物理因子疗法在心血管疾病康复治疗中的应用

近些年随着人口老龄化加速、生活方式改变等因素,心血管疾病已经超越恶性肿瘤成为我国居民致死致残的首要病因。心脏康复可以显著降低心血管疾病患者的再入院率和死亡率,并且使患者的生活质量得到改善,从而回归正常社会生活。物理因子疗法作为康复治疗的重要途径之一,虽然效果明显,但是由于其不断更新而存在许多不确定性。因此,本文总结了现阶段物理因子疗法在心血管疾病治疗当中的应用情况,从而为物理因子在心血管疾病中的进一步应用提供参考和依据。     

血脂康胶囊临床应用中国专家共识

一、背景 心血管疾病已成为当今社会患病率、致残率和死亡率最高的疾病.近些年,随着不健康生活方式的流行,心血管疾病的危险因素迅速增多.其中,血脂异常是导致心血管疾病的重要原因.2002年中国居民营养与健康状况调查显示,中国人群中血脂异常者达1.6亿.我国一项队列研究表明,TC和LDL-C升高是我国冠心病的独立危险因素.因此,干预血脂异常是防治心血管疾病的重要措施.     

脂蛋白相关磷脂酶A2在冠心病诊治方面的研究进展

<正>心血管疾病是整个亚洲和中东地区日益严重的公共卫生问题^[1]。在我国，心血管病死亡率居首位，占居民疾病死亡构成的40%以上，且现今我国心血管疾病患病率及死亡率仍处于上升阶段^[2-3]。冠心病是常见的心血管疾病，其发生发展与动脉斑块的形成及破溃密切相关。脂蛋白相关磷脂酶 A2 (lipoprotein-associated phospholipase A2,Lp-PLA2 )是一种炎症标志物，其介导的炎症反应参与了动脉粥样硬化的进程，     

2017欧洲ST段抬高型心肌梗死管理指南要点

正根据《中国心血管病报告2017》,随着社会老龄化和城市化进程加快、居民不健康生活方式流行,近年来我国的心血管疾病(尤其是冠心病)发生率逐年增高,且呈现低龄化和农村快速增长的趋势[1]。至今,急性ST段抬高型心肌梗死(STEMI)仍然是冠心病患者最危险的并发症,而且住院期死亡率高达5%~8%[2]。如何提高急性STEMI的诊治水平、改善患者的预后,历来是我国基础研究工作者和临床医生面     

冠心病与高血压病现状与展望

<正> 当今世界上,凡是传染病得到满意控制的国家或地区,心血管疾病已成为危害人类健康和导致死亡的主要原因,仅美国每年约70多万人死于心脏病,在中国也是如此.随着人们生活水平的不断提高,生活节奏的加快,心血管病也有逐年增多的趋势.目前,心血管疾病已成为我国第一致死原因,尤其是高血压、冠心病.在我国三大城市(北京、上海、天津)中,高血压、冠心病的死亡率80年代比70年代升高了3～4倍,它已成为严重的卫生健康与社会问题,现将近年来心血管疾病的现状、进展和今后发展方向等有关问题作一扼要评述,供读者参考.     

反式脂肪酸对心血管的危害及机制的研究进展

正心血管疾病已成为我国居民的首要死亡原因。据统计,我国现有心血管病患者2.3亿,年死亡率为210/10万人,相比肿瘤增加了65%。随着生活水平的提高及生活方式的改变,冠心病的发病及死亡率呈逐年增加的趋势,而恶性室性心律失常是冠心病患者心脏性猝死的主要原因。随着西式快餐的兴起,饮食文化的日益西化,以及食品营养知识的缺乏使得我国居民对反式脂肪酸(trans fatty acids,TFA)的认识远     

辨证、发展地看待介入治疗——独家专访:武汉亚洲心脏病医院院长朱国英教授

随着物质生活水平提高,心血管疾病已位居我国居民死亡原因的前列,其发病率和死亡率逐年升高。我国心血管病人已超过1亿人口,其中冠心病患者达4300万,每年新发冠心病75万,令人生畏!并且冠心病的发病年龄逐渐年轻化,许多40-50岁的中年人也患上了冠心病。为此,本刊特别邀请我国著名心脏介入治疗专家朱国英教授,给大家谈谈冠心病的诊断和治疗问题。     

高血压抗动脉粥样硬化（AS）治疗理念

根据2006年中国慢性病报告,自1985年至2010年我国心脑血管病的死亡率逐年上升。然而2007年的美国冠心病的死亡率自1968年开始逐年下降。在这一升一降当中．我们可以看到美国在20世纪60年代开展的一级预防作出了重大的贡献,而我国对AS的干预措施还远远不够。2008年中国卫生部提出“健康中国2020战略”,2010年美国心脏协会（AHA）专家委员提出新的10年战略目标,即“AHA2020健康战略”,其中要求到了2020年全美心血管健康改善率达20％以及由于心血管疾病和脑卒中导致的死亡率降低20％。由此可见中美都十分重视人群心血管疾病的发展,并将“健康2020”上升为国家战略。     

辨证、发展地——独家专访：武汉亚洲心脏病医院院长朱国英教授

随着物质生活水平提高，心血管疾病已位居我国居民死亡原因的前列，其发病率和死亡率逐年升高。我国心血管病人已超过1亿人口，其中冠心病患者达4300万，每年新发冠心病75万，令人生畏!并且冠心病的发病年龄逐渐年轻化，许多40—50岁的中年人也患上了冠心病。为此，本刊特别邀请我国著名心脏介入治疗专家朱国英教授，给大家谈谈冠心病的诊断和治疗问题。     

心脑血管病患者的心理反应及护理措施

随着生活水平的提高和生活节奏的改变,因“三高症”（即高血压、高血糖和高血脂）导致的心脑血管病发病率和死亡率逐年上升,已成为我国居民致残、死亡的主要原因。由于它具有发病急、致残率高、死亡率高、复发率高,并发症多的特点,给社会和家庭带来了沉重的负担。一旦患上心脑血管病,对患者的心理影响特别大,能否以良好的心态对待疾病,对患者的康复影响极大。这就需要护理人员了解患者在心脑血管病各个阶段的心理变化,有针对性地做好心理护理,让患者积极配合治疗,促进早日康复。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.