简单人体测量指数与肥胖相关性的再认识

目的:探讨南京地区人群中体重指数(BM I)、腰臀围比(WHR)、腰围这三项简单人体测量指数在评估肥胖中各自的特点。方法:对3 445例南京地区汉族人检测身高、体重、腰围、臀围,并测定空腹血清各项血脂指标和空腹血糖(FPG)、真胰岛素(TI)和瘦素(Leptin),以S i=1/(FPG×TI)作为胰岛素敏感指数,对人体测量指数和各种代谢指标的相关性分别进行分析。结果:利用目前的腰围切割点(男性为85 cm,女性为80 cm)来判断,男性超重率为24.6%,女性仅13.0%,显示BM I切割点和目前WHR及腰围切割点对人群肥胖状况的特异性和敏感性不在同一水平,而男性WHR为0.85,女性为0.80;男性腰围为80 cm,女性为75 cm,与BM I=24 kg/m2处于同一水平。BM I与糖代谢指标FPG、TI、S i、Leptin的相关性强于WHR和腰围,而WHR和腰围与脂代谢指标TG、LDL、apoB的相关性强于BM I。结论:应适当放宽以WHR和腰围为指标的肥胖诊断标准。WHR和腰围是反映内脏型肥胖的较好指标,而BM I是胰岛素抵抗的敏感因子,都是评估肥胖的良好指标,但侧重不同。     

生物电阻抗、BMI、腰围等方法检测青年健康人肥胖率

目的:比较不同方法检测青年健康人肥胖率的差异。方法:对369名青年健康人进行身高、体重、腰围、臀围、上臂围、三头肌皮褶厚度(TSF)、肩胛下皮褶厚度(SSF)的测量及采用BCA-2A人体成份分析仪测定人体成份,选择五种不同的指标计算男性、女性肥胖率,包括体脂百分比、BM I、腰围、理想体重和(TSF SSF),比较各种方法对男女肥胖率检出率的差异。结果:男性、女性各人体测量指标均数有显著性差异(P<0.05),五种不同指标对男女肥胖检出率有显著性差异(P<0.05),其中,体脂百分比检出率最高,理想体重法检出率最低。结论:生物电阻抗法检测肥胖检出率较高。     

内蒙古地区汉族成人体重指数与脂肪厚度的分析

目的:了解内蒙古地区汉族成年人体重指数与脂肪厚度年龄变化与性别差异。方法:对1077名汉族男女的体重、身高、皮褶厚度进行测量。结果:(1)男女体重指数随年龄增长呈增长趋势,45岁之前男性体重指数大于女性,之后女性大于男性;(2)男女皮褶厚度随年龄增长变化趋势为男性在30岁之前增长呈上升趋势,30岁之后进入相对平台期;女性在20～25之间为平台期,25岁之后快速增长,35岁达到第一个高峰,然后下降40岁进入第一个低谷,之后又持续升高。结论:各年龄段的男女平均体重指数绝大部分有显著性差异,只有在45岁组无差异;皮褶厚度男女各个年龄段均有显著性差异。     

社区居民超重、肥胖与糖尿病患病率的关系

目的了解不同体重指数、腰围与糖尿病患病率的关系,为社区居民的糖尿病的早期干预提供理论依据。方法采用分层整群抽样方法抽取40岁及以上的常住居民4752人进行调查,测量身高、体重、腰围,测定空腹口服75g葡萄糖后2h血糖。结果本次共调查40岁以上居民4752人,查出DM患者220人,患病率为4.63%,其中男性4.35%,女性4.86%;查出IGT患者282人,患病率为5.93%,其中男性7.48%,女性4.67%,性别患病率未见显著性差异(P0.05)。除40~岁组以外,其他年龄组随着BMI水平增高,DM、IGT患病率也明显上升(P0.05);除BMI18.5组外,DM、IGT患病率与年龄增长密切相关(P0.05)。男女各年龄组腹型肥胖的DM、IGT患病率比正常体型组的明显增加(P0.05)。结论 BMI≥24或男性WC≥85cm、女性WC≥80cm者是DM患病高危人群,因此做好中老年肥胖人群的行为干预是预防糖尿病的有效措施。     

百色地区乡村壮族中小学生肥胖状况的调查

目的了解百色地区乡村壮族中小学生肥胖分布状况,为预防成人肥胖症、冠心病、脑血管疾病奠定基础。方法采用国际通用的人体测量法,测量身高、体重、肱三头肌部皮褶厚度、肩胛下角部皮褶厚度4项指标,推断出壮族中小学生的肥胖状况,并同国内其他群体进行比较。结果男、女学生身高、体重、肱三头肌部皮褶厚度、肩胛下角部皮褶厚度四项指标随年龄增长而逐渐增长;男、女学生体脂在青春期前呈增加趋势,随年龄的增长而增加;同一年龄组女学生皮褶厚度均大于男学生。男、女学生肱三头肌位、肩胛下位的皮褶厚度在10岁~、12岁~和13岁~三个年龄组间比较差异有高度显著性(P均<0.01)。超重率为0.26%。结论百色地区乡村壮族中小学生肥胖率较低,其皮下脂肪发育年龄和性别差异与儿童青少年身心发育阶段相关。     

正常BMI腹型肥胖者胰岛素抵抗、血脂及膳食分析

目的 探讨正常体质指数(BMI)腹型肥胖者胰岛素抵抗(IR),血脂代谢水平及其营养素摄入与正常体型人群的差异.方法 以男性腰围≥85 cm,女性腰围≥80 cm为腹型肥胖判断标准,将收集到的BMI小于24 kg/ m2的111例志愿者分成体型正常组和腹型肥胖组,测定其空腹状态下的血糖、胰岛素、胆固醇、甘油三酯、高密度脂蛋白、载脂蛋白B及皮褶厚度等指标,并进行连续三天24 h膳食回顾调查.结果 腹型肥胖组人群的空腹胰岛素水平、稳态评估模型胰岛素抵抗指数、甘油三酯均高于体型正常组(P值分别＜0.01、＜0.05和＜0.05),而高密度脂蛋白水平低于体型正常组(p＜0.01);其中男性仅高密度脂蛋白水平差异有统计学意义(P＜0.05),而女性空腹胰岛素(P＜0.01),甘油三酯(P＜0.05)及高密度脂蛋白(P＜0.01)差异均有统计学意义.两组人群均有营养素撮入不足现象.结论 正常BMI腹型肥胖人群与体型正常人群相比,空腹胰岛素、稳态评估模型胰岛素抵抗指数和甘油三酯水平较高,而高密度脂蛋白较低,胰岛素抵抗和脂代谢紊乱的危险性增加,应加强饮食指导,预防糖尿病和高脂血症的发生.     

成年人身高与去脂组织重的关系

目的 :研究成年人身高与去脂组织重 (fatfreemass,FFM)之间的关系 ,并建立预测FFM的简单方程。方法 :对 95 5名健康成年人进行人体测量和生物电阻抗测量 ,按BMI分为肥胖组和非肥胖组 ,按年龄分为 4 5岁以下组和 4 5岁以上组 ,分析FFM与年龄和肥胖的关系。根据FFM是身高的异速生长指数的模型关系 ,进行非线性回归 ,建立指数曲线回归方程。结果 :健康成年人的FFM并不随年龄增加 ,非肥胖组与肥胖组的FFM也是相对不变的。预测男性FFM的适宜方程为 :FFM (kg) =2 4 .98×Height1.68,女性为 :FFM(kg) =2 2 .84×Height1.42 。结论 :以身高为变量能估计出正常成年人FFM的近似值。     

甘肃省成年人身体形态的年龄变化特点和趋势分析

通过对2005年甘肃省国民体质测试结果的分析发现,甘肃省成年人的身体形态较好,具有明显的亚高原人和北方人的特征--男性身材高大、体格健壮,女性身材修长、丰满.成年人的身高随年龄的增长呈现逐年降低的趋势;男性的体重、胸围、腰围、臀围、皮褶厚度、BMI指数在54岁前随年龄的增长逐年增大,54岁后呈现随年龄的增长而逐年减小的趋势;女性则呈现随年龄的增长持续增大的趋势.     

代谢综合征相关肥胖程度的适宜指标及其切点

目的分析代谢综合征中腰围(WC)/体质量指数(BM I)的适宜切点。方法利用该院2002~2003年在上海市浦东新区塘桥社区的调查资料,分析男性和女性不同WC/BM I水平与代谢综合征其他成分聚集的关系,并寻找检出两个及以上危险成分敏感性和特异性均较好的WC/BM I切点,比较各切点检出2个及以上危险因素异常的比值比(OR),并计算在此切点以上的人群归因危险度百分比(PARP)。结果随WC/BM I增大,代谢综合征成分聚集的OR值显著增高。男性WC≥85 cm、女性WC≥80 cm、男性BM I≥24 kg/m2、女性BM I≥25 kg/m2为受试者工作特征曲线距离最短和(或)正确指数最大的切点。女性以WC≥80 cm为切点的OR值及PARP均较以BM I≥25 kg/m2为切点的大,而男性情况恰与女性相反。结论结果提示,女性WC≥80 cm以及男性BM I≥24 kg/m2能较好地反映代谢综合征危险因素的聚集,为选择较合适地反映与该地区代谢综合征相关肥胖程度的指标和切点提供了流行病学依据。     

Framingham心脏研究中发展为肥胖的估测风险

背景:发展为超重或肥胖的短期和长期风险尚不清楚。目的:评估社区成年人发展为超重或肥胖的短期、长期以及终生风险。设计:1971—2001年间进行的前瞻性队列研究。地点:马萨诸塞州Fram ingham基于社区的研究。参与者:4117例来自Fram ingham心脏研究的白人(51.9%为女性)。观察指标:BM I正常(18.5～25.0kg/m2)的不同年龄(30岁、40岁和50岁年龄段)男性和女性受试者中发展为超重(BM I≥25kg/m2)或肥胖(BM I≥30kg/m2)的短期(4年)和长期(10～30年)风险。结果:所观察到的4年后发展为超重的比例在女性中为14%～19%,男性中为26%～30%。4年后发展…     

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.