卡托普利联合硝苯地平治疗原发性高血压的临床研究

[目的]探讨卡托普利联合硝苯地平治疗原发性高血压的临床疗效.[方法]选择近期某院牧治76例原发性高血压患者为研究对象,随机分为两组.对照组给予卡托普利,观察组加服硝苯地平缓释片.[结果]观察组总有效率(94.7%)明显高于对照组(78.9%).两组比较差异有统计学意义(X2=4.15,P<0.05);观察组不良反应发生率(28.9%)明显高于对照组(10.5%),两组比较差异有统计学意义(X2=4.07,P<0.05).[结论]卡托普利联合硝苯地平治疗原发性高血压,可发挥协同作用,显著提高疗效,是一种安全有效的治疗方案,值得临床进一步推广应用.     

硝苯地平缓释片联合常规控糖方案治疗高血压合并2型糖尿病的疗效观察

目的观察硝苯地平缓释片联合常规控糖方案治疗高血压合并2型糖尿病的疗效。方法选取2015年6月-2018年6月天津市河西区陈塘庄街社区卫生服务中心收治的120例高血压合并2型糖尿病患者,随机分为观察组和对照组各60例。对照组给予绷沙坦联合常规控糖方案,观察组给予硝苯地平缓释片联合常规控糖方案,比较两组血压、血糖指标改善程度、临床效果及不良反应发生情况。结果观察组血压、血糖指标改善情况及治疗效果均优于对照组,差异有统计学意义(P<0.05).两组不良反应发生情况差异无统计学意义(P>0.05).结论硝苯地平缓释片联合常规控糖方案治疗高血压合并2型糖尿病安全有效,值得推广。     

坎地沙坦西酯与硝苯地平治疗糖尿病肾病合并高血压的临床对比研究

[目的]比较观察坎地沙坦西酯与硝苯地平治疗糖尿病肾病合并高血压的临床疗效。[方法]2009年12月～2010年12月,102例糖尿病肾病合并高血压患者随机分为坎地沙坦西酯组和硝苯地平组,每组51例,比较观察两组治疗前后血压和血尿素氮(BUN)、肌酐(Cr)水平变化。[结果]两组治疗后SBP、DBP明显降低,与治疗前比较差异均有统计学意义(P﹤0.05);两组治疗后SBP、DBP水平比较,差异无统计学意义(P﹥0.05)。坎地沙坦西酯组治疗后BUN及Cr水平明显降低,与治疗前比较差异有统计学意义(P﹤0.05);坎地沙坦西酯组治疗后BUN及Cr水平明显低于同期硝苯地平组(P﹤0.05),而硝苯地平组治疗前后BUN及Cr水平比较,差异无统计学意义(P﹥0.05)。[结论]坎地沙坦西酯与硝苯地平治疗糖尿病肾病合并高血压患者,均有明显的降压效果,但坎地沙坦西酯具有更好地保护肾脏作用,值得临床推广应用。     

硝苯地平缓释片联合依那普利治疗老年冠心病合并高血压的临床疗效观察

目的观察硝苯地平缓释片联合依那普利治疗老年冠心病合并高血压患者的临床疗效和安全性。方法 150例老年冠心病合并高血压患者随机均分为两组。对照组采用硝苯地平缓释片治疗,观察组采用硝苯地平缓释片联合依那普利治疗,比较两组的治疗效果和不良反应。结果观察组的治疗总有效率显著高于对照组,治疗后的舒张压、收缩压均显著低于对照组,缺血事件发生率显著低于对照组,差异均有统计学意义(P <0.05)。两组的不良反应发生率无统计学差异(P>0.05)。结论硝苯地平缓释片联合依那普利治疗老年冠心病合并高血压患者的效果显著,可有效降低缺血事件发生风险,安全性高。     

硝苯地平联合厄贝沙坦治疗老年2型糖尿病肾病合并高血压70例

目的探讨硝苯地平联合厄贝沙坦治疗老年2型糖尿病肾病合并高血压的临床效果。方法选取2012年5月-2013年12月收治的2型糖尿病肾病合并高血压老年患者140例,随机分为对照组和治疗组各70例,对照组给予硝苯地平,10 mg/次,3次/d,观察组在此基础上给予厄贝沙坦,150 mg/次,1次/d,两组均治疗4个月;比较两组近期疗效,治疗前后收缩压、舒张压、糖化血红蛋白,血尿素氮、血肌酐及尿蛋白排泄率。计量资料采用t检验,计数资料采用χ2检验,P0.05为差异有统计学意义。结果治疗组近期总有效率94.29%明显优于对照组的71.43%,比较差异有统计学意义(P0.05)。治疗组治疗后收缩压和舒张压分别为(124.77±28.63)、(81.72±9.36)mm Hg(1 mm Hg=0.133 k Pa)均优于对照组的(138.25±36.94)、(94.39±13.82)mm Hg,比较差异均有统计学意义(均P0.05)。治疗组治疗后尿蛋白排泄率为(104.27±13.19)μg/min低于对照组的(128.63±26.65)μg/min,比较差异均有统计学意义(均P0.05)。结论硝苯地平与厄贝沙坦联用于老年2型糖尿病肾病合并高血压治疗在提高血压控制效果、改善尿蛋白排泄水平方面具有优势,值得推广。     

硝苯地平联合卡托普利方案治疗原发性高血压的临床疗效分析

目的 分析硝苯地平联合卡托普利方案治疗原发性高血压的临床疗效.方法 选择笔者所在医院2010 年6 月-2011 年12 月原发性高血压患者112 例,随机分为两组,观察组56 例患者给予硝苯地平联合卡托普利方案治疗,对照组56 例患者仅给予卡托普利治疗,2 个月后观察两组治疗效果.结果 观察组显效18 例,占32.14%,有效37 例,占66.07%,总有效率为98.21%;对照组显效16 例,有效30 例,总有效率为82.14%,两组比较差异有统计学意义（P〈0.05）.两组治疗后血压较治疗前均显著下降,治疗前后比较差异有统计学意义（P〈0.05）.观察组血压控制情况明显好于对照组,两组比较差异有统计学意义（P〈0.05）.结论 硝苯地平联合卡托普利治疗高血压疗效确切,是治疗原发性高血压的有效方案,可在临床推广应用.     

观察硝苯地平缓释片联合厄贝沙坦片治疗高血压合并糖尿病的疗效

目的 探讨硝苯地平缓释片(圣通平)与厄贝沙坦片联合治疗对原发性高血压(以下简称高血压)合并2型糖尿病(以下简称糖尿病)患者的应用效果。方法 回顾性分析2017年10月至2018年9月在某社区服务中心治疗的112例高血压合并糖尿病患者的临床资料,依据用药方案的不同,分为观察组(硝苯地平缓释片+厄贝沙坦片,56例)与对照组(硝苯地平缓释片,56例),比较2组降压效果与肾功能指标[尿素氮(Blood urea nitrogen,BUN)、尿白蛋白排泄率(Urinary albumin excretion ratio,UAER)、尿微量白蛋白(Microalbuminuria,mAlb)]。结果 治疗前,两组血压、BUN、UAER及mAlb水平对比,差异无统计学意义(P>0.05);治疗3个月后,观察组血压、UAER与mAlb水平均明显低于对照组,差异有统计学意义(P<0.05)。结论 高血压合并糖尿病患者采用硝苯地平缓释片与厄贝沙坦片联合治疗后,可有效控制血压水平,利于减轻肾功能损伤。     

硝苯地平控释片联合缬沙坦治疗老年2型糖尿病肾病合并高血压的临床观察

目的观察硝苯地平控释片联合缬沙坦治疗老年2型糖尿病肾病合并高血压的临床疗效。方法选择2008年5月一2012年5月在我院治疗的老年2型糖尿病肾病合并高血压者58例,按照随机的方式分为观察组和对照组各29例。对照组给予硝苯地平控释片治疗,观察组在对照组治疗的基础上再给缬沙坦治疗。比较两组患者治疗前后血压、肾功能的指标：比较两组临床疗效。结果观察组和对照组治疗后血压和肾功能各指标均优于治疗前,差异具有统计学意义（P〈0．05）：观察组治疗后血压和肾功能各指标均优于对照组治疗后,差异具有统计学意义（P〈0．05）;治疗后观察组和对照组的总有效率分别为89．66％、68．97％,观察组明显优于对照组,差异具有统计学意义（P〈0．05）。结论硝苯地平控释片联合缬沙坦治疗老年2型糖尿病肾病合并高血压疗效确切,能显著改善患者临床指标,值得推广使用。     

奥美拉唑联合心得安、硝苯地平治疗肝源性溃疡疗效观察

[目的]观察奥美拉唑联合心得安、硝苯地平治疗肝源性溃疡的疗效。[方法]肝源性溃疡42例,联合治疗组21例给予奥美拉唑联合心得安和硝苯地平口服,对照组单纯用奥美拉唑,治疗4周为1个疗程。[结果]联合治疗组的有效率为95.2%(20/21),对照组为80.9%(17/21),两组比较差异有统计学意义(P﹤0.05)。[结论]奥美拉唑联合心得安、硝苯地平对肝源性溃疡的疗效优于单纯抑酸治疗。     

硝苯地平缓释片治疗高血压合并糖尿病的临床观察

目的硝苯地平缓释片治疗高血压合并糖尿病患者的临床应用和疗效。方法选取我院在2011年1月至2014年1月收治的高血压合并糖尿病患者60例，随机分为观察组和对照组，两组均给予常规降糖治疗，观察组加用硝苯地平缓释片治疗，对照组加用厄贝沙坦治疗，并比较两组疗效。结果观察组治疗后的降压效果明显优于对照组，且P〈0.05；两组治疗期间均未见明显不良反应。结论在常规降糖治疗的基础上，应用硝苯地平缓释片治疗高血压合并糖尿病患者安全、有效，值得临床推广。     

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.     

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.     

Psychopathological features of a patient population of targets of workplace bullying

BACKGROUND: A strong association between workplace bullying and subsequent anxiety and depression, indicated by empirical research, suggests that bullying is an aetiological factor for mental health problems. AIMS: To evaluate levels of stress and anxiety-depression disorder developed by targets of workplace bullying together with outcome at 12 months and to characterize this population in terms of psychopathology and sociodemographic features. METHODS: Forty-eight patients (36 women and 12 men) meeting Leymann Inventory of Psychological Terror criteria for bullying were included in a prospective study. Evaluations were performed at first consultation and at 12 months using a standard clinical interview, a visual analogue scale of stress, the Hospital Anxiety and Depression (HAD) scale, the Beech scale of stress in the workplace and a projective test (Picture-Frustration Study). RESULTS: At first consultation, 81% of patients showed high levels of perceived stress at work and 83 and 52% presented with anxiety or depression, respectively. At 12 months, only 19% of working patients expressed a feeling of stress at work. There was a significant change in symptoms of anxiety while there was no change in symptoms of depression. Stress at work and depression influenced significatively capacity to go back to work. At 12-month assessments, workers showed a significantly better score on the HAD scale than non-workers. Over half the targets presented a neuroticism-related predominant personality trait. CONCLUSION: Workplace bullying can have severe mental health repercussions, triggering serious and persistent underlying disorders.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.     

Organophosphate toxicity and occupational exposure

The ubiquitous organophosphates present a continuing health hazard in agriculture, public health eradication programmes and as chemical warfare agents. Despite significant progress in understanding the potential mechanisms of toxicity far beyond the commonly accepted mechanism of cholinesterase inhibition in intentional exposures, the precise health effects following occupational exposures are yet to be completely defined. A much greater understanding exists of the clinical features of organophosphate poisoning. These are characterized by a triphasic response involving an initial acute cholinergic phase, an intermediate syndrome (both associated with high mortality) and a disabling but non-lethal delayed polyneuropathy. The delayed polyneuropathy may occur in the absence of the cholinergic or intermediate phases. However, progress is still required in order to improve the quantification and assessment of occupational exposures and the implementation of appropriate preventive measures. Finally, evidence-based guidelines for appropriate or optimal therapeutic interventions following poisoning are required urgently and collaborative work with colleagues in developing countries, where the occurrence of organophosphate exposures is more frequent, may provide the answers.     

Miliaria rubra of the lower limbs in underground miners

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.     

Planning research

The starting point for any research project should be a question.Once this has been defined and the relevant scientific literaturereviewed, a protocol should be drawn up. This will be used notonly as a guide to the conduct of the study and in the preparationof the final report, but also in seeking any financial supportand approvals that are required for the investigation. A protocolis normally arranged in sections covering the background tothe study, the question(s) that it will address, the methodsthat will be used for the collection and analysis of data, thestatistical power of the investigation (where relevant), anyethical considerations, and the financial input that will beneeded. A pilot study is often helpful where aspects of thestudy method are untried or of uncertainvalidity.     

Stress in the Norwegian police service

BACKGROUND: High levels of stress have been attributed to the conditions of police work, but there is little empirical evidence for this. AIMS: To develop a new instrument to measure job stress in the police; to assess the most severe and frequent police stressors; to compare levels of stress according to the demographic and organizational factors; and to study stress in relation to personality traits, work locus of control and coping strategies. METHODS: A comprehensive nationwide questionnaire survey of 3272 Norwegian police at all hierarchical levels, including the Norwegian Police Stress Survey (NPSS), the Job Stress Survey, the Basic Character Inventory, the Work Locus of Control Scale, and the Coping Strategies Scale. RESULTS: Work injuries were appraised as the most stressful but least frequent stressor and job pressure was reported the least severe but most frequent stressor. Females experienced job stressors less frequently, but appraised them as more severe than men did. Older police officers reported more job pressure severity and fewer work injuries. The police in districts where peer support was planned but not implemented, and who worked in districts with more than 50,000 inhabitants, perceived the lack of support more severely than others. The correlations between stress and personality traits, work locus of control, and coping were moderate. CONCLUSIONS: The NPSS captures police-specific stressors that are not adequately measured by global stress instruments. The study of stress in police work should preferably involve a nationwide use of police-specific stress instruments.