目的:了解黑龙江省中老年人慢性病患病情况及影响因素,提出改善黑龙江省中老年人健康状况的建议和对策.方法:采用便利取样法对黑龙江省45周岁及以上中老年人进行问卷调查,运用SPSS17.0进行x2检验和二元Logis-tic回归分析.结果:黑龙江省中老年人两周患病率为48.0％,慢性病患病率为44.1％;患一种慢性病的人数占调查总人数的30.4％,患两种慢性病的人数占调查总人数的10.0％,患三种及以上慢性病的人数占调查总人数的3.9％;排名前三位的慢性病分别是高血压、糖尿病和脑血管病;年龄(P＜0.05)、文化程度(P＜0.05)、自评健康状况(P＜0.05)是影响慢性病患病的主要因素.结论:加强形式多样的健康教育,提升健康意识;对不同年龄人群分层管理,防治结合事半功倍;完善社区卫生服务,精准靶向指导高危人群,以延缓或减少慢性病患病,提高生命质量.

老年人作为当今社会的一个特殊群体,在生理和心理上与其他年龄段人群有着显著的差异.老年人的健康状况和其他年龄段人群相比较差,由此导致了老年人卫生服务需求较大.在老龄化视角下对老年人卫生服务需求现状及影响因素进行文献综述,并从经济因素、人文关怀以及健康意识等方面完善相应对策,以实现健康老龄化.

目的:调查慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者接种流感疫苗的现状,评价COPD患者接种流感疫苗的获益情况.方法:选取192例用药相似的COPD患者,脱落2例,接种组118例,对照组72例,人组前对患者过去1年基本状况进行问卷调查,接种后对患者进行为期1年的随访调查.结果:COPD患者流感疫苗接种率仅5.21％,74.17％的患者不知道有流感疫苗,17.58％患者不知道去哪接种疫苗.接种流感疫苗不良反应发生率仅0.52％.接种组患者接种流感疫苗前后1年相比较,年急性发作次数、年急性期病程、年住院次数、年住院天数、年门诊次数、年门诊天数、住院率均有明显改善,差异有统计学意义(P＜0.05).接种组与对照组相比较,年急性发作次数、年急性期病程、年住院次数、年住院天数、年门诊次数、年门诊天数、住院率均有明显改善,差异有统计学意义(P＜0.05),两组在观察前,肺功各项指标无显著差异(P＞0.05);接种流感疫苗1年后,两组肺功能各项指标无显著差异(P＞0.05).结论:COPD患者接种流感疫苗接种率较低.COPD患者接种流感疫苗安全有效、可多方面获益,短期接种疫苗对肺功能无改善.

目的 研究流感疫苗对慢性阻塞性肺疾病(COPD)患者肺功能的影响.方法 选取192例平时用药相似的COPD患者,有2例脱落,接种组118例接种流感疫苗,对照组72例,入组前和每年均测定肺功能,观察3年.结果 COPD患者接种流感疫苗不良反应发生率仅0.85％.接种流感疫苗第1年和第2年,肺功能与对照组差异无统计学意义.接种流感疫苗第3年,接种组与对照组肺功能相比:深吸气量(IC)分别是(1 812±215)mL与(1 630±202) mL(P＜0.05),用力肺活量(FVC)分别是(1 805±199)mL与(1 624±185)mL(P＜0.05);对照组肺功能与入组前相比:IC分别是(1 779±216) mL与(1 630±202) mL (P＜0.05),FVC分别是(1 798±200)mL与(1 624±185)mL(P＜0.05).结论 接种流感疫苗安全,长期接种流感疫苗对COPD患者肺功能有益.

念珠菌血症病死率高达45％～75％〔1〕，真菌早诊断，早治疗，有助于降低患者的死亡率。寻找一种快速、敏感、特异的早期预测深部真菌感染的方法极其重要。本研究探讨白色假丝酵母菌感染的早期临床诊断。

Objective:To discuss clinical effect of shenxiong gluose injection on patients with middle and serious Chronic Obstructive Pul -monary Disease ( COPD) .Methods:A randomized controlled clinical trail was conducted in patients with COPD .Shenxiong gluose group were treated by shenxiong gluose injection and contrast group were treated by 5 percent gluose injection .Clinical effect , pulmonary func-tion examination and blood gas analysis were done .Results:After third therapy course , shenxiong gluose group significantly provided im-provement with Po2 and Dlco, and averagely increased 21.4mmHg、22.7mL/min/mmHg respectively.Improvement rate:Shenxiong glu-ose group was 22.7%VS contrast group was 0(P﹤0.05).Corruption rate:Shenxiong gluose group was 4.55%VS contrast group was 12%(P﹤0.05).Conclusion:Shenxiong gluose injection could significantly increase improvement rate and decrease corruption rate, it could improve lung diffusion function and hypoxia status in patients with COPD at certain courses.

Objective To investigate the effect of Shenxiong glucose injection on transforming growth factor-β1 (TGF-β1) in airway of middle and serious chronic obstructive pulmonary disease (COPD).Methods A total of 64 patients with middle and serious COPD were divided into Shenxiong glucose group (42 cases) and control group (22 cases) by random digits table method.Conventional therapy of COPD was given in two groups.The patients in Shenxiong glucose group were treated by Shenxiong glucose injection and the patients in control group were treated by 5 percent glucose injection for 3 courses.TGF-β1 was measured before treatment and after each course in two groups by enzyme linked immunosorbent assay.Results There was no significant difference in TGF-β1 level of phlegm before treatment between two groups [(95.4 ± 8.1)μg/L vs.(94.8 ± 7.5) μg/L,P ＞ 0.05].TGF-β1 level of phlegm was decreased after 1 course [(85.5 ± 5.2)μg/L] compared with that before treatment in Shenxiong glucose group,but there was no significant difference (P ＞ 0.05).TGF-β1 level of phlegm was decreased after 2,3 courses [(61.5 ± 5.8),(49.1 ± 4.5)μg/L] compared with that before treatment,which was lower than that in control group [(89.6 ± 6.2),(91.2 ±6.2) μg/L],and there was significant difference (P＜ 0.05).There was no significant difference in TGF-β1 level of phlegm after 1,2,3 courses in control group,compared with that before treatment (P ＞0.05).The adverse reaction (including liver and kidney dysfunction) was not found in Shenxiong glucose group.Conclusion Shenxiong glucose injection has significant effect on TGF-β1 level of phlegm in patients with COPD at certain courses,and improve airway remodeling in patients with COPD at certain courses.

Objective To investigate the trend of drug-resistance bacterial in hospital.Methods 6202 strains of bacteria were isolated from various types of patients.Antimicrobial susceptibility tests were performed by Kirby Bauer methods and the results were analyzed according to the standards recommended by CLSI(2010 edition).Results Compared with 2010,cocco bacteria increased to 19.41%(P<0.005),enterococcus faecalis decreased to 9.28%(P<0.025),and MSCON decreased to 4.4% in 2011(P<0.05).The top three of cocco bacteria,which didn′t change compared with last year.Bacilus decreased to 80.59%,but acinetobacter increased to 21.66% in 2011(P<0.005).The top three of bacilus were acinetobacter,ESBLs(-),klebsiella pneumoniae and ESBLs(+) klebsiella pneumoniae.The top three of fungus didn′t change,which were candida albicans,smooth false candida and aspergillus.Conclusion The monitoring and management of antibiotics use should be strengthened further in hospital,which has important value for the monitoring and analysis of bacterial and rational antibiotic application.

Objective To observe the quantities of interleukin-8 (IL-8)and tumor necrosis factor alpha(TNF-α)in sputum in patients with pulverization of asarone injection combined with routine methods in acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods 154 patients with AECOPD were divided into two groups randomly. In the combined group, we added pulverization of asarone injection in the treatment. The quantities of IL-8 and TNF-α in sputum were tested by ELISA.Results The quantities of IL-8 of routine methods group increased significantly compared with that of the combined group(3.081 2±0. 378 1 vs 1. 246 6±0. 604 9, P ＜0.05). The quantities of TNF-α of routine methods group increased significantly compared with that of the combined group(0. 205 5 ± 0. 516 6 vs 0. 115 2 ±0.073 4, P ＜ 0.05). Conclusions On the basis of routine treatment, combined with pulverization of asarone injection can remarkably reduced the quantities of IL-8 and TNF-α in AECOPD.

目的 探讨茶多酚对人结肠癌细胞(SW-480)凋亡的影响.方法 用MTT方法观察茶多酚对结肠癌细胞增殖的影响,在光镜及电镜下观察细胞结构的变化.结果 茶多酚对SW-480细胞株有明显的抑制作用,且与浓度和作用时间呈正比;在光镜下可见SW-480细胞在茶多酚作用后呈梭形和圆形,细胞松散分布,部分圆形细胞内颗粒增多.电镜下加入茶多酚后,细胞大小不一,核异型性不明显,有细胞凋亡崩解,核偏于一侧,胞质内有丰富游离核蛋白体,线粒体嵴粗大;可见凋亡细胞及凋亡小体,同时可见部分细胞呈坏死改变.结论 茶多酚能够在体外抑制结肠癌细胞凋亡.

Objective: To study the effects of the nuclear factor kappa B(NF-kB) in the endothelin-1(ET-1) expression in the PASMCs of rats under hypoxia.Methods: 28 male Wistar rats were selected and their PASMCs were isolated and incubated at normal situation or under hypoxia for 48 hours.The ET-1 level in the supernatant was detected by ELISA.RT-PCR was used to investigate the mRNA expression of ET-1 in the PASMCs.The IkB,which is the most prominent indicator of activation of NF-kB,was detected by Western blotting in the PASMCs.The inhibitor of NF-kB(10uM),PDTC,was added to the culture to investigate the effect of it on the expression of ET-1.Results: The ET-1 expression can be induced significantly in the hypoxia situation.The inhibitor of NF-kB can decrease the expression of ET-1 induced by hypoxia.The IkB expression decreased significantly under hypoxia.Conclusion: The expression of ET-1 increased obviously in the PASMCs under hypoxia,which may participate in the pathological events of the PASMCs in the hypoxia situation and contribute to the activation of NF-kB signal pathway.So inhibiting NF-kB activation could be a new therapy for pulmonary artery hypertension induced by hypoxia.

目的通过对569例晚期肺癌死亡病例分析,讨论生存期与不同年龄组以及疾病是否转移之间的关系,对宁养院收治病人的范围、病程和年龄提供依据.预测疾病生存率,对癌症病人临终期的研究提供参考.方法对接受过宁养服务自然死亡的全部晚期癌症病例,计算各癌症、各年龄段的中位生存期、平均生存期和预期生存率.结果(1)经宁养院服务的肺癌病人平均中位生存期54.92天,预期生存率(1周预期生存率为47.10%,5周预期生存率为10.19%,10周预期生存率为1.58%);(2)不同年龄段的中位生存期(天):＜30:77.00,30-:42.50,40-:62.00,50-:58.25,60-:54.75,70-:50.00,80-:88.00,提示小于30岁和80岁以上年龄组中位生存期较长;(3)癌症无转移与有转移的病例之间中位生存期经时序检验有显著差异.结论所有检验均采用双侧检验,比较客观反映生存期情况,对各种疾病的临终期提供参考.

目的观察芬太尼透皮贴剂治疗中度癌痛病人的效果,为恰当选择使用芬太尼透皮贴剂的时机提供临床依据.方法2003年3月～12月在哈尔滨医科大学附属肿瘤医院宁养院接受宁养服务的中度癌瘤患者108例,单中心开放试验给药,自身对照方法进行研究,观察周期28天.结果符合入组标准患者108例,其中完成15天连续用药患者98例,治疗前疼痛评分平均为5.2173±0.3185,第15天为0.9184±0.7822,其中79.6%的患者达到基本无痛,其他患者仅有轻度疼痛,从平均用药剂量及疼痛评分变化曲线图可以发现,疼痛强度很快下降,而平均药物剂量增长缓慢,尽早给癌痛患者进行规范化的疼痛处理,相对较低的剂量即可取得良好镇痛效果.结论芬乙太尼透皮贴剂可以安全用于中度癌痛的治疗.我们认为最佳使用时机为:常规一、二阶梯镇痛药物效果不满意,疼痛评分在4～6分以上即可使用,尽早减轻疼痛,提高患者的生活质量.