Critical review of treatment trials in hypertension

Summary: Despite numerous deficiencies in some antihypertensive drug treatment trials, and some questionable selections of studies for inclusion in several meta-analyses, undoubtedly such trials have shown treatment benefits from reducing hypertension. Complications that can be corrected or prevented include malignant hypertension, hypertensive heart failure, stroke and coronary artery morbidity. the all-cause mortality has been lowered in several trials. the benefits have been seen in subjects aged over 60 years, in women and men, and in patients with isolated systolic hypertension. the benefits have been achieved using a wide range of drugs, not only with beta-blockers or diuretics. Non-pharmacological means of lowering blood pressure have not been evaluated in relation to morbidity.     

The treatment of hypertension

1 A 'retrospective' of the development of the drug treatment of hypertension is presented from the early days of ganglion blockers to the present time together with a review of the evidence of benefit from treatment.
2 Current issues and debates are summarised including shortfalls in the control of hypertension in populations, difficulties surrounding the measurement of blood pressure, disagreement on the levels of blood pressure to treat, the goal blood pressures to aim at, issues surrounding lifestyle measures such as the low salt diet and low intensity exercise, and treatment with diuretics and with calcium antagonists.
3 A 'perspective' is presented on some avenues for progress in the years ahead. These will include the identification of genetic markers to determine the hypertensive individuals with the greatest risk of death and of cardiovascular complications.     

正大维他和维伦滴眼液治疗眼表疾病的疗效

干眼和眼表疾病为眼科最常见疾病。本文报告包括干眼症在内的各种眼表疾病６８例１００眼，应用正大维他和维伦滴眼液治疗，获得良好的疗效。在这些滴眼液内含有玻璃酸钠粘多糖类粘性增强剂，可延长药液在角膜前表面的仪时间和增强药效。在治疗中未出现任何副作用。     

Duration of serum antibody responses following vaccination and revaccination of cattle with non-living commercial Pasteurella haemolytica vaccines

This study was designed to determine the duration of serum antibody responses to Pasteurella haemolytica whole cells (WC) and leukotoxin (LKT) in weanling beef cattle vaccinated with various non-living P. haemolytica vaccines. Serum antibodies to P. haemolytica antigens were determined periodically through day 140 by enzymelinked immunosorbent assays. At day 140, cattle were revaccinated, and antibody responses periodically determined through day 196. Three vaccines were used in two experiments (A and B), OneShot™, Presponse^® HP/tK, and Septimune^® PH-K. In general, all three vaccines between 7 and 14 days induced antibody responses to WC after vaccination. Antibodies to LKT were induced with OneShot and Presponse. Revaccination at days 28 and 140 usually stimulated anamnestic responses. Serum antibodies to the various antigens remained significantly increased for up to 84 days after vaccination or revaccination. The intensity and duration of antibody responses were variable depending on the experiment and vaccines used. Vaccination with OneShot usually stimulated the greatest responses to WC. Vaccination with OneShot or Presponse resulted in equivalent primary anti-LKT responses. In experiment B, spontaneous seroconversion was found in numerous calves on day 112. Revaccination of those cattle at day 140 resulted in markedly variable antibody responses such that several groups had no increase in antibody responses.     

Making poverty a practice issue

Trends in poverty and changes in service provision are combining to make the promotion of health in poverty a particular challenge to health and welfare practitioners. The evidence suggests that practitioner groups have failed to respond adequately to this challenge. Factors concerned with professional perceptions of poverty, the nature of qualifying and post-qualifying education and the difficulties associated with taking research into practice all appear, in some way, to contribute to practitioners’ failure to incorporate a poverty perspective in their work. A team training approach appears to offer one way forward in the practice-setting. Using a team training approach, the‘Health Promotion in Poverty Project’ has sought to enable the lessons learnt from the broad base of poverty theory and research to be used by practitioners to build responsive and integrated support strategies for low-income families with dependent children.     

Observations on two members of the Swedish family with congenital dyserythropoietic anaemia,type III

Abstract: Two affected individuals of the Swedish family with CDA, type III, in which the disease is transmitted as an autosomal dominant character, were studied. Both cases displayed features hitherto undescribed in this family but described in patients with CDA, type III, in whom the inheritance may have been as an autosomal recessive character. Such features were: (a) haemosiderinuria, (b) grossly disorganised erythroblast nuclei, (c) differences in the ultrastructural appearances of individual nuclei within the same multinucleate erythroblast and (d) intraerythroblastic inclusions resembling precipitated globin chains. In both cases the giant mononucleate erythroblasts and the multinucleate erythroblasts had total DNA contents up to 28c (1c = haploid DNA content) and 48c respectively, and some DNA synthesising bi- and multinucleate erythroblasts contained one or more nuclei which were unlabelled with ³H-thymidine. These findings are similar to those in patients with the autosomal recessive type of disease. Thus no major phenotypic differences are yet apparent between cases of CDA, type III, with different patterns of inheritance. Analysis of the surface erythrocyte proteins of the 2 Swedish CDA, type III, patients with monoclonal antibodies recognising Band 3, glycophorins A, B, C and D, Rh, CD44, CD47, CD55, CD58, CD59, Lutheran, Kell, LW and acetylcholinesterase did not reveal any gross abnormality of expression of these proteins. A slightly altered expression of blood group antigens A and H was revealed by the lectins Dolichos biflorus and Ulex europaeus and the Mr of Band 3 as judged by SDS polyacrylamide gel electrophoresis was also slightly reduced, suggesting that there may be minor alterations in the degree of N-glycosylation of some red cell membrane constituents.     

颈动脉间隙肿瘤的MRI诊断

目的：探讨颈动脉间隙肿瘤的MRI影象特征及其病理、解剖学基础和诊断价值。材料和方法：分析25例颈动脉间隙肿瘤的MRI征象，并与手术病理或血管造影比较。结果：多数肿瘤的病理改变或血管造影的特征能在MRI图像上反映，囊变和含丰富粘液的神经源性肿瘤T2加权像呈边界光滑的极高信号，化学感受器瘤瘤内的血管表现为扭曲条状和圆点状的极低信号，颈内动脉瘤信号分层，转移瘤边界毛糙或不清；不同来源的肿瘤与颈内、外动脉或颈总动脉和颈内静脉的位置关系有解剖上的相关性，有利于准确的定位和鉴别诊断；25例中术前诊断正确22例（88％）。结论：MRI对颈动脉间隙肿瘤的定位和定性具有重要的诊断价值，结合病史可减少误诊。     

蝮蛇抗栓酶对老年冠心病患者血液流变学的影响

用蝮蛇抗检酶治疗老年冠心病50例．通过对治疗前后血液流变学变化的观察，了解到蝮蛇抗栓酶能有效改善血浓浓粘聚状态，降低纤维蛋白原，是治疗冠心病的理想药物．     

人碱性成纤维细胞生长因子基因在大肠杆菌中的克隆与表达

应用DNA重组技术将编码人碱性成纤维细胞生长因子（bbFGF）的基因克隆至原核高效表达质粒pBV_(221)的启动子下游。SDS-SAGE、ELISA和NTT活性监测结果表明:该重组质粒pBV-hbFGF在大肠杆菌DH5α中,经42℃诱导后,可表达出有较高生物活性的hbFGF。     

Blood-brain barrier dysfunction in Binswanger’s disease; an immunohistochemical study

Binswanger’s disease is pathologically characterized by a combination of diffuse cerebrovascular white matter lesions and lacunar infarcts in the basal ganglia and white matter. Although a blood-brain barrier (BBB) dysfunction has been implicated in the pathogenesis of these white matter (WM) lesions, few authors have addressed this problem. In the present study, we describe BBB dysfunction and its regional differences in the brains of Binswanger’s disease patients. Twelve brains from Binswanger’s disease patients (group III) were examined and compared with those from five patients with non-neurological disease (group I) and five cortical infarct patients without significant WM lesions (group II). Immunohistochemistry was performed for glial fibrillary acidic protein and vimentin as astroglial cell markers, and for immunoglobulins, complements and fibrinogen as extravasated serum protein markers. The grading scores for IgG extravasation were significantly higher in group III as compared to group I, in both the periventricular WM and the subcortical WM (P < 0.01). In group III, the scores in the periventricular WM and subcortical WM were significantly higher than in the subcortical U fibers and cerebral cortex (P < 0.01 for the periventricular WM; P < 0.001 for the subcortical WM), respectively. Clasmatodendritic astroglia, which had swollen cell bodies and large cytoplasmic vacuoles with disintegrated processes, incorporated the serum components IgG, IgM, C3d, C1q and fibrinogen, both in the periventricular WM and subcortical WM in 5 out of 12 (42%) Binswanger’s disease brains. These results indicate that WM lesions in Binswanger’s disease are accompanied by BBB dysfunction, although it remains uncertain whether BBB dysfunction is secondary to either chronic cerebral ischemia or arterial hypertension. Received: 25 April 1997 / Revised, accepted: 21 July 1997