奥美沙坦酯片联合苯磺酸氨氯地平治疗老年高血压的临床效果观察

目的 观察奥美沙坦酯片联合苯磺酸氨氯地平治疗高血压的临床疗效.方法 将2011年7月-2013年7月收治的老年高血压患者116例随机分为研究组及对照组各58例.研究组给予奥美沙坦酯片联合苯磺酸氨氯地平治疗,对照组给予单纯苯磺酸氨氯地平治疗.治疗后比较2组临床疗效,血压值及不良反应发生情况.结果 研究组总有效率为94.8%高于对照组的82.8%,差异有统计学意义（P＜0.05）.治疗后研究组收缩压、舒张压均低于对照组,差异均有统计学意义（P＜0.05）.116例患者服药后出现不良反应3例,发生率为2.58%,主要表现为轻微头痛,患者可耐受,不影响治疗.结论 奥美沙坦酯片联合苯磺酸氨氯地平治疗高血压的临床疗效优于单纯苯磺酸氨氯地平治疗,且不良反应少,值得临床推广应用.     

The add-on effect of dengzhan shengmai capsules on secondary prevention of ischemic stroke: A multicentre,randomised, placebo-controlled clinical trial

ObjectiveThe Dengzhan Shengmai (DZSM) capsule is a commercially available type of Chinese herbal medicine frequently administered to improve neurological impairment after stroke. Its ability to prevent recurrent stroke, however, has not been determined. This study therefore evaluated the ability of DZSM as an add-on to conventional secondary preventive agents to prevent recurrent ischemic stroke.MethodsIn this randomised, double-blind, placebo-controlled trial, conducted at 83 hospitals in Mainland China, 3143 patients in 14–180 days after the initial onset of ischemic stroke, were randomly allocated to the DZSM (0.36 g, twice daily for 12 months) or the placebo group. All patients in both groups received standard secondary preventive medications. The primary outcome was the 1-year incidence of stroke. Between group differences were assessed using the Cox proportional hazards model.ResultsIntent-to-treat analysis showed that 58 (3.8%) participants in the DZSM group and 82 (5.4%) in the placebo group experienced new stroke events (hazard ratio = 0.70, 95% confidence interval = 0.50–0.98, P = 0.036). The type and incidence of adverse events were similar in the DZSM and placebo groups.ConclusionsThe addition of DZSM capsules to standard secondary preventive agents provides additional benefits after the initial onset of ischemic stroke, reducing recurrent stroke without increasing severe adverse events. However, further study is needed to elucidate the role of DZSM on the updated practice of conventional secondary prevention for ischemic stroke.     

特发性间质性肺炎患者18F-FDG PET/CT与肺功能及炎性指标的相关性

目的 观察特发性间质性肺炎（ⅡP）患者¹⁸F-FDG PET/CT显像与肺功能及实验室炎性指标的关系。方法 回顾性分析20例ⅡP患者（ⅡP组）和20例肺部正常患者（对照组）的PET/CT图像,测量全肺最大标准摄取值（SUV_max）和平均标准摄取值（SUV_mean）,并校正获得最大靶背景比（TBR_max）和平均靶背景比（TBR_mean）,比较ⅡP组与对照组间SUV和TBR的差异,评价ⅡP组TBR与肺功能及炎性指标的相关性。结果 ⅡP组SUV_max、SUV_mean、TBR_max和TBR_mean均显著高于对照组（P均<0.001）。ⅡP组TBR_mean与用力肺活量（FVC,r=-0.811,P=0.004）、肺一氧化碳弥散量（DLCO,r=-0.715,P=0.020）、第1秒用力呼气量（FEV1,r=-0.698,P=0.025）、残气量（RV,r=-0.844,P=0.002）、肺总量（TLC,r=-0.693,P=0.026）及RV/TLC（r=-0.711,P=0.021）呈负相关,与FEV1/FVC（r=0.888,P=0.001）呈正相关。TBR_max与FVC（r=-0.667,P=0.035）和RV（r=-0.643,P=0.045）呈负相关,与DLCO、FEV1、FEV1/FVC、TLC、RV/TLC无明显相关性（P均>0.05）。ⅡP组TBR_max和TBR_mean分别与红细胞沉降率、C反应蛋白均无明显相关性（P均>0.05）。结论 ⅡP患者¹⁸F-FDG放射性摄取增高,其程度与肺功能具有一定相关性。     

借鉴管理体系认证经验保证医院评审规范公平

回顾了国内外医院评审的现状、分析了我国医院评审管理中存在的问题.介绍了国内外管理体系认证的方法,提出我国医院评审应在评审研究、审核员注册、持续改进措施、评审咨询及评审机构管理等方面吸收借鉴.     

Vitamin E and memantine in Alzheimer's disease: Clinical trial methods and baseline data

BackgroundAlzheimer's disease (AD) has been associated with both oxidative stress and excessive glutamate activity. A clinical trial was designed to compare the effectiveness of (i) alpha-tocopherol, a vitamin E antioxidant; (ii) memantine (Namenda), an N-methyl-D-aspartate antagonist; (iii) their combination; and (iv) placebo in delaying clinical progression in AD.MethodsThe Veterans Affairs Cooperative Studies Program initiated a multicenter, randomized, double-blind, placebo-controlled trial in August 2007, with enrollment through March 2012 and follow-up continuing through September 2012. Participants with mild-to-moderate AD who were taking an acetylcholinesterase inhibitor were assigned randomly to 2000 IU/day of alpha-tocopherol, 20 mg/day memantine, 2000 IU/day alpha-tocopherol plus 20 mg/day memantine, or placebo. The primary outcome for the study is the Alzheimer's Disease Cooperative Study/Activities of Daily Living Inventory. Secondary outcome measures include the Mini-Mental State Examination; the Alzheimer's Disease Assessment Scale, cognitive portion; the Dependence Scale; the Neuropsychiatric Inventory; and the Caregiver Activity Survey. Patient follow-up ranged from 6 months to 4 years.ResultsA total of 613 participants were randomized. The majority of the patients were male (97%) and white (86%), with a mean age of 79 years. The mean Alzheimer's Disease Cooperative Study/Activities of Daily Living Inventory score at entry was 57 and the mean Mini-Mental State Examination score at entry was 21.ConclusionThis large multicenter trial will address the unanswered question of the long-term safety and effectiveness of alpha-tocopherol, memantine, and their combination in patients with mild-to-moderate AD taking an acetylcholinesterase inhibitor. The results are expected in early 2013.     

Changes in Spectral Characteristics and Copper (II)-Binding of Dissolved Organic Matter in Leachate from Different Water-Treatment Processes

The aim of the present study was to investigate the fluorescence properties of dissolved organic matter (DOM) from four leachate samples, which were disposed by regulating tank (RTK), anaerobic treatment (ATT), oxidation ditch (ODH), and membrane bioreactor and to assess their binding capacities and stability constants by Cu(II). The results showed that five fluorescent peaks, including three humic-like peaks (peaks A, C, and E) and two protein-like peaks (peaks B and D), were identified. Most fluorescent components can be degraded after ODH. Fluorescence-quenching titration showed that the modified Stern–Volmer model can be used to fit the quenching data and calculate conditional stability constants (log K) and the % of fluorophores (f %) between DOM and Cu(II). DOM–Cu(II) complexes had relatively high log K values in the RTK and ATT disposals. After the ODH-treatment process, log K values showed a marked decrease. The f % values of protein-like materials were evidently greater than those of humic-like substances. The results showed the impact of the water treatment on the metal-binding ability of various fractions.     

Analysis and Study on 47 Cases of Adverse Reactions of Chinese Medicine Injection

Background

Along with efficacy, Chinese medicine is increasingly being known to people, Chinese medicine and its preparations are increasingly widespread in clinical use. People generally believe that Chinese medicine has few side effects and is safe, especially Chinese medicine injections. Due to the direct injection in blood, rapid onset and good efficacy, they are welcomed by people. However, with increased use, adverse reactions are increasing, even causing serious consequences. The objective is to learn about the characteristics and laws of the adverse effects of Chinese medicine injections, provide references for the clinical safe drug use, and reduce the incidence of adverse reactions.

Materials and Methods

The method was established to analyze the data of 47 cases of adverse reactions caused by Chinese medicine injections in our hospital from the year, 2009 to 2010.

Results

The organs / systems involved in the 47 cases of adverse reactions are primarily skin and its accessories and secondly systemic damage, involving a total of eight varieties of drugs.

Conclusion

The adverse reactions of Chinese medicine injections are mostly in Chinese patent drugs, which should be paid attention to, to find out the problems and laws, use the drugs rationally, and reduce the incidence of the adverse reactions.     

咬合抬高对后牙重度磨耗患者咀嚼肌表面肌电值的影响

目的：探讨后牙重度磨耗患者咬合抬高后对咀嚼肌表面肌电反应的影响。方法：随机选取2012年1月至2014年1月在我北京航空总医院口腔诊疗中心就诊的,伴有双侧后牙重度磨耗的患者40名为受试对象,其中男性23名,女性17名,年龄40-50岁,治疗前及咬合抬高不同距离后分别进行咬肌及颞肌的肌电检查,并对结果采用多样本均数比较的单因素方差分析进行统计学处理。结果：切牙区颌间距离增加1mm时,双侧咬肌,双侧颞肌肌电值差异无统计学意义。切牙区颌间距离增加2mm时,左侧咬肌,右侧咬肌,左侧颞肌肌电值差异无统计学意义,右侧颞肌肌电值有所增加（17.08±3.27 VS 24.66±3.18,P〈0.05）。切牙区颌间距离增加3mm时,除右侧咬肌肌电值差异无统计学意义外（22.35±3.14 VS 27.74±4.26,P〉0.05）,左侧咬肌,左侧颞肌,右侧颞肌肌电值差异均有统计学意义。切牙区颌间距离增加4mm时,双侧咬肌,颞肌肌电值差异均有统计学意义。结论：切牙区颌间距离增加2mm时对咬肌和颞肌肌电值影响不大,切牙区颌间距离增加3mm会对咬肌和颞肌肌电值产生较大影响。     

Enhanced nitrite accumulation under mainstream conditions by a combination of free ammonia-based sludge treatment and low dissolved oxygen: reactor performance and microbiome analysis

Partial nitritation under mainstream conditions is one of the major bottlenecks for the application of deammonification processes to municipal wastewater treatment plants. This study aimed at evaluating the combination effect of a side-stream free ammonia (FA) treatment and low dissolved oxygen (0.2 ± 0.1 mg L⁻¹) on inhibiting nitrite oxidizing bacteria (NOB) from enhancing nitrite accumulation in long-term lab-scale experiments. Two continuous floccular sludge reactors treating low-strength synthetic wastewater (60 mg N–NH₄⁺ L⁻¹ without COD) with a fixed nitrogen loading rate of 0.22 ± 0.03 g N per L per day were operated in a varied temperature range of 7–31 °C, with one acting as the experimental reactor and the other as the control. Side-stream sludge treatment with a stepwise elevation of FA concentration (65.2–261.1 mg NH₃ L⁻¹) was carried out every day in the experimental reactor; the nitrite accumulation ratio (NAR, (NO₂–N/(NO₂⁻–N + NO₃⁻–N) × 100%)) in the experimental reactor was always about twice that in the control one. Quantitative PCR (q-PCR) and high-throughput sequencing analyses showed the dominant NOB was mostly Nitrobacter, while there was an alternating trend between Nitrobacter and Nitrospira. Even though the whole microbial communities of each experimental stage between the two reactors were relatively clustered due to an incomplete NOB washout, three abundant metabolisms (amino acid metabolism, pyruvate metabolism and nitrogen metabolism) and key functional genes of nitrification predicted by PICRUSt in the experimental reactor were enriched, providing a better understanding of nitrite accumulation. These results have demonstrated that the positive hybrid effects of FA side-stream sludge treatment and a low DO could enhance nitrite accumulation. It is expected that a complete washout of NOB would be achieved after further process optimization.

An introduction of the combination of side-stream sludge treatment using FA and low DO could more effectively enhance nitrite accumulation than single low DO.     

Vanadium exposure-induced neurobehavioral alterations among Chinese workers

Vanadium-containing products are manufactured and widely used in the modern industry. Yet the neurobehavioral toxicity due to occupational exposure to vanadium remained elusive. This cross-sectional study was designed to examine the neurotoxic effects of occupational vanadium exposure. A total of 463 vanadium-exposed workers (exposed group) and 251 non-exposed workers (control group) were recruited from a Steel and Iron Group in Sichuan, China. A WHO-recommended neurobehavioral core test battery (NCTB) and event-related auditory evoked potentials test (P300) were used to assess the neurobehavioral functions of all study subjects. A general linear model was used to compare outcome scores between the two groups while controlling for possible confounders. The exposed group showed a statistically significant neurobehavioral alteration more than the control group in the NCTB tests. The exposed workers also exhibited an increased anger-hostility, depression-dejection and fatigue-inertia on the profile of mood states (p < 0.05). Performances in the simple reaction time, digit span, benton visual retention and pursuit aiming were also poorer among exposed workers as compared to unexposed control workers (p < 0.05). Some of these poor performances in tests were also significantly related to workers’ exposure duration. P300 latencies were longer in the exposed group than in the control (p < 0.05). Longer mean reaction times and more counting errors were also found in the exposed workers (p < 0.05). Given the findings of our study and the limitations of neurobehavioral workplace testing, we found evidence of altered neurobehavioral outcomes by occupational exposure to vanadium.