辽宁省农村人群脑卒中的流行病学特征及危险因素调查

目的了解辽宁省农村地区成年人群脑卒中的流行病学特征和相关危险因素，为辽宁省农村地区脑卒中的防治和干预提供科学依据。方法采用随机分层整群抽样对7个乡镇≥35岁30214名农村常驻（≥5年）成年人进行了调查。由培训过的医师对调查对象进行了血压测量和常见脑卒中危险因素资料的收集。结果辽宁省农村居民脑卒中患病率为2．48％，标化率为2．56％；男性患病率2．97％，显著高于女性患病率1．98％。随着年龄和血压分级的增高，脑卒中患病率呈明显的增高趋势。多元Logistic逐步回归显示年龄、性别、超重肥胖、高血压家族史、高血压、高血脂及高文化等因素是脑卒中患病的危险因素。超重、肥胖伴有高血压、高血脂者患脑卒中的危险性是同龄健康者的54．01倍（95％CI：37．09～78．64）。结论辽宁省农村居民脑卒中患病率高，高血压是脑卒中最显著的危险因素，许多居民对脑卒中危险因素的防治知识非常匮乏。     

南源社区居民高血压与肥胖等相关因素调查分析

目的调查南源街社区居民健康状况,分析高血压患病率与超重、肥胖等因素的相互关系。方法随机抽取广州市荔湾区南源街13个居委中4个居委35～75岁本街道户籍居民为调查对象,对1216例南源街社区居民进行问卷调查及身体测量,用Excel录入,用SPSS17．0统计软件进行统计分析。结果男性418人,占34．4％,女性798人,占65．6％。高血压的患病率为35．6％,65岁以上人群高血压患病率高达56．9％,患病率随年龄增加而增加。超重与肥胖的检出率为40．2％,腹型肥胖检出率81．7％,高血压与年龄、家族史、超重与肥胖（尤其是腹型肥胖）密切相关。结论高血压患病与年龄、遗传及超重与肥胖有关,超重与肥胖,尤其是腹型肥胖是高血压患病的重要危险因素,BMI及腰围检测作为预测高血压、糖尿病等各种肥胖相关疾病风险具有重要价值。     

广州城郊社区居民糖尿病及糖调节受损的流行现状调查分析

目的 了解广州城郊社区18岁以上居民糖尿病及糖调节受损的流行情况并分析其影响因素.方法 采用分层整群抽样方法,抽取广州市城郊6个社区18岁以上,居住5年及5年以上的居民共1532人进行糖尿病患病率及糖调节受损的流行病学调查.结果 完成调查1532人,广州城郊社区居民糖尿病患病率为8.48%,糖调节异常患病率为6.59%;年龄、体质量指数、糖尿病家族史、高血压家族史、高血脂、高血压和吸烟均为糖尿病和糖调节异常的独立危险因素.结论 广州城郊社区居民糖尿病患病及糖调节异常流行状况严峻,防治糖尿病的关键在于对40岁以上有糖尿病和高血压家族史人群在肥胖、高血压及脂代谢紊乱等危险因素的控制.     

基层高血压现况及危险因素调查分析

目的：了解基层高血压患病率及其危险因素。方法：对年龄≥35岁的4158人进行调查。采用SPSS11．5统计软件进行相关分析。结果：本地区高血压患病率为40．21％，其中男性患病率39．98％，女性为40．42％，且年龄与高血压患病率呈正相关；高血压知晓率为26．44％，服药率21．36％，血压控制率7．47％。结论：基层高血压患病率高，超重、肥胖、家族史是基层高发的主要危险因素，知晓率、控制率较低，必须提高其对高血压知识的认识度，及时采取干预措施。     

辽宁省阜新县农村冠心病流行病学特征及危险因素调查

目的了解北方农村地区成年人群冠心病的流行病学特征和相关危险因素，为北方农村地区冠心病的防治和干预接供科学依据。方法采用随机分层整群抽样对辽宁省阜新县地区7个乡镇≥35岁30214名常住（≥5年）成年人进行调查。由培训过的医师对其进行血压测量和冠心病危险因素资料收集。结果辽宁省农村居民冠心病患病率为3．64％，标化率为3．58％；男性患病率（2．55％）显著低于女性水平（4．75％），性别比为0，54：1。随着年龄和血压级别的增高，冠心病蔗病率呈明显的增高趋势。多元Logistic逐步回归显示年龄、性别、超重肥胖、腰臀比、高血压家族史、高血压、高血脂、高文化不良生活习惯等是冠心病的危险因素。超重肥胖伴有高血压、高血脂者患冠心病的危险性是同龄健康者的10．04倍（95% CI：7．45—13．54）。结论辽宁省农村居民冠心病患病率高，高血压是冠心病最显著的危险因素。     

银川市区中年以上人群高血压的流行病学调查

按标准化方法调查了银川市区居民5160人(≥35岁)的血压情况。结果表明确诊高血压患病率为19.0%,临界高血压患病率为2.9%。高血压患病率随年龄增长而上升。对相关因素分析结果提示:超重或肥胖、饮酒量大、高血脂、有高血压阳性家族史人群中患病率显著增高,并有统计学意义。现将调查结果分析如下。材料和方法本文资料选用中国七城市“七五”攻关项目《脑血管病危险因素干预试验及脑卒中人群监测》1987年银川市区的基线调查资料。共调查≥35岁5160人(男2399人,女2761人),占本市同龄人口     

南京市城区社区居民高血压现况调查及影响因素分析

目的：了解南京市社区居民高血压患病情况及其相关影响因素,为社区高血压综合管理与干预提供科学依据。方法：通过整群抽样的方法对南京市模范西路丁山社区15岁以上的居民2215人进行入户问卷调查及体格检查。结果：调查人群高血压患病率为23．0％（标化率21．2％）;不同职业、文化程度、婚姻状况人群的高血压患病率差异有统计学意义（均P值＜0．01）;有高血压家族史及相关慢性疾病史人群的高血压患病率显著增高（均P值＜0．01）;超重及肥胖、吸烟、饮酒、口味偏咸、经常失眠等人群的高血压患病率显著高于非以上特征者（均P值＜0．01）;多因素logistic回归分析显示,男性、高龄、超重及肥胖、睡眠时间过少和过多、高血压家族史、糖尿病、高脂血症、冠心病、脑血管病、慢性肾病可能是社区居民高血压病的危险因素。结论：南京市社区居民高血压患病率处于较高水平,人群分布及相关危险因素具有地方特征,高血压的防治应结合本地特点进行针对性的社区综合管理与干预。     

湖北某石化社区居民高血压危险因素分析

目的了解湖北某地石化工业区居民高血压患病率及危险因素，为制定干预措施提供科学依据。方法整体随机抽取某地石化社区内3个居委会作为调查点，对每个调查点30岁以上常住居民进行高血压相关调查。结果共有效调查10000人，其中男性4263人，女性5737人。高血压总患病率为26．56％，标化率为25．60％，男性为29．60％，女性为24．30％。多因素非条件Logistic回归分析，男性、吸烟史、肥胖、血糖及血脂异常是当地石化社区居民高血压患病的危险因素。结论当地高血压患病率较高，应针对高血压现况及危险因素采取措施。抓好高血压的经常性宣传教育和不良生活方式的改变，是控制高血压及有关危险因素、遏制心脑血管病增长趋势的工作重点。     

固原市回族35岁以上人群高血压患病率及血压控制状况

目的:了解固原市回族35岁以上人群高血压患病率及血压控制状况。方法:从我市健康体检者中随机抽取回族居民3000例,年龄35岁以上调查抽样人群高血压患病率、危险因素及血压控制达标率。结果:调查资料完整的研究对象2200例,调查人群高血压患病率15.18%,调查人群高血压知晓率44.31%%,治疗率28.7%,控制率为7.4%,高血压危险因素包括年龄、高血压家族史、高盐饮食、肥胖、饮酒、糖尿病、高血脂。结论:固原市35岁以上人群高血压患病率低于全国整体水平,但高血压知晓率、治疗率、控制率不理想,高血压防治力度仍需提高。     

广州市海珠区龙凤街社区诊断

目的 了解广州市海珠区龙凤街社区居民慢性病的患病情况。方法 采用入户调查的方法对龙凤街2237名社区居民进行调查，并随机抽取361人测定血糖、血脂。调查数据经SPSS软件进行统计学处理。结果 龙凤街社区居民糖尿病、高血压、超重和肥胖的粗患病率分别为16．9％、7．7％、20．1％和5．5％；血脂异常中高密度脂蛋白和低密度脂蛋白异常的比例最高；该社区居民的第一位死因是心血管疾病，其次为肿瘤。结论 糖尿病、高血压、肥胖、高血脂互为危险因素，随着年龄的增长呈上升趋势，有必要从年轻时就进行干预。     

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.