查体职工血压水平与心电图改变的相关性分析

目的观测不同年龄组查体职工的血压水平及其与心电图异常改变的关系。方法将6498名查体职工按年龄分为两组：23～44岁为青年组（3652名）;45岁以上为中老年组（2846名）。对比两组及组内的血压水平,以及血压水平与心电图异常改变之间的关系。结果中老年组的高血压患病率明显高于青年组（P〈0.01）,青年组男、女性高血压患病率具有显著性差异（P〈0.05）。中老年组异常心电图检出率明显高于青年组（P〈0.01）;组内男、女性的异常心电图总检出率比较差异不显著（P〉0.05）;高血压者临床心电图异常检出率显著高于非高血压者（P〈0.01）。结论血压水平随年龄增长而增高。随着血压升高,临床心电图异常检出率明显增高,定期心电图检查对心脑血管疾病的防治具有重要意义。     

江苏无锡地区机关人员血压分类及其与血尿酸水平的关系

目的：探讨机关人员的血压水平及其与血尿酸水平的关系。方法：通过对江苏无锡地区部分机关的5821名工作人员的系统体检，计算不同性别的血压分类及高血压患病率，分析不同血压水平的血尿酸水平及高尿酸血症发生率。结果：①男性正常高限血压占11．63％，高血压病占38．95％；女性正常高限血压占7．01％，高血压病占21．84％，男性正常高限及高血压病患病率显著高于女性（P〈O．01）。②高血压患病率随年龄增高而增高，除70—79岁组外，均为男性显著高于女性（P〈0．01）。③随着血压升高，血尿酸水平增高；随着高血压程度加重，高尿酸血症发生率显著增加（P〈0．01）。结论：随着血压升高，血尿酸水平增高，高尿酸血症发生率也随之增加。血压达到高血压病1期时，高尿酸血症发生率已开始增加。     

245例郊区农村老年人体检资料分析

目的：了解郊区农村老年人患病特点。方法：分析245例本地区60岁以上老年人的体检资料。按年龄和性别分组统计分析。结果：本地区老年人血压、血糖和总胆固醇总体异常率分别为50.8%、38.4%和31.8%;血压异常以单纯收缩期高血压（ISH）为主要临床体征,占异常总数的77.0%,且ISH患病率随增龄而升高,男女都表现收缩压随年龄的增加而升高、脉压差随年龄的增加而增大。     

4455名机关工作人员高血压患病流行特征及危险因素分析

【目的】研究机关工作人员高血压发生率、血脂水平、心电图变化，了解本地区此类人群高血压发生和流行规律。【方法】对某市政府、企、事业单位4455名（男、女分别为2314、2141人）机关工作人员进行体检，检测血压、血脂、心电图。按受检者年龄分为24—34、35—44、45—54、及55岁以上4组。【结果】（1）高血压检出率为7．11％，55岁以下年龄组男性较女性高血压发生率高，55岁以上组男、女性高血压发生率无明显差异。（2）未观察到35岁以上各组随年龄增加高血压发生呈增高趋势。（3）高血压患者中高血压病知晓率42．27％，降压治疗率为28．70％。（4）高血压与血脂异常间关系密切。（5）血压升高程度与心电图异常间关系密切。【结论】随血压增高血脂水平异常、心电图改变发生率增加，高血压患者中高血压知晓率、降压治疗率低，高血压防治工作应进一步加强。     

老年人高血压的特点及中药调治

老年人高血压主要表现为收缩压（SBP）升高。因此，单纯收缩期高血压（ISH）是老年人群中最为常见的高血压类型。老年人ISH其实质就是动脉硬化性高血压。老年人的动脉壁发生了病理改变，大动脉粥样硬化，使血管的弹性功能降低；小动脉管腔狭窄，使总外周阻力升高。此外，随着增龄，有效肾单位减少，肾小球滤过率降低，肾小管浓缩功能减退，肾排钠功能降低，引起水钠潴留，血压升高。由此可以看出，     

老年人异常心电图高危因素分析

目的探讨引起老年人异常心电图的高危因素。方法对864例老年人体检的异常心电图危险因素进行分析。结果异常心电图人群中吸烟、高血糖、高血压、高血脂、脂肪肝的发生率和正常心电图人群相比，差异有统计学意义（P〈0．05）；吸烟、高血糖、高血压、高血脂是导致异常心电图的危险因素。结论心电图异常改变与吸烟、高血糖、高血压、高血脂、脂肪肝密切相关，对上述危险因素进行强化干预很有必要。     

呼和浩特地区高血压患病率与血脂和血糖的相关性研究

目的 调查呼和浩特地区人群高血压的患病情况与血脂、血糖的关系,为健康管理提供理论依据.方法 内蒙古自治区人民医院体检中心进行健康体检的690例31～94岁的健康人群为研究对象,检测血压、血脂全项、空腹血糖,并行12导联心电图检查,分析血脂、血糖与高血压患病率之间的关系.结果 该地区人群高血压患病率为37.8％,显著高于其他地区人群高血压患病率（P＜0.05）.高血压患病率随甘油三酯、总胆固醇、低密度脂蛋白、空腹血糖的升高以及心率增快而升高,随高密度脂蛋白水平降低而升高,差异均有统计学意义（P＜0.05）.结论 呼和浩特地区人群高血压患病率较高,高血压患病率与TC、TG、血糖异常升高以及心率增快密切相关,应加强该地区人群的血糖、血脂、静息心率的系统化健康管理,以控制该病的发生率.     

无症状高尿酸血症与高血压关系的临床研究

目的 研究血尿酸水平对血压的影响.方法 将上海市第八人民医院2009年8月至2010年12月心内科门诊收治的113例高血压患者（为高血压组）和51例健康体检者（为正常组）进行血尿酸测定,比较不同尿酸水平检测者的血压情况.结果 与正常组相比,高血压组的血压、血尿酸、血糖和血脂水平显著升高,体质量指数以及高尿酸血症患病率也显著高于正常组（P＜0.05）;随着血尿酸水平的升高,血压也有逐渐升高的趋势（P＜0.05）.结论 高血压患者无症状高尿酸血症的患病率较高,尿酸具有促进血压升高的作用.     

氨氯地平联用苯那普利治疗老年高血压

目的：观察氨氯地平缓释片联用苯那普利治疗老年人高血压的临床疗效。方法;对老年人高血压患者５２例进行治疗,观察治疗前后血压,心率,心电图,血脂,血糖,肾功能变化。结果：经治四周后观察到血压稳定下降（Ｐ〈０．０５）,同时改善了肾功能和心电图血性改变。结论：钙通道拮抗剂氨氯地平缓释片和血管紧张素转换酶抑制剂苯那普利的联合利用,对老年人高血压有明显的治疗作用。     

深圳市学龄儿童高血压危险因素调查

目的了解深圳市儿童血压水平及高血压患病率情况,探讨儿童高血压的易患因素。方法采用整群随机抽样的方法,对深圳市6～14岁儿童进行血压测量及问卷调查,观察与小学生高血压可能相关的危险因素。结果在调查的1140名儿童中,高血压患病率为4．04％,男女儿童血压均随着年龄增长而呈升高的趋势;高血压儿童与正常儿童之间的身高、体重、腰围、臀围和体质指数（BMI）均具有显著差异（P〈0．05）;深圳户籍儿童高血压患病率显著高于非户籍儿童（P〈0．05）。肥胖、高盐高脂饮食是儿童高血压的危险因素。结论儿童血压随着年龄增长呈升高趋势,高血压患病率与生长发育、家庭经济水平、肥胖及饮食习惯有关,控制体重,改变不良饮食习惯可减少高血压的发生。     

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.     

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.     

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.