体位性心动过速综合征的年龄和性别差异

目的探讨体位性心动过速综合征(POTS)的年龄和性别差异。方法2001-01~2005-05在中南大学湘雅二医院从316例直立倾斜试验(HUTT)检查中诊断的POTS患者66例,分为成年(>18岁)和儿童(≤18岁)两组,分析其病程、诊断率、心率变化的年龄和性别差异。结果①病程及发病年龄:POTS病程在成年组1.00~11.33 a(平均5.22±4.33 a),男性略短于女性(3.00±4.24 a vs 5.71±4.44 a,P>0.05);儿童组0.08~4.00 a(平均0.73±1.13 a),男性长于女性(1.21±1.46 avs 0.46±0.81 a,P<0.05)。发病年龄在成年组为18~49岁(平均25.75±8.33岁),女性小于男性(P<0.05);儿童组为4~16岁(平均11.73±2.54岁),未见性别差异(P>0.05)。②诊断率及心率变化:POTS诊断率在年龄组间无差异(P>0.05),女性比例成年高于儿童;倾斜试验10 min内心率增加量在年龄组间及男女间未见差异(P>0.05)。结论POTS病程及心率增加量不存在年龄和性别差异,成年患者发病年龄女性<男性,诊断率无年龄差异,但成年女性比例高于儿童,这对临床上诊治POTS具有指导意义。     

Detection of the carrier state of Hurler's syndrome by assay of α-l-iduronidase in leukocytes

The mean specific activity of α-l-iduronidase in leukocytes from six obligate heterozygotes for Hurler's syndrome was found to be slightly less than one-half of the mean in normal controls; no overlap of normal and known heterozygote values was encountered. The assay has been applied with success to six potential heterozygotes, siblings of a child with Hurler's syndrome. Thus heterozygote detection of Hurler's syndrome is clearly possible; this finding, as well as the ready availability of leukocytes for screening tests, recommends their use for examination of potential carrier status in this disorder.     

Sex- and age-dependency of IgG auto-antibodies against IL-1α in healthy humans

Abstract. Naturally occurring anti-interleukin (IL)-1α IgG antibodies (Ab-IL-1α) were measured in sera of 466 healthy Danish blood donors. Ab-IL-1α bound IL-1α with exceptionally high affinity (Kd: 10^-11 M) and neutralized both cell-associated and extracellular IL-1α but not IL-1β or IL-1 receptor antagonist. More than 80% of the saturable binding of rIL-1α to serum was to Ab-IL-1α, suggesting that these antibodies are the quantitatively most important IL-1α-binding components in serum. Judged by second antibody precipitation assay, the prevalence of Ab-IL-1α varied between 30% and 75% and correlated positively with age ( P = 0·037). The binding capacity of serum also increased with age. Although men were more frequently positive than women ( P < 0·001), there were no sex- or age-dependent alterations in the average affinities of the antibodies. Free IL-1α-like molecules were generally not detected in these sera. However, acid treatment showed that 25% of Ab-IL-1α-positive sera contained low amounts of IL-1α-Ab-IL-1α immune complexes. IgG4 represented the main IgG isotype, whereas IgG3 Ab-IL-1α were undetectable. The relative amounts of IgG4 Ab-IL-1α increased while IgG2-and IgG1 Ab-IL-1α decreased in elderly individuals. The presence in normal individuals and the lack of affinity maturation with age suggest that Ab-IL-1α may be regulatory natural auto-antibodies perhaps coded by germline genes.     

Propofol versus midazolam for procedural sedation in the emergency department: A study on efficacy and safety

Background

Procedural sedation for painful procedures in the emergency department (ED) can be accomplished with various pharmacological agents. The choice of the sedative used is highly dependent on procedure- and patient characteristics and on personal- or local preferences.

骨龄测评桡骨接近完全融合与融合遗迹的影像学鉴别探讨

目的探讨桡骨接近完全融合时与融合遗迹的影像学鉴别方法。方法18岁以下研究组31例，每1例均有同日同次2张左手腕部正位片和分别倾斜30。和45。2张斜位X线片，共124次曝光片。18．0岁以上对照组，每例有1张手腕部正位片，其中6例另有1张手腕部斜位片，共17次曝光片。合计42例141次曝光片。对比分析两组间桡骨远端缺口形态、与桡骨关系、低密度骺线是否存在及尺骨融合情况。结果研究组：桡骨未完全融合者其缺口均深入桡骨轮廓之内，尺骨茎突基底部均存在低密度骺线及缺口，多位置和多角度观察发现低密度骺线者8例。对照组桡骨远端缺口位于桡骨轮廓之外并能未深入桡骨轮廓之内，且缺口内缘为正常骨皮质封闭。桡骨致密融合线未见显示7例（64％），尺骨已完全融合。结论与融合遗迹不同，在多位置和多角度片中如能发现桡骨低密度骺线存在、明确缺口位于桡骨轮廓之内和尺骨茎突基底部尚未完全融合，即可确定桡骨尚未完全融合。     

Evaluation of new two-thumb chest compression technique for infant CPR performed by novice physicians. A randomized,crossover, manikin trial

Background

The impact of high-quality chest compressions during CPR for the patients' outcome is undisputed, as it is essential for maintaining vital organ perfusion. The aim of our study is to compare the quality of chest compression (CC) and ventilation among the two current standard techniques with our novel “nTTT” technique in infant CPR.

Quality of life and symptoms among older people living at home

AIM: This paper reports a study comparing the socio-demographic data, quality of life (QoL) and symptoms of older people living at home with and without help. BACKGROUND: Despite growing numbers of older people worldwide, little is know about the differences between older people receiving help to live at home and those not receiving this, especially as regards QoL and symptoms. Not only symptoms but also dependency on others per se may reduce older people's QoL. From a nursing perspective, knowledge about such issues is important because the impact of symptoms may be reducible, even when diseases cannot be cured. METHOD: A postal questionnaire was sent to an age-stratified random sample of 1866 people aged 75 years or over. Of the respondents (n = 1248) 448 received help and 793 did not. RESULTS: The group receiving help had a significantly higher age, more women, more people widowed and living alone, more children, a higher number of self-reported diseases and symptoms, greater inability to remain alone at home and lower QoL. Loneliness, depressed mood and abdominal pain were significantly related to low QoL in both groups. Living alone, not being able to remain alone at home without help, and fatigue were also predictive of low QoL among those receiving help, and number of diseases and sleep problems in those without. CONCLUSION: Receiving help with daily living seems to be significantly related to low QoL and goes along with a high number of symptoms that need to be considered in nursing care. Through regular visits, systematic assessment and intervention, especially focusing on older people's symptoms, nurses may contribute to improved QoL for this section of the population.