温州口岸出入境人员心房颤动分析

目的了解温州口岸出入境人员中的心房颤动的发生情况，探讨旅行保健方法。方法对检出的48例心房颤动患者的资料进行分析。结果对2003．11-2004．10从温州口岸出入境的19862名人员进行心电图检查，发现心房颤动病例48例，检出率为0．24％，其中男性29例，女性19例，男女之间检出率没有显著差异。心房颤动多见于老年人。结论出入境人员进行健康体检具有重要意义。确保出入境人员的健康。     

Special needs of adolescent and young women in accessing reproductive health: promoting partnerships between young people and health care providers.

This article considers the unique challenges and opportunities that health care providers (HCPs) face when they address the sexual and reproductive health and rights of young women accessing services. Some of the difficulties that HCPs encounter in their work are highlighted, including poor remuneration, the impact of their personal biases and the effect of an under-equipped working environment. The financial, logistical and emotional challenges young people face in accessing services are also described, as well as some small changes that could promote fruitful partnerships between HCPs and their young clientele. Also considered is how international documents concerning reproductive health can be utilized as advocacy tools to ensure that, when governments speak of making young people's needs a priority, resources are also made a priority-so that reproductive health can become a reality for all young people.     

青年人原发性肝癌的治疗与预后分析

目的:探讨青年人原发性肝癌手术切除率低及术后复发率较高的原因.方法:将1985年1月～2000年1月收治的原发性肝癌173例患者分为青年组(≤35岁)83例和中老年组(≥36岁)90例,对其临床资料、手术切除率、术后复发率及生存率等进行比较分析.结果:青年组原发性肝癌手术切除率、术后1年复发率分别为26.51%(22/83)和68.18%(15/22),术后1、3、5年生存率分别为59.09%(13/22)、22.73%(5/22)和9.09%(2/22).中老年组原发性肝癌手术切除率、术后1年复发率分别为53.33%(48/90)和37.50%(18/48),术后1、3、5年生存率分别为81.25%(39/48)、47.92%(23/48)和39.58%(19/48).青年组各项生存率指标均较中老年组低(P＜0.01).结论:青年组原发性肝癌具有肿瘤生长迅速、侵袭力强、门静脉癌栓发生率高、多表现为巨块型及弥漫型等特点,导致手术切除率较低及术后复发率较高.     

Normal obstetric ultrasound reduces the risk of Down syndrome in fetuses of older mothers

The objective of this study is to determine whether a normal fetal morphology ultrasound scan in women older than 35 years reduces the risk of aneuploidy. We reviewed the results of amniocentesis and second trimester sonogram in all women older than 35 years from 1991 to 1995. None had prior screening. We excluded fetuses with structural anomalies. We determined the sensitivity and specificity of minor markers in detecting Down syndrome and also determined the reduction in risk of a normal sonogram. Among the 2060 women older than 35 years giving birth during the study period, 16 (0.78%) delivered an infant with Down syndrome. Of the 16 fetuses, two had no prenatal testing or ultrasound, two had invasive testing but no second trimester sonogram, five had a normal sonogram and seven had one or more sonographic markers of Down syndrome. At least 17% of women older than 35 years did not participate in prenatal testing or ultrasound. Ultrasound detected Down syndrome with a sensitivity of 59% (95% confidence interval: 45–72%), a false‐positive rate of 10.6% (9.4–11.8%) and a positive predictor value of 1 in 9. The likelihood of having normal karyotype if the sonogram was normal was 0.46 (0.31–0.61). In women older than 35 years, a normal second trimester sonogram reduces the risk of Down syndrome by more than 50%. At least 17% of women older than 35 years do not participate in prenatal testing or ultrasound.     

对血脂异常人群实施生活方式干预后的观察

目的：探讨生活方式治疗在血脂异常人群中的作用，观察其效果。方法：100例在体检中发现的血脂异常者，随机分为实验组和对照组，对实验组进行生活方式治疗，对照组未进行生活方式治疗，两组均未使用药物降脂，随访6—9个月，平均7．6个月，复查血脂，以检测血脂结果是否达到目标值进行对比。结果：经统计学处理，两组血脂在达到目标值方面存在显著性差异（p〈0．01）。结论：生活方式治疗对血脂异常人群具有明显的防治作用。     

Immunological responses to pneumococcal vaccine in frail older people

Advanced age has been associated with a wide range of defects in both the innate and adaptive immune systems including diminished specific antibody responses that increase the risk of invasive pneumococcal disease (IPD) and limit the effectiveness of vaccines. However, the elderly are a heterogeneous group and measures of overall frailty may be a better indicator of disease susceptibility (or vaccine response) than chronological age alone.     

血管内皮型一氧化氮合酶基因Glu298 Asp多态性与老年脑梗死的相关性研究

目的　通过病例对照研究 ,了解中国老年人群血管内皮型一氧化氮合酶 (eNOS)基因目的　通过病例对照研究 ,了解中国老年人群血管内皮型一氧化氮合酶 (eNOS)基因Glu2 98Asp多态性的分布 ,分别探讨其与老年脑梗死及血脂以及一氧化氮等脑梗死危险因素的关系。 方法对门诊及住院中确诊的 4 0例老年脑梗死和 16 9例性别、年龄相匹配的老人 ,测量他们的身高、体重及座位血压 ,并测定他们的空腹血脂、空腹血糖 (FBS)及一氧化氮 (NO)等 ,应用聚合酶链反应 (PCR)和限制性片断长度多态性 (RFLP)检测eNOS基因Glu2 98Asp多态性。结果　脑梗死和对照组eNOS基因Glu2 98Asp多态性构成有显著性差异 (χ2 =4 31,P =0 0 38) ,脑梗死组Glu/Asp基因型高于对照组(32 5 %vs 17 8% ) ;脑梗死组 2 98Asp等位基因频率高于对照组 (16 2 5 %vs 8 9% ) ,但是两组等位基因频率的分布比较 ,没有显著性差异 (χ2 =3 81,P =0 0 5 1)。结论　eNOS基因Glu2 98Asp多态性在中国老年人群中存在 ,并且基因...     

17β-雌二醇对子宫内膜异位症患者在位子宫内膜间质细胞β-catenin mRNA和蛋白表达的影响

目的研究17β-雌二醇(17β-E2)对子宫内膜异位症(内异症)患者在位子宫内膜间质细胞β-catenin mRNA和蛋白表达的影响,探讨Wnt/β-catenin信号通路在介导雌激素促进内异症发生发展的作用。方法体外分离培养内异症患者在位子宫内膜间质细胞。用不同浓度17β-E2处理子宫内膜间质细胞48 h;此后选用10-10mol/L 17β-E2处理子宫内膜间质细胞12、24和48 h,逆转录聚合酶链反应(RT-PCR)和免疫印迹法(Western blotting)检测17β-E2处理前后子宫内膜间质细胞β-catenin mRNA和蛋白的表达水平。同法分析雌激素受体拮抗剂ICI182,780(10-6mol/L)对17β-E2促进β-catenin mRNA和蛋白表达的影响。免疫组织化学染色观察17β-E2作用后β-catenin在子宫内膜间质细胞中的定位。结果17β-E2能明显促进内异症患者在位子宫内膜间质细胞β-catenin mRNA和蛋白的表达,并呈剂量和时间依赖性,于10-10mol/L作用48 h最明显。雌激素受体拮抗剂ICI182,780能明显抑制17β-E2对子宫内膜间质细胞β-catenin mRNA和蛋白的表达。免疫组织化学染色发现17β-E2能促进β-catenin在子宫内膜间质细胞核内的表达。结论雌激素可能通过激活Wnt/β-catenin信号通路促进内异症在位子宫内膜的异位种植。     

A literature review exploring how healthcare professionals contribute to the assessment and control of postoperative pain in older people

Little research has examined the care older people receive in the acute surgical setting. Although pain assessment and management are judged to be a priority in nursing, often pain, in older people, is undermanaged for a variety of reasons. Factors such as stoicism, communication and ageism can shape both the patients’ and nurses’ attitude towards the perception of pain which subsequently affects pain management. Through a review of the literature, this paper aims to: (i) identify how healthcare professionals contribute to the assessment and control of postoperative pain in older people and (ii) explore potential barriers to achieving more advantageous pain control in this group. It is suggested that to improve pain management there is a need to individualize pain assessment for older people and to assist clinicians with enhancing their education and decision‐making abilities in this field. This may best be achieved by supporting a programme of change to develop the skills of staff and encouraging learning through reflective practice. There is however a need for further research in this area.     

老年人肺功能与年龄增长的关系

目的: 探讨60岁以上老人动态肺功能随年龄增长的变化规律及机制.方法: 用日本PM-81型胸描仪对60岁以上老人动态肺功能的各项指标进行测量和分析.结果: 60岁以上老人动态肺功能各项指标均随年龄增加而降低,差异有高度显著性(P<0.01).结论: 60岁以上老人动态肺功能随年龄的增加而降低.其机制主要是呼吸中枢的功能降低,肺和胸廓的弹性阻力、呼吸道的非弹性阻力增加所致.