糖尿病并发抑郁症的主要危险因素(P＜0.05).结论 糖尿病患者的抑郁症患病率较高;对家庭情感支持不足、躯体合并症多、高HbA1c水平的糖尿病患者应常规进行抑郁症筛查.     

朝阳地区2型糖尿病患者抑郁症患病现状调查及相关危险因素分析

目的 分析朝阳地区糖尿病病人抑郁症的发病情况,以及年龄、性别、文化程度、经济状况、病程等对抑郁症的影响,有针对性的对患有抑郁症的糖尿病患者进行干预治疗,以有效控制其病情. 方法 采用问卷调查和抑郁自评量表（SDS）对研究对象进行评定 将合并抑郁症患者随机分为干预治疗组和对照组 对照组按常规治疗,干预组在常规治疗基础上,给予健康教育、心理及抗抑郁药物治疗.结果 334例糖尿病患者中合并抑郁症138例,患病率为41.3%.通过多因素回归分析发现学历、收入、体力劳动强度、脑力强度、业余活动、糖尿病病程、糖尿病并发症等是糖尿病合并抑郁症的7个重要危险因素.干预组经干预治疗后FBG、2hPBG、HbA1c及抑郁评分明显降低,与对照组比较差异有统计学意义（P〈0.05）.结论 2型糖尿病患者抑郁症发生率较高,该研究提供了高危个体界定标准,对此类人群应在医生指导下有针对性地进行干预治疗,以减少发生抑郁症的可能性.     

引起肿瘤患者忧郁症相关影响因素及护理预防对策

目的：探讨引起肿瘤患者忧郁症的相关因素及护理预防措施。方法：选择2011年1月－2013年12月我院诊治的50例肿瘤忧郁症患者作为观察组，按照1∶1比例选择50例同期无忧郁症肿瘤患者作为对照组，比较两组的年龄大小、性别构成、家族病史、家庭支持程度、文化水平、经济收入、肿瘤疾病知识等方面上的差异。结果：观察组年龄（66．56±12．56）岁、缺少家庭支持36．00％、缺少肿瘤疾病知识34．00％，高于对照组的（61．13±13．34）岁、12.00％、12．00％，两组比较 P＜0．05；观察组经济收入（1686．33±234．90）元／月低于对照组的（2176．90±321．76）元／月，两组比较 P＜0．05，以上因素是肿瘤患者产生抑郁症的主要影响因素。两组患者性别构成、家族病史、文化程度比较无显著性差异（P＞0．05）。结论：抑郁症是肿瘤患者常见并发症，是一个多因素的结果，通过了解相关因素，可为明确抑郁症提供线索，并指导早期护理预测，促进患者身心全面健康。     

2型糖尿病合并精神疾病的风险因素调查

目的调查分析2型糖尿病合并精神疾病的风险因素。方法采用入户问卷法对360名2型糖尿病患者的抑郁症、一般资料、糖尿病等情况进行调查,之后进行统计学分析。结果患者抑郁症发病率为30.6%。性别、是否使用胰岛素、糖尿病病程、家庭人均月收入、职业、性格、情绪类型、糖尿病并发症数量等在单因素分析调整后仍有统计学意义（P〈0.05）。多因素分析提示抑郁症风险因素包括糖尿病病程长、并发症多和情绪不佳（P〈0.05）。结论 2型糖尿病对患者抑郁症的发病有一定的影响,糖尿病病程长、并发症多和情绪不佳是影响2型糖尿病合并精神疾病的主要风险因素。     

新诊断2型糖尿病抑郁症的患病率及独立危险因素分析

目的调查新诊断2型糖尿病患者抑郁症的患病率,探讨与抑郁相关的危险因素。方法对南海区人民医院内分泌代谢科2010年2月～2012年2月新诊断的545例2型糖尿病患者,应用Beck抑郁问卷（BDI）进行抑郁评分并分组,收集年龄、性别、月收入、吸咽史、糖化血红蛋白（HbA圯）、C肽水平、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、尿微量白蛋白／肌酐及糖尿病周围神经病变（DPN）发生率资料,计算抑郁症的患病率,采用Logistic回归筛选与抑郁相关的危险因素。结果新诊断2型糖尿病抑郁症的患病率为37．8％。女性,低年龄,高HbAm低C肽水平,血脂代谢紊乱,诊断时合并糖尿病肾病及糖尿病周围神经病变的患者发生抑郁症风险较高。其中女性,年龄,HbA_1C、C肽水平、尿微量白蛋白／肌酐、DPN为抑郁症的独立危险因素。结论新诊断2型糖尿病患者抑郁症患病率较高,诊疗时应及早筛查,及时干预。存在抑郁危险因素的患者,建议定期随访。     

肿瘤放疗患者及家属心理状况及其影响因素分析

目的 探讨肿瘤放疗患者及家属心理状况及其影响因素分析.方法 选取2018年12月—2020年1月医院肿瘤放射治疗科治疗癌症患者100例(A组)及其主要照顾者100例(B组),采用心理痛苦温度计(DT)对A、B组进行问卷调查,并采用logistic回归模型分析放疗患者及家属心理状况的影响因素.结果 患者DT平均分为(3.18±0.97),其中显著痛苦检出率为42％(42/100).家属心理痛苦平均分为(2.57±0.81),显著痛苦检出率为32％(32/100);费用支付方式、文化程度、家庭人均月收入、TNM分期、陪护人员和合并其他疾病为患者心理的独立危险因素(P<0.05);费用支付方式、患者文化程度、家庭人均月收入、患者TNM分期为家属心理状况的独立危险因素(P<0.05).结论 肿瘤放射治疗患者及家属心理状况较差,而回归分析结果可能为临床针对性干预提供新思路.     

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.