维吾尔族先天性唇腭裂婴儿的病因病例对照研究

目的：研究维吾尔族先天性唇腭裂的致畸原因，探讨其预防措施。方法：调查新疆11所医院自1992年1月至2001年12月出生的新生儿，对检出的维吾尔族唇裂新生儿进行成组病例对照研究。资料作单因素和非条件logistic多因素回归分析。结果：108427名维吾尔族新生儿中发现唇裂婴儿123例，发病率11.34/万。病例组和维族健康新生儿作对照分析，进入logistic回归模型的变量有：家族史（OR=29.898），孕期营养差（OR=17.092），孕期患风疹（OR=12.139），孕期患全身疾患（OR=7.452）。与汉族健康新生儿作对照，进入logistic回归模型的变量有：家族史（OR=21.317），孕期患风疹（OR=16.204），饲养动物（OR=15.848），孕期患全身疾患（OR=9.297），胎次（OR=0.095）。结论：家族史，孕期营养差，孕期患风疹，孕期患全身疾患，可能是维吾尔族发生唇腭裂的危险因素。     

复发性泌尿系结石患者24h尿枸橼酸盐含量的病例对照研究及结石成分分析

目的:分析复发性泌尿系结石患者尿枸橼酸排泄量与结石成分及微观形态,探讨泌尿系结石形成与复发的防治措施。方法:采用病例对照的研究方法,比较复发性泌尿系结石患者与对照组之间的尿枸橼酸排泄量,并运用红外光谱、X线衍射及扫描电镜分析复发性结石的成分与微观形态。结果:复发性结石患者尿枸橼酸排泄量显著低于对照组。结石的成分以草酸钙(80%)和尿酸结石(33%)为主。结论:结石患者术后的代谢分析、严格随访和适量的枸橼酸盐补充,可能在一定程度上降低泌尿系结石的复发率。泌尿系结石的成分分析可为制定预防结石复发方案提供理论依据。     

维吾尔族男性不育症危险因素对照研究

目的 探讨维吾尔族男性不育症的危险因素.方法 对133例不育症患者进行1:1配对病例对照研究.结果 Logistic回归分析显示,与维吾尔族男性不育症有关联的危险因素是:(1)食用棉籽油(OR=5.72,95%CI:1.20～27.33);(2)吸烟(OR=8.60,95%CI:2.52～29.34);(3)生殖系统疾病史(OR=8.347,95%CI:1.027～67.846);(4)结核病史(OR=4.32,95%CI:1.16～16.07);(5)婚外性生活史(OR=3.66,95%CI:1.21～11.01);(6)性病史(OR=5.49,95%CI:1.38～21.85).结论 本研究显示:男性不育症是由多种危险因素导致的.应从改变不良的生活习惯及行为方式,早期积极治疗影响生殖健康的疾病以预防不育症的发生.     

获得性肾囊肿危险因素的配对病例对照研究

目的 :探讨影响获得性肾囊肿 (ARC)发病的危险因素。方法 :回顾性分析 5 3例ARC患者临床资料 ,进行 1∶1配对病例对照研究 ,并建立回归模型分析其危险因素 ,在α =0 .0 5水平确定其危险因素。结果 :经过单因素条件回归、多因素条件Logistic回归、逐步条件回归分析 ,结果显示肌酐清除率 (Ccr)水平 (OR =0 .4 98,P =0 .0 112 ,β =- 0 .6 976 2 )和年龄 (OR =2 .0 93,P =0 .0 2 71,β =0 .7385 2 )与ARC有显著性 (P <0 .0 5 )关联。结论 :Ccr水平和年龄是ARC的危险因素 ,慢性肾脏疾病患者随着Ccr下降和 (或 )年龄增加 ,ARC发病率呈上升趋势。     

新疆南部维吾尔族人群尿石症与血管内皮生长因子基因多态性关系的研究

目的 探讨新疆南部维吾尔族人群血管内皮生长因子(VEGF)-460位点基因多态性与泌尿系结石的关系.方法 应用聚合酶链反应-限制性片段长度多态性分析(PCR-RFLP)、基因测序等方法检测200例尿石症患者的VEGF-460基因多态性,200例健康人群体检标本作为对照组,比较2组VEGF-460基因型和等位基因的分布频率.结果 2组VEGF-460位点CC、TT、CT基因型和等位基因比较差异均无统计学意义(P＞0.05),基因型分布频率分别为1.5%、29.0%、69.5%和0.5%、27.5%、72.0%,等位基因C、T分别为36.2%、63.7%和36.9%、63.1%,2组比较差异均无统计学意义(P＞0.05).结果 新疆南部地区维吾尔族人群VEGF-460基因多态性与尿石症无关,VEGF-460位点可能不是维吾尔族尿石症的易感基因.     

股骨头坏死危险因素病例对照研究

目的研究发生股骨头坏死的危险因素,为该病的预防提供依据。方法采用病例对照研究方法,以临床确诊的股骨头坏死的100例作为病例组,按1∶3比例配对与病例同性别、同一年龄组、同一居住地区的非股骨头坏死者(排除严重的心、肝、肺、肾疾病)作为对照组,对主要疾病史、服药史、吸烟饮酒史以及一些中医症候等因素进行调查研究,并进行统计学分析。结果危险度分析表明,可能与股骨头坏死危险性有关的因素(OR及95%CI)病史有下肢骨折、髋关节炎和类风湿关节炎、高脂血症、糖尿病史;服用糖皮质激素类药物如强的松、地塞米松、氢化可的松;发现面色苍白、畏寒、四肢酸软等肾阳虚症状与股骨头坏死也有联系(P<0.05)。结论下肢骨折、髋关节炎等病史和使用激素类药物可能是股骨头坏死的主要危险因素;肾阳虚症状与股骨头坏死有联系;对股骨头坏死的预防有着重要意义。     

重庆地区尿石症危险因素的研究

目的　探讨尿石症患者的发病年龄、发病诱因及发病季节等因素与家族史的关系。　方法　采用问卷调查形式对 36 0例有家族史和 12 0 0例无家族史尿石症患者及 10 0 0例正常对照组进行调查。　结果　① 36 0例有家族史尿石症者中 ,一级亲属和二级亲属的患病率分别为 10 .71% (14 7/1372 )、1.6 8% (5 4 / 32 14 ) ;而对照组一级亲属和二级亲属的患病率分别为 0 .6 6 % (2 3/ 3480 )、0 .12 % (9/7345 )。②有家族史尿石症者中 ,男性平均发病年龄 (2 6 .35岁 ) ,女性 (36 .4岁 ) ,两组比较差异有显著性意义 (t=1.75 ,P <0 .0 5 )。有家族史男性发病年龄 (2 6 .35岁 )早于无家族史男性 (2 9.31岁 ,t =2 .2 15 ,P <0 .0 5 ) ,女性患者有家族史者平均发病年龄 34.9岁 ,无家族史者平均发病年龄 35 .2岁 ,二者比较差异无显著性意义 (t=0 .739,P >0 .0 5 )。③发病诱因、发病季节在有家族史和无家族史间无统计学意义 ,但环境因素两组比较差异均有显著性意义 (χ2 =0 .2 3,P <0 .0 5 )。　结论　尿石症是一种多因素的且可能与遗传因素有关的疾病。     

新疆墨玉县维吾尔族成人牙周炎与慢性肾脏病患病率的流行病学研究

目的 探讨维吾尔族成人牙周炎与慢性肾脏病（CKD）患病率的关系。 方法 采用分层容量随机抽样方法,从墨玉县364个村抽取15个村18岁以上维吾尔族成人1650人,进行问卷调查、慢性肾损伤指标检测、相关危险因素调查及口腔检查。依据慢性牙周炎的诊断标准,将调查对象分为牙周炎组和非牙周炎组,其中牙周炎组按其严重程度进一步分为轻度牙周炎组、中度牙周炎组和重度牙周炎组。 结果 在资料完整的1415人中,慢性牙周炎患病率为65.2％（95%CI：65.0～65.4）,CKD患病率为5.2%（95%CI：5.1～5.3）,蛋白尿的患病率为4.2%（95%CI：4.1～4.3）,慢性肾功能不全的患病率为1.3%（95%CI：1.3～1.4）。牙周炎组和非牙周炎组CKD患病率差异有统计学意义（6.4%比2.9%,χ2 = 7.841,P = 0.005）。单因素Logistic回归分析显示重度牙周炎为CKD的危险因素（OR = 3.2,95%CI：2.0～5.2）。多因素Logistic回归亦显示重度牙周炎是CKD发生的独立危险因素（OR = 1.9,95%CI：1.1～3.3）。 结论 新疆农村维吾尔族成人是牙周炎的高发人群。牙周炎人群CKD患病率明显高于非牙周炎人群。重度牙周炎是CKD的独立危险因素。     

布氏杆菌人间感染危险因素病例对照研究

目的探讨现阶段人间布鲁氏菌病感染的危险因素,指导防控。方法应用病例对照研究的方法,对32例感染者和87例正常者作对照,进行危险因素分析。结果剥死羊羔（OR=5.03,95%CI=1.67～16.13）、手部有伤口或皲裂（OR=4.93,95%CI=1.52～15.93）、接触流产物或为羊接生（OR=3.17,95%CI=1.41～12.63）、不使用防护衣或手套（OR=3.76,95%CI=1.29～11.54）、外省牲畜（OR=1.59,95%CI=1.24～2.01）与布病发病感染存在独立的关联。结论剥死羊羔、手部有伤口或皲裂、接触流产物或为羊接生、不使用防护衣或手套、接触外地牲畜是现阶段济宁市布病感染的高危险因素。     

拉萨地区尿结石发病情况及危险因素的调查研究

目的:通过单中心调查,研究拉萨地区尿结石的发病情况及其危险因素,为本地区尿结石的诊治及预防提供科学依据。方法:对我院确诊为尿结石的362例患者进行问卷调查,对调查因素进行统计分析。结果:362例患者中,尿结石患者男女比例为3.36∶1(279/83),高发年龄段为20~39岁,且以上尿路结石为主;饮水少、高脂肪、高蛋白、高食盐、饮酒是本地区引发尿结石的危险因素。结论:减少饮酒和动物蛋白脂肪的摄入,限制钠盐日摄入量,并合理增加饮水,对本地区泌尿系结石的防治有积极意义。     

Urinary stone risk factors in the siblings of patients with calcium renal stones

PURPOSE: We determined which, if any, urinary stone risk factors accurately discriminate stone forming and nonstone forming siblings of patients with calcium renal stones. MATERIALS AND METHODS: A total of 252 siblings of stone formers provided 2, 24-hour urine samples, which were sent overnight and analyzed at a central laboratory. Standard stone risk factors were measured and the supersaturation of calcium oxalate, calcium phosphate and uric acid was calculated. RESULTS: Discriminant functions were derived for each gender by multivariate analysis. In stone forming sisters higher urinary calcium and pH discriminated with a success rate of 70%. In stone forming brothers higher urinary calcium, lower urinary potassium and older age discriminated with a success rate of 79%. CONCLUSIONS: Select urinary measurements as well as age classify siblings into those with and without stones with fair accuracy. Calcium excretion and urinary pH in females, and calcium excretion, urinary potassium and age in males are feasible identifiers of stone forming siblings. To determine whether these measurements can be used to predict new stone onset may require years of observation of our current cohort.     

Risk factors for calciphylaxis in Chinese hemodialysis patients: a matched case-control study

IntroductionCalciphylaxis is a rare but potentially fatal disease commonly occurred in dialysis patients. Despite some previous studies on risk factors for calciphylaxis, there is still a lack of data from Chinese population.MethodsThe retrospective matched case–control study about calciphylaxis was performed in Zhongda Hospital affiliated to Southeast University. The case group involved 20 hemodialysis patients who were newly diagnosed with calciphylaxis from October 2017 to December 2018. The 40 noncalciphylaxis patients undergoing dialysis with the same age and duration of dialysis were randomly selected as controls.ResultsMost of calciphylaxis patients were male and elderly, while overweight people were more susceptible to the disease. Although incidence of secondary hyperparathyroidism was higher in calciphylaxis patients, the differences in duration of elevated serum intact parathyroid hormone (iPTH) and its highest value did not reach statistical significance compared with controls. No significant difference in warfarin therapy was discernible between two groups. The univariate regression analysis indicated that male, score of use of activated vitamin D and its analogues, corrected serum calcium level, serum phosphate, Ca × P product, iPTH, albumin, and alkaline phosphatase (ALP) level were significantly associated with calciphylaxis. Elevated levels of serum phosphate (OR 4.584, p = 0.027) and ALP (OR 1.179, p = 0.036), decreased level of serum albumin (OR 1.330, p = 0.013) were independent risk factors after multivariate analysis.ConclusionThis is the first report of risk factors associated with calciphylaxis in China. Increased levels of serum phosphate and ALP, decreased level of serum albumin were vital high-risk factors for calciphylaxis in Chinese hemodialysis population.     

Genetic heritability of urinary stone risk in identical twins

PURPOSE: Quantitative measurements of urinary parameters are valuable clinical tools for predicting the risk of nephrolithiasis. To our knowledge no previous studies have evaluated the heritability of urinary stone risk in identical twins. Because these individuals share identical genetics, the R defined by their phenotypic data are theoretically equal to the entire population H2. MATERIALS AND METHODS: A total of 12 sets of healthy homozygous twins, including 4 males and 8 females for a total of 24 individuals, with a mean age of 25.9 years (range 21 to 36) volunteered for this study. All subjects provided informed written consent before assessment. Urinary stone risk profiles were done elsewhere on 2 consecutive days after 5 days of a standardized diet (170 mEq Na and 2500 kcal). Linear regression was performed on the data to determine R. Because identical twins were used, R was theoretically an estimate of H2. RESULTS: Certain urinary stone risk markers were highly heritable, including urinary calcium (94%), oxalate (94%), citrate (95%), uric acid (96%) and brushite supersaturation (90%), as determined by genotype (H2 90% or greater). Uric acid supersaturation (58%) and urinary sodium (64%) had low degrees of heritability. CONCLUSIONS: H2 is a measure of how much of the total variance in phenotype results from differences in genotype, as opposed to environmental differences. For example, an H2 of 95% for citrate suggests that genetic differences account for 95% of the variation in urinary citrate and environmental differences account for the remaining 5%. Therefore urinary calcium, oxalate and citrate are primarily determined by genotype, while environmental factors, particularly those that impact urine pH and urinary volume, may be increasingly important for determining uric acid supersaturation.     

Adequacy of a single stone risk analysis in the medical evaluation of urolithiasis

PURPOSE: We tested the hypothesis that a single 24-hour urine sample for stone risk analysis would be sufficient for the simplified medical evaluation of urolithiasis. MATERIALS AND METHODS: We retrospectively analyzed stone risk profile data on 24-hour urine samples obtained during random and restricted diets in 225 patients with recurrent urolithiasis. RESULTS: In 2 random samples we noted no significant difference in urinary calcium, oxalate, uric acid, citrate, pH, total volume, sodium, potassium, sulfate or phosphorus. For these risk factors there was a highly significant positive correlation in the 2 random samples (r > or = 0.68, p <0.0003) and the value of each was abnormal or normal in at least 81% of patients. Urinary magnesium and ammonium were significantly lower in random sample 2 than 1, the former by 4%. After calcium, sodium and oxalate dietary restriction mean urinary calcium and sodium plus or minus standard deviation decreased significantly by 25% from 251 +/- 125 to 187 +/- 98 mg. daily and by 38% from 183 +/- 87 to 113 +/- 57 mEq. daily, respectively. Other risk factors had a slight or no significant change. Correcting random urinary calcium for the excessive urinary excretion of sodium brought urinary calcium to 210 +/- 108 mg. daily, similar to the value on the restricted diet. CONCLUSIONS: The reproducibility of urinary stone risk factors is satisfactory in repeat urine samples. A single stone risk analysis is sufficient for the simplified medical evaluation of urolithiasis.     

新疆汉族、维吾尔族患者保胆取石术后结石复发的危险因素分析

目的探讨新疆地区保胆取石术后维吾尔族与汉族胆囊结石复发的危险因素。 方法对2010年1月至2015年1月期间在新疆军区总医院行微创保胆术治疗的5 126例维吾尔族、汉族患者进行出院后结石复发随访,每年一次,连续随访满3年,随访截止时间2018年1月。对胆囊结石复发患者进行流行病学调查并填报流行病学量表《新疆维吾尔自治区胆囊疾病危险因素调查表》,未复发的维吾尔族、汉族保胆术后患者各随机抽取100 例作为对照进行流行病学分析。采用单因素方差分析及Logistic回归分析影响术后结石复发的危险因素。 结果术后随访满3年患者共4 654例,共有320例患者胆囊结石复发（复发率6.9%）,其中3 066例汉族患者中胆囊结石复发171例（5.6%）,1 588例维吾尔族患者中胆囊结石复发149例（9.%）,维吾尔族患者保胆取石术后胆囊结石复发率高于汉族患者,差异有统计学意义（χ²=17.64,P<0.01）。回收有效调查问卷288份（90.0%）。Logistic回归分析显示父母胆石症家族史、术后胆囊排空功能是汉族和维吾尔族保胆取石术后胆囊结石复发的共同危险因素,体质量指数、牛羊肉饮食是维吾尔族患者胆囊结石复发的特有危险因素（均P<0.05）。 结论新疆地区保胆取石术后维吾尔族胆囊结石复发率高于汉族患者,复发率高的原因可能与肥胖、牛羊肉饮食有关。胆结石家族史、术后胆囊排空功能是胆囊结石复发的主要危险因素。     

Percutaneous renal stone extraction: in vitro study of retrieval devices

PURPOSE: Traditionally, percutaneous stone extraction has relied on the use of 2-prong and 3-prong graspers, which are prone to causing trauma to the urothelium. We evaluate the efficiency of stone removal with a novel tipless stone basket designed specifically for percutaneous procedures. MATERIALS AND METHODS: A 3, 5 and 8 mm human calculus were placed in the calix of a percutaneous renal model. A 26Fr Storz nephroscope (27093B, Storz Medical AG, Kreuzlingen, Switzerland) was inserted through a 30Fr Amplatz sheath into the model with camera input from a Storz telecam SL-NTSC feeding to a 20-inch Sony Triniton monitor (Sony Corp of America, New York, New York). Operators were randomized to start stone extraction with a Storz 3-prong grasper (27090RB) or a Cook 12Fr Perc-NCircle (38 cm) (Cook Urological, Inc., Indianapolis, Indiana). Subsequent testing alternated between the 2 devices until 10 extraction attempts were conducted with each device. Time to extraction of all 3 calculi and number of inadvertent withdrawals of the sheath were recorded. Three experienced operators tested each device. RESULTS: Stone extraction times were shorter with the Cook Perc-NCircle than the 3-prong grasper for all operators. Mean time for stone extraction was 25.3 +/- 11.2 seconds for the Perc-NCircle compared to 35.1 +/- 18.5 seconds for the 3-prong grasper (p = 0.016). Loss of access by inadvertent removal of the Amplatz sheath occurred in 53% of the attempts with the 3-prong grasper compared to 7% of attempts with the Perc-NCircle. CONCLUSIONS: The Cook Perc-NCircle facilitates a more expeditious approach to percutaneous stone removal with less risk of sheath withdrawal.     

ICU住院患者压疮发生危险因素的病例对照研究

目的探索ICU患者压疮发生相关危险因素,为采取针对性预防措施提供依据。方法参考相关文献拟定ICU患者压疮危险因素调查表,经专家审定后用于某三级甲等医院ICU住院患者资料的收集。365例患者纳入研究,将发生院内获得性压疮的164例归为病例组,符合纳入标准患者中方便抽取未发生压疮的201例归为对照组,以性别、年龄、手术、体温、Norton评分等19项变量进行探索性非配比病例对照研究。结果单因素分析除营养状态、体位、吸烟及白细胞数4项变量两组比较差异无统计学意义(均P>0.05)外,其余15项差异有统计学意义(P<0.05,P<0.01);多因素Logistic回归分析显示年龄、住院时间、Norton评分、体温、APTT、白蛋白数、血红蛋白数是压疮影响因素(P<0.05,P<0.01)。结论ICU住院患者压疮发生受多种因素的影响,应针对上述危险因素采取有据可依的预防措施,以降低压疮发生率。     

Risk factors for urinary stone formation in men with spinal cord injury: a 17-year follow-up study

OBJECTIVE: To establish hazard ratios for risk of urinary stone formation in men with chronic spinal cord injury. PATIENTS AND METHODS: In all, 140 men injured before 1987 were eligible for this investigation and were followed yearly from January 1987 and December 2003. RESULTS: Over the 17 years, 39 patients (28%) and 21 (15%) were diagnosed with bladder and renal stones for a total of 59 and 25 episodes, respectively. In multivariate analysis, bladder stone was more common in patients injured when aged > or = 24 years than in those injured when aged <24 years (odds ratio 2.5; 95% confidence interval 1.1-5.7; P = 0.03). In another model, patients with complete injury had a greater risk of renal stone formation than those with incomplete injury (4.1, 1.3-12.9; P = 0.016). Renal stone was more common for patients with urethral catheterization than for those voiding spontaneously (5.7, 1.3-24.6, P = 0.021) and for patients with bladder stone than for those without (4.7, 1.5-15.1; P = 0.01). CONCLUSION: Injury characteristics are important for the development of urinary stone in chronic traumatic spinal cord injury. In addition, the present findings suggest that in men who cannot use intermittent catheterization or when the bladder cannot empty spontaneously, suprapubic cystostomy is better than urethral catheterization to avoid renal stone formation.