左右手臂血压差异调查

<正> 对某厂266名工人进行双手臂血压测量(坐位或卧位),受测者17～56岁,平均39岁,男114人,女性152人,高血压者97人。正常坐位血压平均收缩压,男性左121±10.9mmHg(16.1±1.4kPa),右120±10.5mmHg(15.9±1.4kPa):女性左115±8.7mmHg(15.3±1.2kPa),右114±     

老年体位性低血压的评价

老年体位性低血压已形成众多的研究课题。但其真正的发病率,各学者报道不一。立位收缩压(SBP)下降>2.7kPa(20mmHg)的发生率,Caird等报告为24％,而Myers等仅为10.7％。站立后测量血压(BP)的时间及一天当中何时测定,迄今尚     

急性心肌梗塞并发心原性休克的鉴别诊断

急性心肌梗塞(AMI)时,由于大面积心肌受损导致心脏泵功能衰竭,使心输出量尤其是每搏量急剧降低,动脉压下降,组织灌注降低,冠脉流量进行性减少,梗塞面积扩大,最终导致心原性休克。 但在AMI时,血压下降是否就是心原性休克?在基层医院无血液动力学监测条件下,如何与血容量不足,疼痛引起的低血压相鉴别? AMI并发心原性休克的诊断主要依据:(1)血压降低,收缩压降至10.7kPa(80mmHg)以下或原有高血压者较基础水平降低10.7kPa(80mmHg)以上。(2)周围灌注不足,表现为面色苍白,皮肤湿冷、大汗淋漓、紫绀、四肢厥冷、     

高血压微循环与体循环动力学临床研究系列(下)——Ⅶ.高血压病人毛细血管压与某些血流动力学指标之间关系的探讨

用间接法测定30例高血压病人甲襞毛细血管压明显高于正常血压组(68.68±19.42mmHg对43.11±10.30mmHg,1mmHg=1/7.5kPa,P<0.01)高血压组用心痛定或巯甲丙脯酸干预后,毛细血管压明显下降(57.4l±14.78对68.68±19.42mmHg,P<0.02)。高血压病人毛细血管与肱动脉舒张压呈正相关(r=0.731,P<0.05),降压治疗后,毛细血管压与甲襞毛细血管密度呈负相关(r=0.697,P<0.05),提示高血压病人检查毛细血管压可作为无创性评价外周阻力的临床指标之一。     

小鼠病毒性心肌炎的心肌结构及左室功能变化的初步研究

目的:探讨病毒性心肌炎时的心肌结构与收缩力变化的关系。方法:建立病毒性心肌炎的动物模型,观测病毒损伤阶段和免疫损伤阶段心肌的超微结构和心肌收缩力改变。结果:病毒性心肌炎早期的心肌细胞的线粒体超微结构发生了变化,心肌细胞收缩力下降,左室压(LVP)为(14.2±0.8)kPa,dp/dt为(273.1±10.0)kPa/s,正常对照LVP为(17.1±0.7)kPa,dp/dt为(359.8±9.3)kPa/s,P＜0.01;后期心肌组织严重损害,不仅有线粒体溶解破坏,而且肌原纤维变细、减少等,并且心肌收缩力指标明显下降,LVP为(11.8±0.2)kPa,dp/dt为(209.5±6.9)kPa/s,与早期相比差异有显著,P＜0.01。结论:病毒性心肌炎早期,即病毒损伤期,造成心脏功能下降的原因主要是病毒引起心肌细胞的超微结构改变,特别是对线粒体的损伤,使心肌细胞供能障碍,心肌收缩力减小;病毒性心肌炎后期,免疫反应造成心肌组织损害较病毒直接损害更严重,造成心肌收缩力明显减小。     

高血压脑出血继续出血88例临床分析

目的 探讨高血压脑出血继续出血的临床、CT特点及预测因素.方法 对88例高血压脑出血继续出血患者的临床及CT资料进行回顾分析.结果 显示下列情况容易引起继续出血:既往长期饮酒者、肝肾功能不全、止凝血功能异常、有糖尿病、长期服阿司匹林者、入院前超急性期用甘露醇及扩血管药、入院24h内(每小时测一次血压)平均收缩压>24kPa(180mmHg)及舒张压>14.7kPa(110mmHg)者、168h内意识障碍逐渐加重及肌力进行性下降者、首次CT示血肿形状不规则者.继续出血确诊距发病时间在7d以内,多在24h以内.出血部位可在丘脑、壳核、脑叶、脑干,但以丘脑为多.结论 高血压脑出血继续出血主要与止凝血功能异常、入院前超急性期用甘露醇者、血压水平、血肿形态、出血部位等有关.选择适当的治疗方法,包括镇静、调整血压、止血、降颅压等保守治疗或手术清除血肿治疗.     

二维斑点追踪成像检测正常人左心室心肌应变

目的 运用二维斑点追踪成像(2D-STI)评价正常人左心室心肌应变.方法 选择50例正常人,其中男性31例,女性19例;年龄48～54岁,平均年龄51.16岁.收缩压为(15.63±1.77)kPa[(117.53±13.30)mmHg],舒张压为(9.87±1.04)kPa[(74.18±7.84)mmHg];心率(...     

新型电磁搏动式血泵的实验研究

目的探究一种新型电磁搏动式血泵的动力输出性能及血液相容性。方法首先通过建立理论模型对该血泵驱动力进行分析,并基于该模型计算出满足条件的实验驱动电压。设计体外模拟循环实验,对新型血泵的输出流量和输出压力特性及血泵的体外溶血性能进行初步实验研究。结果实验测得当血泵后负荷为73.5 mmHg(9.78 kPa, 1 mmHg=0.133 kPa)、驱动电压达到35 V、搏动频率为75/min时,实际输出的流量为3.18 L/min,可以提供高压132 mmHg(17.56 kPa)、低压66 mmHg(8.78 kPa)、平均压力98 mmHg(13.03 kPa),体外实验标准溶血指数(normalized index of haematolysis, NIH)为(0.049 15±0.003 75) mg/dL。结论该新型搏动式血泵能够满足离体器官灌注和体外循环短期辅助的临床要求,对体外循环血泵的发展具有重要意义。     

肠道内给予氟碳代血液对家兔肠系膜上动脉夹闭休克的保护作用

于家兔肠系膜上动脉夹闭后立刻肠道内给予充氧的氟碳代血液(PFBS)10ml/kg或等量生理盐水(对照)。肠系膜上动脉夹闭45分钟后,对照组动物MAP进行性下降,血浆K~ 浓度逐渐升高,4小时存活率25％,平均存活时间165分钟,病理检查肠粘膜广泛水肿,绒毛坏死脱落。PFBS组动物MAP维持平稳,实验结束平均为8.26kPa(62mmHg),明显高于对照4.67kPa(35mmHg),血浆K~ 浓度基本正常,4小时存活率75％,平均存活时间227分钟,与对照组相比差异显著;肠粘膜结构基本完整。结果表明:在肠系膜上动脉夹闭休克中,肠道内给予PFBS可保护肠粘膜结构,减轻休克程度,提高动物存活率。     

平板运动试验评价国产C-L Ⅲ型短柱瓣术后远期的跨瓣压差

目的采用平板运动试验评价国产C-LⅢ型短柱瓣术后远期的跨瓣压差。方法随机选择10例单纯主动脉瓣置换术后10年以上的患者,型号均为21mm,分为2组,其中5例置换C-LⅢ型短柱瓣,5例置换进口Medtronic-Hall侧倾碟瓣,采用彩色多普勒超声心动图记录患者平板运动试验前、后的跨瓣压差,比较两组静息和运动状态下的心率、血压及跨瓣压差。结果在静息状态下,C-LⅢ型短柱瓣组和Medtronic-Hall侧倾碟瓣组的最大跨瓣压差分别为(1.57±0.46)kPa[(11.77±3.45)mmHg]和(1.33±0.47)kPa[(9.88±3.56)mmHg],平均跨瓣压差分别为(0.88±0.32)kPa[(6.64±2.44)mmHg]和(0.73±0.35)kPa[(5.45±2.64)mmHg];运动第Ⅳ阶段后C-LⅢ型短柱瓣组和Medtronic-Hall侧倾碟瓣组的最大跨瓣压差分别为(2.99±0.86)kPa[(22.48±6.45)mmHg]和(2.57±0.65)kPa[(19.32±4.88)mmHg],平均跨瓣压差分别为(2.09±0.56)kPa[(15.66±4.23)mmHg]和(1.79±0.70)kPa[(13.43±5.23)mmHg]。统计学检验结果显示:运动第Ⅳ阶段后国产C-LⅢ型短柱瓣组的跨瓣压差明显升高,与安静状态相比有统计学意义(P<0.05);但与运动第Ⅳ阶段后Medtronic-Hall侧倾碟瓣组的跨瓣压差相比无统计学意义(P>0.05)。结论中度体力活动会引起国产C-LⅢ型短柱瓣主动脉瓣置换术后远期跨瓣压差升高,但仍在可接受的范围内,且与Medtronic-Hall侧倾碟瓣有类似的血液动力学表现,所以仍是瓣膜置换时的一个可靠选择。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.