匹伐他汀钙治疗老年冠心病的疗效及安全性

目的 观察匹伐他汀钙治疗老年冠心病的疗效及安全性.方法 将年龄≧75岁的60例老年冠心病患者随机分为匹伐他汀组30例(1～2 mg/d)和辛伐他汀组30例(10～20 mg/d),分别于治疗前,治疗后2、4、8周检测并比较肝功能、血脂、磷酸肌酸激酶的变化.结果 匹伐他汀组降低总胆固醇和低密度脂蛋白胆固醇的作用与辛伐他汀...     

阿托伐他汀钙在2型糖尿病病人中的疗效及安全性观察

目的综合评价2型糖尿病病人强化他汀治疗(20mg阿托伐他汀钙)与常规他汀治疗(辛伐他汀20mg)的疗效与安全性差异。方法选择2型糖尿病患者92例,随机分为2组进行研究。阿托伐他汀组患者每天晚饭前服用阿托伐他汀钙20mg/d,辛伐他汀组患者服用辛伐他汀20mg/d,疗程12周。观察2组治疗后1,3个月的相关血脂参数变化:血清总胆固醇(TC),甘油三酯(TG),高密度脂蛋白胆固醇(HDL-C),低密度脂蛋白(LDL-C),空腹血糖(FBS),谷丙转氨酶(ALT),谷草转氨酶(AST)以及肌酸激酶(CK)并观察2组的副反应。结果治疗4周后,阿托伐他汀组TC,LDL-C较治疗前的降低幅度,明显优于辛伐他汀组(P<0.01)。治疗后12周,20mg/d阿托伐他汀钙降低TC和LDL-C水平明显优于辛伐他汀20m/d且有统计学差异(P<0.05)。升高HDL-C水平及降低甘油三酯水平2组无统计学差异(P>0.05)。结论针对2型糖尿病患者,阿托伐他汀钙20mg/d的降脂疗效明显优于辛伐他汀20mg/d,且安全性更好。     

阿托伐他汀治疗2型糖尿病并高脂血症疗效观察

目的 观察阿托伐他汀治疗2型糖尿病高脂血症的疗效及安全性.方法 2型糖尿病并高脂血症患者286例随机分为对照组142例与治疗组144例.对照组给予辛伐他汀10 mg/次,1次/d,每晚口服;治疗组给予阿托伐他汀10mg/次,1次/d,每晚口服.2组疗程均为12周,比较2组治疗前、后总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)水平.结果 2组治疗后TG,TC,LDL-C水平较治疗前下降(P＜0.05),治疗组下降优于对照组(P＜0.05);治疗组治疗后HDL-C水平较治疗前增高(P＜0.05),对照组治疗前、后HDL-C水平比较差异无统计学意义(P＞0.05);治疗组不良反应发生率低于对照组(P＜0.05).结论 阿托伐他汀治疗糖尿病高脂血症疗效优于辛伐他汀,且不良反应轻.     

小剂量阿托伐他汀治疗高龄老年人高脂血症的观察

目的观察阿托伐他汀的调脂疗效及安全性。方法 48例高龄老年人(年龄≥80岁)高脂血症患者服用阿托伐他汀10 mg,每晚1次,疗程6个月。服药前及6个月后检测血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)。每周询问有无服药后不良反应,1个月、3个月、6个月时进行血常规、血生化、肝肾功、心肌酶谱等实验室检测。结果治疗6个月后,患者血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)较服药前分别降低了28.47%,25.00%,34.78%,未见药物不良反应。结论阿托伐他汀对高龄老年人调脂疗效显著且安全性高。     

不同他汀对绝经后高血压血脂异常合并糖耐量减低患者的疗效观察

目的观察瑞舒伐他汀和匹伐他汀治疗绝经后女性高血压血脂异常合并糖耐量减低(IGT)的效果。方法连续选取2013年5月至2014年6月间就诊的绝经后高血压血脂异常伴IGT患者242例,随机分为瑞舒伐他汀组(10 mg/d,n=121)和匹伐他汀组(2 mg/d,n=121),观察两组治疗前和治疗后2、6、12、24个月总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、空腹血糖、餐后2 h血糖及新发糖尿病例数。结果治疗前后比较:两组治疗后与本组治疗前比较,TC、LDL-C(2、6、12、24个月时)明显降低(P0.01)、HDL-C(12、24个月时)明显升高(P0.05)。组间比较:瑞舒伐他汀组与匹伐他汀组同期比较,TC和LDL-C均降低明显(P0.05),匹伐他汀组HDL-C(24个月时)升高较瑞舒伐他汀组明显(P0.05)。瑞舒伐他汀组治疗12、24个月时与本组治疗前比较,空腹血糖、糖化血红蛋白均升高(P0.05);匹伐他汀组与本组治疗前比较,空腹血糖、糖化血红蛋白无明显变化。治疗12、24个月时新发糖尿病例数分别为瑞舒伐他汀组10、21例,匹伐他汀组8、14例(P0.05)。结论常规剂量的瑞舒伐他汀降低绝经后高血压高血脂合并IGT患者的血脂水平的效果优于常规剂量的匹伐他汀,匹伐他汀对糖耐量减低患者血糖影响小于瑞舒伐他汀。     

瑞舒伐他汀在高龄老年人血症异常危险分层高危患者中疗效及安全性观察

目的:观察瑞舒伐他汀治疗高龄老年人(≥80岁)血脂异常危险分层高危患者中的疗效及安全性.方法:选择98例高龄老年血脂异常患者口服瑞舒伐他汀10mg/d,疗程6周.观察治疗前后血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、尿素氮(BUN)、肌酐(Cr)、肌酸激酶(CK)等变化以及不良反应.结果:98例患者使用瑞舒伐他汀治疗后与治疗前比较TC、TG、LDL-C明显下降,HDL-C升高,差异有统计学意义(P均＜0.05).治疗过程中有3例患者出现轻微不良反应,但均能够耐受,无严重不良反应.结论:瑞舒伐他汀治疗高龄老年人血脂异常疗效可靠,且不良反应小,服用方便,适合高龄老年人血症异常危险分层高危患者使用.     

三种他汀药物治疗糖尿病合并血脂异常的疗效观察

目的比较三种他汀类药物治疗2型糖尿病合并血脂异常的临床疗效及安全性。方法83例2型糖尿病合并高脂血症患者随机分为阿托伐他汀(10mg/d)、辛伐他汀(20mg/d)和血脂康(1.2g/d)治疗组,观察三组治疗前及治疗12周的血脂水平。结果经阿托伐他汀、辛伐他汀和血脂康治疗的2型糖尿病患者的血脂水平与治疗前比较,总胆固醇(TC)分别下降29%,18%和21%;低密度脂蛋白(LDL-C)分剐下降37%,19%和22%;甘油三酯(TG)分别下降41%,26%和24%,高密度脂蛋白(HDL-C)分别升高5%,7%和5%(差异未见显著性)。组间比较,只有降低LDL-C的效果阿托伐他汀明显好于辛伐他汀或血脂康(P<0.05)。结论三种他汀药物中,阿托伐他汀对2型糖尿病患者血脂异常的调脂作用更好。     

依折麦布在老年冠心病合并高脂血症患者中的应用

目的观察依折麦布在老年冠心病合并高脂血症患者中的调脂疗效和安全性。方法选取老年冠心病合并高脂血症患者96例,将其随机分为常规治疗组(阿托伐他汀,20 mg/d)及依折麦布联合治疗组(阿托伐他汀,20 mg/d;依折麦布,10 mg/d),观察两组患者治疗前及治疗12周后总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和三酰甘油(TG)的水平及药物不良反应。结果两组治疗均可使TC、LDL-C、TG降低(P0.05),依折麦布联合治疗组的TC及LDL-C达标率显著高于常规治疗组(P0.05),而肝损害等不良反应发生率两组间比较,差异无统计学意义。结论依折麦布联合他汀类药物对老年冠心病合并高脂血症患者有更好的调脂效果,且有良好的安全性和耐受性。     

瑞舒伐他汀联合依折麦布治疗急性冠脉综合征的临床观察

目的：观察瑞舒伐他汀联合依折麦布对急性冠脉综合征患者血脂及hs-CRP的影响。方法选取急性冠脉综合征病人168例,随机分为观察组86例,口服瑞舒伐他汀10mg联合依折麦布10mg每晚一次,对照组82例,口服瑞舒伐他汀10mg每晚一次,所有患者治疗前及治疗8周后检验血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及hs-CRP,并观察肌酸激酶及转氨酶的变化。结果与治疗前比较,观察组治疗12周后的TC、LDL-C、hs-CRP均有明显降低(P＜0.05),HDL-C明显升高（P＜0.05）,肌酸激酶及转氨酶无统计学差异（P>0.05）。结论对急性冠脉综合征患者采用瑞舒伐他汀联合依折麦布口服治疗可以更有效的抗炎、调脂。     

瑞舒伐他汀对高血压合并高脂血症患者超敏C反应蛋白及血脂的影响

目的探讨瑞舒伐他汀对高血压合并高脂血症患者超敏C反应蛋白(hs-CRP)及血脂的影响。方法 100例高血压合并高脂血症患者随机分为对照组和他汀组各50例。两组均予常规降压治疗,他汀组在此基础上每晚加服瑞舒伐他汀10 mg,随访治疗前及治疗4周后的血压及血清hs-CRP、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、丙氨酸氨基转移酶(ALT)、肌酐(Cr)、肌酸激酶(CK)变化。结果两组降压效果差异无统计学意义(P0.05)。治疗后对照组hs-CRP、TC、LDL-C、HDL-C及TG无明显变化(P0.05);他汀组hs-CRP、TC、LDL-C及TG显著降低,HDL-C显著升高(P0.05)。他汀组hs-CRP与血脂各项指标均无直线相关关系(P0.05)。两组患者治疗前后ALT、Cr及CK水平无明显变化(P0.05)。结论瑞舒伐他汀可短期内安全有效地降低血浆hs-CRP水平,具有减轻血管炎性反应、改善内皮功能的作用,且该作用独立于降脂作用之外。     

Lunasin is prevalent in barley and is bioavailable and bioactive in in vivo and in vitro studies

Lunasin, a unique 43-amino acid peptide found in a number of seeds, has been shown to be chemopreventive in mammalian cells and in a skin cancer mouse model. To elucidate the role of cereals in cancer prevention, we report here the prevalence, bioavailability, and bioactivity of lunasin from barley. Lunasin is present in all cultivars of barley analyzed. The liver and kidney of rats fed with lunasin-enriched barley (LEB) show the presence of lunasin in Western blot. Lunasin extracted from the kidney and liver inhibits the activities of HATs (histone acetyl transferases), yGCN5 by 20% and 18% at 100 nM, and PCAF activity by 25% and 24% at 100 nM, confirming that the peptide is intact and bioactive. Purified barley lunasin localizes in the nuclei of NIH 3T3 cells. Barley lunasin added to NIH 3T3 cells in the presence of the chemical carcinogen MCA activates the expression of tumor suppressors p21 and p15 by 45% and 47%, decreases cyclin D1 by 98%, and inhibits Rb hyperphosphorylation by 45% compared with the MCA treatment alone. We conclude that lunasin is prevalent in barley, bioavailable, and bioactive and that consumption of barley could play an important role of cancer prevention in barley-consuming populations.     

Salmonellas in pigs and animal feeding stuffs in England and Wales and in Denmark

A comparison has been made between the incidence of salmonellas in pigs and feeding stuffs in England and Wales and in Denmark. In Denmark there is veterinary legislation requiring the sterilization of imported and home produced feed ingredients of animal origin. There is no such legislation in England and Wales. In Denmark 0·3% of resterilized imported meat and bone meal was contaminated with salmonellas. This compared with 23% of meat and bone meal in England and Wales and 20-27% of other ingredients of animal origin. In England and Wales salmonellas were isolated from 7% of caecal samples and 6% of lymph node samples, while in Denmark they were isolated from 3% of caecal samples and 4% of lymph node samples. In England and Wales 25 serotypes were found in both pigs and feeds and these included nearly all the most prevalent human pathogens. In Denmark four of the six serotypes in pigs had been found in resterilized feed. One notable difference between the two studies was the very wide range of serotypes found in pigs in England and Wales and the narrow range in Denmark. A second was that Salmonella typhimurium formed 15% of all Salmonella strains isolated from pigs in England and Wales, and 60% of those in Denmark.     

Management of pregnancy and childbirth in England and Wales and in France

This paper reviews national data on obstetric and neonatal practices in England and Wales, and in France between 1970 and 1980. The data have been derived from national statistics and surveys on national samples of births in 1970, 1975 and 1980 in England and Wales, and 1972, 1976 and 1981 in France. The analysis shows that there was no major difference in pregnancy outcome, but wide variations in medical practices, and their trend over time. The main differences were: in England and Wales a higher number of antenatal visits, a higher percentage of inpatient admissions during pregnancy, a higher rate of induction, more episiotomies, a higher rate of resuscitation at birth, and admission to neonatal special care units; in France, a higher rate of caesarean sections before and during labour, some evidence of a more active management of labour, and a longer hospital post-natal stay. These differences in practice reflect differences in objectives and assessment of the effectiveness of care between the two countries: they point out the need for better monitoring and evaluation of obstetric and neonatal practices.     

Research and teaching in social and preventive medicine and in public health

Summary Both public health and social and preventive medicine are characterised by the common goal of promoting, maintaining and improving health and preventing disease, and both are concerned with a population-related, preventive and environmental perspective. But whereas public health is interdisciplinary and goes far beyond the medical focus, social and preventive medicine is medically based and forms a bridge between public health and medical practice. Research in a department of social and preventive medicine serves to support preventive and medico-social activities in medical practice as well as in public health. This is illustrated by results from research conducted at the author's department during the last twenty years. Examples are research in support of smoking cessation activities, and research used for the planning of care for the elderly. Both the research and the teaching activities of the department take into account the population focus of public health as well as the focus on individual medicine in clinical practice.

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Forschung und Lehre in Sozial-und Präventivmedizin und öffentlicher Gesundheit

Zusammenfassung Sowohl das Gebiet der öffentlichen Gesundheit als auch dasjenige der Sozial-und Präventivmedizin sind durch das Ziel der Förderung, Erhaltung und Verbesserung der Gesundheit sowie der Krankheitsvorbeugung gekennzeichnet, und beide beschäftigen sich mit einer bevölkerungsbezogenen, präventiven und umweltbezogenen Perspektive. Aber während die öffentliche Gesundheit stark interdisziplinär ist und weit über den medizinischen Fokus hinausreicht, ist die Sozial-und Präventivmedizin ein medizinisches Fach und stellt eine Brücke zwischen der öffentlichen Gesundheit und der ärztlichen Praxis dar. Die Forschung in einem Institut für Sozial-und Präventivmedizin dient der Förderung präventiver und sozialmedizinischer Tätigkeiten in der ärztlichen Praxis wie auch in der öffentlichen Gesundheit. Dies wird durch die Forschungstätigkeit des Instituts des Autors aus den letzten 20 Jahren illustriert, wobei Beispiele aus den Gebieten der Förderung der Raucherentwöhnung und der Betreuung behinderter Betagter dargestellt werden. Sowohl in den Forschungs-als auch in den Lehrtätigkeiten des Instituts finden der Bevölkerungsbezug der öffentlichen Gesundheit wie auch der individualmedizinische Ansatz der ärztlichen Praxis ihren Ausdruck.

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La recherche et l'ensignement en médecine sociale et préventive et en santé publique

Résumé La santé publique aussi bien que la médecine sociale et préventive sont caractérisées par le but commun de promouvoir, maintenir et améliorer l'état de santé et de prévenir les maladies, et elles s'orientent vers une perspective de population, de prévention et environnementale. Mais la santé publique est interdisciplinaire et va loin au-delà de la médecine, tandis que la médecine sociale et préventive est basée sur la médecine et représente le lien entre la santé publique et la pratique médicale. La recherche d'un institut de médecine sociale et préventive sert à appuyer les activités préventives et médico-sociales au cabinet médical aussi bien qu'en santé publique. Cela est illustré par des résultats de recherches conduites dans les vingt années passées à l'institut de l'auteur, et les exemples sont tirés de la recherche en appui de la promotion de la cessation de fumée et de la planification de la prise en charge des personnes âgées et handicapées. Les activités de recherche et de l'enseignement de l'institut tiennent compte de la perspective de population cacactéristique de la santé publique, aussi bien que de la dimension de médecine individuelle caractéristique de la pratique clinique.

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Paper presented at a symposium on The Public Health Perspective of Social and Preventive Medicine, in celebration of the 20th anniversary of the Department of Social and Preventive Medicine, University of Berne, 25 June 1992 in Berne.     

Eggs enriched in omega-3 fatty acids and alterations in lipid concentrations in plasma and lipoproteins and in blood pressure

Effects of dietary eggs enriched with omega-3 fatty acids on lipid concentrations in plasma and lipoproteins and blood pressure were determined in 11 men and women in two groups. Group 1 consumed four omega-3 eggs per day during the first 4-wk period and four control eggs for the second 4-wk period. Group 2 ate the same number of eggs in the reverse order. Mean plasma cholesterol concentration was significantly increased by control eggs (P less than 0.01) but unchanged by omega-3 eggs. Mean plasma triglyceride concentration was decreased by omega-3 eggs but increased by control eggs. Both systolic and diastolic blood pressures were significantly lowered by omega-3 eggs in group 1 whereas only systolic pressure was significantly decreased on omega-3 eggs in group 2. The control eggs did not change blood pressure. In conclusion, the omega-3 eggs may be more healthful than the control eggs.     

Prevalence and Trends in Overweight in Mexican-American Adults and Children

Overweight and obesity have been increasing in many countries. Our objective is to describe the trends in overweight and obesity occurring in the Mexican-American population in the United States. Data on measured height and weight for Mexican Americans come from the following surveys: the Hispanic Health and Nutrition Examination Survey (HHANES, 1982–84), the Third National Health and Nutrition Examination Survey (NHANES III, 1988–94), and NHANES 1999–2002. In 1999–2002, 73% of Mexican-American adults were overweight and 33% were obese. Obesity increased between NHANES III and NHANES 1999–2002, from 24% to 27% for men and from 35% to 38% for women. Increases were also seen for children and adolescents. The Mexican-American population in the United States, both children and adults, is showing trends in overweight and obesity over time that are similar to those seen in other segments of the U.S. population and indeed in many countries