肇庆市巩固基本消灭麻风病的防治措施和效果

目的分析肇庆市麻风病基本消灭达标前后的流行情况,为制定麻风病防治策略提供科学依据。方法收集整理1956~2010年期间肇庆市麻风病综合防治报表等资料,以麻风病发现率、发病率、患病率等指标对巩固基本消灭麻风病采取的防治措施和效果进行分析,评价麻风病防治工作的成效。结果肇庆市基本消灭麻风病达标后年均发现率为0.16/10万、年均发病率0.14/10万、年均患病率0.35/10万,二级畸残率5.66%,儿童病例、病死率均大幅下降,平均病期缩短。结论肇庆市巩固基本消灭麻风病防治措施取得显著成效。     

300例麻风畸残统计分析

目的:了解麻风病畸残的影响因素,为预防、减少麻风畸残提供科学依据。方法:采用数理统计方法,回顾性分析1958～1995年麻风病共300例。结果:总致残率为32％;男女病人间的畸残32.1％与31.7％及病人各年龄组发生畸残无明显差异(P>0.05);多菌型与少菌型发生Ⅱ°和Ⅲ°畸型比多菌型多且严重(P>0.05);而病期长短却与畸型残率之间呈正比关系。结论:病期越长,畸残发生越多越重,提示了麻风病早发现早治疗对预防畸残发生的重要意义。     

深圳市宝安区基本消灭麻风病后13年发病情况

目的了解深圳市宝安区1996年麻风病基本消灭后的流行特征,为制订麻风病预防控制措施与方法提供科学依据。方法按人口平均数计算发现率、患病率,结合新发现病例的性别、确诊时年龄、病期、发现途径、菌型比、传染来源和畸残进行流行病学分析。结果1996～2008宝安区新发现麻风病人41例,年平均发现率0．15／10万;病人发现途径以皮肤科门诊接诊为主,发现38例,占92．68％。新发现病人87．8％是暂住,流动人口;新发现病人中多菌型与少菌型比值2．73：1;2年以内早期病例25例,占60．98％;Ⅱ级畸残率24．39％;工人患者31例,占75．61％。结论宝安区在麻风低流行状态下,应重点加强暂住人口的麻风病防治,尤其是工厂工人的麻风病防治。皮肤科门诊和工厂用工体检发现麻风病人,是目前人口结构特殊条件下最为经济可行的发现途径。     

1949-2016年中山市麻风病流行病学特征分析

目的 通过探讨1949-2016年中山市麻风病的流行病学特征分析,为更好地制定预防控制麻风病的策略和措施提供科学依据.方法 收集1949-2016年登记于全国麻风病信息管理系统(LEPMIS)的中山市辖区的所有麻风病患者1 560例.分析其流行病学特征,并采用X2检验和非条件的logistic回归分析方法分析麻风病患者发生畸残的影响因素.结果 10年平均发病率以1961-1970年最高,1970年后年平均发病率呈下降趋势.1980年以后,年平均发病率下降到5/10万以下;1990年以后下降到1/10万以下.麻风病发生畸残因素分析延迟期>2年(晚期病例)是延迟期≤2年(早期病例)发生麻风畸残的2.85倍(P<0.001).结论 20世纪80年代后中山市麻风病疫情得到了较好的控制;麻风病发生畸残的主要影响因素为麻风病发现的延迟期.     

西双版纳州2001～2005年麻风新发现病例分析

目的 分析西双版纳州近5年新发现患者的情况,进一步指导麻风防治工作的深入开展.方法 对2001～2005年新发现麻风疫情资料进行统计.结果 新发现麻风患者129例,其中临床多菌型75例,少菌型54例,型率为58.14%;男79例,女50例;皮肤涂片阳性95例(73.64%);Ⅱ级畸残17例(13.18%);儿童麻风比例为1.55%;主动发现38例(29.46%),被动发现91例(70.54%);病期在2年以内的81例(62.79%),2005年患病率为0.5/万;近5年发病率为0.72/10万.结论 西双版纳州麻风病疫情与1996～2000年段相比有所回升,流行尚未全面控制,仍有较多的传染源潜伏在人群中尚未发现,目前面临的形势依然十分严峻,麻风病防治工作任重而道远.     

北海市1956～2000年麻风病流行趋势分析

目的：分析北海市1956～2000年麻风病流行趋势．揭示麻风流行特征。方法：根据全市1956～2000年麻风患登记表，分析麻风病流行趋势。结果：北海市的麻风平均发病率和发现率分别由1956～1960年的21．05／10万和39．81／10万下降到1996～2000年的0．29／10万和0．23／10万；平均患病率从最高的1961～1965年的1．72‰下降到1996～2000年的0．003‰。普查发现患比例明显地随年代下降，皮肤专科门诊就诊发现成为麻风的主要发现方式。结论：北海市达到基本消灭麻风的目标；今后应认识到鼓励各级医院皮肤科医生参与麻风防治并加强对其进行麻风知识培训的重要性。     

麻风病基本消灭阶段新发现病例分析

目的 探讨麻风病基本消灭后的流行病学特征，以指导麻风病防治。方法 采用回顾性调查的方法对广东省湛江市基本消灭麻风病后的1997-2004年新发现病例进行分析。结果 全市新发现病例186例，年均发现率为0．274／10万，以门诊等被动发现为主。少年儿童发病占新发现病人数的6．99％，未见明显下降。发病年龄显著增高，传染源不明者增多以及多菌型病人所占比例逐年升高是主要的流行特点。病期缩短，Ⅱ级畸残率下降。结论 麻风病高流行区已达到基本消灭麻风病后，应根据其流行病学特征采取相应的防治对策，以确保达标后的防治成果。     

电白县麻风病流行病学分析

目的分析麻风病流行病学特点,为麻风病防治提供依据。方法对1955年以来现存资料中麻风病流行病学各项内容进行回顾整理作统计学分析。结果共登记2642例,分布在沿海15个镇占84．78％,其他11镇占15．22％,男女之比为2．91：1,0～14岁占16．12％;15～59岁占68．05％;60岁以上占15．82％。患病总型比为29．06％,逐年上升;总平均发病率为8．06／10万,患病率为0．67％,发现率为7．07／10万,呈逐年下降趋势。2003年底患病率为0．0059‰,近五年发病率为0．15／10万,平均延迟期逐年缩短。最长为1955年段4．3年,最短为2000年段0．5年。新发畸残占27．02％,逐年下降。复发率为1．61％,以MB及DDS单疗病例为主。结论麻风病流行与环境因素和易感机体有关,青壮年男性是主要易感人群,电白县麻风病已呈低流行状态,达到基本消灭麻风病指标。     

连云港市1997-2014年麻风病流行现状分析

目的通过对连云港市1997-2014年近18年麻风病流行现状进行分析,为制定现阶段麻风病防治措施提供科学依据。方法统计发现率、患病率,结合新发现病例性别、确诊时年龄、病期、发现方式、型比、传染源和畸残率,运用描述流行病学方法进行分析。结果连云港市麻风病病例分布于全市4区3县,其中灌云最多。发病男性多于女性,男女比为3.29∶1;发病职业主要为农民,占95.56%(86/90);最大年龄84岁、最小17岁,平均45.83岁,以30~44岁组发病较多,占41.11%(37/90);家内传染是较常见的传染来源,占28.89%(26/90);多菌型与少菌型比值为10.13∶1;皮肤科门诊发现的占60.00%(54/90)。结论连云港市麻风病处于低流行状态,提倡主动、被动发现方式相结合,以期早期发现,及时治疗,控制传染源。     

广东省1990～2004年新发现麻风病例的流行病学分析及防治策略探讨

目的 分析15年广东省麻风病的流行特征,并探讨低流行状态下的防治策略.方法 对1990～2004年间广东省近15年的新发现病例的流行病学特征进行分析.结果 15年麻风病的发现率和患病率明显下降,并保持在较低的水平,病例的早期（诊断延迟期≤2年）发现比率为73.82%,发病到确诊的平均延迟期为27.6个月,Ⅱ级畸残率为17.60%,早期发现的病例其Ⅱ级畸残率明显低于延迟期〉2年的畸残率（P〈0.001）,城乡的病例数明显高于城市的病例数（P〈0.001）,门诊发现的病例约占3/4.结论 经过近50多年的综合防治,我省的麻风病已处于低流行状态,98.00%的地区已达到基本消灭的指标.但局部地区尤其是边远地区是当前新发病例较集中的地区,防治工作力度丝毫不可放松,当前防治策略应把工作重点放在边远地区,加强培训和宣传,着重提高早期发现病人,以控制传播和降低畸残率.     

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.     

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.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.