中国部分地区中老年人群骨质蔬松症流行病学研究

Theresearchisthelargesteffortonosteoporosisthathasbeenundertaken，andoneofthefewcountry－wideglobalefforts．TheresearchisespeciallyimportantwiththesuggestionthatChinesehavelowbonedensityingeneral，andtherapidagingoftheChinesepopulation犤１－２犦．１Materialsandmethods１．１SubjectsSubjectswereobtainedwithinformedconsentfrom５５９３HannationalityandregisteredinfiveareasofChinaincludingNorth，South－middle，East，South－westandNorth－eastbythestrati－fied－multi－steps－clustersamplingmethod…     

奇曼丁治疗晚期癌症疼痛的疗效

Itisestimatedthat７０％patientssufferedfromadvancedtumorsdevelopedpainofdifferentextent．Painaffectsqualityoflifedirect－ly，mind，psychology，socialandpersonalrelationandleadtodis－comfort犤１犦．WiththespreadingofWHOthree－stepmanagement，ad－ministrationwaysaretransformedfromdemanddependanttotimedepend犤１犦．Tramcontin（slowreleasedtramadol），theweakthebaicdrug，cancontrolmoderatepain．１Subjectandmethod１．１Subject１１６caseswithpathologicallyandradiologicallyprovedadvancedtumors（６…     

神经根性疼痛与肿瘤坏死因子相关性研究

Itisgenerallythoughtthatnerveroot，whichiscompressedbydiscprotrusionorbonehyerplasia，doesn＇tresultinpain．PGE－２，PLA－２，NOandsoonareallinflammationagents．TNFisalsoakindofinflammationagent．TNFhaswidebiologyrole．Itsimpor－tancewasemphasizedandithasbeenreportedthatTNFhasex－pressionindisc犤１犦．ThesubjectofthisarticleaimstostudythecorrelationbetweenTNFandnerverootpain．１Subjectsandmethod１．１SubjectsInthearticle４５caseswerereported，male２４cases，female２１cases；cervicalsy…     

采用四股半腱肌肌腱和缝线钢板重建前十字韧带后的康复训练

FromMay１９９７toApril２００１，wereconstructedoldanteriorcruciateligament（ACL）injuryusingquadrupled－strandedsemi－tendinosustendonandsutureplateand１－yearrehabilitationexer－cise，andtherapeuticeffectwasfavorable．Hereisthereport．１Subjectandmethod１．１Subjects５１patients（２７malesand２４femalesaged１３～５７years，meanage：２４．７）enteredourstudy．Patientswithseverecompoundinjuriesofposteriorinnerandouterligamentswereex－cludedfromourstudy．AccordingtoLysholmkneescorescale犤１犦…     

He-Ne激光重复照射抑制培养增生性瘢痕成纤维细胞胶原合成的实验研究

Hypertrophicscar（HS），atypeoffibrosisdiseaseofskinwhichischaracterizedbyhyperproductionanddepositionofcolla－genmatrix．So，inhibitionofcollagensynthesisanddepositionofcollageninfibroblastsareimportantforpreventionofHS犤１犦．Inthecurrentstudy，He－NelaserofvariouspowerdensitywasusedtoirradiateculturedfibroblastsderivedfromHStostudythepre－ventingeffectsofHe－NelaseronHS．１Materialsandmethod１．１Cellcultureandgrouping５casesofHSwereincludedinthisstudyaged１２～３１yearsold（２males，…     

腹膜后转移瘤介入治疗后生存质量随访

Nowadays，interventionaltherapyacquiredmoresignificanceinthetreatmentofmalignanttumors．Weappliedintra－tumorinjectionofanti－carcinomadrugs，inducedbyB－ultrasound，totreatpost－peritoneummetastatictumor．Hereisthereport．１Materialsandmethods１．１Materials１１caseswithpost－peritoneummetastatictumorswerechosenduringJanuary１９９８andJanuary２００１．Theoriginaltumors：２casesoflungcancer，２casesofgastriccarcinomaand６casesofcoliccarcinoma．７malesand４femaleswithaverageageof４９years．１…     

腰椎间盘突出症术后早期主动训练效果的临床观察

FromJanuary１９９３toJanuary１９９９，wehaveobserved７９casesaftertheoperationformonosegmentallumberintervertebraldischer－niationcontinuously，andthepatientsweredividedintoearlyactivetraininggroupandroutinecontrolgrouprandomly，aswellasacceptedtrainingandfollow－upof１～６yearsrespectively．Theresultsshowedthattheearlyactivetraininggrouphadbetterrecentanddistantob－jectiveeffectandmorepatientsweresatisfiedwiththeoperationalef－fects．Sowewillreportitasfollowing．１ObjectsandMethod１．１Obje…     

脑卒中后癫痫的危险因素分析

Inthisstudy，etiologyofepilepsywasanalyzedusingmulti－variatenonconditionlogisticanalysistoprovidebasisforpreventionandrehabilitationofepilepsy．１Subjectandmethod１．１SubjectDuringNovember１９８７～May１９９６，１６２６sub－jectsunderwentfirstonsetofcerebrovasculardiseasewerere－cruitedfromintraneuralDepartment．１７９patientsexperiencedepilepsysecondarytostroke．AllprimarylesionswereprovedbyCTorlumbarspinepuncture．Nopatientshadhistoryofepilep－sy．Rheoencephalogramshowedepilepticchanges…     

P27基因对人喉癌细胞抑制作用的研究

１Materialsandmethods１．１CelllinesandvectorHumanlaryngealcarcinomacelllineHep－２weregrowninDulbeccomodifiedEaglemedium．Thep２７eu－karyoticexpressionvectorpCMV－p２７wasagiftfromDrLijinge．１．２DNAtransfectionDNAtransfectionbyLipofectamineac－cordingtothemanufacturer｀sinstructions（Gibco）．１．３AnalysisofcellcyclebyflowcytometryCellstransfectedwithpCMV－p２７werecollectedbytrypsinization，fixedwith７０％ethanol．After４８hours，cellswerecollected，resuspendedin１mloflysisbuffe…     

非稳态噪声作业对油田压裂工人听力损伤的调查研究

１Subjectandmethod１．１Subject１４５６fracturingworkersofoilfieldwererandomlyselectedassubjects．Workerssufferingfromhearinglossduetononindustrialdamagewereexcludedfromthestudy．３５１workerswhodidnotworkedinfracturingplantwereselectedascontrolgroup．１．２MethodUsingfinesound－levelmeterND－２correctedbyChinaAcademic，weassessfieldnoiseofenvironmentwherefrac－turingworkersworkedaccordingtoEvaluationStandardsfornoiseofIndustryandEnterprise．Self－madequestionnairewasusedforas－sessmentofp…     

曲美他嗪对冠心病稳定性劳力型心绞痛患者心肌缺血的影响

目的探讨曲美他嗪对冠心病（CHD）稳定性劳力型心绞痛患者心肌缺血的影响。方法选择在1周内经2次运动试验,结果为阳性且运动持续时间变异低于10％的CHD稳定性劳力型心绞痛患者40例,在原有治疗不变的情况下,加用曲美他唪20mg,3次／d,治疗12周。治疗前后均行平板运动试验,观察用药前后下述指标的变化：①用药前后每周心绞痛发作的次数;②每周硝酸甘油片的用量;③心率及心率与收缩压的乘积;④运动诱发心绞痛发作所需的时间;⑤运动后ST段下降1mm所需的时间;⑥运动持续时间;⑦总工作量。结果曲美他嗪应用12周后,患者每周心绞痛发作次数及硝酸甘油片的用量明显下降（P〈0．05）,而对心率及心率与收缩压的乘积的影响无统计学意义（P〉0．05）。与试验前相比,运动耐量和总工作量显著提高（P〈0．01）,至心绞痛发作的时间及ST段下降1mm所需的时间均明显延长（P〈0．01）。不良反应较少。结论曲美他嗪能增加CHD稳定性劳力型心绞痛患者的运动耐量,改善运动诱发心绞痛的心肌缺血,且安全有效,易于耐受。     

Effects of nipradilol, a new beta-blocking agent with vasodilating properties, on exercise tolerance in patients with stable effort angina: a double-blind study

The effects of nipradilol, a new beta-blocking agent with vasodilating properties, on exercise tolerance were examined in eight patients with stable effort angina. Symptom-limited treadmill tests were performed two hours after administration of oral nipradilol (9 mg) or placebo in a double-blind manner. Exercise time to the onset of angina was significantly longer after nipradilol than after placebo (6.8 +/- 2.5 min versus 5.0 +/- 1.2 min, P less than 0.05). Exercise duration after nipradilol was not statistically different from that after 0.3 mg of sublingual nitroglycerin (7.2 +/- 1.9 min). Nipradilol significantly decreased heart rate both at rest and during exercise (P less than 0.01). Systolic blood pressure at rest did not change after nipradilol. However, an increase in systolic blood pressure during exercise was inhibited by nipradilol. The pressure rate product was significantly lower after nipradilol than after placebo. It is concluded that nipradilol improves exercise tolerance in patients with stable effort angina by decreasing the myocardial oxygen consumption during exercise.     

运动疗法对老年陈旧性心肌梗死患者心率变异性影响

目的探讨运动疗法对老年陈旧性心肌梗死(OMI)患者心率变异性(HRV)的影响. 方法在运动疗法前和疗程结束后,应用24 h连续动态心电图监测老年OMI患者的HRV时域指标,并行心脏超声获取老年OMI患者EDV、ESV、EF、CO值且设对照组. 结果①试验组在运动疗法前,HRV和EDV、ESV、EF、CO值均低于对照组值(P<0.05);②试验组运动疗法后HRV和EDV、ESV、EF、CO值较对照组无明显差异(P>0.05);③试验组运动疗法后HRV和EDV、EF、CO值较其运动疗法前明显增高,差异有非常显著性意义(P<0.01). 结论运动疗法利于改善老年OMI患者的心脏功能.     

Trimetazidine in Angina Combination Therapy--the TACT study: trimetazidine versus conventional treatment in patients with stable angina pectoris in a randomized, placebo-controlled, multicenter study

The aim of this study was to assess the efficacy and acceptability of trimetazidine (TMZ) in combination with hemodynamic agents (beta-blockers or long-acting nitrates) in 177 stable angina patients. In this randomized, placebo-controlled study (TACT: Trimetazidine in Angina Combination Therapy), stable angina patients resistant to nitrates or beta-blockers were selected. After a 1-week selection period (W0), patients who had a difference of <10% in duration between 2 positive exercise tests, defined as 1-mm ST-segment depression (STD) 80 milliseconds after J point with angina pain or 1.5 mm without pain were randomly treated with TMZ (20 mg t.i.d., n = 90) or placebo (Pbo t.i.d., n = 87) orally. A final exercise test was performed after 12 weeks of treatment (W12). The efficacy was assessed by exercise test duration, time to 1-mm STD, time to angina onset, mean number of angina attacks, mean short-acting nitrate consumption, and rate-pressure product. Differences (W12 - W0) in these parameters were analyzed using the Student t test. All statistical tests were conducted at the 5% significance level. At inclusion and during the study, 52% of patients received long-acting nitrates, and 48% were treated with a beta-blocker as monotherapy. At the beginning of the study, the TMZ and Pbo groups were statistically homogeneous with respect to all analyzed characteristics (demographic characteristics, characteristics of anamnesis, characteristics used for evaluation of antianginal therapy efficacy). For various reasons, 11 patients (7 from the Pbo group and 4 from the TMZ group) were excluded from the trial. A total of 166 patients (80 from the Pbo group and 86 from the TMZ group) completed the study in full compliance with the protocol. After 12 weeks of therapy, exercise test duration increased from 417.7 +/- 14.2 (W0) to 506.8 +/- 17.7 seconds (W12) in the TMZ group versus 435.3 +/- 14.8 (W0) to 458.9 +/- 16.2 seconds (W12) in the Pbo group (P < 0.05). Time to 1-mm STD increased from 389.0 +/- 15.3 (W0) to 479.6 +/- 18.6 seconds (W12) in the TMZ group versus 411.8 +/- 15.2 (W0) to 428.5 +/- 17.3 seconds (W12) in the Pbo group (P < 0.05). Time to onset of anginal pain increased from 417.0 +/- 16.9 (W0) to 517.3 +/- 21.0 seconds (W12) in the TMZ group versus 415.1 +/- 16.5 (W0) to 436.4 +/- 18.5 seconds (W12) in the Pbo group (P < 0.005). The mean number of anginal attacks per week decreased from 5.6 +/- 0.6 to 2.7 +/- 0.5 in the TMZ group versus 6.8 +/- 0.7 to 5.1 +/- 0.7 in the Pbo group (P < 0.05), mean consumption short-acting nitrates per week decreased from 5.2 +/- 0.9 to 2.8 +/- 0.8 in the TMZ group versus 5.5 +/- 0.8 to 4.1 +/- 0.9 in the Pbo group (NS). No change in the rate-pressure product was seen in both. The combination of trimetazidine with beta-blockers or long-acting nitrates significantly improves exercise stress test parameters and angina symptoms compared with placebo. Due to its metabolic effect, free of any hemodynamic action, trimetazidine has proven to be beneficial for combination in patients with stable angina.     

负荷剂量曲美他嗪对不稳定型心绞痛介入治疗术后肌钙蛋白I的影响

目的评价口服负荷剂量曲美他嗪在不稳定型心绞痛经皮冠状动脉介入术（PCI）治疗中对心肌损伤的保护作用。方法 291例不稳定型心绞痛患者,选择经冠脉造影后只需单支血管接受PCI,且球囊预扩张1次者,排除多支血管病变、行1次以上球囊预扩张、术前肌钙蛋白I（cTnI）增高、术前曾口服曲美他嗪治疗及药物禁忌证后,最后共136例患者入选,随机分成两组：曲美他嗪组（术前一次性口服曲美他嗪60 mg）70例及对照组（未服用曲美他嗪）66例。测定PCI前及PCI后6、12、18、24 h的cTnI水平。结果两组cTnI水平均升高,升高率曲美他嗪组与对照组比较差异无统计学意义（21.4%vs 19.7%,P〉0.05）,但曲美他嗪组cTnI水平在介入术后6、12、18、24 h均低于对照组（P均〈0.01）。结论负荷剂量曲美他嗪预处理后能明显减轻不稳定型心绞痛PCI治疗所致的心肌损伤。     

曲美他嗪对稳定性劳力型心绞痛的疗效观察

目的 :观察曲美他嗪 (Trimetazidine)联合传统疗法对冠心病 (CHD)稳定性劳力型心绞痛患者抗心绞痛的疗效和安全性。方法 :将 12 0例确诊的稳定性劳力型心绞痛患者 ,随机分为 A组和 B组各 6 0例 ,两组均予传统疗法治疗 ,B组加服曲美他嗪 2 0 mg,3次 / d,疗程均为 12周。观察全组病例治疗前后每周心绞痛发作次数、基础心率、运动诱发心绞痛所需时间、运动至 ST段压低 1mm所需时间及运动持续时间。结果 :B组治疗前后自身比较每周心绞痛发作次数、运动诱发心绞痛所需时间、运动至 ST段压低 1mm所需时间及运动持续时间均有显著统计学差异 (P<0 .0 1) ,治疗后组间比较运动诱发心绞痛所需时间 B组明显优于 A组 (P<0 .0 1) ;每周心绞痛发作次数、运动至 ST段压低 1mm所需时间及运动持续时间 B组明显优于 A组 (P<0 .0 5 )。结论 :曲美他嗪联合传统疗法对稳定性劳力型心绞痛患者抗心绞痛的疗效优于单纯用传统药物治疗     

冠心病患者等长收缩运动与心肌缺血的关系

目的　探讨冠心病患者等长收缩运动与心肌缺血的关系。方法　采用超声多普勒技术 ,比较 2 0例冠心病患者和 10例正常人极量短暂等长收缩运动 (briefisometricexercise ,BIE)、极量持续等长收缩运动(sustainedisometricexercise ,SIE)与动力性运动 (dynamicexercise ,DE)时的血流动力学反应和心功能表现。 结果　有心肌缺血的冠心病患者在DE运动终点时有心肌缺血表现 ,但BIE和SIE时无相应表现。心血管反应总体趋势为 :DE时心率和两项乘积运动增量均明显高于BIE和SIE ,各组间差异不显著。正常组DE时血流动力学多数指标的运动增量均高于BIE和SIE ,但有无心肌缺血的冠心病患者之间无明显差异。结论　在同等主观用力的前提下 ,冠心病患者等长收缩运动时心肌缺血发生率低于动力性运动。等长收缩运动时较高的舒张压和较长的灌注时间对心肌缺血有一定的保护作用。等长收缩运动在冠心病康复中的应用有合理的生理学基础。     

曲美他嗪治疗陈旧性心肌梗死合并心力衰竭患者的疗效观察

目的观察曲美他嗪（TMZ）治疗陈旧性心肌梗死合并心力衰竭患者的疗效。方法将入选患者随机分为对照组35例和曲美他嗪组35例,疗程均为6个月。结果所有患者在用药前和用药6个月时分别行B型钠酸肽（BNP）及超声心动图（用LVEF、CO、CI等指标）评价心功能。对照组虽能改变LVEF,但CO无显著变化（P〉0．05）;而TMZ组能显著改善LVEF,且能显著增加CO（P〈0．05）;两组均能降低BNP（P〈0．01或P〈0．05）,但TMZ组更能有效降低BNP及改善心功能（P〈0．05）。结论在常规治疗陈旧心肌梗死后心力衰竭基础上加用曲美他嗪可以明显改善心脏功能。     

运动疗法在心脏术后康复中的作用

目的：探讨运动疗法在心脏术后康复中的作用。方法：21例心脏手术后患者均接受功率自行车或／和跑台训练为主的康复训练，并采用常规心电运动试验对康复训练前后的各项指标进行比较。结果：运动训练后，运动时间和最大运动负荷显著增加，安静时，心率、血压（包括收缩压和舒张压）、心率－血压乘积均显著下降（P＜0．05，P＜0．01），安静时心电图最大ST段压低明显改善（P＜0．01）；同等负荷量运动时，心率、血压、心率－血压乘积及运动诱发的最ST段压低与安静状态时有相似的改变(P＜0．05，P＜0．01）。结论：心脏术后的康复训练有助于增加体能，减轻心肌缺血，增加心肌储备功能，从而改善了患者的生活质量。     

The Acute Administration of Trimetazidine Modified Myocardial Perfusion and Left Ventricular Function in 31 Patients with Ischaemic Ventricular Dysfunction

Trimetazidine (TMZ) increases the mithocondrial oxidative metabolism and improves Tc-99m sestamibi uptake in myocardial single photon emission tomography (SPECT). The aim of this study was to evaluate whether the acute administration of TMZ improved myocardial perfusion and modified left ventricular ejection fraction (LVEF) in ischaemic left ventricular impairment. METHODS: Thirty-one patients (23 males, age 66 years) with prior myocardial infarction (>6 months) and echocardiographic LVEF < or = 45% underwent coronary angiography, rest basal myocardial SPECT (after 3-day placebo administration) and rest TMZ myocardial SPECT [after 3-day TMZ administration (60mg/die)]. The left ventricle was analysed in 16 segments. The summed placebo score (SPS) and the summed TMZ score (STS) were calculated with a 5-point scale (from 0 = normal uptake to 4 = absent uptake) by two blinded operators. The GATED Tc-99m SPECT was always provided. RESULTS: After TMZ administration GATED LVEF improved from 26.5+/-9.7% to 29.1+/-11.3% (p = 0.04) and left ventricular end-systolic volume (LVESV) was reduced from 90.2+/-40.7 to 85.6+/-39.2 ml/mq (p = 0.006). Similarly the addition of TMZ to myocardial SPECT significantly reduced the STS compared to SPS (21.5+/-11 vs. 26.6+/-10.5 p = 0.0001). Eleven patients (35.5%) had an echocardiographic LVEF < or = 30%; in these patients who had severe ventricular dysfunction, GATED LVEF and LVESV did not change after TMZ (20.2+/-5.7% vs. 21+/-6.9% p =0.6; 116.7+/-35.3 ml vs. 112.6+/-32.3 ml p = 0.08, respectively). CONCLUSION: In comparison with placebo, the addition of TMZ to myocardial Tc-99m tetrofosmin SPECT improved myocardial perfusion and LVEF, reducing LVESV. These effects were lost in patients with more severe ventricular dysfunction.