Identifying Chinese populations in the UK for epidemiological research: experience of a name analysis of the FHSA register

Definition of Chinese. For the purposes of this study, Chinese refers to residents of the UK who either on the basis of name (face-to-face contact not made), or self-definition and appearance (contact made) had origins in China and included those born in the UK and others migrating to the UK via a third country (for example Vietnam, Singapore, Hong Kong etc). This is a pragmatic definition.There is a paucity of research on health in the UK Chinese community partly due to the difficulties of identifying and accessing study populations. For a survey of cardiovascular disease we aimed to identify and recruit all Chinese adults aged 25–64 y living in Newcastle-upon-Tyne, UK. One thousand, eight hundred and sixty-five potential subjects were identified using a variety of methods. Of the 1702 potential subjects identified from a name analysis of the 1991 FHSA register (FHSA group), 638 students in halls of residence were excluded and the remaining 1064 were invited to participate. Non-respondents were followed up. Of the 1064, 658 (65.5%) addresses were no longer valid, 21 (2%) were reclassified as non-Chinese and no contact was made with 18 individuals (1.6%). A further 163 subjects (non-FHSA group) came forward in response to publicity, giving a total of 530 Chinese actually identified in Newcastle. Three hundred and eighty subjects took part in the study. Compared to the 1991 Census, the recruitment procedure underestimated the total population size, particularly for men and younger ages. In the FHSA group, men were significantly more likely to be current drinkers, and women were more likely to smoke and have a lower educational attainment that the non-FHSA group. There were no other important differences in the distribution of CHD risk markers in the two groups. Our experience indicates that the FHSA register is suitable for identifying Chinese but should be used alongside other complementary methods to augment samples for ethnicity and health research.     

Surgical management of traumatic cardiac fistulae

Seven cases of traumatic intracardiac lesions following penetrating stab wounds of the heart are presented. The surgical management and complications encountered in these cases are discussed.     

蛇床子素对去卵巢大鼠近侧胫骨代谢影响的定量研究

切除3月龄SD大鼠双侧卵巢12周后,其骨形成的参数值明显增加(%L.Pm+58%,BFR/BV+105%,BFR/BS+74%,%O.Pm+188%),同时骨吸收的参数值增加(%Er.Pm+155%),荧光标记周长与吸收周长的比率-41%,由于骨吸收大于骨形成,骨质丢失(%Tb.Ar-59%,Tb.Th-14%),出现高转换型骨质疏松。分别用蛇床子素(osthole)6.7mg·kg^-1ig,每周6次,尼尔雌醇(nilestri-ol) 1 mg·kg^-1ig,每周1次,持续12周,均能明显抑制去卵巢诱导的骨高转换,防止骨质丢失。但蛇床子素抑制骨高转换的效应比尼尔雌醇低(蛇床子素治疗组比尼尔雌醇治疗组%Tb.Ar-55%)。     

The Use of Automobile Safety Restraint Systems during Pregnancy

The American Medical Association's Committee on Medical Aspects of Automobile Safety recommends that pregnant women use seat belts. Currently, all military installations, 39 states, and the District of Columbia mandate varying degrees of seat belt usage. A survey was conducted to evaluate seat belt usage in the antepartum population at the Wilford Hall United States Air Force Medical Center. Eighty-eight percent of the respondents used automobile safety restraints 100% of the time when driving, and 90% of the respondents used automobile safety restraints 100% of the time when riding as a passenger. Twenty-three percent, however, were uniformed or misinformed about seat belt safety procedures and practices during pregnancy. Increased education regarding seat belt safety would be beneficial to this population.     

Perioperative risk of complete heart block in patients with bifascicular block and prolonged PR interval.

Because there is a paucity of information on the perioperative risk of developing complete heart block among patients with bifascicular block (either right bundle branch block and left anterior hemiblock or left bundle branch block) and a long PR interval on the surface electrocardiogram, we undertook an analysis of 76 such patients. Twenty-three patients had right bundle branch block and left axis deviation with a long PR interval and 53 had left bundle branch block with along PR interval. Thirty patients had 37 general anaesthetics, 23 had 32 spinal anaesthetics, and 50 had 64 local anaesthetics or endoscopic procedures. No patient developed complete heart block. Four patients developed sinus bradycardia during general anaesthetics, responsive to atropine or isoproterenol. Similarly, none of the 23 such patients in the literature reviewed had developed complete heart block. Because placement to temporary pacemakers is not without risk, we conclude that prophylactic pacing is not necessary in asymptomatic patients with bifascicular block even in the presence of a long PR interval. Since we did not study patients with recent syncope or myocardial infarction, caution should be exercised in applying these results to such patients.     

Health-related worries, self-image, and life outlooks of long-term survivors of childhood cancer.

This article poses three questions: what do childhood cancer survivors worry about? What characteristics prompt some to worry more and others less? What effect do worries have on survivors' self-image and life outlooks? Data from 303 survivors of childhood cancer demonstrated significant relationships among worries, "objective" factors like physical after-effects or relapse, and survivors' self-images and life outlooks. However, findings also indicated that subjectively experienced worries, perceptions about one's cancer status, age at diagnosis and gender were more strongly associated with self-image and life outlook. Psychosocial interventions andfuture research are suggested.     

Combined diffusion-weighted and perfusion-weighted flow heterogeneity magnetic resonance imaging in acute stroke

BACKGROUND AND PURPOSE: The heterogeneity of microvascular flows is known to be an important determinant of the efficacy of oxygen delivery to tissue. Studies in animals have demonstrated decreased flow heterogeneity (FH) in states of decreased perfusion pressure. The purpose of the present study was to assess microvascular FH changes in acute stroke with use of a novel perfusion-weighted MRI technique and to evaluate the ability of combined diffusion-weighted MRI and FH measurements to predict final infarct size. METHODS: Cerebral blood flow, FH, and plasma mean transit time (MTT) were measured in 11 patients who presented with acute (<12 hours after symptom onset) stroke. Final infarct size was determined with follow-up MRI or CT scanning. RESULTS: In normal brain tissue, the distribution of relative flows was markedly skewed toward high capillary flow velocities. Within regions of decreased cerebral blood flow, plasma MTT was prolonged. Furthermore, subregions were identified with significant loss of the high-flow component of the flow distribution, thereby causing increased homogeneity of flow velocities. In parametric maps that quantify the acute deviation of FH from that of normal tissue, areas of extreme homogenization of capillary flows predicted final infarct size on follow-up scans of 10 of 11 patients. CONCLUSIONS: Flow heterogeneity and MTT can be rapidly assessed as part of a routine clinical MR examination and may provide a tool for planning of individual stroke treatment, as well as in targeting and evaluation of emerging therapeutic strategies.