黑龙江省垦区福利院65岁以上老人阿尔茨海默病患病率调查

目的：调查黑龙江垦区福利院老年人老年痴呆患病率,分析有关危险因素。方法：在全垦区9个管理局66家福利院,采用简易精神状态量表（MMSE）、日常生活活动能力量表ADL和感知社会支持多维量表进行筛查,结果用SPSS 13.0软件分析。结果：黑龙江垦区福利院老年人阿尔茨海默病患病率为31.79%,其中女性为38.32%,男性为24.81%。单因素分析显示电磁辐射、性别、文化水平、婚姻状况与AD发生有关。结论：黑龙江垦区福利院65岁以上老人AD患病率较高,应引起社会重视。     

重庆市养老机构老年人老年痴呆患病率及其影响因素研究

目的 了解重庆市养老机构老年人老年痴呆的患病率及影响因素.方法 采用整群抽样的方法,以重庆市10所养老机构60岁以上的老年人为调查对象,通过面对面的调查方式,应用简易智力状态量表(MMSE)和工具性日常生活活动能力量表(IADL)评价老年人的认知状况,应用自制的老年人一般情况调查表和老年人抑郁量表(GDS)收集老年人老年痴呆的影响因素.结果 符合条件的415名老年人中,119名被诊断为老年痴呆,患病率为28.67％,不同年龄、性别、婚姻状况、文化程度、居住状况,是否吸烟、饮酒、锻炼,不同家务劳动、参加户外活动频率,是否有宗教信仰,是否患有肥胖、高血压、糖尿病、冠心病、脑卒中和抑郁老年人的老年痴呆患病率比较,差异有统计学意义(P＜0.05).不同职业、经济状况,是否食用河鲜、海鲜、鱼油类保健品、肝脏或肥肉、禽蛋,不同亲友邻居交往频率、打麻将或棋牌频率、看电视频率、参加社会活动频率老年人的老年痴呆患病率比较,差异无统计学意义(P＞0.05).多因素Logistic回归分析显示,年龄大于或等于70岁、女性、吸烟、超重或肥胖、患有高血压是重庆市养老机构老年人老年痴呆的危险因素;在婚、非独居、每天参加户外活动为重庆市养老机构老年人老年痴呆的保护因素.结论 重庆市10所养老机构老年人老年痴呆的患病率较高,应重视老年痴呆的预防和控制.     

柳州市8572人糖尿病、糖耐量低减、空腹血糖损害的调查和分析

目的：了解糖尿病、糖耐量低减、空腹血糖损害的流行病学特点，为开展糖尿病的社区干预作准备。方法：于1999年8月至2000年3月按WHO1999年推荐的糖尿病诊断新标准，对柳州市8572名25岁以上成人进行了糖尿病(DM)和糖耐量低减(IGT)、空腹血糖损害(IFG)的流行病学调查。结果：查出DM873人，IGT671人，IFG544人，3组实际患病率分别为10．18％、7．83％、6．35％，按广西人口标化，3组标化患病率分别为9．19％、7．09％、5．86％。3组患病率与年龄、危险因素个数成正比，与文化程度呈反比，女性高于男性。结论：影响患病率的突出因素为年龄、文化程度、性别、拥有危险因素个数、相关知识程度。职业与患病率的直接关系不明显。     

某社区老年脂肪肝患者相关危险因素调查及社区干预研究

目的研究老年脂肪肝患者相关危险因素及社区干预。方法通过回顾性分析2012年某社区663名老年人脂肪肝及相关危险因素体检结果,了解社区老年人脂肪肝与相关危险因素的关系。结果社区老年人脂肪肝患病率为49．02％（325／663）,其相关危险因素为超重、肥胖、高血压、高血糖、高血脂,除胆固醇外与非脂肪肝组比较,差异均有高度统计学意义（P〈0．01）。在性别上,男性脂肪肝患病率为60．1％（191,318）,高于女性[38．8％（134／345）],差异有高度统计学意义（P〈0．01）。在年龄方面,随着年龄增长,患病率降低。结论社区老年人脂肪肝患病率较高,脂肪肝组危险因素高于非脂肪肝组,且有性别、年龄差异。脂肪肝危险因素与行为生活方式有关,是可以改变的危险因素。全科医师针对危险因素发挥其在地理位置、管理方法及熟悉程度方面的优势,使用低成本高效的方法进行社区干预。     

乌鲁木齐市社区老年人轻度认知功能障碍的患病率调查

目的：了解乌鲁木齐市社区老年人轻度认知功能障碍（MCI）的患病情况,分析与此患病相关的因素。方法：2008年7～10月,根据美国精神病学会的精神障碍诊断和统计手册第4版修订版（DSM-Ⅳ）中轻度认知功能障碍的临床诊断标准,采用随机整群抽样的方法对乌鲁木齐市3个社区,年龄≥60岁的老年人进行现况调查。调查分为两个阶段：第一阶段为筛查,由经过培训的调查员完成调查问卷及简易精神状况量表（MMSE）;第二阶段临床诊断,对有主诉或家属诉其有明显记忆障碍者,及MMSE分数低于界值者进一步进行临床体格检查及总体衰退量表（GDS）、Hachinski缺血指数量表（HIS）、汉密尔顿抑郁量表（HAMD）、神经系统检查表、临床痴呆评定量表（CDR）等测验,并由两名神经科医师作出最后诊断。结果：共计调查1511例,其中男性686例,女性825例,MCI者148例,占9．79％,在不同年龄段、不同文化程度及不同职业间,MCI患病率之间的差异均有统计学意义（P〈0．05）。结论：乌鲁木齐市社区老年人MCI的患病率为9．79％;MCI患病率存在显著的年龄、受教育程度和职业的差异;患病率均随年龄增加而上升,随着文化程度的增高而降低。高龄、低教育水平、体力劳动者为老年MCI的高发人群。     

西北地区军队离退休干部老年痴呆及认知障碍流行病学调查和危险因素分析

目的:通过调查西北地区军队离退休干部老年痴呆及认知障碍的患病率,并分析其危险因素,掌握其健康状况,指导保健工作的开展.方法:对西北地区军队46个干休所18 820人中60岁以上3047名人员进行病史采集、临床体检等检测,由专科医师做出诊断. 使用量表为<长谷川智力量表(HDS)>和<临床记忆量表>.结果:老年痴呆的患病率分别为痴呆期0.7%,痴呆前期1.5%,轻度异常21.4%,总患病率为23.6%. 在多种相对危险因素中女性、高龄、脑萎缩、脑梗死、无喝茶嗜好、冠心病、高血压病、文化程度低等8种危险因素尤为突出.结论:西北地区军队离退休干部老年痴呆及认知障碍的患病率高于国内其他地区. 8种危险因素严重影响着老年痴呆及认知障碍患病率的高低. 对痴呆前期及轻度异常患者采取积极的综合干预可提高部队离退休老干部的生活质量.     

衢州市老年痴呆的患病率及危险因素

目的 探讨衢州市老年痴呆的患病率及危险因素。方法 随机选取2019年1—5月衢州市三个社区为研究地点,共抽查60岁以上老年人2454例,对其个人资料及相关因素进行调查,分析影响老年痴呆患病的相关因素。结果 老年痴呆患病率随年龄增长呈上升趋势,女性患病率高于男性,差异有统计学意义(P0.05);多因素非条件Logistic回归分析结果显示,年龄、听力、吸烟、鱼油类保健品、河鲜、户外活动、锻炼、读报纸、心理情绪状态、月收入、受教育年限及自觉健康状况是老年痴呆的独立危险因素(P0.05)。结论 衢州市老年痴呆主要以阿尔兹海默症及血管性痴呆为主,且女性患病率高于男性,对于女性、收入较低、听力障碍、受教育年限较低及自觉健康状况差的老年人,应当给予充分的关心和相应的干预方式,以降低老年痴呆的患病率。     

长沙市老年人血脂异常分布及其影响因素

目的：了解长沙市社区老年人血脂异常的患病率及其影响因素,为制定慢性病防控策略提供科学依 据。方法：采用多阶段抽样的方法抽取健康体检的65 岁以上社区老年人3 500 名,对血脂异常的患病情况及相 关因素进行调查分析。结果：长沙市社区老年人血脂异常检出率为43.72%,其中高TG 血症、高TC 血症、高 LDL-C 的检出率分别为26.54%,25.31%,16.65%。Logistic 回归分析显示：吸烟、饮酒、超重或肥胖是血脂异 常的危险因素,文化程度高、体育锻炼是血脂异常的保护因素。结论：长沙市社区老年人血脂异常患病率较高, 危险因素普遍存在,开展社区干预极为重要。     

一般人口学对老年人认知障碍的调查研究

目的通过了解国内对22个省城乡老年人认知障碍相关因素的调查研究,为采取相应的对策预防老年人认知障碍提供科学依据。方法采用简易智力状态检查量表（MMES）进行测评,测评对象为国内22个省的60岁以上老年人,采用多级随机抽样的方法,在每省选取100人,城乡各50人,男女各一半。结果2161名老年人中,老年人认知障碍（MCI）的患病率为26．42％,其中女性高于男性;农村高于城市;体力劳动者高于脑力劳动者;文化程度越低,老年人认知障碍的患病率越高：生活压力大者的患病率高于生活压力小者。结论应加强对老年人认知功能的监测和关注,尤其是高危人群。     

某兵团65岁以上老年人慢性肾脏病分层随机抽样调查

目的：了解某后团65岁及以上老年人慢性肾脏病（CKD）的患病率及相关因素。方法兵团第四师65岁以上共2030名老年人,分布在6个社区。采用分层随机抽样方法,抽取2个社区334名65岁以上常住居民进行问卷调查,及肾损伤指标和相关因素的检测。结果在资料完整的329例居民中,经年龄校正后,清蛋白尿的患病率为22．2％,血尿的患病率为14．2％,肾功能下降的患病率为4．9％。该人群CKD的患病率为32．8％,以早期CKD 1～3期为主,知晓率为15．1％。多因素Logistic回归显示,与CKD相关的独立影响因素有性别、高血压。结论该兵团65岁以上老年人CKD患病率较高,相关因素为性别、高血压。     

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.