北京市宣武区中学生生殖健康知识调查分析

【目的】掌握青少年性发育特点,以便开展有针对性的青春期生殖健康教育,提高自我保护能力,使其健康的成长。【方法】重点高中2所、普通高中4所、职业高中3所,分别选择同年级、同号班级22个班的1 800名高中生,由专门调查员进班发问卷,要求学生在15 min内完成。学生填写问卷时,采用校方人员回避,问卷不记名方式,填写后当场封存,确保学生的隐私权。【结果】调查学生中生理知识知晓率达到70.74%,性病、艾滋病方面知识知晓率达53.9%,相关避孕知识知晓率15%,学生中的性活动发生率17.9%,缺乏保护意识的学生占25.4%,接触过淫秽品的学生43.5%,对婚前性行为的看法持开放态度的学生占38%。【结论】学生的性观念开放,综合自我保护能力较低,易受疾病和社会危险因素伤害,对其成长过程造成障碍。     

替米沙坦治疗原发性高血压的疗效和安全性

目的 :观察替米沙坦治疗原发性高血压的疗效和安全性。方法 :进行随机、双盲、双模拟、平行分组对照试验。符合条件的轻中度高血压患者随机分为 2组 :替米沙坦组和氯沙坦组。每天一次口服替米沙坦 40mg或氯沙坦 5 0mg ,每 2周随访 1次。 4周后 ,如患者舒张压 (DBP)≥ 90mmHg则增加剂量 ,每天一次口服替米沙坦 80mg或氯沙坦 10 0mg。治疗前后分别查心电图 ,血、尿常规 ,血生化检查和常规查体。 结果 :(1)治疗 8周末 ,替米沙坦组和氯沙坦组患者的DBP均显著降低 ,2组下降幅度相似 (11.9mmHgvs 10 .4mmHg) ;(2 )治疗8周末 ,替米沙坦组收缩压 (SBP)下降幅度稍大于氯沙坦组 (9.5mmHgvs 6.2mmHg) ;(3 )替米沙坦降压有效率为 83 .3 % ,稍高于氯沙坦组 69.2 % ,无统计学差异 ;(4 ) 2组的不良事件发生率相似 (替米沙坦组 3 3 .3 % ,氯沙坦组 3 4.6% )。最常见的不良事件是头晕、头痛 ,多为轻度 ,可迅速缓解。结论 :替米沙坦 40mg～ 80mg ,每天一次口服治疗轻中度高血压安全有效     

Rehabilitation of the patient with chronic back pain. A search for outcome predictors

This prospective study was initiated 3 years ago to evaluate the outcome and to identify predictors of success or failure in patients admitted to a rehabilitation program for chronic low-back pain. Multiple parameters were evaluated, including psychologic data (MMPI, personal interview, pain drawing, etc.), physical measurements (flexibility, strength and endurance), and demographic data concerning the patient's home and working environment. Information was available on each patient admitted to the program prior to his admission, at completion of the program, 6 weeks following completion of the program and 3 months following completion of the program. A telephone interview was carried out 2 1/2 years following the patient's discharge from the program. Linear regression analysis was used to identify the important independent variables with regard to the dependent variables of relief of back pain, return to work and increased activities at home. Demographic data were of no value as a predictor with the exception of age and returning to work. The patients over the age of 50 returned to work with much less frequency than those less than 50. Psychologic information from the MMPI and similar tests were of no value. The personal preadmission interview of a trained psychologist, however, was a good predictor of an individual's eventual return to work and overall improvement. Worker's Compensation and other litigation was a negative factor in a patient's prognosis. The treatment team's prognosis at the time of discharge from the program was the best overall predictor of a patient's chance of success or failure in the longterm.     

利多卡因对N-甲基-D-天冬氨酸抑制大鼠肾上腺嗜铬细胞瘤细胞增殖的影响

目的 观察利多卡因对 N-甲基-D-天冬氨酸(NMDA)抑制大鼠肾上腺嗜铬细胞瘤细胞(PC12细胞)增殖的影响。方法 将体外培养的 PC12细胞分为6组，分别采用正常不含药液的培养基(C组)；含400μmol·L(-1)NMDA 的培养基(N组)；NMDA 分别混合10μmol·L~(-1)(L_1组)、10~2μmol·L~(-1)(L_2组)、10~3μmol·L~(-1)(L_3组)以及10~4μmol·L~(-1)(L_4组)利多卡因的培养基培养5d，应用流式细胞仪测定细胞 DNA 相对含量，解析细胞周期，计算 S 期细胞荧光强度占受测细胞总荧光强度的百分数为 S期分数(SPF)和 S 期与 G_2期细胞荧光强度之和与 M 期细胞荧光强度的比值[(S G_2)/M]。结果 与C 组比较，N、L_1组 SPF 和(S G_2)/M 均降低(P<0.05)，L_4组 SPF 降低(P<0.05)，而 L_2及 L_3组 SPF和(S G_2)/M 差异无统计学意义(P>0.05)。与 N 组比较，L_2、L_3及 L_4组 SPF 和(S G_2)/M 升高(P<0.05)，L_1组 SPF 升高(P<0.05)，而(S G_2)/M 差异无统计学意义(P>0.05)。结论 NMDA 可以通过抑制 PC12细胞 DNA 合成而影响细胞的增殖活性，利多卡因能拮抗 NMDA 对 PC12细胞增殖的抑制作用。     

中国男性原发不育的遗传高风险因子:Y染色体DAZ基因拷贝缺失

目的 探讨Y染色体无精症因子C区(azoospermia factor C，AZFe)无精症缺失基因(deleted-in-azoospermia，DAZ)家族基因拷贝缺失与中国男性原发不育之间的关系。方法 运用多重PCR与PCR-RFLP检测技术，对210例已生育男性、216例原发无精症与189例严重少精症患者Y染色体AzFc区域DAZ基因家族的基因拷贝数进行分析。结果 在所有已生育男性中未检出DAZ基因拷贝的完全或部分缺失，而在原发无精症与严重少精症患者中DAZ基因拷贝完全缺失率分别为8．8％和12．2％，DAZ1／DAZ2共缺失率分别为8．3％和5．3％。结论 在中国男性原发无精症与严重少精症患者中存在较高频率的DAZ基因拷贝缺失现象，提示Y染色体AZFc区域DAZ基因家族基因拷贝的完全与部分缺失是中国男性原发不育的遗传高风险因子。     

重症肌无力胸腺切除术后呼吸道管理与并发症的防治

目的 探讨重症肌无力胸腺切除术后呼吸道管理与并发症的防治.方法 32例ICU收治的重症肌无力胸腺切除术后的患者,根据危象预测积分,分为普通组(积分＜12分,n=21)和高危组 (积分＞12分,n=11),对两组患者术后呼吸机支持时间、拔管前后肌力恢复情况、自主呼吸情况、动脉血气分析情况以及两组患者术后体温、胸片和痰培养结果进行统计分析.结果 高危组患者术后呼吸支持时间(18 ～ 30 h,平均26 h)大于普通组患者(4 ～ 28 h,平均14 h),两组有显著性差异(P＜0.01),同时术后发热、胸片渗出影以及阳性痰培养结果的发生率也高于普通组.结论 术后给予高危患者严密的监测和充分的呼吸支持,有助于降低重症肌无力危象的发生率和死亡率,同时应充分重视气道护理和感染的防治.     

低脉压与晚期慢性心衰患者利钠肽和死亡率升高独立相关

目的:脉压(PP)升高一贯用来预测有心血管疾病危险患者和轻度慢性心衰(CH F)患者的心血管疾病发生率和死亡率增高。相反,PP降低与急性失代偿性心衰患者死亡率升高相关。然而,尚不清楚PP对于晚期CH F患者的预测价值。方法和结果:采用Cox比例风险回归分析研究了1901例N YH A III或IV级CH F患者(平均年龄65岁,平均射血分数26%)的资料,经校正其他危险因素后,分析PP对死亡率的影响。检测了1个亚组患者的利钠肽水平。多元Cox回归分析表明,PP降低与死亡率增高相关(每增加10m m H g的H R为0.91,95%CI0.93～0.99),这一相关性独立于平均…     

超声诊断异位妊娠249例临床分析

目的为了提高对异位妊娠的诊断技术。方法选择在我院经手术病理证实的异位妊娠249例住院患者行2DB超和CDFI的声像图特征进行分析。结果2D超声声像图特征在249例异位妊娠中内膜增厚223例，厚度为4—8mm／2；宫内假环状孕囊28例，大小为4．12mm；宫外探及孕囊178例，大小为8-48mm；盆腔混合性包块28例，大小为40．80mm：伴有黄体囊肿的123例，存活宫外孕3例，可显示原始心管搏动；CDFI声像图特征为宫外孕急性破裂的患者显示肿块及周围组织的彩色血流信号增多，动脉频谱血流速度增快，RI降低。结论超声检查对妇产科急诊有显著性作用，可直接指导临床明确诊断，选定治疗方案。     

桡骨颈骨折经皮撬拨复位的远期疗效

用经皮撬拨复位治疗桡骨颈骨折56例,其中复位良好46例,较好6例和不良4例;经3年7个月平均随访,复位良好和较好的44例中,后期疗效良好32例,较好11例和一般1例。骨折解剖复位、撬拨复位的手术损伤轻和石膏固定时间较短是后期疗效满意的关键。成人桡骨颈骨折伴肘内侧副韧带严重损伤比儿童多见,但儿童桡骨颈骨折严重倾斜移位和完全移位比成人多见,后期疗效更满意。     

Relationship among dosages of aminophylline, plasma levels of theophylline and variation of pulmonary arterial pressure]

The relationship among the dosages of aminophylline, plasma levels of theophylline and variations of mean pulmonary arterial pressure (mPAP) in 72 patients with COPD was investigated. The results showed that after a different loading dosage of aminophylline (6 mg/kg, 5 mg/kg and 4 mg/kg) was administered by intravenous injection, mPAP in the 6 mg/kg group was decreased more significantly (P less than 0.01) than that in the 4 mg/kg group. In the 6 mg/kg group, the decreased mPAP period sustained for 120 min, which was longer than that in the other 2 groups. The plasma levels of theophylline in the 6 mg/kg group of patients 30 to 120 min after loading dose injected were 115.54-79.04 mumol/L, which were higher than that in the others. Within the 120 min period of observation after the drug was administered no patients in any of these groups showed severe untoward effects. According to the results of this experiment, we suggest that the 6 mg/kg as a loading dose should be advised for the treatment of pulmonary hypertension in COPD. The optimum time to give the maintenance dosage should be set within 2 h after the loading dose. It is necessary to monitor the plasma levels of theophylline while aminophylline is administered, so that optimal therapeutic effects could be achieved without side effects.