Objective: From the evaluation of TCM constitution, to investigate the effect of adjustment of the TCM biased constitutions to improve the condition of impaired glucose regulation(IGR) by individual comprehensive intervention. Methods: 60 IGR patients participated in the examination from April 2009 to April 2012 were randomly divided into intervention group and control group, all patients were assessed by questionnaires of TCM constitution. The intervention group took individual interventions to adjust its biased constitution, the control group received conventional health guidance. After 3 months, the changes of body mass index(BMI), blood pressure(BP), fasting plasma glucose(FPG), 2 hour postprandial blood glucose(2h BG) and glycosylated hemoglobin(Hb A1c) were observed and compared with 3 months ago. Results: compared with before intervention levels of FPG, 2h BG in intervention group were decreased after intervention(P0.01). The intervention group was better than control group(P0.01). Conclusion: The TCM biased constitutions could be adjusted through diet, exercise or other lifestyle and individual TCM constitution intervention, which could reduce the blood glucose in IGR patients, and was helpful in improving the prognosis of IGR patients, achieving the purpose of effective prevention and control of type 2 diabetes mellitus.

随着人们健康意识的不断提高,健康体检越来越受到重视.如何科学地进行健康体检?如何合理地选择健康体检项目?如何正确地解读健康体检报告?如何有效防控慢性病的发生发展?本文将一一为您解答. 健康体检的概念 健康体检是指以健康为中心的身体检查,区别于以疾病为中心的医疗性体检.中华人民共和国卫生部2009年8月5日颁布的《健康体检管理暂行规定》中提出:“健康体检是指通过医学手段和方法对受检者进行身体检查,了解受检者健康状况,早期发现疾病线索和健康隐患的诊疗行为.

目的:通过测量未安装和已安装DAVID系统两种情况下加速器射束的参数,分析DAVID系统对射束的影响。方法:西门子ARTISTE直线加速器,配备160叶多叶光栅,选择6 MV的X线。多丝电离室（DAVID）,型号为T34084。利用三维水箱、半导体探测器等仪器测量未安装和已安装DAVID系统两种条件下PDD、profile、TPR20/10和水下5 cm吸收剂量,分析DAVID系统对加速器射线束PDD、平坦度、对称性、射线质的影响,并计算出DAVID系统的衰减系数。结果:无和有DAVID两种条件下,5 cm×5 cm、10 cm×10 cm和20 cm×20 cm三个射野R100偏差在0.6 mm~1.3 mm,R80偏差在0.13 mm~0.66 mm,R50偏差在0.38 mm~1.12 mm;40 cm×40 cm的射野R100、R80和R50的偏差分别为3.12 mm、3.31mm和2.04 mm;QI的偏差分别为0.0020、0.0045、0.0101、0.0061;x和y方向平坦度偏差在0.10%~0.58%,对称性偏差在0.04%~0.26%;TPR20/10的偏差0.002。射线穿过DAVID,使剂量衰减了7.67%。结论:DAVID系统的复杂结构和材料对6MV的X射线束的PDD、对称性、平坦度和TPR20/10影响甚微,最主要的是射线经过DAVID系统造成了剂量的衰减。

目的探讨经导管动脉化疗栓塞(TACE)联合射波刀治疗肝癌的临床效果。方法分析收治的肝癌患者80例临床资料进行分析,依据治疗方式不同进行分组,对照组(单纯TACE治疗组)40例和观察组(TACE联合射波刀治疗组)40例。对比观察两组疗效。结果观察组肝癌患者生活质量评分和临床治疗总缓解率均优于对照组,差异有显著性(P<0.05)。结论 TACE联合射波刀治疗肝癌可以明显改善患者生活质量,提高临床疗效。

Objective G4 cyberknife system adopts five tracking modes aiming at tumors of different parts,and uses the phantom to verify the geometric targeting accuracy,which provides proofs for clinical care.Methods GE 64-slice spiral Computerized Tomography(CT) was used in our hospital to acquire the images of head and neck phantom,synchrony phantom and X-sight lung tracking phantom;these images data were transmitted to the data server of the cyberknife data management system(CDMS),and treatment planning system(TPS) was planned and devised.The phantom equipped with EBT2 film was placed on the treatment couch to carry out the phantom planning,and the film was took out after the phantom planning was completed,then the accuracy of radiation was calculated by using E2E software to analyze the accuracy of 6D skull tracking,X-sight spine tracking,Fiducial tracking,Synchrony tracking and X-sight lung tracking.Results The accuracy of 6D skull tracking,X-sight spine tracking,fiducial tracking,synchrony tracking and X-sight lung tracking was 0.47 mm,0.74 mm,0.49 mm,0.77mm and 1.05 mm in turn.Conclusion The accuracy of G4 cyberknife is less than 0.9 mm for fixed objectives and less than 1.5 mm for motive objectives,which thus shows this high accuracy can fully meet the demands of stereotactic radiosurgery(SRS) and stereotactic radiotherapy(SRT).

目的通过分析2009-2010年度北京市行政管理人员健康体检人群中血脂异常人群的流行病学状况,探讨行政管理人员中血脂异常人群中西医健康管理模式的可行性与实践应用。方法对我院2009-2010年度我院体检的行政管理人员人群5706例,使用横断面调查的方法对血脂异常的发病情况以及与体重指数、血压、血糖的发病情况进行研究分析。结果行政管理人员体检人群中共检出血脂异常者1633人,患病率为28.62%,女性患病率为17.58%,男性患病率为33.14%。年龄分布以50-69岁为主。男性组30岁起、女性组50岁起血脂异常检出率明显升高,男性血脂异常患病率除70岁以上年龄组外均高于女性,除60岁以上年龄组外差别均有统计学意义(P<0.05)。血脂异常人群多同时伴有高血糖、高体重指数、高血压。结论北京市行政管理人员人群中血脂异常发病率较高,中青年男性是血脂异常发生的主要人群,并多伴有高体重、高血压、高血糖的发生。应用中西医结合的健康管理模式对血脂异常早期干预具有重要意义,除了对体重的控制外,还应同时对高血压、高血糖等综合干预以早期预防心脑血管疾病的发生。

To observe the effects of Xiaopiyishen Herbal Extract Granule (XPYS-HEG) on the quality of life in people with fatigue-predominant subhealth (FPSH) and liver-qi stagnation and spleen-qi deficiency syndrome, the participants were allocated randomly to the treatment group (XPYS,n=100) and the control group (placebo,n=100) in this study. The study period was 18 weeks (6 weeks for the intervention and 12 weeks for followup). The results show that there were no differences between the two groups for the scores of eight factors on the SF-36 (Chinese version of the SF-36 universal quality-of-life scale) at baseline. Compared with the baseline score, intervention with XPYS-HEG led to a significant increase in scores for the factor of bodily pain at the end of the 6th week. Compared with the score at the end of the 6th week, the score for the factor of mental health in the XPYS group significantly increased at the end of the 18th week. Therefore, XPYS-HEG could partially improve the quality of life for people with FPSH and liver-qi stagnation and spleen-qi deficiency syndrome, which can ease bodily pain, stimulate a positive mood, and ease a negative mood.

Objective:To study the correlation between traditional Chinese medicine(TCM) constitution and essential hypertension(EH) in civil servants.Methods:A total of 3700 civil servants participated in the examination were randomly sampled from 2010 to 2011,Questionnaire on TCM constitution was performed in 174 cases of EH for clinical investigation according to the classification method of"classification and determination of constitution in TCM".And the comparative Study of the relevant factors on phlegm-dampness constitution and non-phlegm-dampness constitution of EH was done.Results:Phlegm-dampness constitution was the most biased constitution in the civil servants crowd of EH(21.84%).Phlegm-dampness constitution BMI was significantly higher than that of non-phlegmdampness constitution,and Phlegm-dampness group HDL was significantly lower than that of non-Phlegm-dampness group,the difference was statistically significant(P < 0.01).Conclusion:Phlegm dampness constitution is the main risk factor in civil servants of EH.High weight is a major cause of EH phlegm-dampness constitution.The intervention for Phlegm-dampness constitution of EH is mainly through the management of the index weight of health,so as to effceively prevent the cardiovascular and cerebrovascular diseases.

目的通过研究健康体检中高血压的发病情况及主要危险因素,探讨中医体质干预在健康管理中的应用模式。方法随机抽取2010年度健康体检者3700例,使用横断面调查的方法对不同性别、年龄段高血压病患病状况以及与性别、年龄、腰围、体重指数的相关性,分析了高血压发病的主要危险因素,并对174例进行中医体质评估分析。结果共检出高血压1029人,患病率为27.81%,男性患病率为31.02%,女性患病率为20.69%。高血压患病率有随年龄增加而增高的趋势。超重、肥胖、中心性肥胖、痰湿体质者高血压检出率显著高于正常者。结论健康体检中超重、肥胖、中心性肥胖、痰湿体质是高血压患病的主要危险因素。采用中医体质干预方案结合健康管理的模式,可全面控制高血压危险因素,提高干预效果,有效预防心脑血管疾病的发生。

目的通过对北京市公务员人群健康体检中高血压的发病状况及相关危险因素的分析,探讨我院高血压人群健康管理的干预模式。方法在我院2010年度健康体检者中随机抽取3700例,使用横断面调查的方法对不同性别、年龄段高血压病患病状况以及性别、年龄、腰围、臀围、空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、体重指数(BMI)、血尿酸(UA)等危险因素进行研究,以期为北京市公务员高血压病的健康管理工作提供依据。结果随机抽取的3700例体检者,检出高血压病者1029人,患病率为27.81%,男性患病率为31.02%,女性患病率为20.70%。高血压患病率有随年龄增加而增高的趋势,在30～49岁组开始明显增高。男性高血压患病率除70岁以上年龄组外均高于女性。超重、肥胖、中心性肥胖者高血压检出率显著高于正常者。Logistic回归结果显示年龄增高、BMI增高、中心性肥胖、高血糖、高TG、高尿酸是高血压病的危险因素。结论健康体检中超重、肥胖、中心性肥胖、高血糖、高TG、高尿酸是高血压病的主要危险因素。采用中西医结合的健康管理模式,除了控制体质量外,还应重点对中心性肥胖人群及其他高血压危险因素进行综合干预以预防心脑血管疾病的发生。

目的 探讨高尿酸血症(HUA)与性别、体重指数(BMI)、血糖(Glu)、血脂之间的关系,为HUA的健康管理提供科学依据.方法 以2010年来我院健康体检的20 103人为研究对象,对该人群的性别、血尿酸(UA)、Glu、血脂等检查结果进行统计分析,采用身高体重电子测量仪测量身高、体质量,计算BMI;清晨空腹常规静脉采血,检测UA、TC、TG、HDL、LDL和Glu.结果 HUA组和正常尿酸组在性别、BMI分布及Glu异常、血脂异常的发生率上差异均有统计学意义(P＜0.01).HUA组UA水平、BMI、Glu水平、TC、TG、LDL水平均明显高于正常尿酸组,HDL水平则明显低于正常尿酸组,各组间差异均有统计学意义(P＜0.01).结论 男性更易发生HUA,且HUA患者比尿酸正常人群更易发生超重、肥胖、Glu及血脂代谢异常.

[Objective] To explore the fatigue characteristics in people with fatigue-predominant sub-health based on TCM syndrome.[Methods] Referring to related standards of TCM,the differentiations of TCM was performed and in accordance with the definite principle the differentiated results were classified.Using self-evaluating criteria(FSAS) the fatigue degree for fatigue was quantified in each patient with fatigued sub-health status.Fatigue was assessed in all of people using fatigue self-assessment scale and fatigue characteristics were analyzed among different people by statistics software.[Results] In addition to physical fatigue factor score,fatigue consequences factor score,and other factors scores are different among different people based on TCM syndromes(P<0.05).[Conclusion] 1)Different people with fatigue-predominant sub-health based on different TCM syndromes have different fatigue characteristics.2)Physical fatigue,mental fatigue and total fatigue are more obvious in liver-Qi stagnation and spleen-Qi deficiency in TCM than in other syndromes.Mental fatigue,total fatigue,fatigue consequences are less obvious in Yin deficiency syndrome than in other syndromes.3)It is most obvious that sleep or rest cannot reduce fatigue in Yang-qi deficiency syndrome.The characteristics of fatigue on situation specificity is most obvious in liver-Qi stagnation.

Objective:To explore the correlation between the fatigue and the basic physical fitness in cases with sub-health of fatigue type and the TCM syndrome pattern of liver-qi stagnation and spleen-qi deficiency.Methods:200 cases with sub-health of fatigue type and the TCM syndrome pattern of liver-qi stagnation and spleen-qi deficiency were chose from the three hospitals in Beijing,Henan and Liaoning,and their fatigue and the basic physical fitness and cognitive function were measured with Fatigue Self-assessment Scale(FSAS)and GMCS-2 type physical detector separately.Results:The factors of FSAS were positive correlation to height and weight and cognitive function;the mental fatigue,the consequences of fatigue and the fatigue scores were significantly negative correlation to vital capacity and the step test;the fatigue response after sleep /rest and the situations sensitive were significantly negative correlation to vital capacity;all factors were significantly positive correlation to cognitive function.Conclusion:The fatigue state in cases with sub-health of fatigue type and the TCM syndrome pattern of liver-qi stagnation and spleen-qi deficiency may cause the significant negative effect of the basic physical fitness.

目的本文通过对我院2009年度健康体检人群中高脂血症的发病情况及伴发疾病的相关性研究,探讨了我院高脂血症人群健康管理的干预模式。方法在我院2009年度健康体检者中随机抽取5999例,使用横断面调查的方法对不同性别、年龄段高血脂分类检出率以及与体重指数(BMI)、血压、血糖的发病情况进行相关性研究。结果共5706例资料齐全者进入调查,检出高脂血症1633人,患病率为28.62%,男性患病率为33.14%,女性患病率为17.58%。年龄分布以50～69岁为主。男性组30岁起、女性组50岁起高脂血症检出率明显升高,男性高脂血症患病率除70岁以上年龄组外均高于女性,除60岁以上年龄组外差异均有统计学意义(P<0.05)。BMI、空腹血糖、舒张压、性别、年龄与高脂血症的发生密切相关。结论健康体检中高脂血症与高BMI、高血压、高血糖的发生密切相关。采用中西医结合的健康管理模式,除了控制体质量外,还应同时对高血压、高血糖等进行综合干预以预防心脑血管疾病的发生。

目的本研究旨在对我院2009年体检人群中代谢综合征(MS)及其主要组分相关性的调查分析,并基于我院现行的健康管理模式,进行了针对MS的健康管理方案的探讨和研究。方法对2009年在我院进行体检和健康管理的企事业单位及退休人群6000例个体进行横断面调查。根据国际糖尿病联盟2004年推荐的有关中国人MS的标准,对样本进行了MS诊断、MS患病率调查、MS与其各组分分别按年龄段、性别和腹型肥胖分组后的相关性分析。结果本次调查数据中有一项即M1的比例为30.1%(符合MS仅1项升高例数/总样本量),两项并存即M2比例为26.9%(两项升高例数/总样本量),3项以上MS为15.2%(3项及3项以上例数/总样本量),共909例,其中男性777例(18.4%),女性132例(7.4%)。全数据分析中,MS、超重、高血压、高血糖、HTG超标5项指标的患病率男性均高于女性;MS老年组有多项指标均高于其他各组;中心性肥胖与MS其他组分的相关性分析发现,中心性肥胖患者伴随着超重、TG超标、高血糖的组分的高患病率,且具有相关性(P<0.05),存在显著性差异。结论本次调查研究中,北京市公职人员及退休人员的MS患病率较高,并且肥胖和超重在各年龄段的占有比例明显高于其他组分。

目的探讨高尿酸血症与脉搏波传导速度的相关性,为早期发现和干预动脉硬化相关危险因素提供科学依据。方法选择2009年1月至2009年12月在我院健康体检部体检发现的高尿酸血症患者300例为观察组,以年龄、性别匹配的血尿酸正常者300例作为对照组,检测踝臂脉搏波传导速度(brachial-ankle Pulse Wave Velocity,baPWV),比较2组baPWV的变化,分析高尿酸血症与动脉弹性的相关性。结果高尿酸血症组和正常尿酸组比较,2组的臂踝脉搏波传导速度有显着差异,高尿酸血症组的臂踝脉搏波传导速度较正常血尿酸组明显升高,差异有统计学意义(P<0.05)。结论高尿酸血证与脉搏波传导速度呈高度正相关,即血尿酸越高,脉搏波传导速度越快,动脉僵硬度增加。提示高尿酸血症可能是独立于传统心脑血管危险因素以外新的危险因素,应注重早期干预与治疗。在健康体检中定期检测脉搏波传导速度,可对防治心血管疾病起到提前预警作用。

BACKGROUND:The demand for effective intervention for subhealth conditions is growing with increasing numbers of people being in a state of subhealth with a poor quality of life. Future research and evaluation of the treatment methods for subhealth conditions from the perspective of traditional Chinese medicine (TCM) may provide an important direction for developing effective management of these conditions.OBJECTIVE:To evaluate the efficacy and safety of Xiaopi Yishen herbal extract granules (XPYS-HEG), a compound traditional Chinese herbal medicine for relieving fatigue and promoting a cheerful spirit for the treatment of people with fatigue-predominant subhealth due to liver-qi stagnation and spleen-qi deficiency. DESIGN, SETTING PARTICIPANTS AND INTERVENTIONS: A multi-center, randomized, double-blinded, placebo-controlled clinical study was undertaken. The study period was 18 weeks, including 6 weeks for intervention and 12 weeks for follow-up. Participants were recruited from medical center and outpatient clinics of three hospitals in China, i.e. Xiaotangshan Hospital of Beijing, the First Affiliated Hospital of Henan University of TCM and the Affiliated Hospital of Liaoning University of TCM. Two hundred participants who met the criteria of fatigue-predominant subhealth and liver-qi stagnation and spleen-qi deficiency in TCM were allocated randomly to the treatment group (XPYS, n=100) and control group (placebo, n=100).MAIN OUTCOME MEASURES:The total score of Fatigue Scale-14 (FS-14) was used to evaluate the fatigue status of subjects and the extent of liver-qi stagnation and spleen-qi deficiency syndrome was also recorded.RESULTS:Three cases in the XPYS group withdrew from the trial. There were 200 subjects who entered to full analysis set (FAS) analysis and 197 subjects fitted in the per-protocol set (PPS) analysis. (1) According to the score changes of FS-14, the effectiveness rates in the XPYS and placebo group were as follows: 14.0% vs 9.0% (FAS) and 14.4% vs 9.0% (PPS) for complete remission, 19.0% vs 15.0% (FAS) and 19.6% vs 15.0% (PPS) for obvious effects, 39.0% vs 26.0% (FAS) and 39.2% vs 26.0% (PPS) for effective, and 72.0% vs 50.0% (FAS) and 73.2% vs 50.0% (PPS) for complete efficacy. The efficacy of XPYS-HEG was superior to the placebo statistically (P<0.05). (2) According to the score changes of TCM syndrome, the effectiveness rates in the XPYS group and placebo group were as follows: 1.0% vs 0.0% (FAS) and 1.0% vs 0.0% (PPS) for complete remission, 20.0% vs 7.0% (FAS) and 19.6% vs 7.0% (PPS) for obvious effects, 29.0% vs 24.0% (FAS) and 29.9% vs 24.0% (PPS) for effective, and 50.0% vs 31.0% (FAS) and 50.5% vs 31.0% (PPS) for complete efficacy. The efficacy of XPYS-HEG was superior to that of placebo statistically (P<0.05). (3) The follow-up results at 12 weeks and 18 weeks showed that the efficacy of XPYS-HEG was superior to that of placebo statistically (P<0.05). (4) No adverse effects were found in the XPYS group.CONCLUSION:It can be concluded that XPYS-HEG is effective and safe for the treatment of people with fatigue-predominant subhealth due to liver-qi stagnation and spleen-qi deficiency.

目的探讨中医偏颇体质与2型糖尿病(T2DM)、糖调节受损(IGR)的相关性。方法根据《中医体质分类与判定》的分类方法,对T2DM患者和IGR者进行体质分类,并分别统计其在各偏颇体质中的分布。结果 52例T2DM患者和90例IGR者的偏颇体质差异较大,2组均以阴虚质、阳虚质和痰湿质为主,其中T2DM患者阴虚质最多,占23.08%I;GR者以痰湿质最多,占28.89%。T2DM患者和IGR者的阴虚质、阳虚质和痰湿质3种偏颇体质与其他5种偏颇体质分布比较,差异有统计学意义(P<0.05)。痰湿质T2DM患者的体重指数、糖化血红蛋白较阴虚质高,差异有统计学意义(P<0.05)。结论阴虚质、阳虚质、痰湿质3种偏颇体质在高血糖人群中的分布及变化规律与T2DM的发生发展具有内在相关性。从中医体质入手,通过调整高度相关的偏颇体质,早期干预高血糖,同时配合生活方式管理,将有助于提高T2DM的防控效果。

Objective To compare the efficiency and the costs of Non-classical Antipsychotic Drugs commonly used for Schizophrenia.Methods A total of 300 patients with schizophrenia were randomly assigned to receive group risperidone,group quetiapine,group olanzapine and group ziprasidone.The therapeutic efficacies and adverse drug reactions(ADR)were monitored and cost-effectiveness Analysis were performed.Results All 289 patients completed the study.To clozapine as a reference,the incremental cost-effectiveness ratio were risperidone(391.84),aripiprazole(1026.64),ziprasidone(1178.16),quetiapine(2072.38),olanzapine(2250.95).Conclusion Risperidone's price is lower,the cost-effectiveness and incremental cost-effectiveness ratio is the lowest.

[Objective] To explore the correlation of the common TCM syndromes in population with sub-health of fatigue and iris images.[Methods] The iris images in population with sub-health of fatigue were collected by LG-D1 iris detector of Shang gong rui tai.Then the iris images were analyzed in accordance with iris positioned map and relative theory.The TCM symptoms of population with sub-health of fatigue were collected through the scale evaluation about TCM four physical examinations information.The patients were divided into each syndrome type according to their symptoms by two doctors.[Results] There were correlations between 16 common TCM syndromes in population with sub-health of fatigue and iris images.It showed positive correlation between liver-depression and spleen-deficiency syndrome and tighten collarette contour,intestines ring stenosis.It showed positive correlation between liver-qi stagnation syndrome and sodium ring,and negative correlation between liver-qi stagnation syndrome and skin metabolism ring.It showed negative correlation between the flaring of liver fire syndrome and pressure ring.It showed positive correlation between disordered liver and stomach syndrome and debility collarette contour,connective tissue type,and negative correlation between the disordered liver and stomach syndrome and colour-heavy intestines ring,anxious type.It showed positive correlation between damp obstruction due to spleen deficiency syndrome and neurogenic type.It showed positive correlation between deficiency of both heart and spleen syndrome and overlarge pupil,blue ring.It showed positive correlation between yin deficiency of liver and kidney syndrome and overlarge pupil.It showed positive correlation between yang deficiency of spleen and kidney syndrome and pigmentation,sodium ring.It showed positive correlation between disturbance of phlegm-heat syndrome and overlarge pupil.It showed negative correlation between qi deficiency of lung and spleen and acidity stimulation ring.It showed positive correlation between stagnation of pathogenic dampness and heat of spleen syndrome and tighten collarette contour,thin and misty collarette contour.It showed positive correlation between qi deficiency of spleen and pressure ring.It showed positive correlation between stagnation of pathogenic dampness and heat syndrome and polymorphic glands type,connective tissue type,and negative correlation between stagnation of pathogenic dampness and heat syndrome and anxious type.It showed positive correlation between qi deficiency of lung and thin and misty collarette contour.It showed negative correlation between yang deficiency of kidney and abnormal stomach ring.It showed positive correlation between qi and yin deficiency syndrome and debility collarette contour,and negative correlation between qi and yin deficiency syndrome and aging arc.[Conclusion] There are some correlations between common TCM syndromes in population with sub-health of fatigue and the iris images.It may provide the evidence basis for the further study on TCM syndromes and the iris images.