Heart Rate Variability in Peritoneal Dialysis Patients: What Is the Role of Residual Renal Function?

Background: The relationship between heart rate variability (HRV) and residual renal function (RRF) has not been elucidated previously. Methods: In this cross-sectional study, HRV was evaluated in 71 peritoneal dialysis patients. Patients were divided into RRF decline group, RRF stable group and anuric group. Results: RRF was negatively correlated with SDNN (r = -0.284, p = 0.017), TP (r = -0.247, p = 0.039), and HF (r = -0.238, p = 0.047). Significant sympathetic nerve activation was found in the RRF decline group (significantly lower SDNN, SDSD, RMSSD, pNN50, LF, HF, TP and higher LF/HF ratio) as compared to the RRF stable and anuric groups. Besides, significantly parasympathetic activation was found in the anuric group (the lowest LF/HF ratio as compared to the other groups (both p < 0.05). Multivariate stepwise regression analysis showed that the status of RRF was an independent factor associated with HRV parameters. Conclusion: This study showed autonomic nervous function in peritoneal dialysis patients was associated with a different status of RRF.     

游离髂骨联合腹股沟皮瓣带蒂移植修复手指背侧骨皮缺损

目的观察游离髂骨联合腹股沟皮瓣移植修复手指背侧骨皮缺损的临床效果。方法自2008年2月至2011年12月我中心收治的7例手指背侧骨皮缺损的患者,手术方案为:3例污染较轻者经急诊清创后Ⅰ期给予修复,4例感染者Ⅰ期彻底清除病灶,控制感染后,Ⅱ期行游离髂骨植骨微型接骨板内固定手指于功能位,腹股沟皮瓣修复软组织缺损。结果术后3⁴周断蒂,皮瓣全部成活;临床植骨愈合时间为8周3例,9周4例,平均8.5周;术后3个月复查全部病例均达到骨性愈合。随访104周断蒂,皮瓣全部成活;临床植骨愈合时间为8周3例,9周4例,平均8.5周;术后3个月复查全部病例均达到骨性愈合。随访10³6个月,皮瓣质地良好,外观满意,髂骨塑形良好,未出现骨髓炎、骨不愈合等情况。结论游离髂骨联合腹股沟皮瓣移植修复手指骨皮缺损是一种理想方法,简单易行,值得临床推广。     

第一跖趾关节镜在矫治拇外翻中的应用进展

随着技术和器械的不断发展,小关节关节镜技术日趋成熟.在足踝领域,第一跖趾关节镜治疗拇外翻的方法被越来越多的医师应用于临床,并取得了一定成效.它不仅可以用于诊断,也可以用于治疗.由于是新技术,它也不可避免的存在一些问题和局限性.本文将对第一跖趾关节镜在矫治拇外翻中的应用进展做一综述.     

六分钟步行距离试验在鉴别肺高血压血流动力学类型中的价值

目的 探讨6 min步行距离试验在鉴别肺高血压血流动力学类型中的意义.方法 收集164例心功能Ⅱ～Ⅲ级初诊肺高血压患者的临床资料进行回顾性分析.根据肺高压血流动力学指标及右心功能状况分为A组(毛细血管前肺动脉高压、右心功能正常,62例)、B组(毛细血管后肺动脉高压、右心功能正常,58例)、C组(毛细血管前肺动脉高压合并右心功能不全,44例),主要分析指标为6 min步行距离及运动前后动脉血氧饱和度.结果 A组、B组和C组6 min步行距离分别为(397±112)、( 299±63)和(294±111)m,A组明显高于B组和C组,组间差异有统计学意义(P＜0.01)；B组与C组间比较差异无统计学意义(P＞0.05).结论 肺高血压合并心功能不全6 min步行距离明显减少；但单独6 min步行距离检查不能区分血流动力学类型.     

结直肠癌流行病学特征及其危险因素

近几十年内,随着经济的发展,生活方式的改变以及医疗科技水平的提高,尤其是我国,结直肠癌发病率和死亡率迅速的增长,使其防治工作面临着巨大的考验。结直肠癌的发生是一个多因素、多步骤的过程,是机体的内因和环境的外因相互作用的结果。因此,了解结直肠癌流行病学特征及其危险因素,对于结直肠癌的预防、筛查和治疗都是十分重要的。文中对结直肠癌流行特征及其危险因素进行综述。     

醒脑液对PAP双转基因痴呆小鼠行为学及胆碱能系统的早期干预作用说

目的:观察醒脑液早期干预对阿尔茨海默病模型APPswe/PS△E9双转基因小鼠行为学及脑中胆碱能系统相关酶的影响。方法:将75只PAP双转基因小鼠随机随机分为空白对照组(模型组)、阳性对照组、用药高剂量组、用药中剂量组和用药低剂量组,每组各15只。15只遗传背景相同的转基因阴性的小鼠作为正常动物组。所试药物稀释至相同体积灌胃给药,正常动物组及空白对照组给以等体积蒸馏水灌胃,连续灌胃4个月。采用Morris水迷宫测定小鼠空间学习记忆能力,避暗箱测定其条件学习记忆能力。使用比色法检测小鼠脑中乙酰胆碱(Ach)、乙酰胆碱转移酶(ChAT)及乙酰胆碱酯酶(AchE)的活性。结果:与正常组比较,模型组小鼠的学习记忆能力均有所下降,脑组织中Ach、ChAT、AchE的含量均下降。与模型组比较,阳性对照组、用药高剂量组及用药中剂量组小鼠血浆中Ach含量均有所提高,而AchE含量则出现下降。结论:醒脑液能改善阿尔茨海默病模型小鼠的学习记忆能力,其作用机制可能与调控胆碱能系统有关。     

基于社会接触网络的大规模人群天花传播并行仿真

天花生物恐怖是世界各国面临的重大潜在威胁.本文利用并行仿真的技术手段,研究天花在大规模城市人群中的传播规律并对环形接种和大规模疫苗接种这两种主要的天花疫苗接种策略进行有效性分析,结果表明环形接种措施能够有效控制天花疫情的扩散,在天花疫苗储备不足的情况下可以优先考虑采用该措施.     

MRI contrast agents: Basic chemistry and safety

Magnetic resonance imaging (MRI) contrast agents are pharmaceuticals used widely in MRI examinations. Gadolinium‐based MRI contrast agents (GBCAs) are by far the most commonly used. To date, nine GBCAs have been commercialized for clinical use, primarily indicated in the central nervous system, vasculature, and whole body. GBCAs primarily lower the T₁ in vivo to create higher signal in T₁‐weighted MRI scans where GBCAs are concentrated. GBCAs are unique among pharmaceuticals, being water proton relaxation catalysts whose effectiveness is characterized by a rate constant known as relaxivity. The relaxivity of each GBCAs depends on a variety of factors that are discussed in terms of both the existing agents and future molecular imaging agents under study by current researchers. Current GBCAs can be divided into four different structural types (macrocyclic, linear, ionic, and nonionic) based on the chemistry of the chelating ligands whose primary purpose is to protect the body from dissociation of the relatively toxic Gd³⁺ ion from the ligand. This article discusses how the chemical structure influences inherent and in vivo stability toward dissociation, and how it affects important formulation properties. Although GBCAs have a lower rate of serious adverse events than iodinated contrast agents, they still present some risk. J. Magn. Reson. Imaging 2012;36:1060–1071. © 2012 Wiley Periodicals, Inc.