体检人群血黏度差异及影响因素

目的分析不同性别、年龄人群血黏度指标的差异,并探讨引起差异的原因。方法随机选取200例大连市美年大健康体检中心标本,将其按年龄分为35～44岁、45～54岁、55～64岁、65～74岁及≥75岁5个年龄组,每组40人,采用t检验、单因素方差分析法对不同性别、年龄组之间数据进行统计分析。结果男性除血液屈服应力显著低于女性外,其余血液黏度指标均显著高于女性(均P0.001)。65～74岁年龄组的全血黏度高切、全血黏度中切、全血黏度低切、红细胞电泳时间、卡松黏度指标较35～44岁、45～54岁、55～64岁组均显著降低(P0.05)。结论由于个体差异,男性的血液黏度高于女性,随着年龄逐渐增长,当人群年龄到65～74岁时,血液黏度明显下降。     

新疆兵团农二师29团梨华社区老年人健康体检结果分析

目的分析新疆生产建设兵团农二师29团梨华社区65岁以上老人健康体检的异常结果及患病风险性,找出患相应慢性病的高风险人群,为制定预防干预措施提供科学依据。方法采用分类统计法,分别统计出该社区65岁以上老人不同性别、年龄组的血糖、总胆固醇、甘油三酯异常及心电图异常的发生例数和所占比例,并采用率的比较及χ2检验等方法推算出发生相应慢性病的风险率。结果 65~70岁年龄组血糖异常率为20.3%,是糖尿病发病的高危人群,男性高于女性,并有随年龄增长逐渐上升的趋势;71~75岁年龄组总胆固醇异常率为26.0%,是胆固醇增高症发病的高危人群,女性高于男性;65~70岁年龄组甘油三酯异常率为25.3%,是高血脂症发病的高危人群,女性高于男性;各年龄组受检人群(尤其是80岁以上年龄组)均是各种类型心脏疾病发病的高危人群。结论 65岁以上各年龄组老人均为糖代谢、脂类代谢以及心脏疾病发病的高风险人群,并呈现出随着年龄增长患病风险不断增高的趋势。     

C-反应蛋白水平在健康人群分布的性别和年龄差异

目的：了解健康成人性别和年龄因素对C-反应蛋白（CRP）水平有无影响。方法：采用胶乳增强免疫透射比浊法对522例健康成人进行定量测定。结果：健康人群CRP水平呈偏态分布,中位数男性为1.92mg/L,女性为2.97mg/L,女性高于男性,差异有统计学意义（P〈0.05）;50岁以上年龄组CRP水平明显高于其他年龄组（P〈0.05）。结论：健康人群CRP浓度受年龄和性别因素影响,应根据不同人群特征建立参考值范围;并需要进行进一步研究以确定CRP水平的性别和年龄差异是否影响用于心血管病风险评价的临界值。     

1990-2017年中国艾滋病疾病负担分析

目的分析1990-2017年中国艾滋病疾病负担变化。方法利用全球疾病负担研究资料分析1990-2017年中国艾滋病疾病负担变化趋势;描述1990年和2017年死亡、伤残调整寿命年(DALY)、伤残损失健康寿命年(YLD)和过早死亡损失寿命年(YLL)的年龄、性别分布。结果 1990-2017年中国艾滋病年龄别标化死亡率(0.29/10万～1.95/10万)和年龄别标化DALY率(16.10/10万～91.31/10万)呈上升趋势。男性死亡、DALY、YLD、YLL指标均高于女性。2017年中国艾滋病死亡数、DALY值以15～49岁组最高。1990-2017年50岁及以上组艾滋病死亡数、DALY值平均增速要高于50岁以下组。结论中国艾滋病负担呈升高趋势,青壮年人群受到威胁最为严重,及早发现并接受治疗是降低艾滋病死亡的重点。     

2002年北京市居民心脑血管疾病的疾病负担分析

目的:计算5种心脑血管疾病的疾病负担,以评价心脑血管疾病对社会及人群所致危害程度的大小。方法:根据2002年北京市居民营养与健康状况调查中有关居民患病数据和北京市疾病预防控制中心统计信息中心死因统计数据资料,采用综合描述死亡与伤残负担的定量指标——伤残调整生命年(disability adhysted life year,DALY)作为反映疾病负担的量化指标。结果:2002年北京市居民心脑血管疾病的疾病负担中脑血管疾病造成的DALY损失最严重,平均每千人口造成15.77个DALY损失;男性脑血管病和心肌梗死的疾病负担高于女性;65岁以上老年人的心脑血管疾病负担高于中青年和青少年。结论:影响北京市居民健康的重点心脑血管疾病是脑血管病、急性心肌梗死、其他冠心病;重点人群是中老年人群。     

湖南省某县居民呼吸系统疾病死亡的疾病负担

目的 探讨安仁县居民呼吸系统疾病死亡的疾病负担.方法 收集并分析2004～2005年呼吸系统疾病死亡监测资料,分别计算潜在期望寿命损失年(the expected years of potential life lost,EYPLL)、早死生命损失年(years of life lost,YLLs)、死亡率等疾病负担指标.结果 2004呼吸系统疾病死亡率、EYPLLP、YLLs/1 000分别为82.79/10万、885.83年、10.42,2005年上述指标分别为85.74/10万、706.22年、10.38.2005年死亡率较2004年升高,而EYPLLP、YLLs/1000下降;疾病负担为女性高于男性,呈现0岁和60岁以上两个高峰,肺炎和慢性阻塞性肺病(COPD)分别以0岁组和>35岁组为疾病负担之首.结论 COPD和肺炎是安仁县居民呼吸系统疾病死亡的主要疾病负担,<1岁和>60岁居民是重点人群.     

山东省部分19岁以下正常人群VCG上的Q/R,S/R,Rx,Ry,Rz值的监测

目的对19岁以下不同年龄和性别正常人群在VCG上的Q/R,S/R值及最大R振幅在X,Y,Z轴上的投影进行研究,探讨不同年龄和性别有关这些项目均值的变化规律.方法在城市1个月至19岁正常人群中,选择经检查无心脏病者1 950名健康人群进行了VCG描记,在VCG上测量与分析Q/R,S/R比值及最大R振幅在X,Y,Z轴上的投影. 结果 Q/R值在性别上区别不明显,但在年龄上稍有所不同,男女的S/R 值在8岁前无性别上的明显区别,8岁后各年龄组男性高于女性;Rx值男性在10岁前,女性在8岁前随年龄增长而增高.男性在10岁～14岁,女性在8岁～14岁随年龄的增长而降低,男女在14岁后稳定在一定范围;在1岁内男女的Ry较小外,其余年龄组在性别和年龄上无明显的区别;Rz值各年龄组的男性均高于女性,男女各年龄组均随年龄的增长而降低. 结论该组人群的VCG各项指标在年龄和性别有所差异,因而应用这些项目监测心脏大小时,应考虑年龄和性别的差异.     

住院患者HIV感染的流行病学分析

目的 通过对住院患者检测艾滋病病毒(HIV)抗体，了解HIV感染及艾滋病(AIDS)在人群中的发病状况和流行病学意义。方法 对2000年1月～2002年12月住院病人，常规采用明胶颗粒凝集试验或HIV抗体金标快速测试进行初筛，阳性者由北京市疾病预防控制中心复检确定。结果 3337份血清共检出48例HIV抗体阳性，阳性率1．44％。其中静脉吸毒者45例，占1．35％(45／3337)；性传播感染者3例。男44例，占1．32％(44／3337)；女4例。少数民族37例，汉族11例。年龄20～49岁47例；无业46例；小学及以下文化程度46例。其中23例已确定为AIDS。结论 HIV在高危人群中有很高的感染率，以静脉吸毒为主要感染途径，男性感染率明显高于女性，少数民族、青壮年、无业人员、小学及以下文化程度者阳性率高。在高危人群中宣传有关AIDS的知识已经成为预防AIDS的最根本措施之一。     

2004～2005年湖南省城乡居民糖尿病人口学死因分析

目的了解湖南省城乡居民糖尿病人口学死因分布特征及造成的潜在寿命损失(PYLL)和工作损失(WPYLL)。方法采用人口学死因回顾性抽样调查方法,收集湖南省2004~2005年城乡居民死亡监测资料,分别计算糖尿病死亡率、总死因构成和早死所致的PYLL和WPYLL。结果 2004~2005年湖南省城乡居民糖尿病年死亡率7.10/10万(标化率4.88/10万),占总死因构成比的1.17%(标化比1.18%);女性高于男性,城市高于农村。糖尿病死亡率随着年龄增高而呈现上升趋势,主要危及中老年人群。从55岁以上年龄组死亡率陡增,死亡专率为21.16/10万,80岁以上年龄组最高,达到93.98/10万。糖尿病死亡造成的PYLL率为0.51‰,WPYLL率为0.35‰。女性PYLL率和WPYLL率高于男性,农村PYLL率和WPYLL率高于城市。结论糖尿病已成为湖南省城乡居民的主要死因之一。老人和妇女是防治的重点对象,应开展以代谢综合征为先导的社区综合防治。     

北京地区城乡人群吸烟状况比较

了解北京地区城市和农村人群中吸烟率的水平、分布特征，比较城市及农村之间不同性别、年龄及文化程度人群吸烟特性的差异，为今后在人群中开展戒烟干预活动提供基础资料。采用问卷调查的形式，对中关村及北京大学地区的城市居民和四季青地区的农民进行分层随机抽样调查。被调查者年龄范围为２５岁至６４岁。调查项目包括：一般情况、吸烟状况、测量血压水平、血脂水平等。（１）农村人群的吸烟率高于城市人群（男性：农村７５％，城市４９％；女性：农村１６％，城市４．６％）。（２）无论男性或女性，相同文化程度及年龄组的人群中农村人群的吸烟率均高于城市人群。（３）从总体上看，男性吸烟率高于女性，文化程度较低的人群吸烟率高于文化程度较高的人群，男性和女性人群的吸烟率随年龄段增加而变化的趋势不同。（４）无论城市或农村男性吸烟者的吸烟量高于女性吸烟者。城乡之间不同年龄段及不同文化程度吸烟者的烟量无明显差异。男性烟民中吸烟量有随文化程度的增加而减少的趋势，但未达到统计学显著性差异     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Angiographic diagnosis of the degree of serosal invasion of carcinoma of the colon

Angiography using Prostaglandin El^® was performed on 38 patients with carcinoma of the colon in order to diagnose the degree of serosal cancer invasion. The findings at angiography were classified into four groups:1) AG-S3, abnormal change (irregularity and/or encasement) up to marginal vessels; 2) AG-S2, abnormality up to vasa recta; 3) AG-S1, abnormality of penetrating branches of vasa recta within the wall of the colon; and 4) AG-S0, no distinct findings of abovementioned vessels. These angiographic findings were compared with both macroscopic and microscopic serosal cancer invasion. Angiographic diagnosis is in accord with the macroscopic findings in 84.2 percent of cases. Angiographic diagnosis is in accord with the microscopic findings in 32.4 percent of cases. Macroscopic findings confirm the angiographic diagnosis precisely but the conflict with microscopic findings should not be overlooked. This may be the result of inflammatory change, adhesion, and fibrosis around carcinoma of the colon.