绝经后妇女2 060名月经初潮年龄等因素与骨密度的关系

目的 探讨绝经后妇女月经的初潮年龄、绝经年龄、绝经年限等因素与腰椎及股骨近端骨密度(BMD)的关系.方法 调查2 060名上海地区绝经后妇女的月经初潮年龄、绝经年龄、绝经年限,测量其身高、体重、L1～L4和股骨近端的BMD.结果 调整年龄、身高、体重后,初潮年龄、绝经年限与L1～L4(r=-0.0717、-0.123)、股骨颈(r=-0.035、-0.127)、全髋(r=-0.054、-0.127)、大转子(r=-0.067、-0.090)的BMD呈负相关(P值分别＜0.05、0.01),绝经年龄、行经时间与L1～L4(r=0.123、0.144)、股骨颈(r=0.126、0.129)、全髋(r=0.122、0.136)、大转子(r=0.089、0.112)的BMD呈正相关(P值分别＜0.05、0.01).初潮年龄≤14岁、初潮年龄＞14且＜18岁、初潮年龄≥18岁组间L1～L4、股骨颈、大转子和全髋的BMD的差异均有统计学意义(P值均＜0.05),随初潮年龄的增大各部位的BMD呈下降趋势;绝经年龄≥54岁组各部位的BMD显著高于绝经年龄＞45且＜54岁组(P值均＜0.05),后组又显著高于绝经年龄≤45岁组(P值均＜0.05).多元回归分析发现,体重及绝经年限分别可解释其变异的15.0%～28.3%及4.5%～24.6%,初潮年龄及行经时间对BMD变异的贡献较小,仅可分别解释腰椎及全髋BMD变异的0.4%及0.2%.结论 绝经后妇女月经初潮年龄越大、绝经年龄越早、绝经年限越长,BMD相对越低,体重和绝经年限对BMD变异的影响最大.本研究有助于建立筛选骨质疏松高危妇女的标准.     

广西壮、汉族妇女骨密度初步分析

目的　探讨广西壮、汉族妇女骨密度 (bonemineraldensity ,BMD)和绝经后壮、汉族妇女骨质疏松 (osteoporosis,OP)发生率是否存在差异性 ,为骨质疏松防治提供依据。方法　居住南宁 1 0年以上的健康绝经前妇女 1 79名 ,绝经后妇女 1 6 3名 ,记录其祖父母、外祖父母的民族 ,祖父母和外祖父母均为同一民族 (汉族或壮族 )者纳入本研究。同时记录受试者的年龄、初潮年龄、绝经年限 (绝经后妇女 )、孕次、产次。受试前 3个月内至少有 1次月经来潮者纳入绝经前妇女组 ;绝经 1年或以上者纳入绝经后妇女组。测量身高、体重 ,计算体重指数 (BMI)。用法国DMS公司的DEXA检测受试者腰椎 (L2 ～L4)正位、左髋部(股骨颈、Word s三角、大转子 )、左前臂 (超远端、远端 )的BMD ,并进行比较。结果　绝经前壮族妇女除股骨颈、前臂BMD略高于 (0 93%～ 1 4 4 % )或等于汉族妇女外 ,其余检测部位的BMD均低于汉族妇女 (0 92 %～ 5 92 % ) ,其中L2 ～L4的BMD分别较汉族妇女低 4 92 % (P =0 0 6 7)、5 2 6 % (P =0 0 5 4 )、5 92 % (P =0 0 37) ;相反 ,绝经后壮族妇女除L2 和前臂超远端的BMD略低于 (0 1 5 %～ 0 99% )汉族妇女外 ,其余部位的BMD均高于 (0 1 3%～ 2 79% )汉族妇女 ,虽然差异无统计学意义 (P >0 0 5     

初孕年龄、产次与绝经后妇女骨密度的关系

目的　探讨初孕年龄、产次与绝经后妇女骨密度(BMD)的关系。方法　调查180名健康绝经后妇女年龄、初孕年龄、产次、绝经时间,并测量身高、体重、腰椎L2~4及左侧股骨近端(Neck、Ward三角、Troch)BMD。结果　①初孕年龄≤20岁的绝经后妇女在L2~4及股骨近端各部位BMD值均低于初孕年龄在21~25岁者(Neck、Ward三角、TrochP<0 .01,L2~4 P<0 .05 )和初孕年龄在26 ~30岁者(L2~4、Neck、Ward三角、TrochP<0. 01 ),在L2~4、Neck、Ward三角部位低于初孕年龄>30岁者(Ward三角P<0 01,L2~4、NeckP<0 .05)。②随着产次的增加,股骨近端各部位BMD逐渐下降,产3次,产4次,产次≥5次各组BMD显著低于产1次和产2次组(P<0 .01)。③多因素分析显示:产次与股骨近端各部位BMD呈显著负相关,绝经年限与L2~4、Neck和Troch部位BMD呈显著负相关,初孕年龄与Neck和Troch部位BMD呈负相关。结论　初孕年龄≤20岁的绝经后妇女腰椎和股骨近端BMD减低,产次影响绝经后妇女股骨近端各部位BMD。     

体质指数对女性骨密度及骨质疏松症患病率的影响

目的 :探讨体质指数 (BMI)对女性骨密度 (BMD)及骨质疏松症 (OP)患病率的影响。方法 :采用双能X线骨密度仪测量骨峰值期女性 10 12例和绝经后女性 5 76例不同骨骼部位的骨密度 ,按BMI不同各分为低体重组、正常体重组 (对照组 )和肥胖组进行分析。结果 :除腰椎侧位外 ,骨峰值期和绝经后女性各部位BMD与BMI均呈正相关 (r=0 .130～ 0 .4 4 9和r =0 .189～ 0 .4 2 3,P <0 .0 5～ 0 .0 0 1) ;骨峰值期女性低体重组腰椎正位和髋部各部位BMD均低于对照组 (P <0 .0 5～ 0 .0 0 1) ,肥胖组腰椎正位和髋部各部位BMD均高于对照组 (P <0 .0 5～ 0 .0 0 1) ;绝经后女性除腰椎侧位外 ,低体重组各部位BMD均低于对照组 (P <0 .0 1～ 0 .0 0 1) ,而肥胖组BMD均高于对照组和低体重组 (P <0 .0 5～ 0 .0 0 1) ;除腰椎侧位三组之间及桡骨远端 1 3段肥胖组与对照组的OP患病率差异无显著性外 ,其它各部位OP的患病率为 :肥胖组 <对照组 <低体重组。结论 :女性骨峰值期 ,BMI大者通过负重作用刺激负重骨骼的BMD增加 ;绝经后 ,BMI大者通过负重和雌激素共同作用 ,延缓负重和非负重骨骼的骨量丢失。     

护骨素和骨钙素与骨密度的关系

目的　探讨血清护骨素 (sOPG)、血清骨钙素 (sBGP)、尿脱氧吡啶啉 (uDPD)与女性年龄和骨密度 (BMD)之间的关系。方法　用ELISA测定 6 72名 2 0 80岁女性志愿者的sOPG、sBGP和uDPD/Cr,用双能X线吸收法 (DXA)测定腰椎正位总体和股骨颈的BMD。根据年龄段、是否绝经分组。结果　 ( 1)sOPG、sBGP和uDPD/Cr在 30 39岁年龄段最低 ( 2 8pmol/L± 1 4pmol/L、5 μg/L± 3μg/L、4 9nmol/mmol± 2 5nmol/mmol) ,与 4 0 6 9岁的各组比较差异有显著意义 (P均 <0 0 5 )。 ( 2 ) 4 0～ 5 9岁人群中 ,绝经后组的sOPG、sBGP和uDPD/Cr( 5 7pmol/L± 3 1pmol/L、11μg/L±5 μg/L、6 9nmol/mmol± 3 3nmol/mmol)高于绝经前组 ( 3 4pmol/L± 2 0pmol/L、6 μg/L± 3μg/L、5 2nmol/mmol± 3 9nmol/mmol) (P均 <0 0 0 1)。 ( 3)年龄与sOPG、sBGP、uDPD/Cr和腰椎及股骨颈的BMD相关 (r值分别为0 130、0 35 5、0 10 6、- 0 6 0 0、- 0 5 4 5 ,P均 <0 0 1) ;sOPG、sBGP与腰椎和股骨颈的BMD呈负相关 (r =- 0 183和 - 0 10 8,P <0 0 1;r=- 0 5 4 1和 - 0 4 4 1,P <0 0 0 1)。sOPG与sBGP、uDPD/Cr也存在正相关关系 (r值分别为 0 2 16、0 0 83,P均 <0 0 5 )。结论　sOPG、sBGP和uDPD/Cr能敏感地反映妇女随年     

沈阳地区绝经后妇女绝经年限与腰椎骨密度关系的分析

随机调查沈阳地区289例健康的绝经后妇女,年龄和绝经年限,身高、体重、正位腰椎BMD,应用SPSS软件统计分析.发现腰椎L2部位BMD低于其它部位,随绝经年限的增加腰椎各部位BMD有下降的趋势,绝经后前6年间腰椎各部位BMD下降较快,以后下降减慢,并且相对而言L2的BMD下降速度高于其它部位.以年龄和体重指数(BMI)为协变量,经协方差分析显示各绝经年限L2及L3部位BMD有显著差异.提示对绝经后妇女应注意绝经后的前6年的腰椎BMD变化,特别是L2部位的BMD变化.     

绝经后妇女绝经年限、绝经及初潮年龄与骨密度关系的研究

目的探讨安徽合肥地区绝经后妇女绝经年限、绝经及初潮年龄与骨密度关系。方法调查240例合肥市健康妇女的年龄、绝经年限、绝经年龄和初潮年龄、测量身高、体重、体重指数（BMI）,及正位腰椎（L2～L4）、股骨各部位（Neck,ward,GT）的骨密度（BMD）,并进行相关分析。结果绝经年限与各部位骨密度呈负相关（P〈0．01）,初潮年龄与L2、L3、L4、大转子的骨密度呈负相关（P〈0．01）,绝经年龄与L2、L3、L4的骨密度呈正相关（P〈0．01）。结论随着绝经年限增加,初潮年龄越大,绝经年龄越早,骨密度呈下降趋势。     

绝经后2型糖尿病患者骨密度与胰岛素抵抗和体质成分的关系

目的:观察绝经后2型糖尿病患者(T2DM)骨密度(BMD)的变化,及其与胰岛素抵抗和体质成分的关系。方法:以26例绝经后2型糖尿病女性患者为研究对象,26例年龄、绝经年限、体重指数(BMI)相匹配的绝经后健康女性为正常对照组。应用双能X线骨密度仪测定腰1-4(L1-4)各腰椎骨密度和全身体肌肉、脂肪组织含量,以稳态模型HOMA-IR指数评估胰岛素抵抗。结果:①绝经后T2DM患者L1部位BMD值高于对照组(P<0.05),胰岛素抵抗明显高于对照组(P<0.01)。②多元逐步回归分析显示:T2DM组L1、L2、L3各腰椎BMD均与胰岛素抵抗呈明显正相关(r=0.42,0.45,0.41;P均<0.05),L1部位BMD与肌肉含量正相关(r=0.44,P<0.05)。结论:绝经后2型糖尿病患者腰椎骨密度高于对照组;胰岛素抵抗、肌肉含量可能是T2DM患者BMD的保护因素。     

评价双能X线骨密度仪预测绝经女性骨质疏松性椎体骨折的价值

目的 探讨双能X线骨密度仪预测绝经女性骨质疏松性椎体骨折的价值.方法 采用双能X线骨密度仪对100例椎体骨折绝经后女性患者及100例相应年龄的健康者进行腰椎各部位骨密度(BMD)检测.结果 椎体骨折与第2腰椎、第3腰椎、第4腰椎、第2～4腰椎(L2～4)BMD值均呈负相关,且差异均有统计学意义(P＜0.05);设骨折发生率为80%的L2～4BMD值为骨折上限值,绝经女性椎体骨折的L2～4BMD上限值为0.641 g/cm2.结论 双能X线骨密度仪检测腰椎骨密度值,对绝经女性椎体骨折的预报有较高的实用价值.     

高血压病患者血清瘦素水平的相关性分析

目的　探讨血清瘦素与血压、体重指数 (BMI)、腰围、臀围、腰臀比 (WHR)及血脂、血尿酸等因素的关系。方法　测定 6 8例高血压患者及 4 8名正常人的血清瘦素浓度、血压、人体测量变量值及生化指标。血清瘦素用ELISA法测定。结果　 (1)两组血清瘦素浓度无显著性差别 (P >0 .0 5 ) ,肥胖者血清瘦素浓度显著于非肥胖者 (P<0 .0 0 1) ,女性显著高于男性 (P <0 .0 0 1) ;(2 )高血压组血清瘦素与BMI、血尿酸 (URIC)、总胆固醇 (TC)、腰围、臀围、WHR显著正相关 ;经多元回归分析 ,血清瘦素浓度的影响因素为性别、BMI、URIC、WHR。结论　血清瘦素浓度与血压、年龄无关 ,而与BMI、腰围、臀围、WHT、URIC显著相关。     

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.