Estimation of salt intake by urinary sodium excretion in a Portuguese adult population and its relationship to arterial stiffness.

BACKGROUND: Portugal has one of the highest mortality rates from stroke, a high prevalence of hypertension and probably a high salt intake level. AIM: To evaluate Portuguese salt intake levels and their relationship to blood pressure and arterial stiffness in a sample of four different adult populations living in northern Portugal. METHODS: A cross-sectional study evaluating 24-hour urinary excretion of sodium (24 h UNa+), potassium and creatinine, blood pressure (BP), and pulse wave velocity (PWV) as an index of aortic stiffness in adult populations of sustained hypertensives (HT), relatives of patients with previous stroke (Fam), university students (US) and factory workers (FW), in the context of their usual dietary habits. RESULTS: We evaluated a total of 426 subjects, mean age 50 +/- 22 years, 56% female, BMI 27.9+/-5.1, BP 159/92 mmHg, PWV 10.4+/-2.2 m/s, who showed mean 24h UNa+ of 202 +/- 64 mmol/d, corresponding to a daily salt intake of 12.3 g (ranging from 5.2 to 24.8). The four groups were: HT: n = 245, 49 +/- 18 years, 92% of those selected, 69% treated, BP 163/94 mmHg, PWV 11.9 m/s, 24 h UNa+ 212 mmol/d, i.e. 12.4 g/d of salt); Fam: n = 38, 64 +/- 20 years, 57 % of those selected, BP 144/88 mmHg, PWV 10.5 m/s, 24 h UNa+ 194 mmol/d, i.e. 11.1 g/d of salt; US: n = 82, 22 +/- 3 years, 57% of those selected, BP 124/77 mmHg, PWV 8.7 m/s, 24h UNa+ 199 mmol/d, i.e. 11.3 g/d of salt; FW: n = 61, 39 9 years, 47% of those selected, BP 129/79 mmHg, PWV 9.5 m/s, 24 h UNa+ 221 mmol/d, i.e. 12.9 g/d of salt. The ratio of urinary sodium/potassium excretion (1.9 (0.4) was significantly higher in HT than the other three groups. In the 426 subjects, 24h UNa+ correlated significantly (p < 0.01) with systolic BP (r = 0.209) and with PWV (r=0.256) after adjustment for age and BP. Multivariate analysis showed that BP, age and 24h UNa+ correlated independently with PWV taken as a dependent variable. CONCLUSIONS: Four different Portuguese populations showed similarly high mean daily salt intake levels, almost double those recommended by the WHO. Overall, high urinary sodium excretion correlated consistently with high BP levels and appeared to be an independent determining factor of arterial stiffness. These findings suggest that Portugal in general has a high salt intake diet, and urgent measures are required to restrict salt consumption in order to prevent and treat hypertensive disease and to reduce overall cardiovascular risk and events.     

Cardiovascular protection from alcoholic drinks: scientific basis of the French Paradox.

This article discusses the cardiovascular protection afforded by low to moderate consumption of ethanol and the role of ethanol-induced preconditioning. Ethanol, a compound that is found in many popular beverages, has a whole range of cardiovascular protective effects when consumed in low to moderate doses. Although they have yet to be totally clarified, recent data suggest that a combination of several actions at the biochemical and molecular levels play a role in this protection. These include favorable changes in lipid metabolism, antioxidant effects, changes in hemostasis and platelet aggregation, arterial vasodilation mediated by NO release, induction of the expression of cardioprotective proteins, insulin sensitization and lower levels of inflammatory markers. Special emphasis will be given to ethanol-induced preconditioning. Some of the compounds present in red and white wine, such as resveratrol and quercetin, are also partly responsible for some of the cardioprotective effects of alcoholic drinks. These are due to antioxidant effects and changes in platelet aggregation, endothelial function and inflammatory response. The last part of the paper will focus on the clinical applications and possibilities raised by these new findings.     

医院门诊心理咨询与治疗分析

随着社会的发展，人们从事精神文明与物质文明建设的过程中，生活节奏不断加快，人际关系日趋复杂，竞争的激烈，心理障碍已渐增多，对于医院门诊心理咨询情况，既往横向研究较多，纵向研究较少，笔者试图对近三年来医院进行心理咨询的人群进行比较，了解医院门诊心理咨询的变化特点及其规律。得出对心理障碍危机干预供同道参考。     

98例尿道下裂手术的体会

目的通过对尿道下裂手术的改进,进一步完善尿道下裂手术的技巧和护理。方法A组50例尿道下裂Ⅰ期成形术中,采用皮下连续内翻缝合形成新尿道,且固定于阴茎海绵体,由阴茎根部自下而上多层次,多点缝合皮瓣皮下组织至阴茎海绵体上,均无间隙和死腔。B组48例采用常规手术方式作对照。结果A组50例尿道下裂Ⅰ期成形术成功44例,B组48例成功17例,A组与B组相比成功率显著提高(P＜0．05)。结论尿道下裂Ⅰ期成形术成功率关键在于术者对术式掌握的熟练程度和术中及术后对每个细节的认真处理。     

结直肠de novo癌的研究概况

近年来，随着内镜技术的发展，已能发现越来越多的微小和早期结直肠病变。部分报道曾描述了一种微小而极具侵袭性的结直肠癌，因其缺乏起源于腺瘤的证据，被称为“de novo癌（de novo carcinoma）”。这类肿瘤由于挑战了经典的腺瘤癌变途径而引起众多争议，但由于其所显示的独特生物学特性，也得到了各国学者的充分重视。本文将对de novo癌的概念、争议及其临床、分子生物学水平的特点进行初步概述。     

应用输尿管镜放置双J管早期治疗输尿管阴道瘘

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.     

RNA干扰及其在胶质瘤基因治疗中的应用

RNA干扰（RNA interference。RNAi）是双链RNA（double—stranded RNA，dsRNA）降解特异性靶基因转录出的mRNA。从而抑制靶蛋白表达的现象。自从二十世纪九十年代发现RNAi这一现象以来，RNAi已被广泛应用于研究基因功能、信号转导通路和基因治疗等方面。随着分子生物学、分子遗传学等学科的发展．发现了许多与肿瘤发生、发展和预后密切相关的基因。经过大量临床前期试验表明，针对特异性靶基因的小干扰RNA（short／small interfering RNA．siRNA）治疗胶质瘤是行之有效的。为基因治疗胶质瘤提供了新的思路。[第一段]     

垂体腺瘤的分子病因学研究进展

垂体腺瘤是发生于垂体前叶的良性肿瘤，约占中枢神经系统肿瘤的10％-20％，而无功能微腺瘤占到成人尸检的23％左右。生理上根据免疫组化将垂体腺瘤按功能分为有激素分泌活性腺瘤（functioning pituitary adenoma，FPA）和非激素分泌活性腺瘤（non—functioning pituitary adenoma，NFPA）两大类。[第一段]     

宫颈癌放疗后家庭阴道冲洗效果观察

目的:为寻找一种院外阴道冲洗的有效方法,从而帮助一些由于各种原因不能来医院行阴道冲洗术的患者继续完成治疗。方法:对204例宫颈癌放疗结束后的患者随机分实验组与对照组,实验组实施家庭阴道冲洗,对照组未行阴道冲洗,通过放疗结束后1个月、3个月、6个月门诊随访,观察阴道粘膜急性放射反应治疗后消退情况,对家庭阴道冲洗患者和未行阴道冲洗者进行对照研究。结果:行家庭阴道冲洗者在阴道粘膜急性放射反应方面与未冲洗者差异有显著性(P<0.05)。结论:家庭阴道冲洗是对因各种原因出院后不能来医院行阴道冲洗的患者可以采取的一种行之有效的方法。     

定量组织速度成像对右室起搏患者左室收缩运动的研究

目的　应用定量组织速度成像 (QTVI)评价右室心尖起搏 (RVAP)VVI型对左心收缩功能的影响。方法　应用GEVivid 7彩色多普勒超声显像仪对 2 0例RVAP患者和 2 0例正常人的心尖四腔切面的室间隔和左室外侧壁速度和位移曲线进行观察 ,测量心电图Q波分别至室间隔和左室外侧壁收缩期峰速度的时间 ,并除以R R间期进行校正。结果　QTVI显示右室起搏器置入者的室间隔与左室外侧壁速度曲线的收缩期S波非同步出现。Q波至室间隔收缩期峰速度的时间短于Q波至左室外侧壁收缩期峰速度的时间 ,两者分别为 ( 0 .12± 0 .0 2 )s和 ( 0 .14± 0 .0 2 )s,P <0 .0 5。结论　右室起搏后早期的左室整体收缩功能虽未见明显下降 ,但QTVI可以发现室间隔与左室壁收缩明显的不协调 ,可作为早期分析左室收缩运动的定量方法。