血府逐瘀丸治疗老年2型糖尿病伴失眠的临床疗效及其对认知功能的影响

目的:探究血府逐瘀丸治疗老年2型糖尿病伴失眠患者的临床疗效及其对认知功能影响。方法:选取43例我院收治的老年2型糖尿病伴失眠患者,将其随机分为实验组及对照组。对照组21例予地西泮治疗,实验组22予血府逐瘀丸治疗。观察两组治疗前后失眠症状及认知功能的变化情况。结果:治疗后,实验组总有效率(86.4%)高于对照组(61.9%),其差异经比较有统计学意义(P0.05);两组匹兹堡睡眠质量指数量表(PSQI)评分均较治疗前显著降低(P0.05),与对照组相比,实验组PSQI评分较低(P0.05),空腹血糖水平较低(P0.05),蒙特利尔认知评估量表(MoCA)评分较高(P0.05)。结论:血府逐瘀丸可有效降低老年2型糖尿病伴失眠患者的血糖水平,提升睡眠质量,改善失眠及认知功能障碍。     

改良曲张静脉点式剥除术治疗中老年下肢静脉曲张的临床疗效

目的:探究改良曲张静脉点式剥除术在治疗中老年下肢静脉曲张的临床疗效。方法:收集我院已确诊为下肢静脉曲张的中老年患者37例,分成实验组与对照组。对照组18例行传统曲张静脉点式剥除术,实验组19例行改良曲张静脉点式剥除术。对比两组患者手术后的下肢静脉曲张的治疗效果。结果:实验组有效率(94.7%)显著高于对照组(72.2%),差异具有统计学意义(P0.05);与对照组相比,实验组患者手术时间较短、术中出血量较少、下床活动时间较早,术后并发症总治愈率较高,复发率、术后并发症发生率较低,其差异均有统计学意义(P0.05)。结论:采用改良曲张静脉点式剥除术治疗中老年下肢静脉曲张的患者能够更彻底的剥除曲张额静脉,有效的改善患肢症状,明显降低复发率。     

社区老年人慢性肾脏病患病率调查及其危险因素分析

目的:调查北京市通州区永顺社区老年人的慢性肾脏病(CKD)患病率,并分析其危险因素。方法:采用横断面调查方法,对该社区长期居住的65岁及以上的通州区户籍老年人进行问卷调查、肾脏损伤指标及其他实验室指标的检测,收集资料并分析CKD患病的危险因素。结果:本次调查共获得948例该社区常住老年人的完整资料,参与研究的老年人平均年龄为70.86±4.89岁;镜下血尿患病率为9.39%,白蛋白尿患病率为22.15%,5.70%的老年人出现肾功能下降,该人群中CKD患病率为36.81%(349/948)。单因素分析结果显示,两组吸烟史、饮酒史、血肌酐、体质量指数(BMI)、尿微量白蛋白肌酐比(ACR)、糖尿病、甘油三酯、总胆固醇及血尿酸水平对比无显著性差异(P0.05),而CKD组较非CKD组年龄更大、合并高血压的比例更高、女性占比更高(P0.05),多因素logistic回归分析显示年龄、女性与高血压是通州区永顺社区老年人CKD患病的危险因素(OR=1.432、1.163、1.335,P0.05)。结论:北京市通州区永顺社区老年人CKD患病率较高,其危险因素为年龄、女性与高血压。     

肥厚型心肌病患者认知功能障碍的发生及影响因素分析

目的:探讨肥厚型心肌病(HCM)患者认知功能障碍的发生及影响因素。方法:收集2018年4月至2019年7月期间空军军医大学第一附属医院超声医学科HCM患者198例。综合北京版蒙特利尔认知评估(MoCA)量表结果及教育程度,判断患者认知功能:文盲且MoCA得分14分、1年≤教育年限≤6年且MoCA得分20分、或教育年限6年且MoCA得分25分为认知功能障碍组(n=37),其余为认知功能正常组(n=161)。比较两组患者一般资料、超声心动图检查结果及认知功能评估结果。采用多因素logistic回归分析筛选HCM患者认知功能障碍的可能危险因素。结果:HCM患者认知功能障碍的发生率为18.7%(37/198)。与认知功能正常组相比,认知功能障碍组HCM患者年龄较大(P0.05),受教育年限较短(P0.05),心功能分级及左心室舒张功能较差(P0.05),激发左心室流出道压差较高(P0.05)。认知功能障碍组HCM患者MoCA得分较低(P0.05),尤其在视空间与执行功能和延迟回忆(P0.05)两项上得分较差。多因素logistic回归分析结果表明,调整年龄(OR=14.435, 95%CI:4.476-46.550; P0.001)和教育年限(OR=5.274, 95%CI:2.024-13.744; P=0.001)后,激发左心室流出道压差(OR=3.844, 95%CI:1.551-9.524; P=0.004)是HCM患者认知功能障碍的独立危险因素。结论:激发左心室流出道压差可以增加HCM患者认知功能障碍的发生风险。     

社区高血压规范化管理研究

目的:探讨社区高血压规范化管理应用价值,总结高血压社区综合干预经验。方法:选取A、B两社区高血压180例作为管理观察对象,以同社区高血压患者180例为管理后对象,对比管理前后相关指标。结果:管理后知晓率、治疗率、控制率分别为100.00%、98.33%、91.67%优于管理前98.33%、91.11%、50.00%,管理后女性指标高于管理前女性,管理后6~9个月三项指标优于管理前,管理后发生不良事件8例次优于管理前18例次,差异具有统计学意义(P<0.05)。结论:于社区建立高血压危险分级电子病历,开展信息管理,给予社区卫生服务干预,可有效提高干预率,抑制不良事件发生,改善患者结局。     

中老年女性居民骨密度与膳食模式的关联分析

目的：探讨社区中老年女性居民骨密度与不同膳食模式的关系,为骨质疏松症的营养指导提供科学依据。方法：纳入乌鲁木齐市社区45岁及以上女性居民566人,采用超声骨密度仪检测及问卷调查获得骨密度及膳食摄入情况,通过因子分析法提取膳食模式,分析膳食模式与中老年女性骨密度的关系。结果：本次调查中老年女性人群骨质疏松症患病率16.8%;共获得5种膳食模式：副食品模式,油盐模式,薯类及蔬菜模式,水产类及豆类膳食模式和主食模式;其中高水平水产类及豆类膳食模式人群较低水平该模式人群的骨密度T值高（t=-1.905,P=0.043）。结论：高水产与豆类的膳食模式摄入是骨质疏松症的保护因素;建议中老年女性居民应合理膳食,多摄入水产及豆类食物,促进骨健康。     

甲状腺功能减退症患者心理健康状况及影响因素分析

目的:研究甲状腺功能减退症患者的心理健康状况及其影响因素,为预防、改善甲减患者心理健康状况提供参考依据。方法:选取2014年1月-2016年1月来我院治疗的226例甲减患者作为甲减组,另从杨浦区多个社区随机抽取同期254例健康者作为健康组,采用SCL-90症状自评量表、社会支持评定量表(SSRS)及一般情况调查问卷对两组研究对象进行调查,采用Logistic回归分析甲减患者的影响因素。结果:两组性别、年龄及职业之间的差异无统计学意义(P0.05),而文化程度、经济收入的差异具有统计学意义(P0.05);甲减组患者强迫症状、抑郁、焦虑、精神病性评分及总分均高于健康组(P0.05);甲减组患者中焦虑、抑郁、人际关系敏感所占比重较高,分别为30.97%,26.11%,26.11%;与健康组相比,甲减组患者SSRS评分中主观支持、客观支持、支持利用度评分及总分均明显降低(P0.05);多因素Logistic回归分析显示社会支持、文化程度为小学、经济收入30000元/年是甲减患者心理健康的影响因素(P0.05)。结论:甲减患者心理状况较差,存在较严重的焦虑和抑郁情况,在治疗同时应注意健康教育和心理关怀,尤其是对收入低、文化程度低或社会支持程度低的患者,应给予及时的心理治疗,可提高患者的生活质量。     

四川省南充市高坪区居民高血压现状调查

目的:了解四川省南充市高坪区居民患高血压病现状、居民对高血压知识认知程度、高血压的诱因、高血压并发症情况,为高血压防治提供依据。方法:采用统一测量120位居民血压情况,并进行相关知识问卷调查的方法,然后对调查结果进行统计分析。结果:调查人群中血压值在高血压患病值45.83%,其中,已知晓患有高血压的占有25.00%,由于调查的人群年龄段和文化教育程度的不同,对高血压相关知识的认知程度及治疗也不同。结论:本地区部分居民高血压偏高,并且对高血压防治的认知程度较低,为增进居民对高血压的了解需普及增强居民的保健意识,教会他们做好这类慢性病的预防工作。     

医院保洁人员医疗废物管理认知水平的调查与分析

目的 通过对培训前后保洁员医疗废物管理认知水平的调查,了解培训所产生的效果,为加强医疗废物管理提拱依据。方法 对6家医院402名保洁人员进行培训前后2次问卷调查。结果 （1）培训后保洁人员对医疗废物管理认知水平有了明显的提高,培训起到明显的效果,差异有统计学意义。（2）培训后保洁人员发生利器刺伤事件明显下降,由培训前的98.51%降至76.87%,差异有统计学意义（χ²=87.19,P＜0.05）;能正确处理皮肤伤口人员由培训前23.38%增加到70.40%,差异有统计学意义（χ²=225.59,P＜0.05）。（3）培训后对医疗废物管理现状评价为“好”的增加到39.30%,“差”的降至10.70%,差异有统计学意义（χ²=69.05,P＜0.05）。结论 经培训后保洁人员对医疗废物管理认知水平明显提高。     

城乡老年人营养状况与认知功能的相关性研究

目的：调查城乡老年人营养状况及认知功能状况,探讨两者的相关性。方法：采用多层次随机抽样法,抽取某地65岁及以上城乡居民1 246人进行调查,采用微型营养评价量表（MNA-SF）评价营养状况、采用简易智能精神状态检查量表（MMSE）评价认知功能,采用多因素Logistic回归分析营养状况与认知功能关系。结果：调查对象中121人（9.7%）有营养不良风险或营养不良,450人（36.1%）有不同程度的认知功能障碍。城乡营养不良的老年人认知功能障碍率高于其营养正常的老年人,差异具有统计学意义（P＜0.05）。多因素分析显示,居住地在农村、教育程度低、营养不良、未规律运动是老年人认知功能障碍的危险因素（P＜0.05）。结论：老年人营养状况与认知功能相关,且存在城乡差异。加强营养支持改善营养状况对提高老年人认知功能,实现成功老龄化有着积极的作用。     

白蚁与动物及微生物的共生类型及其机制

综述了白蚁螱客的主要种类、共生关系及相关机制的研究进展。白蚁螱客中,已报道的动物种类达170种。在与动物的共生关系中存在偏利共生（宾主共栖和异种共栖）、互利共生和无关共生三种;在与微生物的共生关系中,存在与内生菌（原生动物、细菌、真菌和放线菌）和外生菌（蚁巢伞菌等）间的互利关系。指出了白蚁与螱客研究中存在的问题,给出了解决方案,并提出了今后可能的研究热点或方向,为白蚁的综合利用（如纤维素酶）及今后研究物种间的协同进化提供了基础资料。     

Relative and combined effects of ethanol and protein deficiency on strontium and barium bone content and fecal and urinary excretion

To elucidate accumulation of minerals in human iliac arteries with aging, the content of minerals was analyzed by inductively coupled plasma atomic emission spectrometry. Bilateral common, internal, and external iliac arteries of 16 men and 8 women, ranging ages from 65 to 93 yr, were examined. It was found that an extremely high accumulation of calcium and phosphorus occurred in the common iliac artery at old age, being higher than that of the internal and external iliac arteries. It should be noted that the accumulation of calcium and phosphorus is the highest in the common iliac artery among the human arteries examined to date. Regarding sexual differences, the content of calcium and phosphorus in the common and internal iliac arteries was higher in women than in men, whereas their content in the external iliac artery was lower in women than in men.     

New amino-dithiaphospholanes and phosphoramidodithioites and their rhodium and iridium complexes

New sulfur derivatives of phosphoramidite ligands were synthesized and the impact of the sulfur unit on the spectroscopic properties of their rhodium and iridium complexes was investigated. The new ligands Bn₂NPSCH₂CH₂S^a(P-S^a) (Bn = benzyl, 4), Bn₂NPSCHCHS^a(CH₂)₃C^aH₂(P-S^a)(C^a-S^a) (6) and Bn₂NP(4-XC₆H₄OMe)₂ (X = S, 7a; X = O, 7b) were converted to the rhodium and iridium complexes trans-[Rh(CO)Cl(L)₂] (L = 4, 6, 7), [RhCl(COD)(L)] (L = 4, 6, 7), [IrCl(COD)(7a)] and [IrCl₂Cp∗(6)]. For comparison, some phosphoramidite complexes of these formulations also were synthesized. The new metal complexes were spectroscopically analyzed. For the carbonyl complexes, the ν_CO IR stretching frequencies were lower than for the corresponding phosphite and phosphoramidite ligands. The ¹J_PRh coupling constants for the rhodium complexes with the new ligands were also smaller than for the respective phosphoramidite and phosphite complexes. Finally, the ¹J_PSe coupling constants of the selenides of the new ligands were lower than those of the phosphoramidite ligands but higher than for PPh₃. The spectroscopic data reveal that the new thio ligands 4, 6 and 7a are more electron donating than phosphites and phosphoramidites but less electron donating than PPh₃.     

Astrocytes and Synaptosomes Transport and Metabolize Lactate and Acetate Differently

Astrocytes transport the monocarboxylate acetate, but synaptosomes do not. The reason for this is unknown, because both preparations express monocarboxylate transporters (MCT). The transport and metabolism of lactate, another monocarboxylate, was examined in these two preparations, and the results were compared to those for acetate. Lactate transport is more rapid in astrocytes than in synaptosomes, but of lower affinity (Kms of 17 and 4 mM, respectively). Lactate (0.2 mM) is metabolized to CO2 more rapidly in synaptosomes than in astrocytes (rates of 0.37 and 0.07 nmol x mg protein(-1) x min(-1), respectively). The reason for this is unclear, but cellular differences in lactate dehydrogenase isotype expression may be involved. Acetate is metabolized to CO2 more rapidly in astrocytes than in synaptosomes (rates of 0.43 and 0.02 nmol x mg protein(-1) x min(-1), respectively). This is likely due to cellular differences in the expression of monocarboxylate transporter subtypes.     

Rapporteur report: Basics and technology and metrology and standards

The first and second sessions of the Workshop focussed on the basics of ultrasound and infrasound, their applications in both industry and medicine, and metrology and protection standards for ultrasound applications.     

Chemokines and cytokines: axis and allies in asthma and allergy

Allergic asthma can be precipitated by many factors. For the atopic person, fungus, pollen, dust mites, cockroach antigens, and diesel exhaust are all agents that may trigger an allergic attack. Cytokines and chemokines are integral mediators of fungal asthma. From the earliest time points, they recruit and activate the cells required for the clearance of fungus as well as being critical factors involved in the immunopathology of this disease. In the final analysis, it is clear that these mediators can act to the benefit or the detriment of the host.     

Prostaglandin and thromboxane production by human and guinea-pig macrophages and leucocytes

The ability of partially purified human and guinea-pig haematogenous cell populations, when cultured in vitro, to metabolise arachidonic acid (AA) has been studied. Supernatants from 24 hour cell culture have been subjected to analysis for products of AA metabolism by gas chromatography with electron-capture detection.The cell types studied were human peripheral blood monocytes (both glass adherent and non-adherent), neutrophils, eosinophils and leukemic leucocytes; thoracic duct lymphocytes and lung alveolar macrophages. From the guinea-pig, induced and non-induced macrophage or neutrophil enriched peritoneal exudate populations, lymph node cells, peritoneal eosinophils and peripheral blood platelets were examined. Supernatants were assayed for the presence of PGE₂, PGD₂, PGF_2α, TXB₂ and 6-keto-PGF_1α. In all types studied PGE₂ and TXB₂ were the major products formed. The identification of PGE₂ and TXB₂ was confirmed by GC/MS with multiple ion monitoring.The results have been compared with other reports and their possible significance discussed in relation to the proposed role of prostaglandins as mediators and modulators in immunopathology.     

Hip Circumference and Cardiovascular Morbidity and Mortality in Men and Women

Objective: It has recently been demonstrated that, in middle‐aged women, a wide hip circumference is a protective factor for a number of health endpoints in later years. The effect seems to be independent of both overweight and waist circumference. This paper aims to replicate this finding in another population‐based sample consisting of women and men. Research Methods and Procedures: This was a prospective observational study consisting of a random subset of adult Danes. A total of 2987 subjects born in 1922, 1932, 1942, or 1952 and 35, 45, 55, or 65 years of age (at examination in 1987 to 1988) participated in the Danish MONICA (MONItoring trends and determinants of CArdiovascular disease) project, with measurements of height, weight, and hip and waist circumference taken. Through personal identification numbers, incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) until the end of 1998 and all causes of death until 2001 were retrieved from the National Registers of Hospital Discharge. There was an average of 10 years of follow‐up for incidence of CVD and CHD and 13 years of follow‐up for total mortality. Results: Large hip circumference, relative to body size and waist circumference, predicted less incidence of CVD, CHD, and total death in women. This was not the case in men; BMI and waist circumference were the strongest independent predictors. Discussion: A large hip circumference seems to have independent and positive effects on CVD and CHD morbidity and mortality in women, but no protective effect on cardiovascular health in men. However, a borderline significant protective effect on total mortality was observed.