山东地区型糖尿病流行特点的研究

1目的　明确山东地区 型糖尿病 (DM)的患病率及影响因素。 2方法　采用分层抽样法 ,对山东地区居住 5年及 5年以上 2 0～ 74岁不同城市和农村的自然人群进行调查。 3结果　 DM和糖耐量减低 (IGT)的患病标化率分别为 2 .79%和 4.72 % ,其中新诊断 DM病人 10 6例 ,占患病总人数的 6 7.95 % .DM和 IGT的患病标化率农村低于城市 ,五莲农村 DM和 IGT患病率低于招远市农村 ,城市 DM和 IGT患病率由高到低依次为青岛、济南、招远、五莲。 30～ 39岁年龄组 IGT的患病率高于对照组 (χ2 =7.80 ,P<0 .0 1) ;40岁以上各年龄组 DM和 IGT的患病率均高于对照组 (χ2 =7.94～ 6 6 .73,P均 <0 .0 1) ,并随年龄的增加发生 DM和 IGT的比数比也增加 (OR =6 .6 5～ 18.49)。 42 % DM和 30 % IGT病人有明确的 DM家族史 ,但无性别差异 (χ2 =1.17,0 .13;P均 >0 .1)。离退休人员和家庭妇女 DM和 IGT患病率高于工人 (χ2 =9.88～ 6 2 .41,P均 <0 .0 1)。从事轻度职业性体力活动以及休闲时轻度体力活动者 DM和 IGT患病率高于中、重度体力活动者 (χ2 =4.0 5～ 37.12 ,P<0 .0 5 ,0 .0 1) ,超重、肥胖者DM和 IGT患病率也高于正常体重者 (χ2 =8.84～ 75 .31,P均 <0 .0 1)。 DM组和 IGT组病人的年龄、体质指数、腰围、腰围与臀围比值     

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     

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。     

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。     

灵武地区成人血糖水平及糖尿病患病率的调查研究

目的了解灵武地区成人血糖水平及其糖尿病患病情况,为制定防治措施提供科学依据。方法采用分层随机整群抽样方法,对城乡居民2575例进行了糖尿病流行病学调查。结果灵武地区平均空腹血糖水平为(4.24±0.79)mmol/L,DM标化患病率为3.16%,IGT标化患病率为7.32%;随着年龄的增长,平均血糖水平逐渐升高,DM患病率、IGT患病率均逐渐增加,城乡之间DM患病率及IGT患病率有明显的差异。结论灵武地区成人DM患病率与全国平均水平一致,但IGT患病率明显高于全国水平。     

广州市荔湾区10080例糖尿病患病情况调查

目的　了解广州市荔湾区居民糖尿病 (DM)的患病特点 ,探讨DM发病的危险因素。方法　 2 0 0 1年对 10 0 80例 2 5岁以上常住居民进行DM患病情况调查。标化患病率按照 2 0 0 0年全国人口构成计算。结果　DM和空腹血糖偏高 (IFG)患病粗率分别为 11 2 2 %和 17 2 8% ,标化患病率分别为 9 4 6 %和 15 88% ;DM和IFG患病率基本上呈随年龄递增趋势 ;肥胖组DM患病率比正常体重人群高 1 5 4倍 ;DM和IFG患者的高血压与高脂血症患病率高于血糖正常人群。结论　DM是该区居民的常见疾病 ;年龄增长、肥胖是糖尿病的重要危险因素 ;DM与高血压及高脂血症之间存在着内在关系。     

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。     

城市居民体重指数与糖尿病关系的研究

目的:分析南宁市城市居民体重指数(BMI)与糖尿病(DM)发病的关系.方法:对南宁市样本区随机抽取五个街道社区(居委会)810户,每户抽取年龄在35～74岁的居民1人,共810人.分别检测体重、BMI、餐后12 h空腹血糖(FPG);按DM糖耐量低减(IGT)诊断标准分别计算各组的患病率并对照比较.结果:DM患病率以65～74岁组最多,达14.56%;IGT患病率以55～64岁组最多,达16.28%;BMI肥胖组DM、IGT患病率均比正常体重组高,分别高出8.49%及14.48%;不同性别DM、IGT患病率比较差异无统计学意义(P>0.05).结论:南宁市城市居民DM与IGT的患病情况随年龄增长而逐渐升高,提示超体重和肥胖是糖尿病的重要危险因素之一;糖尿病及糖耐量低减在南宁市城市居民中已占有相当大的比例.     

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。     

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.     

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.     

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.     

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.