成人大骨节病膝关节间隙的X线观察

Objective To observe and scale knee joint space of the patients who suffered adults' Kaschin-Beck disease (KBD) in Shangzhi City of Heilongjiang Province in order to acquire basic knowledge for upcoming intervention trial. Methods Clinical test was proceeded in adults aged above 40 in Guanghui Village of Shangzhi City in 2007. In typical patients, bilateral knee X-ray was taken and knee joint space was scaled. Three points were chosen on inner and outer epicondyle of each knee and results were recorded. Results There were 307 peoples over the age of 40 in the village. Two hundred eighty-two accepted clinical test, in a rate of 91.9%. Eighty out of 282 suffered KBD, accounting for 28.4%. When the patients' condition became more serious, measurements from flank, middle, inside points on outer epicondyle of joint space presented a narrowing trend [degree Ⅰ: (5.85±0.17), (4.84±0.17), (4.36±0.18)mm; degree Ⅱ: (5.11±0.43), (4.24±0.34), (3.48±0.28)nun; degree Ⅲ: (3.59± 0.78), (3.10±0.56), (2.14±0.62)mm; Fflank,middle,inside= 6.547,5.372,10.302, all P < 0.05], but those on inner epicondyle of joint space did not[degree Ⅰ:(3.66±0.17), (3.47±0.17), (3.73±0.18)mm; degree Ⅱ:(3.55± 0.34), (3.54±0.29), (4.35±0.35)mm; degree Ⅲ: (3.19±0.72), (3.92±0.66), (4.51±0.72)ram; Finside,middle,flank= 0.351,0.356,1.883, all P > 0.05]. Joint space < 5.00 mm were found in 618, among which 363 were measured on inner epieondyle, obviously greater than those measured on outer epicondyle of joint space(255), the difference being statistically signifieant(χ2=9.59, P<0.05). Conclusions Adult cases of KBD occur in Guanghui Village. Knee joint space of adult patients narrows obviously, the more serious, the narrower, especially occurring more obviously on outer epicondyle, but frequently on inner epicondyle.     

成人大骨节病膝关节间隙的X线观察

Objective To observe and scale knee joint space of the patients who suffered adults' Kaschin-Beck disease (KBD) in Shangzhi City of Heilongjiang Province in order to acquire basic knowledge for upcoming intervention trial. Methods Clinical test was proceeded in adults aged above 40 in Guanghui Village of Shangzhi City in 2007. In typical patients, bilateral knee X-ray was taken and knee joint space was scaled. Three points were chosen on inner and outer epicondyle of each knee and results were recorded. Results There were 307 peoples over the age of 40 in the village. Two hundred eighty-two accepted clinical test, in a rate of 91.9%. Eighty out of 282 suffered KBD, accounting for 28.4%. When the patients' condition became more serious, measurements from flank, middle, inside points on outer epicondyle of joint space presented a narrowing trend [degree Ⅰ: (5.85±0.17), (4.84±0.17), (4.36±0.18)mm; degree Ⅱ: (5.11±0.43), (4.24±0.34), (3.48±0.28)nun; degree Ⅲ: (3.59± 0.78), (3.10±0.56), (2.14±0.62)mm; Fflank,middle,inside= 6.547,5.372,10.302, all P < 0.05], but those on inner epicondyle of joint space did not[degree Ⅰ:(3.66±0.17), (3.47±0.17), (3.73±0.18)mm; degree Ⅱ:(3.55± 0.34), (3.54±0.29), (4.35±0.35)mm; degree Ⅲ: (3.19±0.72), (3.92±0.66), (4.51±0.72)ram; Finside,middle,flank= 0.351,0.356,1.883, all P > 0.05]. Joint space < 5.00 mm were found in 618, among which 363 were measured on inner epieondyle, obviously greater than those measured on outer epicondyle of joint space(255), the difference being statistically signifieant(χ2=9.59, P<0.05). Conclusions Adult cases of KBD occur in Guanghui Village. Knee joint space of adult patients narrows obviously, the more serious, the narrower, especially occurring more obviously on outer epicondyle, but frequently on inner epicondyle.     

中国成人骨关节炎手骨X线检出水平的地理分布

目的 探讨中国成人骨关节炎手骨x线检出水平的地理分布及其差异。方法 流行病学现场调查，涉及黑龙江、辽宁、河北、山东、河南、江苏、浙江、湖北、湖南、福建、广东、广西、海南、山西、陕西、甘肃、青海、四川、新疆等19个省份；每个省选出2—3个有代表性的村落，每个村找出40岁以上人口70—100人拍摄右手x线片，共拍摄了2698张，按计分法给病变程度量化，用Ridit法作统计分析。结果 以Ridit指数及其95％可信限表示检出水平及其可靠程度：①尚志、吉县、永寿、麟游、若尔盖等原大骨节病重病区成人骨关节炎最重，指数及其95％可信限分别为0．83，0．81—0．86，为全国之最；②贵德、张家川等原大骨节病较轻病区，相应数值为0．55，0．50—0．60；③哈尔滨及其郊区、吉县雷家、宝鸡金台、青海湟中、哈密等北方面食的非病区再次之，为0．47，0．45-0．50；④苏家屯、淄博、张掖、酒泉、保定、黄骅、新郑、咸宁、会同、桂林、三亚、惠东、漳州等广大地区又次之，为0．4l，0．39——0．42，代表中国成人骨关节炎患病程度的基本水平；⑤扬州、绍兴、郫县等大米占主食绝大部分的水田区病情最低，为0．36，0．39-0．40。差别明显，呈规律的梯度。结论 中国中老年骨关节炎的右手x线检出水平有明显的地理分布差异，在不同的地理环境中与疾病相关的原因、因素、条件的质和量可能均有不同。这是一个有待研究的重要领域。     

2008年黑龙江省饮水型地方性氟中毒病区成人颈动脉粥样硬化病情调查

目的 调查黑龙江省饮水型地方性氟中毒(简称地氟病)病区成人颈动脉粥样硬化病情,探讨饮水型氟中毒与颈动脉粥样硬化发生的关系.方法 2008年,在黑龙江省肇州县选取4个饮水含氟量≥1.0 mg/L的自然村作为病区组,在泰来县选取4个饮水含氟量＜1.0 mg/L的自然村作为对照组.用B超对40岁以上居民进行了颈动脉粥样硬化检查,保留超声图片并做记分、诊断、评分.结果病区组4个村(新丰村、太平山村、宝产村和后郑村)共检查266人,颈动脉粥样硬化检出率分别为47.3%(35/74)、63.5%(40/63)、73.3%(33/45)、60.7%(51/84);对照组4个村(哈拉村、乾兴村、三家村、爱林村)共检查283人,颈动脉粥样硬化检出率分别为32.7%(17/52)、32.9%(24/73)、39.2%(31/79)、30.4%(24/79),两组间检出率比较,差异有统计学意义(T=26,P＜0.05);病区村与对照村按年龄标准化后的颈动脉动脉粥样硬化检出率分别为47.3%、63.5%、73.3%、60.7%,34.7%、36.3%、43.0%、41.3%,两组间预期阳性率[57.5%(153/266)、37.8%(107/283)]比较,差异有统计学意义(x2=21.36,P＜0.01);按年龄标准化的颈动脉粥样硬化病例病变严重程度两组间比较,差异有统计学意义(x2=36.15,P＜0.01).结论饮水型地氟病病区成人颈动脉粥样硬化的检出率高于对照,病变程度重于对照,高氟与动脉粥样硬化的发生存在一定的关系.     

硫酸软骨素和硫酸氨基葡萄糖对成人大骨节病的疗效分析

目的 观察硫酸软骨素和硫酸氨基葡萄糖对大骨节病的疗效.方法 2007年7月,在黑龙江省尚志市光辉村按<大骨节病诊断标准>检出患者80例.按病情等级、年龄、性别将80例患者分成治疗组、对照组.每组40人.治疗组给予硫酸软骨素和硫酸氨基葡萄糖治疗,对照组给予安慰剂(等量淀粉).在治疗前及治疗后(第8个月)对患者进行直立体位的膝关节X线拍片,利用刻度放大镜测量X线膝关节腔宽度.结果 对照组治疗前、后的X线膝关节腔宽度分别为(4.30±2.14)、(4.10±2.07)mm,治疗组分别为(4.17±2.15)、(4.16±2.11)mm.药物对X线关节腔宽度没有影响(F=0.50,P>0.05),时间、药物与时间的交互作用对X线关节腔宽度有影响(F值分别为67.66、46.74,P均<0.05).治疗组X线关节腔宽度治疗前低于对照组(P<0.05),治疗后高于对照组(P<0.05);对照组治疗前X线关节腔宽度高于治疗后(P<0.05).结论 硫酸软骨素和硫酸氨基葡萄糖减缓了成人大骨节病患者膝关节间隙继续变窄的进程,对关节软骨起到了保护作用,为成人大骨节病治疗在药物选择和疗效判定上提供了依据.     

成人大骨节病膝关节间隙的X线观察

Objective To observe and scale knee joint space of the patients who suffered adults' Kaschin-Beck disease (KBD) in Shangzhi City of Heilongjiang Province in order to acquire basic knowledge for upcoming intervention trial. Methods Clinical test was proceeded in adults aged above 40 in Guanghui Village of Shangzhi City in 2007. In typical patients, bilateral knee X-ray was taken and knee joint space was scaled. Three points were chosen on inner and outer epicondyle of each knee and results were recorded. Results There were 307 peoples over the age of 40 in the village. Two hundred eighty-two accepted clinical test, in a rate of 91.9%. Eighty out of 282 suffered KBD, accounting for 28.4%. When the patients' condition became more serious, measurements from flank, middle, inside points on outer epicondyle of joint space presented a narrowing trend [degree Ⅰ: (5.85±0.17), (4.84±0.17), (4.36±0.18)mm; degree Ⅱ: (5.11±0.43), (4.24±0.34), (3.48±0.28)nun; degree Ⅲ: (3.59± 0.78), (3.10±0.56), (2.14±0.62)mm; Fflank,middle,inside= 6.547,5.372,10.302, all P < 0.05], but those on inner epicondyle of joint space did not[degree Ⅰ:(3.66±0.17), (3.47±0.17), (3.73±0.18)mm; degree Ⅱ:(3.55± 0.34), (3.54±0.29), (4.35±0.35)mm; degree Ⅲ: (3.19±0.72), (3.92±0.66), (4.51±0.72)ram; Finside,middle,flank= 0.351,0.356,1.883, all P > 0.05]. Joint space < 5.00 mm were found in 618, among which 363 were measured on inner epieondyle, obviously greater than those measured on outer epicondyle of joint space(255), the difference being statistically signifieant(χ2=9.59, P<0.05). Conclusions Adult cases of KBD occur in Guanghui Village. Knee joint space of adult patients narrows obviously, the more serious, the narrower, especially occurring more obviously on outer epicondyle, but frequently on inner epicondyle.     

B超法测定甲状腺容积的适宜样本含量估算

用计算机方法对Ｂ超测量甲状腺容积的适宜样本含量进行了估算。中位数适合表示甲状腺容积频数分布的集中趋势。对于３００名儿童的总体，只需随机抽取５０名即可。对于均衡或非均衡扩大总体，样本含量有所增加，但无倍数关系。     

高血压病与肾损害

本文主要以原发性高血压为对象,将高血压性肾损害分为良性肾硬化和恶性肾硬化,并就其临床和病理所见,以及疾病因素,结合文献和肾活检介绍如下。一、良性肾硬化症(一)临床所见:多数病例尿无异常,但有时见到尿沉渣有少数红细胞、白细胞、透明管型、颗粒管型。伴随血压上升的同时,出现蛋白尿。用RIA测定尿白蛋白时,多数未治疗的病例,其排泄量增加;经治疗后血压下降者,尿蛋白多减少,经统计舒张压在119mmHg以下的,蛋白尿占10%;120mmHg以上者,蛋白尿占41%。另据报道,曾有尿蛋白日达3g以上,表现为肾病综合征的嗜铬细胞瘤,但一般如此大量蛋白尿者少见。     

中国大骨节病病情监测结果分析与未来流行趋势的估计

目的汇总分析全国大骨节病重点监测结果,为国家和政府制定防治大骨节病策略提供科学依据。方法数据来源于1990～2007年全国大骨节病病情监测结果,将相应的数据合计,计算算术均数,然后进行省区之间的横向比较,说明全国最重病区的分布和严重程度,绘制流行严重程度和活跃程度曲线,进行长期趋势的判定和描述,分析全国宏观病情,预测未来流行趋势。结果中国大骨节病病情监测分为两个阶段。第一阶段为定点监测,监测结果可概括为4种情况：（1）开始时检出率在10%以下,观测期间基本未见波动,稳定在2%～3%;（2）开始时检出率在10%～30%的病区,在稍有波动中一路下降,到1996年即稳定在10%以下,达到基本控制的水平;（3）开始时检出率〉30%的病区监测之初相当严重;这一类的病情在监测中陡然下降,直到1997年达到20%以下或更低;（4）青海省病区是中国大骨节病病区中的一个特例,X线检出率与干骺端检出率都在一个水平上,没有明显变化。第二阶段为动点监测,监测结果仍可概括为4种情况：（1）监测开始时检出率在10%以下的病区没有变化,仍然保持在控制水平。（2）监测开始时的中、重病区,如甘肃、陕西、内蒙、黑龙江在一路下迭中达到了控制水平。（3）90年代末的中国重病区青海和2000年新增加的西藏病区,也在2005年由重病区变为中等病区。（4）全国大骨节病X线检出率区间分布,控制病区由31.25%增加到82.61%、轻病区由18.75%下降到8.70%、中等病区由6.25%下降到4.35%、重病区由43.75%下降到4.35%,这说明中国的大骨节病的流行状况已经被遏制。结论中国的大骨节病在一段时间内应是以散发为主,2020年以后中国应该能够全面控制乃至消除大骨节病。     

1999年全国8～10岁儿童甲状腺容积调查

目的 分析1999年全国8～10岁儿童甲状腺容积的频数分布及其统计值,为建立有效的地方性甲状腺肿防治策略服务。方法 收集全国安例用B超法测定甲状腺容积,在中国地方病防治研究中心处理。结果 ①全国8～10岁儿童甲状腺容积统计值（ml）为,均数3.6、中位数3.4、众数3.0、95%分位数5.9、99%分位数7.9。②全国8～10岁儿童甲状腺容积95%分位数,男性依次为4.8,5.6,6.3ml,女性依次为5.2,5.8,6.5ml。③甲状腺容积地区差明显,按中位数计算最低上海1.2ml,居中安徽、山西3.7ml,居高重庆、贵州、新疆4.0ml。④对触诊法的适用性问题做了详细讨论,认为可用。结论 全国8～10岁儿童甲状腺容积地区差非常明显,原因未详。