目的 基于Joinpoint回归方法分析我国成人过去10年间肥胖在不同性别间的差异化流行趋势.方法 以《中国健康与营养调查》(CHNS)2006-2015年的4次横断面调查数据库为研究对象,通过Joinpoint回归方法分析男性和女性肥胖人群长期变化趋势,利用年度变化百分比(annual percent change,APC)描述长期变化趋势.结果 2006-2015年男性超重率从29.4％增长到36.5％,APC(95％CI)为2.5％(0.8％ ～4.3％)(P<0.05);女性超重率也呈现线性增长趋势,从2006年的28.3％增到2015年的33.3％,APC(95％CI)为1.9％(0.6％ ～3.2％),男性与女性APC比较无统计学差异(2.5％vs 1.9％,P=0.391).另外,2006-2015年男性肥胖率呈线性增长趋势(从7.3％增长到14.5％),APC(95％CI)为8.2％(4.5％ ～12.1％)(P<0.05);女性肥胖率也呈现线性增长趋势,从2006年的9.4％增长到2015年的14.6％[APC(95％CI)为5.2％(2.1％ ～8.4％),P<0.05];进一步比较分析男性和女性的APC,不同性别间没有统计学差异(8.2％vs 5.2％,P=0.131).结论 我国成人超重肥胖率在逐年增长,无论男性还是女性,我们都应该采取积极整合措施进行干预.

ObjectiveTo evaluate the long⁃term prevalence of hypertension in Chinese women based on the American College of Cardiology（ACC）and American Heart Association（AHA） hypertension guidelines and the "2010 Chinese hypertension guidelines".MethodsA total of 47 385 adult women were enrolled in nine cross⁃sectional surveys conducted by the China Health and Nutrition Survey（CHNS）from 1991 to 2015.Long⁃term trends in the prevalence of hypertension were analyzed.ResultsBased on the "2017 ACC/AHA hypertension guidelines"，the prevalence of standardized hypertension in Chinese women increased from 27.0%［95%CI（25.6%，28.4%）］ in 1991 to 51.8%［95%CI（50.1%，54.3%）］ in 2015（Ptrend<0.001）.Based on the “2010 Chinese hypertension guidelines"，the prevalence of standardized hypertension in women increased from 8.4%［95%CI（7.7%，9.1%）］ in 1991 to 24.1%［95%CI（23.1%，25.2%）］ in 2015（Ptrend<0.001）.However，the annual increase rate of hypertension among women based on the "2017 ACC/AHA hypertension guidelines" was significantly higher than that based on the "2010 Chinese hypertension guidelines"（P=0.001）.ConclusionsBased on the hypertension guidelines of China and the United States，the prevalence of hypertension in Chinese women has been increasing for a long time.However，according to the "2017 ACC/AHA hypertension guidelines"，the prevalence of hypertension among female adults in China was increasing at a higher rate.

目的:了解辽宁省肿瘤医院(以下简称"我院")曲妥珠单抗住院医嘱的用药合理性及药品不良反应发生情况,为临床合理用药提供参考.方法:通过我院PASS系统,选取2018年使用曲妥珠单抗的全部住院医嘱,进行回顾性分析;对医嘱中患者的性别、年龄和诊断进行汇总分析;评价曲妥珠单抗住院医嘱的用药合理性;对病例报道的不良反应进行分类汇总.结果:共收集2646条曲妥珠单抗住院医嘱,涉及495例患者,其中,女性患者483例(占97.58％),远多于男性患者(12例,占2.42％);>40～60岁患者居多(324例,占65.45％).2646条曲妥珠单抗住院医嘱中,乳腺癌患者医嘱居多(2525条,占95.43％),其次为胃癌患者(58条,占2.19％);不合理医嘱385条,医嘱不合理率为14.55％,主要为用法与用量不合理(309条,占不合理医嘱数的80.26％);曲妥珠单抗致不良反应440例次,均为常见不良反应,未发现严重不良反应.结论:我院部分曲妥珠单抗住院医嘱存在不合理情况,需基于处方点评制度进一步加强处方前置审核,提高药物合理应用水平;虽未发现曲妥珠单抗所致严重不良反应,但仍需加强不良反应的监测、上报制度,保障安全用药.

烟雾病是指双侧颈内动脉末端及大脑前、中动脉起始部动脉内膜缓慢增厚,动脉管腔进行性狭窄或闭塞,并伴有脑底异常血管网生长为特征形成的一组脑血管病.病因及发病机制尚不明确.但该病遗传学方面的研究正在大量开展,尤其是致病基因的鉴定及验证方面的研究.而研究发现微RNA、长链非编码RNA以及环状RNA等非编码RNA在烟雾病患者中呈现差异性表达,由此预测的靶基因及靶通路可能为该病发病机制的研究提供一定的理论基础,从而为该病的预防及治疗提供新的思路与方法.

Objective To investigate the effects of selective psychological intervention on cancerous fatigue and life quality of patients with breast cancer after operation.Methods A total of 110 patients with breast cancer who reveived surgical treatment in our hospital from September 2014 to December 2016 were randomly divided into observation group (n =55) and control group (n =55) accorded to random envelope lot method.The patients in control group were treated by conventional nursing care,however,the patients in observation group,on the basis of control group,were treated by selective psychological intervention,with a treatment course of 3 months for both groups.Results The incidence rotes of postoperative incision infection,subcutaneous effusion,upper limb edema,skin flap necrosis and other complications in observation group were significantly lower than those in control group (P ＜ 0.05).The levels of CD3+ and CD4+ on 3 months after operation in both groups were significantly higher than those on 1d after operation (P ＜0.05),moreover,which in observation group were significantly higher than those in control group (P ＜ 0.05).In addition the scores of behavior/severity,emotion,sensation,cognition/emotion in observation group were significantly lower than those in control group (P ＜ 0.05),moreover,the scores of somatization,compulsion,interpersonal relationship,depression and anxiety in observation group were also significantly lower than those in control group (P ＜ 0.05).Conclusion The application of selective psychological intervention in patients with breast cancer after operation can alleviate cancerous fatigue status,which can decrease incidence of complications,improve patient's immunity function so as to improve life quality and prognosis of patients,therefor,which provides a basis for further improving the psychological intervention of breast cancer.

Objective:To detect the expression level of miR-148b in AML,and to analyze the relationship be-tween the expression level and clinical data.Methods:40 patients with AML and 20 cases with non-malignant blood disease were collected.Expression level of miR-148b was detected by RT-PCR.Results:miR-148b was signifi-cantly decreased in AML patients compared with non-malignant hematologic disease control group.The expression level of miR-148b related to white blood cell count and the blast cells in bone marrow.In the comparison of thera-peutic effect,patients with relative lower expression of miR-148b showed higher recurrence rate than the group of pa-tients with relatively high expression of miR-148b(P=0.038).RFS difference was statistically significant in both groups(P=0.029).But there was no obvious difference among the complete remission rate and overall survival.Con-clusion:Expression of miR-148b was significantly lower in AML patients than control.The expression of miR-148b level has certain correlation with clinical data,and is of great significance for disease recurrence.

目的 分析2015—2017年辽宁省肿瘤医院麻醉药品的应用情况及变化趋势,为临床合理用药提供参考.方法 通过医院数据系统收集2015—2017年麻醉药品数据,对麻醉药品的消耗量、销售金额、用药频度(DDDs)、限定日费用(DDC)及药品排序比(B/A)等进行统计分析.结果 2015—2017年麻醉药品的销售总金额持续增长,盐酸羟考酮缓释片(40、10 mg)的销售金额增长远高于总金额增长速度,芬太尼透皮贴剂(8.4、4.2 mg)的销售量持续下降.羟考酮缓释片有替代芬太尼透皮贴剂的趋势.各麻醉药品DDC值2015年与2016年完全相同,2017年各麻醉药品DDC值均有所下降.B/A值接近1.00的麻醉药品有盐酸吗啡注射液、盐酸吗啡控释片、盐酸吗啡片(10 mg)、盐酸哌替啶注射液和阿片片.结论 2015—2017年辽宁省肿瘤医院麻醉药品在临床上的应用基本合理.

Objective To cultivate human leukemia cells (HL-60) which were transiently transfected either a miR-126 mimic or inhibitor,and then to characterize the proliferation and apoptotic behavior of the transfected leukemia cells.Methods The leukemia cell line was developed and RT-PCR was performed to evaluate miR-126 expression levels.An instantaneous plasmid tmnsfection technique was used to transfect cells with either the miR-126 mimic or inhibitor.CCK-8,FCM,and clone formation tests were performed to analyze the proliferative and apoptotic behaviors of the leukemia cells.Results Proliferation was significantly decreased in cells transfected with the miR-126 mimic for 0,24,48,and 72 hours (P ＜ 0.05).Specifically,the G1,S,and G2 phases were significantly inhibited (P ＜ 0.05),the late and early apoptosis (UR+LR) rate increased (P ＜ 0.05),and the average rate of colony formation was also significantly decreased (P ＜ 0.05).Additionally,proliferation was significantly increased in cells transfected with the miR-126 inhibitor for 0,24,48,and 72 hours (P ＜ 0.05).Specifically,the G1,S,and G2 phases were increased (P ＜ 0.05),the UR + LR decreased significantly (P ＜ 0.05),and the average rate of colony formation was significantly increased (P ＜0.05).Conclusion In HL-60 cells,miR-126 can inhibit proliferation and promote apoptosis;thus,miR-126 may play an important role in the occurrence and development of leukemia as a tumor-suppressor miRNA.

Objective To study the effect of betulonic acid on proliferation of human breast cancer MCF-7 cells and human cervical cancer C-33A cells.Methods MTT assay was used to observe the effect of BTA on growth of cell MCF-7 and cell C-33A in various concentrations for different time periods.Cell cycle and cell apoptosis of these cells were assessed by flow cytometry.Results MTT results showed that the IC50 on MCF-7 cells were (37.62±1.72),(27.32±0.99) and (19.19±0.90) μmol/L after being cultured for 24 h,48 h,and 72 h,while on C-33A cells they were (34.55±0.88),(27.20±1.03) and (16.74±0.79)μmol/L.BTA could significantly inhibit the proliferation of MCF-7 cells and C-33A cells in a dosage-and time-dependent manner (P<0.05).Flow cytometry analysis showed that BTA could induce MCF-7 cells arrest at S phase,and induce apoptosis,while it induced MCF-7 cells arrest at G1-S phase.Conclusion BTA can inhibit the proliferation of MCF-7 cells and C-33A cells;the change of cell cycle and apoptosis may be involved in the process of inhibition.

目的:探讨肌动蛋白结合蛋白细丝蛋白A(filamin A,FLNa)在肿瘤坏死因子α(tumor necrosis factor α,TNFα)调节支持(Sertoli)细胞屏障功能过程中发挥的作用.方法:体外分离培养20日龄大鼠睾丸支持细胞,用10 μg/L TNFα处理后测定跨上皮电阻(trans-epithelial electrical resistance,TER),反映屏障功能改变;Western blotting分析TNFα处理后FLNa表达水平变化;细胞免疫荧光或鬼笔环肽染色分别检测FLNa及微丝(F-actin)的定位改变;FLNa siRNA干扰后检测支持细胞屏障功能.结果:TNFα处理后TER值较对照组显著降低(P＜0.01); Western blotting结果显示TNFα处理组FLNa水平明显下降(P＜0.01);细胞形态学检测亦表明TNFα处理后FLNa及F-actin在支持细胞的分布有显著改变;TER测定结果表明FLNa经siRNA沉默后可降低血睾屏障(BTB)功能(P＜0.01).结论:FLNa可通过调节F-actin在支持细胞中的排布参与TNFα引起的BTB功能降低.

Objective To explore the changes of serum lipid of acute promyelocytic leukemia ( APL) treated by all-trans retinoic acid in combination with arsenic trioxide. Methods 49 hospitalized patients with acute promyelo-cytic leukemia who attained complete remission by using all-trans retinoic acid in combination with arsenic trioxide and then consolidated for two cycles were retrospectively analyzed. The index of serum lipid( serum triglycerides,serum to-tal cholesterol) were detected and statistical analysis was performed respectively before treatment,after complete remis-sion ( CR) ,at the end of the first and second cycle of combination consolidation treatment. Results After complete re-mission, no significant change was observed in the indexes of serum lipid (P>0. 05). At the end of the first cycle of combination consolidation treatment, the serum triglyceride and cholesterol increased (P<0. 05);and the indexes con-tinued to raise at the end of the second cycle of treatment (P<0. 01). Conclusion Patients with APL treated by AT-RA combined with ATO can lead to elevated blood lipids.

Objective To evaluate the morbidity,clinical manifestation,risk factors and prognosis of diffuse large B-cell lymphoma(DLBCL)patients with central nerve system(CNS)infiltration.Methods Clinical data of DLBCL patients with CNS infiltration between Jan 2005 and Jan 2012 were reviewed.Results Among 168 DLBCL patients,11 patients(6.5 ％)had CNS infiltration.ECOG scores ≥ 2,elevated lactate dehydrogenase(LDH)＞ 2 times of normal range and the involvement of ≥ 2 extranodal sites were clinical risk factors associated with CNS inflitration(x2 =11.6,4.61,3.92,all P ＜ 0.005).Median survival time after CNS infiltration was 4.5 months.Conclusion DLBCL patients with CNS infiltration are not rare,the patients demonstrate significantly bad prognosis.

Objective To investigate the expression and the correlation with clinical variables of miR126 in adult patients with acute myeloid leukemia. Methods The miR126 relative expression level was detected by TaqMan real-time quantitative PCR in bone marrow cells of 47 AML patients and 9 nomal subjects. The relation between miR126 and the corresponding clinical indexes such as the patients′ gender,age,peripheral blood,subtype classification and genotype was statistically analyzed. Results The relative expression level of miR126 in bone marrow in AML patients was higher than normal subjects,but the differences was not statistically significant(P>0.05). In AML patients,the expression of miR126 with M3 type was less than that in non-M3 type(P<0.05). The difference of expression level of miR126 in normal gene and the abnormal genes had no statistical significance(P>0.05). Expression level of miR126 in AML patients with genotypes of t(15;17)or PML/RaRa+ was less than that in AML patients with other genotypes(P<0.05);the expression level of miR126 was negatively correlated with the initial percentage of bone marrow blast cells(r =-0.352,P=0.018),but no correlation with peripheral white blood cell count,age or sex. Conclusion The expression of miR126 in M3 type with AML is less than that with non M3 patients,and expression of miR126 in patients with genotypes of t(15;17)or PML/RaRa+ is less than expression AML patients with other genotypes. The results suggest that miR126 can be used to differentiate between AML subtypes.

目的 通过研究染色体核型异常及其比例和临床表现的关系,探讨不孕不育及发育异常患者染色体异常机制及治疗方法的选择.方法 对2011年至2013年于中国医科大学附属第一医院门诊就诊的2 160例不孕不育患者及发育异常患者进行染色体R显带核型及临床分析.结果 2 160例不孕不育患者及发育异常患者中456例存在染色体异常,其中常染色体异常134例,占29.39％;性染色体异常322例,占70.61％ .结论 染色体异常是导致男女不孕不育及发育异常的重要因素之一,患者应积极进行遗传优生和产前诊断,以指导临床治疗.

Objective To assess the right ventricular function of pulmonary hypertension patients by sRT-3DE,and study the influence factors of right ventricular function.Methods A total of 25 inpatients with clinical diagnosis of pulmonary hypertension and sPAP≥40 mmHg estimated by echocardiography were included as case group,presence of left heart disease and congenital Systemic-pulmonary circulation shunt were excluded.A total of 25 healthy people were selected as control group.Conventional 2D-Echocardiography and sRT-3DE were performed in both groups and the offline workstation was used to obtain the right ventricular 2D and 3D parameters.Results In control group,The RVEDV was slightly larger than RVEDV(3.98± 6.93 mL,P 0.05),RVEF was slightly smaller than LVEF(3.34%± 5.7%,P 0.05),LVSV had no statistical difference from the RVSV.RVEDV,RVESV increased and RVEF decreased in case group compared with control group(P 0.01);RVSV had no significant difference with control group.3DRVEF was well correlated with FAC,TAPSE in case group(r 1=0.887,r 2=0.664,P 0.01).The RVEDV was positively correlated with sPAP(r =0.435,P 0.05);RVEF was negatively related with sPAP,RVEDV,RVESV and RVSV(r 1=-0.721,r 2=-0.692,r 3=-0.866,P 0.01;r 4=0.481,P 0.05).Conclusion The right ventricular volume and function can be well evaluated by sRT-3DE in both healthy people and pulmonary hypertension patients.Right ventricular volume increased and ejection fraction decreased in PH patient,which were correlated with the degree of pulmonary hypertension.

Objective To investigate left ventricular systolic function before and after operation in atriel septal defect(ASD)patients by real-time three dimensional echocardiography.Methods Thirty-two samples of complete secundum ASD patients with complete closure or repair of ASD patients(ASD group,preoperative and postoperative)and thirty normal subjects served as the control.Real-time three dimensional echocardiography(RT-3DE)was performed on all subjects to obtain and analyze parameters as follows:left ventricular end-diastolic volume(LVEDV),Left ventricular end-systolic volume(LVESV),Left ventricular stroke volume(LVSV),Left ventricular ejection fraction(LVEF).Results The LVEDV,LVESV,LVSV of the ASD patients before treatment were lower than that of the after treatment(P<0.05),but LVEF had no significant difference(P>0.05).After treatment the LVEDV,LVESV,LVSV,LVEF had no significant difference between the ASD group and the NOR group(P>0.05).Conclusions The volume of left ventricular in ASD patients decrease,but systolic function is normal.The volume of left ventricular in ASD patients are recoverd after treating.RT-3DE has an unique advantage in the evaluation of the left ventricular volume and systolic function.

Objective To assess the changes of left ventricule and analyze the influential factors in pulmonary hypertension (PH) by comparing the changes of left ventricular volume and function using single cardiac cycle real-time three dimensional echocardiography ( sRT-3DE ) and two-dimensional echocardiography (2DE).Methods In case group,there were 30 inpatients diagnosed as PH,systolic pulmonary artery pressure(PASP)≥40 mmHg estimated by echocardiography,excluding left heart disease or congenital systemic-pulmonary circulation shunt.There were 30 healthy people as control group.Conventional 2DE and sRT-3DE were performed in both groups and obtained 2D and 3D parameters.Results ①In case group,the 2D-LVEF were significantly larger than 3D-LVEF (P ＜ 0.01 ).There was less agreement of 2DE and 3DE in case group than in control.②Comparing with the control group,left ventricular EDV,ESV and SV in ease group decreased ( P ＜0.01 ),so as to 3D-LVEF ( P ＜0.05).The left ventricular spherical index(SIs,SId)and eccentric index (EId,EIs ) in case group were significantly larger than those in control group ( P ＜0.01 ).③LVEDV in case group was negatively correlated with PASP (r =- 0.47),and positively correlated with RVSV and RVEF ( r =0.84,0.66) ;3D-LVEF in case group was negatively correlated with PASP ( r =- 0.54),and positively correlated with RVSV and RVEF ( r =0.58,0.53); there was no significant correlation between LVEDV and RVEDV.LVEDV was negatively correlated with SIs and SId ( r =-0.65,-0.61),so as to EId and EIs ( r =-0.67,0.67).LVEF was negatively correlated with SIs and SId ( r =-0.64,-0.61),so as to EId and EIs ( r =-0.66,-0.68),and the corresponding P all above were less than 0.01.Conclusions PH can result in reductions of left ventricular volume and systolic function,and the variations of which have the correlations with the severity of PH and the increase in SI and EI.sRT-3DE can provide a method to get more accurate information of left ventricle.

<正>患者男,31岁,以"心脏杂音2个月"入院。体格检查:于胸骨左缘第二、三肋间可闻及2/6级收缩期吹风样杂音。常规二维心脏超声检查(图1):房间隔中部中断34 mm,多普勒探及左向右分流,分流峰速0.8 m/s,右心增大(右心室内径:36 mm,右心房面积:61 mm×53 mm),肺动脉内径增宽(32 mm)。左心房内可见隔膜回声,将左心房分为真房、副房,肺静脉均回流

目的 探讨重性抑郁障碍(MDD)氟西汀疗效及不良反应与5-羟色胺转运体启动子区基因多态性(5-HTTLPR)的关系.方法 选取符合美国精神障碍诊断与统计手册第4版(DSM-IV)重性抑郁障碍诊断标准的89例患者为研究对象.给予氟两汀治疗6周.利用聚合酶链反应(PCR)多态性技术检测5-HTTLPR多态性.结果 不同基因型患者组之间治疗后HAMD总分减分率的差异有统计学意义(P<0.005),L/L基因型组的减分率高于另两种基因型组;有效组和无效组之间、有无恶心不良反应组之间的5-HTTL-PR的基因型和等位基因频率的差异均有统计学意义(P<0.05),L/L基因型组的疗效和恶心发生率高于另2组.结论 5-HTTLPR基因多态性可能与氟西汀抗抑郁疗效及其恶心不良反应相关.

<正> 目的探讨 BCR/ABL(P210型)融合基因的检测对白细胞升高性疾病诊断、鉴别诊断的重要意义。方法采外周血用 RT-PCR 的方法检测首诊于中国医科大学附属第一医院内科,血常规提示白细胞升高大于10.0×10~9/L60例患者的(BCR/ABL P210融合基因),其中男38例、女22例,年龄从16岁到86岁,中位数年龄30岁。正常对照20