目的 探讨老年人卧位血压与尿微量白蛋白的关系.方法 在参加开滦研究第3次健康体检的人群中,采取整群抽样的方法抽取年龄≥60岁的开滦集团离退休员工3064人,其中符合入选标准纳入统计分析者1692人.采用偏相关分析坐位、卧位、立位收缩压,舒张压与尿微量白蛋白的相关性,多因素Logistic回归分析卧位高血压对尿微量白蛋白的影响.结果 观察对象1692人(男性1122人,女性570人),年龄为(67.3±6.2)岁,尿微量白蛋白为(25.9±43.5)mg/L.校正年龄、性别后,坐位、卧位、立位即刻、立位3 min收缩压、舒张压均与尿微量白蛋白呈正相关.多因素Logistic回归分析显示:校正了年龄、性别等混杂因素后,坐位、卧位高血压是尿微量白蛋白增加的危险因素(坐位:OR=1.66,95％ CI 1.23～2.24;卧位:OR=1.48,95％ CI 1.14～1.92),而立位高血压、立位低血压的相关性无统计学意义;坐位高血压、立位高血压、立位低血压、卧位高血压同时代入方程,并校正其他相同变量,坐位高血压是尿微量白蛋白增加的独立危险因素(OR=1.44,95％ CI 1.01～2.07),而卧位高血压、立位高血压、立位低血压的相关性无统计学意义.结论 老年人坐位高血压与尿微量白蛋白增加相关性最大,卧位高血压次之,立位高血压或立位低血压与尿微量白蛋白增加相关性无统计学意义.

Introduction: Inflammation plays a key role in the pathophysiology of atherosclerosis. Little is known about the association between high sensitivity C-reactive protein (hs-CRP) especially long-term hs-CRP and asymptomatic carotid artery stenosis (ACAS) in healthy Chinese adults. The aim of this study was to assess the relationship between hs-CRP levels and the prevalence of ACAS in a Chinese community-based cohort.Methods: A sample of 5349 participants aged >= 40 years (40.36% women) were enrolled in this study, all without preexisting stroke. Ultrasonography of the bilateral carotid arteries was performed for the evaluation of carotid stenosis. Participants were stratified into three groups according to hs-CRP levels. We used both baseline (hs-CRP levels analyzed during 2010) and average hs-CRP values for the last four years (the average of hs-CRP levels analyzed at the year of 2006, 2008 and 2010) in the analysis. Multivariable logistic regression models were used to analyze the association between hs-CRP levels and ACAS.Results: A total of 356 (6.66%) subjects showed evidence of ACAS. Multivariate analysis showed that both baseline and average hs-CRP values for the last four years were independent indicators for the presence of ACAS (P for trend = 0.007, 0.001, respectively). Stratified by age and sex, higher baseline hs-CRP levels were associated with ACAS in old adults (>= 60 y) (multivariate-adjusted, odds ratio [OR] = 1.03, 95% confidence interval [CI]: 1.01-1.05) and male (multivariate-adjusted, OR = 1.03, 95% CI: 1.01-1.05), but not in middle-aged adults (40-59 y) and female. Similarly, higher average hs-CRP values for the last four years were associated with ACAS in old adults and male, but not in middle-aged adults and female.Conclusion: Both baseline and chronic elevation of serum hs-CRP were associated with ACAS, especially in older or male adults. hs-CRP might be used as a useful marker and a potential therapeutic target for carotid atherosclerosis. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

Objective To investigate the correlation of the 24?hour ambulatory systolic blood pressure (SBP) and carotid intima?media thickness(CIMT) in the elderly. Methods A total of 2 464 who were more than or equal to 60 years old participants were selected with random sampling in accordance with the inclusion criteria from the retired workers in Tangshan Kailuan Company. Dynamic blood pressure monitoring, neck vascular ultrasound and other examination were performed for the participants. . Multivariable linear regression analysis was used to analyze correlation between the SBP of 24?hour, daytime and nightime with CIMT, respectively. Results ( 1) The observation population was divided into three groups according to the tertiles of SBP of 24?hour, daytime and nightime, respectively. With the levels of different SBPs inceasing, CIMT values thickened markedly ( P<0. 01 ) . ( 2 ) Multivariable linear regression analysis showed that after adjusting for confounding factors,the SBP of 24?hour,daytime and nightime associated with CIMT positively and linearly(P<0. 05),and regression coefficient(95%CI) were 0. 022(0. 009-0. 035), 0. 021(0. 008-0. 035), 0. 019 ( 0. 006-0. 032) respectively. In addition,clinic SBP step into the multivariable linear regression,and regression coefficient ( 95%CI ) were 0. 016 ( 0. 003-0. 029 ) , 0. 016 ( 0. 003-0. 030 ) , 0. 019 ( 0. 007-0. 032 ) , respectively. Conclusion The effect of increased 24?hour ambulatory SBP on CIMT was greater than the clinic SBP. Active monitoring of 24 h ambulatory blood pressure and maintaining a low level of blood pressure is essential for preventing and delaying atherosclerosis.

Objective To explore the relationship between different blood glucose levels and new carotid artery plaques.Methods A total of 5 440 participants met the inclusion criteria were selected stratified randomly from the 101,510 serving and retired workers of Tangshan Kailuan Company who participated the health examination from 2006 to 2007.The follow-up health examination were respectively preformed from 2010 to 2011 and from 2012 to 2013 which included carotid ultrasound for these 5 440 participants.The 5 440 participants were divided into three groups (ideal blood glucose group,impaired fasting glucose group and diabetic group) according to their fasting glucose levels in 2010-2011 examination.Multivariate Logistic regression analysis was used to analyze the risk factors of new carotid artery plaques.Results Among 5 440 subjects,participants whose FPG,ultrasound data incomplete and ultrasound detection of carotid plaques during the 2010-2011 health examination were excluded,then 3 084 participants were included in this study,among them,175 participants who did not participate the 2012-2013 health examination and 561 participants whose carotid plaque ultrasound data incomplete were excluded.Thus,a total of 2 348 participants were included in the present analysis.The total detection of new carotid artery plaque rate was 15.0％ (352/2 348) after 2 years of follow-up.The detection of new carotid artery plaque rate in normal glucose group(n =1724),impaired fasting glucose group(n=464) and diabetic group(n=160) were 14.2％(245/1 724),14.9％(69/464) and 23.8％(38/160),respectively.The diabetic group was higher than that of the ideal blood glucose group and the impaired fasting glucose group,the difference was statistically significant(P＜0.05).Impaired fasting glucose group and diabetic group had an increased risk of new carotid artery plaque compared with those in ideal glucose group(OR =0.924,95％CI 0.691-1.235 and OR =1.733,95％CI 1.107-2.713,respectively),the difference was statistically significant(P＜0.05).After adjusted for the other risk factors,with the risk-adjusted ratio (OR =1.117,95％CI 0.824-1.513 and OR =1.393,95％CI 0.872-2.226).Conclusion The detection of new carotid artery plaque increase in the diabetic group.However,after adjustment for other risk factors associate with emerging danger of new carotid artery plaque is no significant difference.This requires more long-term follow-up study of a large sample to be further confirmed.

目的 观察夫西地酸乳膏联合丙酸氟替卡松乳膏治疗湿疹的临床疗效及安全性.方法 通过随机数字表法将入选的102例湿疹患者随机分为两组,治疗组52例,用夫西地酸乳膏和丙酸氟替卡松乳膏交替外涂于皮疹处,间隔时间约为1h,早、晚各一次.对照组50例,单用丙酸氟替卡松乳膏外搽,疗程14d.结果 治疗组治疗第7天和第14天时有效率分别为50.00％为80.76％;对照组分别为46.00％和62.00％.仅治疗第14天时差异有统计学意义(P＜0.05).治疗过程中均未出现严重的不良反应,未经特殊处理均于1 ～5d消失.结论 夫西地酸乳膏联合丙酸氟替卡松乳膏治疗湿疹效果较好,且无明显不良反应.

OBJECTIVE To explore the impact of ideal health behaviors on the newly developed carotid plaques. METHODS A total of 5 852 employees (including retired employees from Tangshan Kailuan company) aged over 40 years were included in this study through stratified random sampling. Subjects with previous stroke, transient ischemic attack, myocardial infarction were excluded. Results from the unified questionnaire, blood biochemistry measurements and ultrasonography carotid artery measurements were analyzed. Present study analyzed the data from 2 372 participants without carotid plaques in 2010-2011 examinations. The newly developed carotid plaques in 2012-2013 health examinations were observed and multiple logistic regression analysis was used to explore the impact of ideal health behaviors and factors on the newly developed carotid plaques. RESULTS (1) There were 359 subjects with newly developed carotid artery plaques among the 2 372 subjects (15.1%), prevalence rate was 23.1% (43/186), 17.5% (186/1 065), 12.4% (122/986), 5.9% (8/135) in the groups with 0-1, 2-3, 4-5 and 6-7 components of ideal cardiovascular health behaviors and factors, respectively (P < 0.001). (2) Multiple logistic regression analysis showed that after adjusting for age, gender, high density lipoprotein cholesterol, heart rate, and high sensitive c-reactive protein, compared to with 0-1 components of ideal cardiovascular health behaviors and factors, participants with 4-5 and 6-7 components of ideal cardiovascular health behaviors and factors were associated with reduced risk of the newly developed carotid plaques, the OR (95% CI) values were 0.52(0.34-0.80) and 0.28(0.12-0.64), respectively. CONCLUSION Higher number of ideal cardiovascular health behaviors and factors is associated with lower incidence of newly developed carotid plaques.

剥脱性唇炎的确切病因和发病机制尚不清楚，临床上缺乏比较有效的治疗方法和药物。我们采用1％吡美莫司乳膏外用治疗剥脱性唇炎，获得了满意的疗效。

目的 探讨正常高值血压与新发颈动脉斑块形成的关系.方法 在参加2006-2007年度开滦集团健康体检的职工101 510人中分层随机抽取观察对象,按入选标准选取观察对象5440人组成研究队列,分别于2010-2011年和2012-2013年对观察队列进行随访健康体检,同时进行颈动脉超声检查.根据2010-2011年血压水平将观察队列分成3组:正常血压组、正常高值血压组、高血压组,并对新发颈动脉斑块的危险因素进行多因素Logistic回归分析.结果 在5440名观察对象中,排除2010-2011年超声检测发现颈动脉有斑块者,纳入本次研究3089人,其中未参加2012-2013年健康体检者175人,颈动脉斑块超声资料不完整者561人,最终纳入统计分析的有2353人.随访2年后,全部人群新发颈动脉斑块检出率为15.0％;正常血压组(n=618)、正常高值血压组(n=950)、高血压组(n=785)新发颈动脉斑块检出率分别为7.9％、15.5％、19.9％,差异有统计学意义(P＜0.05);进一步将正常高值血压组按不同血压水平分为正常高值血压1组(收缩压/舒张压120～129/80～84mm Hg)和正常高值血压2组(收缩压/舒张压130～139/85～89mmHg),调整其他危险因素后,正常高值血压1组、正常高值血压2组、高血压组新发颈动脉斑块的风险分别比正常血压组增加67.6％、73.4％和109.6％,其OR值分别为1.676(95％ CI1.145～2.454),1.734(95％00 CI 1.137～2.644),2.096(95％ CI 1.468～2.993).结论 随着血压水平的增高,新发颈动脉斑块的检出率增加.在正常高值血压阶段,新发颈动脉斑块的检出率已显著增加.

目的：对老年高血压动脉粥样硬化患者实施生活方式干预的效果进行分析与探讨。方法选取2012年1月～2014年9月在我院接受治疗的200例老年高血压动脉粥样硬化患者，以随机方式将其分为对照组与观察组，对照组患者实施常规护理，在常规护理基础上，对观察组患者实施生活方式干预。对两组患者动脉粥样硬化与血压控制情况进行分析与对比。结果干预后，与对照组相比，观察组患者收缩压（SBP）、舒张压（DBP）较低，且两组差异有统计学意义（P＜0.05），且观察组患者颈动脉内膜-中层厚度（IMT）与颈动脉斑块面积明显优于对照组患者，差异有统计学意义（P＜0.05）。结论研究表明，生活方式干预有助于改善高血压患者生活习惯，降低患者动脉粥样硬化度，提升控压效果，值得临床应用与推广。

Objective To evaluate the clinical value of segmental anterior cervical decompression with fusion on hyperextension injury of multilevel cervical spine.Methods A total of 26 patients with hyperextension injury of multilevel cervical spine were treated with segmental subtotal vertebrectomy and discectomy,fusion and internal fixation.All patients were regularly followed up.JOA scoring method was used to evaluate the nerve function improvement 3 months after operation;grafted bone fusion,deformity correction and complications were also observed.Results A total of 26 patients were followed up for 12 months to 24 months.Patients' functional status was improved in different degree.According to the Frankel grading system,there was 8 cases of grade A:2 cases didn't recover,2 cases recovered to grade B,2 cases recovered to grade C,2 cases recovered to grade D;there were 4 cases of grade B:2 cases recovered to grade C,1 case recovered to grade D and 1 case recovered to grade E;there were 6 cases of grade C,5 cases recovered to grade D,1 case recovered to grade E;there were 8 cases of grade D,7 cases recovered to grade E.Spinal cord function was not recovered in 2 cases,despite of significant alleviation of clinical symptoms such as pain and numbness.No complications such as pseudoarticulation formation,graft dislocation,screw and plates loosing or broken happened.Conclusion Segmental anterior cervical decompression with fusion for treating hyperextension injury of multilevel cervical spine can achieve effective spinal cord decompression,good nerve functional status,satisfactory fusion,and fewer complications.