上海市嘉定区1996—2016年结直肠癌流行规律分析

目的 探讨上海市嘉定区结直肠癌流行趋势与时空特征,为结直肠癌防控措施以及卫生资源合理分配提供依据。方法 收集上海市1996-2016年嘉定区结直肠癌发病数据,计算标化发病率,采用时空扫描统计分析结直肠癌发病的空间聚集性。结果 1996-2016年上海市嘉定区共报告大肠癌4 279例,发病率为36.2/10万,标化发病率为16.4/10万。结肠癌占58.0%,标化发病率总体呈上升趋势,并伴有波动性。直肠癌发病例数与标化发病率低于结肠癌,占42.0%。男性结肠癌和直肠癌标化发病率普遍高于女性,且结肠癌与直肠癌的分街道标化发病率存在明显差异。空间扫描统计检测到1个聚集群,并有2个群集的结肠癌和1个群集的直肠癌年龄别分布在统计上显著不同于圆外的其余区域。结论 上海市嘉定区结直肠癌发病总体呈上升趋势,且其发病可能存在空间聚集性趋势,本研究结果能为结直肠癌防控与资源分配提供参考。     

浙江省嘉善县三十年肺癌发病趋势研究

目的: 了解浙江省嘉善县1987-2016年肺癌发生情况及变化趋势,并预测2017-2019年的发病情况,为肺癌防治提供科学依据。方法: 利用嘉善县肿瘤登记报告系统中1987-2016年肺癌患者的资料,计算肺癌粗发病率、中国人口标准化发病率（中标率）和世界人口标准化发病率（世标率）,用年度变化百分比（APC）评估发病率的时间变化趋势,并用时间序列分析方法中的ARIMA模型预测2017-2019年肺癌的发病率。结果: 1987-2016年嘉善县肺癌新发病例6103例,粗发病率为53.77/10万,中标率和世标率分别为25.24/10万和34.15/10万,男性（粗发病率为78.30/10万,中标率为34.77/10万,世标率为51.87/10万）高于女性（粗发病率为29.15/10万,中标率为14.31/10万,世标率为17.99/10万）。1987-2016年嘉善县肺癌发病率呈上升趋势,从1987年的27.58/10万上升到2016年的111.24/10万,APC为5.28%。ARIMA模型预测2017、2018、2019年发病率分别为135.64/10万、145.97/10万和152.63/10万,其中2017年发病率预测值与实际值（135.95/10万）较吻合。结论: 1987-2016年浙江省嘉善县肺癌发病率呈上升趋势,预计2017-2019年肺癌发病率会进一步上升。     

2013年招远市恶性肿瘤发病和死亡分析

目的探讨招远市恶性肿瘤发病与死亡流行特征,为恶性肿瘤的防治工作提供科学依据。方法发病和死亡数据来源于山东慢性病监测信息系统,采用Excel 2010、SAS 9.2等软件进行数据分析,计算粗发病率、粗死亡率、标化率等指标。结果 2013年招远市恶性肿瘤粗发病率为373.94/10万,中标率为206.35/10万,世标率为201.52/10万,男女比为1.41:1。恶性肿瘤发病第1位的是肺癌,其次依次为胃癌、肝癌、结直肠癌和乳腺癌,前10位恶性肿瘤占全部恶性肿瘤的82.8%。随着年龄的增加,发病率呈现上升趋势,从35~岁年龄组开始,发病率增加幅度越来越大,到80~岁年龄组发病率最高。恶性肿瘤粗死亡率260.53/10万,标化死亡率101.34/10万,死亡率男性高于女性;死亡顺位前5位依次为肺癌、胃癌、肝癌、结直肠癌和食管癌。结论招远市恶性肿瘤发病率和死亡率高于全国平均水平,肺癌、胃癌是威胁招远市居民健康的主要恶性肿瘤。加强危险因素研究,开展早诊早治,仍将是今后恶性肿瘤防治的重点。     

辽宁省鞍山市2005—2014年城区恶性肿瘤发病分析

目的 分析鞍山市城区2005—2014年恶性肿瘤的发病趋势及分布情况,为更好的防治恶性肿瘤提供科学依据。方法 收集鞍山市肿瘤登记处2005—2014年的恶性肿瘤发病资料,计算恶性肿瘤发病率、标化发病率、年龄别发病率和构成比等指标。标化率采用2000年全国人口普查标准人口年龄构成和Segi′s世界标准人口年龄构成为标准。结果 2005—2014年,鞍山城区恶性肿瘤粗发病率整体呈缓慢上升趋势,而世标率2008年之前呈缓慢上升,2008年以后呈缓慢下降趋势。2005—2014年鞍山城区恶性肿瘤发病率为324.1/10万,中标率为198.0/10万,世标率为192.0/10万,截缩率(35~64岁)为214.9/10万,累积率为（0~74岁）21.6%。男性发病率高于女性（男性为339.0/10万,女性为309.4/10万）。恶性肿瘤发病率随着年龄增加而上升,35岁之前处于较低水平,35岁之后上升较快,60岁之后上升更快;男、女发病率均在80~84岁组达到高峰,85岁之后有所下降。男性恶性肿瘤发病前5位为肺、结直肠、肝、胃、膀胱,占全部恶性肿瘤68.0%。女性恶性肿瘤发病前5位为乳腺、肺、结直肠、子宫颈、肝,占全部恶性肿瘤的65.6%。结论 2005—2014年恶性肿瘤发病率总体呈上升趋势,肺癌、结直肠癌、乳腺癌等是今后工作防控重点。     

2018年河南省结直肠癌流行现状及2010～2018年流行趋势分析

目的:分析河南省2018年结直肠癌流行现状及2010～2018年流行趋势。方法:收集河南省肿瘤登记数据库中的结直肠癌发病及死亡数据,结合户籍人口数据,计算2018年河南省结直肠癌发病率、死亡率,分别采用2000年全国普查的标准人口和Segi′s世界标准人口进行标化。分析2010～2018年河南省结直肠癌中标发病率/死亡率的平均年度变化百分比(AAPC)。结果:2018年河南省结直肠癌中标发病率为14.32/10万,中标死亡率为6.39/10万,均略低于全国平均水平。中标发病率和死亡率均为城市(16.88/10万、7.02/10万)高于农村(13.14/10万、6.10/10万),男性(15.80/10万、7.31/10万)高于女性(12.89/10万、5.53/10万),随年龄增加而上升。2010～2018年,河南省结直肠癌中标发病率/死亡率整体呈平稳趋势,但城市地区男性中标发病率呈上升趋势,AAPC(95%CI)为2.8%(0.3%～5.4%)。结论:河南省结直肠癌发病率与死亡率均未出现下降趋势,应进一步提高结直肠癌的早诊早治及精准干预水平。     

2009-2013年苏州20岁及以上居民冠心病发病率变化趋势及类型分析

目的 分析2009-2013年苏州20岁及以上居民冠心病发病率变化趋势及其类型,为本地的冠心病防治工作提供参考依据。方法 收集苏州市公共卫生监测系统2009-2013年慢性病监测数据库和年度报表资料,按年度、性别、年龄计算冠心病粗发病率和标化发病率。以2009-2013年的各年度累计新发病例数与累计人口数之比计算平均发病率。结果 2009-2013年苏州20岁及以上居民冠心病平均粗发病率为171.2/10万（46 334/27 061 706）,平均标化发病率为118.8/10万;男性冠心病平均粗发病率和平均标化发病率分别为194.1/10万（25 726/13 256 950）和137.8/10万;女性冠心病平均粗发病率和平均标化发病率分别为149.3/10万（20 608/13 804 757）和100.1/10万。男性冠心病平均粗发病率和平均标化发病率均高于女性（χ2=793.20、151 423.46,P＜0.01）。2009-2013年苏州20岁及以上男性、女性冠心病粗发病率和标化发病率均呈上升趋势（P＜0.001）;男性和女性粗发病率年平均增长速度分别为5.18%和7.06%,标化发病率年平均增长速度分别为2.17%和5.35%;女性标化发病率年平均增长速度高于男性（χ2=57.31,P＜0.01）。随着年龄的增长,冠心病发病率呈上升趋势（P＜0.001）;20~49岁居民冠心病发病率年平均增长速度为6.37%;2009-2013年60岁及以上老年人冠心病新发病例占累计新发病例总数的83.5%（38 697/46 334）。冠心病发病类型以心绞痛（57.2%,7 845/13 704）和急性心肌梗死（38.7%,5 302/13 704）为主;冠心病猝死构成比年平均增长速度为6.12%。结论 2009-2013年苏州20岁及以上居民冠心病发病率随年龄增长而增加,冠心病类型主要为心绞痛和急性心肌梗死,发病年龄年轻化,老年人和女性发病率较高值得关注。     

江苏省大丰市1999至2007年恶性肿瘤发病趋势

目的 了解大丰市恶性肿瘤发病流行特征,并为该市的恶性肿瘤流行趋势的评价和恶性肿瘤综合防治规划执行效果的评估提供科学依据.方法 对大丰市1999至2007年恶性肿瘤发病资料进行统计分析,计算粗发病率和标化发病率,分析恶性肿瘤的发病趋势.结果 1999至2007年大丰市恶性肿瘤粗发病率为244.99/10万,标化发病率为175.48/10万.男性粗发病率299.22/10万,标化发病率214.41/10万;女性粗发病率190.92/10万,标化发病率137.34/10万.男性粗发病率和标化发病率分别是女性的1.57倍和1.76倍.男性前10位恶性肿瘤分别是胃癌、肝癌、食管癌、肺癌、直肠癌、胰腺癌、脑肿瘤、膀胱癌、骨癌和白血病;女性前10位恶性肿瘤分别是食管癌、胃癌、肺癌、肝癌、乳腺癌、宫颈癌、宫体癌、脑肿瘤、直肠癌和胰腺癌.结论 9年来大丰市恶性肿瘤仍有上升趋势,肺癌上升较为明显,呼吸系统和消化系统恶性肿瘤是大丰市当前肿瘤防治的重点.     

大连市旅顺口区1991-2010年恶性肿瘤患者的发病趋势分析

目的：分析大连市旅顺口区1991-2010年恶性肿瘤患者的发病趋势,为肿瘤防制提供科学依据。方法：对大连市旅顺口区疾病预防控制中心收集的本辖区1991-2010年户籍人口中恶性肿瘤新发病例进行世界标准人口标化发病率及病例数加权基础上的年度变化百分比（APC）计算。结果：1991~2010年间,男性所有部位恶性肿瘤患者世界人口标化发病率由199.1/10万上升至244.0/10万,女性由156.0/10万上升至225.0/10万,差异均有统计学意义。男性直肠癌和膀胱癌患者均呈显著上升趋势,肺癌和肝癌患者的发病率变化不大,胃癌患者的发病率有所下降。女性肺癌患者的发病呈上升趋势,乳腺癌和甲状腺癌患者呈显著上升趋势,胃癌和肝癌患者的发病率有所下降。结论：男性直肠癌、膀胱癌和女性肺癌、乳腺癌、甲状腺癌患者的发病呈上升趋势与人口老龄化、不良生活方式等危险因素的共同作用有关,恶性肿瘤已成为旅顺口区的主要公共卫生问题。     

结直肠癌临床研究进展

结直肠癌是最常见的消化道肿瘤之一 ,发病率和死亡率呈上升趋势 ,而早期诊断和根治办法尚未有突破性的进展 ,故此 ,许多国家 ,特别是西方国家 ,仍然把结直肠癌作为重点癌瘤进行研究。现将有关临床研究进展简述如下。1　临床流行病学1 1　发病率和死亡率　全世界结肠癌平均发病率 ,男性为 16 6 /10万 ,女性为 14 7/10万 ;直肠癌平均发病率 ,男性为 11 9/10万 ,女性为 7 7/10万。但是地域分布差异性很明显 ,高发区如北美、西欧、澳大利亚和新西兰 ;中发地区如东欧、南欧、拉丁美洲 ;低发地区如非洲、亚洲和南美洲。结直肠癌高、低发区的发病…     

深圳市罗湖区2001—2015年居民鼻咽癌发病趋势

目的 分析2001—2015年深圳市罗湖区常住居民鼻咽癌发病情况,为鼻咽癌防控提供依据。方法 利用2001—2015年深圳市罗湖区鼻咽癌监测数据,计算粗发病率、标化发病率、累积率、截缩率等,并对发病率进行趋势分析。结果 2001—2015年深圳市罗湖区鼻咽癌粗发病率为6.20/10万,中标发病率为7.95/10万,世标发病率为7.57/10万,累积率为0.87%,截缩率为17.02/10万。男性发病率明显高于女性（P<0.05）,发病平均年龄为（48.34±12.70）岁,以65~<70岁年龄组最高,70岁以后开始下降。鼻咽癌粗发病率呈上升趋势（APC=4.20%,P<0.05）,中标发病率和世标发病率变化不明显（P>0.05）。40~<45岁年龄组鼻咽癌发病率呈上升趋势（APC=5.23%,P<0.05）,其余各年龄组发病趋势变化不明显（P>0.05）。结论 深圳市罗湖区鼻咽癌发病率高,2001—2015年粗发病率呈上升趋势,提示鼻咽癌仍是我区癌症防控的重点,建议开展针对性的早诊早治工作。     

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.