原发性高血压患者血压变异性与左室肥厚的相关性分析

目的 探讨原发性高血压血压变异性与左室肥厚的相关性.方法 60例原发性高血压患者根据有无左室肥厚分为左室肥厚(LVH)组及非LVH组,同时选择30例血压正常患者为对照组,对3组进行动态血压和超声心动图监测.结果 高血压LVH组与非LVH组或健康组动态监测各时间段血压均值及血压变异性比较差异有显著性(P＜0.05),非高血压LVH组与非LVH组或对照组超声心动图检测的左心室质量指标(LVMI)差异有显著性(P＜0.05).血压变异性和左心室肥厚质量指标相关性好.结论 原发性高血压血压变异性与左室肥厚关系密切,血压变异性增大对左室肥厚的风险性预测有较好的参考价值.     

高血压左心室肥厚患者血清胰岛素生长因子1、Ⅲ型前胶原浓度变化及其临床意义

目的 探讨原发性高血压患者血清胰岛素样生长因子1(IGF-1)、Ⅲ型前胶原(PCⅢ)水平与左心室肥厚(left ventricular hypertrophy, LVH)的关系以及血清IGF-1与PCⅢ二者之间的关系.方法 采用放射免疫分析方法测定61例原发性高血压患者和28例正常人的血清IGF-1、PCⅢ水平.根据心脏多普勒超声各项参数计算左心室质量指数(left ventricular mass index, LVMI).用单因素方差分析比较正常对照组、单纯高血压(EH)组和高血压合并左心室肥厚(EH-LVH)组LVMI、IGF-1和PCⅢ差别,用Pearson直线相关分析血清IGF-1和PCⅢ与LVMI的相关性.结果 EH组血清IGF-1显著高于正常对照组(P＜0.01),EHLVH组血清IGF-1显著高于EH组(P＜0.01)与正常对照组(P＜0.01);血清IGF-1与LVMI存在正相关(r=0.640,P＜0.01).EH组血清PCⅢ显著高于正常对照组(P＜0.01),EHLVH组血清PCⅢ显著高于EH组(P＜0.01)与正常对照组(P＜0.01);血清PCⅢ与LVMI存在正相关(r=0.423,P＜0.01),但在EH组与EH-LVH组各组中血清IGF-1与PCⅢ之间不存在相关性(P＞0.05).结论 ①循环血IGF-1、PCⅢ水平与高血压及高血压合并LVH密切相关,表明其参与了高血压的发生发展,且可能在高血压心肌重构中起到关键性的作用.②IGF-1与PCⅢ之间在高血压病的发生发展及高血压心肌重构中没有相关性,提示原发性高血压合并LVH时,IGF-1、PCⅢ这两种体液因子是独立作用于心血管系统而发挥其作用.     

高血压患者血压变异性和左室肥厚关系的研究

目的观察原发性高血压患者血压变异性与左心室肥厚的关系。方法原发性高血压患者60例,分别进行超声心动图检查和24 h动态血压监测,根据超声心动图测量指标计算所得的左心室重量指数(LVMI)分为左心室肥厚(LVH)组和无LVH组,分析比较两组间的血压均值和血压变异性。结果 LVH组24 h、白昼、夜间的收缩压和舒张压水平以及各阶段的收缩压和舒张压标准差均比无LVH组明显增大,差异有显著性;且LVH组LVMI高于无LVH组,差异有显著性。结论原发性高血压患者LVH的发生和血压变异性密切相关,血压变异性增高对左心室肥厚风险有一定预测价值。     

高血压患者血压变异性与左心室肥厚的关系

【目的】探讨原发性高血压患者血压变异性与左心室肥厚的关系。【方法】60例原发性高血压患者分别进行超声心动图和动态血压监测,根据左心室重量指数（LVMI）分为左心室肥厚（LVH）组和无LVH组,分析比较两组间的血压均值和血压变异性。【结果】LVH组24 h平均收缩压（24hSBP）、24 h平均舒张压（24hDBP）及白昼收缩压（dSBP）与夜间收缩压（nSBP）、白昼舒张压（dDBP）均显著高于无LVH组,且差异显著（ P ＜0．05）;LVH组血压变异性各指标除白昼舒张压标准差（dDSD）外,均比无LVH组增大,差异显著（ P ＜0．05）。【结论】原发性高血压患者LVH的发生和血压变异性密切相关,血压变异性增高对左心室肥厚风险有一定预测价值。     

高血压不同左心室构型患者血清PCⅠ和PCⅢ含量及其临床意义

目的初步探讨血清Ⅰ和Ⅲ型前胶原(PCⅠ、PCⅢ)对高血压患者左室重构不同构型的影响。方法采用放射免疫法测定140例高血压患者和30例健康体检者的PCⅠ、PCⅢ浓度;超声心动图检查心脏各结构指标,据此将高血压组分为正常构型组(25例)、向心性重构型组(43例)、向心性肥厚型组(40例)和离心性肥厚型组(32例)4个亚组。结果①高血压组的血清PCⅠ和PCⅢ水平均显著高于正常对照组;高血压不同左心室构型组间,血清PCⅠ和PCⅢ水平均有统计学差异(P<0.05),但两者在不同构型间升高的情况有所不同,血清PCⅢ水平在向心性与离心性肥厚组显著升高,但两肥厚组间无显著差异,而血清PCⅠ水平在离心性肥厚组显著高于其他各组(P<0.05);高血压正常构型与向心性重构型组的PCⅠ水平虽高于正常对照组,但差异不显著。②血清PCⅠ和PCⅢ均与左室质量指数、左心室室壁相对厚度、室间隔厚度和左室后壁厚度呈正相关;血清PCⅠ与PCⅢ亦呈正相关。结论血清PCⅠ和PCⅢ水平升高均与高血压病左心室重构有关,临床上检测血清PCⅠ和PCⅢ水平有助于尽早发现高血压病左心室重构,并为逆转左心室重构提供客观的监测指标。     

高血压不同左心室构型患者血清PCⅠ和PCⅢ含量及其临床意义

目的 初步探讨血清Ⅰ和Ⅲ型前胶原（PCⅠ、PCⅢ）对高血压患者左室重构不同构型的影响。方法 采用放射免疫法测定140例高血压患者和30例健康体检者的PCⅠ、PCⅢ浓度；超声心动图检查心脏各结构指标，据此将高血压组分为正常构型组（25例）、向心性重构型组（43例）、向心性肥厚型组（40例）和离心性肥厚型组（32例）4个亚组。结果 ①高血压组的血清PCⅠ和PCⅢ水平均显著高于正常对照组；高血压不同左心室构型组间，血清PCⅠ和PCⅢ水平均有统计学差异（P〈0．05），但两者在不同构型间升高的情况有所不同。血清PCⅢ水平在向心性与离心性肥厚组是著升高。但两肥厚组间无显著差异，而血清PCⅠ水平在离心性肥厚组显著高于其他各组（P〈0．05）；高血压正常构型与向心性重构型组的PCⅠ水平虽高于正常对照组，但差异不显著。②血清PCⅠ和PCⅢ均与左室质量指数、左心室室壁相对厚度、富间隔厚度和左室后壁厚度呈正相关；血清PCⅠ与PCⅢ亦呈正相关。结论血清PCⅠ和PCⅢ水平升高均与高血压病左心室重构有关，临床上检测血清PCⅠ和PCⅢ水平有助于尽早发现高血压病左心室重构，并为逆转左心室重构提供客观的监测指标。     

高血压患者动态血压、血压负荷值及血压变异性与左心室肥厚的关系——附62例报告

目的:探讨原发性高血压(高血压)患者动态血压、血压负荷值及血压变异性与左心室肥厚(left ventricular hypertrophy,LVH)的关系.方法:对208例高血压患者进行24小时无创性动态血压监测和彩色多普勒超声检查,根据左心室质量指数(left ventricular mass index,LVMI)分成LVH组和非LVH组2组,分析比较24小时、日间、夜间的血压、血压负荷及其变异性与LVH的相关性.结果:高血压LVH组24小时、日间、夜间的收缩压,收缩压负荷及其变异性均显著高于非LVH组(P＜0.01);高血压患者LVMI与24小时、日间、夜间的收缩压,收缩压负荷及其变异性呈正相关(P＜0.01),与夜间收缩压变异性的相关性最强.结论:24小时收缩压负荷及其变异性增大是高血压LVH的危险因素,高血压伴LVH者夜间的收缩压负荷及其变异性均高于不伴LVH者,可见仅仅控制血压还不足以保护心脏,还应该重视降低24小时收缩压、尤其是夜间收缩压负荷及其变异性,从而降低LVH的发生率.     

辛伐他汀改善高血压左室肥厚及舒张功能的作用

目的：研究辛伐他汀对原发性高血压左室肥厚及舒张功能的改善效能。方法：选择1～2级原发性高血压患者72例，分成辛伐他汀组（38例）和对照组（34例），均以苯那普利每日10mg或缬沙坦每日80mg为基础进行血压控制，如血压控制不佳则每日加用双氢克尿噻12.5mg，辛伐他汀组另加用辛伐他汀每晚20mg，观察期为4个月。治疗前后用放免法测定血清中Ⅲ型前胶原（PCⅢ）含量，采用干式快速免疫荧光法定量测定血浆B型钠尿肽（BNP）浓度，用超声心动图检测左室质量指数（LVMI）、左室射血分数（EF）。结果：两组患者药物治疗后血压降低的同时LVMI、血清PCⅢ浓度及血浆BNP浓度均较治疗前降低（P〈0．05）；辛伐他汀组血清PCⅢ浓度和血浆BNP浓度的降低较对照组更明显（P〈0．05）。而LVMI的降低两组间差异无显著性（P〉0．05）；两组患者治疗前后EF值无显著变化（P〉0．05）．结论 辛伐他汀能逆转高血压左室肥厚．同时改善左室舒张功能。     

原发性高血压患者血浆脑钠素水平的变化

目的 观察原发性高血压血浆脑钠素水平变化及其与左心室肥厚的关系。方法 原发性高血压患者70例，其中伴左心室肥厚40例，无左心室肥厚30例；正常对照组30例。采用超声心动图测定左心室质量指数（LVMI），舒张早期速度峰值（E）／舒张晚期速度峰值（A）比值；放射免疫分析法测定血浆脑钠素水平并与LVMI、E／A比值作直线相关分析。结果 ①原发性高血压左心室肥厚组血浆脑钠素水平明显高于无左心室肥厚组和正常对照组（P〈0．01）。②血浆脑钠素水平与LVMI呈显著正相关（r=0．452，P〈0．01），与E／A比值呈显著负相关（r=-0．703，P〈0．01）。结论 血浆脑钠素水平可作为判断原发性高血压左心室肥厚与逆转的一个敏感指标。     

卡维地洛对原发性高血压患者左心室肥厚及心肌纤维化的影响

目的　观察卡维地洛对原发性高血压 (EH )患者左室肥厚 (LVH)和心肌纤维化的影响。方法　 3 4例经超声心动图检查确诊为EH伴LVH患者 ,服用卡维地洛治疗 12周。治疗前、后分别测算左室重量指数 (LVMI) ,测定血清Ⅲ型前胶原 (PCⅢ )、透明质酸 (HA)、层黏蛋白 (LN)、Ⅳ型胶原 (CⅣ )。并与对照组 (2 8例 )比较。结果卡维地洛治疗 12周 ,LVMI明显改善 ,治疗前除血清CⅣ外 ,PCⅢ、HA、LN在EH伴LVH组均高于对照组 ,治疗 12周后 ,PCⅢ、LN下降明显 (P <0 .0 1) ,PCⅢ、LN与LVMI呈正相关 (P <0 .0 5 )。结论　卡维地洛可以减轻EH患者LVH ,同时减少心肌纤维化程度。     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

胃癌DNA含量与E-cad、EGFR表达的关系及其意义

目的　探讨胃癌组织DNA含量与E cad、EGFR表达的关系 ,评价其在浸润、转移潜能及预后判断中的作用。方法　应用图像分析仪及SP免疫组化法检测 30例正常胃黏膜上皮、30例不典型增生和 5 0例胃癌组织DNA含量与E cad、EGFR蛋白表达情况。结果　①正常胃黏膜上皮、Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌组的DI、PI、S %、>5c %逐渐增高 ,与胃癌分期、淋巴结转移显著相关 (P <0 0 1)。②E cad在正常胃黏膜上皮阳性表达率 10 0 % ,EGFR呈阴性表达 ;Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌E cad阳性表达率逐渐降低 ,EGFR的阳性表达率逐渐升高 ,且差异显著 (P <0 0 5 ) ;E cad表达减弱、EGFR表达升高与胃癌分化差、淋巴结转移显著相关 (P <0 0 1)。③E cad表达阴性的胃癌DNA指数及EGFR表达水平显著高于E cad阳性 (P <0 0 1)。结论　检测DNA含量及E cad、EGFR蛋白表达有助于胃癌的早期诊断及转移潜能和预后的判断。     

Quality and suitability of antimicrobial discs: theoretical and practical sources of error and variability

ABSTRACT

Introduction: The use of antimicrobial discs remains one of the main methods for assessing antibiotic activity. Most discs are made to one of three main standards (FDA, WHO, DIN); these all describe an assay method for assessing the quality of discs using a linear method. Theory predicts a curved relationship, and this is backed up in many cases in practice. In such cases, the assays are potentially invalid. Other sources of uncertainty arising from the manufacturing processes employed are also discussed.

Areas covered: This includes error arising from applying FDA, WHO, and DIN standards, the manufacturing techniques employed, and variation in the materials used in production. The need for a specification that relates directly to the use of the discs is also discussed.

Expert opinion: Manufactured discs, some of which may be out of specification due to curvature and other sources of error, have been used to establish quality zone sizes. Quality zone sizes have then been used to measure the quality of discs. This circular quality system where there is no quantitative check is potentially unsafe. In the many decades of their use, there has been no comprehensive check on the quality of manufactured discs using quantitative, validated assays.