徐州矿务集团尘肺患者死亡状况调查分析

目的调查尘肺发病状况，探讨分析尘肺发生、发展及死亡规律。评价徐州矿务集团40余年来的尘肺病控制工作效果，为有效防治尘肺提供科学依据。方法回顾性分析徐州矿务集团2005年底前诊断的3291例尘肺病患者资料。结果死因构成居前4位的是：尘肺、肺结核、慢性肺心病、肺癌；1990年开始，死因构成顺序变化为尘肺、慢性肺心病、肺癌、脑血管意外，肺结核已不再是导致尘肺患者死亡的主要因素；死亡尘肺病例累计死亡百分比变化与接尘工龄长短有关，接尘工龄5～20年间累计死亡百分比呈快速直线上升；死亡尘肺病例中不同接尘工种之间平均死亡年龄、发病工龄有显著性差异（P〈0．01），纯掘进工、纯采煤工尘肺患者的平均死亡年龄和发病工龄短于其他接尘工种；20世纪70年代以后，尘肺患者死亡年龄和病程呈延长趋势；尘肺的晋期率逐步下降，晋期时间明显延长。结论该集团尘肺控治措施取得了较明显的效果。     

48例煤工尘肺肺心病并发肺部感染临床分析

为了探讨煤工尘肺肺心病（以下简称尘肺肺心病）并发肺部感染的临床特点，对我院48例住院患者分析如下。fiB床资料1．回一般资料48例均为男性，年龄47～76岁，平均63．9岁，接尘史3～45年，平均23．卫年，l期尘肺12例，1期25例，皿期11例。肺心病根据1977年全国第二次肺心病专业会议修订的诊断标准确诊。1．2Iw床症状与体征气急咳嗽较前加重48例（100．0％），痰量增多或痰色变黄45例（93．8％），心悸胸闷39例（sl．3％），发热19例（39．6％），痰中带血3例（6．25％），胸痛7例（14．8％），紫纣44例（91．7％）。肺部可闻及于性罗音25…     

煤工尘肺合并肺癌流行病学调查

为探讨煤工尘肺与肺癌的关系,调查了１９６３年来煤工尘肺７１７例,结果显示,肺癌发病年龄平均６５．４岁,尘肺首次诊断至合并肺癌１０年以下为多（５２．３８％）;尘肺期别,接尘工龄,接尘性质与肺癌合并率之间差别均无显著性意义（Ｐ〉０．０５）;煤工尘肺合并肺癌的危险性较对照组高１．７１－１８．７９倍,提示煤工尘肺发生肺癌的危险性与粉尘游离ＳｉＯ２含量无明显的关系,与期别不成正比,吸烟对煤工尘肺合并肺癌可有     

肺心病并呼吸系统感染412例临床分析

肺心病并呼吸系统感染４１２例临床分析广州市越秀区第一人民医院（５１００３０）张幼石慢性肺源性心脏病（肺心病）常因呼吸系统感染而使病情迅速加重，并发症多，死亡率高．现收集我院１９９２年７月～１９９５年１月间收治的肺心病并呼吸系统感染病人４１２例进行临床...     

轩岗煤电集团有限责任公司尘肺病死亡原因分析

目的:分析轩岗煤电集团有限责任公司尘肺病死亡原因。方法:对公司267例尘肺死亡病例分别按期别、工种、接尘工龄、年龄和死亡病因进行统计分析。结果:Ⅱ期尘肺合并肺结核、纯掘进工、接尘工龄为21a～30a组和年龄为61岁～70岁组的尘肺病例死亡率最高,尘肺病合并肺心病和肺结核为主要死亡原因。结论:加强职业卫生防护,降低作业场所粉尘浓度,早期诊断和治疗尘肺病例,积极预防并发症的发生是提高尘肺病患者寿命及生存质量的主要措施。     

热电厂工人接尘剂量与尘肺发病关系的探讨

为研究热电厂接尘工人接尘剂量与尘肺发病的关系，根据某热电厂接尘工人接尘时间、肺总通气量及车间的粉尘浓度和游离ＳｉＯ２含量，计算职工肺内石英负荷量，然后采用累积剂量患病率寿命表法研究尘肺患病率与粉尘剂量反应关系，推算该类粉尘的容许浓度。结果：接尘剂量与尘肺患病率呈显著正相关关系（ｒ＝０．９２３，Ｐ＜０．００５），并推算出其直线回归方程为Ｙ＝－４５．４０４４＋１１．０１０１２Ｘ。提示：如果要求每人平均工作３０ａ，且尘肺患病率低于０５％，则接触煤粉（ｃｏａｌｄｕｓｔ）者和接触灰粉（ｆｌｙａｓｈ）者作业场所平均粉尘浓度分别应控制在１０００ｍｇ／ｍ３和３２５ｍｇ／ｍ３以下。     

慢性肺心病合并神经精神症状48例分析

目的：慢性肺心病呼吸衰竭导致缺氧和二氧化碳潴留所引起的神经精神症状，为慢性肺心病晚期严重的并发症之一，病死率甚高。方法：本组对48例慢性肺心病合并神经精神症状分析，48例病人均作动脉血气分析，同时测静脉血电解质。结果：48例病人给予有效抗炎治疗，畅通呼吸道，纠正缺氧和二氧化碳潴留以及酸碱失衡和电解质紊乱，降低肺动脉压力等支持治疗．有34例（70．84％）患者病情缓解或临床治愈，14例患者因病情危重抢救无效而死亡（29．17％）。结论：通过对48例慢性肺心病合并神经精神症状分析，使过去错误诊断为肺性及病的病人得到正确诊断、治疗，提高了肺心病的好转率和治愈率，降低了肺心病患者的死亡率。     

煤工尘肺合并肺癌流行病学调查

目的探讨煤矿工人吸烟与尘肺、肺癌的关系。方法对1964年以来确诊的煤工尘肺例进行回顾性流调。结果肺癌发病年龄平均65．4岁；尘肺首次诊断至合并肺癌10年以下为多（65．25％）；尘肺期别、接尘工龄、性质与肺癌合并率之间差别均无统计学意义（P〉0.05）；煤工尘肺合并肺癌的危险性较对照组高1．71～18．79倍。结论吸烟对煤工尘肺合并肺癌可能有协同作用。     

肺心病并高钠血症的探讨

回顾性分析了近１０年来收治的８１１例肺心病患者１６６６例次检测中血清电解质紊乱情况，高钠血症发生率（８．０４％），较低钠（３０．６７％），低氯（１９．３８％），低钾９．０％）和高钾（９．７２％）为低，但大多病情危害，死亡率高，应引起临床重视，同时探讨了引起高血钠的原因，指同支气管－肺感染是肺心病合并高钠血症的最主要原因。     

687例开滦煤矿新发尘肺患者特点分析

目的：探讨开滦煤矿接尘职工新发尘肺特点,了解煤矿接尘职工中尘肺患者检出情况,依据接尘工龄、发病工龄做好接尘职工的普查工作,进行早期临床干预。方法：对2005年1月～2010年12月开滦职业病防治所尘肺诊断组新诊断的687例尘肺患者的检出率、构成比、接尘工龄、发病年龄、发病工龄等方面进行回顾性分析。结果：尘肺患者检出率为1.83%;接尘工龄超过20年的尘肺患者占尘肺患者总数的72.20%;尘肺发病人数随接尘工龄延长而增多,在所有新发尘肺职工中Ⅰ期尘肺患者最多,占尘肺患者总数的95.77%。新发尘肺患者的发病人数以51～60岁年龄段最多,发病年龄在41～50、61～70岁和超过70岁年龄段与51～60岁年龄段比较,差异均有高度统计学意义（均P〈0.001）。掘进作业人员的发病工龄与采煤作业人员在防护措施相同的情况下发病工龄明显缩短,差异有高度统计学意义（P〈0.001）。结论：新发尘肺患者中以Ⅰ期尘肺最多,大规模的尘肺普查工作最迟应在接尘20年开始,尘肺平均发病年龄超过退休年龄,众多工种中纯掘进工的发病工龄最短,其次是纯采煤工。     

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.