普洱市精神疾病现状调查

目的：了解普洱市≥15岁人群各类精神障碍的患病率和分布特点。方法：按多阶段整群分层随机抽样的方法调查≥15岁人群14424例,采用精神疾病流行病学调查手册为调查工具,以国际疾病分类第10版精神与行为障碍分类（ICD-10）和中国精神障碍分类与诊断标准第3版（CCMD-3）为诊断标准。结果：在完成的14424例调查中,精神疾病的时点患病率（不含神经症）为9．71‰,终生患病率为11．44‰;排在前三位是精神分裂症（5．42‰）、酒精所致精神障碍（1．59‰）、精神发育迟滞（1．32‰）。时点患病率：男性（11．60‰）高于女性（7．70‰）,P〈0．01;城市（9．95‰）略高于农村（9．45‰）,P〉0．05。绪论：普洱市精神疾病患病率低于国内同类凋查结果,男性患病率比女性高,精神分裂症是本市患病率最高的精神疾病,酒精所致精神障碍患病率高为本次调查的特点。     

青海省黄南州4～17岁人群先天性心脏病流行病学调查

目的调查青海省黄南藏族自治州4县4—17岁少年儿童先天性心脏病流行病学特征。方法对33235名被调查者进行了先天性心脏病流行病学调查。结果检出先天性心脏病222例，总患病率为6．68‰。女性患病率明显高于男性（x^2=26．21，P〈0．001）。不同县别之间患病率有统计学差异，其中河南县患病率最高，为12．40‰，尖扎县4．39‰，同仁县6．39‰，泽库县6．10‰（x^2=30．10，P〈0．001），不同民族间患病率无明显差异。先天性心脏病的类型列前三位的分别是房室间隔缺损（41．44％）、动脉导管未闭（30．63％）、室间隔缺损（22．07％）。结论在青海省黄南藏族自治州发生的先天性心脏病以房间隔缺损型居多。女性患病率明显高于男性。各民族之间患病率无差异。     

呼和浩特市特应性皮炎流行病学调查

目的：了解呼和浩特市青少年特应性皮炎（AD）的发病情况,方法：对中小学6－20岁年龄段的学生进行问卷调查,结果：调查人口总数7216人,发现AD患者33例,男性24例,女性9例,总标化患病率为0．46％,男性标化患病率为0．61％,女性标化患病率为0．24％,两者间有显著性差异（P＜0．01）,城市标化患病率为0．81％,农村为0．32％,两者间存在显著性差异（P＜0．01）,结论：1998年11,12月呼和浩特市6－20岁年龄段中小学生AD的时点患率经标化后,表现为男性高于女性,城市高于农村。     

深部真菌感染的人群易感因素探讨

目的：研究真菌感染的人群易感性，以便对可控因素进行控制。方法：阅录1996年～2003年间出院诊断明确呼吸道真菌感染者832例病历资料和同期住院病人统计报表，针对不同状况计算其患病率，并作统计学处理。结果：呼吸道真菌感染患病率（‰）男：女=11．2：4．5，X^2=138．9，P〈0．005，统计学上有显著性差异，男性较女性易患真菌感染；年龄增大，真菌感染率亦随之增大，特别是≥61岁组患病率高达33．5‰，占全部病例的78．6％，P〈0、005，统计学上有显著性差异，提示老年人有较大易感性；汉族：彝族：其他民族=8、4：5．7：7．5，P〈0．05，民族之间也有差异，汉族略高；干部：工人：农民：其他=21.8：6．0：2．3：2．4，P〈0．005，统计学上有显著性差异，易感性干部〉工人〉农民和其他职业；城市：农村=10，7：2．5，城市明显高于农村，P〈0.005。结论：男性、老龄、汉族、干部职业、城市居住等，是深部真菌感染的人群易感因素。对高危人群，尤其是疑似患者，应尽早做呼吸道分泌物涂片和培养，一旦真菌检查阳性，务必高度重视。     

青海高海拔地区4～8岁儿童先心病流行病学调查

目的调查青海省平均海拔3500米地区4～8岁儿童先天性心脏病（CHD）流行病学特征。方法对14056名幼儿园及小学一到二年级儿童按初筛、复筛、彩超多普勒确诊3个阶段进行调查。将该地区4个县CHD的患病率、病种分布、性别间变化进行了比较,并将世居藏族CHD的患病率与生活在同一环境的其他民族进行了比较。结果共检出CHD155例。总患病率为10.956‰。男性为9.246‰,女性为12.922‰（掊2=4.345,P〈0.05）。4县中河南县患病率为13.124‰,泽库13.09‰,尖扎10.242‰,同仁8.054‰,不同县别之间发病率无统计学差异。各民族的患病率存在显著性差异（掊2=10.708,P〈0.05）。其中世居民族藏、蒙族儿童患病率明显高于汉族,（掊2=9.943,P〈0.005）和（掊2=7.342,P〈0.001）。病种构成以动脉导管未闭占首位（40.00%）,其次是房间隔缺损（25.81%）,卵园孔未闭（14.09%）,室间隔缺损（13.55%）。结论藏族、蒙古族的CHD患病率高于生活在同一环境的其他民族,女性患病率明显高于男性。CHD的构成比以动脉导管未闭为主。     

1141名电厂职工脂肪肝及常见伴发病流行病学调查

目的了解电厂职工脂肪肝及常见伴发病的患病率，为防治提供依据。方法采用分层整群抽样方法，对电厂共1141名职工进行脂肪肝及其常见伴发病的流行病学调查。结果脂肪肝的患病率为20．95％（239／1141），男性为26．21％，女性为7．26％，男性明显高于女性（P〈0．01）；高脂血症、高尿酸血症、糖尿病和胆石症患病率分别为36．02％（411／1141）、17．09％（195／1141）、3．86％（44／1141）和8．94％（102／1141），男女之间有显著性差异（P〈0．05）；高血压病患病率为7．8％（89／1141），男女之间无显著性差异（P〉0．05）。随着年龄增加女性脂肪肝患病率升高，以60岁以上最高38．89％（7／18），男性脂肪肝患病率则无明显变化；高脂血症、高血压病、糖尿病和胆石症患病率随着年龄增加而升高，高脂血症患病率在50岁以前男性高于女性，50岁以后则无明显差异，而高血压病、糖尿病和胆石症患病男性和女性均为大于60岁最高；高尿酸血症患病率各个年龄组均是男性高于女性，但不随年龄而升高。结论电厂职工脂肪肝及常见伴发病（高脂血症、高血压病、高尿酸血症、糖尿病、胆石症）患病率较普通人群高，并与性别、年龄有一定关系，应当尽早采取综合性的预防措施，以降低脂肪肝的患病率和控制常见伴发病发生。     

普洱市精神疾病现状调查

目的:了解普洱市≥15岁人群各类精神障碍的患病率和分布特点。方法:按多阶段整群分层随机抽样的方法调查≥15岁人群14 424例,采用精神疾病流行病学调查手册为调查工具,以国际疾病分类第10版精神与行为障碍分类(ICD-10)和中国精神障碍分类与诊断标准第3版(CCMD-3)为诊断标准。结果:在完成的14 424例调查中,精神疾病的时点患病率(不含神经症)为9.71‰,终生患病率为11.44‰;排在前三位是精神分裂症(5.42‰)、酒精所致精神障碍(1.59‰)、精神发育迟滞(1.32‰)。时点患病率:男性(11.60‰)高于女性(7.70‰),P<0.01;城市(9.95‰)略高于农村(9.45‰),P>0.05。结论:普洱市精神疾病患病率低于国内同类调查结果,男性患病率比女性高,精神分裂症是本市患病率最高的精神疾病,酒精所致精神障碍患病率高为本次调查的特点。     

成都市糖尿病流行病学调查报告

本文报导对成都市11046人进行的糖尿病流行病学调查,其患病率为12。94‰。40岁以后患病率似有逐年增长之趋势,60岁以后又稍有下降。在城市男性高于女性,农村女性高于男性。脑力劳动者患病率明显高于体力劳动者。受检者中有糖尿病家族史者占一半确诊为糖尿病。     

兰州市七里河区人群高血压的流行现状及干预对策

目的：研究城市高血压的流行现状及如何采取预防和控制对策。方法：普查示范区35岁以上人群,内容为个人基本情况,血压测量,高血压知晓情况等。收缩压≥140mmHg和／或舒涨压≥190mmHg,或两周内服降压药患者均为高血压目标人群。结果：高血压的患病情况,本次普查对象共2768人。男1215人,女1553人。患病总人数897人,患病率为32．4％,男、女患病率分别29．4％、34．8％。女性患病率高于男性（P〈0．01）,高血压患病率随年龄增加而升高,差别有统计学意义（P〈0．01）;对高血压的知晓、治疗及控制情况,共调查患者1071人,其中农村人口402人,城镇人口669人。高血压患者中知晓率、治疗率和控制率分别为19．7％、13．6％和4．3％。患者中知晓率、治疗率和控制率总体城市均高于农村（P〈0．01;P〈0．01;P〈0．05）。知晓率、控制率中城市和农村男女相比差别无统计学意义（P〉0．05）,治疗率中城市女性高于男性（P〈0．01）有统计学意义。结论：高血压的防治必须走综合防治的道路,控制高血压,必须严格控制,相关的危险因素,同时采取针对全人群和高危人群的策略,才能取得最佳的综合干预效果。个体化的疾病管理模式不仅提高了“三率”,减少了危险因素,而且更好地整合了社区卫生资源．在社区中切实可行。     

脂肪肝流行病学调查及B超检测的意义

[目的]了解南宁市人群脂肪肝的分布情况，探讨现代生活的健康问题及B超检查在防病治病中的作用及意义。[方法]对2007年1月～2008年1月期间来我院健康体检人群按性别、年龄分为12组，每小组取100人，抽样选取被调查对象1200名，回顾分析B超检查脂肪肝患病情况。[结果]1200人中脂肪肝患病者347名（28．92％）。男性患病率（32．50％），女性患病率（25．33％），男性患病率高于女性（P〈0．01）。男性40-49岁年龄组为脂肪肝患病率高峰，女性60～69岁年龄组为脂肪肝患病率高峰。50岁以前男性脂肪肝患病率明显高于女性，50岁以后女性脂肪肝患病率高于男性。[结论]B超检查能及时发现脂肪肝，在脂肪肝的早期诊断和防治中具有重要作用；脂肪肝的发生与年龄、性别有关，青壮年的男性、更年期妇女应列为预防脂肪肝疾病的重点对象。     

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.