矽肺与人体体成分关系临床研究

目的:探讨矽肺对男性患者人体体成分的影响。方法:根据GBZ 70-2015《职业性尘肺病的诊断》标准选择111例男性矽肺患者作为研究对象(其中矽肺Ⅰ期组44例、矽肺Ⅱ期组35例、矽肺Ⅲ期组32例),平均年龄(65.80±6.34)岁。114例男性健康志愿者作为对照组,平均年龄(63.09±5.93)岁。用生物电阻抗测定人体组成并进行对比。结果:男性矽肺患者的体重、身体质量指数、去脂体重、全身肌肉量、躯干肌肉量、左下肢肌肉量、右下肢肌肉量、左上肢肌肉量、右上肢肌肉量较对照组均显著减少,两组比较差异有统计学意义(P<0.01);男性矽肺患者的全身脂肪量、内脏脂肪量、躯干脂肪量与对照组对比有所减少,两组比较差异有统计学意义(P<0.05,P<0.01);男性矽肺组身体水分、蛋白质、细胞内液、细胞外液较对照组减少,两组比较差异有统计学意义(P<0.05)。结论:男性矽肺患者存在不同程度的体重减轻,肌肉含量及脂肪含量均有所减少,男性矽肺患者的全身水分、蛋白质、细胞内液及细胞外液也有减少。     

慢性阻塞性肺疾病严重程度与骨骼肌营养不良的相关性研究

背景　慢性阻塞性肺疾病（COPD）是全球主要致死性慢性病之一,不断加重全球经济负担。骨骼肌营养不良作为COPD常见并发症之一,严重影响了患者的生活质量及预后,但目前关于其发生机制、预防和治疗的研究尚不完善。目的　探讨COPD严重程度与骨骼肌营养不良的相关性。方法　以2017年9月-2019年6月就诊于锦州医科大学附属第一医院的COPD患者205例作为病例组,另选取同一时期于该院行体检的性别、年龄与病例组相匹配的健康成年人125例为对照组,检测两组各项身体成分指标、舒张气管后肺功能。采用单因素分析比较两组同性别受试者的各项身体成分指标,采用Pearson相关分析和Spearman秩相关探讨COPD患者第1秒用力呼气末容积占预计值百分比（FEV1%）、深吸气量与肺总量比值（IC/TLC）与各项身体成分指标的相关性。结果　男性COPD患者BMI、去脂体质量（FFM）、全身肌肉量、躯干肌肉量、双上肢肌肉量、双下肢肌肉量、四肢肌肉量、握力、骨骼肌指数、去脂体质数低于对照组男性（P<0.05）,女性COPD患者BMI、FFM、全身肌肉量、躯干肌肉量、双上肢肌肉量、双下肢肌肉量、四肢肌肉量、握力、骨骼肌指数、去脂体质数低于对照组女性（P<0.05）。相关分析结果显示,男性COPD患者IC/TLC与FFM、全身肌肉量、躯干肌肉量、双上肢肌肉量、双下肢肌肉量、四肢肌肉量、握力、骨骼肌指数、去脂体质数呈正相关（P<0.05）,女性COPD患者IC/TLC与BMI、FFM、全身脂肪量、全身肌肉量、躯干肌肉量、双上肢肌肉量、双下肢肌肉量、四肢肌肉量、握力、骨骼肌指数、去脂体质数、脂肪体质数呈正相关（P<0.05）。除男性COPD患者FEV1%与握力呈线性正相关外（P<0.05）,FEV1%与男性、女性COPD患者其他身体成分指标无相关关系（P>0.05）。结论　COPD患者BMI、FFM、肌肉量及握力低于健康者;COPD患者身体成分指标与FEV1%不相关,与反应疾病严重程度的另一项指标IC/TLC存在明显相关性。     

民族医学院校护理学专业女大学生的亚健康调查

目的了解护理学专业女大学生的健康情况以及影响亚健康的主要因素,为学校对护理学专业女大学生的健康干预提供参考依据。方法利用人体能量测量仪Auramed Biopulsar收集395名护理专业大学生左手掌反馈各部位器官的生物电能量流动趋势,观察护理学专业学生45个部位的生物电指标变化。结果护理学专业毕业生的亚健康检出率为46.07%,明显高于非毕业生亚健康状态的检出率(33.82%);亚健康检出率呈波浪形,在23岁年龄组达高峰,随后逐渐下降;Logistic回归分析结果显示:签约单位级别、工作压力、与同学的关系、遇事处理方式和家庭居住地是影响护理学专业毕业生亚健康的主要因素,而非毕业生亚健康的主要因素是专业喜欢程度、失眠、与同学的关系和月话费。结论护理学专业毕业女大学生的亚健康检出率明显高于非毕业生,学校有关部门应加强对护理学专业毕业生的身心健康的干预,以提高护理学专业毕业生的健康水平。     

我院城乡大学生身体健康指标对比分析

目的：了解我院城乡大学新生的体质健康状况,并对如何提高大学生体质健康水平提出对策。方法：根据我院2005-2007级新生的户籍所在地分为城市和乡镇大学生,测定他们的体质健康指标并进行统计学处理。结果：城市男、女大学生的身高、体重均优于乡镇大学生;城市大学女生的心肺功能、呼吸机能、最大摄氧水平均优于乡镇大学女生;前臂力量、手部肌肉、总体肌肉力量和相对力量的握力,乡镇男、女大学生均优于城市男、女大学生,上肢力量、下肢爆发力和身体协调能力乡镇大学男生均优于城市大学男生。结论：我院大学生身体形态和身体机能方面以城市大学生为佳,而身体素质方面以乡镇大学生总体为优。     

百色市壮族中老年人脂肪分布特点

目的测量百色市壮族中老年人身体各部分脂肪含量,探讨百色市壮族中老年人的脂肪分布特点与规律,为少数民族人群改善健康提供科学依据。方法随机抽取三代均为壮族的百色市壮族健康中老年人作为研究对象,共选取625名(男性248名,女性377名)。应用体成分分析仪,对所有受试者进行检测,计算去脂体重、脂肪总量、体脂率、内脏脂肪等级;计算左上肢、左下肢、右上肢、右下肢、躯干脂肪量和左上肢、左下肢、右上肢、右下肢和躯干脂肪率。结果去脂体重、脂肪总量、体脂肪率同年龄段男性与女性比较,差异均有统计学意义(P<0.05或P<0.01);内脏脂肪等级同年龄段男性与女性比较,50岁^和60岁和60岁^组差异有统计学意义(P<0.05),其余均无统计学意义(P>0.05);壮族中老年人身体各部体脂量及体脂率同年龄组男、女性比较,除50岁组差异有统计学意义(P<0.05),其余均无统计学意义(P>0.05);壮族中老年人身体各部体脂量及体脂率同年龄组男、女性比较,除50岁^、70岁、70岁^、75岁、75岁^组躯干体脂量外,差异均有统计学意义(P<0.05或P<0.01)。结论百色市壮族中老年人的脂肪分布和年龄变化存在性别差异。建议内脏脂肪等级超标的人群合理膳食,加强体育锻炼以预防疾病的发生。     

广西桂林地区回族儿童身体成分的测量分析

目的了解广西桂林回族儿童身体成分的状况,分析其年龄和性别变化特点。方法随机抽取118名7~11岁广西桂林地区回族儿童(其中男49名,女69名),测量其身高、体重,计算其身体质量指数(BMI),利用生物电阻抗分析仪测量身体成分各指标(体肌肉量、躯干肌肉量、去脂体重、蛋白质、体脂肪量,躯干脂肪量,体脂肪率,躯干脂肪率、身体水分等)。采用SPSS 17.0软件对数据进行统计分析。结果广西桂林回族7~11岁儿童的身高、体重无性别差异,男童的BMI值大于女童,差异有统计学意义(P<0.05),超重和肥胖的男童检出率比女童高但差异无统计学意义。男童的体肌肉量、躯干肌肉量、去脂体重、蛋白质、身体水分显著高于女童(P<0.05),而脂肪量、躯干脂肪量、躯干脂肪率、体脂率的差异无统计学意义(P>0.05)。结论桂林回族儿童的身体成分存在性别差异,且与其他地区及民族的儿童体成分有一定差异。     

结直肠癌患者肌肉量､脂肪量､水分及基础代谢率､骨密度的体质分析

目的:探讨结直肠癌患者肌肉量?脂肪量?水分及基础代谢率?骨密度变化特征?方法:应用身体成分分析仪?骨密度仪等测定198例结直肠癌患者和129例健康人身体组成并进行体质人类学分析?结果:结直肠癌患者体重?腹围?体质指数?全身脂肪量?躯干脂肪量?细胞内水?骨密度小于对照组(P < 0.05),细胞外水?基础代谢率大于对照组(P < 0.05)?不同体质指数及病理分期患者的脂肪量?细胞内水?细胞外水均存在着组间差异(P < 0.05)?结论:结直肠癌患者身体组成变化明显,表现为脂肪减少?细胞内水减少?细胞外水增加?基础代谢率增加?骨密度减低?     

6～14岁肥胖儿童的体成分特点

目的 分析6～14岁肥胖儿童的体成分特点。方法 纳入636名6～14岁肥胖儿童，均行体格测量和体成分分析。比较各年龄段不同性别肥胖儿童之间体成分指标的差异，并分析肥胖儿童的体质指数与各体成分指标的相关性，以及相对肌肉量与相对蛋白质量、年龄与相对四肢肌肉量的相关性。分析青春期前和青春期肥胖儿童的体成分变化。结果 (1)在14岁年龄段，女生的身体脂肪百分比(PBF)和脂肪质量指数(FMI)均高于男生，女生的相对总水分和相对肌肉量均低于男生(均P<0.05);在13～14岁年龄段，女生的基础代谢率(BMR)均低于男生(均P<0.05)。(2)肥胖儿童的体质指数与体脂肪、PBF、FMI、内脏脂肪面积(VFA)、BMR均呈正相关，与相对总水分、相对蛋白质、相对无机盐、相对肌肉量均呈负相关(均P<0.05)。随着相对蛋白质量的增加，肥胖儿童的相对肌肉量增加(P<0.05);随着年龄增长，肥胖儿童的相对四肢肌肉量增加(P<0.05)。(3)与青春期前男生相比，青春期男生的体质指数、FMI、VFA均增加；与青春期前女生相比，青春期女生的体质指数、PBF、FMI、VFA均增...     

城镇中老年女性骨密度和身体成分研究

目的　探讨城镇中老年女性骨骼和身体成分的增龄性衰退变化规律,提出科学的运动干预对策与建议。方法　选取山东省某市10个城市社区421例健康中老年女性为研究对象,依据年龄分为4组（55~59、60~64、65~69及70~74岁组）,使用骨密度仪和身体成分测试仪对骨骼、肌肉、脂肪、水分等指标进行测试,比较4组间上述指标的差异。结果　4组骨矿含量、骨质疏松指数（OI）、骨密度T值和Z值、全身肌肉含量、全身蛋白质含量、左上肢肌肉含量、右上肢肌肉含量、右下肢肌肉含量、躯干肌肉含量、全身水分含量、全身水分比例、细胞内液含量、细胞外液含量及身体水肿指数比较,差异有统计学意义（P<0.05）;脂肪指标比较,差异无统计学意义（P>0.05）。两两比较：70~74岁组骨矿含量低于60~64岁组,70~74岁组骨密度T值低于60~64、65~69岁组,65~69岁组骨密度Z值大于60~64、70~74岁组,差异有统计学意义（P<0.05）;70~74岁组全身肌肉含量、全身蛋白质含量低于55~59、60~64、65~69岁组,65~69岁组左上肢肌肉含量低于55~59、60~64岁组,70~74岁组左上肢肌肉含量低于55~59、60~64、65~69岁组,65~69、70~74岁组右上肢肌肉含量低于55~59、60~64岁组,60~64岁组右下肢肌肉含量高于65~69岁组,70~74岁组躯干肌肉含量低于60~64、65~69岁组,差异有统计学意义（P<0.05）;70~74岁组全身水分含量、细胞内液含量、细胞外液含量低于55~59、60~64、65~69岁组,70~74岁组全身水分比例低于65~69岁组,55~59、70~74岁组水肿指数低于60~64、65~69岁组,差异有统计学意义（P<0.05）。结论　70岁是城镇女性骨骼和身体成分衰退变化的重要时间节点,其前、后5年分别是骨质强度下降、肌肉和身体水分丢失的重要潜伏期和表现期,应进行相应的运动锻炼和水分补充,预防与干预潜伏性衰退;下肢肌肉快速萎缩早于躯干肌肉,提示老年女性肌肉功能锻炼应有部位侧重和时序计划;肌肉萎缩可能是引起骨质疏松和水分缺乏的重要原因,我国中老年女性需要加强肌肉锻炼。     

老龄人群甲状腺功能与身体成分的相关性分析

目的：探索老龄人群中甲状腺激素与肌肉及脂肪等身体成分的内在联系。方法：74例年龄≥60岁的甲状腺功能正常的健康体检者,平均年龄(74.6±7.7)岁,测定其体重、甲状腺功能及身体成分等。结果：游离三碘甲状腺原氨酸（free triiodothyronine,FT3）与四肢肌肉质量（appendicular muscle mass , ASM）呈正相关（P=0.003）,校正年龄、性别及体重指数（body mass index,BMI）后二者间仍存在正相关性（P=0.011）;FT3与总肌肉量（去除头部）呈正相关（P=0.024）,校正年龄、性别及BMI后仅发现女性入组者中二者仍呈正相关,而男性中未见明显相关;促甲状腺激素（thyroid stimulating hormone, TSH）与四肢脂肪含量、总脂肪量（去除头部）呈负相关（P=0.039;P=0.038）,校正混杂因素后并未发现明显相关性。结论：甲状腺功能正常的老龄人群中甲状腺激素水平影响身体成分。     

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.