FEASIBILITY OF CONDUCTING CARDIOVASCULAR OUTCOME RESEARCH IN AUSTRALIAN GENERAL PRACTICE: RESULTS FROM THE ANBP2 PILOT STUDY

1. The present study aimed to determine the feasibility of conducting a 5 year cardiovascular outcome trial of the treatment of 6000 elderly hypertensive patients in Australian general practices. 2. General practitioners (GPs) were invited to participate by mail and personal follow-up. Patient records were reviewed to identify subjects for a blood pressure (BP) screening programme. Blood pressure was measured on three occasions and eligible subjects were included if the average BP was 160 mmHg systolic or 90 mmHg diastolic if systolic BP was 140 mmHg. 3. Seven hundred and forty-one GPs were approached and 89 were enrolled in the study (12% of mail invites and 75% of those receiving a personal contact). In 16 practices where screening was completed, 82 000 records were reviewed to identify 4% patients eligible for screening. Twenty-two per cent of eligible subjects attended screening. Of 1938 subjects screened, 180 (9%) had BP 5=160/90 mmHg. Forty-seven percent of subjects (n = 916) were receiving antihypertensive therapy and 184 (20%) were withdrawn from therapy. One hundred and sixteen (63%) of these subjects had BP return to study entry levels within 6 weeks. Fifty-seven newly diagnosed and 81 previously treated subjects were randomized (7% of the screened population). 4. Based on the high participation rate of GPs, the response rate of patients to attend a BP screening programme and the 7% randomization to screening ratio for entry into the study, the ANBP2 pilot study has demonstrated that it is feasible to recruit subjects from Australian general practices to a cardiovascular outcome trial.     

肌病肾病代谢综合征治疗进展

肌病肾病代谢综合征是急性动脉阻塞致骨骼肌溶解的严重并发症。积极治疗原发病，及早补液扩容、碱化尿液、早期血液净化治疗是降低截肢率、病死率的关键。本文就肌病肾病代谢综合征治疗进展作一综述。     

硫酸镁对普鲁帕酮致心律失常的干预作用

目的探讨静脉滴注硫酸镁对普鲁帕酮致心律失常作用的干预效果。方法将92例心律失常患者随机分为对照组和干预组,每组46例。两组均口服普鲁帕酮,干预组同时静脉滴注硫酸镁,于治疗1周后常规心电图观察心律失常变化及致心律失常作用。结果心律失常消失率对照组为43.4%(20/46)、干预组为82.6%(39/46),致心律失常率对照组为19.6%、干预组为4.4%,两组比较有统计学意义(P<0.01)。结论普鲁帕酮抗心律失常同时有致心律失常作用,使用硫酸镁干预可降低致心律失常发生率。     

金属硫蛋白和肿瘤增殖抗原在肾癌组织中的表达及意义

目的　探讨金属硫蛋白 (MT)和肿瘤增殖抗原 (Ki 67)在肾癌组织中的表达及意义。　方法　应用免疫组化SABC法检测 5 9例肾癌患者组织标本及 19例正常肾组织标本中MT及Ki 67蛋白表达 ,流式细胞术检测DNA含量及S期比例。　结果　MT在肾癌及正常肾组织中的阳性表达率分别为 5 2 .5 %和 78.9% (P <0 .0 5 ) ;G1表达率高于G2 、G3(P <0 .0 1) ,Ⅰ、Ⅱ期高于Ⅲ、Ⅳ期 (P <0 .0 5 ) ,有无淋巴结转移之间差别有显著性意义 (P <0 .0 1) ,不同直径肿瘤之间差别无显著性意义 (P>0 .0 5 )。MT( )及MT( - )患者术后 5年生存率分别为 5 8.1%和 2 8.6% (P <0 .0 5 )。肾癌组织Ki 67指数高于正常肾组织 (P <0 .0 1) ,且与病理分级、临床分期相关 ;Ki 67指数较高者 ,MT表达率较低 ,MT表达率及Ki 67指数分别与S期比例显著相关。　结论　MT及Ki 67蛋白可能参与肾癌的发生、进展及转移过程 ,可作为肾癌细胞增殖及预后估计的参考指标。     

老年退行性心脏瓣膜病与多器官疾病发生的调查分析

目的：分析老年退行性心脏瓣膜病（SDHVD）与多器官疾病的发生状况。方法老年人3896例,男2884例,女1012例,年龄60～103（78±13）岁。所有研究对象均进行心脏彩超、体检、相关辅助检查,并对多器官疾病进行分析。结果3896例患者中,SDHVD1225例（31.4%）,无SDHVD2671例（68.6%）,SDHVD组与对照组多器官疾病的发病率分别为高血压病49.3%vs 28.4%,冠心病38.5%vs23.8%,心力衰竭36.2%vs 17.3%,肺心病6.3%vs 3.1%,脑卒中21.6%vs 9.6%,肾功能不全6.9%vs 3.2%,胃食管反流病21.3%vs 10.3%,两组比较差异均有统计学意义（P＜0.05）,而糖尿病为11.2%vs 12.1%,两组比较差异无统计学意义（P＞0.05）。结论 SDHVD组多器官疾病显著增高,可能由于SDHVD心脏重构改变,血流动力学异常,促发了多器官疾病的发生。     

伤湿止痛流浸膏的提取工艺研究

目的:优选伤湿止痛流浸膏的提取工艺。方法:采用正交试验法考察药材浸泡时间、煎煮时间、溶媒pH值、药液处理方法对提取工艺的影响。结果:确定最佳提取工艺为溶媒pH3~4的酸水,药材浸泡12h,煎煮6h,药液75%醇沉处理。结论:按优选的最佳提取工艺条件,以指标性成分士的宁的得率为指标,预测并验证试验结果满意。     

含氯消毒液氧化还原电位与杀菌效果关系的研究

目的研究一种含氯消毒粉水溶液氧化还原电位变化与其杀菌效果的关系。方法以悬液定量杀菌试验方法对该消毒液不同氧化还原电位条件下杀菌效果进行了观察。结果以含有效氯50 mg/L不变的条件下,该消毒液的氧化还原电位分别为700、800、900、980 mV,对悬液内大肠杆菌作用5 min,杀灭对数值分别为2.45、2.83、6.75和6.75;对金黄色葡萄球菌作用5 min,杀灭对数值分别为2.22、3.11、6.41和6.41。以含有效氯300 mg/L,氧化还原电位分别为900、980、1050 mV,对枯草杆菌黑色变种芽孢作用30 min,杀灭对数值分别为0.79、2.91和6.23。结论提高含氯消毒剂的氧化还原电位值,可明显提高其杀菌能力。     

稳定型含氯消毒剂消毒性能的研究

目的研究稳定型含氯消毒剂消毒效果及其有关性能。方法采用悬液定量、定性杀菌试验和动物试验方法,对该消毒剂的消毒相关性能进行了试验观察。结果该稳定型含氯消毒剂原液有效氯含量为63 g/L,经37℃存放90 d,有效氯含量下降率为9.05%。用含有效氯1 200 mg/L的该稳定型含氯消毒剂作用40 m in,对悬液内枯草杆菌黑色变种芽孢的平均杀灭对数值5.00。含有效氯600 mg/L的消毒剂作用5 m in,对悬液内脊髓灰质炎病毒灭活对数值4.00。含有效氯300 mg/L的该消毒剂作用2.5 m in,对悬液内大肠杆菌和金黄色葡萄球菌杀灭对数值均5.00。该稳定型含氯消毒剂小鼠急性经口LD505 000 mg/kg(体重);对小鼠骨髓嗜多染红细胞微核试验结果阴性。含有效氯1 200 mg/L该消毒剂溶液对家兔一次完整皮肤刺激试验结果为无刺激性。结论该稳定型含氯消毒剂性能稳定,对悬液内病毒、细菌繁殖体和细菌芽孢杀灭效果较好,属于实际无毒级物质。     

细菌快速检测试纸片法与传统方法培养结果的比较

目的比较细菌快速检测试纸片法与传统的方法在细菌检测结果上的差异。方法用试纸片法对物体表面污染菌总数和大肠杆菌进行检测,同时与传统方法作平行比较。结果检测细菌总数,用常规方法培养48 h后,细菌生长正常;而纸片法培养48 h,营养琼脂平板上无菌生长,继续培养至72 h才出现菌落。大肠菌群检测中,传统9管发酵法培养24h即有菌生长,国产大肠菌群快速检测试纸法培养36 h和日本产试纸片培养48 h才出现肉眼可见菌落。结论细菌快速检测试纸片虽能简化操作,但存在技术缺陷,且成本高。