大连市2003年交通事故流行病学分析

目的及方法:对大连市2003年发生的3868起交通事故伤害原因进行回顾性分析及总结。结果:2003年共发生交通事故3868起,造成590人死亡,698人受伤,死亡率为10.35/10万。高发年龄为21岁～50岁的青壮年。摩托车和行人是车祸的高危人群,占死亡总数的67.9%。机动车驾驶员原因导致的事故占总事故的92.3%。结论:机动车驾驶员因素是导致交通事故的主要原因。事故伤亡的主要人员是具有劳动能力的青壮年。摩托车和行人是车祸的高危人群。改善交通环境、加强交通管理以及提高人的交通安全意识对预防道路交通事故伤害是十分重要的。     

惠州市惠阳区道路交通事故伤临床及流行病学情况调查研究

目的:探讨惠州市惠阳区道路交通事故伤发生特点、规律及临床救治经验,为进一步控制和预防道路交通事故伤的发生,降低意外伤害死亡率提供依据。方法:对惠州市惠阳区1995年1月~2004年12月道路交通事故统计监测资料进行分析、讨论。结果:10年来发生道路交通事故40176起,总伤亡人数25390人,其中死亡349人,致残907人,经治疗痊愈24134人。调查显示,交通事故伤的发生与季节、道路交通高峰时段、道路状况、职业、驾驶员违章驾驶、群众交通意识低下、道路交通管理水平及医疗网络建设不足等因素密切相关。结论:加强事故高发路段的交通管理,严格执法,改善道路交通条件,提高交通安全意识和加强医疗急救网络建设,是预防和控制道路交通事故伤害的主要措施。     

新疆维吾尔自治区道路交通事故死亡者流行病学调查分析

目的 对新疆维吾尔自治区道路交通事故的发生进行流行病学调查,为加强交通监管力度提供依据.方法 回顾性分析新疆地区2003年1月至2007年12月9 824例道路交通事故死亡者流行病学资料,重点分析年龄、驾龄、人员素质、天气及道路状况等.结果 交通事故导致的死亡以17岁以上多见,职业以居民、农民、干部和司机多见.导致事故的司机3年以上驾龄者多于3年以下驾龄,实习司机高于学习司机.高速路上交通事故占致死性交通事故的80.34%,晴天占85.71%.发生事故的车辆以货车、农用车、小车和摩托车为主.结论 加强交通安全教育,加强交通监管力度,尤其是高速路上执法力度,是降低新疆维吾尔自治区交通事故死亡率的关键.     

北京市2009年道路交通事故伤的特点分析

目的:探讨北京市道路交通事故发生特点和规律,为事故预防提供依据。方法:对北京市急救中心提供的2009年北京市道路交通事故资料进行整理录入,并进行描述性统计分析。结果:(1)2009年经北京市急救中心参与抢救的道路交通事故伤且病例记录相对完整者2 984人,其中受伤2 942人,死亡42人,伤亡人员以男性为主,年龄主要分布于18～59岁之间。(2)机动车和机动车之间的交通事故受伤人数最多,为1 883人;机动车与行人之间的事故死亡人数最多,为26人;机动车与机动车之间的重、特大事故最多,为11起。(3)一个月中的交通事故呈现持续频发均匀分布的状态,8∶00～10∶00、14∶00～18∶00是一天中的事故高峰,死亡事故高峰多发生在2∶00～4∶00和18∶00～20∶00。(4)伤员最常见的损伤部位是头面伤,为921人,其次分别为多发伤761人,下肢伤541人。(5)事故原因中人为因素为主,其次为车辆因素。结论:司机违章驾驶、行人违章穿行车道等人为因素是导致北京市道路交通伤的主要原因;加强对市民尤其是外来流动人口的交通安全教育以及对驾驶员进行严格的交通规章培训,提高市民的交通安全意识,进一步完善事故高发时段和路段的交通管控措施,是预防和控制交通伤害的主要措施。     

汽车驾驶员的人格与交通安全的关系

<正>在造成交通事故的人-车-道路环境系统中,人的因素起主要作用。文献报道90%以上的道路交通事故与驾驶员有关,驾驶员负主要责任的事故占70%以上[1]。可见,驾驶员是交通安全的主导因素,其生理、心理因素对交通事故均有一定的影响。而在心     

宁夏回族自治区2008-2010年交通事故流行病学调查

目的探讨宁夏回族自治区2008-2010年交通事故流行病学特点。方法与宁夏回族自治区公安厅交警总队合作,统计2008-2010年宁夏回族自治区道路交通事故数据,分析事故和人员伤亡特点及其原因,数据采用SPSS17.0软件进行统计学分析。结果 2008-2010年共发生交通事故5673起,事故次数、死亡人数、受伤人数及直接经济损失无明显上升或下降趋势。发生事故的人群年龄集中在21～45岁(81.2%),男性、农民和自主经营者。事故多发生于每年6～8月份(27.8%),以周1、日的18:00～20:00为事故高峰期。多发生于银川市区、一般城市道路(33.7%),多为客车事故(45.0%)。结论宁夏回族自治区的交通事故有自身的特点,在事故多发时段及地段适当增加交通管理人员和安全提示标志,加强对客车管理,提高农民和自主经营者交通安全意识,可有效地减少道路交通事故。     

高速公路行人交通伤特点分析

目的　探讨高速公路行人交通伤特点。方法　对广深高速公路 1998～ 2 0 0 0年 3年间 2 4 84起交通事故中 4 2起车 -人交通事故伤的病例资料进行分析统计。结果　 2 4 84起交通事故中死亡 12 8例 ,伤 812例 ,其中4 2起车 -人交通事故中死亡 34例 ,占死亡总数的 2 6 . 6 % (34/ 12 8) ,伤 8例 ,车 -人交通事故死亡率为 81. 0 % (34/ 4 2 ) ,死亡平均年龄 31岁 ,死亡患者中有 6 7 .6 % (2 3/ 34)现场死亡 ,17例为多发伤 ,ISS评分为 4 2分 ,事故发生时间 14 :0 0～ 2 2 :0 0共发生 30起 ,占 71 4 % (30 / 4 2 ) ,4 2例伤亡人群中 ,共有 34例合并有颅脑损伤 ,占 81 .0 % (34/ 4 2 )。结论　广深高速公路行人交通伤具有时间的聚集性 ,伤情重 ,死亡率高 ,颅脑损伤的发生率高 ,加强全社会高速公路的法律法规学习 ,对减少高速公路行人交通伤的发生具有显著意义。     

职业汽车驾驶员心理能力研究进展

<正>我国道路交通安全形势严峻,道路交通事故死亡人数占全世界的15%,多年高居世界第一。综观我国各种道路事故中,客车肇事造成交通事故最为突出。根据公安部数据显示:2005年发生一次性死亡10人以上特大交通事故47起,其中客车事故29起(61.7%);2006年发生一次性死亡10人以上特大交通事故38起,其中客车事故24起(63.2%);2007年发生一次性死亡10人以上特大交通事故26起,其中客车事故16起(61.5%);2008年发生一次性死亡     

145例摩托车交通事故死亡人员的特征分析

目的:探讨摩托车交通事故死亡人员的特征,为预防事故发生和降低摩托车交通事故死亡率提供可靠信息和参考数据.方法:收集重庆市道路交通事故技术鉴定中心2004年所检验的重庆市主城区摩托车交通事故135起、死亡145人的法医学资料,包括详细的事故经过、事故时间、发生地点、死者交通方式以及是否经过救治等,死者的基本情况、损伤情况及死亡原因等相关参数,进行回顾性分析.结果:性别、年龄差异显著,死者的交通方式为摩托车驾驶人占59.31%,乘坐人占20%,行人占20.69%,其中驾驶人中40岁以下的占79%,行人中50岁以上的占60%;当场死亡占36.55%,抢救无效死亡占63.45%;死亡原因65.52%为颅脑损伤,34.48%为其他损伤或联合损伤;95.17%的死者存在四肢损伤,下肢骨折与上肢骨折的比率为2.1∶1;2、3季度与1、4季度的事故发生比为1.64∶1.结论:摩托车交通事故死亡案例具有明显特点,具有可预防性.     

深圳市宝安区2004年至2011年道路交通事故伤的特点分析

目的：了解2004年至2011年深圳市宝安区交通伤的分布特点,为本市交通伤预防提供科学依据。方法：回顾性分析2004年1月至2011年12月经深圳市交警处理的交通事故数据,统计深圳市宝安区近8年交通事故发生的时间分布情况（年份、月份、日期及发生时间）、空间分布情况（发生路口路段及道路类型等）、交通事故患者伤亡情况（受伤、致死）。结果：2004年至2011年深圳市宝安区共发生道路交通事故422 730起,受伤63 809人,死亡2 790人,受伤/死亡比率为22.87∶1。宝安区交通事故发生数呈递增趋势,2010年发生数最高,达90 358起;2007年因交通事故致死人数最多,达473人。按月份统计,8月份交通事故发生率最高（9.77%）,2月份最低（5.39%）;12月份交通事故致死人数最多（9.02%）。按发生时间统计,一天中交通事故的发生高峰时间为9∶00至11∶00及15∶00至18∶00,而凌晨3∶00至6∶00交通事故发生数较低。交通事故多发生于路口路段、平直路线、城市主干道及仅有标示、标线的路段。结论：针对区域性交通事故发生特点,提高全民交通安全防范意识,合理调配急救人员、交通管理人员等人力资源,制定科学的防范措施,改进急救体系和服务模式,是预防和控制交通伤害的重要措施。     

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.