大学生打鼾的危险因素分析

目的通过调查某医科大学在校大学生中打鼾的人群分布特征,对可能引起打鼾的危险因素进行回顾性分析,为预防、控制打鼾提供依据。方法采用整群抽样的方法抽取大学三年级的485名同学进行问卷调查和体格检查,并应用Logistic回归分析进行危险性的评价。结果有效问卷485份,打鼾者占35.7%;单因素分析显示,男性打鼾高于女性,肥胖、鼻咽部疾病、饮酒均为打鼾的相关因素。多因素Logistic回归分析进一步证实,性别、超重、鼻咽部疾病三个因素仍有统计学意义(P<0.05)。结论大学生打鼾患病率较高,肥胖、饮酒、卫生习惯以及鼻咽部疾病等因素与打鼾显著相关。     

武警内蒙古总队驻呼部队鼾症的流行病学调查

目的 结合目前鼾症的流行病学调查现状,了解内蒙古呼市地区军人鼾症的患病率,分析鼾症的影响因素,为临床实施有针对性的制定干预策略,提供理论依据。方法 采取整群抽样法,对武警内蒙古总队驻呼部队部分支队进行鼾症的问卷调查,分析其危险因素。结果 五个支队共发放问卷259份,回收240份,回收率为91.89%。41例轻度打鼾者(17.1%),20例中度打鼾者(8.3%),3例重度打鼾者(1.3%),鼾症患病率是26.67%。打鼾与年龄、颈围、腹围有相关性,P0.05。打鼾与吸烟史、饮酒史、打鼾家族史有相关性,打鼾与舌体肥大、小颌畸形、天包地、上下齿吻合等解剖因素具有相关性,P0.05。logistic多因素回归分析显示,打鼾家族史、舌体肥大、饮酒史、吸烟史、腹围是鼾症的独立危险因素。结论 武警内蒙古总队驻呼部队部分支队鼾症患病率是26.67%。打鼾家族史、舌体肥大、饮酒史、吸烟史、腹围是鼾症的独立危险因素。     

大学生鼾症的形成因素及非手术护理干预措施研究

目的:探讨大学生鼾症的影响因素及非手术治疗护理干预措施。方法:采用抽样调查方式对湖州师范学院医学院246名学生进行问卷调查、体格检查及护理干预,并进行相关分析。结果:246名调查对象中,打鼾者92人(37.4%),经常打鼾者21人(8.5%)。打鼾的危险因素中有肥胖、悬雍垂过长、颈围、性别因素(男性高于女性,P<0.05);而仰卧会加重打鼾程度(P<0.05);遗传、烟酒、运动、心理状况分布未见。结论:大学生中鼾症患者占有一定比例,但经常打鼾者比例较少,且影响因素中肥胖、卧位等因素均可通过护理干预改变。因此,可有针对性地制定护理干预措施,通过非手术护理改善打鼾症状,甚至达到治愈目的。     

南宁市寄宿高中生睡眠打鼾的调查研究

目的 调查南宁市寄宿高中生打鼾情况及其相关因素,为防治中学生打鼾提供依据.方法 对南宁市3所寄宿制学校高中生共663名进行问卷调查及体格检查,分析高中生打鼾情况,并对打鼾影响因素进行单因素和多因素Logistic回归分析.结果 663名学生中打鼾发生率为22.3%,其中男生发生率31.2%,高于女生的14.7%,差异有统计学意义(P＜0.05);打鼾组的体重指数和颈围大于不打鼾组(P＜0.05);有鼻咽部疾病患者的打鼾率高于无鼻咽部疾病者(P＜0.05).Logistic回归分析显示性别、颈围、体重指数、鼻咽喉疾病等因素与打鼾有关(P＜0.05).结论 打鼾在寄宿高中生中发生率较高,应引起学生、家长及有关机构的重视.     

鼾症及其相关危险因素流行病调查

目的：探讨不同性别鼾症的发病率及其相关危险因素,为该病的防治提供依据。方法：采用整群抽样的方法对克拉玛依市区天山社区35岁以上常住居民进行入户鼾症问卷调查,调查包括同屋居住者,问卷采用柏林国际睡眠问卷结合Epworth嗜睡量表评分（ESS评分）而成。结果：实际调查人数为2590人,其中有效问卷2493份（有效率为96.7%）,男性1054人,打鼾者645名（61.2%）,女性1439人,打鼾者649（45.1%）,打鼾随年龄、体重指数（BMl）、颈围、ESS评分的增加而增加。绝经期妇女鼾症发病率高于未绝经期妇女（54.2%VS26.2%）,男性吸烟、饮酒与打鼾程度及发病率相关（P〈0.01）。结论：克拉玛依市区天山社区35岁以上人群男性鼾症发病率高于女性,BMI、ESS评分、男性吸烟、饮酒、女性绝经是鼾症的主要危险因素。     

克拉玛依市区35岁以上人群鼾症发生率调查及危险因素分析

目的调查克拉玛依市区35岁以上人群鼾症的发生率及其相关危险因素。方法采用整群抽样的方法对克拉玛依市区两个社区5个新村35岁以上常住居民进行入户睡眠问卷调查。问卷内容包括打鼾情况、Epworth嗜睡量表评分(ESS评分),吸烟、饮酒等个人史,测量身高、体重、颈围、腹围、腰围及臀围。根据问卷内容评分将调查对象分为鼾症高危组和低危组。结果实际有效问卷2513份,打鼾者1312例(52.2%),其中中重度打鼾者占38.9%。鼾症发生率在60岁以前随年龄的增加而增加,男性高于女性(61.7%比45.1%),随颈围的增粗而增加(P0.05)。鼾症高危组与低危组间在体质量指数(BMI)[(28.2±3.6)kg/m2比(25.1±3.9)kg/m2]、ESS评分(4.4±3.8比3.4±3.2)、颈围[(37.7±3.6)cm比(35.6±3.6)cm]、腹围[(96.9±13.6)cm比(88.7±11.1)cm]、腰围[(92.2±9.8)cm比(84.7±10.2)cm]、臀围[(102.9±9.6)cm比(96.4±9.3)cm]、腰臀围比(0.90±0.07比0.88±0.08)、收缩压[(132.0±17.5)mmHg比(125.6±16.8)mmHg]及舒张压[(83.3±12.8)mmHg比(78.3±12.6)mmHg]等方面差异有统计学意义(P均0.01)。多因素Logistic回归分析显示,年龄(OR=1.519)、BMI(OR=2.549)、颈围(OR=2.473)、吸烟(OR=2.765)、ESS评分(OR=2.575)及女性绝经(OR=1.806)是打鼾的主要危险因素(P0.05)。结论克拉玛依市区35岁以上人群打鼾发生率高,年龄、BMI、颈围、吸烟、ESS评分及女性绝经是打鼾的主要危险因素。     

济南地区学龄儿童睡眠呼吸障碍流行病学调查

目的探讨济南地区学龄儿童睡眠呼吸障碍及相关问题的发生情况。方法2006年10月至2007年9月以调查表的形式随机抽样调查济南市区四所小学7～12岁1995名健康学龄儿童的睡眠呼吸障碍及相关问题。结果收回1596份有效调查表,其中睡眠时几乎每晚都打鼾者64人,占4％。有呼吸暂停者31人,占1.9％。打鼾的相关危险因素包括:鼻通气不畅、男性、父亲打鼾、母亲打鼾等;呼吸暂停的相关危险因素包括:打鼾、鼻通气不畅、扁桃体炎反复发作。结论济南地区学龄儿童的睡眠状况应引起家长和医务工作者的重视。     

交通肇事司机82例睡眠打鼾调查分析

目的:通过对交通肇事服刑的司机睡眠打鼾患病率调查,呼吁社会为保障交通安全,应重视司机鼾症问题。方法:选取交通肇事服刑汽车司机82例,由监狱医师进行问卷填写,对2级及2级以上打鼾者进行统计分析。结果:(1)在被调查82例服刑司机中,从不打鼾者占总数48例(58.54%),有不同程度打鼾者占34例(41.46%),≥2级打鼾14例(17.07%)中,2级打鼾者5例(6.10%);3级打鼾者4例(4.88%);4级打鼾5例(6.10%)。服刑司机中偶尔饮酒34例(41.47%),经常饮酒9例(10.98%),肇事前24小时饮酒20例(24.39%),疲劳驾驶19例(23.17%),肇事前不清醒22例(26.83%),肇事前未采取措施19例(23.17%),违章驾驶30例(36.59%),行驶路况不熟悉21例(25.61%)。(2)应用日间Epworth嗜睡量表(ESS)评分≥9分为标准,对打鼾组34例和非打鼾组48例进行ESS评分比较,打鼾组9例(26.47%),而非打鼾者2例(4.17%),两组比较差异有统计学意义(χ2=8.52,P<0.01)。服刑的司机认为打鼾不是病39例(47.56%),打鼾是病但不需要治疗11例(13.41%),打鼾是病需要治疗31例(37.80%),已经接受过治疗仅1例(1.21%)。结论:(1)交通肇事服刑的司机鼾症的患病率较高;(2)打鼾造成交通肇事与其它因素造成交通肇事的司机发生率十分接近;(3)交通肇事服刑司机年龄轻、文化程度低,对打鼾是病的认识程度相对较低,需要加大睡眠打鼾和由此引发的睡眠呼吸暂停对交通肇事危害的警惕及宣传,也需要国家行政干预对于重症打鼾的司机进行驾驶限制。     

信阳市2 281名大学生群体无偿献血相关KAP水平现况调查及影响因素分析

目的 探讨市大学生群体无偿献血相关知信行(Knowledge,Attitude,Practice,KAP)水平现况及影响因素。方法 以多级抽样方法从市4所高校抽取2 281名大学生(2019年1月～2019年12月)作为研究对象,自制KAP水平调查问卷,调查其无偿献血相关KAP水平,并分析影响KAP水平的因素。结果 2 281名大学生群体无偿献血知识得分为(4.71±1.66)分,有无偿献血意愿的650名,占28.50%,有无偿献血行为的579名,占25.38%;不同年级、专业的大学生群体无偿献血知识得分比较差异显著(P＜0.05),不同性别、父母文化水平的大学生群体无偿献血知识得分比较无明显差异(P＞0.05);不同性别、专业的大学生群体无偿献血意愿比较差异显著(P＜0.05),不同年级、父母文化水平的大学生群体无偿献血意愿比较无明显差异(P＞0.05);不同性别、专业、父母文化水平的大学生群体无偿献血行为比较差异显著(P＜0.05),不同年级大学生群体无偿献血行为比较无明显差异(P＞0.05);经Logistic多因素分析得知,年级低、非医学类专业为影响大学生群体无偿献血知识的危险因素,女性、非医学类专业为影响大学生群体无偿献血态度的危险因素,女性、非医学类专业、父母文化水平低为影响大学生群体无偿献血行为的危险因素(P＜0.05)。结论 市大学生群体无偿献血相关KAP水平现况不容乐观,受到专业、年级、父母文化水平、性别等因素影响,应采取针对性干预措施,提高KAP水平。     

承德市区青少年过敏性鼻炎及生活质量相关问题调查

目的:了解承德市区青少年过敏性鼻炎流行病学特征、患者生活质量相关问题及相关危险因素.方法:随机选取承德市五所中学初中三年级(15-16岁)学生为研究对象,设计"承德市青少年过敏性鼻炎问卷调查表",调查分问卷调查及专科检查后确诊两阶段.对结果进行统计学处理.结果:发放问卷总数为1000份,回收925份,应答率为92.5%.承德市青少年过敏性鼻炎现患病率为5.3%(49/925),其中男5.44%(27/496),女5.13%(22/429),男女发病率无明显差异(P＞0.05).在过敏性鼻炎危险因素中,34.49%患者有家族史.结论:承德市15-16岁青少年过敏性鼻炎现患病率为5.3%,初步了解承德市区过敏性鼻炎流行情况,为过敏性鼻炎标准化防治提供了流行病学资料.     

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.