深圳中青年健康体检人群高血压患病率及其危险因素分析

目的：探讨深圳市中青年健康体检人群高血压患病状况及其危险因素,为高血压的防治工作提供基础资料与理论依据。方法以2013年10～11月深圳市平湖镇1498例中青年健康体检人群为研究对象,计算人群中高血压患病率,分析正常血压和高血压人群体质量指数、血脂和血糖等指标关系,并采用logistic回归模型进行危险因素分析。结果高血压总患病率为9．2％;男性为11．9％高于女性的4．8％,差异有统计学意义（P＜0．05）。高血压组的体质量指数、总胆固醇、三酰甘油（T G ）、低密度脂蛋白胆固醇和血糖均高于血压正常组;而高密度脂蛋白胆固醇低于血压正常组,差异均有统计学意义（P＜0．05）。多因素logistic回归分析表明,男性、高 TG、高血糖、超重或肥胖是深圳中青年人群患高血压的危险因素。结论深圳市中青年人群高血压患的主要危险因素是超重或肥胖、高TG、高血糖,应尽早针对相关危险因素采取相应预防措施。     

某市脂肪肝发病率及危险因素调查

目的探讨酒泉市健康体检人群脂肪肝的患病率及其危险因素。方法收集26929例体检者通过超声检查肝、胆和肾脏,测量身高、体质量、血压,应用全自动生化分析仪检测空腹血糖(FPG)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血尿酸(BUA)。结果总体检者、男性、女性脂肪肝患病率分别是:24.2%、32.1%、8.5%,50～60岁年龄段人群脂肪肝的患病率最高,50岁以下各年龄段人群脂肪肝患病率男性高于女性,差异有统计学意义(P<0.01)。脂肪肝组肥胖、高血压、高血糖、高TC、高TG、低HDL-C、高LDL-C、高BUA的患病率高于对照组,差异有统计学意义(P<0.01),多因素回归分析表明脂肪肝的危险因素包括高血糖、高TG、高BUA、高血压、低HDL-C、肥胖。结论酒泉市脂肪肝的患病率较高,其危险因素包括高血糖、高TG、高BUA、高血压、低HDL-C、肥胖等。     

扬州地区脂肪肝发病率及危险因素调查

目的 探讨扬州地区健康体检人群脂肪肝的患病率及其危险因素.方法 体检包括10 334例.通过超声检查肝、胆和肾脏,测量身高、体质量、血压,应用自动化分析仪检测空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血尿酸(BUA).结果 总人群、男性、女性脂肪肝患病率分别为20.4%、26.2%、8.O%,60岁以下各年龄段脂肪肝患病率男性高于女性(P<0.01).脂肪肝组肥胖、高血压、高血糖、高TC、高TG、低HDL-C、高LDL-C、高BUA、胆结石、肾结石的患病率高于对照组(P<0.01).多因素logistic回归分析表明脂肪肝的危险因素包括高TG、高血糖、高BUA、高血压、男性、低HDI-C、高BMI.结论 扬州地区脂肪肝的患病率较高,其危险因素包括高TG、高血糖、高BUA、高血压、男性、低HDL-C、肥胖.     

不同标准空腹血糖受损人群高血压分布特征及相关因素分析

目的:探讨2种标准空腹血糖受损人群高血压分布特征及相关危险因素.方法:时年龄>40岁3 828人进行流行病学调查,分析空腹血糖≥5.6 mmol/L和空腹血糖≥6.1 mmol/L者的血压状况.结果:空腹血糖≥5.6 mmol/L 627例中,高血压患病率为31.74%,男性(34.54%)高于女性(29.89%)(P<0.05),高血压前期患病率为47.05%,男性(51.41%)高于女性(44.18%)(P<0.05);Logistic回归结果分析显示,血压升高的危险因素为高血压家族史、腰围、总胆固醇升高和高密度脂蛋白胆固醇降低.空腹血糖≥6.1mmol/L 245例中,高血压患病率为31.43%,男性(34.55%)高于女性(28.89%)(P<0.05);高血压前期患病率为44.90%,男性(43.64%)低于女性(45.93%)(P>0.05);Logistic回归分析结果显示,血压升高的危险因素为年龄、高血压家族史、腰围和低密度脂蛋白胆固醇升高.结论:分别以空腹血糖≥5.6 mmol/L和≥6.1 mmol/L为诊断切点的空腹血糖受损人群高血压和高血压前期总患病率分别为78.79%和76.33%,可控危险因素主要是中心性肥胖和血脂代谢紊乱.     

北部新区参保居民高血压患病率及危险因素分析

目的调查重庆北部新区40岁以上参保居民高血压的患病率及危险因素分析,以期为社区高血压防治提供流行病学依据。方法收集3 500名社区参保居民的既往病史、用药史、糖尿病家族史、吸烟及饮酒史情况。受试者均接受常规体格检查,包括体质量、身高、血压,体质量指数(BMI)。测定三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)及葡萄糖口服耐量试验(OGTT)后2h血糖(2hPG)。结果高血压患者的年龄、BMI、FPG、2hPG、TC、TG、HDL-C和LDL-C均显著高于血压正常者(P<0.01)。与血压正常者相比,高血压患者中男性的比例、肥胖、超质量、空腹血糖调节受损(IFC)、糖尿病、高三酰甘油的患病率均明显升高(P<0.05)。结论重庆北部新区参保居民高血压的患病率高,控制率低,     

西安市某社区中老年人代谢综合征现状及组分分析

目的 了解西安市兵器工业521社区中老年人代谢综合征(MS)患病情况及其各组成成分构成情况,同时了解该社区糖尿病及糖尿病前期的患病情况.方法 选取西安市兵器工业521社区参加体格检查的443例中老年人作为调查对象,分析MS患病情况和其相关单病种、MS类型构成情况,以及糖尿病的患病情况.结果 男性MS检出率与女性MS检出率比较,差异无统计学意义(P>0.05);65～<75岁男性MS检出率高于女性,差异有统计学意义(P<0.05).高血压、高血糖、超体质量和(或)肥胖、高密度脂蛋白胆固醇异常和三酰甘油(TG)异常的中老年人发生MS风险分别是正常中老年人的7.92、8.21、8.49、9.99和16.85倍.男、女性中老年人最常见MS类型均为超体质量和(或)肥胖+高血压+TG异常.超体质量和(或)肥胖+高血压+TG异常对中老年人MS发病的危险度最大.不同体质量指数分类患者糖尿病、糖尿病前期检出率比较,差异无统计学意义(P>0.05).结论 该社区中老年人MS检出率较高,血糖异常检出率也较高,血脂异常、超体质量和(或)肥胖、高血糖和高血压是该人群MS防治的重点.     

连云港市老年人代谢综合征的现状调查

目的调查连云港市60岁以上老年人群代谢综合征的患病状况。方法对2015年1~12月到该院体检的60岁以上老年人群进行血压、身高、体质量、体质量指数、空腹血糖、三酰甘油、高密度脂蛋白胆固醇等指标按中华医学会糖尿病分会(中华医学会糖尿病分会)2004年制订的诊断标准进行统计分析。结果代谢综合征患病率27.42%,其中男性患病率25.20%,女性29.89%,高血压患病率56.35%,高血糖患病率32.71%,高血脂患病率36.58%,肥胖患病率50.05%;代谢异常情况检出率从高到低依次为高血压、肥胖、高血脂和高血糖,高收缩压、高三酰甘油、肥胖不同年龄间代谢异常检出率比较,差异有统计学意义(P0.05);高舒张压、高血糖不同年龄间代谢异常检出率比较,差异无统计学意义(P0.05),随着体质量指数的增高,代谢综合征、高血糖、高血压、高三酰甘油、低高密度脂蛋白胆固醇都呈明显增高趋势(P0.05)。结论代谢综合征患病率及各项单独指标的患病率比例相当高;女性代谢综合征的患病率明显高于男性(P0.05)。加强对社区老年人特别是女性的健康教育是社区医务工作者的首要任务。     

糖尿病前期人群脂肪肝发病危险因素的病例对照研究

目的探讨糖尿病前期人群脂肪肝发病危险因素,为后期健康指导提供参考依据。方法选取2019年4-8月在华东疗养院健康体检中心进行健康体检的糖尿病前期人群作为研究对象,其中322例脂肪肝患者为病例组,219例非脂肪肝患者为对照组。比较两组基础资料、生活习惯及血生化相关指标的组间差异,通过单因素及多因素Logistic回归分析筛选糖尿病前期人群脂肪肝发病危险因素。结果病例组吸烟史、运动频率、饮食特点及体质量指数(BMI)、超重或肥胖比例、三酰甘油(TG)、高密度脂蛋白胆固醇、丙氨酸氨基转移酶及天门冬氨酸氨基转移酶、空腹血糖水平与对照组比较,差异均有统计学意义(P0.05);单因素与多因素Logistic结果均显示,吸烟史、偶尔或从不运动、荤食、超重或肥胖、TG水平异常是糖尿病前期人群脂肪肝发病的独立危险因素(P0.05),而超重或肥胖人群与TG水平异常人群出现脂肪肝的风险分别是BMI正常人群的2.148倍及2.108倍。结论经常吸烟、运动量较少、荤食为主、体质量过高及TG水平异常是糖尿病前期人群形成脂肪肝的危险因素,对于超重或肥胖及TG水平异常人群应重点进行早期健康指导及治疗,以降低脂肪肝的发病率。     

健康体检人群高血压前期与糖脂代谢异常状况研究

目的研究健康体检人群高血压前期与血糖血脂代谢异常状况。方法选择2014年1月至2015年6月在该院接受健康体检者200例,测量血压、体质量指数,及血清三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖、尿酸等指标;比较不同性别、年龄段人群高血压检出率和糖脂代谢异常检出率,比较合并及不合并糖脂代谢异常高血压患者各指标水平。结果共检出高血压前期患者54例,检出率为27.00%,且男性患者所占比例高于女性(P0.05)。高血压前期患者中,25~45岁者所占比例高于血压正常者和高血压患者(P0.05)。高血压前期患者HDL-C水平低于血压正常者且高于高血压患者,其他血清指标水平高于血压正常者且低于高血压患者(P0.05)。单纯脂代谢异常、高TG血症、高TC血症及混合型高血脂症患者中,男性所占比例高于女性(P0.05),各年龄段人群糖脂代谢异常检出率比较差异有统计学意义(P0.05)。高血压前期患者糖脂代谢异常检出率高于血压正常者且低于高血压患者(P0.05)。合并糖脂代谢异常高血压前期患者年龄、舒张压、TG、TC、LDL-C等指标水平高于不合并者,HDL-C水平低于不合并者(P0.05)。结论健康体检人群高血压前期和糖脂代谢异常发病呈年轻化趋势,且男性所占比例较大,合并糖脂代谢异常高血压前期患者存在更多的心脑血管疾病危险因素。     

中国西北地区民航飞行员代谢综合征患病率调查及其特征分析

目的调查中国西北地区民航飞行员代谢综合征(MS)患病率,并分析其主要特征,为民航飞行员MS防控提供理论支持。方法采用整群抽样的方式,以2014年1月1日至12月31日在民航西安医院(民航西北航空医学体检中心)参加年度体检的驻地为西北地区所有在飞民航飞行员共565例为研究对象。测量身高、体质量、血压、总胆固醇、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、血尿酸、糖化血红蛋白,并计算体质量指数(BMI),所有数据双人录入计算机,并由第三人核查,应用SPSS17.0软件并采用2004年中华医学会糖尿病学分会提出的适合中国人群的MS诊断标准统计MS患病率,并对其特征进行分析。结果本次调查人群MS患病率为4.25%,MS患者相关组分组合形式超体质量/肥胖+高TG/低HDL-C血症+高血压比例最高;本次调查人群及MS患者单个组分异常率以超体质量/肥胖、高TG/低HDL-C血症、高血压为主;MS组与非MS组相关指标比较差异具有统计学意义的包括BMI、身高、体质量、收缩压、舒张压、TG、FPG。结论中国西北地区民航飞行员呈现相对较低的MS患病率,MS各组分中以BMI、TG、HDL-C、血压异常为主;为有效预防民航飞行员心脑血管疾病的快速发展,特别是防范民航飞行员突发猝死及空中失能事件的发生,建议关注民航飞行员健康相关问题,加强民航飞行员MS及相关疾病的有效防控,特别是肥胖、血脂异常、血压异常及高血糖的有效控制。     

Measurement of L-carnitine and acylcarnitines in body fluids and tissues in children and in adults

We have developed a reliable and validated radio-enzymatic method for the assay of L-carnitine and acylcarnitines, using a modification of existing methods. The sensitivity of the assay is 10 mumol/l using 10 microliters of plasma or urine. It is also suitable for measurements of carnitine in a 10 mg sample of liver or muscle obtained by percutaneous biopsy. The use of N-ethylmaleimide in the reaction mixture together with an excess of [1-14C]acetyl CoA ensures that the reaction proceeds to completion and a linear response is obtained. Using this method control ranges have been established for plasma and urine carnitine concentrations in healthy children and adults, and for the carnitine content of liver and muscle in adults. No significant difference was found between fasting and post-prandial plasma carnitine levels. An age-related increase was found in urinary total carnitine and acylcarnitine concentration throughout childhood. These data provide a reliable basis for studies of patients with abnormal carnitine and acylcarnitine metabolism, distribution and excretion.     

Activity of amikacin and ampicillin in succession and in combination

One strain each of Escherichia coli and Streptococcus faecalis were exposed to amikacin and ampicillin in combination as well as in succession. Exposure to ampicillin for 1 hr followed by amikacin for 3 or 4 hr had the greatest antibacterial activity when the antibiotics were applied in succession. The least effective exposures for both organisms were 1 hr to amikacin followed by 3 or 4 hr to ampicillin. Exposure to the antibiotics in combination each at 1 MIC had the overall greatest antibacterial activity. Simultaneous exposure to the antibiotic combination does not necessarily mean simultaneous activity of both ampicillin and amikacin on the E. coli. The cell wall autolytic activities produced by ampicillin are triggered within 10 min after physical contact with the bacteria. In contrast, amikacin requires at least 30 min after physical contact to manifest its activity on the ribosome. Although physical exposure to both antibiotics in the combination is simultaneous, the specific activity of each is in fact sequential, with ampicillin acting first. This explains the synergistic effect of the combination. It appears, therefore, that the synergistic or antagonistic affect of a drug combination is determined by the sequence and timing of the antibacterial manifestations of its components.     

纤维支气管镜在儿童咯血诊断与治疗中的应用

目的 评价纤维支气管镜术在儿童咯血病因诊断及治疗中的价值以及安全性.方法 应用用日本产Olympus BF 3c-40纤维支气管镜(最小外径3.6 mm)给58名咯血原因不明的患者行纤维支气管镜检查,并予镜下局部止血治疗.判断出血部位、观察病变情况和出血的原因、临床表现、其他辅助检查、治疗及转归等进行综合分析.结果 引起咯血的主要疾病为气管支气管、肺部的炎症24例(41.3%)、支气管内膜结核12例(20.7%)、支气管异物8例(13.7%)、特发性肺含铁血黄素沉着症7例(12.1%)、支气管扩张4例(6.9%)、心肺血管发育异常1例,原因不明2例.诊断阳性率为96.5%.镜下发现有活动性出血18例,镜下局部止血治疗后显效者10例,有效者8例,有效率为100%.术中并发短暂低氧血症(SaO2＜85%,＜20 s)15例,加大吸氧流量后均改善;术后发热3例均为低热,24 h后热退.结论 纤维支气管镜检查可明确出血部位及原因并可进行局部治疗,且安全的有效.     

Sites of in vivo extraction and interconversion of testosterone and androstenedione in dogs

The interconversion and extraction of testosterone and androstenedione across and within different tissues or areas have been studied by the constant infusion technique. The results were calculated using the (3)H/(14)C ratios and radioactive concentrations of testosterone and androstenedione obtained from afferent and efferent blood and tissues at equilibrium. In each tissue studied, the interconversion between testosterone and androstenedione inside the tissue was significantly higher than the corresponding interconversion across the tissue. The pulmonary contribution to the total interconversion between testosterone and androstenedione was far more important than that of any of the other tissues studied. The hepatic metabolic clearance rates of testosterone and androstenedione were not different from their metabolic clearance rates in the mesenteric area. The extraction of each of these compounds, although not negligible, was lower in the kidney and the femoral bed compared with the extraction in the liver and the mesenteric area. Finally, with the possible exception of the liver, testosterone and androstenedione were more completely metabolized when they originated from the cells than from afferent blood.The evaluation of these different tissue transfer constants provides more precise information concerning the relative importance of different sites in the metabolism of these interconverting hormones.     

Evaluation of aprotinin and tranexamic acid in different in vitro and in vivo models of fibrinolysis, coagulation and thrombus formation

BACKGROUND: The serine protease inhibitor aprotinin and plasminogen inhibitor tranexamic acid are used in coronary artery bypass graft (CABG) surgery to reduce bleeding. Clinicians may consider these agents as readily substitutable regarding their pharmacological profiles. OBJECTIVE: These agents were evaluated in assays of hemostasis to elucidate their underlying mechanism(s) of action. METHODS: In human plasma, effects on both clot fibrinolysis and coagulation were spectrophotometrically quantified in vitro. Rat-tail bleeding and arteriovenous shunt thrombus formation models were conducted in vivo. RESULTS: Fibrinolysis was inhibited by aprotinin (IC(50), 0.16 +/- 0.02 micromol L(-1)) and tranexamic acid (IC(50), 24.1 +/-1.1 micromol L(-1)). In vivo, aprotinin dose-dependently reduced rat-tail bleeding time (minimal effective dose, 3 mg kg(-1) bolus plus 6 mg kg(-1 )h(-1) infusion); tranexamic acid reduced bleeding time (minimal effective dose, 100 mg kg(-1) h(-1)). In vitro, coagulation time was doubled by aprotinin at 3.2 +/- 0.2 micromol L(-1), while tranexamic acid showed no effect at concentrations up to 3 mmol L(-1). Aprotinin inhibited thrombus formation in vivo in a dose-dependent manner (minimal effective dose, 3 mg kg(-1) bolus plus 6 mg kg(-1) h(-1) infusion). Conversely, tranexamic acid dose-dependently increased thrombus formation and thrombus weight (minimal effective dose, 100 mg kg(-1 )h(-1) infusion). CONCLUSIONS: These data show that aprotinin and tranexamic acid have differential effects on hemostasis and are not necessarily substitutable with respect to mechanism of action. Although both agents have been shown to reduce bleeding in patients undergoing CABG, their divergent effects on thrombus formation observed in vitro and in vivo should be critically evaluated clinically.     

Noradrenaline and Adrenaline in Blood and Urine in a Case of Phaeochromocytoma

A case of phaeochromocytoma is described in which X-ray investigation and pharmacodynamical tests with tetraethyl-ammonium and Regitin were non-informative. The diagnosis was established by the increased excretion of catechols with the urine (1010–2400 μg noradrenaline and 16–19 μg adrenaline per 24-hour period).

Estimation of catechols in samples of the blood and of the urine from the same period showed an average blood level of 3.6 μg/100 ml noradrenaline and a corresponding urinary output of 110 μg per hour.

The high systolic and diastolic blood pressure, the electrocardiographic changes, the increased basal metabolic rate, the response to the glucose tolerance test, sweating, eosinopenia and fatigue are explained as symptoms and signs of hypernoradrenalinemia.

Biological estimation of the catechols in the tumor, which weighed 40 g, showed 590 μg/g noradrenaline and 12 μg/g adrenaline.

After operation the blood pressure and the level of the urinary catechols returned to normal.     

Population pharmacokinetics and pharmacogenetics of alcohol in Chinese and Indians in Singapore

What is known and Objective:  Interindividual variability in alcohol pharmacokinetics is influenced by a number of factors, including polymorphisms in genes mediating alcohol pharmacology, ethnicity, sex and body size. Several studies have evaluated the population pharmacokinetics of alcohol from breath alcohol measures. None of these studies, however, have evaluated ethnicity and alcohol‐metabolizing enzyme genotypes as covariates in their population pharmacokinetic modelling. We aimed to develop a population pharmacokinetic model using clinical and genetic factors and to identify covariates that influenced interindividual variability in alcohol clearance and volume of distribution. Methods:  Hundred and eighty healthy subjects (90 Chinese and 90 Indians; 45 males and 45 females from each ethnic group) ingested a vodka–orange juice mixture to simulate social drinking. Subjects were genotyped for the ADH1B (Arg48His), ALDH2 (Glu504Lys) and CYP2E1 (c.‐1293G>C and c.‐1053C>T) polymorphisms. A base pharmacokinetic model was developed using the nonmem software (NONMEM Project Group, University of California, San Francisco, San Francisco, CA, USA) to determine the alcohol clearance and volume of distribution. The model was extended to include covariates that influenced the between‐subject variability. Results and Discussion:  Body weight and sex significantly influenced absorption rate and volume of distribution of alcohol. Body weight and ADH1B Arg48His polymorphism significantly influenced alcohol clearance. The Michaelis–Menten elimination rate (V_max) was decreased by 10% in homozygous ADH1B*1/*1 subjects. Ethnicity was not determined to be a significant covariate in the final population pharmacokinetic model. What is new and Conclusion:  Gender and body weight were covariates that contributed most to explaining the observed interindividual alcohol pharmacokinetic variability. Of the four SNPs examined in this study, only ADH1B Arg48His polymorphism had a significant, though modest, effect on the pharmacokinetics of alcohol.     

Safety and efficacy of linezolid in 16 infants and children in Japan

Linezolid, an oxazolidinone antibiotic, exhibits a broad spectrum of activity against Gram-positive bacteria. It has been licensed for adult use in Japan since 2006 for MRSA infections, and has also been used off-label for pediatric patients. At our university hospital, a total of 16 infants and children (including one non-Japanese Asian) were administered linezolid owing to infection with multidrug-resistant Gram-positive bacteria, after consent had been provided. All patients had severe underlying diseases or indications for surgery. Eighty-eight percent of the causal microorganisms were methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-resistant coagulase-negative Staphylococcus and all were sensitive to linezolid. Linezolid was administered because the antecedent anti-MRSA medications were ineffective or contraindicated, or intravenous-to-oral switch therapy was requested owing to cardiac or orthopedic surgical-site infections. The median duration of administration was 13 days (range 3-31 days). The overall efficacy was 91 % (10/11) in those for whom efficacy could be evaluated. Only two patients (both teen-aged) encountered linezolid-related adverse effects (13 %, 2/16). One patient showed elevation of liver enzymes (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]), requiring that administration be withdrawn, but enzyme levels returned to normal after the patient had been switched to vancomycin. The other patient showed transiently decreased platelet counts. Linezolid is considered generally safe and effective for children in Japan, especially for those who cannot use other anti-MRSA medications or those who require oral antibiotics for infections with multidrug-resistant Gram-positive bacteria.