无锡市南长区2005～2010年麻疹流行病学特征分析

目的:了解无锡市南长区2005～2010年麻疹流行病学特征。方法:对2005～2010年南长区麻疹发病情况进行描述流行病学分析。结果:2005～2010年南长区麻疹年平均发病率为6.13/10万,外来人口发病率高于本市人口,本区人口以20岁以上成人病例为主,外来人口麻疹病例集中在8月龄～6周岁年龄组儿童和20岁以上成人,发病均以无免疫史为主。结论:外来人口存在免疫空白是导致麻疹发病率上升的主要原因。加强外来人口管理,杜绝免疫空白,是消除麻疹亟需解决的问题。     

2005～2007年昆山市麻疹流行特征分析

目的 了解昆山市2005～2007年麻疹流行特征,探讨及发病原因,为制定消除麻疹策略提供参考.方法 采用描述流行病学分析方法,对2005～2007年昆山市麻疹监测资料进行分析.结果 2005～2007年昆山市累计报告了1030例麻疹病例,年均发病率23.91/10万,不同年份间发病卒的差异有统计学意义.(P<0.01)3～5月为发病高峰季节,占总报告病例61.84%.麻疹发病年龄有"双向移位"现象.结论 昆山市麻疹发病可能有周期性规律.易感人群积累是发病的主要原因.另外,病例逐渐向成人和未到免疲年龄段人群转移,因此达到消除麻疹目标,除要做好儿童常规免疫外,加强成人麻疹监测和免疫也具有重要意义.解决麻疹发病的"双向移位"将是今后工作的重点.     

麻疹疫苗高覆盖背景下麻疹控制策略探讨

目的探讨麻疹疫苗高覆盖背景下麻疹的控制策略。方法综合分析鹿邑县1995～2011年麻疹疫苗接种率、麻疹的发病情况等,同时联系我国其他地区的麻疹发生情况进行比较。结果 1995～2011年,鹿邑县麻疹疫苗接种率98.58%,儿童在麻疹疫苗接种后抗体阳性率95.43%,同期报告麻疹病例784例,平均每年发病率为3.17/10万,麻疹患者中免疫患者占72.35%。年龄小于8个月及大于15岁麻疹患者呈现上升趋势。结论麻疹疫苗高覆盖率不能达到消除麻疹的目标,故在日常工作中,不仅要扎实地开展儿童基础免疫和强化免疫工作,还要努力开发研究更有效的麻疹疫苗,同时建立新的成人免疫规划体系。     

普兰店市1952～2008年麻疹发病情况及免疫效果分析

目的对普兰店市1952～2008年麻疹发病的特点及免疫效果进行分析,为进一步控制和消除麻疹提供科学依据。方法将普兰店市1952年～2008年麻疹流行情况划分为三个阶段：无麻疹疫苗时期、有麻疹疫苗非计划免疫时期、计划免疫时期。采用描述性流行病学方法 ,对三个时期麻疹发病资料进行分析。结果无麻疹疫苗时期,平均发病率为566.73/10万,发病最高年份为1964年,高达2130.26/10万。开展免疫接种后发病率逐年下降,尤其是计划免疫巩固和消除时期（1984～2008年）效果显著,平均发病率为0.09/10万。麻疹发病的性别差异不显著,男女发病率比为1.09：1。发病季节高峰为3～5月。发病率与接种率两者呈高度负相关。结论开展计划免疫工作以来,麻疹的发病率大幅度下度,充分显示了免疫预防效果。目前,婴幼儿和成人发病所占比例显著增大,出现＂双相移位＂现象,预防婴幼儿（〈1岁）和成人发病,是消除麻疹工作的关键。     

2005年—2011年华县麻疹流行病学分析

目的掌握我县麻疹发病特点,更好地指导我县消除麻疹工作.方法资料源于国家传染病疫情信息网华县疫情信息报告网,对我县2005年-2011年的麻疹病例进行了认真核对分析.结果2005年-2011年共发病39例,无死亡病例,2006年发生1次麻疹爆发流行.报告发病率:2005年发病率1.92∕10万,2006年发病率为3.00∕10万,2007年发病率,2008年发病率0.54/10万2009年发病率0.54/10万,2010年发病率2.42∕10万、2011年发病率1.24/10万.结论我县麻疹发病率呈下降趋势,但流动儿童和麻疹疫苗下限月令儿童发病呈上升趋势.消除麻疹工作刻不容缓.     

海南省流动儿童查漏补种控制麻疹效果分析

目的了解海南省7岁以下流动儿童基本情况和免疫接种状况,探索提高流动儿童麻疹疫苗接种率策略,为加速海南省实现消除麻疹目标提供依据。方法每年3月利用外省流动人口进入海南务工、旅游、务工人员探亲返回高峰,在全省进行专项免疫状况摸底登记调查和疫苗查漏补种活动,3～5月麻疹发病流行高峰前快速补种麻疹等疫苗;通过发病率评估查漏补种效果。结果专项查漏补种后,流动儿童免疫接种率大幅提高,流动儿童麻疹发病率、构成比大幅下降;2009、2010年海南省麻疹发病率均为0.5/100万,降至历史和全国最低水平,提前2年实现消除目标。结论海南省流动儿童查漏补种策略控制麻疹效果显著,消除了流动儿童麻疹接种薄弱人群,为海南省提前实现消除麻疹目标提供了必要条件,可为全国消除麻疹行动提供策略依据。     

广州市白云区2009年麻疹疫苗强化免疫效果评价

目的评估麻疹疫苗强化免疫的实施对控制麻疹发病的效果,探讨控制和消除麻疹的对策。方法综合分析麻疹疫苗强化免疫现场调查资料、评估法定传染病报告系统中麻疹发病率的变化。结果 2009年白云区麻疹疫苗强化免疫共接种目标人群362454人,报告接种率和调查接种率均大于95%;强化免疫后麻疹发病率锐减;零剂次免疫儿童主要分布在流动儿童。结论白云区2009年在强化活动后麻疹发病率显著降低。但如流动儿童较多地区常规免疫服务质量不能有效加强,还需要考虑1～2年后在该地区重点人群中开展后续强化免疫活动,以达到2012年消除麻疹的目标。     

2013年-2015年龙岩市麻疹监测结果分析

目的：了解龙岩市麻疹监测工作情况,为我市麻疹防治策略的调整提供依据。方法对龙岩市2013年—2015年收集的疑似麻疹病例血清免疫球蛋白M（IgM）抗体检测结果结合流行病学调查资料进行分析。结果3年全市共收集疑似麻疹病例血标本360份,麻疹IgM抗体阳性12份,阳性率为3.33%。麻疹发病呈散发,以2岁以下儿童为主。发病有明显季节分布,发病高峰在3月～7月。成人麻疹发病占有相当的比例（33.33%）。结论我市近年来麻疹发病率得到有效控制,要关注<8月龄的儿童和成人麻疹发病情况,提高麻疹疫苗接种率为消除麻疹工作的重点。     

天津市蓟县2005-2010年麻疹流行病学特征分析

目的了解天津市蓟县2005-2010年麻疹流行病学特征,为预防控制麻疹提供科学依据。方法采用描述流行病学方法对天津市蓟县2005-2010年麻疹发病情况进行分析。结果 2005-2010年共报告麻疹729例,年平均发病率为14.80/10万,呈下降趋势。发病例数最多的是渔阳镇,占28.12%;3～5月份为麻疹高发季节,占76.95%;发病以散居儿童、农民和学生为主;男女性别比例为1.28∶1;发病年龄呈现典型的小年龄组模式和趋向大年龄组模式,≤1岁儿童麻疹病例构成增加,占33.06%,≧20岁成人发病也占较大比例,占35.94%。结论应进一步加强麻疹疫苗常规免疫,适时在重点地区和人群中开展麻疹疫苗强化免疫;加强对麻疹病例的监测工作,做好麻疹散发和暴发疫情的防控工作,降低麻疹发病率。     

增城市2004年麻疹疫苗应急接种效果评价

目的:通过对增城市2004年麻疹疫苗应急接种效果评价和麻疹发病特征分析,为进一步制订我市有效的麻疹防制措施,达到消除麻疹的目标。方法:周边地区麻疹疫情紧张和我市麻疹病例上升,对8月龄至11岁儿童开展麻疹疫苗应急接种。结果:2004年4-5月份开展全市8月龄至11岁儿童麻疹疫苗应急接种后,5月份发病48例,为发病高峰,6月份发病高峰逐步下降,至10月份发病为0例,年发病率控制在12.59/10万。结论:疫点开展麻疹疫苗应急接种,消除人群免疫空白,提高人群整体免疫水平,可在短期内迅速有效控制麻疹疫情。     

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.