比索洛尔和乌拉地尔逆转原发性高血压患者左心室肥厚的对比研究

目的对比研究比索洛尔和乌拉地尔逆转原发性高血压(EH)患者左心室肥厚的作用。方法将76例EH伴左心室肥厚的患者随机分为比索洛尔组和乌拉地尔组,于服药前及服药后6、12及24个月分别测定左室舒张末内径(LVDT)、舒张期室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室射血分数(LVEF)、心排血量(CO)、A峰/E峰比值(A/E比值)。结果两组治疗前后比较LVEF、CO均无变化,而A/E比值则明显降低;左室重量指数(LVMI)、左室舒张末内径(LVDd)I、VST、LVPDWT在比索洛尔组明显下降,而在乌拉地尔组则无变化。结论比索洛尔和乌拉地尔均能明显改善左室舒张功能,且比索洛尔能明显减轻左心室肥厚。     

比索洛尔与卡维地洛对原发性高血压疗效及逆转左心室肥厚的对比研究

目的对比研究富马酸比索洛尔和卡维地洛治疗原发性高血压的疗效以及逆转左心室肥厚的作用。方法将106例原发性高血压伴左心室肥厚的患者随机分为富马酸比索洛尔组(49例)和卡维地洛组(46例),于服药前及服药后3、6及12个月分别监测两组患者血压、心率,并测定左心室舒张末内径、舒张期室间隔厚度、左心室后壁厚度、左心室射血分数、心排血量、A峰速度、E峰速度及A峰与E峰比值(A/E比值)。结果两组治疗后心率比治疗前减慢,差异有统计学意义(P0.05);富马酸比索洛尔组治疗后心率低于卡维地洛组,差异有统计学意义(P0.05)。两组治疗后随访3、6、9个月的血压均比治疗前降低,差异有统计学意义(P0.05)。两组治疗前后左心室射血分数、心排血量比较,差异无统计学意义(P0.05);两组治疗后A/E比值均比治疗前明显降低。两组左心室质量指数、左心室舒张末内径、舒张期室间隔厚度、左心室后壁厚度治疗后均比治疗前降低,差异有统计学意义(P0.05);富马酸比索洛尔组治疗后上述指标比卡维地洛组低,差异有统计学意义(P0.05)。结论富马酸比索洛尔和卡维地洛在降低血压的同时,均能改善左心室舒张功能,并明显减轻左心室肥厚;富马酸比索洛尔比卡维地洛减轻左心室肥厚效果更强,并可以有效控制心率。     

比索洛尔和乌拉地尔对高血压伴左室肥大患者左室结构及功能的影响

将76例高血压病（EH）伴左室肥大的患者随机分为比索洛尔组和乌拉地尔组，于服药前及服药后6个月、12个月分别测定左室舒张末内径（LVDT）、舒张期室间隔厚度（IVST）、左室后壁厚度（LVPWT）、左室射血分数（LVEF）、心排量（CO）、A峰、E峰。结果治疗后左室重量指数（LVMI）、LVDT、IVST、LVPWT在比索洛尔组明显下降，乌拉地尔组则无变化。     

不同剂量比索洛尔治疗舒张性心力衰竭临床疗效的对比研究

目的比较不同剂量比索洛尔治疗舒张性心力衰竭的临床疗效。方法选取2015年3月—2017年3月临沂罗庄中心医院收治的舒张性心力衰竭患者90例,根据用药剂量分为低剂量组与高剂量组,每组45例。在常规治疗基础上,低剂量组患者予以低剂量比索洛尔治疗(1.25 mg/d),高剂量组患者予以高剂量比索洛尔治疗(5.00mg/d);两组患者均连续治疗1个月。比较两组患者治疗前后窦性心率震荡指标[震荡初始(TO)、震荡斜率(TS)]、左心室舒张末期内径(LVEDD)、室间隔厚度(IVST)、左心室后壁厚度(PWT)、舒张早期最大峰值血流速度(E值)、舒张晚期最大峰值血流速度(A值)、E/A比值,并观察两组患者治疗期间不良反应发生情况。结果治疗前两组患者TO、TS比较,差异无统计学意义(P>0.05);治疗1个月高剂量组患者TO低于低剂量组、TS高于低剂量组(P<0.05)。治疗前两组患者LVEDD、IVST、PWT、E值、A值、E/A比值比较,差异无统计学意义(P>0.05);治疗1个月高剂量组患者LVEDD、IVST、PWT小于低剂量组,E值、E/A比值高于低剂量组,A值低于低剂量组(P<0.05)。两组患者治疗期间均未发生严重不良反应。结论与低剂量比索洛尔相比,高剂量比索洛尔可更有效地改善舒张性心力衰竭患者心率及心功能,且安全性较高。     

培哚普利治疗高血压患者左室舒张功能的疗效

目的:观察培哚普利对原发性高血压(EH)患者左心室舒张功能的影响。方法:采用自身对照开放试验方法,观察50例EH患者培哚普利治疗6月后,左心室舒张内径(LVDd)、舒张期室间隔厚度(IVST)、舒张末期左心室后壁厚度(LVPWT)、左心室重量指数(LVMI)、二尖瓣口E峰、A峰、A/E比值的变化。结果:50例EH患者治疗6个月后,IVST、LVPWT、LVMI明显下降(P<0.05),A峰、A/E比值亦明显下降(P<0.05)。结论:培哚普利在降压的同时,不但能逆转左心室肥厚,并且能有效改善左心室舒张功能。     

不同剂量比索洛尔对老年高血压病并发舒张性心力衰竭左室舒张功能的影响

目的: 观察不同剂量的比索洛尔对舒张性心力衰竭患者左室舒张功能的影响。方法: 92例高血压病并发左室舒张功能不全但左室射血分数（LVEF）>50%的患者,在氨氯地平控制血压达标（<140/90 mmHg）的基础上,按照加用比索洛尔的剂量随机分为3组:对照组（不用比索洛尔组,n=31）,低剂量组（加用比索洛尔1.25 mg,1次/d,n=30）,高剂量组（加用比索洛尔5 mg,1次/d,n=31）,平均随访观察30周。采用超声多普勒心动图评估治疗前后左室结构和功能参数的变化。结果: 3组治疗后LVEF和收缩压无明显改变,舒张压和心率在低剂量组和高剂量组下降明显（P<0.05）。加用比索洛尔治疗后,患者E峰、A峰、E/A、E峰流速积分（VTIE）、A峰流速积分（VTIA）、流速时间积分比率(E-VTI/A-VTI）有不同程度改善,高剂量组较低剂量组改善更加显著（P<0.05）。左室舒张末内径（LVEDD）、室间隔厚度（IVSD）、左室后壁厚度（PWT）、左室质量指数（LVMI)在高剂量组变化显著(P<0.05),对照组无显著改善。结论: 在氨氯地平降压达标基础上,比索洛尔能够进一步改善高血压病患者左室舒张功能,较大剂量作用更加显著。     

比索洛尔对老年高血压伴心功能不全病人血压及心室重塑的影响

目的探讨比索洛尔对老年高血压伴心功能不全病人血压及心室重塑的影响。方法将80例老年高血压伴心功能不全病人随机分为两组,对照组给予常规治疗;观察组在对照组治疗基础上加用比索洛尔治疗,治疗3个月后比较两组血压、超声心动图结果及血清胰岛素样生长因子1(IGF-1)、B型利钠肽(BNP)水平。结果治疗后,观察组24 h收缩压(SBP)、舒张压(DBP)及平均动脉压(MAP)均显著低于对照组(P0.05);观察组左室舒张末容量(LVEDV)、左心室质量(LVMI)、室间隔舒张末期厚度(IVST)、左室后壁舒张末期厚度(LVPWT)、左室收缩末容量(LVESV)、左室舒张早期快速充盈峰(E峰)/舒张晚期(心房收缩)充盈峰(A峰)均低于对照组,左室射血分数(LVEF)显著高于对照组(P0.05);观察组血清IGF-1、BNP水平均低于对照组(P0.05);观察组心功能分级显著优于对照组(Z=2.125,P0.05)。结论比索洛尔可提高老年高血压伴心功能不全病人的血压控制效果,改善病人心室重塑。     

比索洛尔联合卡托普利对中老年原发性高血压患者血压及心功能的影响研究

目的探究比索洛尔联合卡托普利对中老年原发性高血压患者血压及心功能的影响。方法选取南阳市第二人民医院2013—2014年收治的中老年原发性高血压患者100例,随机分为对照组与观察组,每组50例。对照组患者给予氯沙坦联合卡托普利口服治疗,观察组患者给予比索洛尔联合卡托普利口服治疗。14 d为1个疗程,两组患者均治疗3个疗程。比较两组患者治疗前后舒张压(DBP)、收缩压(SBP)及心功能指标〔包括左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、心排血量(CO)、左房室瓣舒张早期血流频谱E峰/舒张晚期血流频谱A峰(E/A比值)〕,治疗期间不良反应发生情况。结果治疗前两组患者SBP、DBP比较,差异无统计学意义(P>0.05);治疗后观察组患者SBP、DBP均低于对照组(P<0.05)。治疗前两组患者LAD、LVEDD、LVEF、CO、E/A比值比较,差异无统计学意义(P>0.05);治疗后观察组患者LAD、LVEDD小于对照组,E/A比值高于对照组(P<0.05);治疗后两组患者LVEF、CO比较,差异无统计学意义(P>0.05)。观察组患者不良反应发生率为6.0%,对照组患者不良反应发生率为10.0%,差异无统计学意义(P>0.05)。结论比索洛尔联合卡托普利能有效降低中老年原发性高血压患者的血压,改善心功能,且不良反应较小。     

氯沙坦与福辛普利逆转原发性高血压左心室肥厚的对比研究

目的 :对比研究应用氯沙坦和福辛普利逆转原发性高血压 (EH)伴左心室肥厚 (LVH)的作用。方法 :将 12 0例EHLVH患者随机分为氯沙坦组 (n =6 0 )和福辛普利组 (n =6 0 ) ,于服药前及服药 6个月后分别测定血压、室间隔厚度 (IVST)、左心室后壁厚度 (PWT)、左心室舒张末期直径 (LVDd)、左心室重量指数 (LVMI)、左心室射血分数 (LVEF)、心排血量 (CO)和A/E峰值。结果 :两组患者经治疗后血压、IVST、PWT、LVDd、LV MI、A/E峰值均显著降低 (均P <0 .0 1) ,而LVEF、CO无显著变化 (P >0 .0 5 )。结论 :氯沙坦与福辛普利均能逆转LVH ,明显改善左心室舒张功能     

卡维地络联合缬沙坦逆转高血压左心室肥厚的临床观察

目的 比较β受体阻滞剂联用血管紧张素转换酶抑制剂（ACEI）与联用血管紧张素Ⅱ受体拮抗剂对逆转高血压患者左心室肥厚的疗效.方法 临床收集高血压伴左心室肥厚患者96例,随机分为卡维地络联合咪达普利组（A组）和卡维地络联合缬沙坦（B组）,每组各48例.观察两种治疗方法对于逆转左心室肥厚的疗效.结果 两组治疗后左室舒张末内径（LVDd）、舒张期室间隔厚度（IVST）、左室后壁厚度（LVPWT）、左室射血分（LVEF）、心排出量（CO）、A峰/E峰比值（A/E比值）、左室重量指数（LVMI）均明显下降,与治疗前比较差异有统计学意义（P＜0.01）,但两组间比较差异无统计学意义（P＞0.05）.结论 卡维地络联用缬沙坦与联用咪达普利一样能显著逆转原发性高血压伴左室肥厚,并能改善预后.     

Anti-malarial efficacy of pyronaridine and artesunate in combination in vitro and in vivo

Pyronaridine is a Mannich base anti-malarial with demonstrated efficacy against drug resistant Plasmodium falciparum, P. vivax, P. ovale and P. malariae. However, resistance to pyronaridine can develop quickly when it is used alone but can be considerably delayed when it is administered with artesunate in rodent malaria models. The aim of this study was to evaluate the efficacy of pyronaridine in combination with artesunate against P. falciparum in vitro and in rodent malaria models in vivo to support its clinical application. Pyronaridine showed consistently high levels of in vitro activity against a panel of six P. falciparum drug-sensitive and resistant strains (Geometric Mean IC50=2.24 nM, 95% CI=1.20-3.27). In vitro interactions between pyronaridine and artesunate showed a slight antagonistic trend, but in vivo compared to pyronaridine and artesunate administered alone, the 3:1 ratio of the combination, reduced the ED90 of artesunate by approximately 15.6-fold in a pyronaridine-resistant P. berghei line and by approximately 200-fold in an artesunate-resistant line of P. berghei. Complete cure rates were achieved with doses of the combination above or equal to 8 mg/kg per day against P. chabaudi AS. These results indicate that the combination had an enhanced effect over monotherapy and lower daily doses of artesunate could be used to obtain a curative effect. The data suggest that the combination of pyronaridine and artesunate should have potential in areas of multi-drug resistant malaria.     

Parameters of anorectal and colonic motility in health and in severe constipation

Anorectal function and colonic transit was assessed in 17 severely constipated patients and 15 age-matched controls. The constipated patients were divided into those who had immobile perineum (perineal descent 1.0 cm during attempted defecation) and those who had a normal descent (>1.0 cm) of the perineum. When constipation was accompanied by an immobile perineum, patients had impaired balloon expulsion, impaired and delayed artificial stool expulsion, decreased straightening of the anorectal angle, decreased descent of the pelvic floor with defecation, and prolonged rectosigmoid colon transit compared with the patients with constipation who had a mobile perineum and with normal controls. The mobile-perineum group differed from controls only in colon transit times, having prolonged total colon transit. Anal sphincter resting pressures, immediate artificial stool expulsion, resting anorectal angles, and electromyography of the external anal sphincter and puborectalis did not differentiate the constipated patients from the controls. We concluded that descent of the perineum of <1 cm was associated with impaired expulsion, an adynamic anorectal angle, and slowed distal colon transit. This simple sign of pelvic floor function distinguished constipated patients with disordered expulsion from constipated patients with normal pelvic floor function. These patients may respond poorly to surgery and conventional management and would therefore be candidates instead for pelvic floor retraining. Accurate characterization and appreciation of pelvic floor dysfunction in patients with severe chronic constipation may improve the selection for and results of surgical and nonsurgical intervention.Supported in part by Research Grants DK37990, RR585, and DK34988 from the National Institutes of Health and by the Mayo Foundation, Rochester, Minnesota.     

Effects of dietary phytoestrogens in vivo and in vitro in rainbow trout and Siberian sturgeon: interests and limits of the in vitro studies of interspecies differences

A study of the effects of dietary genistein on trout and sturgeon in vivo showed that sturgeon was sensitive to 20 ppm of genistein, whereas trout was not. To analyze the origin of this interspecies difference in sensitivity, a cell culture technique was developed with hepatocytes from sturgeon and compared to results obtained with hepatocytes from trout in the same system. The hepatocyte culture proved to be useful as bioassay for estrogenicity. Vitellogenin (VTG), assayed by a specific enzyme-linked immunosorbent assay, was used as a biomarker of the estrogenic activity. 17 beta-Estradiol, its glucuronide and sulfate derivatives, and estradiol analogues (ethynylestradiol and diethylstilbestrol) were tested. Nonestrogenic compounds such as androgens, progesterone, and cortisol were tested as negative controls. VTG production was monitored at doses ranging from 1 nM to 10 microM estradiol. Phytoestrogens, from the isoflavone family, were tested individually at increasing doses exhibiting dose response curves for concentrations from 500 nM to 10 microM. With tamoxifen, an antagonist of estrogen receptors, the estrogenic effect was partially reduced. The effect was the same with ICI182,780 in sturgeon, whereas the effect was the opposite in trout. The estrogenic potency of the isoflavones ranged differently between the two species in the following order: biochanin A < daidzein = formononetin < genistein < equol in trout and biochanin A < genistein < daidzein < formononetin < equol in sturgeon. Further, in sturgeon, formononetin was the most potent phytoestrogen in vitro, whereas its activity was weakest in vivo. These data suggest that one must reconsider the relevance of heterologous estrogenic tests and of homologous in vitro tests for estrogenic potency of chemicals.     

The role of alcohol and drugs in homicides in England and Wales

BACKGROUND: The annual number of homicide convictions in England and Wales is increasing. Previous studies have highlighted the aetiological role of alcohol and drugs in homicide. AIMS: To examine rates of alcohol and drug misuse and dependence in people convicted of homicide; the role of alcohol and drugs in the offence; the social and clinical characteristics of alcohol- and drug-related homicides; and the social and clinical characteristics of patients with dual diagnosis who commit homicide. METHODS: A national clinical survey based on a 3-year (1996-9) consecutive sample of people convicted of homicide in England and Wales. Information on rates of alcohol and drug misuse/dependence, the role of alcohol and drugs in the offence and social and clinical characteristics of perpetrators were collected from psychiatric reports prepared for the court in homicide convictions. Detailed clinical information was gathered from questionnaires completed by mental health teams for those in contact with mental health services. RESULTS: Of the 1594 homicide perpetrators, more than one-third (42%) occurred in people with a history of alcohol misuse or dependence and 40% in people with a history of drug misuse or dependence. Alcohol or drug misuse played a contributory role in two-fifths of homicides. Alcohol played a major role in 52 (6%) and a minor role in 364 (39%) homicides. Drugs played a major role in six (1%) and a minor role in 138 (14%) homicides. Forty-two homicides (17%) were committed by patients with severe mental illness and substance misuse. Alcohol- and drug-related homicides were generally associated with male perpetrators who had a history of violence, personality disorders, mental health service contact and with stranger victims. CONCLUSIONS: Substance misuse contributes to the majority of homicides in England and Wales. A public health approach to homicide would highlight alcohol and drugs before severe mental illness.     

Trends in COPD mortality and hospitalizations in countries and regions of Asia-Pacific

Background and objective: The growing burden of COPD in the Asia‐Pacific region supports the need for more intensive research and analysis of the epidemiology of COPD to raise awareness of the disease and its causes, to ensure the development of effective national health policies and to facilitate equitable deployment of finite health‐care resources in the prevention and management of COPD. This study estimated and compared COPD mortality and hospital morbidity rates and trends in these rates over time across countries and regions of Asia‐Pacific. Methods: Data consistent with standard definitions of COPD (ICD‐9/ICD‐10) for the period 1991–2004 were obtained from national health statistics agencies. For countries/regions with complete national mortality and hospitalization data (Australia, Pacific Canada (British Columbia, Hong Kong, South Korea and Taiwan), annual age‐standardized mortality and hospitalization rates were calculated for men and women aged ≥ 40 years. Negative binomial regression modelling was used to estimate rate ratios for country/region, gender and age differences and general trends over time. Results: Mortality rates per 10 000 population ranged 6.4–9.2 in men, 2.1–3.5 in women and 3.7–5.3 overall in 2003. Corresponding ranges for morbidity were 32.6–334.7, 21.2–129 and 28.1–207.3 per 10 000. Trend analysis of data since 1997 produced annual percentage changes in mortality versus hospitalization of ?4.4% versus ?0.7% in Australia, ?3.6% versus 7.5% in Pacific Canada (British Columbia), ?7.15% versus ?5.6% in Hong Kong and ?2.9% versus ?4.2% in Taiwan. Conclusions: In Asia‐Pacific, overall mortality and morbidity rates are high and trends in mortality and morbidity vary between countries/regions. Differences in rates and trends for men and women most likely reflect the different trends in historical and prevalent smoking profiles for COPD in the different countries and regions.     

Modulation of enterotoxin binding and function in vitro and in vivo

The use of the nontoxic B subunits of cholera and Escherichia coli enterotoxins in vitro and in vivo led to a decrease in toxin binding to target cells and a decrease in toxin-induced effects (i.e., morphological effects, adenylate cyclase activation, and fluid secretion). The reduction in toxin binding involves a process of down-regulation of cellular receptors for the toxin and not toxin occupancy of receptors. The extent of inhibition was dependent on the amount of B subunit used and on the duration of time after its use. Thus, in vivo exposure to a single bolus of B subunit was sufficient to block toxin binding and activity for up to 18 h. Because the B subunit binds extensively to the esophagus and the stomach, peroral administration will require a preparation that allows the subunit to reach the small bowel in a protected form. Our data provide a rationale for using B subunit therapy for short-term protection against the effects of enterotoxins, before the development of an immune response.     

Morbidity and maternal and infant outcomes of hypertensive disorder in pregnancy in China in 2018

Hypertensive disorder in pregnancy is a disease that occurs during pregnancy. We aimed to analyze the morbidity and maternal and infant outcomes with respect to the hypertensive disorder in pregnancy in China in 2018. Clinical data of 38 590 cases from 161 hospitals were retrospectively collected. The differences in morbidity and maternal and infant mortality among the major regions and provinces were compared. The overall national average morbidity was 4.74%, and the ratios of gestational hypertension, preeclampsia, eclampsia, chronic hypertension, and chronic hypertension with superimposed preeclampsia were 29.17%, 55.02%, 0.66%, 6.53%, and 8.62%, respectively. The overall maternal mortality was 0.61/100 000, and the case fatality was 0.13%. Morbidity associated with hypertensive disorder in pregnancy was 7.74% in North China, 6.62% in Northwest China, 6.40% in Central China, 5.83% in Northeast China, 4.28% in East China, 3.85% in South China, and 2.88% in Southwest China. The morbidity in each province was 1.62‐11.28%. The overall perinatal mortality was 3.59% (81.09% for stillbirths; 18.91% for neonatal deaths). Perinatal mortality decreased with increasing gestational weeks from 24 to 37 + 6 weeks. Perinatal mortality for delivery at 32 weeks of gestation in all regions of the country was <10%. Morbidity varied across regions in China, with the lowest in Southwest and the highest in North China. The low maternal mortality is related to the large‐scale development of standardized maternal health care in China. For severe hypertensive disorder patients, gestation should be prolonged to 32 weeks as often as possible for better neonatal survival rates.