湖南农村侗族老年人生命质量及影响因素分析

目的了解湖南省侗族地区农村老年人生命质量现状及相关影响因素,为提高侗族老年人的生命质量提供依据。方法用SF-36量表对湖南省农村地区60周岁及其以上的侗族老年人1727名进行生命质量测评并对影响因素进行分析。结果农村侗族老年人生理健康方面加权平均分为（60．25±16．99）,心理健康加权平均分为（59．32±10．88）。性别、年龄、婚姻状况、慢性疾病和月收入影响农村侗族老人生命质量。结论农村侗族老年人的生命质量不容乐观,应重视少数民族地区老年人的医疗保障,加强慢性病防治,提高生命质量。     

社区老人生命质量及影响因素

目的 了解社区老人生命质量及其影响因素,为有关部门提高老年人生命质量提供决策依据.方法 采用健康状况调查问卷中文版(SF-36)调查上海市闵行区社区老人生命质量,采用单因素、多因素统计方法进行数据处理.结果 老年人生命质量情况为:躯体功能(71.94±23.29)分,躯体角色(73.64±43.03)分,肌体疼痛(80.24±20.25)分,一般健康状况(53.20±19.07)分,生命力(70.40±15.67)分,社会功能(83.79±20.24)分,情感角色(81.13±37.16)分,心理健康(78.14±15.43)分,加权平均分为(74.06±17.49)分.影响社区老人生命质量的因素有疾病(冠心病、关节炎、糖尿病、脑血管意外、白内障、胆结石和慢支),非疾病(居住、体育锻炼、年龄、性别、娱乐、以前从事家务或无业等).结论 影响社区老年人生命质量的可控因素为居住、体育锻炼、娱乐和疾病.     

重庆市黔江区农村老年高血压患者生命质量现状及影响因素调查

目的:了解重庆市黔江区农村老年高血压患者生命质量现状及影响因素,为改善该人群生命质量提供参考依据。方法:采用分层随机抽样的方法,应用SF-36 V2量表对974例农村老年高血压患者进行调查,运用多水平模型和多元线性模型进行多因素分析。结果:农村老年高血压患者躯体综合评分(PCS)加权平均分为(45.54±19.72),心理综合评分(MCS)加权平均分为(49.30±19.50)。农村老年高血压患者生命质量受个体、供方、环境等多重因素影响,具体包含性别、就业状况、文化程度、是否患有其他疾病、自感病情严重程度、防治知识知晓度、坚持运动、主动咨询等。结论:重庆市黔江区农村老年高血压患者生命质量较差。应重视健康教育并建立规范化的随访服务;建立发展"以农村社区为依托"的保健模式;女性群体应受到关注和重视;针对性地制定干预措施,促进目标人群生命质量的提高。     

农村精神分裂症患者的生存质量及其影响因素分析

目的 分析农村精神分裂症患者生存质量及其影响因素.方法 纳入652例农村精神分裂症病情稳定患者,采用家庭关怀度指数问卷、领悟社会支持量表、精神病人生存质量量表对患者的生存质量进行调查,并分析影响患者生存质量的因素.结果 652例患者家庭关怀量表得分为(6.77±3.05)分,社会支持量表得分为(52.55±11.81)分,生存质量量表得分为(118.78±21.10)分;影响患者总体生存质量的因素有婚姻状况、家庭关怀、社会支持(P＜0.05).在生存质量的生理维度、心理维度、社会维度及症状维度中,社会支持是最主要的影响因素(P＜0.05).结论 农村精神分裂症患者的生存质量较低,影响生活质量的因素主要是家庭关怀和社会支持.     

美沙酮维持治疗海洛因依赖者的生命质量及其影响因素研究

目的 了解参加美沙酮维持治疗的海洛因依赖者的生命质量及其影响因素.方法 在四川省自贡市社区药物维持治疗中心抽取216名海洛因依赖者进行问卷调查,问卷包括WHOQOL-BREF及影响生命质量的相关因素的条目.结果 美沙酮门诊治疗者的得分为13.14±2.79(生理领域),12.17±3.38(心理领域),12.20±3.17(社会关系领域),11.94±3.31(环境领域),12.06±3.73(总的生存质量与健康状况).单因素分析显示,年龄越大,吸毒年限越长,没有工作,与家人关系越差,过去3个月被抓,性生活越少,服用过安定,对治疗没有信心,各领域生命质量越差(P<0.05).治疗6～12个月的患者环境领域的生命质量高于治疗6个月以内者(P<0.01).注射与其他方式混用的患者生理领域的生命质量低于单纯口吸者(P<0.05).多元逐步回归分析结果表明,美沙酮门诊治疗者生命质量的影响因素包括年龄、吸毒年限、是否工作、与家人关系、性生活频率、过去3个月是否被抓、是否服用安定、治疗的信心. 结论应根据治疗者不同的个体和家庭情况,采取相应的措施提高其生命质量.     

长治某农村老年人生存质量影响因素及护理需求调查研究

目的:调查长治各县区农村老年人生存质量现状,分析其影响因素。方法:采用分层随机抽样的方法,选择长治各县区农村老年人1 048名作为研究对象,对本组人群的生存质量、自理能力及护理需求进行调查,并对结果进行分析。结果:依据老年人生存质量划分标准,长治县区农村老年人生存质量处于"中(72.1～117分)"占92.27%。影响农村老年人群生存质量的主要因素是自理能力、健康状况、文化程度、年龄、性别、职业和婚姻;农村老年人对社区护理需求总体得分为(3.63±0.74)分,其中健康促进得分最高(3.71±0.77)分,其次是疾病预防(3.57±0.87)分,对疾病护理需求得分最低(3.23±0.99)分;农村老年人对社区护理各领域需求与生存质量各维度之间呈负相关关系,生存质量得分越低,其社区护理需求越大。结论:本组农村老年人群生存质量总体处于中等水平,而老年人护理服务需求与基层医疗机构实际提供服务情况存在较大差距,这种差距将全面影响农村老年人未来的生存质量,故需政府给予农村卫生服务相关政策支持,从而维持老年人现有的生存质量水平。     

贵州农村侗族老年人生活质量及其影响因素研究

目的:了解贵州农村侗族老年人生活质量及其影响因素。方法:使用简明健康状况量表(SF-36),采用随机抽样方法,对60岁以上能够正常交流的农村侗族老年人进行问卷调查。结果:贵州农村侗族老年人生活质量总分为(61.15±15.55)分,其中年龄、睡眠质量、自理能力、近两周是否患病、近一年是否住院、总体生活满意程度6个因素(P <0.05)是影响老年人生活质量的主要因素。结论:贵州农村侗族老年人生活质量呈中等水平,需从加强体育锻炼、增强心理素质、转变养老旧思想观念和提高基本生活保障水平等方面,促进老年人生活质量的提升。     

常州老年人生存质量及相关因素的研究

为了解常州老年人的生存质量和相关影响因素,采用世界卫生组织生命质量测量量表简表(WHOQOL-BREF)为主要内容的调查问卷对常州老年人进行抽样调查,运用单因素方差分析进行数据统计.结果显示,常州老年人在生理和心理领域的得分低于常模,年龄、学历水平、婚姻状况、有无疾病和养老方式均可影响老年人生存质量.全社会应积极关注老年人人群,根据不同影响因素,采取策略提高老年人的生存质量.     

广东省260名高校学科带头人生存质量状况分析

目的 了解高校学科带头人生存质量状况,探讨其生存质量的影响因素.为改善高校学科带头人生存质量制定合理措施提供参考.方法 采用整群抽样方法,抽取2006～2008年被列入国家级、省级和校级"千百十工程"培养对象的各级学科带头共260位.采用WHOQOL-BREF量表以网络匿名调查形式了解高校学科带头人生存质量现状.结果 高校学科带头人生存质量4个维度的得分分别为:生理维度13.59±1.66,心理维度14.97±2.19,社会维度14.71±2.15,环境维度12.62±2.30,除生理领域外均较常模偏高(P<0.01).婚姻状况、是否从事行政工作、培养级别这3个因素对高校学科带头人生存质量的影响有统计学意义(P<0.05).结论 高校学科带头人的生存质量普遍偏高,其主要影响因素是婚姻状态、是否从事行政职务和培养级别.离婚、分居、丧偶,兼任行政职务和培养级别较高的学科带头人,其生存质量较差.     

农村佤族老年人生命质量影响因素的逐步回归分析

目的探索农村佤族老年人生命质量的影响因素,为提高少数民族老年人生命质量提供依据.方法采用SF-36量表对248例老年人进行生命质量的测定,应用SPSS统计软件包进行统计描述和逐步回归分析,进行生命质量的影响因素分析.结果经逐步回归分析,经济状况、职业、性别是SF-36总体评分的主要影响因素,其回归系数分别为:6.02、9.53、-4.82.结论农村佤族老年人生命质量的影响因素是多因素.     

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.