肺表面活性物质治疗新生儿呼吸窘迫综合征30例临床分析

目的 探讨肺表面活性物质(PS)在新生儿呼吸窘迫综合征(NRDS)治疗中的应用及其效果.方法 将60例NRDS患儿按照是否使用PS分为治疗组与对照组,分析比较其血气分析指标、吸氧时间、机械通气时间及住院时间等指标.结果 治疗6h后,治疗组血pH值(7.41±0.11)、氧分压(PaO2) (69.8±11.9)mm Hg及二氧化碳分压(PaCO2) (48.7±11.1)mm Hg等指标均优于对照组的(7.24±0.13)、(53.3±9.8)mm Hg、(59.1±12.7)mm Hg(t =3.35、2.88、3.24,均P＜0.05)；治疗组吸氧时间(98.2±29.2)h、机械通气时间(77.6±30.4)h及住院时间(12.9±1.7)d也短于对照组的(143.9±26.5)h、(121.4±22.9)h、(17.6±2.1)d(t=4.56、5.32、4.86,均P＜0.05).结论 在NRDS治疗中应用PS,有助于改善患儿通气和换气功能,缩短患儿吸氧时间及机械通气时间.     

Treatment of osteoarthritis in hypertensive patients

Importance of the field: Osteoarthritis and hypertension commonly co-exist. Treatment of osteoarthritis in hypertensive patients is a therapeutic challenge due to the adverse effects of some analgesics, especially non-steroidal anti-inflammatory drugs (NSAIDs), on blood pressure. Even small drug-induced rises in blood pressure due to therapy may significantly increase cardiovascular risk in these patients if sustained over the long term. Patients treated with certain classes of antihypertensive agent may be at particular risk of deterioration in blood pressure control with NSAID therapy. NSAIDs may also increase cardiovascular risk due to mechanisms other than by raising blood pressure.

Areas covered in this review: We discuss the management of osteoarthritis in the hypertensive patient, review the evidence for the effects of paracetamol and NSAIDs on blood pressure and discuss novel therapeutic strategies for osteoarthritis that might diminish this problem. A literature search was undertaken in PubMed including the years 1980 – 2009.

What the reader will gain: Insight will be gained into the complexity of treating patients with co-existent osteoarthritis and hypertension and into possible new approaches to treating osteoarthritis symptoms effectively in these patients while minimising any adverse impact on blood pressure control.

Take home message: There are ways to minimise the adverse impact of treatment of osteoarthritis on blood pressure control in hypertensive patients.     

Risk conferred by tagged SNPs of AGT gene in causing susceptibility to essential hypertension

Introduction: AGT gene harbors several variants of which 21 are found to be in high linkage disequilibrium as per Hapmap database. Studies delineating the importance of these tagged SNPs are very limited and lacking from Indian population. In the present study, we evaluated the contribution of four tagged SNPs namely, g.6635G?>?A, g.6506G?>?A, g.12840G?>?A, and g.13828T?>?C at AGT locus along with the analyses of haplotype and epistatic interactions in causing susceptibility to essential hypertension (EHT).

Methods: About 215 hypertensives and 230 normotensives were genotyped for selected tagged SNPs using PCR-RFLP method.

Results: Significant association was obtained for g.6635G?>?A and g.6506G?>?A polymorphisms wherein GG homozygotes for both the markers were at risk for developing the condition. g.13828T?>?C polymorphism specially, female heterozygotes (TC) were found to be at increased risk for EHT. Haplotype GGGC was found to have a significant protective effect (p?=?0.0059). Markers g.6506G?>?A and g.12840G?>?A resulted in the creation of new enhancer sites thereby affecting splicing process.

Conclusion: The present report is the first one in the literature showing general- and gender-specific association of g.6506G?>?A and g.13828T?>?C polymorphisms, respectively, with EHT. However, further studies for replication of present observations are warranted from other populations and other parts of India.     

某社区难治性高血压患者的艾森克人格因素调查分析

目的:探讨难治性高血压患者的人格特征,为预防治疗疾病提供科学依据。方法:使用艾森克人格问卷和患者一般资料问卷对某社区高血压患者进行调查分析。结果:经t检验(P=0.023),x2检验(P=0.008),协方差分析(F=3.899,P=0.049),Logistic回归(P=0.032,OR=0.916,95%CI:0.845～0.992)结果表明艾森克人格问卷P量表得分差异有统计学意义。结论:难治性高血压患者具有态度温和、善解人意、不粗暴,能友好地与人相处,较好地适应环境等人格特点。     

The Effects of Performance Enhancement Training on Hypertension,Human Attention,Stress, and Brain Wave Patterns

Abstract

Background: The purpose of this study was to evaluate the effects of alpha-increase neurofeedback training (Performance Enhancement Training) on blood pressure, stress reduction, attention, and observe changes in brainwave patterns. A forty-nine-year-old male college student diagnosed with essential hypertension controlled by medication had undergone twenty-six sessions of alpha-increase biofeed-back (8-13 Hz) at PZ electrode site for a period of 15 weeks.

Method: Pre- and post-blood pressure measurements were taken for every session. At the beginning of week number eight, the participant discontinued his medication as advised by his physician. Pre- and post-visual TOVA CPT test was administered to assess the changes in accuracy, reaction time (RT), and RT variability. Osterkamp and Press Self-Assessment Stress Inventory was administered before and after training to assess the level of stress. QEEG evaluation was conducted prior, as well as upon completion of the study.

Results: Mean Arterial Blood Pressure (MAP) yielded statistically significant results between pre- and post-sessions within participant blood pressure measurements. The participant's systolic and diastolic blood pressures during the first thirteen sessions were not significantly different from those of the last thirteen sessions when his medication was discontinued, suggesting his ability to control his blood pressure within normal limits without the use of medication. The results of the TOVA test clearly indicate an improvement in individuals' reaction time and the reaction time variability. The results of the Osterkamp and Press Self-Assessment Stress Inventory indicated an improvement in two of the scales: Work and Social Life. Statistical analysis showed that before and after QEEG evaluations were within normal limits.

Discussion: The mechanism through which Performance Enhancement Training simultaneously affects blood pressure, reaction time (RT), and variability needs further investigation. However, the positive changes in the measured variables appear to be a function of enhanced self-awareness that leads to the improved self-regulation.     

Relationship between oxidative stress parameters and asymptomatic organ damage in hypertensive patients without diabetes mellitus

Abstract

Objective. We aimed to evaluate the levels of oxidative stress (OS) parameters such as total antioxidant status or TAS, total oxidant status (TOS), OS index (OSI), paraoxonase 1 (PON1), arylesterase, and total thiol in hypertensive patients with and without asymptomatic organ damage (AOD), and to determine the relationship between these parameters and AOD. Design. Sixty-six patients (21 men, 45 women) with AOD and 66 patients without AOD (21 men, 45 women) were enrolled in the study. Serum OS parameters were measured by colorimetric method. Results. The OSI levels were found to be higher while PON1, PON1/high-density lipoprotein, and arylesterase levels were found to be lower in patients with AOD compared with those in the patients without AOD. Stepwise regression analysis showed high 24-h mean systolic blood pressure, OSI, and low arylesterase level to be independent predictors of AOD. Conclusion. OS level was found to be higher in hypertensive patients with AOD compared with the patients without AOD. However, it is not clear whether increased OS leads to AOD or AOD increases the level of OS. For this purpose, OS level needs to be decreased by antioxidant therapies and patients need to be followed up for a longer duration.     

A preliminary controlled evaluation of the antihypertensive effect of indapamide

Summary

A controlled, single-blind trial was carried out in 10 hypertensive patients to compare the effectiveness of a single daily dose (2.5 mg to 5?mg) of indapamide with that of placebo. Blood pressure was measured with a bias-free sphygmomanometer. Indapamide produced a significant reduction in mean systolic and diastolic pressures in both supine and erect positions. It was generally well tolerated: few side-effects were reported and no significant changes were noted in laboratory tests. It is concluded that further long-term studies of indapamide are indicated in larger numbers of patients.     

益气化痰活血法对血脂正常的高血压患者血管内皮功能的影响

目的:探讨益气化痰活血法对血脂正常的原发性高血压(Essential Hypertension,EH)患者血管内皮功能的影响。方法:218例EH患者按1∶1随机分为对照组和试验组。前者给予常规西医治疗,后者在常规治疗基础上加用益气化痰活血法。治疗30d,比较两组的临床效果、内皮依赖性血管舒张功能(Flow-mediated Vasodilation,FMD)和收缩压。结果:疗程结束时,试验组总有效率显著高于对照组(97.25%VS 86.24%,P0.05);试验组FMD显著高于对照组[(8.17±0.85)%VS(6.26±0.74)%,P0.05];试验组SBP明显低于对照组[(128.64±17.35)VS(134.72±19.57),P0.05]。结论:在常规西医治疗基础上加用益气化痰活血法能显著提高血脂正常EH患者的临床疗效,改善FMD和降低SBP。     

高血压心肌肥厚患者心脏交感神经分布与勿动蛋白A表达变化的关系

目的探讨高血压心肌肥厚患者心脏交感神经分布与神经元轴突生长抑制因子勿动蛋白A(neurite out-growth inhibitor-A,Nogo-A)的表达变化。方法从我院老年患者尸体标本库中,随机入选男性高血压患者10例,并根据患者去世前1周心脏超声结果分为心肌肥厚组4例和非心肌肥厚组6例。检测超声心动图,并计算左心室重量指数。免疫组织化学分析测定酪氨酸羟化酶(tyrosine hydroxylase,TH)与Nogo-A的表达。结果与非心肌肥厚组比较,心肌肥厚组患者室间隔厚度、左心室后壁厚度、左心室重量指数明显升高(P<0.05);心肌肥厚组患者心肌TH阳性表达明显降低[(6.35±3.85)%υs(22.17±8.19)%,P<0.05],Nogo A表达明显增加[(11.34±7.16)%υs(2.17±4.10)%,P<0.05]。心肌肥厚患者心肌Nogo-A表达与心肌TH表达呈负相关(r=-0.33,P<0.05)。结论老年高血压心肌肥厚患者心肌交感神经分布减低,然而心肌神经元轴突生长抑制因子Nogo-A表达增加,两者间存在密切相关性。