山东地区肥胖症流行特点的研究

①目的　探讨山东地区肥胖症流行特点。②方法　采用分层整群抽样法 ,对山东地区居住≥ 5年2 0～ 74岁不同城市和农村的自然人群进行调查。③结果　山东地区人群体质量指数 (BMI)的分布近似正态分布 ,其BMI的均数为 2 3.16± 4 .0 2 ,其 95 %正常值范围为 15 .2 8～ 31.0 4。按照WHO标准 ,山东地区人群体质量超标准率 (超标率 )和肥胖患病率分别为 7.32 %、18.79% ,城市肥胖和超标率由高到低依次为青岛市、济南市、招远市、五莲县 ,前三者明显高于后者 (χ2 =5 .5 6～ 2 6 .2 7,P <0 .0 5、0 .0 1)。男女肥胖率和超标率随年龄的增长均逐步增高 ,30～ 39岁年龄组男性高于女性 (χ2 =4 .2 5、8.92 ,P <0 .0 5、0 .0 1) ;6 0岁以上年龄组男性肥胖的患病率低于女性 (χ2 =5 .91,P <0 .0 5 )。 2型糖尿病 (DM )、糖耐量减低 (IGT)、高血压的患病率随BMI的变化而变化 ,Logistic回归分析显示BMI2 5 .0～ 2 8.9时 ,DM、IGT患病的危险性与BMI呈中度相关 ;BMI≥ 2 9.0时 ,上述疾病患病的危险性与BMI呈高度相关 ;BMI 2 4 .0～ 2 7.9时 ,高血压患病的危险性与BMI呈中度相关 ,BMI≥ 2 8.0时 ,高血压患病的危险性与BMI呈高度相关。男性腰围≥ 90cm、腰围 /臀围比值≥ 0 .90、女性腰围≥ 80cm、腰围 /臀围比值≥ 0 .85     

青岛地区2型糖尿病的流行特点

①目的　明确青岛地区 2型糖尿病 (DM )的流行特点。②方法　采用分层抽样法 ,对青岛地区居住 5年及 5年以上 ,2 0～ 74岁 ,市区、近郊区和远郊区的自然人群进行调查。③结果　青岛地区DM总患病率和糖耐量减低 (IGT)的患病率为 4.19% ,6 .2 8% .市区、近郊和远郊DM患病率分别为 6 .18% ,4.2 4% ,2 .0 1% ,标化率分别为 3.13% ,1.41% ,0 .32 % ;市区与近郊DM的患病率差异无显著性 ,但市区与远郊、近郊与远郊之间差异均有显著性 (χ2 =5 .40 ,16 .14,P均 <0 .0 5 )。市区、近郊和远郊IGT的患病率分别为 10 .74% ,5 .30 % ,2 .74% ;标化率分别为 8.88% ,3.10 % ,0 .39% ;市区的IGT患病率高于近郊和远郊 (χ2 =5 .72 ,34 .10 ,P均 <0 .0 5 )。新诊断DM病人2 1例 ,占患病总人数的 2 8% .本组 34 %的DM病人有明确DM家族史。Logistic回归分析表明 ,糖尿病的发生与年龄、腰围、收缩压、脂肪的摄入量、饮酒量等因素呈明显的正相关 ,与文化水平、体力活动等因素呈明显负相关。④结论　青岛市近郊区DM患病率接近市区。增龄、腹性肥胖、低体力活动、高脂饮食以及遗传背景是发生DM和IGT的重要危险因素     

社区单位职工糖尿病调查分析

为了解社区单位职工糖尿病 (DM )患病情况 ,探讨其患病相关因素 ,以利于对DM进行预防和控制 ,对社区单位职工的DM ,糖耐量减低 (IGT)患病率、血压、肥胖指数 (BMI) ,年龄、性别、血脂、摄食情况、体力活动等情况进行调查并作统计学分析处理。结果显示 :DM、IGT患病率分别为 8.72 %、2 .0 6 % ,发病与血压、血脂升高 ,摄食过多 ,体力活动少有明显关系。认为可通过控制摄食量 ,加强体力活动 ,降低体重 ,降血脂、血压等进行预防控制。     

医务工作者糖尿病患病情况的调查

作者调查了680名25～75岁（平均年龄314岁）医务工作者的糖尿病（DM）和糖耐全异常（IGT）患病率情况。结果显示，医务工作者DM和IGT患病率分别为2．06％和1．03％。此患病率明显低于同期全国普查患病率（2．51％和3．20％），但DM患病申明显高于81年全国普查的患病率（0．607％）。医务工作者DM和IGT的患病率在性别上无差异，患病率随年龄增长而增加，体重超重者,IGT患病率高于非超重者。提示医务工作者还应进一步增强对糖尿病的预防意识，减少糖尿病的发生。     

青岛地区肥胖症流行特点的研究

①目的　明确青岛地区肥胖症的患病率及其影响因素。②方法　采用分层整群抽样法,对青岛市市区和农村年龄20~74岁,居住5年及5年以上以家庭为单位的自然人群进行肥胖症流行特点抽样调查。③结果青岛地区肥胖和体质量超标的总患病率分别为9.01%和39.40%。市区、近郊和远郊肥胖患病率分别为 14.16%、9.34%、3.56%,标化率分别为4.72%、2.53%、1.41%;体质量超标的患病率分别为 57.98%、40.41%和 19.29%,标化率分别为19.32%、10.97%、7.63%。162例肥胖者中并 2 型糖尿病(DM)和糖耐量减低(IGT)者占 24.07%,并收缩期和舒张期高血压者分别占32.71%、39.15%。DM、IGT和高血压的患病率随体质量指数(BMI)升高而升高,BMI≥28者DM+IGT患病率与BMI<19组比较明显升高(χ2=7.50~10.15,P<0.05、0.01),BMI≥24 者高血压患病率与<19组比较升高明显(χ2=6.24~18.40,P<0.05、0.01)。DM+IGT和高血压的患病率随腰围/臀围比值(腰臀比)升高而升高,腰臀比≥0.8者DM+IGT和高血压的患病率与<0.7 组比较明显升高(χ2 =3.89~35.36,P<0.05、0.01)。肥胖组和体质量超标组的年龄、腰臀比、收缩期高血压、舒张期高血压、服糖后 2 h血糖均明显高于体质量正常组(t=9.27~15.40,P均<0.01),而肥胖组年龄、腰臀比、收缩压、舒张压也明显高于体质量     

重庆地区老年人2型糖尿病和糖耐量低减的流行病学调查

目的：了解重庆地区老年人2型糖尿病(DM)和糖耐量低减(IGT)的患病情况及相关疾病。方法：采用整群抽样的方法对重庆地区1791例60岁以上老年人群进行横断面研究。结果：(1)2型DM患病率为15．6%,IGT患病率为20．5％。餐后血糖是诊断老年人2型DM的一个敏感指标。(2)70岁以上组与60～69岁组比较2型DM和IGT的患病率有显著性差异,其中IGT患病率的差异尤为显著：(3)Logistic回归分析结果表明,高血压、高TG血症、肥胖和中心性肥胖均为2型DM和IGT患病的危险因素。结论：老年人2型DM和IGT患病率随年龄的增长而增加,餐后血糖是早期诊断老年人2型DM的敏感指标;高血压、高TG血症、肥胖和中心性肥胖是影响老年人2型叫患病率的主要相关疾病。     

中山古镇社区人群糖尿病的流行病学研究

目的 阐明古镇社区糖尿病(DM)患病情况。方法 对古镇社区20岁及以上的人群进行DM的抽样调查，共调查6920人。结果 社区人群DM患病率为4．16％，糖耐量低减(IGT)息病率为6．16％，DM和IGT的标化患病率分别为3．49％和5．12％。各年龄人群组的DM和IGT患病率的线性趋势均有显著性意义(P＜0.01)，DM标化患病率男女间差别无显著性意义。不同文化程度人群DM和IGT的患病率间差别均有显著性意义(P＜0．01)。肥胖和高血压等是导致DM患病率高的主要因素。结论 对DM要进行社区综合防治，减少DM并发症的危害。     

东营市城乡居民IFG与糖尿病患病率及危险因素调查

目的了解山东省东营市城乡居民空腹血糖调节受损(IFG)、2型糖尿病(T2DM)的患病率及合并心血管危险因素情况。方法采用随机整群抽样方法,对东营市城市和农村40~79岁居民4 322人进行问卷调查、体格检查和实验室检查。结果东营市40~79岁居民IFG及T2DM的患病率分别为21.15%、11.70%,男性与女性比较差异无显著性(P>0.05);随着年龄增长,总体IFG患病率及T2DM患病率增加,差异有显著性(χ2=11.21、15.41,P<0.05);城市、农村IFG患病率比较差异无显著性(P>0.05),T2DM患病率差异有显著性(χ2=14.87,P<0.01)。城市男性、女性IFG病人的吸烟比例高于农村,城市女性T2DM病人的吸烟比例高于农村女性,差异均有显著性(χ2=6.144、17.148,P<0.01);城市男性IFG肥胖比例高于农村男性,城市女性T2DM肥胖比例高于农村女性,差异均有显著性(χ2=4.158、17.497,P<0.05);农村男性、女性IFG、T2DM病人血压升高的比例及同型半胱氨酸(Hcy)升高的比例均高于城市男性、女性,差异有显著性(χ2=8.314~37.831,P<0.05)。结论东营市40~79岁居民IFG及T2DM的患病率较高,城市IFG及T2DM居民多合并吸烟、肥胖、血脂异常等心血管危险因素,而农村人群多合并高血压、高Hcy血症等心血管危险因素。     

2002年广西城乡成年居民糖尿病流行病学调查

目的了解广西糖尿病（DM）、糖耐量减低（IGT）的患病状况及其主要影响因素，为制订防治规划提供依据。方法采用多阶段分层整群随机抽样方法在全区抽取8个县（区），对年龄≥18岁的3060人进行DM流行病学调查，采用葡萄糖氧化酶法测定血糖。结果DM、IGT粗患病率分别为2．52％、1．21％，标化患病率为1．43％、0．89％。DM、IGT患病率随年龄增长、家庭经济收入增加、体力活动减少、体重指数的增加等呈上升趋势。城市人群、有DM家族史人群DM和IGT患病率明显增高，少数民族人群DM患病率低。高血压、血脂异常与DM、IGT患病率密切相关，吸烟、饮酒等因素对DM、IGT患病率无明显影响。全区DM防治情况不乐观，≥18岁人群曾经测量过血糖的比例只有4．53％，DM患者知晓率仅为43．59％。结论家族史、高龄、超重、高血压及血脂异常等是DM的危险因素。DM的防治工作需要加大宣传力度、普及DM知识。     

上海市2型糖尿病患病情况现状调查

目的 了解上海市社区居民2型糖尿病、糖调节异常（IGR）患病率及其分布特征。方法 采用多阶段整群随机抽样方法,对上海市城、乡社区居民15-74岁者进行横断面的调查。结果 上海市居民2型糖尿病、糖耐量低减（IGT）和空腹血糖受损（IFG）患病率分别为8．6％（1000／11589）、6．9％（802／11589）和1．0％（120／11589）（标化率为6．2％、5．1％和0．8％）。超重、肥胖人群中2型糖尿病患病率为11．5％（454／3946）和16．3％（207／1273）,IGT患病率为8．9％（352／3946）和12．0％（153／1273）,IFG患病率为1．4％（57／3946）和2．3％（29／1273）,明显高于体质指数正常人群[分别为5．3％（337／6364）,4．6％（294／6364）,0．5％（34／6364）]（均P〈0．01）。中心性肥胖人群中2型糖尿病患病率为16．5％（525／3173）,IGT患病率为11．7％（372／3173）,IFG患病率为1．6％（52／3173）,明显高于无中心性肥胖人群[分别为5．6％（475／8416）,5．1％（430／8416）,0．8％（68／8416）]（均P〈0．01）。高血压人群中2型糖尿病患病率为17．4％（479／2752）、IGT患病率为11．0％（303／2752）、IFG患病率为2．0％（56／2752）,明显高于无高血压人群[分别为5．9％（521／8837）,5．6％（499／8837）,0．7％（64／8837）]（均P〈0．01）。男性2型糖尿病、IGT和IFG患病率分别为8．9％（412／4621）、6．4％（296／4621）和1．0％（47／4621）,女性2型糖尿病、IGT和IFG患病率分别为8．4％（588／6968）、7．3％（506／6968）和1．0％（73／6968）,2型糖尿病、IGT和IFG患病率在男女之间差异无统计学意义（均P〉0．05）。城市2型糖尿病、IGT和IFG患病率分别为11．2％（730／6500）、6．4％（419／6500）和1．2％（77／6500）（标化率分别为6．5％、4．9％和0．8％）,农村2型糖尿病、IGT和IFG患病率分别为5．3％（270／5089）、7．5％（383／5089）和0．8％（43／5089）（标化率分别为3．8％、5．4％和0．7％）,城乡之间2型糖尿病和IGT患病率差异有统计学意义（P〈0．05）,IFG患病率差异无统计学意义（P=0．073）。新诊断2型糖尿病比例为47．6％,其中农村为69．3％（187／270）,明显高于城市[39．6％（289／730）]（P〈0．01）。结论 上海市DM患病率呈快速增长趋势,应注重对富裕起来的农村地区居民的早期2型糖尿病筛查。     

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.     

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.     

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.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

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.