柳州市老年人群高血压调查分析

目的：了解柳州市６０岁以上老年人群高血压浒状况。方法：抽样调查柳州市１５岁及以上成人４１０５７人,其中６０岁以上老年人群４６７９人的高血压患病率,以１９９９年ＷＨＯ推荐的ＪＮＣⅥ标准进行分析。结果：本市老年人群高血压患病率男性４６．５１％,女性４３．５３％,总患病率４５．２４％;理想血压、正常血压人数分别占老年人的２１．６９％和４９．６０％;老年男性高血压患病率随着年龄增加而增高,女性则在６５岁达     

上海市某社区人群高血压流行特征及影响因素分析

目的：通过杜区调查分析人群高血压的流行特征及主要危险因素。方法：以整群随机抽样方法抽取2个居委，对年满20岁以上的城市常住居民调查一般情况、高血压危险因素和体格检查。结果：人群高血压患病率为34．30％，男性与女性高血压的患病率有显著差别(P＜0．01)；随着血压分类级别的升高患病率逐渐降低，Ⅰ级和Ⅱ级高血压占高血压总人数的90．22％；人群高血压的患病率与年龄呈显著正相关，而与文化程度呈负相关(P＜0．01)；超重者和肥胖者患高血压的相对危险性增高。结论：在社区采取全人群和高危人群相结合的策略，加强对中老年、文化程度低、超重、肥胖以及轻、中度高血压人群的健康教育，对防治高血压和控制心脑血管疾病具有重要意义。     

柳州市老年干部代谢综合征患病情况及特点

目的：了解柳州市老年干部代谢综合征的患病情况及特点。方法：选择在我院体检的老年干部486人,中年干部265人,比较两组人群的血糖、血脂、血压、身高、体重的变化。结果：486名干部中代谢综合征52例,占10．70％;265名中年干部中发现16例,占6.04％（P〈0.05）。老年干部糖尿病、高血压分别占16．46％、31．48％,较中年干部的检出率10．94%、21．87％有明显增高（P〈0.05）。结论：老年干部代谢综合征患病率较高,其主要原因是糖尿病和高血压的高发病率。     

梧州市长洲区大塘社区居民高血压患病率的调查

目的：进行社区调查,了解社区居民高血压患病率、防治知识知晓率、目标人群。方法：采取系统抽样和入户面对面方式,对入选的社区18岁及以上的3072名居民记录性别、年龄、身高、体重、血压,同时对高血压防治知识、不良生活方式等状况逐项调查,数据收集后用SPSS13．0软件进行统计学分析。结果：18岁及以上社区居民高血压患病率为20．34％,其中年龄在40～59岁患病率为22．02％,年龄≥60岁患病率为53．45％,各年龄组比较差异有统计学意义（ P＜0．05）,高血压防治知识知晓率为29．46％。结论：社区居民高血压防治知识知晓率低,高血压的目标人群以≥60岁老年人为主,高血压患病率与年龄呈正相关,且随年龄增长极为显著。     

克拉玛依炼油厂社区居民高血压流行病学调查

目的：了解克拉玛依炼油厂社区居民高血压患病率及其影响因素。方法于2007年10月－2010年3月采用整群随机抽样法抽取克拉玛依炼油厂社区年龄＞35岁常住成人作为调查对象,自行设计调查表调查成人高血压患病情况,分析不同民族、不同性别人群高血压患病率的差异。结果抽样获得调查人群为4188人,完成调查者3821人,应答率为91．24％。本社区居民高血压患病率为38．26％,其中男性人群高血压患病率为39．42％,女性为37．20％,不同性别人群高血压患病率差异无统计学意义（χ^2＝1．99,P ＝0．08）。汉族、维吾尔族、哈萨克族不同性别人群高血压患病率差异无统计学意义。高血压的患病率均随年龄的增长而增高。汉族高血压患病率为37．37％,维吾尔族高血压患病率为39．27％,哈萨克族高血压患病率为59．12％,不同民族高血压患病率比较差异有统计学意义（χ^2＝26．49,P ＝0．00）,哈萨克族人群血压水平显著高于汉族和维吾尔族。年龄、饮酒、肥胖、高 TC 血症、高 TG 血症、糖尿病是克拉玛依地区高血压患病的危险因素。结论克拉玛依地区高血压患病率均随年龄增加呈增高趋势,高血压患病率存在民族差异但无性别差异。     

各年龄段成年人的高血压：当前社区人群的预后和控制

背景：对于80岁以上的人群，目前有关高血压的治疗和控制率以及高血压相关危险性的数据很少。目的：明确老年高血压患者各级别血压的患病率、高血压的治疗率和控制率以及心血管危险因素。设计、地点及参试者：社区队列研究，数据收集于20世纪90年代进入Framinghanl心脏研究的全部检查。根据年龄将入选者集中分层：60岁以下、60～79岁和〉t80岁。共5296例入选者，检查14458人次，其中高血压7135人次（治疗4919例）。主要观测指标：比较各年龄段人群高血压的患病率、治疗率和控制率。6年随访期间发生心血管疾病的危险性，采用Cox比例风险回归的多变量校正风险比（hazardratios，HRs）和95％可信区间（confidenceintervals，CIs）评估。结果：高血压的患病率和药物治疗率随着年龄增加而升高，但是在老年女性控制率（收缩压〈140mmHg，舒张压〈90mmHg）显著降低。〈60岁、60～79岁和t〉80岁组男性的控制率分别为38％、36％和38％（P=0．30）；女性的控制率分别为38％、28％和23％（P〈0．001）。随着年龄增加，与血压分级升高相关的心血管疾病的相对危险性没有下降，而绝对危险性显著升高。在〉t80岁的参试者，正常血压组（对照组）主要心血管事件的发生率为9．5％，高血压前期、1级高血压以及2级或治疗的高血压组的发生率分别为19．8％（HR，1．9；95％CI，0．9～3．9）、20．3％（HR，1．8；95％CI，0．8～3．7）和24．7％（HR，2．4；95％CI，1．2～4．6）。结论：相对于目前的国家指南，在社区人群血压的控制率较低，特别是在老年女性高血压患者。短期心血管疾病危险性很高表明，对于老年高血压患者应加大安全有效降低危险性的力度。     

老年人高血压与高血糖、高血脂的相关性分析

目的探讨不同性别、年龄的人群的高血压的患病情况,以及高血压与高血糖、高血脂患病率的关系。方法对1028名老年干部测量血压、血脂、血糖。结果性别对高血压、高血糖患病率的影响是显著的（P〈0.05）,对高脂血症患病率的差异不显著（P〉0.05）;随着年龄的增长3种病症发患者数逐渐增多;1028名受检者高血压患病率为30.84%。结论高血压是老年人的高发病;老年女性易患高血压、高血糖;老年人的高血压与高血脂、高血糖关系密切,应引起高度重视。     

老年人群清晨高血压患病率及相关影响因素探讨

目的研究老年人群清晨高血压患病率并且分析其相关影响因素。方法抽取2016年9月至2017年9月到体检中心进行体检的1698例老年人群进行资料回顾分析,比较老年人群清晨高血压患病率以及影响因素。结果老年人群主要以收缩血压为主,根据性别分类来进行比较,男性老年人群清晨高血压低于女性老年人群,差异较明显(P0.05),具有统计学意义。结论老年人群清晨高血压患病率高;患者性别、年龄、运动、生活习惯、高脂血症等因素可直接对清晨高血压造成影响。因此,合理生活习惯与健康的运动习惯可在一定程度上有效降低清晨高血压患病率。     

高龄高血压的治疗进展

随着老龄社会的到来,高龄老人急剧增加,高血压的患病率随着年龄增长而显著增加。高血压是高龄老年人群最主要的慢性病,其患病率在所有人群中最高,达62．4％～76．1％。     

成都地区老年人群高血压的流行病学调查

目的探讨成都城乡地区老年人群高血压流行状况,为今后成都市老年人群高血压防治奠定基础。方法 2008年在成都地区调查老年人群高血压患病率、知晓率、治疗率及控制率。样本的获取采用分层整群抽样的方法,以社区（村）为单位,抽取成都市2008年城乡社区60～79岁人群2005例进行高血压及相关因素的调查。结果成都地区老年人群高血压患病率51.77%,标准化率为47.36%。高血压患病率随年龄增大而逐渐增高,65岁以上的老年人超过半数有高血压。成都地区老年人群高血压知晓率55.0 1%、治疗率40.08%、控制率20.23%,城市老年人群高血压知晓率58.50%、治疗率43.29%、控制率22.04%,明显高于农村33.33%、20.1 4%、9.03%的知晓率、治疗率及控制率,均P〈0.01。结论成都地区老年人群高血压患病率高,知晓率、治疗率、控制率低。老年人群应作为血压监测重点人群,尤其是65岁以上老年人群。尚需进一步加强成都地区的社区老年高血压防治工作,特别是农村地区,以提高社区老年高血压患者的管理水平,提高老年高血压的控制率。     

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.