妊娠相关血浆蛋白A及其基因IVS6＋95（C／G）多态性与急性冠状动脉综合征的相关性研究

目的研究湖北省十堰地区妊娠相关血浆蛋白A（PAPP-A）及其基因IVS6＋95（C／G）多态性与急性冠状动脉综合征（ACS）的相关性。方法随机选择ACS患者219例,其中男性125例。女性94例．平均年龄63．25岁。健康对照者212例,其中男性114例．女性98例,平均年龄59．66岁。取血液标本．应用荧光探针聚合酶链反应和基因芯片技术对其PAP-A基因IVS6＋95（C／G）多态性进行基因分型,用电化学发光法检测PAPP—A浓度。结果ACS组PAPP—A显著高于对照组[（45．92±18．39）pg／mL vs 5（4．11±0．83）pg／mL],差异有显著统计学意义（P〈0．01）;亚组急性心肌梗死（AMI）组[（82．42±26．41）pg／mL]和不稳定心绞痛（UAP）组[（30．52±12．62）pg,mL]血浆PAPP-A都显著高于对照组,差异有显著统计学意义（P〈0．01）．AMI组与UAP组相比差异也有显著统计学意义（P〈0．01）。ACS组GG、GC、CC基因型频率分别为43．38％、41．09％、15．53％,对照组GG、GC、CC基因型频率分别为50．00％、43．40％、6．60％,差异具有统计学意义（P〈0．05）。G、C等位基因频率在ACS组和对照组分别为63．93％、36．07％和71．70％、28．30％,差异也具有统计学意义（P〈0．05）。在ACS组和对照组．各类基因型人群PAPP—A浓度差异无统计学意义（P〉0．05）。结论PAPP-A及其基因IVS6＋95（C／G）多态性与ACS相关．C等位基因和CC基因型是ACS发病的易感危险因素之一。     

中药注射剂不良反应现状及风险控制措施浅析

目的针对中药注射剂的高风险性,分析其引起不良反应的风险因素,并提出相应的风险控制措施,以促进其临床合理用药。方法根据相关文献和报道,对中药注射剂不良反应特别是过敏反应的现状、发生原因和防治措施进行归纳分析。结果中药注射剂的风险因素包括药物、临床使用和用药者三方面。结论改进制剂工艺,规范临床使用,重视患者个体差异,加强安全性相关的基础研究和上市后的安全性再评价工作,以降低中药注射剂的用药风险。     

Determinants of physical and mental health complaints in dentists: a systematic review

Occupational determinants of ill health in dentists were systematically reviewed in literature. The methodological quality of the studies was evaluated. Studies were included if they evaluated health‐related risk factors in dental practice by means of quantitative methods and statistical analysis of collected data. Despite all the factors affecting dentists' physical and mental health, evidence of the predictive value of all these risk factors remains scarce. More than one‐third (37%) of the studies appraised were found to be low quality research (weak or invalid). Results from studies investigating the factors associated with ill health in dentists do not allow for conclusions at the meta‐level. More prospective and retrospective case‐control studies should be conducted and attention should be paid to measuring outcomes with validated instruments to enable comparative studies and statistical summation of findings.     

Women at the Military Academies

In brief: This study compared three stages of iron deficiency (iron depletion, iron deficiency erythropoiesis, and iron deficiency anemia) in athletes and controls immediately after menstruation and at midcycle. All athletes had subnormal serum ferritin levels at both test periods, indicating stage 1 iron deficiency. The control group's serum ferritin levels were normal. Two athletes were stage 2 iron deficient, but no athletes or control subjects were in the third stage of iron deficiency. This study shows that stage 1 and 2 iron deficiency may exist in female athletes even in the absence of anemia. Therefore, sports programs should provide nutrition counseling, but indiscriminate use of oral iron supplements should be discouraged.     

5-year results of a comprehensive rehabilitation programme after myocardial infarction

A comprehensive cardiac rehabilitation programme has been offeredto a non-selected consecutive group of patients who have survivedan acute myocardial infarction (MI). The programme includesfollow-up at a post-MI clinic, physical training in outpatientgroups, the provision of information on smoking and diet, andpsychological support to patients and their families. The interventiongroup, consisting of the 147 patients participating in the programmehas been compared with a nonselected consecutive reference groupof 158 patients receiving standard care. During the five-year follow-up there was no difference in cardiacmortality between the groups, but the recurrence rate of non-fatalMl (17.3 vs 33.3%. P = 0.02) and the rate of total cardiac eventswas lower in the intervention group (39.5 vs 53.2%, P = 0.05).There was an alteration of risk factors, as there were fewersmokers and uncontrolled hypertensives in the intervention group.Patients in the reference group used more sedatives and long-actingnitroglycerine ami had a lower return-to-work rate during thestudy period. The programme proved to be particularly effective in the agegroup below 55 years, where a significantly lower rate of totalcardiac events was observed and more patients returned to workthan in the reference group. It is concluded that the combined effect of the comprehensiveprogramme has contributed to the long-term results, and thatthe programme offers an effective and safe method of secondaryprevention after MI.     

关于新生儿窒息案例及其相关因素分析

目的探讨新生儿窒息发生的相关因素,提出干预措施.方法对2003年1月～2005年1月在南海金沙医院出生的新生儿窒息140人的相关因素进行回顾性分析.结果新生儿窒息为综合因素所致,多为胎儿窘迫的延续.胎儿高危因素为93.57%,分娩时高危因素高达92.86%,母体高危因素为67.86%.结论加强围产期保健,及时处理高危妊娠,综合分析可能发生新生儿窒息的高危因素,适时正确选择分娩方式是降低新生儿窒息和病死率的关键措施.     

Relationship between the number of endothelial progenitor cell and the severity of coronary artery disease

Background Previous studies have suggested that patients with low endothelial progenitor cell(EPC)counts and impaired endothelial colony forming activity have a higher incidence for cardiovascular events compared to patients with high EPC counts and favorable colony forming activity.The pathophysiological basis for this finding may be an insufficient endothelial cell repair by EPC.The objective of this study was to determine whether the number of EPCs in peripheral blood was associated with the presence and severity of angiographic stenosis in patients of the late phase after acute myocardial infarction(AMI).Methods One hundred and one patients undergoing cardiac catheterization in our hospital were enrolled in the study.The number of circulating EPCs was measured by a fluorescent-activated cell sorter(FACS).Patients with acute coronary syndromes were excluded.Results Compared with patients with normal coronary artery,the number of circulating EPCs was significantly reduced among patients in the late phase after AMI(P < 0.01).We also found that compared with the control group,the number of EPCs of single-vessel stenosis group and multi-vessel stenosis group were significantly reduced(P = 0.005;P = 0.001).Conclusions The number of EPCs in the peripheral blood is decreased in patients of the late phase after AMI.The EPCs number correlated with angiographic stenosis severity,which suggests that endothelial injury in the deficient circulating EPCs may affect the severity of the heart disorder and the clinical presentations.     

Secondary prevention through cardiac rehabilitation: position paper of the Working Group on Cardiac Rehabilitation and Exercise Physiology of the European Society of Cardiology.

The purpose of this statement is to provide specific recommendations in regard to evaluation and intervention in each of the core components of cardiac rehabilitation (CR) to assist CR staff in the design and development of their programmes; the statement should also assist health care providers, insurers, policy makers and consumers in the recognition of the comprehensive nature of such programmes. Those charged with responsibility for secondary prevention of cardiovascular disease, whether at European, at national or at individual centre level, need to consider where and how structured programmes of CR can be delivered to the large constituency of patients now considered eligible for CR.     

50例深部真菌感染病例回顾性分析

目的探讨近年来院内真菌感染的类型及易感因素，为临床医生提高对真菌感染的认识及早诊治提供理论依据，同时为新型抗真菌药在临床上应用提供依据。方法回顾性分析自2005年1月至2005年12月间在郑州大学第一附属医院和第五附属医院住院病人中经微生物学检验证实的50例真菌感染病例，分析院内深部真菌感染与年龄、住院天数、基础疾病、危险因素、治疗经过、用药情况间的关系。结果院内深部真菌感染的主要真菌为念珠菌（82％）；感染部位依次为口腔、呼吸道和泌尿生殖道；感染的发生与应用免疫抑制荆、糖皮质激素、抗生素的应用、气管切开和插管、昏迷、恶性肿瘤、留置导尿及老年患者有关。院内真菌感染的基础疾病包括呼吸系统、神经系统、血液系统、消化系统和泌尿系统疾病等。结论院内接受特殊治疗的患者易发生真菌感染；念珠菌仍是医院内真菌感染的主要病原；临床医生应高度重视真菌感染在院内感染中所占的位置，及早发现及早治疗。