吸烟与代谢综合征的相关性调查与分析

目的探讨吸烟与代谢综合征的关系.方法应用整体抽样横断面调查方法,完成重庆地区3 717例自然人群问卷调查及口服75g葡萄糖耐量试验,检测空腹血糖、血脂、血浆胰岛素及糖负荷2h后血糖,测量空腹状态血压、腰围、体重、身高.结果 (1)887例正常人中,吸烟组体重指数(BMI)、腰臀比(WHR)、体重、腰围、甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-C)高于非吸烟组,高密度脂蛋白胆固醇(HDL-C)低于非吸烟组.(2)3 379例资料完整自然人群按年龄分层后,40岁以下人群吸烟组糖尿病(DM)、糖耐量减低(IGT)、空腹血糖减损(IFG)、高血压、血脂紊乱、超重/肥胖及中心性肥胖的患病率高于非吸烟组.40～60岁年龄层吸烟组超重/肥胖及中心性肥胖、高TG、低HDL-C的患病率高于非吸烟组,60岁以上年龄层吸烟组代谢综合征患病率高于非吸烟组.结论吸烟与代谢综合征有关,是其发生、发展的重要环境因素之一.     

汕头市区30-70岁人群代谢综合征流行病学调查

目的旨在了解汕头市成人代谢综合征（MS）及其相关疾病的患病情况。方法采用分层随机整群抽样方法,调查2006年1月-2007年12月汕头市30-70岁居民3680人,全部进行空腹血糖、血脂、血尿酸等测定。结果调查对象MS的标化患病率为11.6％,而中心性肥胖、肥胖、糖尿病（DM）、糖调节受损（／GR）、高血压、高甘油三酯（1B）和低密度脂蛋白胆固醇（LDL-C）的标化患病率分别为32.1％、11-3％、10.0％、21.0％、28.4％、24.3％和3.9％。随着年龄的增加,MS各年龄组的患病率逐渐增高,其中45岁以下人群,男性MS患病率显著高于女性,55岁以下男性腹型肥胖、高血压和高TG血症患病率均高于女性,而在55岁以上人群中男女性别之间无显著差异。在30-70岁人群中2／3有不同程度的代谢异常,合并2种或2种以上代谢异常者约1,3,合并3种以上代谢异常者占1,5。结论汕头市MS的患病率较高,表现为代谢异常者以45岁以上的中老年人群为主。     

城市居民体重指数与糖尿病关系的研究

目的:分析南宁市城市居民体重指数(BMI)与糖尿病(DM)发病的关系.方法:对南宁市样本区随机抽取五个街道社区(居委会)810户,每户抽取年龄在35～74岁的居民1人,共810人.分别检测体重、BMI、餐后12 h空腹血糖(FPG);按DM糖耐量低减(IGT)诊断标准分别计算各组的患病率并对照比较.结果:DM患病率以65～74岁组最多,达14.56%;IGT患病率以55～64岁组最多,达16.28%;BMI肥胖组DM、IGT患病率均比正常体重组高,分别高出8.49%及14.48%;不同性别DM、IGT患病率比较差异无统计学意义(P>0.05).结论:南宁市城市居民DM与IGT的患病情况随年龄增长而逐渐升高,提示超体重和肥胖是糖尿病的重要危险因素之一;糖尿病及糖耐量低减在南宁市城市居民中已占有相当大的比例.     

广州市荔湾区10080例糖尿病患病情况调查

目的　了解广州市荔湾区居民糖尿病 (DM)的患病特点 ,探讨DM发病的危险因素。方法　 2 0 0 1年对 10 0 80例 2 5岁以上常住居民进行DM患病情况调查。标化患病率按照 2 0 0 0年全国人口构成计算。结果　DM和空腹血糖偏高 (IFG)患病粗率分别为 11 2 2 %和 17 2 8% ,标化患病率分别为 9 4 6 %和 15 88% ;DM和IFG患病率基本上呈随年龄递增趋势 ;肥胖组DM患病率比正常体重人群高 1 5 4倍 ;DM和IFG患者的高血压与高脂血症患病率高于血糖正常人群。结论　DM是该区居民的常见疾病 ;年龄增长、肥胖是糖尿病的重要危险因素 ;DM与高血压及高脂血症之间存在着内在关系。     

中山古镇社区人群糖尿病的流行病学研究

目的 阐明古镇社区糖尿病(DM)患病情况。方法 对古镇社区20岁及以上的人群进行DM的抽样调查，共调查6920人。结果 社区人群DM患病率为4．16％，糖耐量低减(IGT)息病率为6．16％，DM和IGT的标化患病率分别为3．49％和5．12％。各年龄人群组的DM和IGT患病率的线性趋势均有显著性意义(P＜0.01)，DM标化患病率男女间差别无显著性意义。不同文化程度人群DM和IGT的患病率间差别均有显著性意义(P＜0．01)。肥胖和高血压等是导致DM患病率高的主要因素。结论 对DM要进行社区综合防治，减少DM并发症的危害。     

琼海市居民主要慢性病及代谢综合征调查

目的 了解琼海市居民主要慢性病和代谢综合征患病率及其相关危险因素,为全市卫生政策制定提供科学依据。方法 多阶段抽取本市18岁以上常住居民899人进行问卷调查,测量身高、体重、血压,血脂、空腹血糖等生化指标。分析主要慢性病和代谢综合征及其危险因素的流行病学分布特点及其相关性。结果 琼海市居民高血压、糖尿病、肥胖和中心性肥胖患病率和加权率分别是26.4%(26.6%)、10.3%(10.6%)、8.7%(9.1%)和51.8%(53.0%),高TC血症、高TG血症、高LDL-C血症和低HDL-C血症的比率和加权率分别是25.8%(25.3%)、7.1%(7.2%)、25.3%(24.7%)和12.3%(12.7%),代谢综合征患病率为10.6%(10.3%)。高血压和糖尿病患病率随着年龄增加(P<0.01),肥胖、中心型肥胖、低HDL-C血症的患病率男女间存在统计学差异(P<0.05)。多因素Logistic回归分析,年龄、糖尿病、高血压、肥胖、中心型肥胖、体质指数BMI、低HDL-C血症、高TG血症、果蔬不足、红肉过量及身体活动不足等是MS的危险因素。结论 琼海市居民高血压和中心性肥胖处于高发期,应早筛查、早发现、早控制和治疗,以降低代谢综合征的患病率。     

广州市10080人糖尿病患病情况调查

目的了解广州市居民糖尿病(DM)的患病特点,探讨DM发病的危险因素.方法2001年对10080名25岁以上常住居民进行DM患病情况调查.标化患病率按照2000年该地区人口构成计算.结果DM和空腹血糖偏高(IFG)患病粗率分别为11.22%和17.28%,标化患病率分别为9.46%和15.88%;DM和IFG患病率基本上呈随龄递增趋势;肥胖组DM患病率比正常体重人群高1.54倍;DM和IFG病人的高血压与高脂血症患病率高于血糖正常人群.结论DM是该区居民的常见疾病;年龄增长、肥胖是糖尿病的重要危险因素;DM与高血压及高脂血症之间存在着内在关系.     

社区居民超重、肥胖与糖尿病患病率的关系

目的了解不同体重指数、腰围与糖尿病患病率的关系,为社区居民的糖尿病的早期干预提供理论依据。方法采用分层整群抽样方法抽取40岁及以上的常住居民4752人进行调查,测量身高、体重、腰围,测定空腹口服75g葡萄糖后2h血糖。结果本次共调查40岁以上居民4752人,查出DM患者220人,患病率为4.63%,其中男性4.35%,女性4.86%;查出IGT患者282人,患病率为5.93%,其中男性7.48%,女性4.67%,性别患病率未见显著性差异(P0.05)。除40~岁组以外,其他年龄组随着BMI水平增高,DM、IGT患病率也明显上升(P0.05);除BMI18.5组外,DM、IGT患病率与年龄增长密切相关(P0.05)。男女各年龄组腹型肥胖的DM、IGT患病率比正常体型组的明显增加(P0.05)。结论 BMI≥24或男性WC≥85cm、女性WC≥80cm者是DM患病高危人群,因此做好中老年肥胖人群的行为干预是预防糖尿病的有效措施。     

重庆市3 717例人群糖尿病及相关疾病的调查

目的了解重庆市糖尿病(DM)、高血压(HBP)、血脂紊乱及代谢综合征(MS)等病的患病情况.方法采用横断面调查方法对重庆市局部地区3 717例20岁以上自然人群进行口服葡萄糖耐量试验(OGTT)等调查.结果 DM、糖调节受损(IGR)、HBP、血脂异常、超重/肥胖、MS等病的患病率分别为10.38%、15%、35.43%、46.95%、30.87%/3.82%、9.69%.各种疾病随年龄增加而增高,高甘油三酯血症、超重和肥胖的患病高峰年龄男性为50岁,女性为60岁.结论重庆市糖尿病及相关疾病的患病率较高,应加强防治.     

社区中老年人群糖尿病与高血压的调查

目的对社区人群进行糖尿病与高血压的调查,并分析其相关性。方法对社区173例个体测量坐位血压,进行口服75 g葡萄糖耐量试验(OGTT),对其糖尿病及高血压的患病情况进行分析。结果调查人群中60 岁以上的老年人占94.15%,高血压的总患病率达43.93%,IGT/DM的总患病率达39.31%(68/173),其中高血压组IGT/DM的患病率达48.57%。结论社区老年人是糖尿病和高血压病的高危人群,尤其合并高血压的老年人群是糖尿病的高危人群,对其进行筛查早期诊断和防治糖尿病有重要意义。     

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.