Relationship between β1‐adrenergic receptor polymorphisms and cardiovascular disease in patients with diabetic nephropathy

Aim: Activation of β1‐adrenergic receptor (β1AR) enhances contractility and heart rate. The polymorphism Arg389Gly in the β1AR gene was found to be functionally important in determining receptor activity. The relationship between this polymorphism and the risk of cardiovascular disease was investigated in Chinese subjects with overt diabetic nephropathy. Methods: A total of 219 type 2 diabetic subjects with nephropathy were recruited. Genotyping of the β1AR Arg389Gly polymorphism was determined. Patients were followed up to 96 months for the development of cardiovascular events. Results: There were 122, 86 and 11 patients with Arg/Arg, Arg/Gly and Gly/Gly genotype, respectively. At 96 months, the event‐free survival of primary composite cardiovascular end‐point was 33.0% and 44.3% for Gly⁺ and Gly^‐ groups, respectively (log–rank test, P = 0.105), while the event‐free survival for first ischaemic heart disease was 62.4% and 75.9%, respectively (log–rank test, P = 0.038). However, with multivariate analysis by the Cox proportional hazard model to adjust for confounders, only low‐density lipoprotein and baseline glomerular filtration rate were independent predictors of first ischaemic heart event. Conclusion: The β1AR Arg389Gly polymorphism is not an independent predictor of cardiovascular events in subjects with overt diabetic nephropathy.     

Risk of stroke after acute myocardial infarction among Chinese

Following an acute myocardial infarction (AMI), patients have an increased risk of stroke. Estimates of risk are mainly derived from AMI treatment trials or secondary prevention studies. The reported incidence of stroke in Caucasians in the early phase after AMI ranged from 0.5% to 2.5%.1-3 Similar assessment of risk in the Chinese population is lacking. As thrombolytic therapy becomes standard treatment for AMI, there is concern that there may be an increase in haemorrhagic stroke complicating AMI treatment, especially since haemorrhagic stroke is more common in Asian populations.     

Aftercare telephone contacts with problem drinkers can serve a clinical and research function

Research staff typically gather treatment outcome data, whereas clinicians perform aftercare contacts. To date no alcohol treatment outcome study has examined the utility of therapists collecting outcome data through aftercare contacts. Using the Alcohol Timeline Followback (TLFB) method modified for clinical aftercare contacts, 154 problem drinkers who were part of a cognitive-behavioral intervention completed the modified TLFB with their primary therapist during aftercare telephone contacts conducted 1 and 3 months after their last treatment session. Clients reported their daily alcohol use over the past 30 days using four consumption categories (i.e. 0 drinks, 1-4 drinks, 5-9 drinks and 10+ drinks). At a 6-month follow-up research interview, a trained research assistant gathered standard TLFB data from the clients that included the time period for aftercare contacts. Correlations between the two TLFB formats showed good alternate form reliability, especially for frequency of alcohol use. Discrepancies between reports were positively associated with heavier pre-treatment and post-treatment drinking, suggesting possible memory biases among heavier drinkers. Subject reports also closely paralleled collateral reports of the subjects' drinking. These results support the utility of a brief TLFB instrument for use by therapists in assessing clients' outcomes by telephone during aftercare contacts.     

三七皂甙对血管平滑肌上受体操纵Ca~(2 )通道的特异性作用(英文)

三七皂甙能明显抑制狗肠系膜动脉及大隐静脉α肾上腺素能受体触发的收缩反应及~(45)Ca内流(从0.36±0.03降至0.14±0.05μmol·g~(-1)组织湿重),但对高K~ 引起的Ca~(2 )内流无影响。三七皂甙不影响Ca~(2 )释放及受体的亲和力。提示三七皂甙具有特异性阻断受体操纵Ca~(2 )通道的特性,对电位依赖性Ca~(2 )通道无作用。     

毒性中药狼毒质量标准研究

目的:建立毒性中药狼毒的质量标准。方法:采用显微、化学、液相色谱/质谱等方法进行定性鉴别,以液相色谱及液相/质谱法测定含量。结果:狼毒大戟中月腺大戟乙素含量为0.01%w/w,月腺大戟中月腺大戟乙素含量范围为0.01%~0.02%w/w,均未检出瑞香内酯、狼毒色原酮和新狼毒素A。瑞香狼毒中瑞香内酯、狼毒色原酮及新狼毒素A等成分含量范围分别为0.57%~2.12%w/w、0.86%~1.6%w/w及0.45%~0.96%w/w,但未检出含月腺大戟乙素成分。结论:各法能用于常规检测狼毒属植物。     

毒性中药白降丹质量标准研究

目的:建立毒性中药白降丹的质量标准。方法:采用显微、X-衍射方法进行定性鉴别,以滴定法测定含量。结果:各方法可用于白降丹的鉴定。结论:本文建立的显微、X-衍射、滴定等方法可对其进行定性定量分析。     

Editorial: At the Bifurcation of the Last Frontiers

The concept of coronary angioplasty percutaneous coronary intervention (PCI) was pioneered by Andreas Gruntzig. Since then, several modifications, innovative devices, techniques, and advances have revolutionized the practice of interventional cardiology. Coronary bifurcation and chronic total occlusion are the last two frontiers that continue to challenge the skills of the interventional cardiologists. Proceedings of the second Bifurcation Summit held from November 26 to 28, 2009 in Nanjing, China are published in this symposium. In a general review, the state of the art in management of bifurcation lesion is summarized in the statement of the “Bifurcation Club in KOKURA.” A new‐presented concept was the “extension distance” between the main vessel and the sidebranch ostia and its association with restenosis. The results of two studies on shear stress (SS) after PCI showed that contradictory lower SS after stenting was associated with lower in‐stent restenosis. There was better fractional flow reserve after double kissing crush technique than provisional one‐stent technique. There was also lower rate of stent thrombosis after bifurcation stenting with excellent final angiographic results. In a negative note, the SYNTAX score had no predictive values on trifurcated left main stenting. In summary, different aspects of percutaneous management for bifurcated lesion are described seen from different perspectives and evidenced by novel techniques and strategies. (J Interven Cardiol 2010;23:293–294)     

Serial monitoring of nutritional status in Chinese peritoneal dialysis patients by Subjective Global Assessment and comprehensive Malnutrition Inflammation Score

Aim: The Malnutrition Inflammation Score (MIS) has been proposed for the assessment of nutritional status in peritoneal dialysis (PD) patients. The MIS and the Subjective Global Assessment (SGA) for serial monitoring of nutritional status in PD patients were compared. Methods: The change in the MIS and SGA overall score of 59 PD patients (28 male) over 12 months was studied. Clinical factors relating to the discrepancy between the two instruments were explored. Results: The average patient age was 55.8 ± 9.7 years. Thirty of the 59 patients (50.8%) had exact agreement in the changed MIS and SGA scores. Cohen's κ score was 0.274, indicating a modest degree of agreement. For the detection of deterioration in nutritional status and using the MIS as the reference measure, the SGA had a sensitivity of 61.9% and specificity of 86.8%; serum ferritin level was substantially higher in the ones whose SGA did not detect a deterioration in nutrition (1464.1 ± 873.3 vs 800.5 ± 561.6 pmol/L, P = 0.046). For the detection of improvement in nutritional status, the SGA had a sensitivity of 45.8% and specificity of 82.9%; patients whose SGA did not detect an improvement in nutrition were dialyzed longer (53.8 ± 35.3 vs 27.6 ± 18.9 months, P = 0.038), had higher total iron binding capacity (TIBC) (45.6 ± 5.5 vs 38.2 ± 8.1 µmol/L, P = 0.015), had higher total Kt/V (2.02 ± 0.36 vs 1.75 ± 0.23, P = 0.048) and higher normalized protein nitrogen appearance (1.16 ± 0.25 vs 0.95 ± 0.23 g/kg per day, P = 0.048). Conclusion: The longitudinal changes in the MIS and SGA score have modest agreement with each other. However, PD patients with a longer duration of dialysis, higher serum ferritin, TIBC, total Kt/V or normalized protein nitrogen appearance tend to have discrepancies between the longitudinal changes in the MIS and SGA overall score.     

辛普森悖论的范例（英文）

概述:辛普森悖论普遍存在于很多领域。它具有数据的条件性和边缘性解释之间的不一致特征。在本文中,我们通过一些例子来阐述辛普森悖论是如何在连续性、分类和时间-事件数据中产生的。