苯那普利和尼群地平对高血压病患者肾血流动力学及微量蛋白的影响

为探讨苯那普利和尼群地平对高血压病患者肾血流动力学和微量蛋白的作用，本文观察了58例高血压病患者服用苯那普利和尼群地平前后肾血浆流量及微量蛋白的变化。结果发现，治疗后苯那普利组患者有效肾血浆流量上升，肾小球滤过分数下降，尿微量蛋白减少（P均〈0．01），尼群地平患者此三项检查无明显变化（P＞0．05）。结果提示，苯那普利对高血压病患者肾功能的改善作用优于尼群地平。     

高血压病患者治疗前后的血浆NPY含量变化及临床意义

对９２例高血压病（ＥＨ）患者测定苯那普利治疗前后的血浆ＮＰＹ含量,并与５８例健康人作对照。结果：ＥＨ患者血浆ＮＰＹ含量与正常对照组存在非常显著性差异（Ｐ〈０．０１）,ＥＨ分期、高血压程度与血浆ＮＰＹ含量呈正相关关系。苯那普利治疗８周时,ＥＨ患者血浆ＮＰＹ含量显著下降,ＮＰＹ浓度与血压下降幅度呈密切相关（ｒ＝０．７０２３,Ｐ〈０．０１）。提示参与了高血压病的发生,苯那普利可通过降低ＮＰＹ途径起到降压     

苯那普利对糖尿病大鼠肾组织细胞周期蛋白激酶抑制剂P21~(CIPI)蛋白表达的影响

目的：探讨苯那普利对糖尿病大鼠肾组织细胞周期蛋白激酶抑制剂Ｐ２１ ＣＩＰ１ 蛋白表达的影响。　方法：大鼠随机分单侧肾切除对照组（Ｃ 组） 、糖尿病组（ Ｄ 组） 及糖尿病苯那普利治疗组（ ＤＢ 组） 。１ 周后，应用免疫印迹（ Ｗｅｓｔｅｒｎ 杂交） 分析各组肾皮质Ｐ２１ＣＩＰＩ蛋白表达。血浆、肾皮、髓质血管紧张素转换酶（ＡＣＥ） 活性由荧光分光光度法测得。　结果：单侧肾切除糖尿病大鼠１ 周体重即明显下降（ Ｐ＜ ０－０５） ，肾重／ 体重即肾脏肥大指数却明显增加（ Ｐ＜ ０－０５） ，血浆ＡＣＥ 活性有所下降而肾皮质ＡＣＥ 活性却有所上升。Ｗｅｓｔｅｒｎ 杂交分析表明对照组肾皮质几乎没有Ｐ２１ＣＩＰ１ 蛋白表达，然而，糖尿病肾皮质Ｐ２１ ＣＩＰ１ 蛋白表达明显增加；苯那普利治疗１ 周对肾脏肥大有明显的抑制作用，对血浆、肾皮、髓质ＡＣＥ 活性抑制分别达８９－０ ％ 、７０－０ ％ 、７０－５ ％ ，对肾皮质Ｐ２１ ＣＩＰＩ蛋白表达抑制达６０－０ ％ 。结论：苯那普利对糖尿病肾脏肥大的抑制作用至少部分与Ｐ２１ ＣＩＰＩ蛋白表达降低有关，其确切机制尚有待于进一步研究     

高血压病患者血管活性物质水平变化及苯那普利对其干预

目的：了解高血压病（ Ｅ Ｈ）不同时期患者血浆内皮素（ Ｅ Ｔ）、心钠素（ Ａ Ｎ Ｐ）、血管紧张素（ Ａｎｇ）、降钙素基因相关肽（ｃ Ｇ Ｒ Ｐ）和一氧化氮（ Ｎ Ｏ）浓度变化及苯那普利对其影响。　方法：主要采用放射免疫分析方法,分组对６６ 例 Ｅ Ｈ 患者应用苯那普利治疗前后和２４ 例正常人上述血管活性物质水平进行检测。　结果： Ｅ Ｈ 不同时期患者血浆 Ｅ Ｔ、 Ａ Ｎ Ｐ、 Ａｎｇ水平增高与平均动脉压（ Ｍ Ａ Ｐ）有良好相关性（ｒ＝ ０．５６４８,０．３８４１,０．５１６２, Ｐ＜ ０．０１～０．００１）;ｃ Ｇ Ｒ Ｐ、 Ｎ Ｏ 水平降低与 Ｍ Ａ Ｐ无关（ｒ＝ － ０．０４,－ ０．１６, Ｐ＞ ０．０５）,且两者与 Ｅ Ｈ 分期有密切关系,经苯那普利治疗８ 周后其浓度呈明显改变。　结论：提示高血压的发生、发展与上述血管活性物质水平的变化有关,苯那普利在降血压的同时能改变其浓度水平。     

苯那普利与卡托普利治疗轻中度原发性高血压疗效对比

目的比较苯那普利与卡托普利对轻中度原发性高血压的降压效应与安全性。方法８４例轻中度原发性高血压患者随机接受苯那普利（１０～２０ｍｇ／ｄ）和卡托普利（３７．５～７５．０ｍｇ／ｄ）（各４２例）治疗４周，其中４４例（每组２２例）于治疗前后行２４ｈ动态血压监测。结果苯那普利和卡托普利的降压总有效率在偶测血压监测时分别为９２．５％和９０．５％（Ｐ＞０．０５），而动态血压监测时两药有效率分别为９５．５％和６３．６％（Ｐ＜０．０５）。结论苯那普利对轻中度原发性高血压疗效较好而且安全。     

苯那普利对慢性肾功能衰竭患者肾血管阻力的影响及降压疗效观察

应用非巯基血管紧张素转换酶抑制剂（ＡＣＥＩ）——苯那普利治疗４０例慢性肾功能衰竭（ＣＲＦ）伴高血压患者，其中氮质血症期３０例，尿毒症期１０例，观察了治疗前后血压、肾功能的变化，并通过彩色多普勒超声诊断仪测定了ＣＲＦ患者治疗前后肾血管阻力指数（ＲＩ）的变化，结果显示：苯那普利治疗后两组收缩压和舒张压较治疗前均有明显下降（Ｐ＜０．０１）；氮质血症期患者ＲＩ值均较治疗前有明显下降（Ｐ＜０．０１），尿毒症期患者ＲＩ值治疗前后变化无显著性差异（Ｐ＞０．０５）。血清肌酐（Ｓｃｒ）、尿素氮（ＢＵＮ）、肌酐清除率（Ｃｃｒ）治疗前后亦无明显变化；治疗过程中未观察到明显副作用。说明苯那普利能有效地降低ＣＲＦ患者血压，降低氮质血症期患者ＲＩ值，进一步证实了苯那普利扩张肾血管，降低肾血管阻力，保护肾功能的作用，是治疗肾性高血压较理想的药物。     

苯那普利与卡托普利治疗工原发性高血压疗效对比

目的 比较苯那普利与卡托普利对轻中度原发性高血压的降低与安全性。方法 ８４例轻中度原发性高血压患者随机接受苯那普利（１０￣２０ｍｇ／ｄ）和卡托普利（３７．５￣７５．０ｍｇ／ｄ）（各４２例）治疗４周，其中４４例（每组２２例）于治疗前后行２４ｈ动态血压监测。结果 苯那普利和卡托普利的降压总有效率在偶测血压监测时分别为９２．５％和９０．５％（Ｐ〉０．０５），而动态血压监测时两药有效率分别为９５．５％和６     

高血压病人血清一氧化氮水平变化及药物干预的研究

目的观察高血压病人血清一氧化氮（ＮＯ）的水平及药物干预的影响。方法应用比色法测定了３０例正常人和６０例轻中度原发性高血压病人的血清ＮＯ水平，其中５０例高血压病人在应用卡托普利、苯那普利或硝苯地平治疗６周至８周后，复查了血清ＮＯ的浓度。结果高血压病人血清ＮＯ水平较正常对照组明显降低（Ｐ＜０．０１），Ⅱ期病人明显低于Ⅰ期病人（Ｐ＜０．０５），经卡托普利或苯那普利治疗后血清ＮＯ水平明显升高（Ｐ＜０．０５），硝苯地平治疗后无显著变化（Ｐ＞０．０５）。结论高血压病人体内ＮＯ水平显著降低，卡托普利或苯那普利治疗后ＮＯ水平明显升高。提示ＮＯ在高血压病的发生发展中有一定的作用。     

苯那普利对自发性高血压大鼠神经肽Y含量的影响

目的为探讨苯那普利对自发性高血压大鼠神经肽Ｙ（ＮＰＹ）含量的影响及其与高血压治疗的关系。方法本文选择了自发性高血压大鼠（ＳＨＲ）１６只,每８只为一组分成Ａ、Ｂ两组。Ａ组应用苯那普利进行治疗;Ｂ组作为对照组,用生理盐水治疗,４周后分别测定其血压,并测定其血浆以及重要器官组织中神经肽Ｙ的含量。结果Ａ组血压显著低于Ｂ组（Ｐ＜０．０１）。Ａ组血浆ＮＰＹ含量与Ｂ组比较显著降低（Ｐ＜０．０５）;ＮＰＹ在Ａ组的肝、肺及肾组织中的含量也明显低于Ｂ组（Ｐ分别＜０．０５,＜０．０５,＜０．０１）;而心、脑组织中ＮＰＹ略有降低,但无统计学意义（Ｐ＞０．０５）。结论苯那普利对自发性高血压大鼠体内ＮＰＹ含量变化的影响,可能与其治疗作用有关。     

苯那普利对高血压病患者胰岛素抵抗的影响

探讨苯那普利对高血压病（ＥＨ） 患者胰岛素抵抗的影响。测定３２ 例ＥＨ 患者用苯那普利治疗（１０～２０ ｍｇ／ 日,疗程４ 周） 前后及２０ 例正常对照组的空腹血糖（ＦＰＧ） 、空腹胰岛素（ＦＩＮＳ） ,以１／（ＦＰＧ×ＦＩＮＳ）作为胰岛素敏感性指标（ＩＳＩ） 。结果　１－ ＥＨ患者苯那普利治疗后血压较治疗前显著降低（ＳＢＰ：１７ ．８４ ±１ ．５７ ｋＰａ 比２２ ．６３ ±２ ．１３ ｋＰａ,Ｐ＜ ０ ．０１ ;ＤＢＰ：１０．５８ ±１．２１ ｋＰａ 比１４ ．３５ ±１ ．２６ ｋＰａ,Ｐ＜ ０．０１） ,总有效率８４ ．４ ％ 。２－ ＥＨ 组与对照组ＦＰＧ 无明显差异,而ＩＳＩ有显著差异（０ ．０１５ ±０ ．００７ 比０ ．０３１ ±０ ．０１３ ,Ｐ＜ ０ ．０１） ;ＥＨ组苯那普利治疗后ＩＳＩ较治疗前显著改善（０ ．０２３ ±０ ．０１１ 比０ ．０１５ ±０ ．００７ ,Ｐ＜ ０ ．０１） 。苯那普利在有效降压同时对ＥＨ 患者的胰岛素抵抗有明显改善作用     

Cement and Concrete Nanoscience and Nanotechnology

Concrete science is a multidisciplinary area of research where nanotechnology potentially offers the opportunity to enhance the understanding of concrete behavior, to engineer its properties and to lower production and ecological cost of construction materials. Recent work at the National Research Council Canada in the area of concrete materials research has shown the potential of improving concrete properties by modifying the structure of cement hydrates, addition of nanoparticles and nanotubes and controlling the delivery of admixtures. This article will focus on a review of these innovative achievements.     

Medical and Psychology Students' Knowledge and Attitudes Regarding Aging and Sexuality

The current study surveys medical and doctoral psychology students (N = 100) from an urban northeastern university regarding knowledge and attitudes toward elderly sexuality and aging using the Facts on Aging Quiz, the Aging Sexuality Knowledge and Attitudes Scale, and measures of interest in gerontology, academic/clinical exposure to aging and sexuality, and contact with elders. The current study found that psychology students demonstrated greater aging knowledge than medical students; however, both groups showed gaps in knowledge about sexuality. Married students had greater academic/clinical exposure and greater knowledge about aging but less permissive attitudes toward elderly sexuality. Generally, knowledge about aging was the strongest correlate of knowledge about sexuality. Level of knowledge about sexuality was not associated with attitudes. Attitudes toward sexuality and aging may be more strongly tied to demographic variables reflective of religious beliefs or adherence to sociocultural norms.     

Leptin and cellular and innate immunity in abstinent alcoholics and controls

BACKGROUND: Basic studies indicate that in vitro and in vivo doses of leptin modulate cellular immune responses. Given evidence that concentrations of leptin are altered in alcoholics who also show immune abnormalities, this study examined the relationships between circulating levels of leptin and markers of cellular and innate immunity. METHODS: Circulating levels of leptin, natural killer cell (NK) activity, interleukin-2 (IL-2)-stimulated NK activity, and concanavalin A-stimulated production of IL-2, IL-6, IL-10, and IL-12 were compared between abstinent DSM-IV alcohol-dependent men (n = 27) and age- and gender-matched controls (n = 34). RESULTS: As compared with controls, alcoholics showed lower NK activity (p < 0.01) and a trend for lower levels of leptin (p = 0.055). In the total sample, leptin predicted NK activity (beta = 0.33; p < 0.05) after controlling for the confounding influence of body mass index, alcohol intake, and smoking. Leptin was not correlated with any of the cytokine measures. To examine whether the effects of leptin were mediated by its direct action on NK, additional studies examined in vitro effects of leptin on NK activity in healthy volunteers (n = 10); leptin doses (0.1, 1, and 10 nM) yielded levels of NK activity comparable to those with media alone. CONCLUSIONS: These data show that circulating levels of leptin are associated with NK activity in humans and suggest that abnormal in vivo concentrations of leptin may contribute to the declines of NK activity in alcoholics who are at risk for infectious diseases.     

慢性饮酒、吸烟与骨质疏松的相关性研究

目的 探讨长期大量慢性饮酒、吸烟等不良生活方式与骨质疏松的关系.方法 以乏力、腰背痛、双下肢酸困为主诉,且有长期大量慢性饮酒史、吸烟史,无其他慢性疾病史的年轻男性患者45例为观察对象,测定其血钙(Ca)、血磷(P)和血肌酐(Cr)、尿素氮(BUN)、血糖(Glu)、天门冬酸氨基转移酶(AST)、丙氨酸基转移酶(ALT)、血清碱性磷酸酶(ALP)、甲状腺功能、全段甲状旁腺激素(iPTH)、1,25-二羟维生素D3[1,25-(OH) 2D3]、双能X线骨密度仪测定腰椎L1-4及左侧股骨近段(包括颈、股骨颈上部、大粗隆)骨密度(BMD),分析饮酒、吸烟对骨量的影响.以感冒发热就诊、年龄相当、无饮酒、吸烟史及慢性疾病史的45例男性为对照组.结果 观察组1,25(OH)2D3水平均降低,血钙水平偏低,血磷正常,碱性磷酸酶呈不同程度地升高,骨密度T值提示观察组27例骨质疏松,12例骨量减少,6例正常骨量;而对照组仅有6例为骨量减少,1例骨质疏松,38例为正常骨量,两组比较差异有统计学意义(P＜0.05).结论 长期慢性大量饮酒吸烟影响骨量,甚至易导致骨质疏松.     

自身免疫与动脉粥样硬化的发生发展

在动脉粥样硬化的发生发展过程中,自身免疫具有重要作用,本文就近年有关动脉粥样硬化的免疫机制的研究进展作一简要综述.     

Neutropenia and agranulocytosis in England and Wales: incidence and risk factors

The objectives of this study were to estimate the incidence of idiosyncratic neutropenia and agranulocytosis in England and Wales and to evaluate their risk factors and outcomes. The study was conducted using data from the General Practice Research Database. All cases of idiosyncratic neutropenia or agranulocytosis were identified and the incidence was estimated. This was followed by a nested case-control study, estimating odds ratios with drug exposure from conditional logistic regression. From 1987 to 1999, 3,224 patients with idiosyncratic neutropenia (50 with agranulocytosis) were identified. The incidences of neutropenia and agranulocytosis were estimated to be 120 and 7 cases per million people per year, respectively. The adjusted odds ratios for neutropenia were 34.7 (95% confidence interval 12.0-99.7) for current users of thyroid inhibitors, 9.5 (4.4-20.8) for users of disease-modifying antirheumatic drugs, and 7.6 (4.9-11.9) for users of aminosalicylates. Other drugs with statistically significantly increased risks of neutropenia included antibacterial drugs, non-opioid analgesics, NSAIDs, antidepressants, ulcer-healing drugs, and anti-epileptics. The increase in risk of neutropenia predominantly occurred during the first months of treatment. For most drugs investigated in this study, there was no relationship to daily dose. The excess 1-year mortality was low among neutropenia and agranulocytosis cases and mostly explained by the underlying disease state. In conclusion, the highest risks of neutropenia were generally found in patients starting treatment. The excess 1-year mortality was low among neutropenia and agranulocytosis cases and can be mostly explained by the underlying disease state.     

中青年超重和肥胖与高血压及高同型半胱氨酸血症的相关性研究

目的探讨中青年超重和肥胖与高血压及高同型半胱氨酸血症的相关性。方法选取2012年1月—2013年10月在我院进行常规健康体检者750例,测量受试者血压、身高、体质量及血清同型半胱氨酸(Hcy)水平。结果男性超重、肥胖检出率分别为36.87%(198/537)和13.97%(75/537),均高于女性的16.43%(35/213)和7.50%(16/213)(P0.05)。超重者和肥胖者高血压和高同型半胱氨酸血症检出率分别为21.03%(49/233)和11.16%(26/233)、46.12%(42/91)和41.76%(38/91),均高于正常者的9.16%(37/404)和2.23%(9/404),肥胖者高于超重者(P0.01)。收缩压(SBP)、舒张压(DBP)及血清Hcy与BMI呈正相关(r值分别为0.639、0.515、0.497,P0.01)。结论中青年尤其是男性超半数存在超重或肥胖,高血压及高同型半胱氨酸血症与BMI呈正相关,超重和肥胖者高血压及高同型半胱氨酸血症的发生率高,应积极防治。