河北省公务员糖尿病及空腹血糖受损的危险因素分析

目的了解河北省公务员空腹血糖受损(IFG)及糖尿病(DM)患病的现状,并对超重、肥胖与IFG及DM的相关性进行研究。方法选取2011年9～11月在某医院体检中心进行体检的1 067名公务员的体检资料进行分析。结果随着年龄增长,DM、IFG患病率升高,且>50岁年龄段增高更明显,差异有统计学意义(P<0.05);随着体重指数(BMI)增高,DM、IFG患病率相应增高,且超重、肥胖组DM及IFG患病率明显高于BMI正常组(P<0.05)。结论年龄增长、超重、肥胖均是DM、IFG的危险因素,应积极干预危险因素,同时加强IFG阶段健康生活方式宣教和管理力度,从而减少DM及其并发症的发生。     

重庆市4 162例不同身体质量指数代谢综合征及其他相关疾病患病率的相关性调查研究

目的 探讨本地区城市居民不同身体质量指数（BMI）与高血压（HBP）、血脂紊乱、糖尿病（DM）、空腹血糖受损（IFG）及代谢综合征（MS）等相关疾病的患病率的关系。方法 随机对2004～2005年间来我院体检的4162例城市居民进行葡萄糖、血脂、身高、体重、血压的测定,并对其结果进行统计学分析。结果 该人群中,超重、肥胖的人群分别为31.23％、8．98％;超重男性比率（37．17％）高于女性（20．92％）,肥胖男性比率（10．90％）高于女性（5．72％）;男性超重和肥胖HBP、血脂紊乱、DM、IFG、MS患病率分别是30．55％和48．61％;63．95％和82．29％;5．19％和11．81％;7．33％和15．97％;5．3％和15．28％;女性超重和肥胖者有HBP、血脂紊乱、DM、IFG及MS的患病率分别是29．86％和50．88％;53．08％和63．16％;4．73％和17．54％;7．1l％和15．80％;12．32％和22．81％。结论 不论是男性或女性,随着BMI的增加,其相关疾病和代射综合征的患病率亦增高。     

重庆市3 717例人群糖尿病及相关疾病的调查

目的了解重庆市糖尿病(DM)、高血压(HBP)、血脂紊乱及代谢综合征(MS)等病的患病情况.方法采用横断面调查方法对重庆市局部地区3 717例20岁以上自然人群进行口服葡萄糖耐量试验(OGTT)等调查.结果 DM、糖调节受损(IGR)、HBP、血脂异常、超重/肥胖、MS等病的患病率分别为10.38%、15%、35.43%、46.95%、30.87%/3.82%、9.69%.各种疾病随年龄增加而增高,高甘油三酯血症、超重和肥胖的患病高峰年龄男性为50岁,女性为60岁.结论重庆市糖尿病及相关疾病的患病率较高,应加强防治.     

3 891例健康体检人员空腹血糖水平相关分析

目的:调查健康体检人群空腹血糖水平及空腹血糖受损与体重指数(BMI)、血压、血脂水平的关系.方法:对2005年4～10月在我院进行健康体检的南宁市公务员3 891人的体检资料进行统计分析.比较空腹血糖受损组与正常血糖组之间的BMI、血压、血脂水平并进行相关性分析.结果:空腹血糖平均水平为(4.92±0.69)mmol/L;空腹血糖受损(IFG)阳性率为20.15%,糖尿病(DM)阳性率为4.14%.IFG组的BMI、血压、血脂水平均显著高于正常血糖组(P＜0.001);IFG与BMI、血压、血脂水平存在正相关关系(r=0.124,0.164,0.095,0.062,0.173,P＜0.001).结论:IFG是糖尿病的危险因素.     

郑州市2153例退休教师空腹血糖结果分析

目的探讨郑州市教育系统退休教师空腹血糖情况及影响因素。方法根据2003年WHO糖尿病诊断标准将2153例受检教师空腹血糖分为NGT组、IFG组和DM组,分析教育系统退休教师糖代谢异常情况。结果 2153例中NGT组1653例（76：78%）,IFG组321例（14：91%）、糖尿病组179例（8：31%）,男、女与IFG、糖尿病患病率差异无统计学意义,不同性别之间的IFG、糖尿病患病率差异均无统计学意义。超重、肥胖组IFG、DM患病率明显高于BMI正常组,IFG组、DM组四项脂代谢异常的发生率均明显高于正常血糖组。结论糖代谢异常在郑州市教育系统退休教师中发生率较高,应加强对高危人群的定期体检,通过控制BMI、血脂等相关因素以利于对糖尿病的防治。     

温州市公务员肥胖与相关疾病的现状分析

目的:调查和分析温州市公务员肥胖及其相关疾病的患病率,并分析影响其肥胖发病的相关危险因素.方法:检测5414例公务员体重指数(BMI)、空腹血糖、血脂、血压、血尿酸,分析肥胖与血脂、血糖、血压的患病率及相互关系.结果:温州市公务员肥胖的患病率为28.7%,超重的患病率为31.2%.超重组和肥胖组血脂、血糖、血压及血尿酸均高于正常组,各组间差别均有统计学意义(P＜0.01).糖调节受损、高脂血症、高血压的患病率依次为6.35%,46.43%,9.64%.且三种疾病的患病率均随BMI的增加而增加(P＜0.05).60岁以前肥胖和超重、高脂血症患病率随年龄增长而增加,40岁～60岁人群显著增加,但60岁以上人群患病率减少.高血压和糖调节受损患病率随年龄增长而增加(P＜0.05).结论:温州市公务员肥胖、高脂血症、糖调节受损、高血压的病率较高,且不同的年龄段发病率不一样.     

重庆市5 782例体检人群代谢综合征与脂肪肝的相关性研究

目的:研究重庆市5 782例体检人群代谢综合征(Metabolism syndrome,MS)与脂肪肝的患病率,以探讨二者的相互关系.方法:将研究对象按年龄、性别分组,分析5 782例体检人群代谢综合征与脂肪肝的患病率,比较不同年龄段和性别间MS和脂肪肝患病率的差异.采用logistic回归分析对脂肪肝与年龄、性别、BMI、GLU、TC、TG、HDL-C、LDL的关系进行相关性分析,比较脂肪肝组和非脂肪肝组肥胖、HBP、高血糖和血脂紊乱发生率的优势比(Odds ratio,OR).结果:5782例体检人群中MS、脂肪肝的患病率分别为9.58%、25.9%;代谢综合征的患病率随年龄增加而增加,男性代谢综合征和脂肪肝的患病率明显高于女性(P＜0.001);Logistic回归分析表明对脂肪肝患病率有影响的是性别、BMI、GLU、TC、TG、HDL-C 6项;与非脂肪肝组相比,脂肪肝组肥胖、HBP、高血糖和血脂紊乱患病率显著增加,脂肪肝组肥胖、HBP和血脂紊乱患病率的OR分别为9.03、3.08、4.11和5.09.结论:重庆市脑力劳动人群MS与脂肪肝的患病率较高,MS与脂肪肝有很密切的关系,及早进行健康体检并做B超筛查,改变不良生活习惯有利于对二者的早期防治.     

成人空腹血糖异常率及其影响因素

目的评价柳州市人群中空腹血糖(FPG)异常率及其影响因素。方法抽取柳州市居民3894(男性2213,女性1681)例,年龄25～88(43.0±11.0)岁,测量血压、腰围(WC)、身高、体质量,检测FPG、血脂等指标并进行统计分析。结果FPG总异常率达5.70%,其中糖尿病(DM)和空腹血糖受损(IFG)的检出率分别为2.31%和3.39%。两性IFG及DM检出率均随年龄增长而升高(P<0.01)。IFG,DM的检出率均随WC、体质量指数(bodymassindex,BMI)的增大而增高(P<0.01)。与WC男性<85cm,女性<80cm组相比,男性≥85CM,女性≥80cm组和男性≥90cm,女性≥85cm组,IFG的相对危险分别为1.28(95%CI:0.78～2.08)和2.24(95%CI:1.45～3.46);DM相对危险分别为2.47(95%CI:1.47～4.15)和3.24(95%CI:1.94～5.40)。结论本组人群中IFG异常率已达较高水平,其影响因素主要为年龄和腹部肥胖,应教育人们改善生活方式,控制腹部肥胖,防治糖代谢异常。     

新疆某三甲医院医务人员超重、肥胖相关因素现况研究

目的了解某三甲医院医务人员超重、肥胖的年龄、性别等分布情况,以及肥胖相关危险因素的伴发情况。方法选用某三甲医院2016年01月至2016年03月的体检人群共计2904人,并对该院医务人员的超重、肥胖分布情况及高危因素进行了描述性分析。结果我院医务人员超重、肥胖发生率总体为46.1%,男性人群超重、肥胖发生率分别为48.3%、23.6%,女性人群超重、肥胖发生率分别为26.3%、13.4%,男性和女性超重、肥胖人群的发生率比较,差异有统计学意义,男性超重、肥胖人群比例显著均高于女性及全国居民的平均水平,体重过低组人群中女性高于男性,不同年龄段超重、肥胖发生率存在统计学差异,超重发生率50岁以上年龄段最高为48.3%,肥胖发生率以40-50岁年龄段最高,超重与肥胖的发生有随年龄增加而发生率增高趋势。其次随着BMI增加其血糖、甘油三脂、总胆固醇、肝酶、尿酸的水平逐渐增加,差异有统计学意义。结论医务人员的健康状况不容乐观,不同年龄、不同性别超重、肥胖发生率不同,且高于全国居民水平,且肥胖人群因常常与其他危险因素并存,容易出现高血糖、血脂紊乱、高尿酸血症、肝功损害等健康问题,因此该人群也具有很高的心血管病患病风险,应加强自我保健意识,有针对性地进行健康干预。     

2型糖尿病合并非酒精性脂肪肝的临床特征及危险因素分析

目的:研究2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFL)与胰岛素抵抗(IR)、血脂紊乱、肥胖的关系及其发病的危险因素。方法:将符合标准的159例T2DM患者根据有无NAFL分为合并脂肪肝组与无脂肪肝组,分别记录维吾尔族和汉族患者身高(H)、体重(W)、腰围(WL)、血压(Bp)、血肌酐(Scr)、血尿酸(UA)、血脂、血清转氨酶、纤维蛋白原(FIB)及口服葡萄糖耐量试验(OGTT)的血糖与胰岛素水平,计算体重指数(BMI)及胰岛素抵抗指数(HOMA-IR)。通过非条件Logistic回归进行NAFL的危险因素分析。结果:T2DM合并脂肪肝组与无脂肪肝组相比较,BMI、WL及HOMA-IR明显增高(P<0.01);UA、甘油三酯(TG)、总胆固醇(TC)、空腹血糖(FPG)及空腹血浆胰岛素(Fins)增高(P<0.05);Bp、Scr、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、血清转氨酶、FIB、OGTT-2h血糖及OGTT-2h血浆胰岛素差异无统计学意义(P>0.05)。合并脂肪肝组中维吾尔族患者WL较汉族明显增加(P<0.01),而UA较汉族降低(P<0.05);无脂肪肝组中维吾尔族患者与汉族比较,WL明显增加(P<0.01),FPG及HOMA-IR增加(P<0.05)。WL及TG是NAFL的危险因素(P<0.01,OR值分别为1.055、2.358)。结论:T2DM合并NAFL患者存在明显的超重、中心性肥胖、血脂紊乱及IR,WL与TG是NAFL发病的危险因素。维吾尔族T2DM患者比汉族患者具有明显的中心性肥胖及其所引起的IR。     

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.