青岛市市区居民的住院率及影响因素分析

目的　了解青岛市市区居民的住院状况及影响因素。②方法　采取整群随机抽样法 ,对青岛市市区 15个居委会的 30 5 7人进行问卷调查。③结果　市区居民的住院率为 4 6 .78‰ (男性住院率为 37.2 0‰ ,女性住院率为 5 6 .74‰ ) ,女性居民的住院率高于男性 (χ2 =6 .5 2 ,P <0 .0 5 ) ;76 .38%的病人住在市级以上医院 ,因病住院者占 72 .0 3% ;居民的住院率与文化水平、医疗保健制度、是否患有慢性病及职业等因素有关。④结论　青岛市市区居民住院服务利用率较低 ,建议建立健全医疗保障制度 ,以保障居民的健康     

青岛市农村中老年居民患病住院状况及其影响因素分析

目的 了解青岛农村中老年居民住院的状况及影响因素.方法 采取分层与随机抽样相结合的方法,抽取3 675例农村中老年居民进行问卷调查.结果 青岛农村中老年居民的住院率为50.88‰,其中男性为53.51‰,女性为48.22‰;74.66%的病人住在区级及以上医院,因疾病住院者占75.91%;中老年居民住院率与医疗保障方式、家庭年经济收入水平、是否患有慢性病及就诊距离等因素有关(OR=16.822、2.073、0.922).结论 青岛市农村中老年居民住院服务的利用率较高,并与医疗保障方式等因素有关.     

唐山市农村居民住院率及其影响因素的研究

①目的了解唐山市农村住院卫生服务的状况及影响因素。②方法采用多阶段分层整群抽样的方法,抽取了4 416人进行问卷调查,用住院率来反应农村居民的卫生服务利用情况。③结果总住院率为33.29‰,男性住院率为27.39‰,女性住院率为39.29‰,女性高于男性。影响卫生服务利用的因素:年龄、性别、文化程度、婚姻、慢性病,但主要是年龄、慢性病的影响。66.93%的患者住在县级医院,23.62%的患者住到市级以上医院。④结论政府和卫生主管部门应根据本地具体情况采取相应的卫生政策和办医形式,以满足农民的卫生服务需求量。     

昭通不同性别农村居民需住院影响因素分析

目的 比较昭通不同性别农村居民需住院的影响因素, 为不同性别农村居民健康政策的制定提供参考.方法 资料收集采用多阶段随机抽样进行入户问卷调查.为消除年龄对不同指标的需住院率的影响, 对需住院率进行了年龄的标化.用χ2检验和Logistic回归分析需住院的影响因素.结果 调查对象需住院率为8.0%.女性需住院率 (9.5%) 高于男性 (6.8%) , 差异有统计学意义 (P<0.05) .不论是男性还是女性, 过去1 a患慢性病者需住院率均高于未患慢性病者.男性年龄越大, 需住院率越高.对于女性:农民、无职业组需住院的可能性高于其它职业组;离异和丧偶组需住院率高于未婚组、在婚组;家庭人口数越多, 需住院的可能性越小.中等收入组、最高收入组、汉族、初中组、在婚组女性需住院率高于男性, 差异有统计学意义 (P<0.05) .结论 男性需住院的影响因素为年龄、过去1 a是否患慢性病.女性需住院的影响因素为职业、婚姻状况、家庭人口数、过去1 a是否患慢性病.     

青岛市市区居民医疗费用及影响因素分析

①目的　了解青岛市市区居民医疗费用及其影响因素。②方法　根据青岛市居民的经济状况、地理位置等因素 ,采取整群抽样法 ,抽出 1 5个居委会 ,再于每个居委会内进行随机抽样 ,共抽出 3 2 0 0人进行问卷调查。③结果　青岛市市区居民的门诊次均就诊费用的中位数是 85 .0 0元 ,患有慢性病的居民、有残障的居民、女性病人、公费及公费为主病人的次均就诊费用较高。住院病人费用中位数为 3 60 0 .0 0元 ,年龄与病人的住院费用呈正相关关系 (r=0 .356 ,P <0 .0 0 5)。住院费用的主要影响因素为年龄、职业及医疗保障方式等。④结论　青岛市市区居民医疗费用支出受多种因素影响 ,应改革医疗保健制度 ,以满足居民就诊需要     

2004年兵团城市和农场居民住院医疗服务情况分析

目的:了解兵团居民的住院医疗服务利用情况.方法:利用2004年兵团卫生服务家庭入户调查资料.结果:兵团居民的住院率为74.7‰(95%的可信区间为72.2‰～79.2‰),城市为82.2‰,农场为71.8‰,城乡居民住院率比较,χ2=4.177,df=1,P=0.041,城市居民住院率高于团场;兵团居民未住院率为24.5%,城市为31.3%,农场为21.0%,城市和农场居民未住院率比较χ2=16.759,df=1,P=0.00,差异有统计学意义;兵团居民因经济困难未住院所占比例最高达59.0%,城市占66.3%,农场占54.3%.结论:兵团居民住院服务利用高,未住院率低,城市居民多选择大医院住院,增加医疗费用负担.     

青岛市农村居民两周患病率及就诊状况分析

①目的 了解青岛市农村居民两周患病率及就诊状况。②方法 整群与随机抽样法相结合，抽出7个自然村的3700名18岁以上居民进行问卷调查。③结果 青岛市农村居民的两周患病率为199．37‰(男性：184．78‰，女性：211．83‰)，每千人两周因病休工天数为369．6d，每千人因病卧床天数为100．8d。两周患病率与居民年龄、收入、文化水平、是否患有慢性病和是否有残障等因素有关。居民两周就诊率为151．57‰(男：151．35‰，女：151．74‰)，主要就诊医疗机构是村卫生室；未就诊者占患病人数的24．22％。④结论 青岛市农村居民对门诊服务的利用率较低，应建立健全医疗保障制度，以满足居民的医疗需求。     

蓟县社区居民健康状况抽样调查

本文对蓟县社区居民健康状况进行了抽样调查 ,结果为出生率 12 .33‰ ;死亡率 4 .19‰ ,自然增长率 8.14 % 0 ;高血压总患病率 18.18% ,男性 18.96 % ,女性 17.4 4 % ,农村 19.0 5 % ,城镇 17.0 2 % ,;冠心病总患病率 8.16 % ,男性 8.89% ,女性 7.4 6 % ,农村 6 .70 % ,城镇 10 .10 % ;脑血管病总患病率 1.0 5 % ,男性 1.2 3% ,女性 0 .87% ,农村 1.15 % ,城镇 0 .91%。高血压、冠心病、脑血管病三种疾病患病率均男性高于女性 ,农村高于城镇人口 ;但均无明显差别 (P >0 .0 5 ) ;糖尿病总患病率 2 .4 7% ,男性 2 .14 % ,女性 2 .83% ,女性高于男性 ,农村 2 .16 % ,城镇 2 .94 % ,农村低于城镇居民。     

四川省盐亭县不同年代脑血管病潜在生命损失和工作损失年数分析

应用“潜在生命损失年”(ypll)和“潜在工作损失年”(wypll)分析了盐亭县 2 0世纪 70、80、90年代脑血管病死亡危害情况。结果显示脑血管ypll标化率随年代后移而上升 ,尤以女性变化更明显。男性 2 0世纪 70年代为2 .10‰ ,2 0世纪 80年代为 2 .83‰ ,2 0世纪 90年代为 2 .6 8‰。女性 2 0世纪 70年代为 - 0 .46‰ ,80年代为 2 .49‰ ,90年代为 4.94‰。 2 0世纪 7、80年代均是男性高于女性 ,而 90年代女性高于男性 ,说明脑血管病对男性的危害大于女性 ,而近年对女性危害有上升趋势。     

内蒙古自治区凉城县农村居民住院服务利用状况调查

目的：了解内蒙古自治区凉城县农村居民住院服务利用的影响因素,为提高内蒙古西部农村地区医疗卫生服务水平提供参考依据。方法：采用两阶段分层整群随机抽样的方法,对内蒙古自治区乌兰察布市凉城县3个乡镇居住半年以上的农村居民进行入户调查,用Stata10.0软件进行分析。结果：调查对象住院率为31.58‰;住院病人的住院医疗机构主要集中在县/市/区医院;住院人口中90.77%参加了新型农村合作医疗,其住院率为30.52‰;应住院而未住院比例为65.43%,未住院的主要原因是经济困难。结论：调查对象住院服务利用率较低;经济原因依然是影响内蒙古农村地区住院服务利用的主要因素;新型农村合作医疗制度对农村居民利用住院服务起到了推动作用;仍有部分农村居民无任何医疗保障,影响其住院服务的利用;乡镇卫生院建设情况不良。建议：继续深化和加强新型农村合作医疗制度建设,加强乡镇卫生院建设。     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

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.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.