54例不同性别健康大学生“寸口”脉象及脉图参数分析

目的：探索健康人群不同性别及左右手＂寸口＂关部脉象及脉图参数的变化特征。方法：根据纳入标准筛选健康大学生共54例,其中男性28例、女性26例。用DDMX-100型单道脉象仪采集受试者左右手关部脉象信息,并进行统计分析。结果：男性以平脉、滑脉为多见,女性以平脉或平弦脉为多见;男性、女性右手脉图参数h3、h3/h1显著低于左手（P〈0.05）,h5、h5/h1显著高于左手（P〈0.05）,提示男女右手动脉血管壁的紧张性和外周阻力均低于左手;男性左右手脉图参数h1、h5均高于女性,t4、w/t均低于女性,提示男性左心室的射血功能强、心输出量大、动脉管壁顺应性好。结论：男女右手动脉血管壁的紧张性与外周阻力均低于左手;男性左心室的射血功能及动脉管壁顺应性均优于女性,研究结果与中医经典脉学理论基本相符。     

Gender differences in efficacy of primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction

Background The clinical outcome of percutaneous coronary intervention （PCI） is poorer in women than that in men. This study aimed at comparing the impact of gender difference on the strategy of primary PCI in patients with acute ST-segment elevation myocardial infarction （STEMI）.
Methods Two hundred and fifty-nine patients with STEMI who underwent primary PCI within 12 hours of symptom onset were enrolled. The male group consisted of 143 men aged 〉55 years, and a female group included 116 women without age limitation. Procedural success was defined as residual stenosis 〈20% with thrombolysis in myocardial infarction flow grade 〉2 and without death, emergency bypass surgery or disabling cerebral events during the hospitalization. The rate of major adverse cardiac events （MACE）, including death, nonfatal myocardial infarction and target vessel revascularization during follow-up, was recorded.
Results Female patients were more hypertensive and diabetic and with fewer cigarette smokers than male counterparts. The prevalence of angiographic 3-vessel disease was higher in the female group, but the procedural success rate was comparable between the two groups （94.4% vs 92.2%）. The occurrence rate of MACE did not differ during the hospitalization （4.2% vs 6.0%, P=0.50）, but was significantly higher in the female group during follow-up （mean （16.0±11.2） months） than that in the male group （5.4% vs 0.7%, P=0.02）.
Conclusion Despite a similar success rate of primary PCI and in-hospital outcomes in both genders, female patients with acute STEMI still have a worse prognosis during the long-term follow-up.     

The Relationship between Habitual Coffee Drinking and the Prevalence of Metabolic Syndrome in Taiwanese Adults: Evidence from the Taiwan Biobank Database

Previous studies revealed inconsistent results between coffee drinking and metabolic syndrome (MetS). The aim of the study was to evaluate the relationship between habitual coffee drinking and the prevalence of MetS among men and women. We conducted a nationwide, cross-sectional study using 23,073 adults obtained from the Taiwan Biobank database (mean ± SD (range) age, 54.57 ± 0.07 (30–79) years; 8341 men and 14,731 (63.8%) women). Adults who drank more than one cup of coffee per day (n = 5118) and those who drank less than one cup per day (n = 4515) were compared with nondrinkers (n = 13,439). Multivariate logistic regression models were used to evaluate the risk of MetS between the two groups. Separate models were also estimated for sex-stratified and habitual coffee-type-stratified (black coffee (BC), coffee with creamer (CC), and coffee with milk (CM)) subgroup analyses. The MetS diagnosis was based on at least three of the five metabolic abnormalities. Coffee drinkers (≥1 cup/day) had a significantly lower prevalence of MetS than nondrinkers (AOR (95% CI): 0.80 (0.73–0.87)). Women who drank any amount of coffee and any type of coffee were more likely to have a significantly lower prevalence of MetS than nondrinkers. Only men who drank more than one cup of coffee per day or black coffee drinkers were more likely to have a lower prevalence of MetS. Our study results indicate that adults with habitual coffee drinking behaviors of more than one cup per day were associated with a lower prevalence of MetS. Moreover, women could benefit from habitual coffee drinking of all three coffee types, whereas men could only benefit from drinking BC.     

面孔表情识别事件相关电位的性别效应

目的考察面孔表情加工对应的事件相关电位（event-related potentials，ERP）时空模式的性别差异。方法采用正性、中性、负性三种面孔表情简笔画图片为刺激，31名受试者（男18例，女13例）执行隐含面孔表情识别任务，比较了不同性别的ERP差异波（正性和负性分别减去中性表情对应的ERP波形所得的“清绪波”）及N210（对应于文献中的N170）的异同。结果正性情绪波显著的差异在100-200ms的分布由左侧逐渐过渡到右侧、260-280ms分布于两侧但以左侧为主、360-380ms为前部；负性情绪波显著的差异在360-380ms分布在头皮右侧、500-520ms则在左侧并向后部扩布。女性面孔表情识别左半球的比右半球N210潜伏期明显延长。结论不同性别间对面孔表情的神经加工存在差异，女性N210左半球加工速度迟于右半球。     

进食对不同性别健康成年人心率变异性的影响

目的 探讨不同性别健康成年人进食后心率变异性(HRV)变化的特点及差异.方法 运用自身前后对照的方法,分别给予22例健康成年志愿者(男10例,女12例)以摄入食物(进食组)及不进食(对照组)的对照干预,监测干预前后30 min内的心电图和脑电图.根据脑电图结果辨别其睡眠状态,根据心电图结果获取HRV频域指标进行HRV分析.结果 22例志愿者中,19例在实验过程中有进入睡眠状态,清醒与2期睡眠的心率、低频段(LF)、高频段(HF)、标准化低频功率(LFnu)、标准化高频功率(HFnu)等指标差异有统计学意义(P＜0.05).与对照组相比,进食组男性志愿者餐后与餐前心率的差值显著增大(P＜0.01),其余指标差异无统计学意义(P＞0.05);女性志愿者餐后与餐前心率(P＜0.001)、LFnu(P＜0.05)及LF/HF(P＜0.05)的差值显著增大,HF、HFnu的差值为负,其绝对值亦显著增大(P＜0.05).结论 进食对HRV的影响存在性别间的差异,女性的HRV受进食的影响较男性显著.     

广泛性焦虑障碍对冠心病的影响：基于冠状动脉计算机断层扫描血管造影的初步研究

目的 基于冠状动脉计算机断层扫描血管造影(CCTA)评估冠状动脉狭窄程度,探讨广泛性焦虑障碍(GAD)对冠心病的影响,并探索冠心病危险因素和临床特征的性别差异.方法 对2018年4月至2019年6月就诊于天津医科大学总医院并行CCTA检查的1117例患者进行杜克冠心病指数评分,同时对患者进行广泛性焦虑障碍7项(GAD-7)量表测评,采用二分类logistic回归方法分析GAD、性别与高危冠心病的关系.结果 最终入组1099例患者,其中男460例(41.9％),女639例(58.1％).GAD是高危冠心病的危险因素(OR=1.071,95％CI 1.013～1.134,P=0.017).女性患者的GAD患病率高于男性[20.3％(130/639)vs 7.0％(32/460),P<0.01],但在女性中GAD并非高危冠心病的危险因素(OR=1.037,95％CI 0.954～1.129,P=0.392).年龄、GAD、糖尿病、高脂血症、吸烟是男性高危冠心病的危险因素(P均<0.05),而在女性中仅年龄、高血压是高危冠心病的危险因素(P均<0.05).结论 GAD在女性中更为常见,但不是女性发生高危冠心病的危险因素,对有冠心病疑似症状的女性患者,其症状可能是GAD躯体症状而非冠心病症状,因此临床上更应关注其心理因素;对于存在GAD的男性患者,临床上更应注意其高危冠心病的筛查.     

大学生睡眠质量与心理健康状况的相关性研究

  目的  了解中山市成年居民失眠症状现况。  方法  2017年2 — 5月,采用随机抽样方法对中山市25个乡镇和城区的12 182名 > 18岁成年居民进行失眠症状调查。  结果  中山市成年居民失眠症状检出率为10.02 %,其中女性的检出率为11.76 %,男性为8.17 %;成年居民失眠症状总得分为（1.19 ± 0.01）分,入睡困难得分为（0.37 ± 0.01）分,再入睡困难得分为（0.48 ± 0.01）分,早醒得分为（0.35± 0.01）分;回归分析结果显示,除了学历和家庭所在地之外,性别、年龄、职业、婚姻状况、子女人数和家庭经济水平均为失眠症状的影响因素(P < 0.05)。  结论  中山市成人失眠症状的检出率较高;性别、年龄、职业、婚姻状况、子女人数和家庭经济水平等都是失眠症状的主要影响因素。     

Use of Standardized Patients to Evaluate the Physicians in Residence Program

Abstract

The purpose of this study was to evaluate the efficacy of the Physician in Residence (PIR) program at the Hazelden Residential Program of New York City as a substance abuse training approach using standardized patients (SP) and self-report ratings. Using an objective rating scale, two experienced drug counselors evaluated four videotaped interviews carried out by housestaff pre- and post-enrollment in the PIR program. In addition, housestaff completed self-report ratings regarding their knowledge, attitudes, and skills of substance abuse. Of the 23 housestaff who completed both pre- and post-PIR program videotape sessions, significant improvements were noted in both observer and self-reported ratings. Overall, self-report ratings showed a greater percent improvement than the counselor ratings. The PIR program may be an efficacious approach to teach substance abuse clinical skills to housestaff.     

International Abstracts

The goal of this study was to develop an understanding the developmental trajectory of smoking behaviors in adolescents who seek smoking cessation treatment to inform tailored prevention and treatment efforts; this includes identifying gender differences in smoking behaviors. Smoking trajectory was examined retrospectively in 639 treatment-seeking adolescents (59% female; 44% African American, 50% European American, mean ± SD daily cigarettes per day [CPD] 19.16 ± 7.2 for both girls and boys). Smoking trajectory variables examined included age at first cigarette, age at daily smoking (a proxy measure for onset of dependence), and age at treatment request. The time interval from first cigarette to daily smoking was shorter for girls than for boys (mean ± SD 0.9 ± 1.1 years for girls, 1.3 ± 1.5 years for boys, p < 0.01). From this clinical sample of adolescent smokers, findings suggest only a brief window of opportunity for secondary preventive interventions before the development of tobacco dependence. Additional research is needed to explore the specific factors that differentially affect smoking trajectory in girls compared to boys.