淮安市清河区公厕空间布局探讨

运用人群密度分析法和人口分布分析法,对淮安市清河区公共厕所的布局、质量、数量进行分析,并提出了公厕布局方案。     

The role of posterior wall isolation in catheter ablation of persistent atrial fibrillation

The left atrial posterior wall has many embryologic, anatomic, and electrophysiologic characteristics, that are important for the initiation and maintenance of persistent atrial fibrillation. The left atrial posterior wall is a potential target for ablation in patients with persistent atrial fibrillation, a population in whom pulmonary vein isolation alone has resulted in unsatisfactory recurrence rates. Published clinical studies report conflicting results on the safety and efficacy of posterior wall isolation. Emerging technologies including optimized use of radiofrequency ablation, pulse field ablation, and combined endocardial/epicardial ablation may optimize approaches to posterior wall isolation and reduce the risk of injury to nearby structures such as the esophagus. Critical evaluation of future and ongoing clinical studies of posterior wall isolation requires careful scrutiny of many characteristics, including intraprocedural definition of posterior wall isolation, concomitant extrapulmonary vein ablation, and study endpoints.     

Risk for osteoporosis and fracture with glucocorticoids

Glucocorticoid use is ubiquitous and is associated with multiple adverse reactions. Among them, osteoporosis and bone fractures are of our concern. In this review, we present current evidence on the effect of glucocorticoids on bone mineral density and the risk of fractures, the mechanisms underlying those effects, and the recommendations for monitoring and treating patients who take them.The bone mineral density of the lumbar spine and total hip is lower, and the risk of fractures is higher in glucocorticoid users than non-users. These effects have a rapid onset, are dose-dependent, and improve soon after discontinuation of glucocorticoids. They also appear to occur even with non-systemic routes of administration and with low doses.Glucocorticoids reduce bone mineral density by increasing osteoclast activity and decreasing osteoblast and osteocyte activity. Calcium metabolism and parathyroid hormone activity are less important than was initially thought.Treatment decisions are on risk stratification using clinical, radiographic, and prediction tools. Our armamentarium for the treatment and prevention of glucocorticoid-induced osteoporosis includes calcium and vitamin D, bisphosphonates, recombinant parathyroid hormone, monoclonal antibodies against receptor activator of nuclear factor kappa-B ligand, and hormone treatments.     

以生物电阻法检测的身体组成成分与女性骨量的关系

目的 探讨体内的体脂和非体脂对绝经前和绝经后妇女骨密度(BMD)的作用。方法 282例绝经前和205例绝经后妇女参加本研究,用双能X线骨密度仪测定腰椎和股骨颈BMD,用生物电阻法测定体脂和非体脂,同时测量身高、体重、腰围、臀围,并计算体重指数(BMI)和腰臀围比(WHR)。结果 体脂和非体脂与绝经前、绝经后妇女腰椎和股骨颈BMD均呈显著正相关(P＜0．01),多元逐步回归分析显示,在绝经前妇女中,非体脂和年龄是腰椎BMD的独立影响因素(R^2=0．077,P=0．000),非体脂、年龄和BMI是影响股骨颈BMD的决定因素(R^2=0．130,P=0．000),在绝经后妇女中,体脂和年龄是影响腰椎和股骨颈BMD的决定因素(R^2分别为0．153和0．184,P=0．000)。结论 体脂和非体脂对绝经前和绝经后妇女BMD的作用不同,非体脂是决定绝经前妇女骨量的重要因素,而体脂是影响绝经后妇女骨量的重要因素。     

High-Sensitivity Troponins and Outcomes After Myocardial Infarction

Background

It remains unknown how the introduction of high-sensitivity cardiac troponin T (hs-cTnT) has affected the incidence, prognosis, and use of coronary angiographies and revascularizations in patients with myocardial infarction (MI).