早期干预对高危儿在婴儿早期发育的影响

目的：探讨早期干预对高危儿在婴儿早期发育的影响。方法：采用自行设计的一套早期干预方法通过指导家长对实验组实施，分别在3个月、6个月时进行格体生长和行为发育的评估，另设对照组进行比较。结果：实验组和对照组在体重、身长、头围方面均无统计学差异，但实验组的5个能区行为发育商均值都高于对照组，除3个月的语言能区外，其余均有统计学差异。结论：早期干预在婴儿早期就能促进高危儿的行为发育，但对促进高危儿的体格生长无明显效果。     

Non-invasive Assessment of Coronary Flow Velocity Reserve: A New Method Using Transthoracic Doppler Echocardiography

Coronary flow reserve (CFR) has been used toassess coronary microcirculation and epicardial coro-nary stenoses[1— 3 ] . CFR is defined as the ratio ofcoronary flow under maximal coronary vasodilatationto coronary flow under resting conditions[4 ] .Whenthe cross- sectional area of epicardial coronary arteriesis constant,coronary flow velocity (CFV) ratios areequal to volume flow ratios.The most common method used clinically formeasuring CFVR is intracoronary Doppler flow(ICD) analysis re…     

Role of intracortical mechanisms in the late part of the silent period to transcranial stimulation of the human motor cortex

Transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (TES) of the human motor cortex produce a silent period (SP) following motor evoked potentials (MEPs). The early part of the SP can be explained by decreased alpha motor neuron excitability, whereas the late part is presumably due to suprasegmental mechanisms. In order to determine the level of the suprasegmental contribution to the generation of SPs, we recorded excitatory and inhibitory responses to TMS, TES, and percutaneous electrical brainstem stimulation (PBS) in the voluntarily activated first dorsal interosseous muscle of the hand. Stimulus intensities were set so that PBS and TES induced MEPs with areas equal to or larger than those of MEPs obtained with TMS. This procedure revealed that SPs were 49% and 83% shorter with TES and PBS, respectively, than with TMS. As TMS is more effective than TES or PBS in activating cortical interneurons, these findings support the idea that a significant component of the SP arises from intracortical mechanisms.     

The HGAR1 familial hypercholesterolemia pedigree

Data on 232 members of a single pedigree, descended from two pairs of original parents, were made available to the participants of Genetic Analysis Workshop 8 (GAW8). In addition to information concerning age and sex, measurements for 10 quantitative traits and genotypes at 22 polymorphic marker loci were also provided for a subset of 193 of these family members. © 1993 Wiley-Liss, Inc.     

Choice of open or percutaneous procedures in the surgical treatment of trigeminal neuralgia

The aim of this study was to define criteria for the selection of patients for percutaneous or open operations for the cure of drug-resistant trigeminal neuralgia (TN). Trigeminal percutaneous radiofrequency thermorhizotomy (TPRT) has an established place because of its safety in elderly patients, while microvascular decompression (MVD) has appeal in younger patients beause of its non-destructive nature and because it attacks what is believed to be the primary etiology of tic douloureux. Nevertheless, MVD is a successful operation only when true neurovascular conflict (NVC) is ascertained, rather than a simple arterial loop and neurovascular contract. Probably, many immediate failures and early relapses are the consequence of the inadequate patient selection for MVD on the presumption that this operation is in any case the ideal cure. The inadequate selection can be explained by the difficult preoperative diagnosis of NVC in the past. Indeed, angiography and computed tomography showed the neurovascular contact but not the size of compression. Fortunately, today magnetic resonance imaging is a reliable instrument to ascertain NVC. So, the diatribe between the supporters of percutaneous techniques and MVD can be concluded with the following: (1) percutaenous techniques are indicated for patients without demonstrated NVC (including patients with TN in multiple sclerosis) and in those with NVC if MVD is contraindicated by ill-health or refused by the informed patient; and (2) MVD is incated for patients with ascertained NVC who are in good health and who, informed of the surgical risk, favor this operation desiring no sensory deficit. Received: 23 June 2001 / Accepted in revised form: 24 August 2001     

性服务工作者性病和艾滋病的干预研究

目的 了解性工作者的性病/艾滋病知识、态度、信念、行为等现状,积极探索对该人群进行预防性病、艾滋病及行为干预的有效办法,为今后在更大范围的高危人群中进行干预提供科学依据.方法 成立专职高危干预队伍,设计借鉴其他地区经验,深入目标人群进行系列外展服务,利用干预前后封闭式调查问卷评价干预效果.结果 发放干预前后问卷各522份,收回前后有效问卷387份.通过外展服务,娱乐场所从业人员对性病史滋病预防知识知晓率明显提高,对安全套及安全性行为预防性病艾滋病的传播的信念和态度有明显转变.结论 对娱乐场所从业人群开展系列专业外展服务可以提高该人群的防病意识,提升对性病史滋痛的知晓率,是高危人群干预的有效方法.     

经皮激光心肌血运重建术治疗心绞痛的临床疗效观察

【目的】观察经皮激光打孔心肌血运重建术治疗顽固性心绞痛的临床疗效。【方法】应用经皮激光 (HO :YAGlaser)心内膜心肌打孔治疗 2 7例顽固性心绞痛患者 ,以加拿大心绞痛标准分级和Naughton运动试验ST段下移至 1mm所需时间作为激光心肌血运重建术疗效的临床观察指标。【结果】每例打孔 5～ 15个 ,平均 (8± 4)个。打孔前和打孔后 1月、3月、6月按加拿大心绞痛标准分级 ,分别为 (3 5± 0 5 )、(2 2± 0 8)、(2 0± 0 6 )、(2 1± 0 5 )级 ;Naughton运动试验ST段下移至1mm所需时间则分别为 (36 0± 16 0 )s、(4 0 6± 2 6 0 )s、(4 2 0± 2 90 )s、(4 5 0± 312 )s。【结论】经皮激光打孔心肌血运重建术能降低患者心绞痛的严重程度 ,对不能常规施行经皮冠状动脉腔内成形术 (PTCA)或冠状动脉旁路搭桥术 (CABG)的严重冠心病心绞痛的患者 ,经皮激光心肌血运重建术是一种有效治疗方法。     

青年急性冠脉综合征冠脉造特点及随访

目的:探讨青年急性冠状动脉综合征(ACS)冠状动脉(冠状)造影特点及其与远期心脏事件的关系。方法:比较青年ACS与老年ACS患者冠脉病变程度、范围,并进行心脏事件随访。结果:78例青年ACS患者有冠脉病变74例(94.9％),单支病变46例(58.9％);171例老年ACS患者有冠脉病变166例(97.1％),单支病变41例(23.9％)。平均随访9个月,青年ACS患者发生心脏事件者10例(12.8％),其中心绞痛再入院6例(7.7％);老年ACS患者发生心脏事件者47例(27.5％),其中心绞痛再入院30例(17.5％),两组比较差异有显著性(P<0.05)。结论:ACS患者冠状动脉粥样硬化青年时期之前已经发生,ACS预后与冠脉病变程度和年龄呈正相关。     

The 5-Step family intervention in primary care: II. The views of primary healthcare professionals

Background: This is the second of two papers using qualitative methods from a study of an intervention for family members affected by close relatives' substance misuse problems.

Participants: 168 primary healthcare professionals (PHCPs: GPs, practice nurses and health visitors) working in general practices in two areas of England, and who took part in the study.

Data sources: Recruitment and post-session forms completed by PHCPs; telephone interviews with each PHCP 12 weeks after recruitment of a family member; interviews with PHCPs at the end of the study.

Results: At the end of the project PHCPs were overwhelmingly positive about the family member intervention and about primary care as the appropriate site. Difficulties were encountered, however, in identifying and engaging affected family members, who were often excluded on grounds of the complexity of their problems or the level of their distress. Shortage of PHCP time and other practice-related factors added to the difficulty. Active work by a PHCP was often necessary in order to make the link between presenting symptoms of physical or mental ill-health and the existence of a family substance misuse problem. When family members were identified and recruited, PHCPs were usually positive about what was achieved. Nearly all were in favour of an approach that combined giving a self-help manual with some follow-up contact with a family member as needed.

Conclusions: Taken in conjunction with statistical outcome findings of significant reductions in symptoms and changes in ways of coping, plus qualitative analysis of the views of family members, the present results encourage the view that a flexible form of this intervention should be developed for use in primary healthcare, and that further work should build on existing strengths and attempt to overcome weaknesses identified.     

全反式维甲酸对防治经皮冠脉介入治疗后再狭窄的临床疗效观察

目的观察不同剂量全反式维甲酸（ATRA）对防治经皮冠脉介入治疗（PCI）后再狭窄（Rs）的疗效。方法2004年7月至2005年9月连续入院行PCI的冠心病300例。随机分为全反式维甲酸正常剂量组（10mgt．i．d p．o，甲组）、强化剂量组（20mgt．i．d p．o，乙组）、对照组（丙组）。6个月后分别比较甲乙丙三组的再狭窄率、心脏事件发生率和心功能。结果300例患者中男性228例、女性72例。住院期间甲乙丙三组比较：心绞痛9％VS8％VS9％；再次急性心肌梗死（AMI）O％VS2％VS1％；再次缺血性血运重建（TVR）3％VS2％VS3％；心源性死亡4％VS6％VS4％，P〉0．05，无显著统计学差异。随访期间三组比较：心绞痛12％VS9％VS20％；再次AMII％VSO％VS1％；心源性死亡2％VS4％VS4％，P〉0．05，无显著统计学差异；再狭窄率3／33（9．1％）VS2／30（6．7％）VS12／32（37．5％）；TVR3％VS2％VS11％，P〈0．05，有显著统计学差异。结论常规剂量ATRA防治再狭窄安全有效。