老年人骨质疏松影响因素的病例对照研究

①目的探讨老年人骨质疏松的影响因素。②方法某医院老年门诊就诊的60岁及以上老年人703例,按照非匹配病例对照研究形式,将确诊为骨质疏松的303例作为病例组,未发生骨质疏松的400例作为对照组,进行骨密度测定、一般人口学及影响因素调查。③结果单因素分析显示,性别、年龄、婚姻、学历、既往病史、现病史、钙剂使用情况、运动情况、吸烟、饮酒、膳食结构等与老年人骨质疏松相关,差异具有统计学意义（ P ＜0．05）;多因素分析显示,年龄、学历、婚姻状况、钙剂使用情况、骨折史、牙齿脱落情况、吸烟情况是老年人骨质疏松的主要影响因素（ P ＜0．05）;年龄＞65岁、低学历、丧偶或离异、未服用钙剂、有骨折史、牙齿脱落、吸烟的老年人骨质疏松的发生率高。④结论年龄大、丧偶或离异、有骨折史、有牙齿松动脱落、吸烟是老年骨质疏松的危险因素,而高学历、服用钙剂则是其保护因素。     

深圳市东部地区50岁以上人群骨退行性变的危险因素分析

目的:对深圳市东部地区215名50岁以上患有骨退行性变人群的自然状况进行分析,找出其退行性变的危险因素。方法:测定215名50岁以上人群的骨密度(BMD),计算出T评分,诊断其是否发生骨质疏松,以该人群的年龄、性别、身高、民族、有无家族史、有无外伤史、职业、是否发生骨质疏松等作为自变量,以是否发生骨退行性变为因变量进行多因素的logistic回归分析。结果:最终进入模型的影响因素有:性别、有无外伤史、是否发生骨质疏松。结论:50岁以上人群中性别、有外伤史和患有骨质疏松症是发生骨退行性变的危险因素。     

400例骨质疏松患者骨密度与骨质疏松危险因素的相关性研究

目的本研究通过问卷调查400例骨质疏松患者一般情况、生活方式及其其他慢性病史,明确骨质疏松相关危险因素,为骨质疏松症的预防及临床诊疗提供理论依据和指导。方法选取郑州市骨科医院2015年6—12月住院及体检人员550例作为调查对象。根据骨密度分为观察组(骨松组)和对照组(骨量正常),问卷调查包括患者一般情况(年龄、性别、受教育程度)、生活方式(运动情况、抽烟、饮酒、饮食类型等),既往病史及家族史。采用美国双能X线骨密度检测仪检测受试者骨密度,运用统计学软件分析得出危险因素和保护因素与骨密度的相关性。结果发放550份问卷调查,回收550份,有效率为100%,骨松组(BMD<-2.5 SD)400例,骨量正常组(BMD:-1 SD~+1 SD)150例。年龄为37~85岁;男150人,占总人数的27.3%,女400人,占总人数的72.7%。将550例问卷调查内容采用Logistic回归分析方法,得出每天适量运动、每天饮用牛奶、增加日晒时间等可降低骨松的发病率,是骨松的有利因素,牛奶、运动及日晒的OR值分别为0.936、0.920、0.934;而脆性骨折、绝经早、吸烟或接受二手烟或其他烟雾、长期大量饮酒、长期大量激素的使用可增加骨质疏松发病率,是骨质疏松的危险因素,吸烟、饮酒的OR值分别为1.298、1.758。结论年龄增加、饮酒过量、吸烟、绝经、骨质疏松家族史等增加骨质疏松发病率,而规律有效的运动、每天1~2 h的日晒、牛奶为骨骼的保护因素。     

维持性血液透析患者骨密度分析

目的分析维持性血液透析（MHD）患者骨密度变化及骨质疏松发生情况。方法选取行MHD患者96例，另择健康体检者90例作为对照，均行骨密度（T值）检查，T值≤-2.5为骨质疏松。比较MHD患者与健康体检者骨密度检查结果；比较不同临床特征的MHD患者骨密度检查结果。结果MHD患者骨密度低于健康体检者（P＜0.05），骨质疏松患病率高于健康体检者（P＜0.05）。MHD患者中，女性患者骨密度低于男性（P＜0.05），骨质疏松患病率高于男性（P＜0.05）；糖尿病肾病患者骨密度低于非糖尿病肾病患者（P＜0.05），骨质疏松患病率高于非糖尿病肾病患者（P＜0.05）。结论MHD患者骨密度较健康成人降低，骨质疏松患病率升高；性别、糖尿病病因会影响MHD患者骨密度水平。     

良性阵发性位置性眩晕与骨密度的研究#br#

目的〖KG*2〗探讨良性阵发性位置性眩晕（benign paroxysmal positional vertigo,BPPV）患者骨密度的变化规律及骨密度对BPPV的影响。 〖HTH〗方法〖KG*2〗选取BPPV患者105例为试验组,健康体检者108例为对照组。2组均常规行耳鼻喉科专科检查、眼震视图仪检查、位置试验、全身骨密度测定（双能X线吸收法,采用T-值评分计算）,分析不同性别、不同年龄BPPV患者全身骨密度Ｔ值的变化规律。分析骨密度对BPPV的影响。 〖HTH〗结果〖KG*2〗试验组骨密度T值低于对照组,差异有统计学意义（P＜0.05）。男性和女性试验组骨密度T值均低于对照组,骨密度降低发生率高于对照组;2组女性骨密度T值均低于男性,女性骨密度降低发生率高于男性,差异有统计学意义（P＜0.01）。41～50岁、51～60岁、61～70岁和≥71岁试验组骨密度T值低于对照组,骨密度降低发生率高于对照组,差异有统计学意义（P＜0.05或P＜0.01）,≤40岁试验组和对照组骨密度T值和骨密度降低发生率差异无统计学意义（P＞0.05）。随年龄增加,2组骨密度T值呈降低趋势,骨密度降低发生率呈升高趋势,差异有统计学意义（P＜0.05）。Logistic回归分析结果显示,骨密度降低是BPPV的危险因素。 〖HTH〗结论〖KG*2〗BPPV患者骨密度T值明显低于正常对照组,女性尤其明显,并且随年龄增加呈降低趋势。骨密度降低是BPPV的危险因素。     

中老年骨质疏松症患病状况及危险因素分析

目的探讨40岁以上中老年人原发性骨质疏松症患病状况及其相关危险因素。方法对288例女性及188例男性体检者采用超声骨密度测量仪进行骨密度值（T）测定。同时采集被测者的年龄、性别、文化程度及生活方式等资料,并进行统计学分析。结果性别、年龄与骨质疏松呈正相关,体重指数、每周运动次数、钙剂摄入与骨质疏松呈负相关,差异有统计学意义（P〈0.05）。结论年龄和性别是原发性骨质疏松症的独立危险因素,体重指数、运动习惯及钙剂摄入是保护因素。     

社区健康老年男性尿酸水平与骨质疏松的关系研究

【摘要】目的：探讨社区老年人群骨质疏松的发生率及与血尿酸（UA）水平的关系。方法：选取某城市338例相对健康人(＞65岁),应用Prodigy Advance 型双能X 线BMD 测定仪测定骨密度,观察不同性别人群骨质疏松的发病率和骨质疏松与UA等危险因素的相关性。结果：社区老年人群骨质疏松的发生率为52.66%,女性骨质疏松的发生率显著高于男性（P＜0.001）。骨质疏松的发生与性别、UA显著相关（P＜0.001）,女性骨质疏松的发生与血UA水平无明显相关（P=0.119）,老年男性血UA水平与骨质疏松的发生负相关（P＜0.001）,校正了年龄和性激素水平等因素后,这种差异仍有意义。结论：老年男性骨质疏松的发生与UA水平负相关,应进一步研究UA对骨质疏松的保护作用机制。     

不同分级慢性阻塞性肺疾病患者合并骨质疏松症的相关因素分析

目的 探讨不同分级的慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)患者发生骨量减少和骨质疏松(osteoporosis,OP)的危险因素。方法 选取COPD临床稳定期患者63例（均为男性）,采用双能X线骨密度测定仪测定患者左侧股骨颈的骨密度值,完成慢性阻塞性肺疾病评估测试(CAT)问卷,测定肺功能并按照慢性阻塞性肺疾病全球倡议指南进行分级。测定动脉血气、BMI,并记录年龄、吸烟量。选择63位年龄相匹配,有骨密度测定资料的健康男性作为对照组。结果 COPD 2级组和对照组骨量减少和骨质疏松发生率的差异无统计学意义（P>0.05）,COPD 3级、4级组骨量减少和骨质疏松的发生率均高于对照组（P<0.05）。Logistic回归分析显示： 低BMI、低第1s用力呼气容积占预计值百分比(FEV1%pred)和高CAT是COPD患者发生骨质疏松的危险因素（OR值分别为0.656、0.885、1.209,P均＜0.01）。结论 COPD患者骨密度的降低与气流受限,低BMI、生活质量差有关。COPD 3级、4级患者是发生骨量减少及骨质疏松症的高危人群。     

1 000例社区骨质疏松高危人群患病的危险因素分析

目的 探讨郑州市商都路社区中老年骨质疏松高危人群患病的危险因素.方法 选取2019年5月至2020年11月在河南省洛阳正骨医院郑州院区健康管理中心体检的郑州市商都路社区常住中老年居民1000例为研究对象,采取问卷调查及现场测量方式分别获得研究人群年龄、性别、身高、体质量以及饮食、运动、疾病史等资料.使用双能骨密度仪进行骨密度测定,采用单因素、多因素logistic回归分析骨质疏松高危人群患病的危险因素.结果 1000例居民中,有160例患骨质疏松,骨质疏松发生率为16.00％,其中男性为10.78％,女性为20.52％.多因素logistic回归分析显示,年龄(OR=1.401,95％CI:1.091～1.455)、性别(OR=1.396,95％CI:1.024～1.468)、身体质量指数(BMI)(OR=1.382,95％CI:1.011～1.485)、糖尿病(OR=1.408,95％CI:1.024～1.458)、高血压(OR=1.025,95％CI:1.011～1.474)、跌倒(OR=1.352,95％CI:1.025～1.385)、饮酒(OR=1.411,95％CI:1.063～1.438)、吸烟(OR=1.385,95％CI:1.285～1.402)均为骨质疏松高危人群的患病危险因素.结论 高龄、女性、低BMI、糖尿病、高血压、饮酒、吸烟、跌倒史等是骨质疏松高危人群患病的危险因素.     

60～74岁女性骨质疏松症相关因素分析

目的：探讨老年女性低骨密度值的相关因素,为老年女性骨质疏松的早期防治提供理论依据。方法：用双能X线吸收法(DEXA)测定915例第一汽车制造厂60~74岁退休女性职工尺桡骨的骨密度值,并对年龄,大米、杂粮、海产品、牛奶、酸奶、咖啡、豆浆、面、鸡蛋、水果的摄入量,是否吸烟,是否饮酒及绝经年数等进行问卷调查,同时测量身高、体质量。结果：年龄、是否经常摄入面、鸡蛋和水果、是否吸烟、绝经年数、体质指数（BMI）与骨密度值有关,差异有显著性(P<0.05);多重逐步回归分析显示：年龄与骨密度值呈负相关(B=－0.440,P<0.05),绝经年数与骨密度值呈负相关(B=－0.314,P<0.05),是否吸烟与骨密度值呈负相关(B=－0.650,P<0.05),BMI与骨密度值呈正相关(B=0.959,P<0.05)。结论：高龄、吸烟、绝经年数长、低BMI是60~74岁女性原发性骨质疏松的相关危险因素 。     

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.