肇庆市1955—1999年麻风流行病学分析

目的：全面了解肇庆市麻风病流行状况及评价防治效果。方法：对1995－1999年来肇庆市6，867例麻风病患者进行流行病学分析。结果：年均发病率，年均发现率，患病均率由50年代的34．48／10万，26．64／10万，0．95‰分别下降对90年代的0．17／10万，0．15／10万，0．018‰，呈大幅度下降；发病儿童由50年代1．49／10万降至90年代0．01／10万；型比（MB／PB）及畸残率呈“U”字型演变；平均确诊延迟期最高是70年代的5．28年，最低是90年代的2．35年；患病男女比例平均2．54：1；高要市是肇庆市唯一末达标地区，其麻风病流行情况是端州区相比，有明显差异（P＜0．05）。结论：肇庆市麻风病流行呈明显下降趋势，全市六县（市）二区中只有高要市是唯一未达标的县（市）。     

电白县麻风病流行病学分析

目的分析麻风病流行病学特点,为麻风病防治提供依据。方法对1955年以来现存资料中麻风病流行病学各项内容进行回顾整理作统计学分析。结果共登记2642例,分布在沿海15个镇占84．78％,其他11镇占15．22％,男女之比为2．91：1,0～14岁占16．12％;15～59岁占68．05％;60岁以上占15．82％。患病总型比为29．06％,逐年上升;总平均发病率为8．06／10万,患病率为0．67％,发现率为7．07／10万,呈逐年下降趋势。2003年底患病率为0．0059‰,近五年发病率为0．15／10万,平均延迟期逐年缩短。最长为1955年段4．3年,最短为2000年段0．5年。新发畸残占27．02％,逐年下降。复发率为1．61％,以MB及DDS单疗病例为主。结论麻风病流行与环境因素和易感机体有关,青壮年男性是主要易感人群,电白县麻风病已呈低流行状态,达到基本消灭麻风病指标。     

郴州市1954～2009年麻风疫情流行趋势分析

目的分析郴州市历年来麻风病流行状况,摸清其流行趋势的规律和特征,为进一步控制疫情,制订切实可行的防治对策提供科学依据。方法对郴州市1954～2009年麻风病患者的原始资料及年报表进行整理和分析。结果全市累积发生麻风病1153例,其中治愈983例,愈前死亡103例,其他减少8例,有现症麻风病人62例;5年平均发现率、发病率以1955～1959年1．94／10万、2．38／10万最高,患病率1960～1964年段1．14/万最高。型比58．37％,II级畸残率44．06％,平均延迟期为4．42年。地理分布以汝城、资兴、桂东三县市最多占全市70．34％,人群年龄分布15～59岁占87．95％。男女性别比为4．46：1。结论郴州市麻风病疫情明显下降,流行趋势减弱,呈低流行水平。发病年龄多为青中年,地区分布不均匀,早期发现率较低,加强麻风防治机构建设,加大麻风病防治工作力度,有针对性开展接触者检查和线索调查,仍然是今后麻风病防治工作的有效措施。     

364例白裤瑶族麻风流行病学调查分析

目的　探讨麻风病在一个民族内的流行规律及其防治特点。方法　利用广西和贵州两省三县 195 2～ 2 0 0 1年白裤瑶族麻风流行病学调查资料进行统计分析。结果　①在白裤瑶族总人口 2 .9万人中 ,累计发现麻风病 36 4例 ,积累患病率 13 .2 5‰ ,最高年段 ( 195 2～ 195 6年 )麻风发病率为 12 9.15 /10万 ;②患者分布于 130个屯 ,屯患率为 48.5 1% ;③有麻风病的家庭 2 73户 ,户患率为 5 .77% ,有 2例以上的多发麻风家庭 6 1户 ,占 2 2 .34% ;④发现病人病期平均 6 .2 4年 ,病人男女比值为 1.10。结论　白裤瑶族有较高的麻风发病率和患病率 ,分布广 ,家庭内发病较高 ,女性患病率比男性高 ,也比其他民族女性高 ,发现病人病期较长 ,具有明显的民族流行特征。     

1993-2012年亳州市新发现的麻风病的流行病学分析

目的分析亳州市1993-012年新发现的麻风病例的流行病学特征,了解亳州市基本消灭麻风病后麻风病的流行状况,为今后制定防治措施和策略提供科学依据。方法对1993-012年亳州市新发现的27例麻风病例的流行病学特征及发现率、发病率、患病率以及型比、发现方式等相关指标进行描述性分析。结果1993-2012年20年间共新发现麻风病例27例,年平均发现率为0．13／10万。男女性别比为3．50：1。平均发现年龄37．29岁,平均延迟期40．52个月,多菌型（MB）和少菌型（PB）之比为12．50：1。结论1993-2012年亳州市麻风病基本控制后疫情没有明显下降,一直处于低流行状态,但发现病人的延迟期较长,今后应采取综合防治措施,早发现、早治疗麻风病人,清除传染源,以期能尽早彻底消灭麻风病。     

南京市麻风病流行趋势分析

至1998年止,南京市累计发现麻风病人2807人,男2195人、女612人(男∶女为3.58∶1);少菌型2070人、多菌型737人(少菌型∶多菌型为2.81∶1);平均发病年龄为32.12岁(8～84岁);通过专科门诊发现的占75.4%,其它方式发现的占24.6%;Ⅱ级以上畸残率为63.15%。通过40多年几代人的努力,我市麻风病防治取得可喜成果:患病率由最高的1973年的29.4/10万下降到1998年的0.19/10万;患病人数由1973年的1121人减少到1998年的10人;平均发病率和发现率分别由56～60年段的4.69/10万和5.46/10万下降到91年～95年段的0.1/10万和0.12/10万。此外,型率的下降、儿童发病减少、麻风流行疫点减少、病人发现方式改变和畸残率下降等各项指标均有下降。患病率和近五年平均发病率、发现率的下降达到国家卫生部门规定的基本消灭麻风病的指标。我们相信,只要继续努力,流行病学各项指标将继续下降,最终达到完全消灭麻风病的目标     

云南景洪市1956-2005年麻风病流行状况分析

目的分析景洪市麻风病流行状况，摸清其流行规律和特征，为进一步控制疫情，制订防治对策及采取措施提供科学依据。方法对706例麻风病患者的原始资料进行回顾性统计分析。结果麻风病患者呈散在性集簇状分布，5年平均发现率、发病率以1956-1960年15.12／10万、9.69／10万最高，患病率1980年15.74／万最高。≤14岁病人占7．79％，高于全国平均水平；病人畸残率30．03％，MDT治疗（441／527，83．68％）效果显著高于单D治疗（115／478，24.06％）效果（X^2=109．79，P〈0．01）。结论景洪市麻风病流行尚未全面控制，加强宣传，健全三级防治网，实行报病有奖，认真做好门诊、接触者检查和线索调查，仍然是今后麻风病防治工作的有效措施，联合化疗是治疗麻风的最佳手段。     

梅州市1991～2002年病毒性甲型肝炎流行特征分析

目的 分析梅州市1991～2002年病毒性甲型肝炎(以下简称甲肝)的流行规律。方法 回顾性调查分析。结果 1991～2002年年发病率平均为8．05／10万；自1994年起呈逐渐下降趋势，年发病率从1991年的29．24／10万下降到2002年的1．60／10万，下降了94．53％；年平均病死率为0．0l／10万；发病呈春夏季节性高峰；男性发病率高于女性(1．96：1)；199l～1998年以0～15年龄发病率最高，1995～2002年以25～40岁年龄发病率最高；职业分布以农民、学生、散居儿童发病为主。结论 根据梅州市甲肝流行特征分析结果，提示今后应重点做好食源性及水源性甲肝暴发流行的预防控制，以及开展成年人接种甲肝疫苗预防措施。     

1954年-2008年青海省麻风病流行分布及其特征分析

目的:分析青海省1954年-2008年底麻风病流行程度及防治动态趋势,为今后制订麻风病防治工作新策略提供理论依据.方法:对青海省1954年-2008年累计发现登记麻风患者1 635例发现情况和防治基础资料进行归纳、统计分析.结果:患病率、发病率、发现率呈现上升后下降的动态状况,(50～60)年代为高峰期,以后呈逐年下降趋势.流行分布呈现"南高北低,东多西少"的分布特征,至2008年底发现率为0.28/10万,发病率为0.030/10万,近5年平均患病率为0.003 4/10万.结论:经过54年的综合性积极防治,全省麻风病流行已得到有效控制.建立麻风防治网络,有效控制麻风病,提高早期发现率.     

1990～1999年黑龙江省麻风新复发病人分析

黑龙江省位于我国最北部，年平均气温1、3℃，属于寒温带气候。自1949年有麻风病例登记以来，截止到1999年末，累计发现病人1034例，属于非流行区。经过50年的积极防治，共治愈现患891例，目前仅有现患24例，患病率为0．006／万，近5年平均发现率在0．001／10万以下。自1988年以后，我省以县为单位，患病率均在1／10万以下，发现率在0．01／10万以下。实现了国家基本消灭麻风的控制指标，并且一直没有反复。近10年来，发现(发病)率始终维持在一个较低水平。现将1990-1999年间发现的新复发病人分析，报告如下。     

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.