原发性肝癌危险因素病例对照的非条件Logistic回归分析

目的:探讨广西肝癌高发区原发性肝癌的危险因素.方法:采用病例对照的方法进行调查,对200名原发性肝癌病例和200名对照的结果进行单因素和多因素非条件Logistic回归分析.结果:有10个因素最终被选人多因素非条件Logistk:回归模型,包括乙型肝炎、肝癌家族史、A型性格、B型性格、情绪、精神压抑、食鱼生、腌晒食品、收入、人际关系,其OR值分别是22.399、7.841、7.876、5.909、3.315、13.994、15.164、12.175、2.632和6.403.结论:广西肝癌高发区原发性肝癌可能与生活方式、饮食习惯、肝炎病史、肝癌家族史和社会心理因素等因素有关.     

广西区肝癌高发家庭人群乙肝发病情况及生活嗜好的调查分析

目的:探讨广西区肝癌高发家庭人群乙肝发病情况及不良生活嗜好是否与肝癌高发有关。方法:检测肝癌高发组176例与对照组115例的乙肝病毒标志物、肝细胞酶,并统计两组饮酒人数及饮酒量、吸烟人数及吸烟量,以及食鱼生的人数。结果:高发组HBsAg、HBeAg、抗-HBe、抗-HBc阳性率明显高于对照组,而两组的抗-HBs阳性率无明显差异。高发组AST、ALT升高的人数比例显著高于对照组。高发组饮酒人数比例稍高于对照组,但差异无统计学意义(P>0.05)。而吸烟人数及食鱼生人数比例、饮酒及吸烟量,高发组均显著高于对照组。结论:HBV感染是广西区肝癌高发家庭人群肝癌高发的主要危险因素,饮酒、吸烟、食鱼生等不良生活嗜好使这些人群肝癌的发病危险显著增加。     

INVESTIGATION AND ANALYSIS OF THE HEPATITIS B INCIDENCE AND LIVING HABITS IN POPULATION OF HIGH-INCIDENCE HEPATOCELLULAR CARCINOMA FAMILIES IN GUANGXI

目的:探讨广西区肝癌高发家庭人群乙肝发病情况及不良生活嗜好是否与肝癌高发有关.方法:检测肝癌高发组176例与对照组115例的乙肝病毒标志物、肝细胞酶,并统计两组饮酒人数及饮酒量、吸烟人数及吸烟量,以及食鱼生的人数.结果:高发组HBsAg、HBeAg、抗-HBe、抗-HBc阳性率明显高于对照组,而两组的抗-HBs阳性率无明显差异.高发组AST、ALT升高的人数比例显著高于对照组.高发组饮酒人数比例稍高于对照组,但差异无统计学意义(P＞0.05).而吸烟人数及食鱼生人数比例、饮酒及吸烟量,高发组均显著高于对照组.结论:HBV感染是广西区肝癌高发家庭人群肝癌高发的主要危险因素,饮酒、吸烟、食鱼生等不良生活嗜好使这些人群肝癌的发病危险显著增加.     

29例HBV肝硬化并发原发性肝癌相关因素分析

目的探讨乙型肝炎病毒(Hepatitis B virus,HBV)肝硬化并发原发性肝癌患者的相关危险因素,为原发性肝癌的预防提供指导依据。方法以29例HBV肝硬化并发原发性肝癌患者作为研究对象,设为实验组,以同期住院的41例HBV肝硬化患者设为对照组,采用Logistic回归分析法评估各指标对HBV肝硬化患者并发原发性肝癌的影响。结果经Logistic单因素筛选与多因素分析,长期吸烟和饮酒史(OR=2.980)、未抗病毒治疗(OR=2.111)、合并糖尿病(OR=1.782)、HBV DNA(+)(OR=1.791)、抗-HBe(+)(OR=2.010)、HBs Ag(+)(OR=2.131)、肝癌家族史(OR=1.811)等是HBV肝硬化患者并发原发性肝癌的独立危险因素(P0.05)。结论 HBV肝硬化患者若伴有HBV DNA(+)、抗-HBe(+)、HBs Ag(+),或有长期吸烟和饮酒史、肝癌家族史及糖尿病,则存在较高的并发原发性肝癌的风险,抗病毒治疗可降低该风险。     

陕北原发性肝癌危险因素1∶2配比病例对照研究

目的为了摸清并掌握陕北原发性肝癌(HCC)的主要危险因素,探索病因模式,为采取有效预防措施提供科学依据. 方法以1999-12/2000-12在陕北3所市级医院确诊的88例HCC住院患者为研究对象,进行了1:2配比病例对照研究. 结果单因素条件logistic回归分析结果:P<0.01的因素有个人肝病史、HBsAg, anti-HBc, HBeAg, anti-HBe,内向性格、平时心情、乙肝家族史,其OR分别为19.5,54.9,12.1,4.4,27.3,2.1,10.1和11.3. P<0.05的因素有anti-HBs、吸烟、饮酒、负性生活事件、HCC家族史,其OR分别为0.4,1.8,2.0,2.0和2.7. 多因素条件logistic回归分析,以P<0.05为保留条件进入最终模型的因素有:HBV感染、个人肝病史、平时的心情、饮酒和乙肝家族史. 未发现因素之间有相乘模型的交互作用. 结论陕北HCC的主要危险因素是HBV感染、个人肝病史、平时心情、饮酒和乙肝家族史. 另外负性生活事件、内向性格、HCC家族史和吸烟也与HCC的发生有关. anti-HBs是唯一的保护因子. 预防和控制陕北原发性肝癌最根本、最有效的措施是接种乙肝疫苗.     

肝癌高发区原发性肝癌患者家族史调查

目的探讨肝癌高发区原发性肝癌的家族发病情况。方法采用调查问卷的方法,对广西隆安县队列研究中65例确诊为原发性肝癌患者的家系按一、二级亲属进行调查,核实其家族内原发性肝癌的发病情况,比较家族人群的肝癌发病率。结果共调查家属成员1167人,先证者中有肝癌家族史占60．00％,患者亲属发病率（6．17％）高于该地区一般人群的肝癌发病率。一级亲属患病率（14．84％）高于二级亲属患病率（3．03％）。发生肝癌例数最多的一个家族有7例。父亲中肝癌的发病率最高,男性患病率高于女性,乙型肝炎病毒（HBV）DNA阳性者有肝癌家族史的高于HBVDNA阴性者。结论原发性肝癌与HBV感染和肝癌家族史有密切关系,肝癌家族史的遗传模式复杂。     

陕北原发性肝癌危险因素1：2配比病例对照研究

目的 为了摸清并掌握陕北原发性肝癌（HCC）的主要危险因素，探索病因模式，为采取有效预防措施提供科学依据。方法 以1999－12／2000－12在陕北3所市级医院确诊的88例HCC住院患者为研究对象，进行了1：2配比病例对照研究。结果 单因素条件logistic回归分析结果：P＜0．01的因素有个人肝病史，HBsAg,anti-HBc,HBeAg,anti-HBe,内向性格，平时心情、乙肝家族史，其OR分别为19．5，54．9，12．1，4．4，27．3，2．1，10．1和11．3，P＜0．05的因素有anti-HBs、吸烟、饮酒、负性生活事件，HCC家族史，其OR分别为0．4，1．8，2．0，2．0和2．7，多因素条件logistic回归分析，以P＜0．05为保留条件进入最终模型的因素有：HBV感染，个人肝病史、平时的心情、饮酒和乙肝家族史。未发现因素之间有相乘模型的交互作用。结论 陕北HCC的主要危险因素是HBV感染、个人肝病史、平时心情，饮酒和乙肝家族史。另外负性生活事件、内向性格、HCC家族史和吸烟也与HCC的发生有关。anti-HBs是唯一的保护因子。预防和控制陕北原发性肝癌最根本、最有效的措施是接种乙肝疫苗。     

青壮年肝癌10例分析

目的：探讨青年原发肝癌的临床特点。方法：分析10例青年肝癌患者（年龄〈40岁）的临床特点,包括临床症状体征、肝癌家族史、饮酒史、HBV感染率,ALT异常,AFP阳性,合并肝硬化、门静脉癌栓以及肝癌类型。结果：青年肝癌HBV感染（10例）,ALT异常（7例）,AFP阳性（7例）,门静脉癌栓（3例）,结论：青年肝癌恶性程度高对HBV感染青年人也应定期进行B超和AFP检查,以便早期发现、早期治疗原发性肝癌。同时应积极预防及治疗乙肝,避免黄曲霉菌感染、饮水污染、饮酒及精神创伤。     

乙型肝炎病毒传染性在肝癌家族聚集现象中的作用

启东肝癌高发区具有明显的肝癌家族聚集现象。其原因除与这些家族成员共同具有某些易感因素外,还与乙型肝炎病毒（HBV）感染聚集流行有关。HBV慢性感染是高发区肝癌的主要病因之一。本文通过研究有家族史肝癌患者血清HBV的5项标志（HBV-M）,进一步探讨HBV传染性在肝癌家族聚集现象中的作用,为高发区特别是肝癌先证者家族的肝癌防治提供依据。     

肝癌高发区原发性肝癌发病高峰年龄特征

本文通过834例原发性肝癌(PHC)资料分析,探讨高发区PHC发病高峰年龄的特点。结果表明:有HBV感染、家族肿瘤史的男性PHC发病高峰年龄提早到30—49岁,(占总例数的58.39%),均较相应的对照组及文献报道显著提前1—2个年龄组,(P<0.05—0.01),且家族肿瘤史可促使HBV阳性PHC发病高峰年龄提前到30—39岁,提示HBV感染与家族肿瘤史、性别是导致PHC高发和早发的主要因素,也是肝癌高发区重要的流行特征;对上述人群应视为PHC预防重点,其中30—49岁男性更为肝癌的最高危险人群,要加强随访,以期早诊早治。     

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.