2004年长春市5岁以下儿童死亡监测分析

目的:了解长春市5岁以下儿童死亡情况、死因顺位,探讨降低儿童死亡的干预对策。方法:对2004年5岁以下儿童死亡监测情况进行统计、分析。结果:早期新生儿死亡率3.3‰,新生儿死亡率4.05‰,婴儿死亡率5.95‰,1～4岁儿童死亡率0.30‰,5岁以下儿童死亡率6.94‰;农村5岁以下儿童死亡率几乎是城市的2倍。新生儿死因顺位的前3位依次为:早产和低体重、出生窒息、其他先天异常和先天性心脏病;婴儿死因顺位的前3位依次为:先天性心脏病和早产低体重、出生窒息和肺炎、其他先天异常;0～4岁儿童死因顺位依次为:先天性心脏病、早产和低体重、出生窒息和肺炎。结论:早发现、早诊断、早治疗,提高住院分娩率是降低5岁以下儿童死亡的有效措施。     

漳浦县2008-2013年5岁以下儿童死亡状况分析

目的:分析漳浦县2008-2013年5岁以下儿童死亡状况,提出干预措施。让每个儿童拥有最佳的人生开端。方法:收集2008-2013年漳浦县5岁以下儿童生命监测结果资料,按死因进行分类统计分析。结果:漳浦县2008-2013年5岁以下儿童死亡率呈下降趋势(x2=32.512,p0.05)。2013年漳浦县5岁以下儿童死亡率6.04‰,,较2012(6.76‰)年下降了11.9%,较20 08年(9.09‰)下降了50.4%。死亡原因的前六位依次为早产低出生体重(1.60‰),意外窒息(1.38‰),先天性心脏病(0.96‰),出生窒息(0.89‰),其他先天异常(0.85‰),肺炎(0.84‰)。新生儿、婴儿和1-4岁儿童死亡率(例数)分别为3.95‰(284)、6.11‰(439)、2.07‰(149),婴儿死亡例数占5岁以下儿童死亡的74.66%,新生儿死亡占婴儿死亡的64.69%。男性死亡率(4.50‰)显著高于女性(3.69‰)(x2=10.856,p0.05)。结论:围生期疾病(早产低出生体重和出生窒息)和出生缺陷(先天性心脏病和其他先天异常)是婴儿的主要死因。意外伤害窒息死亡占5岁以下儿童死因的第二位。需要综合干预。     

桂林市区2006～2008年5岁以下儿童死亡分析

目的 了解近三年来桂林市区5岁以下儿童死亡情况及主要死因并探讨干预措施。方法 以2006年1 月1日～2008年12月31日桂林市区各级妇幼保健机构上报的5岁以下儿童死亡报告卡为基本资料，计算新生 儿、婴儿、5岁以下儿童死亡率及5岁以下儿童主要死因。结果 2008年的新生儿、婴儿、1～4岁儿童死亡 和5岁以下儿童死亡分别为3.47‰、6.70‰、1.60‰、8.87‰，较2006年（5.43‰、7.98‰、2.89‰和9. 58‰）分别下降了19.6%、12.8%、7.1%。前5位死因主要为先天性心脏病、早产和低出生体重、肺炎、其 他先天异常及出生窒息。结论 降低婴儿死亡率是降低5岁以下儿童死亡率的关键，应加强孕产妇、围产期 保健，提高产科、儿科质量，扩大健康教育的覆盖面，是降低5岁以下儿童死亡的有效措施。     

2010～2014年度怀化市5岁以下儿童死亡监测分析及干预措施

目的 :通过分析近5年怀化市0~4岁儿童死亡监测中儿童死亡率的变化趋势及主要死因构成,为政府制定进一步降低5岁以下儿童死亡率措施提供科学依据。结果 :5年来,监测地区5岁以下儿童死亡率呈逐年下降趋势。主要死亡原因按顺位依次为早产和低出生体重、肺炎、先天性心脏病、出生窒息、其他先天异常、意外窒息、交通意外和溺水等8种因素。新生儿死亡前5位死因依次为早产和低出生体重、出生窒息、肺炎、先天性心脏病和其他先天异常等。死前接受住院治疗的儿童呈现明显上升趋势。结论 :采取多种措施,减少新生儿死亡是降低怀化市5岁以下儿童死亡率的关键。另外,加大儿童疾病综合管理技术在基层医疗机构的推广应用;减少出生缺陷;加强宣传教育,降低意外的发生;均可有效的减少5岁以下儿童死亡。     

永仁县2006-2010年5岁以下儿童死亡原因分析

目的 了解永仁县5岁以下儿童死亡情况及主要死因,为制定儿童生存、保护性战略措施提供科学依据.方法 对2006-2010年我县76例0-4岁儿童死亡情况、死因构成及相关因素进行回顾性分析.结果 5年间共出生活产儿5047例,其中5岁以下儿童死亡76例,死亡率为15.05‰,婴儿死亡率为13.27‰,新生儿死亡率为10.30‰,1-4岁儿童死亡率为1.98‰.城区5岁以下儿童死亡率低于农村,5岁以下儿童的死因顺位前3位是早产低出生体重、肺炎、出生窒息.结论 应将农村作为妇幼保健工作的重点,同时加强对新生儿的监护,加强围产期保健和儿童保健服务质量.     

登封市2008-2013年5岁以下儿童死亡情况分析

目的了解登封市5岁以下儿童死亡趋势及其死亡原因,降低5岁以下儿童死亡率,提高儿童健康水平。方法对登封市2008-2013年5岁以下儿童死亡监测报告卡进行统计,调查分析5岁以下儿童死亡趋势及其死亡原因。结果 2013年登封市5岁以下儿童死亡率为6.03‰,比2008年5岁以下儿童死亡率7.15‰有明显下降趋势。主要死亡原因为早产和低出生体质量、先天性心脏病、出生窒息、意外窒息、交通意外、肺炎等。结论要降低5岁以下儿童死亡率,关键是要预防早产和低出生体质量,提高窒息复苏技术水平,加强儿童保健工作,防止意外伤害,做到早发现、早干预、早治疗。     

海安县2008年—2011年5岁以下儿童死亡分析

目的了解5岁以下儿童死亡率及主要原因,为制订相关干预措施提供科学的参考依据。方法应用回顾性调查方法对海安县2008年—2011年130例5岁以下儿童死亡情况进行分析。结果 5岁以下儿童死亡率为6.28‰,新生儿死因前3位顺位是早产、低出生体重,出生窒息,新生儿肺炎;婴儿死因前3位顺位是早产、低出生体重,肺炎,先天性心脏病和出生窒息并列第三;5岁以下儿童死因前3位顺位是早产、低出生体重,溺水,肺炎。结论威胁我县5岁下儿童健康的主要死因是早产、低出生体重、溺水和肺炎。     

合肥市蜀山区2008至2012年5岁以下儿童死亡率及死亡原因分析

目的：通过对蜀山区2008至2012年5岁以下儿童的死亡率和死亡原因分析,掌握5岁以下儿童主要死因及变化趋势,为降低儿童死亡率提供科学根据。方法按照《5岁以下儿童死亡监测实施方案》要求,对2008至2012年5岁以下儿童死亡监测资料进行统计分析。结果2012年新生儿死亡率4．18‰,婴儿死亡率5．57‰,5岁以下儿童死亡率6．79‰,与2008年相比较新生儿死亡率下降（4．96‰）,婴儿死亡率下降（5．76‰）,5岁以下儿童死亡率下降（5．27‰）;新生儿死亡占5岁以下儿童死亡的56．47％,占婴儿死亡的69．06％,婴儿死亡占5岁以下儿童死亡的81．76％,1～4岁儿童死亡占5岁以下儿童死亡的18．24％;前5位死因为早产或低出生体质量、先天性心脏病、出生窒息、肺炎和其他先天异常。结论5岁以下儿童各年龄组儿童死亡率均呈下降趋势,不同年龄组儿童死亡原因不同,降低5岁以下儿童死亡率主要是降低新生儿死亡率。     

银川市2010年5岁以下儿童死亡因素分析

目的 了解银川市5岁以下儿童死亡的主要原因及死亡相关因素,为制定降低儿童死亡率干预措施提供科学依据.方法 收集银川市5岁以下儿童死亡报告卡,对相关因素进行分析.结果 银川市2010年5岁以下儿童死亡率为14.74‰,婴儿死亡率为11.10‰,新生儿死亡率为8.18‰.死因顺位前8位分别为早产或低体重、先天性心脏病、出生窒息、肺炎、其它先天异常、意外窒息、交通意外与溺水.结论 大力推进基本公共卫生服务均等化,加强基层卫生机构服务能力建设,开展新生儿疾病筛查.加强农村1-4岁儿童安全管理,是降低5岁以下儿童死亡率的关键措施.     

2009年宁夏5岁以下儿童死亡监测分析

目的 了解2009年宁夏5岁以下儿童死亡状况,探求降低5岁以下儿童死亡率的干预措施.方法 对宁夏2009年5岁以下儿童死亡监测资料进行分析.结果 新生儿死亡率、婴儿死亡率、5岁以下儿童死亡率,分别为12.45‰、15.93‰、20.09‰,前3位死因分别为早产或低出生体重、出生窒息、先天性心脏病.结论 做好围产期保健工作、加强早产儿临床管理、强化新生儿窒息复苏技术、减少出生缺陷是降低5岁以下儿童死亡的关键.     

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.