2000～2003年我院收治的宫外孕年发生率变化趋势分析

目的：了解本地区宫外孕发生率变化趋势、主要原因及变化特征，方法：采用回顾性资料分析方法，对我院收治的妇科手术患者及其中的宫外孕患者的临床资料进行分析结果：宫外孕占妇科手术的年发生率2000年为8．9％，2001午为13．9％，2002年10．0％，2003年为24．1％．呈现逐年上升趋势。发病年龄由2000年31岁左右，以30岁-39岁年龄段为多：2002年24岁左右。2003年22岁左右，即发病年龄趋于年轻化。发病人群由2000年的城市人群占主要转变为二者基本持平，发病的主要原因仍然为妇科炎症，4年间无明显变化。结论：4年间本地区宫外孕占妇科手术的年发生率呈现上升趋势，发病年龄趋于年轻化．发病人群由城市人群占主要转变为二者基本平衡。发病的主要原因仍然为妇科炎症。     

1981～2010年鼻咽癌高发地区鼻咽癌患者发病年龄变化分析

目的 了解1981 ～2010年鼻咽癌高发地区鼻咽癌患者的发病年龄变化情况,分析变化原因,为制订鼻咽癌防治措施提供参考.方法 收集1981年1月至2010年12月14 993例首次住院初治鼻咽癌患者的病历资料;用Cox-Stuart趋势性检验法分析发病年龄变化趋势,并比较不同年份男女性患者的发病年龄,以及不同户籍、不同省区患者的发病年龄.结果 1981 ～2010年鼻咽癌男女比例为2.76∶1;1981～ 1986年、1987 ～1992年、1993 ～1998年、1999 ～ 2004年男性发病年龄均明显高于女性(P＜0.05);2005 ～ 2010年男女发病年龄比较,差异无统计学意义(P＞0.05);Cox-Stuart趋势检验结果显示1981 ～2010年鼻咽癌患者发病年龄呈上升趋势(P＜0.05).非农业患者发病年龄大于农业患者(P＜0.05),广西患者发病年龄大于广东患者(P＜0.05).结论 鼻咽癌高发地区的鼻咽癌发病年龄呈上升趋势,应当采取一级预防措施.     

4255例消化道恶性肿瘤的统计分析

目的　调查本地区消化道恶性肿瘤的年龄、性别、疾病构成及血型分布特点。方法　收集 42 5 5例消化道恶性肿瘤患者的相关资料进行统计分析。结果　消化道恶性肿瘤高发年龄为 5 0～ 60岁。发病居前 5位的肿瘤依次是食管癌、胃癌、贲门癌、直肠癌和结肠癌。常见消化道肿瘤除直肠癌女性发病高于男性外 ,其余 4种肿瘤男性发病均高于女性。与ABO血型的关系 ,与正常对照相比 ,男性 :A型血胃癌、贲门癌、B型血结肠癌发生频率较高 ,女性 :B型血贲门癌发生频率较高。女性O型血食管癌、贲门癌发生频率较低 ;男女AB型血直肠癌发生频率均较低。χ2 检验P <0 .0 5～P <0 .0 1。结论　消化道肿瘤中 ,食管肿瘤和胃肿瘤最常见 (约占 88% ) ,5 0～ 60岁是消化道肿瘤的高发年龄 ,应重点防治。不同肿瘤在不同血型分布的频率似与肿瘤部位及性别有关。     

大肠癌临床特征的变化趋势

目的:分析广东地区大肠癌临床特征的变化趋势,探讨大肠癌发病模式的变化规律。方法:总结分析广东四个地区五间医院1988年~2008年收治的8 172例大肠癌患者的临床资料。结果:2006~2008年段与1988~1990年段比较,中位发病年龄从52岁上升至60岁,上升了8岁,性别比由1.7∶1下降到1.4∶1,右半结肠癌从19.7%上升到25.8%,DukesA期的比例由4.5%升到7.7%。结论:近20年中位发病年龄上升了8岁,右半结肠癌比例上升,发病部位右移提示应重视全结肠镜检查。     

某院2002～2007年恶性肿瘤住院病例统计分析

目的:分析恶性肿瘤患者的年龄﹑性别及种类构成特点,为肿瘤防治工作提供依据。方法:选择南通大学附属医院2002～2007年6年住院恶性肿瘤15570例,对相关资料进行Excel统计学分析。结果:恶性肿瘤高发年龄为50～70岁,50岁以上老年人所占构成比为79.18%。男女性别比1.45:1,发病居前3位的依次为支气管肺癌、胃癌、肝和肝内胆管癌。高发年龄支气管肺癌为60～69岁,胃癌为60～69岁,肝胆恶性肿瘤为50～59岁。结论:恶性肿瘤发病呈逐年增长的趋势,肿瘤发病存在性别、年龄差异(P<0.05),根据恶性肿瘤发病特征对高危人群做好防治工作是降低发病率、提高生存率的关键。     

2001-2010年六灶社区恶性肿瘤发病率分析

目的:了解六灶社区居民近10年来主要恶性肿瘤发病趋势和流行病学特征。方法:对六灶社区2001-2010年主要恶性肿瘤发病资料进行年龄、性别、时间趋势上的分析。结果:10年来六灶社区居民肿瘤发病率居于前6位的是肺癌、胃癌、肝癌、直肠癌、乳腺癌、结肠癌,男性发病率呈明显上升趋势,女性则保持相对平稳态势。结论:上海市六灶社区肺癌、肝癌、胃癌是发病率最高的恶性肿瘤,40岁以上年龄段人群是六灶社区恶性肿瘤的重点防治人群。只有对重点人群进行早发现、早诊断、早治疗,才能有效控制肿瘤发病。     

血清丙氨酸转氨酶在汉族中年人群中随年龄的变化趋势

 目的  了解汉族中年人群中血清丙氨酸转氨酶(alanine aminotransferase,ALT)随年龄增长的变化趋势。方法  在泰州人群健康跟踪调查的基线中选取2012年3月至2013年2月的资料,对11 553名30～64岁常住居民的ALT与年龄进行横断面分析。年龄按五分位数分成5组(30～41岁、42～45岁、46～51岁、52～57岁、58～64岁),多因素调整后,比较各年龄组的ALT水平。结果  男性ALT水平(25.35±13.24) IU/L高于女性ALT水平(19.80±9.94) IU/L,差异有显著统计学意义(P<0.01)。5组男性ALT水平分别是29.49、27.04、25.93、24.26和22.01 IU/L,组间差异有显著统计学意义(P<0.01);5组女性ALT水平分别是18.35、18.23、19.86和21.60、21.00 IU/L,组间差异有显著统计学意义(P<0.01)。汉族中年男性中ALT水平随着年龄增长而降低,而女性ALT水平在52～57岁出现峰值。在调整了吸烟、饮酒、教育程度、体质指数等因素后,男性和女性的ALT水平随年龄增长的变化趋势基本不变。结论  在30～64岁汉族人群中,血清ALT水平随年龄的变化趋势在男性和女性中不同。     

诸城市1998～2007年恶性肿瘤发病情况回顾性分析

目的了解中小城市恶性肿瘤发病的基本情况,为肿瘤防治工作提供基本数据和参考依据。方法以潍坊地区诸城市二级医院经病理确诊的恶性肿瘤患者为研究对象,初步分析这一地区人群恶性肿瘤的发病趋势、发病病因。结果 10年间经病理确诊的恶性肿瘤计8490例,男女之比1.57:1,排序前5位的分别是胃癌、肺癌、乳腺癌、食道癌、结肠癌。胃癌、肺癌分别占居第1位和第2位。吸烟、饮酒分别是肺癌、食道癌的主要致病因素。癌前病变与相关肿瘤发病相关。结论中小沿海发达城市肿瘤发病情况不容乐观,政府应加大肿瘤防治工作的资金投入。     

2004～2008年首次住院前10位恶性肿瘤构成分析

目的分析首次住院恶性肿瘤患者的年龄、性别及种类构成特点,为肿瘤防治工作提供依据。方法选择汕头大学医学院附属肿瘤医院2004～2008年5年首次住院恶性肿瘤20067例,对相关资料进行综合分析。结果恶性肿瘤高发年龄为45～64岁,占构成比为56．31％。男女性别比1．55：1,首次住院居前3位的依次为食管癌、肺癌和鼻咽癌;65岁及以上年龄组是食管癌、肺癌和胃癌;45-64岁年龄组是食管、肺和鼻咽恶性肿瘤;25～44岁年龄组是鼻咽、乳腺癌和宫颈癌。结论食管癌、肺癌、鼻咽癌和胃癌是本地区常见肿瘤,中老年组患病率高,根据恶性肿瘤发病特征对高危人群做好防治工作是降低发病率、提高生存率的关键。     

1627例肺癌的发病年龄趋势分析

目的 分析1980～2008年肺癌发病年龄变化趋势与规律,为肺癌防治提供依据. 方法 收集、整理梧州红会医院肿瘤科1980～2008年共1627例肺癌病例资料,对其进行分析. 结果年龄分布呈正态分布.20～和40～岁年龄组构成比分别从1980～年的6. 77%和44.79%上升至2000～年的7.90%和49.14%,经趋势检验有统计学意义(P<0.01);说明其构成比呈现上升趋势.女性在80～ 年代的构成比由17.84%,上升至21世纪的27.61%, P<0.01.结论 近年肺癌发病年龄呈现年轻化趋势.     

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.