新疆居民两周患病状况调查

目的 :为了解调查本地区居民两周患病状况及卫生服务需求 ,为卫生资源的合理配置和规划提供依据。方法 :采用多阶段分层、整群抽样的方法 ,于 2 0 0 0年 9月 12日～ 10月 1日在新疆维吾尔自治区抽取 8个地州市 1万户居民 ,共计 384 74人 ,进行入户调查。结果 :新疆居民两周患病率 133.4‰ ,其中城市 15 9.9‰农村 111.3‰ ,城乡比较 ,性别、年龄比较 ,在统计学上差异有显著性。结论 :新疆居民两周患病率低于 1998年全国卫生服务总调查两周患病率 ,但高于新疆生产建设兵团居民两周患病率。     

湖北省城乡居民卫生服务需求与利用调查

目的：了解湖北省城乡居民的卫生服务需要、需求和利用情况,为深化湖北省医药卫生体制改革提供相应参考依据。方法：对湖北省第四次卫生服务调查的家庭健康询问数据中的有关城乡居民卫生服务需要、需求和利用的数据进描述性统计分析。结果：调查人群的两周患病率为118.0‰;两周就诊率为120.5‰;两周未就诊率为438.0‰;慢性病患病率为122.3‰;居民住院率为72.1‰。结论：湖北省城乡居民的卫生服务需求和利用明显增加,就诊流向有明显改善,与此同时,城乡居民两周患病率和慢性病患病率有明显增高,加强慢性病防治工作是当前一项重要工作。     

新疆生产建设兵团卫生服务需要分析

目的 为了解现阶段兵团居民的健康水平、卫生服务需要量、医疗保健费用、卫生资及其利用效率,为合理地配置和规划卫生资料提供科学依据。方法 采取多阶段分层、整群抽样的方法,于１９９８年７月２１日～８月１０日在新疆生产建设兵团抽取５个师,１３５５９人进行家庭入户健康访问调查。结果 兵团居民的两周患病率为１０９．９‰,其中市区居民的两周患病率为１１８．０‰、农场的两周患病主为１０６．４‰,城乡两周患病率比较     

湖北省居民两周患病率及其影响因素调查

目的：了解湖北省居民两周患病率,分析其影响因素,为深化湖北省医药卫生体制改革提供相应的参考依据。方法：对湖北省第四次卫生服务调查的家庭健康询问数据中有关两周患病的数据进行描述性统计分析。结果：湖北省城乡居民两周患病率为118．0‰,其中城市地区为123．1‰,农村地区为114．9‰;从疾病系统别来看,前5位依次是呼吸系统疾病、循环系统疾病、消化系统疾病、肌肉骨骼系统疾病、泌尿生殖系统疾病。结论：应充分关注不同年龄、性别、文化程度、职业状况的居民的卫生服务需要,降低两周患病率,全面提高居民健康水平。     

彭阳县农村常住居民两周患病率及其影响因素分析

目的 分析彭阳县农村常住居民两周患病率,探讨其影响因素.方法 采用分层随机抽样对彭阳县10个乡镇的660户,2943名农村居民进行问卷调查,内容包括居民人口学特征、两周患病及就诊和家庭收支等情况.结果 居民两周患病率为118.25‰,按疾病系统分类,排在前5位的依次是:呼吸系统疾病占48.28％,肌肉骨骼等疾病占16.09％,消化系统疾病占12.07％,循环系统疾病占7.18％,泌尿生殖系统疾病4.31％.两周患病率单因素分析显示,男性高于女性,年龄越大、文化程度越低两周患病率越高,职业中农民两周患病率最高,婚姻状况中其他(离异、丧偶等)两周患病率高,慢病人群较无慢病人群两周患病率高.多因素分析结果中年龄组、是否为慢病、文化和职业进入方程.结论 彭阳县农村居民卫生服务需求高,主要危险因素为年龄高、慢病患者、文化程度低和职业为务农、村医、务工、学生及无业.     

城市化发展对居民卫生服务需要及利用的影响分析

目的 通过分析半城市化农民与城市居民和农村居民在卫生服务需要及利用上的差异,探讨城市化发展对居民卫生服务需要及利用的影响,为卫生决策提供参考.方法 采用分层随机抽样方法抽取成都市3个经济圈层常住居民为调查对象,利用自行设计的问卷对城乡居民进行问卷访谈.结果 半城市化农民两周患病率、住院率及未就诊率较高,而城市居民慢性病患病率较高;年龄、就业状况和城乡因素是两周患病和慢性病患病的主要影响因素;在控制了相关因素以后,城乡因素对卫生服务利用影响不大.结论 城乡统筹发展提升了城乡居民的卫生服务可及性并在一定程度上缩小了城乡居民之间的健康差距,而半城市化农民是城市化进程中出现的特殊群体,应当从就业援助等方面加以关注.     

珠海市城乡居民卫生服务需求与利用比较分析

目的了解珠海市城乡居民健康状况以及卫生服务需求、利用现状,为珠海市合理配置卫生资源,构建和谐卫生服务提供政策依据。方法采用整群随机抽样方法,从珠海市斗门区和香洲区共抽取1000户(其中城区、农村各500户),共计城乡居民3609人,其中城区居民1669人,农村居民1940人。结果珠海市城区居民两周患病率128.2‰、两周就诊率为72.5‰,农村居民两周患病率196.4‰、两周就诊率为114.4‰;年住院率,城区为4.0%,农村为3.8%;城区居民应住院而未住院率为11.8%,农村居民为30.8%。结论珠海城乡居民对医疗卫生服务的需求较高,但有效需求没有得到合理的满足,发生了抑制、转移和替代,政府需要采取积极社会卫生政策来满足居民健康需求,推进卫生事业和谐发展。     

贵州省722例少数民族两周患病率及影响因素分析

目的了解贵州省少数民族人群两周患病率及其影响因素,为合理组织卫生服务提供依据。方法采用分层整群抽样方法,对贵州省722名15岁及以上苗族、仡佬族、侗族和布依族进行两周患病及影响因素的访谈式问卷调查。结果少数民族两周患病率为278.4‰,女性患病率315.5‰,高于男性242.5‰;年龄越大、文化程度越低患病率越高;两周患病率的主要影响因素有教育支出、文化程度、婚姻状况以及是否患有慢性病。结论贵州省少数民族人群患病严重程度高于全国水平,卫生服务需要仍处于较高水平,不同性别、年龄差异较大,应加强卫生资源合理配置,关注高危人群以及高危因素。     

江苏省海安县农村居民两周患病率及影响因素分析

目的:了解和探讨江苏省海安县农村居民两周患病现况和影响因素。方法:对该地区用分层整群抽样方法,抽取角斜、胡集、雅周3个镇的3个村600户1964例农村家庭人口进行卫生服务家庭健康询问调查,采用统一设计的调查表,对调查数据采用单因素、多因素logistic回归模型分析≥15岁农村居民两周患病率的影响因素。结果:被调查居民两周患病率为14.56%,农村居民两周患病率受性别、年龄、婚姻状况、文化程度、职业类型、家庭人均年收入及是否患慢性病等因素的影响。结论:海安县农村居民的两周患病率比2003年全国农村平均水平略高,人口学特征和经济因素是主要的影响因素。     

青岛市市区居民的两周患病率及就诊状况分析

①目的了解青岛市市区居民的两周患病率及就诊状况。②方法采取整群随机抽样法，对青岛市市区15个居委会的3057人进行问卷调查。③结果市区居民的两周患病率为108．28‰(男性：103．27‰，女性：113．48‰)，每千人两周因病休工的天数为183d，每千人卧床天数为135d．两周患病率与居民年龄、文化水平、职业及医疗保健方式等因素有关。居民两周就诊率为73．60‰，未就诊者占患病人数的30．24％，④结论青岛市市区居民的医疗需求量较高，门诊利用率较低，应改革医疗保健制度，以方便居民就诊。     

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.