不良生活习惯对新疆公务员生存质量的影响研究

目的探讨不良生活习惯对新疆公务员生存质量的影响。方法采用与健康有关的生存质量测量量表(SF-36量表)和自制的生活习惯问卷对2 695名新疆公务员进行调查。结果新疆2 695名公务员中生存质量标准化总分低于60分的人数占18.33%。单因素分析显示,不同吸烟、饮酒、早餐、睡眠时间、身体锻炼、交通、工作应酬、伏案工作/操作电脑工作和环境污染等情况的新疆公务员,其生存质量低的比例间差异有统计学意义(P<0.05)。多因素分析显示,影响新疆公务员生存质量的不良生活习惯有吸烟[OR=1.395,95%CI(1.096,1.775)]、饮酒[OR=0.541,95%CI(0.425,0.687)]、乘用交通工具[OR=1.741,95%CI(1.372,2.211)]、不吃早餐[OR=0.303,95%CI(0.180,0.512)]、睡眠时间不足[OR=0.515,95%CI(0.434,0.611)]、工作应酬多[OR=1.493,95%CI(1.277,1.746)]和身体锻炼少[OR=0.758,95%CI(0.650,0.884)]。结论新疆公务员生存质量低与吸烟、乘坐交通工具多、不吃早餐、睡眠时间不足、工作应酬多和身体锻炼不足有关。     

维吾尔族中年妇女胆结石患者的饮食因素及生化指标的对比研究

目的:探讨饮食因素、血清生化指标改变与维吾尔族中年妇女胆结石发病的关系.方法:采用1:1配对病例对照研究方法,对90例维吾尔族中年妇女胆结石患者和对照组进行了饮食因素的调查分析和生化指标的检测分析.结果:病例组与对照组饮食因素相比:畜禽肉类、动物油摄入过多(p＜0.05),而蛋类、鱼类、奶类、豆类、蔬菜类、水果类摄入不足(p＜0.05).血清TP、ALB指标病例组低于对照组(p＜0.05),而ALT、AST、γ-GT、ALP、TBIL、DBIL、CH、HDL-C、LDL-C病例组高于对照组(p＜0.05).结论:饮食因素和生化指标与胆结石的发生有关.     

Study on risk factors for the recurrence of cholecystolithiasis after surger

目的 探讨胆总管结石术后复发的危险因素,为胆总管结石术后复发的防治提供参考.方法 对190例胆总管结石手术患者的临床资料进行回顾性分析,对术后复发的相关危险因素进行Logistic回归分析,筛选胆总管结石术后复发的相关危险因素.结果 本组190例胆总管结石患者行EST手术治疗后,经2～5年随访有42例(22.1％)复发.单因素分析结果显示,年龄、结石数量、结石大小、胆石症家族史、缺乏运动、油腻饮食与术后复发有关;多因素Logistic回归法分析表明,结石≥10枚、结石＜8mm、有胆石症家族史、油腻饮食是胆总管结石术后复发的危险因素.结论 术前要对上述危险因素加以重点评估,在考虑手术的同时还要考虑上述危险因素,这样可以降低胆总管结石术后复发率.     

肝衰竭患者发生急性胰腺炎的危险因素分析

目的 探讨肝衰竭患者发生急性胰腺炎(AP)的危险因素.方法 回顾性分析成都医学院第一附属医院2009年6月至2013年6月收治的140例肝衰竭患者的临床资料,通过x2检验分别比较在不同情况下肝衰竭AP发病率的差异,经单因素分析后选取P＜0.05的因素进行多因素Logistic回归分析.结果 单因素分析显示,呕吐症状、直接胆红素/总胆红素(CB/TB)、血清钠、血脂、胆石症、并发症个数、糖皮质激素、人工肝治疗存在统计学差畀(P＜0.05),多因素Logistic回归分析显示,呕吐症状、胆石症、并发症个数、糖皮质激素差异有统计学意义(P＜0.05).结论 呕吐症状、胆石症、并发症个数、应用糖皮质激素是肝衰竭患者发生AP的危险因素.     

胆道感染性休克并发多器官衰竭高危因素分析

目的探讨胆道感染性休克后并发多器官衰竭的高危因素.方法对35例严重胆道感染住院患者进行总结分析.结果外科手术治疗胆石症并急性胆管炎22例、胆道蛔虫并急性化脓性胆囊炎1例,治愈18例,死亡4例.内科治疗12例,治愈8例,死亡4例(均为胆石症并感染患者).总治愈率77.2%,死亡率22.8%.结论胆道感染性休克易并发多器官衰竭(MOF),其高发因素主要与休克时间的长短、治疗方法的选择、患者年龄以及有否心衰等关系密切.     

胆总管结石术后复发的相关因素分析

目的探讨胆总管结石术后复发的危险因素,为胆总管结石术后复发的防治提供参考。方法对190例胆总管结石手术患者的临床资料进行回顾性分析,对术后复发的相关危险因素进行Logistic回归分析,筛选胆总管结石术后复发的相关危险因素。结果本组190例胆总管结石患者行EST手术治疗后,经2～5年随访有42例(22.1%)复发。单因素分析结果显示,年龄、结石数量、结石大小、胆石症家族史、缺乏运动、油腻饮食与术后复发有关;多因素Logistic回归法分析表明,结石≥10枚、结石<8 mm、有胆石症家族史、油腻饮食是胆总管结石术后复发的危险因素。结论术前要对上述危险因素加以重点评估,在考虑手术的同时还要考虑上述危险因素,这样可以降低胆总管结石术后复发率。     

机动车驾驶员心理障碍危险因素的病例对照研究

目的筛选与机动车驾驶员相关的危险因素,预防心理障碍,减少交通事故.方法采用1:1病例对照研究方法,对机动车驾驶员进行问卷调查和SCL-90测度分析,运用Logistic回归进行单因素和多因素分析.结果单因素分析筛选出对心理障碍发生有统计学意义的因素18项(P＜0.05),多因素分析10项因素(OR>1.5,P＜0.05)进入回归模型.3项因素(OR＞2.3,P＜0.001)为主要危险因素.结论社会生活事件、不良生活习惯、业余活动方式、婚姻状况、文化程度、经济收入、驾驶车型、烦恼时的倾诉方式、社会交往可能为机动车驾驶员心理障碍的主要危险因素.     

远航舰艇官兵下腰痛发病情况及影响因素分析

目的 调查远航舰艇官兵下腰痛发生情况,分析影响因素,为其防治提供理论依据。方法 选择2018年4月至2021年7月参加亚丁湾国际联合护航的海军舰艇官兵作为研究对象,采用问卷调查下腰痛的发生情况。按照是否下腰痛分为下腰痛组与对照组,调查2组人员一般情况以及下腰痛发病情况、影响因素等,通过单因素及多因素Logistic回归分析远航舰艇官兵下腰痛的独立影响因素。结果 678例调查对象中,下腰痛336例,发生率49.56%。单因素Logistic分析显示,下腰痛组全身振动、每周锻炼次数、工作姿势、睡眠状况、是否吸烟与对照组比较差异有统计学意义（P<0.05）;多因素Logistic回归分析显示,每周锻炼≤1次、全身振动、固定姿势是远航舰艇官兵下腰痛发生的独立影响因素（P<0.01）。结论 远航舰艇官兵下腰痛发生率较高,每周锻炼≤1次、工作点位涉及全身振动、固定姿势均会增加下腰痛发生的风险。     

体质因素对代谢综合征影响的回归分析

目的 考察中医体质类型对代谢综合征患者发病的影响，为代谢综合征的体质筛查及预防研究提供依据。方法 采用病例-对照研究方法，以60例代谢综合征患者为研究对象，以60例健康体检者为正常对照。以单因素logistic回归分析、多因素logistic回归分析探讨性别、年龄、家族史、职业、文化程度、吸烟、饮酒、嗜肥甘厚味、运动锻炼、精神紧张、体质类型等自变量与代谢综合征的相关性，分析体质因素的作用规律。结果 单因素Logistic回归分析：自变量痰湿质（OR=23.727，95%CI=8.223-68.461）、阴虚质（OR=5.515，95%CI=2.185-13.925）、气郁质（OR=3.574，95%CI=1.374-9.299）OR值大于1，被选入模型。多因素logistic回归分析：痰湿质、饮酒与代谢综合征关联性极高，对应的比数比分别为：20.016、19.834。积极的运动锻炼与代谢综合征的发病成显著性负相关，比数-38.115。 结论 痰湿质、阴虚质、气郁质是代谢综合征主要体质相关因素；吸烟、饮酒、嗜肥甘厚味、精神紧张、家族史与代谢综合征患者呈正相关，是代谢综合征发病的危险因素；运动锻炼与代谢综合征呈负相关性。     

宁海地区体检人群胆石症患病率及相关因素调查分析

目的调查宁海地区健康体检人群胆石症的患病率并分析其相关因素。方法对2376例健康体检人员进行超声及相关生化检查,并进行相关因素调查分析,了解胆石症的患病率及相关因素。结果胆石症患病率为8．2％,胆石症的发生与高龄、吸烟、高血压及胆石症病史、BMI、TC、TG、ALT、LDL-C等因素密切相关。结论宁海地区胆石症患病率较高,与高龄、吸烟、高血压及胆石症病史、BMI、TC、TG、ALT、LDL-C等因素有关,了解其发病相关因素,对于该病的预防和早期干预具有重要意义。     

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.