遵义市红花岗区213例0-6岁智力残疾儿童的调查分析

目的了解红花岗区0～6岁儿童智力残疾的患病情况及分布特征。方法用丹佛发育筛查测验及Gesell发育诊断量表进行智力筛查和智力残疾诊断。结果调查男109例，女104例，发现智力残疾3例，调查0-6岁儿童智力残疾现患率1．4％，城市低于郊区，男童低于女童。结论儿童智力残疾的防治重点在郊区农村地区，我省需结合世界发达国家及我国大城市的经验，建立自己的智力低下监测防治体系。     

广元地区0～6岁智力低下儿童的致残危险因素分析

目的 分析四川省广元地区0～6岁儿童智力低下的主要致残因素,为预防和降低MR发病率提供重要依据.方法 用丹佛智力筛查量表-DDST和韦氏儿童智力量表-CWYCSI,对广元地区的46839例儿童进行智力筛查和测试,对确诊为智力低下(MR)的儿童进行分析,探讨其致残原因.结果 广元地区0～6岁MR儿童的发病率为10.82‰,其中严重智力障碍发病为203例(4.33‰),轻度智力障碍发病为304例(6.49‰),高于文献报道的发达国家发病率(2‰～4‰).躯体因素中各种围生期因素(早产、窒息、缺血缺氧性脑病等)、重度脑瘫和社会心理因素占主要地位,相应比例为27.42%、22.29%和17.16%;农村和城市的病因分布存在显著差异(P＜0.01).多数农村儿童的双亲受教育水平低于同类的城市水平.结论 维生期因素是影响儿童智力发育的重要原因;宫内感染、出生后的脑部感染、脑损伤及营养不良等均可以独立影响到患儿的智力发育;父母文化水平的差异也是影响儿童智力发育的原因之一.     

甘肃省0-14岁儿童智力低下的现患率及分布特点

目的：了解甘肃省0-14岁儿童视力、听力、肢体、智力、精神残疾的现患率及其分布特征，重点考察智力低下儿童的现患率及分布特点。方法：2006-04-01／2006-05-31，采取分层、多阶段、整群概率比例抽样方法对13958名0-14岁儿童进行现况调查，使用丹佛发育筛查测验及Gesell发育诊断量表进行智力筛查和诊断。采用SPSS13.0软件对数据进行统计分析.结果：甘肃省0-14岁儿童智力低下现患率为8.96‰，农村现患率（9.66‰）高于城市（4.32‰），差异显著（X^2=5.17，P〈0.05）；男童（9.79‰）略高于女童（7.97‰），但差异不显著（X^2=1.307，P〉0.05）；0-8岁儿童智力低下（MR）现患率（10.84‰）明显高于9-14岁年龄组（7.24‰），差异显著（X^2=5.08，P〈0.05）.智力低下严重程度构成分别为轻度55.20％，中度23.20％，重度10.40％，极重度11.20％。结论：甘肃省儿童智力低下的防治应以轻度类型为主，重点放在农村地区。应努力创造条件，加强特殊教育，以降低轻度智力低下儿童现患率，提高人口素质。     

"治未病"学术思想对防控0～14岁智力低下儿童病因形成危险因素的护理措施

目的:研究"治未病"思想对防控0～14岁智力低下(MR)儿童病因形成危险因素的护理.方法:使用丹佛发育筛查测验及Gesell发育诊断量表进行智力筛查和诊断,进行logistic、Cox回归模型分析.结果:产后致病因素为63.58%,产前因素为27.78%,产时因素为8.64%.染色体异常是MR形成主要因素,产伤是城市MR形成的主要因素,产后窒息是农村MR形成的主要因素.母亲文化水平低、近亲结婚、家庭收入低、居住在农村是MR发生的影响因素.母孕期受精神刺激、家族中有五类残疾、出生窒息、出生低体重、在婴幼儿期患过癫痫、脑病等使MR发生风险增高.结论:从"未病养生"思想出发开展生殖健康教育;从"欲病救萌"思想出发开展遗传护理干预;从"已病早治"思想出发重视妇幼保健服务;从"瘥后调摄"思想出发建设救治康复体系.     

河南省18岁以上女性听力残疾抽样调查

目的:了解河南省18岁以上女性听力残疾流行病学状况,为制定防治和康复计划提供科学依据.方法:调查采取多阶段分层、定额抽样方法,利用SAS 9.1.3对第2次全国残疾人抽样调查河南省数据库资料进行分析.结果:河南省18岁以上女性听力残疾患病率为3.12%,其中一级占13.57%,二级占11.06%,三级占36.40%,四级占38.97%;城市现患率为1.27%,农村为3.50%,城乡之间差异有统计学意义(χ2=106.155,P<0.001).引起听力残疾的主要原因依次为:老年性聋(53.65%)、原因不明(20.18%)及中耳炎(9.81%).结论:农村18岁以上女性听力残疾现患率较高.老年性聋是首位致残原因.     

宁夏回族自治区智力残疾流行病学调查结果分析

目的了解宁夏地区自然人群智力残疾现患情况及其原因,为本地区有效预防和康复提供科学依据。方法采用抽样调查方法,用智商诊断工具和适应行为评定工具,调查自然人群智力残疾情况。结果智力残疾的现患率为5.60‰,男女无差别,农村明显高于城市,各年龄段现患率有统计学意义,0-14岁年龄组智力残疾的现患率最高(7.71‰)。致智力残疾的原因依次是脑部疾病、原因不明、遗传。结论三级预防是减少和减轻智力残疾的有效措施,对智力残疾儿童进行早干预和康复训练是最重要的三级预防措施。     

广州市海珠区成年人残疾现况分析

目的 了解广州市海珠区成年残疾人现状,为进一步研究残疾人生活质量提供参考。方法 采用整群随机抽样和机械抽样方法,共调查4760户,查出各类残疾人488人。结果总残疾现患率4．22％。男性残疾现患率5．45％,女性残疾现患率3．28％。两者差别有统计学意义(X^2=33．029,P=0．000)。从致残的年龄来看,0～10岁致残的人数最多,致残的可能性随着年龄增长而降低,但60～70岁致残的危险性略有回升。疾病为第一致残原因,意外伤害为第二,其次是先天因素。结论 积极防治慢性病,做好易致残人群的防护是预防青年和中年期残疾的重要措施。     

580例智力残疾患者病情评定及病因分析

目的:探讨智力残疾患者的致残原因,并做残疾程度评定;为智残患者预防、康复提供参考依据。方法:对580例智力残疾患者的资料进行回顾性分析。结果:智力残疾患者的致残原因依次为:脑疾病34.6%,原因不明29.8%,遗传15.2%,发育障碍6.0%,惊厥性疾病5.9%,创伤或意外伤害占5.5%,其他2.9%;各种致残原因导致三级残疾最多(36.0%),而创伤或意外伤害致一级残疾较多(34.4%);致残原因在各年龄分布上17~40岁较多。结论:针对脑疾病患者致残率上升的发病趋势,提出了新的思路,预防脑疾病性患者智力残疾,探讨偏远农牧区智残者的早期干预和社区康复,改善智残患者的生存质量,力争得到社会进一步支持和特殊教育是值得研究的问题。     

浙江残疾儿童浅析

1987年浙江省进行残疾人抽样调查,全省约有22万残疾儿童.智力残疾所占比重(68.03%)最大,视力残疾所占比重(1.86%)最小.城市约有1.12万残疾儿童,乡村约有20.41万.残疾等级中,重度与中、轻度之比为1:1.22,95.91%的残疾儿童具有学习能力,但其中33.19%没有能够上学.致残原因中,先天残疾占25.82%,后天致残占22.55%,发现残疾占51.63%.0~10岁儿童的现残率,随着年龄组提高呈上升趋势;男性与女性儿童的现残率无差别.     

河南省育龄期残疾妇女状况调查

目的:了解河南省育龄期残疾妇女现状并提出干预措施.方法:利用SAS 9.1.3对第2次全国残疾人抽样调查河南省数据库资料进行分析.结果:河南省育龄期妇女残疾现患率为3.44%,农业户口育龄期妇女残疾现患率高于非农业户口育龄期妇女(3.79%vs 1.81%;χ2=51.01,P<0.001).残疾妇女接受高中以下教育的受教育率低于非残疾妇女(60.23%vs 90.17%;χ2=912.2,P<0.001).残疾妇女就业率低于非残疾妇女(24.98%vs52.23%;χ2=112.4,P<0.001).育龄期残疾妇女再婚、离婚及丧偶率分别为3.04%、0.78%和1.86%,育龄期非残疾妇女分别为1.35%、0.39%和0.79%,两者比较差异有统计学意义(χ2=57.154,P<0.001).仅有29.97%的育龄期残疾妇女参加了社会保险,社会资源的实际享有情况远低于社会需求状况.结论:河南省育龄期残疾妇女现状不容乐观.     

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.