闽西南地区861例泌尿系结石患者的结石成分分析

目的：分析闽西南地区泌尿系结石患者的结石成分。方法收集861例泌尿系结石患者的结石标本,进行红外光谱分析测定,比较不同性别、年龄、结石部位的泌尿系结石的化学成分特征。结果30～60岁组泌尿系结石发病率达高峰,男性多于女性,上尿路结石明显多于下尿路结石（ P均＜0．05）。单纯性结石占40．64％,混合性结石占59．36％。结石成分以草酸钙最高（89．99％）,其次为碳酸磷灰石（56．66％）,无水尿酸或尿酸铵、六水磷酸镁铵、二水磷酸氢铵钙、L-胱氨酸等成分较少。男性和女性无水尿酸/尿酸铵结石的检出率分别为11．58％、5．84％,六水磷酸镁铵结石的检出率分别为6．13％、12．41％（P均＜0．05）。结论闽西南地区泌尿系结石化学成分以草酸钙为主,性别对结石成分有影响。     

胆汁成分与胆红素钙结石形成关系的临床研究

肝内外胆管结石的发病率在国内达到4.1～51.6％,此病产生的各种并发症严重危害着病人的生命和健康。临床工作者多年来进行了卓有成效的研究,但对其病因和发病机理的认识尚未获得统一。我们对24例肝内外胆管结石病和7例非结石胆道疾患病人的胆石和胆汁中的几种主要成分行定量检测,并通过分析胆汁中有形成分变化与胆红素钙结石形成的关系,以期对胆红素钙结石的病因和机理作进一步探讨。材料和方法 1.对象随机选择临床诊断原发性肝内外胆管结石病人24例,男性11例,女性13例,最大年龄65岁,最小17岁,平均46.3岁。术中取出胆石目测按日本胃肠病学会拟定标准分类。非结石胆道疾患病人7例作为对照,男3例,女4例.平均年龄40.2岁,经     

泌尿系结石的内科治疗进展

泌尿系结石是一类病因、发病机制不明的疾病,其发病率和再发率高,危害大.如何最大程度清除泌尿系结石,防治结石再发是我们应关注的问题.本文就近年来泌尿系结石的内科治疗进行了综述.     

中医药治疗泌尿系结石研究进展

泌尿系结石属于中医“淋证”的范畴。近年来随着环境污染的不断扩大 ,人们生活习惯的改变 ,泌尿系结石的病人在不断地增加 ,现就中医药治疗泌尿系结石概况综述如下。1　关于证和名的研究泌尿系结石为肾至尿道口路段各部位所发生的结石而言 ,包括现代医学的肾结石、输尿管结石、膀胱结石和尿道结石 ,相当于祖国医学中“淋证”的“石淋”、“砂淋”、“血淋”和“腹痛”、“腰胀”的范围。泌尿系结石的症状 ,中医书籍早有记载。如《华佗中藏经》就有“砂淋者 ,脐腹中隐痛 ,小便难 ,其痛不可忍 ,须萸从小便下如砂石之类”的记载。《诸病源候论…     

中西医结合治疗泌尿系结石的疗效观察

目的 观察中西医结合治疗泌尿系结石的临床疗效.方法 将60例泌尿系结石患者随机分为对照组30例,治疗组30例,对照组采用西药黄体酮治疗,同时大量饮水并进行蹦跳运动.肾下极结石以头低臀高位拍打肾区.治疗组在对照组治疗的基础上加用中药排石汤加减内服.结果 治疗组治愈率为56.7%,总有效率93.3 %,对照组治愈率为20.0%,总有效率50.0%,治疗组疗效优于对照组(P<0.01).结论 中西医结合治疗泌尿系结石疗效较单纯西医治疗好.     

老年泌尿系结石患者微创手术后结石残留影响因素

目的 分析老年泌尿系结石患者微创手术后结石残留的影响因素。方法 选取100例泌尿系结石患者,均行微创手术治疗,于术后根据患者结石残留情况分为残留组和无残留组。设计基线资料调查表,统计并比较两组基线资料,重点分析老年泌尿系结石患者微创手术后结石残留的影响因素。结果 100例老年泌尿系结石患者微创手术后,18例(18.00%)结石残留纳入残留组;82例无结石残留(82.00%)纳入无残留组;残留组结石直径>2 cm、混合结石、输尿管狭窄占比、结石负荷高于无残留组,差异有统计学意义(P<0.05);经Logistic回归分析结果显示,结石直径>2 cm、混合结石、结石负荷较高、输尿管狭窄是导致老年泌尿系结石患者微创手术后结石残留的危险因子(OR>1,P<0.05)。结论 老年泌尿系结石患者微创手术后结石残留受结石直径、混合结石、结石负荷较高、输尿管狭窄等因素影响。     

尿石方治疗泌尿系结石158例临床观察

笔者采用自拟尿石方治疗泌尿系结石158例,通过观察,治愈率68．9％,有效率91．1％,疗程短,简便易行（15d为一疗程,2个疗程观察变化）。本方功在清热淡渗利湿,利尿通淋排石,和里缓急止痛,软坚散结化石;集驱石排石、溶石化石于一炉,凡泌尿系结石虚证不明显且体质好者皆可应用,效果显著。     

尿液pH值与代谢综合征的相关性研究

目的:探讨中老年人群尿液pH水平与代谢综合征的相关性。方法:对上海市嘉定社区2 322名40岁以上居民进行问卷调查和体格检查,空腹采血检测肝功能、肾功能、血糖、血脂及胰岛素,收集晨尿检测尿pH值。采用多元线性回归分析代谢综合征与尿液pH值的相关性,Logistic回归分析代谢综合征和低尿液pH水平的相对风险度。代谢综合征采用按亚洲人特点改良的美国国家胆固醇教育计划成人治疗组第3次报告诊断标准。结果:与正常人群相比,代谢综合征患者腰围、体质量指数、血压、空腹血糖、糖化血红蛋白、低密度脂蛋白胆固醇、三酰甘油等指标偏高(P     

Serum uric acid concentration and metabolic syndrome among elderly Koreans: The Korean Urban Rural Elderly (KURE) study

BackgroundEpidemiologic studies have demonstrated that elevated serum uric acid concentration is an independent risk factor for metabolic syndrome. However, few studies have focused on elderly populations. Thus, we investigated the association of serum uric acid concentration with metabolic syndrome in community-dwelling elderly Koreans.MethodsThis cross-sectional analysis included 2940 participants (986 men and 1954 women) aged 65 years or older who participated in a baseline health assessment for the Korean Urban Rural Elderly cohort study from 2012 to 2014. Serum uric acid concentration was analyzed using both continuous and dichotomous variables. Hyperuricemia was defined as a uric acid concentration ≥7.0 mg/dL in men and ≥6.0 mg/dL in women. Metabolic syndrome was defined according to the 2009 harmonizing definition. Multiple logistic regression models were used to investigate independent association between serum uric acid and metabolic syndrome, after adjusting for age, body mass index, LDL cholesterol, glycated hemoglobin, blood urea nitrogen, estimated glomerular filtration rate health behaviors, and medications.ResultsPrevalence of metabolic syndrome and its components increased significantly according to uric acid concentration in both sexes. The adjusted odds ratios for having metabolic syndrome per 1.0 mg/dL higher uric acid concentration were 1.16 (95% CI: 1.03–1.31) in men and 1.27 (95% CI: 1.13–1.42) in women. Hyperuricemia was also associated with metabolic syndrome, with adjusted odds ratios of 1.71 (95% CI: 1.11–2.63) in men and 1.55 (95% CI: 1.05–2.29) in women.ConclusionsElevated serum uric acid concentration was independently associated with an increased prevalence of metabolic syndrome in community-dwelling elderly Koreans.     

Obesity,metabolic abnormality,and knee osteoarthritis: A cross-sectional study in Korean women

Abstract

Background. This study aimed to analyze the association between knee osteoarthritis and four body size phenotypes defined by the presence or absence of metabolic abnormality and obesity.

Mehods. This was a cross-sectional study using data from 1,549 female participants of the Fifth Korean National Health and Nutrition Examination Survey. Knee osteoarthritis was defined as a Kellgren–Lawrence grade of ≥ 2. Metabolically abnormal state was defined as presence of more than one abnormality among five metabolic risk factors. Obesity was defined using body mass index. Participants were grouped into one of the four body size phenotypes: metabolically healthy normal weight (MHNW), metabolically abnormal but normal weight (MANW), metabolically healthy obesity (MHO), and metabolically abnormal obesity (MAO).

Results. The distribution of each body size phenotype was as follows: MHNW 54.7%, MANW 30.7%, MHO 4.3%, and MAO 10.3%. Prevalence of symptomatic knee osteoarthritis was higher in MANW than in MHNW, and in MAO than in MHO. In multivariable analysis, the association between symptomatic knee osteoarthritis and the body size phenotypes was as follows (OR [95% CI]): MHNW 1.00 (reference), MANW 1.54 (1.15–2.07), MHO 1.61 (0.83–3.13), and MAO 3.47 (2.35–5.14).

Conclusions. Obesity showed closest association with knee osteoarthritis when accompanied by metabolic abnormality.     

代谢综合征患者阿司匹林抵抗的临床研究

目的探讨代谢综合征患者阿司匹林抵抗的发生率和临床特征。方法对2005年5月至6月北京首钢社区人群中221例病情稳定的代谢综合征患者,口服阿司匹林200mg/d共10d后,应用血小板聚集仪测定花生四烯酸(AA)诱导的血小板聚集率。以0.5g/LAA诱导的血小板平均聚集率≥20%为阿司匹林抵抗。结果阿司匹林抵抗发生率为17.6%(39/221)。阿司匹林抵抗(AS)组患者的纤维蛋白原水平显著高于阿司匹林敏感(AR)组的患者[(2.6±0.4)g/L对(2.4±0.4)g/L,P=0.017)]。两组患者的血压、年龄、空腹血糖、血脂以及体重指数等差异均无统计学意义;性别、吸烟、既往心梗或脑梗病史的分布也无统计学意义。进一步根据患者性别进行分层分析发现,在男性患者中心梗病史是阿司匹林抵抗的预测因素(50%对14.5%,P=0.020),在女性患者中舒张压高于85mmHg(1mmHg=0.133kPa)是阿司匹林抵抗的预测因素(34.0%对15.5%,P=0.043)。结论研究人群中阿司匹林抵抗的发生率为17.6%,高纤维蛋白原是阿司匹林抵抗的危险因素,心梗病史和较高的舒张压可能分别是男性和女性阿司匹林抵抗的预测因素。     

Relationships between depolarization abnormality and repolarization abnormality in patients with Brugada syndrome: using body surface signal-averaged electrocardiography and body surface maps

INTRODUCTION: Repolarization and depolarization abnormalities have been reported to be related to Brugada syndrome. METHODS AND RESULTS: We evaluated the relationships between repolarization abnormality and depolarization abnormality using 48-lead unipolar signal-averaged electrocardiograms and 87-lead unipolar body surface maps in 15 patients with Brugada-type ECGs. Data were compared with those from healthy control subjects (n = 5) and within subgroups of Brugada syndrome with (n = 8) and without (n = 7) ventricular arrhythmias (VA) induced by programmed electrical stimulation (PES). Eighty-seven-lead body surface maps were recorded, and potential maps were constructed to evaluate elevation of the ST segment 20 ms after the J point. Forty-eight-lead signal-averaged ECGs were recorded, and isochronal maps of duration of the delayed potential (dDP) were constructed to evaluate the dDP in each lead. Potential maps showed that patients with Brugada-type ECG, especially those with VA induced by programmed electrical stimulation, had greater elevation of the ST segment in the right ventricular outflow tract, especially at E5. Isochronal maps of dDP in the Brugada-type ECG group showed that maximum dDP was located at E5 and that the area with long dDP was larger than that in the control subjects. The dDPs at E7, E5, F7, and F5 in the VA-inducible group were significantly longer than those in the VA-noninducible group. These results showed that the location of greater elevation in the ST segment coincided with the location of longer dDP. CONCLUSION: Repolarization abnormality and depolarization abnormality in the walls of both ventricles, especially in the right ventricular outflow tract, are related to the VA of Brugada syndrome.     

Clinical relevance of different handgrip strength indexes and metabolic syndrome in Chinese community-dwelling elderly individuals

PurposeCurrently there is no consensus on the correlation between metabolic syndrome (MetS) and muscle strength. The objective of this study was to examine the associations between MetS and its components and different handgrip strength (HS) indexes among Chinese community-dwelling elderly individuals. In addition, we hoped to find an optimal cutoff point for the index most relevant to MetS.MethodsData were obtained from 909 participants aged ≥ 60 years (385 men, average age, 68.0 ± 5.9 y). We used the International Diabetes Federation metabolic syndrome guidelines to define MetS. General data of all participants were collected through questionnaires and anthropometric data were measured. At the same time, blood samples were collected.ResultsThe prevalence of MetS was 26.8 % in men and 46.9 % in women. In all HS indexes, HS/body fat mass was most strongly correlated with MetS, and the areas under the receiver-operating characteristic curve were 0.723 (95 % confidence interval [CI] = 0.669-0.776) in men and 0.619 (95 % CI = 0.571-0.667) in women, and the optimal cutoffs were 1.92 in men and 1.25 in women. The adjusted odds ratios (ORs) of MetS for low HS/body fat mass were 5.38 (95 % CI = 3.03–9.56, p < 0.001) in men and 2.39 (95 % CI = 1.56–3.64, p < 0.001) in women.ConclusionsHS/body fat mass appears to be the index best associated with MetS and its components, and in men it is more relevant than in women.     

Obesity,weight change,and mortality in older adults with metabolic abnormalities

Background and aims

It is expected that older adults with metabolic abnormalities may benefit from weight loss; however, data on this population are limited. Our study was to assess the effect of obesity and weight change on mortality risk in older adults with metabolic abnormalities.