血小板分布宽度计数比值与脓毒症心肌病休克的相关性

目的探讨血小板分布宽度计数比值(PDW/PC)与脓毒症心肌病休克的相关性。方法回顾性分析100例脓毒症心肌病患者的临床资料。观察休克组与非休克组的血小板分布宽度(PDW)、血小板计数(PC)等指标。相关性采用Spearman分析,诊断准确率应用受试者工作特征曲线(ROC)曲线。结果休克组PC显著低于非休克组,PDW/PC显著高于非休克组。PDW与急性生理与慢性健康(APACHEⅡ)评分呈正相关(r＝0.404,P＜0.01),PC与APACHEⅡ评分呈负相关(r＝－0.739,P＜0.01)。PDW/PC诊断脓毒症心肌病休克的曲线下面积AUC=0.910(P＜0.01)。结论PDW/PC与脓毒症心肌病休克病情严重程度相关,对其具有一定的诊断价值。     

急性ST段抬高型心肌梗死患者PCI术后无复流现象的研究进展

冠状动脉粥样硬化性心脏病是全球范围内心血管疾病患者死亡的主要原因,其中以急性ST段抬高型心肌梗死(STEMI)最为凶险。及时经皮冠状动脉介入治疗(PCI)是目前急性STEMI患者最主流的再灌注策略。而部分患者在PCI术后仍不能得到充分的血液灌注,即出现无复流现象(NRP),与随后的不良临床预后密切相关。因此,为了有效恢复再灌注后冠状动脉微循环的血流,防治冠状动脉NRP的发生就显得尤为重要。本文回顾NRP的定义、诊断和临床表现,以病理生理机制为桥梁,提出通过相关预测因子来选择防治策略从而提高PCI疗效。     

四谈肝与咳喘哮——肝气虚所致咳喘哮证治述要

因肝肺关系密切,肝肺不和是诱发咳喘哮的重要病理机制。肝气虚致咳喘哮者临床并不少见,但两者之间的联系却甚少论及。本文试从肝气虚的识别要点、肝气虚诱发咳喘哮机制、表现及具体治法方药进行论述,以期进一步扩展、完善调肝理肺理论,指导临床。     

新型冠状病毒肺炎防控期间居家隔离人群心理健康状况调查及影响因素分析

目的 了解新型冠状病毒肺炎防控期间居家隔离人群心理健康状况并分析其影响因素,为进一步做好疫情防控工作,疏导不良情绪及心理恐慌提供依据.方法 选取2020年2月15 17日本研究团队7名研究生居住地为调查单位,采用自制一般情况调查表及12项一般健康问卷(GHQ-12)量表调查居家隔离的380人的心理健康状况.根据GHQ-12评分,将调查对象分为GHQ-12≥3分为阳性组(n=212)和GHQ-12＜3分为阴性组(n=168).采用Logistic回归模型分析居家隔离人群心理健康状况的影响因素.结果 两组在年龄、性别、是否独生子女、经济收入方面比较,差异无统计学意义(P＞0.05);而在居住地、婚姻状况、生育情况、担心感染、文化程度、职业方面差异有统计学意义(P＜0.05).多因素Logistic回归分析结果显示,居住地农村、初中及以下文化程度、已婚、学生、外出务工人员、担心感染是居家隔离人群心理健康的危险因素,年龄是其保护因素.结论 新型冠状病毒肺炎防控期间,居家隔离人群存在一定心理健康问题,其受多种因素影响.医院或社区卫生中心应针对不同人群进行心理疏导,改善其身心健康.     

Inverted U-Shaped Associations between Glycemic Indices and Serum Uric Acid Levels in the General Chinese Population: Findings from the China Cardiometabolic Disease and Cancer Cohort (4C) Study

Objective The relationship between serum uric acid(SUA)levels and glycemic indices,including plasma glucose(FPG),2-hour postload glucose(2 h-PG),and glycated hemoglobin(HbA1 c),remains inconclusive.We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.Methods The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study.A total of 105,922 community-dwelling adults aged≥40 years underwent the oral glucose tolerance test and uric acid assessment.The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.Results A total of 30,941 men and 62,361 women were eligible for the current analysis.Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels,but with different inflection points in men and women.The thresholds for FPG,2 h-PG,and HbA1 c for men and women were 6.5/8.0 mmol/L,11.0/14.0 mmol/L,and 6.1/6.5,respectively(SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes,while the inflection points were reached earlier in men than in women.