日晒海盐工人机体内高镁反应

报道福建某盐场从事日晒海盐生产人工机体内高镁对心血管系统的影响，通过现场空气、饮水、主良的镁含量测定，并对进入机体途径进行分析，得出空气、卤水接触、饮水为机体镁增高的主要来源。不同对象头发镁含量测定结果显示，以接触卤水、劳动强度大的盐工最高，并随机体内镁含量增高，出现血压偏低、心率减慢、心电图Ｐ－Ｒ间期延长、ＱＲＳ波增宽、Ｔ波高尖等机体高镁反应，与临床高镁血症相似。     

A Retrospective Review of the Use and Safety of Droperidol in a Large, High-risk, Inner-city Emergency Department Patient Population

Droperidol (DROP) is used in the emergency department (ED) for sedation, analgesia, and its antiemetic effect. Its ED safety profile has not yet been reported in patients (pts). OBJECTIVES: To document the use of DROP in high-risk pts (those with head injury, alcohol or cocaine intoxication, and/or remote or recent seizures), and to determine the number of serious and minor adverse events (AEs)-seizures, hypotension, extrapyramidal side effects (EPSEs)-after DROP. METHODS: The ED database (EmSTAT) was queried to determine who received intramuscular or intravenous DROP in the ED in 1998; further chart review was done if the patient was considered high risk for or had experienced an AE. Multiple regression analysis using a random-effects model determined the significance of each variable in the occurrence of AEs. RESULTS: 2,468 patients (aged 20 months to 98 years; 112 < or =17 years; 141 > or =66 years) received DROP for agitation (n = 1,357), pain (1,135), anxiety (99), vomiting (173), or other reasons (50). There were 945 pts considered high risk; 933 charts were reviewed (DROP mean dose 4.1 +/- 2.0 mg); of these, 50 patient visits did not meet the criteria for high risk. There were 622 pts with head trauma (401 with alcohol use), including 47 with computed tomography (CT) scans positive for brain injury, 64 with cocaine use, and 197 with recent or remote seizures (137 with alcohol use). Minor AEs such as transient hypotension occurred in 96 pts after DROP (73 with alcohol use); 20 received intravenous fluids, while an additional 28 pts (8 with alcohol use) received rescue medications for EPSEs. Six possible serious AEs occurred in pts with serious comorbidities; 2 cases of respiratory depression, 3 post-DROP seizures, and 1 cardiac arrest (resuscitated) 11 hours after DROP in a cocaine-intoxicated pt (normal QT interval). There was no significant difference among high-risk groups in the occurrence of AEs. CONCLUSIONS: The vast majority of pts who received DROP in the ED did not experience an AE. A few serious AEs were noted following DROP in patients with serious comorbidities; it is not clear that DROP was causative.     

Depression in 11–16-year-old Girls: The Role of Past Parental Psychopathology and Exposure to Recent Life Events

Abstract— Interviews with parents of a non-referred sample of 11–16-year-old girls ( n = 82) revealed that a significantly greater proportion of mothers with a lifetime: history of any psychiatric disorder also reported one or more recent undesirable life events focused on the adolescent compared with mothers with no such history, Lifetime episodes of maternal depression and recent undesirable life events exerted significant additive effects on the likelihood of depression occurring in the previous 12 months in adolescent girls. Some families may be "life event prone" as a consequence of lifetime episodes of parental psychopathology.     

Wnt-frizzled信号通路与心血管疾病关系的研究进展

Many researches have focused on the wnt- frizzled cascade in the recent years, while much work has been done in neoplastic diseases and embryology, the role of the wnt- frizzled signal transduction pathway in cardiovascular diseases has only recently begun to be explored. It plays a very important role in many physiological and pathophysiological processes, such as its transduction pathway, the healing after myocardial infarction, the proliferation, differentiation and orientation of cardiomyocytes, angiogenesis/neovascularization, cardiac hypertrophy and heart failure, the deposition of the extracellular matrix and so on. This article is aimed at its relation with myocardial infarction and the role of this pathway in cardiovascular diseases.     

美托洛尔预防老年围拔管期心血管反应的临床观察

目的探讨美托洛尔用于预防老年患者围拔管期心血管反应的方法。方法40例全身麻醉行择期手术的老年患者随机分为A组20例,B组20例,A组围拔管期分次静注美托洛尔0.06~0.1 m g/kg,B组以生理盐水分次静注。观察手术结束时、拔管前5分钟、拔管时、拔管后5、20分钟的心率(HR)、收缩压(SBP)、舒张压(DBP)及心率收缩压乘积(RPP)的变化。结果A组拔管时、拔管后5、20分钟的HR、RPP与手术结束时比较,差异无统计学意义,用药后最慢心率53次/m in,围拔管期血压维持平稳,RPP保持在较低值;B组拔管前5分钟、拔管时、拔管后5分钟的各参数与手术结束时比较明显升高(P<0.01);两组间比较,B组拔管前5分钟、拔管时、拔管后5分钟的HR、SBP、RPP明显高于A组(P<0.01)。结论老年患者小剂量分次静注美托洛尔可以安全地预防围拔管期心血管反应。     

雌激素及其受体对心血管系统保护作用实验研究进展

雌激素对心血管系统具有重要的保护作用。雌激素及其受体主要通过调节血管舒张功能、抑制血管平滑肌细胞增殖和迁移以及影响肾素 -血管紧张素等介导这一保护作用。但临床上雌激素替代治疗尚未得到肯定 ,需进一步研究     

Depressed pathological gamblers

Depressed gamblers (n = 14) were compared with normal controls (n = 41) for antecedent life events. The depressed gamblers had experienced significantly more life events, and undesirable or exit life events, during the 6 months before the onset of depression.     

影响部队汽车驾驶员心身健康水平和行车安全的相关因素研究

对部队汽车驾驶员203名的心身健康和行车安全的相关因素研究表明:驾驶员可发生心身障碍,尤其眼和耳、呼吸系统,骨胳肌肉系统及抑郁等为著。其影响因素,主要有负性精神紧张总值(-Lcu)、个性的精神质、神经质、掩饰性、内向倾向、开车公里数、开车年限及精神疾病家族史。某些心身问题、神经质、掩饰性较高、年龄偏大、开车公里数多及开车年限长等与事故差错的发生有关。     

The future of cardiovascular imaging and non-invasive diagnosis

Advances in medical imaging now make it possible to investigate any patient with cardiovascular disease using multiple methods which vary widely in their technical requirements, benefits, limitations and costs. The appropriate use of alternative tests requires their integration into joint clinical diagnostic services where experts in all methods collaborate. This statement summarises the principles that should guide developments in cardiovascular diagnostic services.This paper is published simultaneously in the European Heart Journal (2006;27:1750–1753) and in the European Journal of Echocardiography (2006;7:268–273).     

经食管超声心动图在心血管手术麻醉与监测中的应用

目的　评价经食管超声心动图 (TEE)在心血管手术麻醉中的价值。方法　本组共完成 1 2 2例TEE监测。主要观察指标 :(1 )对 4 1例瓣膜置换患者的瓣膜作返流和狭窄分级及评价机械或生物瓣的功能 ;(2 ) 4 8例不停跳冠状动脉搭桥 (CABG)患者手术前后心功能变化〔①面积减少分数(FAC) ;②E波与A波峰值流速比率 (E/A)和各自的流速时间积分比率 (VTIE/VTIA) ;③E波减速时间 (DT) ;④心脏指数 (CI)〕 ;(3)手术前后对 2 0例不停跳CABG患者左室室壁 (前壁、后壁、侧壁和室间隔 )运动分级 ;(4 )监测先心病矫正前后心脏结构变化。结果　TEE检测瓣膜病变与经胸超声结果一致 ,手术后瓣膜活动正常。术后FAC、CI和VTIE/VTIA分别为 (0 5 2± 0 0 8)、(2 6 4± 0 6 9)L·min 1 ·m 2 和 1 2 9± 0 1 8,与术前比较 (0 4 2± 0 0 9)、(2 0 5± 0 4 8)L·min 1 ·m 2 和 1 1 4± 0 1 6有显著性差异 (P <0 0 5 ) ;术后E/A 0 86± 0 2 1与术前 0 77± 0 1 8比较P <0 0 1。DT无显著性变化。术前节段性室壁运动异常大于 2级的占 1 0 % ,术后为 5 %。结论　在心血管手术中 ,TEE是一种新的有用的监测技术