汕尾市高考学生乙型肝炎表面抗原携带状况调查研究

目的调查汕尾市应届高考学生乙型肝炎表面抗原(HBsAg)携带状况。方法采用酶联免疫吸附试验对2003—2008年汕尾地区20108名高考学生进行HBsAg检测,对结果进行统计分析。结果高考学生HBsAg平均阳性率为14.36%,与全国普通人群HBsAg阳性率(9.75%)相比,差异有统计学意义(P<0.01);HBsAg阳性率逐年对比差异均无统计学意义(χ2=0.05,0.05,0.17,0.17,0.62,P>0.05);但2008年相对于2003年阳性率对比差异有统计学意义(χ2=5.54,P<0.05),提示HBsAg感染状况有逐年改善的趋势。男女对比差异无统计学意义(χ2=3.79,P>0.05);城乡对比差异有统计学意义(χ2=9.66,P<0.01)。结论汕尾市高考学生HBsAg感染状况不容乐观,但总体有改善的趋附,农村HBsAg感染状况形势严峻,改变现状任重道远。     

西安市乙型病毒性肝炎感染现状分析

目的:了解我市乙肝感染现状分析,为更好地制定不同人群防制策略提供依据。方法:调查结果来自近年公开发表的文献,采用酶联免疫吸附实验方法(ELISA)检测血清中乙肝感染标志,结果判定参照GB17010-1997,数据处理采用常用统计方法和文献系统综述方法。结果:我市2003年至2007年累计检测317617人的数据表明,各类人群HBsAg阳性率波动在1.21%～5.57%(χ2=22621.0965,P<0.001);累计检出HBsAg阳性4855人,阳性率为4.68(4855/317617),明显低于全国调查HBsAg阳性率9.76﹪的水平,经U检验有极显著差异(U=96.3237,P<0.001)。抗-HBs累计检测14147人,结果表明各类人群抗-HBs阳性率波动在0%～47.71%,累计抗-HBs阳性率为36.63%,不同人群抗-HBs阳性率可见极显著差异(χ2=277.2812,P<0.001)。抗-HBs阳性率最高为健康体检人员(47.71%),其次为医务人员(42.21%)和公务员(40.67%),3类人员平均阳性率42.10%,经χ2检验亦有显著差异(χ2=36.7112,P<0.001)。健康体检,医务人员和公务员3类人员未感染乙肝构成最高的为公务员(53.64%),其次为医务人员(42.74%)和健康体检人员(41.35%),平均阳性率50.30%,经χ2检验可见显著差异(χ2=140.64,P<0.001)。结论:我市乙肝感染现状分析研究对了解感染指标变化、控制乙肝传播有重要意义。     

西藏阿里地区孕产妇及婴幼儿人群乙肝病毒感染状况研究

目的 研究高高原地区孕产妇和婴幼儿人群中乙肝的感染状况,以期制定有效的防控和治疗方案。方法 研究对象为2016年1月1日-2018年3月31日于阿里地区人民医院及所辖七县卫生服务中心就诊的所有孕产妇,共计832名,平均年龄为 （28±2.8）岁,以及该院新生儿科和儿科就诊的所有婴幼儿人群（0月龄~3周岁）,共计1 086名,平均年龄为(1.6±0.8）岁, 其中男性患儿为519名,女性患儿为567名,男女性别比为0.92∶1,分别研究孕产妇和婴幼儿人群中乙型肝炎病毒感染及乙肝免疫保护状况的年龄、地域和性别分布。结果 阿里地区孕产妇人群的HBsAg阳性率为17.19%（143/832）。不同年龄段孕产妇的HBsAg 阳性率差异无统计学意义（P>0.05）。城镇和农牧区孕产妇的HBsAg 阳性率分别为13.66%（56/410）和20.62%（87/422）,差异有统计学意义（P<0.05）。143名HBsAg阳性孕产妇中,HBsAg、HBeAg、HBcAb阳性孕产妇占46.85%（67/143）。3岁以下婴幼儿人群HBsAg总体阳性率为7.73%（84/1 086）,不同年龄段婴幼儿的HBsAg 阳性率差异有统计学意义（P<0.05）。男性婴幼儿和女性婴幼儿的HBsAg 阳性率分别为5.20%（27/519）和10.05%（57/567）,差异有统计学意义（P<0.05）。农牧区和城镇区婴幼儿HBsAg 阳性率分别为9.16%（50/546）和6.30%（34/540）,差异无统计学意义（P>0.05）。孕产妇总体乙肝表面抗体（HBsAb）阳性率为32.51%（224/689）,婴幼儿总体HBsAb阳性率为40.52%（406/1 002）。结论 阿里地区孕产妇及婴幼儿人群HBsAg 阳性率高,需进一步加强孕前检查及母婴阻断干预措施,加强对乙肝患者及携带者的随访管理。     

温带臭虫传播乙型肝炎的流行病学调查

为探讨温带臭虫在乙肝传播中的流行病学意义,采用现场调查与实验检测相结合的方法,对测定结果进行数据统计。结果表明:臭虫HBsAg阳性与阴性的床上人群携带HBsAg阳性率分别为35.29%与8.33%,两者差别非常显著(P<0.005)。有臭虫房间与无臭虫房间的人群血清HBsAg携带率分别19.51%与7.57%,两者差别显著(P<0.05)。这些数据表明臭虫可在人群传播乙肝,中间可能起传播媒介的作用。     

银川市24617名从业人员HBsAg、抗-HBs检测结果探讨

目的:了解银川市食品加工、运输、销售等环节和公共场所服务行业从业人员中HBsAg、抗-HBs阳性情况。方法:采用酶联免疫吸附试验(ELISA)进行检测。结果:共检测从业人员24617人(男性9853人、女性14764人),检出HBsAg阳性人数578人,检出率为2.34%。HBsAg阳性检出率以男性3.05%,高于女性1.82%,X2=38.95 P<0.01差异有显著性;汉族2.22%高于回族0.29%,X2=7.28 P<0.01差异有显著性;公共场所2.67%,高于食品行业2.36%,X2=1.27 P>0.05无显著性差异。检出抗-HBs阳性人数7607人,检出率30.90%,女性31.55%,高于男性29.92%,X2=7.31 P<0.01,差别有显著性;汉族31.01%,高于回族30.42%,X2=0.57 P>0.05差异无显著性。结论:银川市从业人群中HBsAg阳性检出率以男性高于女性,汉族高于回族。抗-HBs阳性率以女性高于男性。     

体检与就诊者中乙型肝炎病毒感染率比较分析

目的:了解本地区乙型肝炎病毒在不同人群中的感染情况.方法:采用酶联免疫吸附试验(ELISA)法对乙肝表面抗原(HBsAg)进行检测;连续检测法测定丙氨酸氨基转移酶(ALT)判断肝脏功能.结果:健康体检者3 894例,HBsAg阳性84例,阳性率2.2%;来院就诊及住院患者10 847例,HBsAg阳性855例,阳性率7.9%.就诊中3岁～10岁2 021例,阳性18例,阳性率0.9%;11岁～87岁8 826例,阳性837例,阳性率9.4%;在HBsAg阳性中,ALT升高健康体检者占19%,就诊者31.1%.结论:两组人群中来院就诊患者比健康体检者HBsAg及ALT阳性率高;就诊者中两年龄组比较幼儿组比大年龄组HBsAg阳性率明显低.经统计学处理均有显著意义.     

孕妇妊娠早期优生优育相关病原体的检测分析及意义

目的 分析青岛地区妊娠早期孕妇乙肝、丙肝、艾滋病、梅毒和TORCH的感染情况,以指导临床加强对育龄夫妇的宣传教育工作,做好优生优育。 方法 收集2013年1月—2014年12月青岛市妇女儿童医院产科门诊收治的建卡妊娠早期孕妇的血清,采用ELISA方法检测血清标本中的HBV (HBsAg,HBsAb、HBeAg、HBeAb、HBcAb)、HCV (HCV-cAg、HCV-Ab)、HIV[HIV (1/2)-Ab]和TP (TP-Ab)血清标志物,采用电化学发光法检测TORCH-IgM。采用SPSS 19.0统计软件进行分析,计数资料之间的比较采用χ2检验,以P＜0.05表示差异有统计学意义。 结果 青岛地区妊娠早期孕妇的HBsAg阳性率为3.961%(650/16 411),HCV-Ab阳性率0.055%(9/16 411),HIV-Ab阳性率为0.000%(0/16 411),TP-Ab阳性率为0.585%(96/16 411),TORCH-IgM总阳性率为9.194%(202/2 197)。高龄孕妇TP感染率为1.684%(26/1 544),显著高于适龄孕妇的0.471%(70/14 867,χ2=33.34,P＜0.01),同样高龄孕妇TORCH感染率为13.333%(30/225),显著高于适龄孕妇的8.722%(172/1 972,χ2=4.61,P＜0.05),而且HBsAg、CMV-IgM和HSV (1/2)-IgM阳性率存在季节差异(HBsAg:χ2=10.52,P＜0.05;CMV-IgM:χ2=14.11,P＜0.01;HSV (1/2)-IgM:χ2=25.34,P＜0.01)。 结论 青岛地区妊娠早期孕妇存在优生优育相关感染性病原体感染的现象,应加强对育龄夫妇的宣传教育,做好孕前和孕期乙肝、丙肝、艾滋病、梅毒和TORCH的筛查工作,提高优生优育。      

南通地区非霍奇金淋巴瘤患者乙型肝炎病毒感染情况调查*

目的：了解南通地区初治非霍奇金淋巴瘤（NHL）患者乙型肝炎病毒的感染情况。方法：回顾性分析138例初治NHL患者临床资料,统计HBV血清学标志阳性患者的比例,并与同期急诊外伤患者HBV检出率比较。结果：138例NHL患者HBsAg阳性率13.77%,明显高于对照组5.82%,差异有统计学意义（P=0.045）;抗-HBc阳性率36.96%低于对照组54.37%,差异有统计学意义（P=0.011）。B细胞NHL与T细胞NHL患者HBsAg阳性率、HBsAb阳性率、HbcAb阳性率差异无统计学意义（4.17% vs 15.79%,54.17% vs 51.75%,41.67% vs 35.09%,P>0.05）。结论：在南通地区NHL患者HBV感染率高于普通人群,与NHL的发病有一定的关联。     

消化性溃疡患者上消化道出血发生状况及其影响因素

目的：探讨消化性溃疡患者上消化道出血发生状况及其影响因素。方法：选取2019年1—12月河南宏力医院接受治疗的85例消化性溃疡患者作为研究对象,观察所有入选者上消化道出血发生状况,并收集患者一般资料,分析可能影响消化性溃疡患者上消化道出血的相关因素。结果：85例消化性溃疡患者发生上消化道出血19例,占22.35%。未发生上消化道出血66例,占77.65%。经单因素分析显示,消化性溃疡患者发生上消化道出血与性别、年龄、体重指数、婚姻状况、吸烟史无关,差异无统计学意义(χ²=0.368、1.762、1.529,P>0.05;t=1.124、1.739,P>0.05),消化性溃疡患者发生上消化道出血可能与病程、心理状况、饮食习惯、非甾体类抗炎药用药史、幽门螺杆菌(Hp)感染史有关,差异有统计学意义(t=10.962,P<0.05;χ²=7.499、5.006、16.587、13.935,P<0.05)。经logistic回归分析显示,病程较长、心理状况不佳、不良饮食习惯、有非甾体类抗炎药用药史、有Hp感染史是消化性溃疡患者发...     

消化性溃疡患者Cag A蛋白及Gas的水平变化特点及诊断学价值分析

目的:探究消化性溃疡患者Cag A蛋白及Gas的水平变化特点,评价两种因子对于消化性溃疡的诊断学价值。方法:选取2016年1月-2017年6月我院消化科收治的128例良性消化道疾病患者为观察组,检测各受试者血清Cag A蛋白表达阳性率及血清Gas水平均值,并以大于所有受试者血清Gas浓度中位数为阳性限,后经胃镜确诊128例患者中胃溃疡35例,十二指肠溃疡45例,慢性胃炎48例,统计各类病变患者Cag A蛋白表达阳性率及血清Gas阳性率,分析Cag A蛋白阳性表达和血清Gas阳性表达两个指标对消化性溃疡诊断的敏感性及特异性。结果:在128例消化性溃疡患者中,94例血清Cag A检测呈阳性,敏感性为73.43%（94/128）,在健康体检者中,104例血清Cag A检测呈阴性,特异性为81.28%（104/128）,消化性溃疡患者血清Gas浓度均值为（56.89±9.24）ng/L,显著高于对照组（40.68±8.27）ng/L。选取所有受试者血清Gas浓度中位数46.50 ng/L 为阳性,对消化性溃疡诊断的敏感性为79.68%（102/128）,特异性为83.59%。结论:消化性溃疡患者血清Cag A阳性表达率和Gas水平均显著高于健康人群,两项指标在消化性溃疡诊断中均具有较高的敏感性和特异性。     

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.