NIDDM患者血浆纤溶酶原激活物抑制剂-1(PAI-1)与并发冠心病关系的探讨

为明确血浆纤溶酶原激活物抑制剂－１（ＰＡＩ－１）在ＮＩＤＤＭ发生冠心病中所起的作用，并分析其影响因素。将６０例ＮＩＤＤＭ患者分为冠心病（ＣＡＤ）组和非ＣＡＤ组，用底物发光法检测血浆ＰＡＩ－１及组织型纤溶酶原（ｔ－ＰＡ），同时检测血糖、血胰岛素、血脂等指标。结果表明：ＣＡＤ组血浆ＰＡＩ－１活性水平明显高于非ＣＡＤ组，分别为１０．０６±２．５与８．０８±２．６２，单位Ａｕ／ｍｌ，Ｐ＜０．０１。两组ｔ－ＰＡ相似。在ＣＡＤ组，血浆ＰＡＩ－１活性与空腹胰岛素、胰岛素敏感指数均相关，相关系数分别为０．２４（Ｐ＜０．０５）与－０．３（Ｐ＜０．０１），且与甘油三酯呈正相关（ｒ＝０．２４，Ｐ＜０．０５），和ＡｐｏＢ正相关（ｒ＝０．５１，Ｐ＜０．０５）。血浆ＰＡＩ－１活性水平的升高与ＮＩＤ－ＤＭ发生ＣＡＤ危险性存在相关。胰岛素抵抗状态、高胰岛素血症、高ＴＧ水平都可刺激血浆ＰＡＩ－１活性的升高，而高血糖对其无直接的作用。ＡｐｏＢ参与ＰＡＩ－１活性改变这一过程，并在ＣＡＤ发生中可能介导其它脂质异常刺激ＰＡＩ－１升高的作用。     

PAI-1和tPA与Ⅱ型糖尿病血管病变关系探讨

目的：以整体的观点,探讨Ⅱ型糖尿病血管病变与纤溶酶原激活物（ｔ Ｐ Ａ） 及抑制物（ Ｐ Ａ Ｉ－ １） 之间的关系。方法：选取４６ 例正常人,７１ 例Ⅱ型糖尿病患者,采用酶联免疫吸附法（ Ｅ Ｌ Ｉ Ｓ Ａ） 定量测定ｔ Ｐ Ａ 及 Ｐ Ａ Ｉ－ １ 水平。结果：单纯糖尿病组（ Ｄ Ｍ 组） , Ｐ Ａ Ｉ－ １ 正常;并发血管病变各组, Ｐ Ａ Ｉ－ １ 比对照组升高,差异显著;合并大血管病变组（ Ｄ Ｍ＋ Ａｔｈ 组） , Ｐ Ａ Ｉ－ １ 比 Ｄ Ｍ 组升高,差异显著;合并微血管病变组（ Ｄ Ｍ＋ Ｄ Ｎ／ Ｄ Ｒ 组） , Ｐ Ａ Ｉ－ １ 有升高趋势,但差异不显著（ Ｐ＝ ０ ．０６７６） ; Ｄ Ｍ 组、 Ｄ Ｍ＋ Ａｔｈ 组、 Ｄ Ｍ＋ Ｄ Ｎ／ Ｄ Ｒ 组,ｔ Ｐ Ａ 比正常对照组升高,差异不显著; Ｄ Ｍ＋ Ａｔｈ组、 Ｄ Ｍ＋ Ｄ Ｎ／ Ｄ Ｒ 组,ｔ Ｐ Ａ 比 Ｄ Ｍ 组下降,差异不显著。多元回归分析结果显示, Ｐ Ａ Ｉ－ １ 与空腹胰岛素呈显著正相关关系。结论：（１） Ⅱ型糖尿病合并血管病变者 Ｐ Ａ Ｉ－ １ 水平升高;（２） Ｐ Ａ Ｉ－ １ 水平与空腹胰岛素水平呈显著正相关关系;（３） 推测ｔ Ｐ Ａ 在糖尿病血管病变的发病中系一代偿因素。     

47例老年肝炎后肝硬化患者外周血纤溶活化水平测定及临床意义

目的：观察老年肝炎后肝硬化患者纤溶功能变化。方法：分别用发色底物法,酶联免疫吸附法测定４７例老年肝炎后肝硬化患者（ 老年组） ,３４ 例非老年肝炎后肝硬化患者（ 非老年组） 及２４ 例健康老年人（ 对照组） 外周血组织型纤溶酶原激活物活性（ｔ＿ｐ Ａ： Ａ） 及其抗原（ｔ＿ Ｐ Ａ： Ａｇ） 、纤溶酶原激活物抑制物活性（ Ｐ Ａ Ｉ： Ａ） 及 Ｄ－ 二聚体。结果：老年组与非老年组比较上述指标无显著性差异（ Ｐ＞ ０ ．０５） 。老年组ｔ＿ Ｐ Ａ： Ａ、ｔ－ ｐ Ａ： Ａｇ 及 Ｄ－ 二聚体显著高于肝功能代偿者（ Ｐ＜ ０ ．０１） ,而 Ｐ Ａ Ｉ： Ａ 显著低于对照组。老年组中肝功能失代偿者ｔ － Ｐ Ａ： Ａｇ 、ｔ－ Ｐ Ａ： Ａ 及 Ｄ－ 二聚体显著高于肝功能代偿者（ Ｐ＞ ０ ．０１） , Ｐ Ａ Ｉ： Ａ 变化与之相反。结论：随着老年肝炎后肝硬化患者肝功能减退,其纤溶活性升高,纤溶功能状态与患者年龄无关。测定纤溶活化功能对预测其肝功能损害、出血、预后及指导治疗有重要意义。     

碘酸钾碘盐自然存放8年碘损失实验研究

「目的」研究碘酸钾碘盐的稳定性。「方法」取２３份干混法生产的ＫＩＯ３碘盐散装暴露在空气中常温湿存放８年,用直接滴定法测定不同存放期碘盐的含碘量。「结果」在２２个月内共检测１４次,经方差分析,Ｆ＝０．０６,Ｐ＝１．００。第２２个月碘下降０．３％（Ｐ＝０．８４５３）;３２个月碘下降６．４％（Ｐ〈０．０１）;３６个月碘下降９．１％（Ｐ〈０．０１）;６０个月碘下降１０．３％（Ｐ〈０．０１）;８４个月碘下降     

儿童单纯性肥胖症危险因素的研究

「目的」筛选出儿童肥胖发生的危险因素。「方法」采用问卷和信访调查,记录研究对象三天的活动情况。分别对４９名单纯性肥胖症儿童及正常儿童的饮食习惯、生活方式等因素进行分析。「结果」单纯性肥胖症儿童进食量、看电视时间、婴儿期及出生体重、父母体质指数等明显高于对照组（Ｐ〈０．０５）;进食速度、进食量、受吃淀粉类食品、爱吃零食、不爱运动、父母体质指数等因素进入Ｌｏｇｉｓｔｉｃ回归方程;而活动量显著低于正常儿     

单纯性肥胖症儿童血脂、红细胞膜脂及其流动性的研究

目的：通过对单纯性肥胖儿童血脂、红细胞膜脂及其流动性的研究,初步了解其脂代谢紊乱的状况,并探讨其动脉粥样硬化危险性增加的可能机制。方法：对筛选出的４９ 名肥胖儿童及其正常对照,测定其血清脂质、红细胞膜磷脂（ Ｐ Ｌ） 、膜胆固醇（ Ｃ Ｈ Ｏ） 及膜流动性（ Ｐ） 。结果：肥胖组儿童 Ｔ Ｇ、 Ｖ Ｌ Ｄ Ｌ Ｃ 的浓度、动脉粥样硬化指数（ Ａ Ｉ） 、 Ｌ Ｄ Ｌ Ｃ／ Ｈ Ｄ Ｌ Ｃ 比值均显著高于正常组（ Ｐ＜ ０ ．０５） ;而 Ｈ Ｄ Ｌ Ｃ 的浓度及 Ｈ Ｄ Ｌ Ｃ／ Ｔ Ｃ 比值则显著低于正常组（ Ｐ＜ ０ ．０５） ,但两组的 Ｔ Ｃ 含量无显著性差异。肥胖组儿童 Ｐ Ｌ 含量显著低于正常组（ Ｐ＜ ０ ．０５） , Ｃ Ｈ Ｏ 和 Ｃ Ｈ Ｏ／ Ｐ Ｌ 比值显著高于正常组（ Ｐ＜ ０ ．０５） ;而 Ｐ 显著低于正常儿童。结论：单纯性肥胖症儿童血脂代谢出现紊乱,膜脂和膜流动性在血清胆固醇水平正常的情况下即出现异常变化,肥胖儿童脂代谢异常在红细胞膜脂质及其流动性方面可能比血脂更早表现出来,并对肥胖儿童 Ａ Ｓ的预测和预防可能会有更大的价值。     

单纯性肥胖症儿童的个性行为与智力分析

采用 ＥＰＱ个性量表、Ａｃｈｅｎｂａｃｈ行为量表及 ＷＩＳＣ－Ｒ智力测验,对 ９１例 ７～１１岁单纯性肥胖症儿童及正常对照儿童进行测试,结果发现单纯性肥胖症儿童个性内向、自卑、社会适应能力差,尤其是社交能力与活动能力明显低于对照组（Ｐ＜０．０１）。社交退缩、抑郁、交往不良等行为问题发生率高于对照组。两组儿童智商均在正常范围,但肥胖组儿童略低于对照组（Ｐ＜ ０．０５）。提示肥胖儿童存在心理偏差,在单纯性肥胖症防治工作中,必须同时采取心理干预措施。     

高脂血症患者前列环素,血栓素及D—二聚体的检测与分析

采用放射免疫法和ＥＬＩＳＡ法测定了６９例高脂血症患者６－酮－前列腺素Ｆ１α（６－Ｋ＝ＰＧＦ１α）、血栓素Ｂ２（ＴＸＢ２）以及Ｄ－二聚体（Ｄ－ｄｉｍｅｒ）和纤维蛋白（原）降解产物（ＦＤＰ）,并与２０例正常人比较。结果发现是血症患者６－Ｋ－ＰＧＦ１α低于对照组（Ｐ〈０．０５）,ＴＸＢ２高于对照组（Ｐ〈０．０１）,同时,Ｄ－ｄｉｍｅｒ和ＦＤＰ也高于对照组（Ｐ〈０．００１）。高脂血症患者体内处于ＰＧＩ２／     

某大型石化企业职业人群混苯暴露水平监测

「目的」通过测定某大型石化企业车间环境中混苯（苯、甲苯、二甲苯）及工人尿液中混苯的代谢产物,评价工人的接触水平。「方法」选择该公司有混苯暴露的芳烃等六个厂以无混苯暴露的职工医院,用气相色谱法（ＧＣ）测定空气中混苯,并用高效液相色谱法（ＨＰＬＣ）法测定工人尿液中反,反－粘糠酸（ｔ,ｔ－ＭＡ）以及马尿酸（ＨＡ）。「结果」车间空气中苯的平均浓度波动在０．７３～２６．９１ｍｇ／ｍ＾３之间,阳大超标率为７．４１％,最大超标倍数为２０．９１;混苯暴露厂工人尿液中ｔ,ｔ－ＭＡ,工后明显高于工前,差值波动在１．１４～３．７８μｇ／ｍｇ．Ｃｒ,明显高于对照单位的０．３３μｇ／ｍｇ．Ｃｒ,且暴露工人尿液的变化值与空气苯浓度呈等级相关性（Ｒｓ＝０．６４,Ｐ＝０．０３）;甲苯、二甲苯检出率较低,ＨＡ工后、工前无明显差异。「结论」该公司     

糖尿病、冠心病血浆t-PA、PAI、血脂变化及意义

糖尿病、冠心病血浆ｔ－ＰＡ、ＰＡＩ、血脂变化及意义衡阳医学院附一医院（４２１００１）文红艳曹仁贤欧大明糖尿病（ＮＩＤＤＭ）、冠心病（ＣＨＤ）均具有高凝倾向，纤溶系统损害与高凝状态紧密相关。血浆组织型纤维蛋白溶解原激活物（ｔ－ＰＡ）及其抑制物（ＰＡＩ）...     

企业职工高尿酸血症与血压、血脂、血糖的相关性研究

目的探讨企业职工高尿酸血症（HUA）与血压、血脂、血糖的相关性,为企业进行健康管理提供依据。方法以中国石油长庆油田公司各下属企业为抽样单位,整群随机抽取2个单位,每个单位中所有的HUA者作为HUA组,共720人;同时在尿酸水平正常者中随机选取620人为正常组。通过Logistic回归分析HUA与年龄、性别、血压、血脂、血糖的关系。结果HUA合并高血压、高血脂、空腹m糖受损任意一项、两项、三项的比例均远高于正常组（OR值分别为：4．036,2．562,4．174）。多因素Logistic回归发现：男性、收缩压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇是HUA的危险因素（OR值分别为7．736,2．309,1．721,2．761,1．411）;高密度脂蛋白胆固醇为HUA的保护因素（OR值为0．211）。结论HUA存在性别差异,且与血压、血脂密切相关。企业对职工的健康管理应充分考虑多危险因素的综合作用,全面的进行健康教育及干预。     

癌缺氧病因及预防和治疗

目的 探讨癌及安阳林州市食管癌高发原因及癌病因预防和治疗措施.方法 对林州市食管癌等疾病现场进行调查,在进行10余年统计分析基础上,综合分析了全国156篇文献成果.结果 提出癌缺氧病因学说,使用制氧机、按摩器、饮用纯净水治疗恶性肿瘤,取得良好效果,改水能够大幅降低林州市居民食管癌发病率、死亡率.结论 癌可能是由于机体长...     

Recruitment and retention challenges and successes

Objective: Addressing health disparities requires well designed, culturally adapted research. However, recruiting/retaining minority participants has often been challenging. We present strategies used to successfully recruit and retain rural Hispanic women during a breastfeeding education intervention.

Design: This study involved a two-group repeated measures quasi-experimental design with assessments at seven intervals between enrollment and 6 months postpartum. Participants (Hispanic women?≥?15 years old) were recruited through a regional hospital.

Results: We successfully met our recruitment goals, most women contacted were enrolled (46 of 58), and 100% completed the study.

Discussion: Research staff with ties within the community helped establish trust. Using bilingual study materials, simple language, and an interpreter addressed language/literacy concerns. Phone assessments facilitated participation as transportation was an issue. Accommodating requests to deliver or mail study materials and providing incentives were important. Extra effort was needed to maintain contact when phone service was disrupted or participants moved. Keys to success were persistence, flexibility, and alleviating barriers to participation.     

初产妇与经产妇焦虑抑郁状态分析及干预

目的：分析初产妇、经产妇心理状态特点,以便采取更有效的干预措施。方法筛选2014年6月至2015年1月在咸阳市旬邑县妇幼保健院产科门诊产前检查的健康初产和经产妇各60名,孕周为28~40周。入组时用焦虑自评量表( SAS)、抑郁自评量表(SDS)对两组孕妇进行心理评定,并给1次支持性心理干预(40~60分钟),1周后再次用SAS、SDS对两组孕妇进行评定分析。结果经产妇干预前SAS(50.73±3.45)、SDS(49.13±3.86)评分明显高于初产妇SAS(42.45±2.08)、SDS(41.77±2.21),差异均有统计学意义(t值分别为-15.921、-12.817,均P<0.01);干预后两组SAS、SDS评分均比干预前明显降低,差异均有统计学意义(t值分别为14.999、15.413;15.724、15.832,均P<0.01);干预后经产妇 SAS(38.61±5.02)、SDS(39.10±3.03)评分明显高于初产妇SAS(34.88±3.31)、SDS(32.01±4.27),差异均有统计学意义(t值分别为-4.805、-10.489,均P<0.01)。结论初产妇和经产妇均伴有焦虑、抑郁情绪,干预前后经产妇抑郁、焦虑情绪均较初产妇明显,支持性心理干预能有效改善孕妇的不良情绪。     

Continuity and change in neighborhood disadvantage and adolescent depression and anxiety

We used data from the Fragile Families and Child Wellbeing Study which includes a sample of adolescents of age 15 at the most recent wave (between 2014 and 2017) from mainly low-income urban families in the United States, to examine the association between neighborhood poverty entries and exits and adolescent depression and anxiety. In addition, we examined whether these associations differed by gender. Adolescents who consistently lived in disadvantaged neighborhoods had the highest level of depression and anxiety. Those who entered poor neighborhoods were more depressed than those who never lived in poor neighborhoods. Those who exited poor neighborhoods showed no significant difference in depression and anxiety compared to those never lived in poor neighborhoods. Furthermore, these associations applied to adolescent girls only and were not statistically significant for boys. The results suggest that neighborhood poverty has cumulative negative impacts on adolescent mental health and disproportionally affects adolescent girls. Reducing neighborhood poverty would substantially improve the health of adolescents, especially girls, which would reduce health disparities.     

Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights

At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described – fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.     

儿童青少年超重肥胖评价方法及SPSS和SAS实现

超重肥胖已成为世界各国儿童青少年面临的重大公共卫生问题之一。现行的儿童青少年超重肥胖筛查标准不统一,逐条评价或自行编写程序容易出错且效率较低。本研究以中国学龄儿童青少年超重与肥胖筛查标准为例,详细介绍了国际和中国共四种评价儿童青少年超重肥胖的方法和步骤,结合具体案例详细介绍其应用方法,同时编制SPSS和SAS程序包和解...     

Car ownership and the association between fruit and vegetable availability and diet

Objective

Nearly all research on the food environment and diet has not accounted for car ownership — a potential key modifying factor. This study examined the modifying effect of car ownership on the relationship between neighborhood fruit and vegetable availability and intake.

Methods

Data on respondents' (n = 760) fruit and vegetable intake, car ownership, and demographics came from the 2008 New Orleans Behavioral Risk Factor Surveillance System. Shelf space data on fresh, frozen, and canned fruits and vegetables were collected in 2008 from a random sample of New Orleans stores (n = 114). Availability measures were constructed by summing the amount of fruit and vegetable shelf space in all stores within defined distances from respondent households. Regression analyses controlled for demographics and were run separately for respondents with and without a car.

Results

Fruit and vegetable availability was positively associated with intake among non-car owners. An additional 100 m of shelf space within 2 km of a residence was predictive of a half-serving/day increase in fruit and vegetable intake. Availability was not associated with intake among car owners.

Conclusions

Future research and interventions to increase neighborhood healthy food options should consider car ownership rates in their target areas as an important modifying factor.