性行为与乙型肝炎及丙型肝炎病毒感染的关系

目的 评估高危性行为人群中乙型肝炎病毒（HBV）及丙型肝炎病毒（HCV）的感染情况及某些高危性行为与HBV、HCV感染的关系。方法 用PCR方法对本院性传播疾病（STD）门诊中的173名就诊者进行HBV、HCV检测,并对被调查者的年龄、初次性生活年龄、3个月内性侣数、终身性侣数、性生活方式、既往STD史等作调查。既往有吸毒史及受血史者不纳入调查范围。结果 HCV感染在高危性行为的人群中尤其在STD人群中常见,并与既往STD史呈正相关。3个月内性侣数超过4个是HBV、HCV感染的危险因素。HBV、HCV感染在梅毒患者中最多见。结论 HBV、HCV经性接触传播的途径不容忽视。     

门诊性病患者危险性性行为及其影响因素

目的 了解综合性医疗机构门诊性病患者的艾滋病病毒(HIV)感染危险性性行为发生现况及其主要影响因素.方法 连续收集于2007年4月19～6月19日期间前来研究点就诊、愿意合作的200名门诊性病患者作为样本,以面时面访谈方式,采用自编一般情况问卷、危险性性行为问卷、相关知识问卷和性态度开放程度量表进行调查.结果 调查时点前1年内,200名性传播疾病患者(STD)患者样本中,192人(96.0%)有固定性伴,22.0%(44/200)有多个固定性伴;临时性性行为发生率为26.5%(53/200),商业性性行为发生率为40.5%(81/200),既有商业性又有非商业性性行为的发生率为39.5%(79/200),多性伴性行为发生率62.0%(124/200);25条目,总分为25分的相关知识中位数得分为18分(P25=15,P75=21);总分为30分的性态度开放程度中位数评分为11分(P25=8,P75=15.75).Logistic多元回归分析发现,性别、婚姻状况、初次性行为年龄和性态度开放程度是患者样本发生危险性行为的主要影响因素.结论 研究点门诊STD患者较高比例的危险性性行为,采取措施及时干预患者的危险性性行为,对预防和控制HIV向普通人群传播和扩散具有极为重要的意义.     

性病门诊性传播疾病病原体感染情况调查

目的:了解性病门诊性传播疾病(STD)病原体感染的流行情况.方法:对1124例就诊者分别检测沙眼衣原体、解脲支原体、梅毒螺旋体、人乳头瘤病毒、白色念珠菌、淋病奈瑟菌和人类免疫缺陷病毒7种病原体.结果:STD感染率为59.0%,其中36.0%为混合感染;沙眼衣原体感染率最高,为40.1%;女性人乳头瘤病毒感染率高于男性(P=0.005);STD患者主要集中在21～30岁、高中及以下学历、工人和干部职业;STD病原体感染者与未感染者相比,二者在性别、年龄和婚姻情况的差异均无统计学意义(P＞0.05);STD病原体感染者平均性伴数高于非感染者(P=0.005).结论:性病门诊就诊者STD感染率较高,其中沙眼衣原体所占比率最高;女性人乳头瘤病毒感染率高于男性;21～30岁、低学历者、工人和干部为STD的主要感染群体;多性伴数者更易感染STD;STD的混合感染不容忽视.     

东湖区男男性行为人群HIV 梅毒 HCV 感染状况及高危行为调查分析

目的 了解东湖区男男性行为(MSM)人群HIV感染状况,和有关艾滋病/性传播疾病(AIDS/STD)知识、态度及行为(KAP)特征,为针对该人群今后开展有效的干预工作提供经验和依据.方法 对东湖区106名MSM进行匿名问卷调查,采集血样本进行检测.结果 106名MSM平均年龄22岁,多为高校学生,文化程度较高.艾滋病病毒(HIV)阳性率为13.21%,梅毒阳性率为6.6%,丙型肝炎病毒抗体(抗-HCV)阳性率为1.89%,调查对象AIDS/STD知晓率较高,但有较高的高危行为,近6个月与男性发生肛交性行为时每次使用安全套的仅占26.52%,平均性伴数为2人.结论 东湖区MSM人群HIV感染率较高,高危行为普遍,必须采取有效的干预措施,同时应加强对高校青少年的性健康教育.     

安康市AIDS监测情况分析

目的:了解安康市艾滋病(AIDS)在重点人群中的分布及其发生频率、现状和流行趋势,为制定AIDS防治策略提供依据。方法:按照全国AIDS/STD检测工作规范要求,在1997-2005年对部分人群AIDS病毒感染进行了监测。结果:监测义务献血、既往有偿供血人员,监狱羁押(吸毒)人员,STD门诊就诊者共计9664人,查出艾滋病病毒(HIV)感染者36例,检出率为0.37%,其中2003-2005年感染者28例,占10年感染总数的77.8%,并以农村青壮年居多,18-45岁人员占91.2%。结论:HIV感染者在安康市主要集中在STD门诊就诊和既往有偿献血人群中,近年来流行速度加快,应采取措施预防HIV从高危人群向一般人群传播,加大健康教育、行为干预和监测力度,是安康地区预防控制AIDS的有力措施。     

广西南宁地区STD患者家庭儿童感染STD情况的分析

目的:了解广西南宁地区性传播性疾病(STD)患者家庭儿童感染STD的状况及途径.方法:对南宁地区78户STD患者家庭成员行病原体检测.结果:STD患者家庭内儿童STD感染率为53.85%(42/78),梅毒为儿童STD的主要病原体,梅毒患儿的母亲梅毒感染率高于未患梅毒儿母亲感染率(P<0.01),0～6岁儿童感染STD明显高于>6岁儿童(P<0.01).结论:广西南宁地区STD患者家庭儿童是STD高危人群,母婴垂直传播和母子(女)密切接触是儿童STD感染的主要途径.     

陕西省咸阳市艾滋病自愿咨询检测结果分析

目的了解2011-2015年咸阳市自愿咨询检测(VCT)门诊求询者艾滋病病毒(Human Immunodeficiency Virus,HIV)感染情况,探讨其相关影响因素。方法将2011-2015年咸阳市VCT门诊开展HIV检测的求询者纳入研究,对其开展问卷调查,最后对调查结果采用卡方检验和多因素Logistic回归对数据进行统计分析。结果此次研究共有35190人参与,男女性别比为0. 73∶1;平均年龄(32. 38±10. 82)岁,求询者来源以主动求询者为主(75. 40%);求询原因以具有输/献血史人员为主(32. 90%); HIV抗体阳性率0. 30%。较近的求询年份、男性、35岁以上、高危人群、发生高危性行为(非商业异性性行为、商业异性性行为、男男性行为)及配偶/固定性伴阳性是感染HIV的危险因素。结论咸阳市VCT求询者HIV阳性率逐年升高,而高危性行为是HIV感染的主要危险因素。今后应大力采取针对高危性行为的防控措施,阻断HIV在普通人群中的传播。     

青海省格尔木市MSM人群特征及HIV/STD流行病学分析

目的:掌握格尔木市MSM(男男同性性行为)人群中HIV(艾滋病病毒)/STD(性传播疾病)感染现状,为今后制定防治策略提供依据。方法:招募志愿者和开展网络平台,对主动求询和外展干预中的MSM人群以问卷调查、血清学检测、生殖器检查等方式了解其人口学特征、性行为特征、安全套使用以及HIV和梅毒等性传播疾病的感染情况。结果:2009年7月—2011年12月共检测235人次,HIV感染率4.26%,梅毒感染率0.85%,尖锐湿疣感染率3.4%。均有2个以上同性性伴,且安全套使用率不足20%。结论:目前全国艾滋病疫情中男男同性性行为是经性途径感染最重要的传播方式。所以格尔木市在MSM人群干预中,须开展针对性干预活动,尤其重视双性性行为和HIV、梅毒阳性的MSM人群,做好家庭内的预防,加强宣传教育,提高安全套使用率,减少其高危性行为。     

桂西山区女性性服务者性病艾滋病筛查与健康教育干预效果评价

目的探讨在性病门诊对女性性服务者(FSW)性传播疾病/艾滋病(STD/AIDS)筛查与健康教育干预效果。方法在桂西山区规范化性病门诊对FSW进行STD/AIDS筛查,针对性临床追踪治疗与健康教育,评价其有效性及可行性。结果374人STD/AIDS筛查及相关认知行为调查,经过临床追踪治疗与健康教育,性病感染率及STD/AIDS知识正确知晓率由47.50%与68.30%,分别下降与提高到38.50%与90.60%,安全套使用率由教育前的55.50%提高到86.80%。结论在性病门诊对目标人群STD/AIDS筛查及健康教育纳入日常防治STD/AIDS诊疗中,能有效地提高该人群遵医行为及自觉改变高危性行为的依从性,得到目标人群与医务人员认可,具有一定的推广意义。     

不同人群解脲支原体和人型支原体感染状况分析

目的 :了解人型支原体 ( MH)、解脲支原体 ( UU)在不同性病患者、健康人群、性病患者性伴中的感染情况和分布特点 ,以及与其他微生物感染的相互关系。方法 :用聚合酶链反应 ( PCR)检测性传播疾病 ( STD)门诊的 1 1 43例、健康人群 465人、性伴 1 34人尿道 (宫颈 )分泌物的 UU、MH感染。结果 :STD患者中 UU感染大大高于 MH感染 ,除梅毒患者外的 STD患者、性伴人群无论男女 UU、MH感染率与健康人群比较差异均有显著性。非淋菌性尿道炎 ( NGU)组、总 STD患者、健康人群的 UU、MH阳性率女性高于男性。健康人群女性与性伴人群女性 UU、MH阳性率相比差异均无显著性。结论 :性病患者中支原体感染率增高 ,不同病种的 STD感染支原体的频率相同 ,临床更应加强女性 UU、MH的检测     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.