2型糖尿病心血管病变的QT离散度分析

目的　探讨 2型糖尿病心血管病变的QT离散度变化的意义。方法　分析 40例 2型糖尿病心血管病变者体表 12导联同步心电图 ,并与 42例 2型糖尿病无心血管病变及 42例正常人作对照。结果　糖尿病心血管病变组QTd及QTcd均显著高于其余两组 (P <0 .0 1)。以QTd >46ms为异常 ,则诊断糖尿病心血管病变的敏感性、特异性及准确性分别为 82 .5 %、85 .7%及 84.1%。以QTcd >5 2ms判为异常 ,则诊断敏感性、特异性及准确性分别为 85 .0 %、83.3 %、84.1%。结论　QTd及QTcd延长可作为临床诊断 2型糖尿病患者伴心血管病变的一项指标。     

伤寒史学研究成果简述

建国以来有关伤寒史学的研究成果表现在相关人物、相关著作、相关事件、学术关系及阶段特征五个方面。前期研究成果 ,尚不足以充分展示伤寒学历史地位和现实意义 ,更无充分依据昭示其未来之发展方向 ,因而有必要继续深入开展伤寒史学研究     

行为干预及生物反馈治疗对老年高血压患者降压疗效的影响

目的 研究应用行为干预治疗及生物反馈治疗对老年高血压患者降压药物的影响。方法 在应用降压药物的基础上,增加行为干预及生物馈治疗,观察综合性行为干预措施对降压疗效的影响。结果 增加行为干预及生物反馈治疗后,降压和情绪障碍矫正的效果比单用药物明显改善。结论 老年高血压患者给予综合性行为干预措施可增加降压药物的疗效。     

Prevalence and control of arterial hypertension in the south-east of Spain: A radical but still insufficient improvement

Stroke mortality rates in Spain are one of the highest in all of Europe. At the same time, the Murcia region (south-east Spain) shows, for both genders, the highest age-adjusted stroke mortality rates in all of Spain. The earliest available hypertension figure estimations for this area go back to 1981, when a high prevalence combined with an almost nonexistent control was detected. One decade later, updated prevalence estimations of hypertension are presented jointly with their degree of control and their association with other risk factors based on the results of a prevalence survey in a random population sample (n = 3,091). Arterial blood pressure was measured following the MONICA protocol, maintaining a tight quality control on between and within-observer variability. As hypertensive was considered as any person with systolic blood pressure (SBP) 140 mmHg or with diastolic blood pressure (DBP) 90 mmHg or with antihypertensive pharmacological treatment. Detected prevalence rises to 32.3% (CI 95%: 29.1%–35.5%) among males and to 23.7% (CI 95%: 21.4%– 26%) among females, maintaining its level regarding figures observed back in 1981. However, its control has been increased, especially among hypertensive women [from less than 5% in 1981 to 35% (95% CI: 32%–37.8%) at present]. Hypertension is strongly associated to hipercholesterolemia, overweight, obesity and diabetes (p < 0.01). On the contrary, it shows an opposite association with current smoking, higher educational level and leisure time physical activity (p < 0.01). The highest educational level was associated with better hypertension treatment and control. In summary, while hypertension prevalence is stabilized in our population, its control has improved in a measurable but still insufficient way. These results are in accordance with a decreasing trend in stroke mortality registered in the Murcia Region along the last decade.     

Observations on the arterial baroreflex in neurally mediated vasodepressor syncope

The arterial baroreflex was studied in subjects who had recently had an episode of vasodepressor syncope. This was determined using 2–3 mcg/kg intravenous boluses of phenylephrine and assessing the bradycardic response. The values were measured in ms/mmHg and expressed as the angular coefficient of the regression line between the increase in R—R interval on the electrocardiograph and the systolic arterial pressure. In subjects examined immediately after the vasodepressor syncope episode the bradycardic response was much more marked than in controls (p < 0.01) and in the subjects themselves 6 months after the episode, provided that they were symptom-free (p < 0.01). It is concluded that in vasodepressor syncope there is a phase in which the baroreflex is highly sensitive and that this is due not to a lowering of the stimulation threshold but to a gain in the efferent arc, which explains a vagotonic response.     

Acute dose-effect relationships of caffeine and mental performance,EEG, cardiovascular and subjective parameters

The present study investigated the dose-effect relationship of caffeine on mental performance using a caffeine-sensitive rapid information processing task (RIP) in a pre/post cross-over design. Twenty female nonsmoking regular coffee drinkers received 0, 1.5, 3 and 6 mg/kg caffeine in a balanced order and the measurements were extended to cardiovascular, EEG and mood parameters. Surprisingly, the dose-effect curves for the different parameters were rather heterogeneous. Whereas increasing effects with increasing caffeine doses were observed for - and -EEG frequencies, anxiety, wakefulness, and some coffee ratings, negative dose-effect relationships were obtained for RIP processing rate and blood pressure. No apparent dose-effect relationships were seen for reaction time and motor activity. Thus, it was concluded that the dose-response relationships are rather shallow and heterogeneous and that the different parameters have different ranges in which they are sensitive to caffeine. The caffeine doses which might have beneficial behavioral effects are at the lower end of the tested dose range and comparable to those found in caffeine-containing beverages.     

Evaluation of low dose prostaglandin E1 treatment for ductus dependent congenital heart disease

This study reports our experience with low-dose prostaglandin E₁ (PGE₁) treatment of 91 newborns with ductus dependent congenital heart disease (CHD). PGE₁ efficacy, side-effects as well as the cardiovascular and respiratory profile of the patients were analysed. PGE₁ doses > 0.02 g/kg per minute were used for only 5.3% of the total 23 656 h of treatment. The mean systolic blood pressures did not differ from the normal mean for patients with cyanotic CHD, while the diastolic values were lowered. Respiratory support was required only during 13.7% of the total treatment time. Apnoeas occurred in 21 (38%) of the 55 spontaneously breathing infants, who all had a cyanotic CHD. The incidence of apnoeas was lower during treatment with doses < 0.01 g/kg per minute.     

Reflex testing I: algorithm for lipid and lipoprotein measurement in coronary heart disease risk assessment

We reviewed the current literature in order to construct a reflex testing algorithm that maximizes clinical utility and cost-effectiveness of lipid and lipoprotein testing. The algorithm was based on the 2nd Report of the National Cholesterol Education Program Adult Treatment Panel guidelines for use of total cholesterol (TC), triglycerides (TG), HDL-C, and LDL-C, and published reports describing the clinical use of apolipoprotein B and lipoprotein (a). The success of this algorithm was tested in a low-risk general and a high-risk hyperlipidemic patient population. Lipid data and non-lipid risk factors were obtained from a national database and from patients seen at two lipid clinics. A total of 16 968 individuals from the National Health and Nutrition Examination Survey III database comprised the low-risk group, and 239 patients examined in the Hartford Hospital and Washington University Lipid Clinics comprised the high-risk group. We found a solid scientific base to support the NCEP guidelines and reasonable support for limited testing of apoB and Lp(a). According to the algorithm, the direct LDL-C assay was deemed unnecessary in 98% and 91% of low- and high-risk subjects, respectively, if one assumes that the Friedewald equation is adequate with TG≤4.00 g/l. With a more conservative cutoff of TG≤2.50 g/l, the algorithm canceled 92% and 81% of direct LDL tests, respectively. The algorithm also limited TG to 20 and 64%, apoB to 6 and 20%, and Lp(a) to 15 and 56%, of low- and high-risk groups, respectively. Use of a comprehensive, reflex algorithm for coronary heart disease risk assessment will substantially reduce the utilization of laboratory services without diminishing the clinical value of these tests. The algorithm will prevent the overuse of certain expensive tests (direct LDL) while promoting the limited use of underutilized tests [apoB and Lp(a)].     

不同诱饵配制成的敌鼠钠盐毒饵杀灭旅客列车拒食残存鼠效果观察

本文报告了0.1％敌鼠钠盐配制成的不同毒饵在旅客列车上对急性灭鼠毒饵拒食残存鼠的杀灭试验效果。采用间隔投饵饱和投药法,投毒14天便有效地杀灭了旅客列车上对急性灭鼠毒饵拒食残存鼠,粉迹法考核灭效达100％。敌鼠钠盐配制的毒饵适口性好,灭效高,现阶段列车灭鼠中,仍有较好的应用价值。     

老年人的发病特点及预防

目的：通过对老年人健康状况的调查,总结老年人发病特点,提出预防和治疗措施,以期延长老年人的寿命,提高老年人生活质量。方法：将７８０铝调查对象集中於医院,按规范化标准作体格检查,并由主任医师作结论。结果：高血压、心脑血管道在病、白内障、前列腺疾患、肺气肿及糖尿病等为老年人常见病。结论：定期体检及提高基知务人璋减少和预防老年病的重要手段。