Reevaluation of the Correlation between Angiotensinogen Gene M235T Polymorphism and Familial Essential Hypertension Using MS-PCR Technique

Renin- angiotensin system( RAS) candidat-ing gene,such as angiotensinogen( Ag T) as wellas angiotensin- converting enzyme( ACE) genepolymorphism were thought to have positive association with various cardiovasculardiseases.In1 992 ,Jeunemaitre[1] detected a microsatellitepolymorphism in the region of the an-giotensinogen gene which has linked to occur-rence of essential hypertension.Further analysisled to detection of several mutations in the cod-ing region of angiotensinogen gene[2 ] . Ma…     

自发性高血压大鼠左室不同部位心肌纤维化程度的改变: 病理变化与心肌密度改变的对比观察

目的：探讨自发性高血压大鼠（SHR）左室室间隔、前壁、后壁及侧壁 心肌纤维化的动态变化,以及心脏超声显像结合计算机分析检测心肌密度这一方法的可靠性。方法：应用病理及生化检查,检测SHR左室室间隔、间壁、后壁及侧壁心肌纤维化的病变程度;通过心脏超声显像并结合计算机分析,检测大鼠的心肌密度的变化。结果：14周时,代表心肌纤维化水平的参数羟脯氨酸浓度（HC）在SHR室间隔、前壁及后壁即已增高,以室间隔最为明显,而左室侧壁虽有增高趋势,但未达到显著性水平;24周时各部位均明显增加,但各部位之间的差异明显减少。在14周时,代表血管周围纤维化水平的参数血管周围胶原面积（PVCA）在左室各部位较对照组均显著增高,24周时增高更为明显,但各部位之间无显著性差异。而代表间质纤维化水平的参数胶原容积分数（CVF）在14周时只有室间隔显著增高,其余各部位无明显变化;24周时各部位均有显著增高,但仍以室间隔增高最为明显。心肌灰度均值在14周时各部位均较对照组显著增高,各部位之间比较,室间隔最高,侧壁最低,二者之间有显著性差别。24周时各部位均较14周显著增高,但各部位之间差别变小。在室间隔,灰度离散度在14及24周均未出现显著性改变,而其他部位则在14周时增高,24周时趋于正常。结论：在高血压发病过程中,心肌纤维化尤其是间质纤维化的变化程度是不均衡的,以室间隔程度最重,左室侧壁最轻;应用心脏超声显像并结合计算机分析测定心肌密度,可客观地反应心肌纤维化的程度。     

原发性高血压患者红细胞[Ca2+]i浓度变化及影响因素

目的：观察原发性高血压患者红细胞[Ca^2 ]i,多巴胺β羟化酶及ATP含量变化并分析其结果。方法：测定35例高血压患者的红细[Ca^2 ]i、ATP、血清多巴胺β羟化酶活性,血糖及血浆胰岛素含量,并以30例健康成年人为对照。结果：高血压患者的红细胞[Ca^2 ]i、ATP、多巴胺β羟化酶均明显高于对照组（P＜0．05,P＜0．01）,但血糖与胰岛素未见明显变化。结论：高血压患者血清多巴胺β羟化酶活性增强伴随ATP与[Ca^2 ]i升高。     

Epistaxis

Epistaxis is a common problem that can affect the whole population. The majority of cases are self-limiting and do not require any medical intervention, but epistaxis can be associated with morbidity and even death in very rare circumstances. If epistaxis does not resolve with first aid measures, or episodes are frequent, patients may require specialist assessment and treatment by ENT, either in the outpatient clinic or via an unscheduled (emergency) admission to the hospital. Here, we provide an overview of the management of epistaxis in the outpatient setting and during an emergency admission in both paediatric and adult patients. We highlight the key considerations in the history and management, covering the common and rare conditions that are associated with epistaxis. This article provides an update from our previous article published in 2018 to include the more recent literature and a useful learning resource for examinations.     

中药解郁胶囊治疗老年抑郁症的临床疗效观察

目的：观察中药解郁胶囊对老年抑郁症的临床疗效和安全性。方法：选取2020年11月至2021年12月甘肃中医药大学附属医院住院或门诊患者200例作为研究对象,按照纳入标准最终产生研究观察对象100例,健康对照组来自我院组织的年龄在60~80岁的健康体检的老年人100例。观察组中男37例,女63例,对照组中男43例,女57例。对照组采取常规治疗,观察组采取中医综合疗法治疗。对2组患者治疗前后减分情况、中医证候分析、服药及依从情况、不良反应及抑郁焦虑因子等无创性指标的影响。结果：对老年抑郁症的治疗效果主要从汉密尔顿抑郁量表减分情况及证候减分率体现,2组经过12个月中药和抗抑郁综合治疗,中医证候量表减分率（8.2±3.1）和（7.8±3.2）,比对照组的（8.8±3）与（8.4±3.6）,P值为0.001 6和0.001 3,治疗前后均有明显变化,差异有统计学意义（P<0.05）,中医证候量表减分率比较,差异有统计学意义（P<0.05）,从服药后出现的不良反应来看,中医综合观察组应明显低于对照观察组,差异有统计学意义（P<0.05）。从中医组治疗患者的依从性分析,差异有统计学意义（P<0.05）。结论：中药解郁胶囊与中医综合治疗患者治疗效果显著,依从性更佳。     

Einflu\ eines Β1-Rezeptorenblockers auf die Plasmaspiegel des atrialen natriuretischen Peptids bei Patienten mit essentieller Hypertonie unter Ergometerbelastung

Summary In order to investigate the behaviour of atrial natriuretic peptide (ANP) in untreated mild to moderate essential hypertension and the influence of blood pressure normalisation by a ₁-receptor blocker a study was conducted in groups of normotensive and hypertensive middle aged subjects. 10 normal subjects and 10 patients with essential hypertension (WHO I–II) without any medication and on betaxolol monotherapy were studied at rest and during graded exercise. In addition the response of ANP, cyclic guanosine monophosphate (cGMP) and the renin-aldosterone-system was investigated.Normal subjects and hypertensive patients did not differ in ANP levels at rest and also responded with a comparable exercise dependent increase at all workload levels. A steady decrease of ANP was noticed during the recovery period in both groups. After-blocker treatment in the hypertensive patients ANP concentrations significantly rose, both at rest and more pronounced during exercise. cGMP reacted in a similar way but showed a more inert response. A counter-regulatory behaviour between ANP and PRA or aldosterone, as seen under volume shifts, could not be detected. These findings demonstrate that plasma ANP is not altered in untreated essential hypertension. Increased ANP levels in ₁-blocker treatment may contribute to its blood lowering effect.

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Abkürzungsverzeichnis ANP atriales natriuretisches Peptid - ALD Aldosteron - C_In Inulin Clearance - cGMP zyklisches Guanosinmonophosphat - irANP immunoreaktives atriales natriuretisches Peptid - PAH Paraaminohippursäure - PRA Plasma-Renin-Aktivität - RAA-System Renin-Angiotensin-Aldosteron-System - RBF renaler Blutflu - RIA Radioimmunoassay - RVR renaler Gefä\widerstand