西雅图心绞痛调查量表对冠心病患者机体功能及生活质量的评估研究

目的对冠心病患者机体功能状态及生活质量进行评估。方法采用Ｓｐｅｔｕｓ等设计的ＳｅａｔｔｌｅＡｎｇｉｎａＱｕｅｓｔｉｏｎｎａｉｒｅ问卷对１００例冠心病患者躯体活动受限程度、心绞痛稳定状态及发作情况、治疗满意程度和疾病认识程度进行测评研究。结果重复测定显示该量表有良好的重复性，心理疗法配合药物治疗组的评分明显优于单纯药物治疗组（Ｐ＜０．０５）。结论该量表用于我国冠心病患者有较满意的信度，同时也证实了心理疗法在冠心病治疗中的重要地位。     

Case-control study of risk factors for cervical neoplasia in Denmark. II. Role of sexual activity,reproductive factors,and venereal infections

Sexual, reproductive and venereal risk factors for cervical neoplasia were investigated in a population-based case-control study of 586 women with histologically verified, cervical squamous-cell carcinoma in situ, and 59 women with invasive squamous-cell cervical cancer, diagnosed from 1985 to 1986 in Copenhagen. Cases were identified from the computerized Danish Cancer Registry. An age-stratified control group (n=614) was drawn at random from the female population in the study area by means of the Danish Central Population Register. A structured questionnaire was mailed to cases as well as controls. Increasing number of sexual partners exerted a significant effect on the risk both for carcinoma in situ, and invasive cancer, independently of age at first intercourse and other potential confounders. Conversely, the association with early age at first intercourse became statistically insignificant after allowance for other risk factors, although an increasing risk was still observed with decreasing age at sexual debut. Early age at first episode with genital warts was a significant risk factor for carcinoma in situ, perhaps indicating a possible increased susceptibility of the cervix epithelium during adolescence. A history of genital warts was a good predictor of risk for carcinoma in situ, whereas a history of previous gonorrhea was associated with an increased risk for invasive carcinoma. Women with multiple births had a significantly increased adjusted risk, especially for carcinoma in situ, although some association was also observed with invasive cervical cancer. The study supports the hypothesis of cervical neoplasia being a sexually transmitted disease, and that carcinoma in situ and invasive cervical carcinoma, to a high degree, have similar patterns of risk factors.Drs Kjaer, Engholm, and Lynge are with the Danish Cancer Registry. Dr Dahl is with the Department of Surgery, Slagelse Hospital, Denmark. Dr Bock is with the Department of Gynecology, Rigshospitalet, Copenhagen, Denmark. Dr Jensen, formerly with the Danish Cancer Registry, is deceased. Address correspondence to Dr Kjaer, Danish Cancer Registry, Institute of Cancer Epidemiology, Danish Cancer Society, Rosenvengets Hovedvej 35, Box 839, Copenhagen. Denmark. The Danish Cancer Society supported this study through grants.     

Changing the College AOD Environment for Primary Prevention

Identifying environmental factors reflected to alcohol use is important for program planning and evaluation in college alcohol and drug prevention programs. Little has been written concerning uses of data in environmental prevention efforts. This paper presents four brief interrelated case studies of how environmental modifications were used by a college alcohol prevention project to 1) change the marketing practices and service policies of a student-oriented bar, 2) alter the sales practices of a campus bookstore concerning alcohol paraphernalia, 3) to develop a campaign with the goal of reducing risk factors related to heavy drinking at private student parties, and 4) stop an unsafe bus from transporting students to bars in Mexico. Creative use of such environmental prevention approaches has potential benefit to colleges and universities concerned with the primary prevention of alcohol-related problems experienced by students.     

Systematic Reviews on the Basis of Methodological Criteria

This paper describes a method of systematic reviewing. This method puts much emphasis on the methodological quality of the randomised clinical trials involved. Various items concerning the internal validity, precision and relevance of the studies are scored in such a way that next to the methodological quality the amount of uncertainty about it also becomes visible. These quality assessments are not only useful for systematic reviews, but also have an educational function for researchers with respect to the design and publication of a clinical trial.     

Cardiovascular autonomic dysfunction in normotensive awake subjects with obstructive sleep apnoea syndrome

Cardiovascular autonomic function in normotensive awake patients with obstructive sleep apnoea syndrome was studied in 21 normotensive (mean age 48 ± 14 years), drug-free men with obstructive sleep apnoea syndrome. Cardiovascular reflex tests with continuous blood pressure monitoring and biochemical indices were performed the morning after a standard polygraphic sleep recording. A group of 20 agematched (mean age 49 ± 19 years) normal subjects was used as controls. The obstructive sleep apnoea syndrome patients showed higher heart rate and noradrenaline plasma levels (p < 0.05) at rest and a higher blood pressure response to head-up tilt (p < 0.01), suggesting sympathetic overactivity. Respiratory arrhythmia, baroreflex sensitivity index and Valsalva ratio were significantly lower in the obstructive sleep apnoea syndrome group (p < 0.01) whereas the decrease in heart rate induced by the cold face test was significantly higher (p < 0.05) showing a blunting of reflexes dependent on baroreceptor or pulmonary afferents with normal or increased cardiac vagal efferent activity. These abnormalities in autonomic regulation may predispose obstructive sleep apnoea syndrome patients to cardiovascular complications like hypertension and cardiac arrhythmias.     

Duchenne型肌营养不良症

作者综述了１０年来对Ｄｕｃｈｅｎｎｅ型肌营养不良症（ＤＭＤ）的研究概况。主要包括①ＤＭＤ的临床研究。②血清生化研究表明ＣＫ、ＬＤＨ、Ｍｂ是诊断ＤＭＤ病人和携带者的敏感指标。③心脏无创性检测和肌肉超微结构研究。④部分抗肌萎缩蛋白基因ＹＡＣ物理图谱，精细限制酶图谱和缺失热区的核苷酸顺序分析，首次发现内含子中ＡＴ富集区的同源顺序与ＤＭＤ断裂有关。⑤抗肌萎缩蛋白的缺失热区疏水肽段存在与否与ＤＭＤ发病密切相关。     

Physiological Effects of Mental Stress and Orthostasis in Young Insulin-Dependent Diabetic Patients

ABSTRACT. The effects of procedures which stimulate sympathetic activity, viz. mental stress induced by a colour-word conflict test (CWT) for 20 min, and orthostasis (ORT) for 8 min were studied in 8 young (16-20 yr) insulin-dependent diabetes mellitus (IDDM) patients and 9 age and sex-matched healthy controls. The IDDM patients showed no signs of neuropathy or retinopathy and their mean HbA_1c value was 8.4 ±0.6% (normal value < 5.0 %). Blood pressure and heart rate increased significantly during CWT and ORT in both groups. The changes in systolic blood pressure and heart rate were comparable in both groups during CWT; the IDDM group showed a higher ( p < 0.05) heart rate after 8 min of orthostasis, however. CWT and ORT elicited equivalent increases in noradrenaline in venous plasma in both groups ( p < 0.05), but the IDDM patients had 50% lower values ( p < 0.01) at rest, during CWT and at rest after CWT than controls. CWT and ORT evoked equivalent plasma adrenaline increases in both groups. The lipolysis marker, plasma glycerol, was about 40 % lower ( p < 0.05) in the IDDM group before and after CWT. Yet, mental stress evoked equivalent increases in glycerol levels ( p < 0.01) in both groups. These findings indicate that sympathetic activity in the young diabetic patients without signs of neuropathy may be blunted.     

Natural killer cell activity and CSF monoamine metabolites in suicide attempters

The aim of this study was to investigate markers of serotonin and immune function in suicidal patients. Cytotoxic activity of natural killer cells (NK) and CD16 lymphocytes were studied in 28 suicide attempters and 26 healthy controls, and related in patients to 5-hydroxyindoleacetic acid (5-HIAA) in cerebrospinal fluid (CSF). Patients with CSF 5-HIAA below the median had significantly lower NK cell activity than other patients. CD16 cell frequency was significantly lower in patients than in controls, and patients also tended to have lower NK cell cytotoxicity than healthy controls. There were no statistically significant correlations between 4-hydroxy-3methoxyphenyl glycol (HMPG), homovanillic acid (HVA), CSF cortisol and NK cell activity. The results support the hypothesis of compromised immune function in suicidal patients with evidence of disordered serotonin function.     

理气类中药对大鼠离体胃平滑肌条的作用

目的：观察理气类中药对大鼠离体胃平滑肌条运动的影响。方法：将肌条放置在灌流肌槽中，用生理记录仪记录肌条的收缩活动。结果：陈皮、枳实对胃各部位平滑肌条均为抑制效应，香附、薤白、木香、柿蒂、乌药对胃底肌条为兴奋效应，但对其他部位肌条则表现为兴奋或抑制不同的效应，沉香仅降低胃窦环行肌收缩波平均振幅，对其他肌条无影响。结论：理气类中药对大鼠离体胃平滑肌条既有兴奋作用，也有抑制作用。