菏泽市艾滋病病毒感染者生存现状的研究

目的 了解HIV感染者及AIDS病人的生存环境和生活质量，以建立适合我市实际的家庭和社会关怀和支持体系。方法 采取典型调查的方式调查已确认的HIV／AIDS患者，在知情、保密的情况下进行个人访谈；另外采用现况调查的方法，选择存在HIV感染者和AIDS病人的村庄或附近村庄的居民，调查社区内存在的相关歧视及原因。结果 HIV／AIDS患者存在着健康状况恶化、就医困难、经济窘迫、遭受歧视等的生存危机。结论 应有计划、有步骤地扩大全民健康教育，宣传歧视和不尊重HIV／AIDS病人权利的危害性，真正消除对艾滋病恐惧；建立对感染者和病人的保护机制；提供关怀、护理、社会和情感支持等的预防控制措施。     

艾滋病病毒感染者生存现状的调查研究

目的了解HIV感染者及AIDS病人的生存环境和生活质量,加强社会关怀支持工作。方法采取问卷调查的方式调查已确认的HIV/AIDS患者,在知情、保密的情况下进行个人访谈;另外选择存在HIV感染者和AIDS患者的社区居民,调查存在的相关歧视及其原因。结果HIV/AIDS患者存在着健康状况恶化,就医困难,经济窘迫,遭受歧视等生存危机。结论应有计划地在普通人群中进行宣传教育,制定有效的措施,降低社会对艾滋病的恐惧、歧视,减少由艾滋病病毒感染者引发的社会问题,为艾滋病患者提供社会性的关怀和情感支持。     

AIDS／HIV阳性患者心理压力的质性研究

获得性免疫缺陷综合征（Acquired Immune Deficiency Syn—drome）简称为艾滋病（AJDs），是由人类免疫缺陷病毒（Human Immunodeficiency Virus，HⅣ）引起的以T淋巴细胞损害为主的慢性传染病。HIV阳性主要指HIV抗体阳性的未发病人群。由于该病尚无有效的治疗措施，病死率高，且社会人群对AIDS患者存在偏见、歧视等，使AIDS／HIV阳性患者面对着疾病、社会或家庭等多重压力[1]。适度压力对维护个体身心健康和功能活动具有促进作用，而长期的、超过个体适应能力的压力对健康是有害的[2]。因此，对MDS／HIV阳性患者进行心理压力质性研究，可以掌握其面临的压力来源，为帮助患者减轻心理压力提供指南。     

艾滋病病毒感染者生存现状的调查研究

目的 了解HIV感染者及AIDS病人的生存环境和生活质量,加强社会关怀支持工作.方法 采取问卷调查的方式调查已确认的HIV/AIDS患者,在知情、保密的情况下进行个人访谈;另外选择存在HIV感染者和AIDS患者的社区居民,调查存在的相关歧视及其原因.结果 HIV/AIDS患者存在着健康状况恶化,就医困难,经济窘迫,遭受歧视等生存危机.结论 应有计划地在普通人群中进行宣传教育,制定有效的措施,降低社会对艾滋病的恐惧、歧视,减少由艾滋病病毒感染者引发的社会问题,为艾滋病患者提供社会性的关怀和情感支持.     

多途径反歧视干预模式在艾滋病患者中的应用效果评价

中国在联大特别会议2010年国家进展报告中估计我国人类免疫缺陷病毒（HIV）／获得性免疫缺陷综合征（AIDS）的人数为74万左右［1］,但是近两年我国累计报告的 HIV／AIDS 只有22～32万例［2］,尚有4万多的 HIV ／AIDS 人群未进行检测和治疗,其中最重要的原因是艾滋病相关羞辱和歧视的存在。来自于家庭和社会各方面的羞辱和歧视使 HIV ／AIDS 人群失去了经济和情感支持,不能公平享有医疗卫生服务,被迫失业,普遍存在焦虑、抑郁,内疚或负罪感,自杀倾向和自杀病死率明显高于一般人群［3‐6］,这不仅使 HIV／AIDS 人群在生理、心理和社会生活等方面的受到很大的影响,而且也成为社会综合防治艾滋病的重大障碍。在我国,艾滋病相关羞辱和歧视的干预措施集中在通过大众传媒、各种形式的教育培训等提高人们的知识,增加大众对 HIV／AIDS 人群的可接受程度［7］。这些干预措施在短时期内起到了一定的效果,但是研究发现,单纯的宣传教育并不能完全改善人们对 HIV ／AIDS 人群的歧视态度,对他们生活质量的影响也很小［8］。国外对艾滋病相关羞辱和歧视的研究主要集中在探索如何降低 HIV／AIDS 人群感知到的羞辱和歧视,于是,强调感染者积极参与的干预项目是以后研究工作的重点。本研究以患者为中心,融合中国传统的家庭文化理念,建立以家庭为基础的艾滋病反歧视干预模式,为进一步开展社区艾滋病反歧视干预活动提供研究基础。     

艾滋病相关羞辱和歧视的辩证思考

应用辩证唯物论分析了艾滋病相关羞辱和歧视产生的原因及其对感染者、感染者家庭成员以及社会产生的影响，并指出了艾滋病预防和控制工作中的不足，从艾滋病知识宣教、社会支持等方面提出了相应的干预措施，这样需要做好社会公众、HIV感染者和AIDS患者（即PLWHA）及其家庭成员三方面的工作。加强公众的正确认知，使他们能以正常的心态看待PLWHA，减少并消除对这一弱势群体的歧视；另外，作为医务工作者更需要重视与其家庭成员多沟通，及时了解他们的身心需要，并提供有效的帮助，使他们在生活上给予患者更多的照顾和支持以及在心理上给予其关怀和鼓励，使患者从真正意义上感受到家庭的温暖，更好地提高其生活质量，本文旨在希望能为今后的艾滋病的防治工作提供新观点和新方法。     

高州市HIV/AIDS流行状况分析

目的分析高州市近年艾滋病流行情况，为制定艾滋病预防控制措施提供依据。方法对高州市1999—2006年12月底29例HIV／AIDS阳性者的个案调查资料进行统计学分析。结果高州市HIV／AIDS流行近年来呈上升趋势；HIV感染者及AIDS患者以涉外婚姻家庭和外出务工返乡人员为主；以异性接触为主要传播途径。结论加大艾滋病预防知识的宣传，提高人民群众对预防艾滋病的认识水平，扩大人群的搜索与监测，做好涉外（尤其是外籍人员）的婚前检查，是预防控制艾滋病发生的重要手段。     

清远市艾滋病流行情况分析

目的:分析清远市艾滋病(HIV／MDS)流行现状，为预防控制HIV／AIDS提供科学依据。方法:收集近年疫情报告、HIV／AIDS监测和流行病学调查资料进行分析。结果:1999～2003年累计发现艾滋病病毒感染(HIV)50例，其中艾滋病人(AIDS)4例，死亡2例。2003年吸毒人群HIV抗体检出率5．62％，静脉吸毒血液传播占68％，性途径传播占22％，并已出现3户家庭的夫妻共同感染HIV／AIDS。结论:清远市目前HIV／AIDS尚处于低度流行期，但感染HIV人数逐年呈倍数增加，HIV／AIDS已从高危人群向一般人群扩散，呈现快速增长趋势。开展健康宣传教育和减少危害的行为干预等综合性防制措施，对有效遏制HIV／AIDS的扩散流行甚为迫切。     

农村中学预防艾滋病健康教育活动的调查

目的了解我校中学生对艾滋病的基础知识的认识以及有关艾滋病的态度、信念、行为状况，为农村中学开展艾滋病健康教育提供科学依据。方法采取整体问卷形式对全校1576名学生进行调查。结果中学生对艾滋病知识了解不全面，特别是对艾滋病的三种传播途径和不传播途径认识模糊，认为艾滋病离自己很遥远，不愿意帮助或歧视艾滋病病毒（HIV）感染者或艾滋病（AIDS）患者。结论学校预防艾滋病健康教育工作应该得到加强，应当采取多种形式对中学生进行艾滋病预防教育，在教育中应注意培养学生正确的性道德观念，培养学生不歧视HIV感染者及AIDS患者。     

贵阳市开展艾滋病病毒感染者／艾滋病病人社区支持与关怀生产自救自助新模式研究

目的 研究在城市开展艾滋病病毒感染者／艾滋病病人（HIV／AIDS）社区支持与关怀生产自救自助新模式。方法 在贵阳市健康关爱苑建立厂房，创造条件购买生产垃圾塑料袋机，培训HIV／AIDS为生产技工，由HIV／AIDS生产加工垃圾塑料袋，组织贵阳市广大的“防艾志愿者”进行义卖，增加HIV／AIDS的收入，改善他们的生活质量，减少他们及家庭成员在生活、就业等方面受到的歧视并减轻压力，提高HIV／AIDS的生活技能，使之成为可持续的自负盈亏的“经济实体”。结果完成了以贵阳市健康关爱苑为平台，由HIV／AIDS生产垃圾塑料袋，组织HIV／AIDS及贵阳地区志愿者义卖，增加HIV／AIDS收入，改善和提高他们的生活质量，形成了以HIV／AIDS社区支持与关怀生产垃圾塑料袋自救自助新模式，初步形成了以生产垃圾塑料袋为主的（另还组织HIV／AIDS编织和义卖“防艾中国结”）、生产自救自助和自负盈亏的“经济实体”雏形。结论开展HIV／AIDS社区支持与关怀，其关键要使其具有可持续性，如何组织HIV／AIDS开展生产自救自助，同时还需要由政府领导，多部门合作，全社会参与，及时制定相关配套政策，解决其中存在的问题。另外疾控部门在牵头、创思、支持、协调、督导起到了至关重要的作用。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.