客运机车乘务员视觉功能状况的研究

目的 了解机车乘务员工作的视觉功能状况.方法 以客运机车的机车乘务员作为调查组,地面的勤杂工作人员为对照组,于工作前、后测定选择反应时值,用t检验进行显著性检验.结果 机车乘务员值乘后选择反应时各项时间平均变化率明显升高,观察组总平均反应时间日班、夜班增加(分别为3.553%,8.102%)高于对照组(分别为2.441%,3.994%);随着工龄增加反应时间呈增加趋势,观察组的不同工龄段总平均反应时间最高、最低增加(分别为9.175%,4.529%)高于对照组(分别为5.525%,3.091%);不同年龄段变化趋势与工龄相似.结论 值乘后机车乘务员视觉疲劳增高;建议定期开展视觉检查,控制和减少视觉疲劳发生,保障行车安全.     

铁路提速列车机车乘务员疲劳程度评价

目的评价铁路提速列车机车乘务员疲劳程度。方法对研究组和对照组采用疲劳评定量表评定乘务员疲劳程度,并选择临界闪光融合频率、选择反应时、手指灵活性、计量作业、数字广度、目标追踪等6项测试内容对乘务员进行出乘前和退乘后测试。结果研究组与对照组机车乘务员作业后均出现一定程度的疲劳,无显著性差异。结论提速列车机车乘务员作业后只产生轻度疲劳,单司机值乘制度较为合理。     

西北某铁路局机车乘务员睡眠质量影响因素分析

目的：了解影响新疆机车乘务员睡眠质量的相关因素。方法：采用横断面调查,使用匹兹堡睡眠质量指数的中文修订版调查表（ PSQI）和自制的影响睡眠质量的调查问卷调查新疆某机务段的1020名机车乘务员。通过一般人口学特征、生活行为习惯和工作情况的单因素分析及Logistic回归分析,探讨影响新疆机车乘务员睡眠质量的相关因素。结果：单因素分析显示不同民族、年龄、婚姻、文化程度、饮食规律、目前吸烟情况、饮酒次数、体育锻炼、工作压力、岗位、岗位工龄、月值乘次数和月值乘时间的机车乘务员睡眠质量差异有统计学意义（P＜0．05）;Logistic回归分析显示,文化程度高和参加体育锻炼是乘务员睡眠质量的保护因素,有婚史、目前吸烟、吸烟量和饮酒次数的增加、中度以上工作压力、岗位、月值乘次数和月值乘时间的延长是乘务员睡眠质量的危险因素。结论：新疆机车乘务员的睡眠质量较差,影响乘务员睡眠质量的因素是多方面的,为改善该人群的睡眠质量,应采取综合的干预措施进行预防。     

脂肪肝与生活行为因素的相关性研究

目的 探讨脂肪肝发病与生活方式和饮食习惯等行为因素的关系。方法 在健康体检的铁路机车乘务员、机车检修员中，以B超检查诊断的脂肪肝304人，同期体检条件相似的非脂肪肝540人作为对照组。结果 病例组的饮酒等级明显高于对照组（P〈0．01）、病例组少运动者明显高于对照组（P〈0．01）、进餐时间快（〈20min者52．25％vs44．07％）、饭店就餐（≥3次／周者37．17％vs14．63％）病例组明显高于对照组（P〈0．01）、病例组少食水果、蔬菜的比率明显高于对照组（1顿／d者63．82％ vs 45．37％，P〈0．01），以车代步、夜晚加餐病例组高于对照组（P〈0．05）、对照组的饮茶比率明显高于病例组（P〈0．01）。结论 脂肪肝的发生与生活方式和饮食习惯密切相关。     

机车乘务员膳食营养状况分析

目的：掌握机车乘务员的膳食营养状况并制定对策。方法：称量每餐烹调前可食物重、烹调后的熟食重以及吃剩食物重并统计用膳人数。结果：蛋白质摄入量为134.16g（其中动物性蛋白质达52．32％），占RDA的119．25％，占总热能的14．12％；脂肪摄入量为147．60g（其中动物性脂肪达61．41％），占RDA的147．60％，占总热能的45．00％；钙摄入量为543．26mg，占RDA的67．91％；提示乘务餐为“高蛋白、高脂肪”的饮食模式，建议其膳食结构为：稳定粮食，保证蔬菜水果，调整肉食，增加豆类及其制品、奶类及其制品。     

去甲长春碱持续静脉输注联合顺铂、大剂量三苯氧胺治疗晚期非小细胞肺癌

目的：观察去甲长春碱（NVB）持续静脉输注联合顺铂（DDP）、大剂量三苯氧胺（TAM）治疗晚期非小细胞肺癌（NSCLC）的近期疗效和毒性。方法：持续静脉输注NVB＋DDP＋大剂量TAM治疗20例为观察组，MVP方案治疗16例为对照组。结果：观察组CR2例,PR9例,总有效率55％；对照组CR1例，PR6例，总有效率43．7％。两组主要毒性反应为骨髓抑制和消化道反应，Ⅱ-Ⅳ度静脉炎，观察组发生率30％，高于对照组（0．0％）（P＜0．01）；Ⅱ-Ⅳ度周围神经毒性发生率，对照组（12．5％）高于观察组（0．0％）（P＜0．05）。结论：NVB持续静脉输注联合DDP、大剂量TAM是治疗NSCLC的较为有效而安全的新方法。     

小剂量芬太尼鼻腔喷雾用于术后止痛的效果观察

目的：观察小剂量芬太尼鼻腔喷雾的术后止痛效果。方法：选择硬膜外麻醉下手术后患者120例，随机分为试验组（A组）和对照组（B组）；A组用喉头喷雾器鼻腔喷入芬太尼0．6μg／kg，B组喷生理盐水；镇痛效果以10cm视觉主观疼痛标尺（VAS）评分。结果：用药30分钟后A、B两组VAS值分别为1．7±0．2cm和8．9±1．7cm（P＜0．01）；30分钟时镇痛有效率分别为100％和1％；其间两组血压、心率、呼吸无明显变化。结论：小剂量芬太尼鼻腔喷雾用于术后止痛安全有效。     

长期低氧环境暴露对人体声光反应时间的影响

目的以单纯及多重声光选择反应时间为指标，探讨脑内信息处理过程在长期高原低氧环境下是否受到低氧干扰对反应时间的影响。方法实验组为10名在海拔4500m低氧环境暴露两年的男性战士，对照组为10名一般正常男性。受试者接受常氧（20．95％）16％、13％及10％等浓度的常压低氧处理后，进行声光选择反应时间测试。结果对照组单一选择声光反应时间及多重选择声光反应时间在低氧环境下均有增加的趋势，单一选择光反应时间。在10％氧浓度与常氧状态差异性有统计学意义（P〈0．05）；实验组不受低氧影响而对声光选择反应时间产生显著干扰，但经过长期高山低氧环境暴露后，反应时间与对照组已有显著性差异（P〈0．05）。结论脑部光反应时间的功能，易受低氧干扰。     

油漆工神经行为功能调查

目的：探讨油漆对作业工人的早期危害。方法：用神经行为核心测试组合（NCTB）法对55名油漆工和66名非油漆作业人员进行神经行为功能检查。结果：观察组数字广度、手提敏捷度、数字译码、视觉持留、目标追踪-Ⅱ得分均低于对照组（P＜0.05)；困惑情绪状态和数字译码、视觉持留得分随工龄增加显著降低，而平均简单反应时随工龄增加明显延长，P均＜0.05。结论：油漆作业对油漆工神经行为功能的影响可能存在一定的剂量反应关系。     

高强度体外聚焦超声用于难治性盆腔内复发/转移癌的临床初探

目的 探讨高强度体外聚焦超声（HIFU）治疗对经综合治疗后在盆腔内不能手术的难治性复发／转移癌的治疗价值。方法 对同期经手术、放疗／化疗等多种综合治疗后在盆腔内难治性复发／转移癌晚期患者，分别采用HIFU＋放／化疗（21例）和放／化疗（26例）治疗，将两组的疗效（患者的客观指标、主观症状改善程度）及毒副反应进行比较。结果 HIFU组近期总有效率857％，对照组26．9％，两组比较P值=0．002。两组间生存期无显著差异，中位生存期分别为7个月和5个月；肿瘤平均消退值P〈0．01。HIFU组主观症状改善程度优于对照组，两组间疗后Kamofsky评分P值=0．001。HIFU组毒副反应较对照组明显轻而低，主要为可耐受的骨痛或坐骨／闭孔神经痛、轻度皮肤灼伤及轻度消化道反应。两组严重并发症发生率分别为9．4％和50．0％，P值=0．001；消化道反应发生率分别为28．8％（6／21）和73．1％（19／26），P值=0．006。结论 HIFU用于经综合治疗后不能手术的难治性盆腔内复发／转移癌，对局部病灶的控制有较好的近期疗效，作为一种姑息性治疗，其具有较高安全性，可提高患者的生活质量。     

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.     

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.     

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.