青春期后痤疮影响因素的临床分析

目的:观察分析青春期后痤疮的影响因素。方法:选取2013年3月-2014年3月收治的120例青春期后痤疮病例(痤疮组)为实验对象,选取同期120健康志愿者(健康组),对两组成员进行问卷调差。结果:皮肤类型、遗传因素、睡眠不足以及心理因素是导致青春期后痤疮的危险因素。结论:心情焦虑、抑郁、偏爱油腻及辛辣食物、油性肤质、睡眠不足是导致青春期后痤疮的重要影响因素。     

广西少女月经情况调查分析

目的调查广西少女月经病的流行病学特征,为开展青春期少女的生殖健康教育提供科学依据。方法采用随机整群抽样方法对广西5个城市10所中学80个班级1 632名15～20岁的少女进行问卷调查。结果初潮年龄（13.00±1.34）岁,不同体重指数的少女初潮年龄不同（P〈0.05）,体重指数越大初潮年龄越早。月经病症状在高中女生中普遍存在,自报发病率为61.5%。月经失调较常见（45.2%）,其次是痛经（18.5%）和经前期紧张综合征（PMS,15.3%）。学习压力大的少女PMS的发病率较高（P〈0.05）;每天睡眠时间〈8 h的女生月经失调、PMS发病率高于睡眠时间≥8 h的少女（P〈0.05）;不同区域的少女月经初潮年龄不同、月经病发病率不同。汉族、壮族少女月经病发病率差异无统计学意义（P〉0.05）。患月经病少女的就诊率为25.8%。少女月经知识主要来自同学之间的交流（64.1%）,其次是书籍（58.1%）、父母（44.5%）。57.4%的少女不知道自己的月经情况是否健康。结论学习压力、睡眠时间、社会生活环境是少女月经病的主要影响因素。少女月经病症状普遍存在,绝大多数少女缺乏月经生理知识,仅部分少女及时就诊。加强少女月经生理健康教育,是减少少女月经病发生的重要措施。     

青春期功血症的中医治疗

青春期功血症，全称叫青春期功能性子宫出血，是青春期女性常见的妇科疾患。常因情绪波动、劳累和经期运动量过大、嗜食生冷辛辣而诱发。若患者出血过久、量多，常发生昏倒，甚至危及生命。治疗该病，除采用止血、输血的应急方法外，还有必要使用中医药调经根治。     

南宁市肠易激综合征患者症状诱发因素的调查

目的：探讨广西南宁市肠易激综合征（ IBS）患者症状发作或加重的诱发因素。方法采用整群、分层、随机抽样方法,抽取南宁市5个城区18～80岁人群2773例进行问卷调查,了解人群中IBS患病情况,并对可能影响IBS患者症状发作或加重的相关因素进行单因素及多因素logistic非条件回归分析。结果根据IBS罗马Ⅲ诊断标准,2773例被调查者中,诊断为IBS 181例（IBS组）,非IBS 2592例（非IBS组）;整体人群患病率为6．53％,每例患者有（3．31±2．29）个诱发因素。单因素分析结果显示：进食生冷食物、辛辣食物、乳制品、水果、饮酒及受凉、情绪不佳、劳累是IBS患者症状的发作或加重的单危险因素（P＜0．05）。多因素logistic非条件回归分析结果显示：进食生冷食物、水果、乳制品及情绪不佳是IBS患者症状发作或加重的独立危险因素（P＜0．05）。结论进食生冷食物、水果、乳制品及情绪不佳是南宁市IBS患者症状发作或加重的独立危险因素。     

青春期异常子宫出血影响因素分析

目的 探讨青春期女性异常子宫出血影响因素,维护青春期女性的生殖健康。方法 回顾性选取2019年6月—2022年6月在郑州大学第三附属医院妇科住院的86例青春期异常子宫出血患者的临床资料作为观察组,同期因其他疾病住院的86例月经规律青春期女性的临床资料作为对照组。回顾性整理相关临床资料并进行组间对照分析,判断是否为青春期异常子宫出血的影响因素。结果 单因素分析显示,两组患者的年龄、母亲月经紊乱史、睡眠情况、居住环境比较,差异无统计学意义（P均>0.05）;两组患者体质指数、饮食情况、精神情况、初潮年龄比较,差异有统计学意义（P均<0.05）。采用Logistic回归分析可见,初潮年龄、体质指数、精神情况均为青春期异常子宫出血的独立危险因素（OR=2.417、2.028、2.185,P均<0.05）。结论 青春期异常子宫出血患者受到体质指数、精神情况、初潮年龄多因素影响。关注以上影响因素,加强针对性预防对策,能维护青春期女性的生殖健康。     

卵巢癌发生的高危因素分析

目的探讨卵巢癌发生的危险因素。方法选取卵巢癌病人90例（观察组）及健康志愿者270例（对照组）,调查2组临床资料。结果2组年龄、婚姻状况及文化程度比较差异无统计学意义（P>0.05）;观察组产次为0次、月经周期>30 d、初潮年龄 < 13岁、有人工流产史、卵巢癌家族史的比例分别为56.67%、46.67%、62.22%、36.67%和23.33%,高于对照组（P < 0.05~P < 0.01）;logistic回归分析显示,产次≥2次、初潮年龄≥13岁是卵巢癌发生的保护因素（P < 0.01）,月经周期>30 d、人工流产史和卵巢癌家族史是卵巢癌发生的危险因素（P < 0.01）。结论卵巢癌的发生受多因素影响,应根据相关危险因素制定针对性措施进行预防。     

腔镜下胆囊切除术转开放手术的危险因素分析

目的：研究腹腔镜下胆囊切除术中转开放手术的危险因素。方法：选择接受腹腔镜下胆囊切除术的90例患者纳入研究,观察是否中转开放手术,分析中转开放手术的危险因素并进行统计分析。结果：（1）不同年龄、上腹部手术史、胆囊壁厚度、焦虑情绪、胆囊炎病程患者,中转开放手术的例数不同,差异有统计学意义（P〈0.05）;（2）中转开放手术的情况与年龄、上腹部手术史、胆囊壁厚度、焦虑情绪呈正相关,与胆囊炎病程呈负相关,差异有统计学意义（P〈0.05）。结论：年龄、上腹部手术史、胆囊壁增厚、术前焦虑情绪、胆囊炎急性发作是腹腔镜下胆囊切除术中转开放手术的危险因素。     

青春期多囊卵巢综合征患者内分泌、代谢紊乱特征分析

目的：探讨青春期多囊卵巢综合征（PCOS）患者的内分泌及代谢紊乱特征。方法：青春期PCOS患者87例（PCOS组）,其中52例体重指数（BMI）≥25 kg/m2或腰臀比（WHR）≥0.85者为肥胖组（OB-PCOS）;35例BMI〈25 kg/m2,WHR〈0.85者为非肥胖组（NOB-PCOS）。正常对照组102例,为月经正常的中学生,同样分为肥胖组（OB-CON）22例,非肥胖组（NOB-CON）80例。所有对象均测定睾酮（T）、促黄体生成素（LH）、泌乳素（PRL）、促黄体生成素/促卵泡激素（LH/FSH）比值、空腹胰岛素及稳态模型指数（HOMA-IR）、空腹血糖、血脂,测定人BMI及WHR,记录月经史。结果：对照组初潮年龄为（13.0±1.3）岁,96%在初潮后2年内建立规律月经。PCOS组初潮年龄为（12.0±1.5）岁,86%的患者在2年内未能建立规律月经。PCOS组肥胖发生率显著高于对照组（P〈0.01）。PCOS组血清T、LH、PRL、LH/FSH比值、空腹FINS、HOMA-IR、TC、TG及BMI、WHR均显著高于对照组（P〈0.01）,并且OB-PCOS组高于NOB-PCOS（P〈0.05）。96.3%PCOS患者卵巢超声提示多囊样改变。结论：青春期多囊卵巢综合征的特征为肥胖,月经初潮提前及持续月经不调,存在胰岛素抵抗,卵巢多囊性增大。     

陕西省青春期少女月经初潮年龄分布及其与体质指数的关系研究

目的　了解陕西省青春期少女的月经初潮年龄现状及其与BMI的关系。方法　选取2007年7—8月陕西省关中、陕南、陕北地区营养与健康生物学调查中处于青春期的少女（10~19岁）534例为调查对象,采用自行设计的调查问卷进行面对面调查。问卷内容包括：一般资料（年龄、受教育年限）、家庭背景（家庭人口数、家庭收入来源）、体格检查（身高、体质量等）,分析青春期少女的月经初潮年龄分布情况。根据美国疾病预防控制中心（CDC）标准按年龄别百分位数对BMI进行分类：低体质量（BMI<5%）、体质量正常（5%≤BMI<85%）、超重（85%≤BMI<95%）。采用多因素Logistic回归分析分析月经初潮与BMI的关系。结果　534例青春期少女中已来月经初潮的446例（83.5%）,未来月经初潮的88例（16.5%）。农村和城区已来月经初潮的青春期少女月经初潮年龄及其分布情况比较,差异均有统计学意义（P<0.05）。陕北已来月经初潮的青春期少女月经初潮年龄大于关中、陕南（P<0.05）。不同体质量已来月经初潮的青春期少女月经初潮年龄分布情况比较,差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示,校正前低体质量与是否来月经初潮呈正相关（P<0.05）;当校正了年龄、城乡和家庭背景因素后,低体质量与是否来月经初潮呈正相关（P<0.05）,与体质量正常者相比,低体质量者不来月经初潮的风险增加11.39倍。校正前超重与是否来月经初潮呈正相关（P<0.05）;校正年龄、城乡和家庭背景因素后,两者无相关性（P>0.05）。结论　陕西省青春期少女的月经初潮年龄在不同地区和城乡间存在显著差异,月经初潮年龄的早晚与其BMI的大小有关联,BMI过小青春期少女的月经初潮年龄有延后的趋势。     

青春期后痤疮发病影响因素分析

目的评价青春期后痤疮患者发病及病情加重的影响因素,为其综合治疗提供依据。方法采用结合文献改编自制的问卷调查表,对2007年9月至2009年10月期间在华中科技大学同济医学院附属同济医院皮肤科就诊的504名青春期后痤疮患者和216名健康志愿者进行问卷调查,并对两组进行对照分析。结果痤疮组与对照组在心理因素(抑郁、焦虑、生气)、遗传、皮肤类型、睡眠不足(<6 h)、饮食习惯等方面的差异具有统计学意义(均P<0.05)。危险因素从大到小依次为:心理因素(OR=2.766)、油性皮肤(OR=2.608)、遗传(OR=2.514)、生理周期(女性)(OR=2.455)、睡眠不足(OR=1.749)和食用辛辣油腻食物(OR=1.374)。结论青春期后痤疮与心理因素、油性皮肤、遗传、生理周期(女性)、睡眠不足、饮食习惯等多种因素有关,其中与心理因素关系最为密切。     

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.