正常血压高值与心脑血管事件的关系

2005年,中国高血压防治指南明确提出,收缩压(SBP)120～139mmHg和/或舒张压(DBP)80～89mmHg人群,其心脑血管疾病发病危险显著上升,并将之命名为正常血压高值,且建议降低高血压发病率和心脑血管疾病病死率,应从正常血压高值人群中预防.     

高血压前期可增加心血管疾病的风险

来自于美国北卡罗来纳大学的Abhijit V．Kshirsagar博士及其同事近日报道的一项最新研究显示,高血压前期的血压水平(在120／80mmHg至139／89mmHg范围内)与心血管疾病(CVD)风险增加关联。     

对治疗高血压疾病的粗浅看法

一般情况下，理想的血压为120／80mmHg，正常血压为130／85mmHg以下。而130～139／85～89mmHg为临界高血压，为正常高限；140～159／90～99mmHg为高血压Ⅰ期，此时机体无任何器质性病变，只是单纯高血压；160-179／100-109mmHg为高血压Ⅱ期，此时有左心室肥厚、心脑肾损害等器质性病变，但功能还在代偿状态；180／110mmHg以上为高血压Ⅲ期，此时有脑出血，心力衰竭、肾功能表竭等病变，已进入失代偿期，随时可能发生生命危险。笔者在医院工作数十年，治疗高血压患者上百例，本文根据自身治疗经验，谈几点看法。     

高血压前期的研究近况

对于血压115／75mmHg的患者，收缩压每升高20mmHg，舒张压每升高10mmHg，发生心血管事件的危险性将增加1倍；Framingham研究表明收缩压120～139mmHg或舒张压80～89mmHg的患者4年后进展为高血压的比例（49．5％，95％CI42．6％～56．4％）显著高于理想血压的人群（25．5％，95％CI20．4％～31．4％）；对老年患者的研究也显示，     

高血压前期的研究近况

对于血压115／75mmHg的患者，收缩压每升高20mmHg，舒张压每升高10mmHg，发生心血管事件的危险性将增加1倍；Framingham研究表明收缩压120～139mmHg或舒张压80～89mmHg的患者4年后进展为高血压的比例（49．5％，95％CI42．6％～56．4％）显著高于理想血压的人群（25．5％，95％CI20．4％～31．4％）；对老年患者的研究也显示，     

诊断高血压病应注意的几个问题

高血压是重要的心脑血管疾炳危险因素，即便是轻度血压升高，甚至正常高值[130-139／8589mmHg（1mmHg=0．133kPa）]或高血压病前期（收缩压为120～139／80-89mmHg）者，卒中与急性心肌梗死等心脑血管疾病的危险性也显著高于血胜处于理想水平者（120／80mmHg），而且本病一旦诊断明确，降压治疗需要长期、持续甚至终身管理。所以高血压病的诊断显得尤其重要。高血压病在诊断过程中应在以下几个方面加以注意。     

包钢高级知识分子高血压前期及危险因素调查分析

2004年《中国高血压防治指南》,设立了"正常高值血压",等同于美国JNC7关于血压分级的"高血压前期",据报道:基线血压在120～139/80～89mmHg的35～64岁亚组人群,10年后发生高血压的比例为52.6%。而且10年前正常血压和"高血压前期"亚组人群,10年后发生高血压的比例分     

高血压前期不同血压水平与颈动脉粥样硬化关系研究

[摘要] 目的 观察高血压前期不同血压水平与颈动脉内膜-中层厚度的关系。方法 根据JNC-7，236例按照血压水平分为4组：正常血压组:收缩压/舒张压(SBP/DBP)<120/80mmHg，高血压前期组:SBP/DBP120～139/80～89mmHg,，高血压组:SBP/DBP≥140/90mmHg，其中高血压前期组按照收缩压水平再分为.高血压前期1组(SBP120～129mmHg), 高血压前期2组(SBP130～139mmHg), 应用颈动脉超声检测颈总动脉，颈内动脉和颈动脉分叉处内膜-中层厚度。结果 高血压组和高血压前期2组颈总动脉、颈动脉分叉处 IMT值均高于正常组,组间比较差异有有显著性（P<0.05）。高血压前期1组颈总动脉，颈内动脉和颈动脉分叉处内膜-中层厚度虽高于正常组,但差异无显著性(P>0.05)。 结论 高血压前期组人群已出现颈动脉内膜-中层厚度增厚的亚临床损害，其中在血压130～139/80～89mmHg时这种更加突出。     

高血压前期生活方式定期干预两年随访

为了强调高血压的一级预防,即把心血管病的防线从防发病前移到防危险因素, 2003年5月21日美国高血压预防、诊断、评估与治疗联合委员会的第七次报告(简称JNC7)提出"高血压前期"的概念[1].它是指收缩压在120～139 mmHg和(或)舒张压在80～89 mmHg,即在正常血压到确诊高血压之间的过渡阶段.北京阜外、安贞等医院调查显示,我国高血压前期的患病率为38.9% ～41.3%,与理想血压人群相比高血压前期患者10年后发生高血压风险增加2倍多,发生心血管事件的风险增加1.8倍[2].     

高血压前期的防治

近几年来高血压患者出现年轻化趋势，笔者发现有很多年轻人的血压经常波动在高血压前期（根据JNC7的标准，即血压波动在120～139／80～90mmHg）。JNC7指出55岁血压正常的人，未来发生高血压的危险为90％。因此及早对这一部分人的预防有重要意义。     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.