瑞舒伐他汀对颈动脉粥样硬化患者血脂与颈动脉斑块的影响

目的探讨瑞舒伐他汀对颈动脉粥样硬化患者血脂与颈动脉斑块的影响。方法将2015年10月—2016年10月进行治疗的54例颈动脉粥样硬化患者随机分为对照组和观察组各27例,对照组应用阿司匹林治疗,观察组在对照组基础上联合瑞舒伐他汀治疗,比较两组用药前后的血脂水平及颈动脉斑块情况,数据进行统计学处理,P0.05为差异有统计学意义。结果观察组用药后甘油三酯、低密度脂蛋白、总胆固醇与高密度脂蛋白均优于对照组,比较差异均有统计学意义(均P0.05);观察组用药后斑块个数(2.31±1.08)个、厚度(1.12±0.38)mm与硬化率(74.07%)均优于对照组的(2.58±1.16)个、(1.43±0.42)mm与40.74%,比较差异均有统计学意义(P0.05)。结论颈动脉粥样硬化患者应用瑞舒伐他汀可有效改善血脂水平及斑块情况,值得推广应用。     

氨氯地平联合瑞舒伐他汀钙片对高血压合并颈动脉粥样硬化患者近远期疗效观察

目的探讨氨氯地平联合瑞舒伐他汀钙片对高血压合并颈动脉粥样硬化患者的近远期疗效。方法选取134例高血压合并颈动脉粥样硬化患者,按照随机对照法分为对照组(n=67)和观察组(n=67),对照组给予苯磺酸氨氯地平,观察组在对照组基础上给予瑞舒伐他汀钙片,治疗8周后比较疗效。结果观察组总有效率显著高于对照组(95.52%VS77.61%,P0.05);治疗后,观察组血压水平较对照组显著下降(P0.05),观察组血脂水平较对照组改善更为明显(P0.05);观察组患者Hcy、Cys-C及hs-CRP水平较对照组显著下降(P0.05),观察组颈动脉粥样硬化指标较对照组下降更为明显(P0.05)。结论氨氯地平联合瑞舒伐他汀钙片通过改善高血压合并颈动脉粥样硬化患者的炎性反应和血管内皮损伤程度,缩小颈动脉粥样硬化斑块。     

瑞舒伐他汀在高血脂症合并颈动脉粥样硬化患者治疗中的应用效果

目的:探讨瑞舒伐他汀在高血脂症合并颈动脉粥样硬化患者治疗中的应用效果。方法 :回顾性分析我院2016年4月～2018年10月间收治的57例高血脂症合并颈动脉粥样硬化患者的临床资料,所有患者均在常规对症治疗基础上给予瑞舒伐他汀治疗,观察患者治疗后的临床疗效。结果 :患者治疗后TC、TG、LDL-C以及HDL-C水平均优于治疗前(P0.05),血脂水平较治疗前有明显改善;患者治疗后颈动脉IMT、斑块数量、斑块面积及斑块积分均优于治疗前(P0.05)。结论 :瑞舒伐他汀治疗高血脂症合并颈动脉粥样硬化的临床疗效较好,不仅能够降低患者的血脂水平,还能够改善颈动脉IMT及斑块情况,可在临床推广应用。     

探讨瑞舒伐他汀的药理作用和临床应用价值

目的:探讨瑞舒伐他汀药物表现出的药理作用,并且观察选择此种药物对颈动脉粥样硬化患者施治后获得的临床效果。方法:选择某院2015年06月~2017年05月收治的82例颈动脉粥样硬化患者作为实验对象;利用随机数表法对所有颈动脉粥样硬化患者展开随机分组;对照组(41例):选择阿司匹林药物对颈动脉粥样硬化患者进行治疗;观察组(41例):选择瑞舒伐他汀对颈动脉粥样硬化患者进行治疗;最终就两组颈动脉粥样硬化患者的TC水平、IMT水平、LDL-C水平以及TG水平展开对比。结果:同对照组颈动脉粥样硬化患者TC水平、IMT水平、LDL-C水平以及TG水平展开对比,观察组颈动脉粥样硬化患者获得显著性改善(P0.05)。结论:合理选择瑞舒伐他汀对颈动脉粥样硬化患者进行治疗,于TC水平、IMT水平、LDL-C水平以及TG水平改善方面可以充分确保,最终对于颈动脉粥样硬化患者综合疗效提高以及疾病恢复促进做出充分保证。     

瑞舒伐他汀钙对短暂性脑缺血发作患者血脂等影响

目的:探讨瑞舒伐他汀钙对短暂性脑缺血发作患者血脂及颈动脉粥样硬化的影响。方法:收集2014年8月-2015年8月期间我院诊治的70例有颈动脉粥样硬化斑块的短暂性脑缺血发作患者,随机分为治疗组和对照组各35例,两组在常规给予抗血小板聚集等治疗的基础上,治疗组口服瑞舒伐他汀钙10mg/d6个月,监测治疗前后血脂水平、颈动脉内-中膜厚度、颈动脉粥样硬化斑块面积,随访并记录患者6个月内的脑血管病发生率及药物不良反应。结果:经过6个月的治疗后,治疗组血甘油三酯、胆固醇、低密度脂蛋白水平低于对照组及同组治疗前,颈动脉内-中膜厚度、斑块面积小于对照组及同组治疗前(均P0.05);对照组指标治疗前、后比较差异无统计学意义(P0.05)。治疗组随访期间脑血管病发生率低于对照组(P0.05)。两组患者均未出现严重药物不良反应。结论:瑞舒伐他汀钙降低患者的血脂水平疗效肯定,改善颈动脉粥样硬化效果显著,可降低脑血管意外发生率。     

阿托伐他汀联合普罗布考治疗颈动脉粥样硬化斑块患者的疗效分析

目的 探讨阿托伐他汀联合普罗布考治疗颈动脉粥样硬化斑块患者的临床疗效.方法 56例颈动脉粥样硬化斑块患者按随机数字表法分为两组,观察组28例在常规治疗的基础上给予阿托伐他汀联合普罗布考治疗,对照组28例在常规治疗的基础上仅给予阿托伐他汀治疗.两组均治疗6个月,比较两组治疗前后颈动脉粥样硬化斑块和血脂的变化.结果 观察组治疗后斑块面积和颈动脉内膜-中层厚度分别为(0.52±0.17) cm2、(2.61 ±0.39) mm,与治疗前比较明显下降(P＜0.05),并且明显低于同期对照组(P＜0.05);而对照组斑块面积和颈动脉内膜-中层厚度治疗前后比较差异均无统计学意义(P＞0.05).对照组治疗后总胆固醇(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)水平分别为(5.62±0.69)、( 1.86±0.52)、(3.85±0.58)、(1.47±0.36)mmol/L,观察组分别为(4.57±0.52)、( 1.48±0.43)、(3.17±0.42)、(1.82±0.44) mmol/L,与治疗前比较差异均有统计学意义(P＜0.05).并且观察组治疗后TC、TG、LDL-C水平均明显低于同期对照组(P＜0.05),HDL-C水平明显高于同期对照组(P＜0.05).两组不良反应发生率比较差异无统计学意义(P＞0.05).结论 阿托伐他汀联合普罗布考对颈动脉粥样硬化斑块的疗效显著,能够稳定斑块,降低血脂水平,值得临床推广应用.     

弗伐他汀、藻酸双酯与阿司匹林合用对颈动脉粥样硬化斑块的影响

目的观察联合应用阿司匹林、藻酸双酯、弗伐他汀对于动脉粥样硬化的疗效。方法 80例缺血性脑血管病合并颈动脉粥样硬化患者,随机分为治疗组40例,应用阿司匹林、藻酸双酯、弗伐他汀;对照组40例,给予阿司匹林、弗洛他汀。随访6个月,分别在治疗前,治疗后6个月检测血脂及颈动脉斑块。比较两组治疗前后血脂水平及颈动脉内中膜厚度,颈动脉斑块面积的变化。结果治疗后治疗组及对照组总胆固醇、低密度脂蛋白胆固醇及颈动脉斑块均下降(p<0.05),治疗组更明显(p<0.01)。治疗后治疗组高密度脂蛋白有升高(p<0.05);而对照组没有明显升高HDL的作用(p>0.05)。治疗后治疗组与对照组甘油三酯均降低(p<0.05),比较无统计学意义(p>0.05)。结论阿司匹林、藻酸双酯、弗伐他汀联合应用治疗颈动脉粥样硬化的调脂、稳定斑块效果明显优于应用阿司匹林、弗伐他汀组。     

瑞舒伐他汀联合阿司匹林对颈动脉粥样硬化的影响

目的探讨瑞舒伐他汀联合阿司匹林对颈动脉粥样硬化的影响。方法选择2012年1月—2014年1月收治的颈动脉粥样硬化患者100例作为研究对象,随机分为对照组和实验组各50例。对照组给予口服瑞舒伐他汀100 mg/次,1次/d睡前服用治疗,实验组在对照组的基础上给予阿司匹林100 mg/次,1次/d,睡前服用治疗,两组均治疗6个月。对比两组患者治疗前后颈动脉中膜的厚度、斑块积分、血清总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)等各项指标差异。计量资料组间比较采用t检验,组内比较采用配对t检验,P0.05为差异有统计学意义。结果对照组治疗前颈动脉中膜厚度、颈动脉斑块积分、TC、LDL-C、HDL-C分别为(1.65±0.45)mm、(6.14±1.90)分、(5.74±1.58)、(3.79±0.97)、(0.84±0.10)mmol/L,治疗后分别为(1.47±0.39)mm、(5.46±2.01)分、(4.92±1.35)、(3.10±0.92)、(1.08±0.17)mmol/L;实验组治疗前分比为(1.66±0.42)mm、(6.12±1.87)分、(5.76±1.63)、(3.81±1.02)、(0.85±0.11)mmol/L,治疗后分别为(1.31±0.32)mm、(4.85±1.27)分、(4.13±1.05)、(2.54±0.84)、(1.23±0.19)mmol/L,两组治疗前后差异均有统计学意义,且治疗后两组间差异均有统计学意义(均P0.05)。结论瑞舒伐他汀联合阿司匹林治疗颈动脉粥样硬化临床疗效明显优于单纯使用瑞舒伐他汀,值得临床推广。     

依折麦布辅助治疗对冠心病合并高胆固醇血症患者颈动脉粥样硬化斑块的影响

目的探讨联合应用阿托伐他汀与依折麦布对冠心病合并高胆固醇血症患者颈动脉粥样硬化斑块的临床治疗效果与意义。方法选取2013年1月~2014年1月我院心血管内科收治的120例颈动脉粥样硬化的冠心病合并高胆固醇血症患者为研究对象,采用随机抽签分组方法将其分成观察组和对照组,每组60例。对照组采用阿托伐他汀口服治疗,观察组在对照组治疗基础上加用依折麦布进行治疗,3个月为1个疗程,治疗1个疗程后观察两组患者总胆固醇(TC)、C反应蛋白(CRP)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、三酰甘油(TG)、颈动脉粥样硬化斑块改善情况以及药物不良反应,探讨治疗的安全性和有效性。结果治疗后两组患者均未出现严重药物不良反应,观察组TC、CRP、HDL-C颈动脉中层厚度、斑块Crouse积分水平明显低于对照组,两组比较有统计学意义(p<0.05);观察组HDL-C、TG、颈动脉内径为水平改善情况与对照组未见显著差异(p>0.05)。结论联合应用阿托伐他汀与依折麦布治疗冠心病合并高胆固醇血症患者颈动脉粥样硬化斑块有较高的安全性和显著的临床疗效,值得在临床中推广应用。     

不同他汀类药物对冠心病患者血脂代谢和动脉硬化程度的影响

目的探讨瑞舒伐他汀与阿托伐他汀对冠心病患者血脂代谢、动脉硬化程度及血管内皮功能的影响。方法选取2017年1月至2018年12月本院收治的冠心病患者300例,随机分为阿托伐他汀组156例和瑞舒伐他汀组144例。于治疗前和治疗6个月后分别测定两组血脂指标;分别对两组进行颈动脉超声检查,测定颈动脉斑块积分;分别检测两组肱动脉内皮依赖性舒张功能,计算肱动脉内径变化百分率。结果治疗6个月后,两组患者总胆固醇、甘油三酯、低密度脂蛋白水平明显低于治疗前,高密度脂蛋白水平明显高于治疗前,差异均有统计学意义(均P<0.05);治疗6个月后,瑞舒伐他汀组患者总胆固醇、甘油三酯、低密度脂蛋白水平明显低于阿托伐他汀组,差异均有统计学意义(均P<0.05)。治疗6个月后,两组患者颈动脉内中膜厚度、颈动脉斑块积分均明显低于治疗前,差异均有统计学意义(均P<0.05);治疗6个月后,瑞舒伐他汀组患者颈动脉斑块积分明显低于阿托伐他汀组,差异有统计学意义(P<0.05)。治疗前阿托伐他汀组和瑞舒伐他汀组患者肱动脉内径变化率分别为(6.48±1.86)%、(6.51±1.93)%;治疗后分别为(8.26±1.70)%、(8.58±1.95)%。治疗后瑞舒伐他汀组肱动脉内径变化率明显高于阿托伐他汀组,差异有统计学意义(P<0.05)。结论瑞舒伐他汀在改善冠心病患者血脂代谢、动脉硬化程度及血管内皮功能方面效果明显,优于阿托伐他汀。     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.