汕头市神经症流行病学调查

目的：了解９０年代汕头市神经症的状况。．方法：于１９９５年在汕头市城乡进行精神疾病流行病学调查,采用１９９３年中国七个地区精神疾病流行病学调查方法。结果：在城乡１５￣５９岁５３３人中,神经症的时点患病率为２８．１４‰（１５例）,其中,以神经衰弱患病率最高（２２．５１‰）,其次为焦虑症（３．７５‰）和抑生神经症（１．８８‰）。农村男、女的神经 患病率差异有显性（Ｐ〉０．０５）。结论：神经症,特别是     

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。     

汕头市精神发育迟滞流行病学调查

目的调查汕头市精神发育迟滞的患病情况,以及可能有关的社会环境及其它影响因素.方法采用《精神疾病流行学调查手册》及《1992年调查补充本》,对汕头市城乡各抽取500户进行精神疾病流行病学调查.结果精神发育迟滞总患病率为5.97‰,标化患病率为7.49‰.结论汕头市精神发育迟滞患病率明显高于1982年全国12地区及1986年汕头地区的流调结果,与经济、文化水平、家庭结构、医疗卫生条件等因素有关.     

汕头市精神发育迟滞流行病学调查

目的：调查汕头市精神发育迟滞的患病情况,以及可能有关的社会环境及其它影响因素。方法：采用《精神疾病流行学调查手册》及《1992年调查补充本》,对汕头市城乡各抽取500户进行精神疾病流行病学调查。结果：精神发育迟滞总患病率为5．97‰。结论：汕头市精神发育迟滞患病率明显高于1982年全国12地区及1986年汕头地区的流调结果,与经济、化水平、家庭结构、医疗卫生条件等因素有关。     

广西玉林市精神疾病流行病学调查

目的:了解玉林市不同职业人群的心理健康水平和各类精神疾病的时点患病率及其分布特点。方法:采用分层整群随机抽样的方法,运用《住户调查表》、《精神疾病流行病学调查筛选表》、《复合性国际诊断交谈表(WMH-CIDI 3.0量表)》和《ICD-10-AM精神障碍症状检查表》,对玉林市城乡15岁以上人口进行精神疾病患病情况调查。结果:3 443个调查对象中,精神疾病患者85例,时点患病率为24.69‰,明显高于1993年中国七地区精神疾病流行病学调查结果11.8‰(x2=40.766,P<0.001)。各类精神疾病中以精神分裂症的时点患病率最高6.68‰,其次为抑郁发作5.52‰。85例精神疾病患者中无业43人,占50.6%,经住院治疗仅10人,占11.8%,家庭年人均纯收入平均(355±192)元,仅为我市居民年人均收入的3.7%。结论:玉林市城乡精神疾病的时点患病率高于全国平均水平,其中精神分裂症排在首位,与其它地区精神疾病流调结果类似。玉林市精神疾病的疾病负担高,患者及其家庭因病致经济条件恶化,为社会的弱势群体,政府及全社会应尽早建立精神疾病救治的社会网络,为社会经济水平更快更好的增长提供支持。     

大同地区精神疾病流行病学调查

目的了解我地区各类精神障碍患病及分布情况。方法采用目前国际通用的"精神疾病筛查表"、"整群分层随机抽样"的方法对我地区精神疾病进行流行病学调查。结果各类精神障碍(不含神经症)时点患病率为15.64‰,终生患病率17.23‰。结论各类精神病终生患病率高于国内,精神分裂症和精神发育迟滞患病率居前2位,而酒精依赖、情感性精神障碍、老年性精神障碍、脑血管所致精神障碍患病率升高,均应列为防治和研究的重点。     

哈尔滨铁路局精神疾病流行病学调查

目的 首次在哈尔滨铁路局范围内调查精神疾病患病率。方法 由5个分局小组在5个地区开展流行病学调查，方法与1993年全国调查方法相同，使用相同调查工具、诊断标准及流程。结果 各类精神障碍（不含神经症）时点患病率12．59‰，终生患病率14．15‰，与全国1993年调查比较，均增高（P＞0．05）。结论 精神分裂症患病率居首位，而脑血管病所致精神障碍、药物依赖从癫痫性精神障碍患病率明显升高，均应重点防治。     

澜沧县重性精神病流行病学调查

目的:调查掌握云南省普洱市澜沧县重性精神病患病率和就诊情况。方法:采用精神疾病流行病学调查手册,重性精神疾病线索调查表为调查工具,以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三版(CCMD-3)为诊断标准,对澜沧县≥15岁人口采取整群调查方法进行逐一筛查。结果:在完成的408 375人调查中,总患病率为2.05‰(不含酒精所致精神障碍),精神分裂症1.44‰,精神发育迟滞0.33‰,脑器质性精神障碍0.18‰,情感性精神障碍0.02‰。男性患病率为2.57‰,女性患病率为1.46‰,就诊率为(14.76‰)。结论:澜沧县重性精神病患病率低于国内同类调查结果,男性患病率高于女性,就诊率低于经济发达地区,高于西部其他地区。     

四川省乐山市精神疾病流行病学调查

目的：了解乐山市各类精神障碍的患病率。方法：采用精神疾病流调手册推荐的方法和流程，于2000年11月1日对乐山市进行流行病学调查。结果：在≥15岁的3519人中查出各类精神障碍59例，其中现患55例。时点患病率15．63论，终生患病率16．77‰。在15—19岁的596人中，查出各类神经症15例，时点患病率25．17℃。经标化后均高于1993年中国七个地区流调结果(P＜0．05或P＜0．001)。结论：精神分裂症患病率仍居首位，应作为防治重点。酒依赖及神经症患病率显著增高，提示应加强心理健康教育。     

1991、2001年绍兴市人群精神疾病患病率及相关情况调查分析

目的　了解 1 991、 2 0 0 1年绍兴市人群中精神疾病的患病率。方法　采用线索调查与逐户调查相结合 ,于 2 0 0 1年 3月 1日对市区、农村共 339651人口进行调查 ,并与 1 991年的相关资料对照。结果　 1 991年与 2 0 0 1年精神疾病终生患病率分别为 1 0 1 7‰和 1 3 85‰ ,时点患病率分别为 9 51‰和 1 2 77‰ ,≥ 1 5岁人口的时点患病率为1 1 70‰和 1 4 60‰ ,2 0 0 1年神经症、酒依赖、药物依赖的患病率较 1 991年相比差异有显著性意义。各类疾病中神经症、精神分裂症、精神发育迟滞居前 3位。城市精神疾病患者的劳动能力、经济状况 (一般、贫困两项 )、就医条件、监护情况与农村相比 ,差异有显著性意义。结论　 2 0 0 1年绍兴市精神疾病患病率较 1 991年升高。城乡精神卫生工作发展不平衡 ,农村精神疾病防治工作应加强     

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.