2002～2005年南宁市校园内突发公共卫生事件流行病学调查分析

目的 掌握我市校园内突发公共卫生事件的特点及其影响,为建立起严密的预防机制提供依据.方法 对2002～2005年南宁市传染病疫情报告及食物中毒调查报告进行统计分析.结果 2002～2005年我市校园内突发公共卫生事件共发生24起,发病1868例,无死亡病例,分别占同期全市突发公共卫生事件起数的45.00%,发病人数的69.06%.公共卫生事件以传染病疫情为主,其发病人数占总病例的67.71%;病例主要集中发生在上学期;传染病疫情乡村高于城市,而食物中毒城市高于乡村,并好发于中学食堂;95%以上的事件及病例发生在中小学校;在传染病疫情中,病毒性疾病疫情占半数以上;生物性污染食物是食物中毒发生的主要致病因素.结论 依法对学校的卫生管理,建立严密的预防机制,加强卫生监督监测,使校园卫生落实到实处.     

红古区2006~2010年学校突发公共卫生事件流行病学特征分析

目的 了解红古区学校内突发公共卫生事件的发生和流行特点.方法 应用描述性流行病学方法 对红古区2006～2010年通过<突发公共卫生事件报告管理信息系统>上报的学校内突发公共卫生事件进行分析.结果 2006～2010年本区共报告学校内突发公共卫生事件10起,发病222例,无死亡病例报告.均为传染病疫情,一般突发公共卫生事件;全部事件及病例发生在各类小学及幼儿园.结论 加强学校内的卫生管理及健康教育,建立严密的疫情监测制度,减少学校内突发公共卫生事件的发生.     

郑州市二七区2007～2010年突发公共卫生事件监测分析

目的了解郑州市二七区突发公共卫生事件的流行病学特征,为突发事件的防控提供依据。方法对2007～2010年网络报告的突发公共卫生事件采用描述性流行病学的方法进行统计学分析。结果本辖区4年报告发生突发公共卫生事件31起,发生病例338例,死亡5例;传染病疫情29起,占93．55％,食物中毒与其他中毒2起,占6．45％。2009年事件发生总数高于2007、2008和2010年。辖区内大中专院校、小学及托幼机构发病人数达259例,占发病总数的76．63％。传染病疫情暴发占我辖区突发公共卫生事件的主要构成比,发病人群主要集中于学校。结论学校内突发的公共卫生事件严重危害广大学生身心健康和生命安全,学校卫生工作是目前疾病控制工作的重点,通过流行病学分析,提出了相应的预防与控制措施。     

南通市2003～2007年传染病突发公共卫生事件流行病学分析

目的:探讨南通市传染病突发公共卫生事件流行特征,为制订预防和控制重大突发传染病对策措施提供科学依据。方法:对南通市2003～2007年传染病突发公共卫生事件进行流行病学分析。结果:南通市2003～2007年共报告甲、乙、丙类及其它传染病突发事件11种152起,其中较大传染病疫情事件(3级)1起,一般传染病疫情事件(4级)151起,发病3823例。学校传染病突发事件占总发生起数的56.58%和总发病数的96.70%,病例相对集中于城乡小学,其中呼吸道传染病占事件发生数的95.35%和病例数的98.10%。结论:城乡小学呼吸道传染病是传染病突发事件防制工作的重点。     

长沙市2003～2006年突发公共卫生事件流行病学分析

目的了解长沙市突发公共卫生事件的流行特征,为预防、控制和有效处理突发公共卫生事件提供依据。方法收集长沙市2003～2006年突发公共卫生事件资料,应用描述性流行病学分析。结果全市2003～2006年共报告75起突发公共卫生事件,发病人数为3 640人,死亡1人,病死率0.03%。发生时间以6月、9月相对较高,事件类型以传染病暴发疫情为主,事件发生场所主要在学校。结论突发公共卫生事件严重危害人民群众的身体健康和生命安全,长沙市农村地区和学校是突发共卫生事件防控的重点。     

宁波市2004～2006年学校突发公共卫生事件分析

目的了解宁波市学校突发公共卫生事件的流行病学规律，为预防、控制及有效处置学校突发公共卫生事件提供科学依据。方法应用描述流行病学方法对宁波市2004—2006年学校突发公共卫生事件数据、资料进行统计分析。结果2004—2006年宁波市报告学校突发公共卫生事件109起，发病人数4068人，占全市突发公共卫生事件发生起数的81．3％和发病人数的70．8％。乡村小学是突发公共卫生事件好发场所；传染病暴发疫情是各类学校突发公共卫生事件的主要类型，发生起数较多的疾病依次为水痘、流行性感冒、流行性腮腺炎。结论学校突发公共卫生事件严重危害广大青少年学生身心健康和生命安全，通过流行病学分析，提出了相应的预防与控制措施。     

2006—2011年深圳市传染病突发公共卫生事件流行病学、特征

目的了解和掌握深圳市传染病突发公共卫生事件的流行病学特征,以便有效预防突发公共卫生事件的发生,提高应对突发公共卫生事件的能力。方法对深圳市2006-2011年报告的传染病突发公共卫生事件信息进行分析。结果 2006-2011年深圳市报告的传染病类突发公共卫生事件共199起,占突发公共卫生事件总数的95.22%,发病6460例,死亡20例,病死率为0.31%。以未分级事件居多,占66.83%（133/199）。各类传染病中,丙类传染病事件数较多,占51.76%（103/199）。报告的高峰期出现在4、6、9和12月,累积占传染病事件总数的56.06%。以聚集性疫情为主,学校和托幼机构是主要发生场所。结论传染病类突发公共卫生事件是主要突发公共卫生事件,而且主要发生在学校及托幼机构,建议进一步加强学校传染病,特别是呼吸道和肠道传染病的预防控制工作。     

重庆市2004—2007年突发公共卫生事件分析

目的对重庆市2004-2007年报告的突发公共卫生事件进行分析,以加强对突发公共卫生事件的预防和应急处理。方法应用描述流行病学方法,分析事件特征。结果全市4年报告突发公共卫生事件478起,发病19884例,死亡56例;渝东南地区多发,时间分布基本呈双高峰;传染病事件占80.98%,学校事件占78.87%;事件平均报告时间3.44d,平均处理时间46.72d。结论突发公共卫生事件的发生与地区经济文化水平密切相关;应提高对乙、丙类传染病和非法定传染病事件的重视程度;学校卫生工作有待进一步加强;突发公共卫生事件报告管理体系有待进一步理顺。     

湖北省宜昌市2006年突发公共卫生事件应急处理分析

目的分析宜昌市突发公共卫生事件的流行病学特点,探索应急处置工作的关键环节,进一步完善突发事件的应急处理机制,提高应急处理能力。方法对宜昌市2006年突发公共卫生事件的接报、处置资料应用描述流行病学方法进行统计和分析。结果2006年接报突发公共卫生事件32起,发病883例,其中传染病疫情30起(93.75%),食物中毒1起(3.13%),其他事件1起(3.13%);春、秋两季突发公共卫生事件频发,共报告25起(78.12%),累计发病人数719例,占总病例数的81.43%;中小学校是各类突发公共卫生事件的高发场所。结论目前宜昌市在春、秋季节以重点人群发生的传染病疫情为主的突发公共卫生事件形势依然严峻。对此,应针对其特点和原因,采取相应的措施,以减少突发公共卫生事件的发生。     

遵义市2010年突发公共卫生事件流行病学分析

目的分析遵义市2010年突发公共卫生事件的流行病学特征,为突发公共卫生事件的防控提供参考依据。方法收集汇总2010年遵义市突发公共卫生事件的数据资料,应用描述性流行病学方法进行分析。结果 2010年遵义市共报告32起突发公共卫生事件,其中一般事件2起,相关信息30起;病例382例、死亡5例,罹患率2.08%、病死率1.31%;传染病疫情30起,占事件总起数的93.75%,食物中毒事件2起,占6.25%;5~9月为高发期,学校发生的突发事件占46.88%,病例占93.72%。结论夏秋季应重点加强遵义市传染病的监测、预警及控制工作,特别是学校呼吸道传染病疫情的应急管理工作。     

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.