低分子肝素钙联合辛伐他汀治疗不稳定型心绞痛疗效观察

目的探讨低分子肝素联合辛伐他汀治疗不稳定型心绞痛的疗效。方法将100例不稳定型心绞痛患者随机分为对照组50例和观察组50例。对照组仅采取常规治疗（硝酸酯类、β-受体阻滞剂、钙拮抗剂、阿司匹林等），观察组在常规治疗的基础上加用低分子肝素和辛伐他汀，观察比较各组的疗效。结果观察组总有效率为90．0％，对照组总有效率为60．0％，两组疗效比较差异有显著性意义（P〈0．05）。结论低分子肝素联合辛伐他汀治疗不稳定型心绞痛取得满意的疗效。     

One-year outcome after first-ever stroke according to stroke subtype, severity, risk factors and pre-stroke treatment. A population-based study from Tartu, Estonia

The aim of the current study was to evaluate the outcome at 1 year following a first-ever stroke based on a population-based registry from 2001 to 2003 in Tartu, Estonia. The outcome of first-ever stroke was assessed in 433 patients by stroke risk factors, demographic data and stroke severity at onset using the Barthel Index (BI) score and the modified Rankin Score (mRS) at seventh day, 6 months and 1 year. Female sex, older age, blood glucose value >10 mmol/l on admission and more severe stroke on admission were the best predictors of dependency 1 year following the first-ever stroke. At 1 year, the percentage of functionally dependent patients was 20% and the survival rate was 56%. The use of antihypertensive/antithrombotic medication prior to stroke did not significantly affect the outcome. The survival rate of stroke patients in Tartu is lower compared with other studied populations. The outcome of stroke was mainly determined by the initial severity of stroke and by elevated blood glucose value on admission. Patients with untreated hypertension had more severe stroke and trend for unfavourable outcome compared with those who were on treatment.     

低分子肝素对急性脑梗塞的影响

为了探讨低分子肝素（ＬＭＷＨ）在脑梗塞应用中的安全性及实用性，采用随机单盲对照方法，对３９例急性脑梗塞病人，予ＬＭＷＨ治疗，并与低分子右旋糖酐治疗进行比较。结果显示：ＬＭＷＨ组对不同程度患者的神经功能恢复程度明显优于低右组（Ｐ＜００１），ＬＭＷＨ组头颅ＣＴ扫描脑梗塞体积缩小的范围比对照组明显（Ｐ＜００５），ＬＭＷＨ不减少血小板数量及纤维蛋白量，不引起出血，可改善血液流变学，降低微循环总积分值。总有效率８７１８％。     

Breastmilk intake and growth in infants from two to ten months

Longitudinal measurements of breastmilk intake in 48 Cambridge infants showed that intake reached a peak of 824 g/24 h in boys and 741 g/24 h in girls in the third and fourth months, respectively. Regression analysis demonstrated that, in the early months, the infants' weight accounted for a major part of the variance in breastmilk intake. Infants in non-manual social classes received more breastmilk and started solids later than those in manual groups. In the early months weight gain showed a relative increase compared to growth standards, but later infancy was characterized by a progressive deceleration in weight and length gain. Adiposity, as measured by triceps skinfold thickness differed most markedly from growth charts and was only equivalent to the tenth standard centile at all ages. The lower skinfold thickness measurements are considered to be more appropriate to breastfed infants in general.     

低分子量肝素化学及生物活性的不均一性

综述了低分子量肝素的化学和生物活性的不均一性,以及药理作用,药物动力学、临床应用等方面的差异。     

Abnormal cardiac histology in severe intrauterine growth retardation infants

Four infants with severe intrauterine growth retardation (IUGR) weighing less than 1000 g at birth developed heart failure and died in our unit, where heart failure of IUGR infants is the main reason of death in extremely low birth-weight infants. The causes of their heart failure are one of the main themes in current neonatal medicine. The subjects of this study were four small for gestational age infants; all died due to heart failure 5 to 10 days after birth. Microscopic specimens of hearts from autopsies were evaluated with respect to the following characteristics: thickness of myocardial fibers, maturation of nuclei, presence of dysgenesis or necrosis in myocardium, and amount of glycogen in the heart. Neither dysgenesis nor infarction of the heart was found but hypoplasia in myocardial fibers and decreased glycogen levels were observed. Maturation delay in myocytes' nuclei did not appear to be severe. We conclude that these infants' hearts failed to adapt to postnatal hemodynamic changes because of inadequate myocardial function and inadequate glycogen reserves.     

壳聚糖辐射效应的研究（Ⅰ）──辐照剂量与分子量的关系及辐射裂解的G（S）值

通过粘度的测量，考察了壳聚糖在不同条件下经不同剂量γ射线辐照所引起的分子量的变化，并分别计算了真空和空气中壳聚糖辐射裂解的Ｇ（Ｓ）值。     

Inter-rater reliability of the original and modified Barthel Index,and a comparison with the Functional Independence Measure

The Barthel Index (BI), the Modified Barthel Index (MBI) and the Functional Independence Measure (FIM) are all widely used by occupational therapists as assessment tools for clinical decision-making and outcome measurement. All of these tools have demonstrated validity and the BI and the FIM have demonstrated inter-rater reliability. The MBI has been modified to increase sensitivity; however, there have been no publications on the inter-rater reliability of this tool following the changes. The purpose of this research was to examine the inter-rater reliability of two versions of the Barthel Index, and draw some comparisons between this assessment tool and the FIM. Twenty-five patients with neurological and orthopaedic conditions were assessed by three occupational therapists using the three tools. The method of analysis selected was percentage agreement and intraclass correlation coefficient. The results indicated that both the original and modified versions of the Barthel Index possess good inter-rater reliability. As all three tools have demonstrated adequate reliability and validity, it is suggested that clinicians select the most sensitive tool that best meets their clinical needs, and use this assessment tool in its standardized format.     

Measurement of biological activity of somatotropin in hypophysectomized rats

目的：建立测定生长激素（ＧＨ）在体生物活性的方法．方法：以去垂体大鼠体重增长（ＢＷＧ）和胫骨骺软骨板宽度（ＴＥＷ）为指标，观察动物性别、给药途径、次数和周期不同对效应的影响；同时进行４ｄＢＷＧ，６ｄＢＷＧ和６ｄＴＥＷ法，测定ＧＨ的效价（平行线３×３设计）．结果：♀和♂ｓｃ和ｉｍ给药以及每日给药１次和２次的ＢＷＧ和ＴＥＷ差异无显著意义．给药６ｄ比给药４ｄ引起较大的ＢＷＧ和ＴＥＷ（Ｐ＜００５）．４ｄＢＷＧ法和６ｄＢＷＧ法在００２０－０５００ＩＵ·ｄ－１有较好的λ值（００６６０和０１７４７）和ｒ值（０９０００和０９２３７）；４ｄＢＷＧ，６ｄＢＷＧ和６ｄＴＥＷ法测得ｒｈＧＨ的效价为４６１３２，３９８２９和４８０２３ＩＵ／ａｍｐ．６ｄＢＷＧ法有较小的λ值和较低的ＡＲＦＬ值．结论：可在同一组去垂体大鼠体内同时用４ｄＢＷＧ，６ｄＢＷＧ和６ｄＴＥＷ法测ＧＨ活性，以６ｄＢＷＧ法较好．     

Why are children living in poverty getting fatter?

In recent decades, there has been a dramatic increase in unhealthy weight for both children and adults. The Canadian standard of living has changed in favour of more easily prepared, calorie-dense foods and sedentary practices. Many family characteristics have also changed over the past 50 years. More Canadian families are living in disadvantaged situations, forecasting a host of unhealthy behaviours and attitudes in adults. The poor are not only getting poorer, they are also becoming heavier. Children from disadvantaged families seem to be leading the trend in increasing prevalence of unhealthy weight. Because they live in neighbourhoods that are perceived as unsafe, these children are likely spending more time indoors. This is associated with watching more television, which not only displaces other forms of educational and active entertainment but also places them at risk of learning inaccurate information about proper eating. Social science research helps identify factors contributing most to the rise in excess weight within this population, thus providing essential clues for effective approaches to its eradication.