杭州市健康人群血液流变学及血脂测定结果分析

目的 了解血流变学及血脂结果 在健康人群中的关系.方法 547例健康体检者男322例,女225例,女性平均年龄为(45.96±11.51岁),男性平均年龄为(44.27±11.35)岁,并按年龄段分为五组;分别用全自动血流变仪测定血液流变学指标及全自动血生化仪测定总胆固醇(TC)、甘油三酯(TG)、高密度胆固醇(HDL)、低密度胆固醇(LDL)、载脂蛋白Al(APOA)、载脂蛋白B(APOB)指标.结果 男性组与女性组血流变指标LBV、MBV、HBV、HBVI、LBVI、CV比较,差异均有统计学意义(t=3.20～11.73,P均＜0.05),男性组与女性组血脂指标除总胆固醇外,TC、TG、HDL、LDL、APOA1、APOB差异均有统计学意义(t=2.34～11.12,P均＜0.05).年龄段在4l～50岁的男性血液流变学与血脂结果 比较,差异均有统计学意义(r=-0.33～0.25,P均＜0.05).结论 322例男性体检41岁以上组血液流变学与血脂检测结果 呈显著相关性,对此类人群应在健康体检中引起重视.     

促甲状腺激素与血糖、血脂水平的相关性研究

目的探讨体检人群促甲状腺激素(TSH)的升高情况及其与血糖、血脂各指标之间的相关性。方法回顾性分析2017年1-5月该院1 070例体检人群TSH、血清总胆固醇(CHOL)、血清三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、血糖(GLU)、糖化血红蛋白(HbA1c)等指标,按性别和年龄进行统计,并分析TSH与血糖、血脂水平的相关性。结果共检出TSH阳性者118例,阳性率为11.03%,其中男性58例,阳性率为9.40%,女性60例,阳性率为13.25%,男女间TSH阳性率差异有统计学意义(χ2=9.819,P0.05)。TSH与TG、LDL、GLU呈成正相关(r分别为0.006、0.048、0.021,P分别为0.038、0.017、0.045),与HDL呈负相关(r=-0.017,P=0.024),而与CHOL、HbA1c无相关性(P0.05)。TSH升高组与TSH正常组相比,CHOL水平差异有统计学意义(P0.05)。结论 TSH的升高已经成为影响人类健康的一个重要因素,应该更加重视。     

某医院健康体检人群血糖与血脂的关系研究

目的探讨该院健康体检人群血糖与血脂的情况及相关性研究。方法收集该院1 000例健康体检者的血清,分别测定各项血脂和血糖水平,包括空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C),并分析血糖水平与各项血脂水平之间的相关性。结果 FBG水平随年龄增长而上升,TG、TC和LDL-C水平也随年龄增长而增长;FBG水平与TG水平之间呈正相关(r=0.175,P0.05);FBG与HDL-C之间呈负相关(r=-0.165,P0.05);在高FBG组和FBG正常组之间,TG、TC、HDL-C水平差异有统计学意义(P0.05),两组间TC升高率分别为58.1%和36.0%,差异有统计学意义(P0.05);TC升高组和TC正常组的FBG水平分别为(5.15±1.45)mmol/L和(4.77±0.75)mmol/L,FBG升高的发生率分别为9.46%和4.76%,差异有统计学意义(P0.05)。结论健康体检人群的FBG与血脂水平存在相关性,积极治疗高血糖有利于控制血脂,积极控制血脂则有利于糖尿病的防治。     

不同人群sdLDL-C水平及其与血脂组分的相关性分析

目的调查不同人群小而密低密度脂蛋白胆固醇(sdLDL-C)水平,分析其与血脂组分的相关性。方法选取于该院进行体检和门诊就医人员共986例作为研究对象。其中血脂正常者654例,并根据性别和年龄划分;血脂增高者根据空腹TG和LDL-C分为高TG组、高LDL-C组、联合增高组。测定上述人群血清sdLDL-C、LDL-C、TG、TC、HDL-C、ApoAⅠ和ApoB水平,并分析sdLDL-C与TG、TC、HDL-C、ApoAⅠ、ApoB的相关性。结果男、女sdLDL-C 70岁之后开始下降,差异有统计学意义(P0.05);sdLDL-C水平总体均值男性高于女性,差异有统计学意义(P0.05)。各血脂增高组sdLDL-C水平、sdLDL-C/LDLC均高于血脂正常组,差异均有统计学意义(P0.05)。sdLDL-C与TC、TG、ApoB呈正相关(r分别为0.254、0.589、0.302),与HDL-C和ApoAⅠ呈负相关(r分别为-0.421、-0.275、-0.311)。结论sdLDL-C与TC、TG、ApoB呈正相关,与HDL-C、ApoAI呈负相关,能较准确地反映机体脂质代谢整体状况。     

汕尾市城区体检人群尿酸和血脂异常率及尿酸与血脂的相关性分析

目的了解汕尾市城区体检人群尿酸和血脂异常率及尿酸与血脂的相关性。方法选取2018年12月至2019年12月在该院体检中心接受体检的8909例健康体检人群为研究对象,检测其血清尿酸(UA)、三酰甘油(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-L)、低密度脂蛋白胆固醇(LDL-C)水平。将研究人群按性别分为男、女两组。比较两组UA、TG、TC、HDL-L、LDL-C水平;统计UA、TG、TC、HDL-L、LDL-C的异常率,分析UA水平与血脂的相关性。将各性别组中的研究人群再分成正常UA组与高UA组,比较其血脂水平及异常率。结果研究人群中,UA、TG、TC、HDL-L及LDL-C的总异常率分别为34.1%、27.3%、47.9%、2.9%、26.3%,且男性高于女性(P<0.05)。男性UA、TG、TC及LDL-C水平高于女性,HDL-L水平低于女性,差异均有统计学意义(P<0.05)。男性与女性的UA水平与TG、TC、LDL-C呈正相关(r=0.21、0.26,0.09、0.18,0.09、0.24;P<0.05),与HDL-C呈负相关(r=-0.13、-0.18,P<0.05)。高UA组TG、TC及LDL-C水平高于正常UA组,HDL-C水平低于正常UA组(P<0.05)。高UA组TG、TC、LDL-C的异常率比正常UA组高(P<0.05)。结论该市城区体检人群男性UA、TG、TC及LDL-C水平和异常率均高于女性,UA水平升高与血脂异常存在一定的相关性。     

某高校教职工近3年血脂、血糖与性别、年龄、体质量指数的相关性研究

目的探讨某高校教职工总胆固醇(TC)、三酰甘油(TG)与性别、年龄、体质量指数(BMI)及血糖(GLU)水平的相关性。方法回顾性分析2016-2018年重庆某高校1 100例职工健康体检的相关数据,最终纳入890例体检者作为研究对象。根据年龄分为3组,测定其血清TC、TG和GLU水平,分别比较TC和TG在各年龄组及性别组间的差异,并分析TC和TG与年龄、BMI和GLU的相关性;并纵向分析不同年龄组TC、TG和GLU在近3年内是否存在差异。结果 TC与TG在不同年龄组与性别组分别存在显著差异,其中,女性TC、TG水平显著高于男性(P=0.023、0.019);TC和TG有随年龄增长而升高的趋势(r=0.32,P0.05;r=0.21,P0.05),且与BMI有相关性(r=0.22,P0.05;r=0.19,P0.05),与GLU均无相关性(P0.05)。青年组和老年组各项指标近3年间差异无统计学意义(P0.05),中年组TC和GLU近3年差异均有统计学意义(P0.05),TG差异无统计学意义(P0.05)。结论 TC、TG与性别、年龄和BMI有相关性,但与GLU无相关性;高校教职工在刚入职期TC、TG和GLU变化不明显,随年龄增长,在稳定期及退休期,其脂蛋白代谢紊乱趋势增高,且男性趋势更明显。     

多器官功能障碍综合征患者循环内皮细胞数量和血脂水平变化及临床意义

目的:探讨循环内皮细胞(CEC)数量与血脂水平与多器官功能障碍综合征(M ODS)的关系及其意义。方法:用等密度梯度离心法分离35例M ODS患者CEC,常规进行血脂测定,并与20名健康体检者进行比较。同时用急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)对M ODS患者的严重程度进行评分,并与CEC数量与血脂水平进行相关性分析。结果:与正常对照组比较,M ODS组CEC数量明显增加,差异有显著性(P<0.01)。M ODS组甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL C)均明显低于正常对照组,差异均有显著性(P<0.05或P<0.01)。TG、TC、LDL C水平与CEC数量呈明显负相关(TG:r=0.396,P<0.05;TC:r=0.672,P<0.05;LDL C:r=0.486,P<0.05)。M ODS组APACHEⅡ评分与CEC数量呈正相关(r=0.436,P<0.05),与TG、TC、LDL C水平呈负相关(TG:r=0.372,P<0.05;TC:r=0.425,P<0.05;LDL C:r=0.487,P<0.05)。结论:M ODS患者血管内皮细胞功能受损,血脂水平下降,血脂水平结合CEC数量可更为准确地预测疾病的严重程度。     

中老年男性动脉弹性与血清尿酸及血脂的相关性

目的研究中老年男性动脉弹性与血清尿酸及血脂水平的相关性。方法选取男性体检者279例,进行体格、生化及动脉弹性检查,根据脉搏波传导速度(PWV)测定分为动脉硬化组138例,非动脉硬化组141例,分析动脉弹性与血清尿酸、血脂水平之间的相关性。结果与非动脉硬化对照组比较,动脉硬化组血清尿酸[(409.38±92.78)mmol/L比(433.84±93.43)mmol/L]、三酰甘油(TG)[(1.64±0.83)mmol/L比(2.26±1.37)mmol/L]水平显著升高(P0.05或P0.01),而低密度脂蛋白(LDL)、高密度脂蛋白(HDL)及总胆固醇(TCH)水平差异无统计学意义。Pearson相关性分析显示,年龄、腰围、TG与肱-踝脉搏波传导速度存在明显的正相关(r=0.169~0.439,P0.05或P0.01)。结论 TG水平与动脉硬化密切相关,同时高尿酸血症、肥胖、高血压及血糖异常是中老年男性动脉硬化的危险因素。     

血生化检验中血液胆固醇异常与ApoB代谢缺陷的关系研究

目的分析血生化检验中血液胆固醇异常与载脂蛋白B(ApoB)代谢缺陷的相关性。方法将2015年10月～2017年10月行体检的395例健康体检者(对照组)及181例血脂异常患者(观察组)纳入研究,对以上576名研究对象进行FBG、2hPBG、TG、TC、LDL﹣C、HDL﹣C、ApoB水平检测,比较两组各项血生化指标的差异,同时分析ApoB与其他血脂指标之间的相关性。结果继发性血脂水平异常比例(81.22%)明显高于原发性血脂水平异常(18.78%),差异具有统计学意义(P0.05)。观察组FBG、2hPBG、TG、TC、LDL-C、HDL-C、ApoB水平与对照组比较,有显著差异(P0.05)。多元分析结果显示,观察组ApoB与FBG、2hPBG、TG、TC、LDL-C、HDL-C等水平之间具有一定相关性,差异具有统计学意义(P0.05)。结论血脂异常以继发性为多见,血脂异常者FBG、2hPBG、TG、TC、LDL-C、HDL-C等水平有异于健康人群,ApoB的代谢缺陷与血胆固醇异常具有密切的关系。     

成年男性血红蛋白水平升高与空腹血糖、血尿酸及血脂检测结果分析

目的探讨进行健康体检的成年男性血红蛋白(Hb)水平升高与其空腹血糖(FBG)、血尿酸(UA)及血脂[三酰甘油(TG)与总胆固醇(TC)]检测结果。方法将2018年10-11月1 007例Hb升高的成年男性按Hb水平不同分为A1、A2、A3、A4、A5组,另选取同期85例Hb水平正常体检者作为对照组,对所有研究对象FBG、UA及血脂水平进行检测,并对检测结果进行分析。结果 A1、A2、A3、A4、A5组FBG、UA及血脂水平均值及异常百分数均高于对照组,差异均有统计学意义(P<0.05)。均值比较:A1、A2、A3、A4、A5组血脂及A3组UA水平与对照组比较,差异均有统计学意义(P<0.05);A1组与A3组UA与TG水平比较,差异均有统计学意义(P<0.05),其他各组UA与TG水平比较,差异均无统计学意义(P>0.05);异常百分数比较:除A1、A2、A3、A4、A5组TG,A1、A2、A3、A4组TC与对照组及A1组与A4组FBG与TC差异有统计学意义(P<0.05)外,其余组间比较,差异均无统计学意义(P>0.05)。结论成年男性Hb水平升高与其生化项目FBG、UA及血脂的变化有一定相关性,与FBG不存在统计学上的差异,但整体呈上升趋势,对非传染性流行病有辅助诊断价值。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Structure and function of "metalloantibiotics"

Although most antibiotics do not need metal ions for their biological activities, there are a number of antibiotics that require metal ions to function properly, such as bleomycin (BLM), streptonigrin (SN), and bacitracin. The coordinated metal ions in these antibiotics play an important role in maintaining proper structure and/or function of these antibiotics. Removal of the metal ions from these antibiotics can cause changes in structure and/or function of these antibiotics. Similar to the case of "metalloproteins," these antibiotics are dubbed "metalloantibiotics" which are the title subjects of this review. Metalloantibiotics can interact with several different kinds of biomolecules, including DNA, RNA, proteins, receptors, and lipids, rendering their unique and specific bioactivities. In addition to the microbial-originated metalloantibiotics, many metalloantibiotic derivatives and metal complexes of synthetic ligands also show antibacterial, antiviral, and anti-neoplastic activities which are also briefly discussed to provide a broad sense of the term "metalloantibiotics."