上海市50岁及以上人群维生素D水平与握力的关联研究

目的 探讨上海市≥50岁人群维生素D水平与握力的关系。方法 数据来源于WHO全球老龄化与成人健康研究我国上海市2018-2019年数据,采用logistic回归模型分析维生素D水平与握力的关系,进一步按照性别、年龄及乳制品摄入情况进行分层;采用限制性立方样条曲线绘制维生素D水平与低握力的剂量-反应曲线。结果 共4 391人纳入研究,其中男性2 054人（46.8%）;年龄（67.02±8.81）岁;低握力1 421人（32.4%）;维生素D不足及缺乏分别为1 533人（34.9%）和401人（9.1%）。在调整相关混杂因素后,logistic回归分析结果显示,维生素D缺乏的人群发生低握力的风险更高（OR=1.41,95%CI：1.09~1.83）;在男性中,调整相关混杂因素后,维生素D缺乏与低握力发生风险呈显著正相关（OR=1.67,95%CI：1.12~2.50）,而女性中两者之间无关联（OR=1.30,95%CI：0.97~1.74）;在60~69岁及≥80岁年龄组中,调整相关混杂因素后,维生素D缺乏与低握力发生风险呈显著正相关（OR=1.57,95%CI：1.05~2.35;OR=2.40,95%CI：1.08~5.31）,在乳制品摄入<250 ml/d的人群中,调整相关混杂因素后,二者之间呈显著正相关（OR=1.57,95%CI：1.17~2.09）,而在乳制品摄入≥250 ml/d的人群中无明显关联。限制性立方条样图显示,低握力的发生风险可能随维生素D含量的上升而降低,但差异无统计学意义（P>0.05）。结论 维生素D水平与握力存在一定的关系,维生素D缺乏人群出现低握力的风险更高。     

落液林治疗慢性肺源性心脏病的疗效观察及机制探讨

目的　观察落液林对慢性肺源性心脏病的临床疗效并探讨其机制。方法　选择 10 8例慢性肺源性心脏病患者 ,随机分成两组 ,试验前评价心功能及监测动脉血气、右房压 (RAP)、右室压 (RVP)、平均肺动脉压 (m PAP)、全血高切黏度、全血低切黏度、血浆黏度、红细胞压积、纤维蛋白原、血红蛋白定量和红细胞计数等指标。对照组只给予常规治疗 ,落液林组在给予常规治疗的同时合并给予落液林 30 0 m g/ d,稀释后静脉滴注 ,疗程 3周 ;3周后 ,复查上述指标 ,比较各组前后的变化。结果　落液林组心力衰竭纠正有效率为 79.6 3% ,显著高于对照组 (P<0 .0 5 ) ;试验前后比较落液林组血氧分压 (pO2 )显著上升 ,血二氧化碳分压 (pCO2 )显著下降 ;而对照组均无显著性变化 ;落液林组 RAP、RVP、m PAP均明显下降 ;而对照组无显著性变化 ;落液林组全血高切黏度、全血低切黏度、血浆黏度、红细胞压积、纤维蛋白原、血红蛋白定量和红细胞计数等指标均明显下降 ;而对照组则无显著变化。结论　落液林对慢性肺源性心脏病具有纠正心力衰竭、降低肺动脉及右心房和右心室压力、改善血液流变和动脉血气的作用。     

超声心动图对儿童完全性肺静脉异位引流诊断价值的探讨

目的　旨在评价超声心动图对完全性肺静脉异位引流 (TAPVD)的诊断价值。方法　对 1987年 9月至2 0 0 2年 11月收治的TAPVD患儿 70例进行分析。均有完整的临床及超声心动图资料 ,其中 35例施行了手术治疗。结果　 70例TAPVD的解剖分型为 :心内型 5 2例、心上型 16例、心下型 2例 ,未发现混合型。 35例施行手术 ,32例与术前超声心动图的诊断一致 ;3例与超声心动图诊断不完全一致 ,其超声心动图诊断分别为 :三房心伴继发孔房缺、左房隔膜伴继发孔房缺、原发孔房缺伴卵圆孔未闭 ,而手术结果均显示为心内型TAPVD伴继发孔房缺。结论　超声心动图检查是诊断TAPVD重要且准确的方法 ,并能确定其分型 ,提供精确的解剖及血流动力学资料。在应用超声心动图诊断TAPVD时 ,应注意与三房心、左房隔膜等疾病进行鉴别。     

母乳喂养不影响乙型肝炎病毒母婴传播阻断效果

目的：比较不同喂养方式对HBsAg阳性母亲的婴儿母婴传播阻断效果的影响。方法：HBsAg阳性母亲的婴儿常规接种乙型肝炎疫苗或接受乙型肝炎疫苗和乙型肝炎免疫球蛋白联合免疫并随访。62例婴儿单用乙型肝炎疫苗免疫，21例母乳喂养，41例人工喂养；168例婴儿联合免疫，33例母乳喂养，135例人工喂养。结果：单用疫苗时1、3、6、12月龄抗-HBs阳性率母乳喂养组分别为4.8％、42.9％、57.9％、80.9％，人工喂养组分别为12.2％、26.3％、60.5％、73.2％；联合免疫时1、4、7、12月龄抗-HBs阳性率母乳喂养组分别为72.7％、75.8％、77.4％、90.9％，人工喂状组为77.0％、72.9％、76.2％、90.4％。单用疫苗时，母乳喂养组1例、人工喂养组3例免疫失败；联合免疫时，母乳喂养组无一例免疫失败，人工喂养组4例免疫失败，母乳喂养和人工喂养比较，差异均无显著性。结论：母乳喂养不影响抗-HBs产生，不增加免疫失败。     

Modulation of Isoflavones on Bone—nodule Formation in Rat Calvaria Osteoblasts in vitro

Objective:to observe the effects of two main isoflavones,daidzein and genistein on the bone-nodule formation in rat calvaria osteoblasts in vitro.Methods:Osteoblasts obtained from newborn Sprague-dawley rat calvarias were cultured for several generations.The second generation cells were cultured in Minimum Essential Medium supplemenmted with ascorbic acid and Na-beta-glycerophosphate for several days,in the presence of daidzein and genistein,with or without the estrogen receptor antagonist ICI 182780.Number of nodules was counted at the end of the incubation period(day 20) by staining with Alizarin Red S calcium stain.The release of osteocalcin,as a marker of osteoblast activity,was also determined on day 7 and 12 during the incubation period.Results:compared with the control,the numbers of nodules were both increased by incubation with daidzin and genistein,17β-estradiol was used as a positive control and proved to be a more effective inducer of the increase in bone-nodules formation than daidzein and genisterin.The release of osteocalcin into culture media was also increased in the presence of daidzein and genistein,as well as 17β-estradiol on day 7 and day 12(day 12 were higher).The estrogen receptor antagonist ICI 182780 completely blocked the genistein-and 17β0estradiol-induced increase of nodule numbers and osteocalcin release in osteoblasts.Howerver,the effects induced by daidzein could not be inhibited by ICI 182780.Conclusion:These findings suggest that geinistein can stimulate bone-nodule formation and increase the release of osteocalcin in rat osteoblasts.The effects,like those induced by 17β-estradiol,are mediated by the estrogen receptor dependent pathway,Daidzin also can stimulate bone-nodule formation and increase the release of osteocalcin in rat osteoblasts,but it is not,at least not merely,mediated by the estrogen receptor dependent pathway.     

Temperature and Daily Mortality in Shanghai： A Time-series Study

Objective To investigate the association between temperature and daily mortality in Shanghai from June 1, 2000 to December 31,2001. Methods Time-series approach was used to estimate the effect of temperature on daily total and cause-specific mortality. We fitted generalized additive Poisson regression using non-parametric smooth functions to control for long-term time trend, season and other variables. We also controlled for day of the week. Results A gently sloping V-like relationship between total mortality and temperature was found, with an optimum temperature (e.g.temperature with lowest mortality risk) value of 26.7℃ in Shanghai. For temperatures above the optimum value, total mortality increased by 0.73% for each degree Celsius increase; while for temperature below the optimum value, total mortality decreased by 1.21% for each degree Celsius increase. Conclusions Our findings indicate that temperature has an effect on daily mortality in Shanghai, and the time-series approach is a useful tool for studying the temperature-mortality association.     

脂质体粒径的分光光度法检测

目的确立分光光度法判断脂质体相对大小,为评估脂质体物理稳定性提供一种简便、快捷的方法。方法以Rayleigh-Gans-Debye理论为基础,固定脂质体膜材的种类、比例及其在溶液中的总量,分别用乙醇注入法和高压乳匀法制备不同粒径的空间稳定脂质体,以电镜法和热力学光散射法测得的粒径作为标准,找出不同方法制得脂质体在436 nm波长处的吸光度A与粒径D的关系。结果单位磷脂浓度的脂质体溶液在436 nm处log(A_436nm/C_p)与脂质体粒径的对数logD呈线性相关(r²≥0.93,n=5)。结论脂质体溶液的吸光度能反映脂质体相对大小,可作为一种评定脂质体物理稳定性的方法。     

三七总皂苷鼻腔用制剂的研究

目的研究能够提高三七总皂苷生物利用度的给药途径和制剂。方法采用鼻腔给药筛选提高药物生物利用度的适宜制剂。结果本试验中制备的制剂在不引起黏膜刺激性的条件下，大幅度提高了PNS的生物利用度。结论可从给药途径和剂型两方面考虑提高药物吸收，降低刺激性。     

Anti-inflammatory effect of methoxyphenamine compound in rat model of chronic obstructive pulmonary disease

AIM: To evaluate the anti-inflammatory effect of methoxyphenamine compound (MC) on chronic obstructive pulmonary disease (COPD) in rats by measurement of proinflammatory cytokines, total and differential white cell counts (WCC) of bronchroalveolar lavage fluid (BALF). METHODS: Adult rat model of COPD (COPD group) was induced by intratracheal instillation of lipopolysaccharides and exposure to cigarette smoke. Treatment groups received different dosage of MC (3, 9, and 27 mg daily, MC group) or prednisone (0.25 mg daily, P group) respectively. Tumor necrosis factor alpha (TNF-α), interleukin 1beta (IL-113), interleukin-6 (IL-6), transforming growth factor β (TGF-β) of BALF were determined by ELISA. Total and differential WCC were performed after Giemsa staining. RESULTS: The levels of TNF-α, IL-1β, IL-6, TGF-β, total and differential WCC in BALF of MC groups were significantly decreased than that of COPD group (P<0.01), and there was no significant difference among MC groups. There was no significa     

放射治疗中的摆位误差

随着放射治疗向高精度方向发展 ,研究放射治疗中的摆位误差具有重要意义。就摆位误差的定义、来源、表示方法、测量予以综述 ,并总结了以往的研究数据 ,提出临床工作中需注意的问题。