Sotalol and metoprolol comparison of their anti-hypertensive effect

Summary 28 patients, aged 35–62 years, with uncomplicated hypertension, entered a double-blind, crossover study, in which the effects of single daily doses of sotalol and metoprolol were compared. Both drugs exerted a clinically useful anti-hypertensive effect as monotherapy, or in combination with a thiazide diuretic. No significant difference in hypotensive effects was noted between the two beta-blocking agents, when the dose was titrated to an optimal clinical effect. Treatment with sotalol and metoprolol was associated with a clinically insignificant increase in serum uric acid concentration. The side-effects observed were few, and in only two cases was therapy discontinued. We regard both sotalol and metoprolol as useful anti-hypertensive drugs.     

医疗保险民营化模式的比较及其对我国的启示

总结了发达国家医疗保险及其经办的民营化模式,深入剖析了发达国家医疗保险的民营化程度,勾勒了当下国际医疗保险民营化的发展趋势,在此基础上进一步阐述了我国医疗保险民营化的可能趋势,提出借鉴国外经验需要遵循系统、严谨、本土化原则。     

The Cultural Heritage of “Black Stones” (Lapis Aequipondus/Martyrum) of Leopardi’s Child Home (Recanati,Italy)

A macroscopic lithological study and physical (hardness, size, weight) investigations, coupled with laser-induced breakdown spectroscopy (LIBS) and X-ray fluorescence (XRF) chemical analyses of three egg- and one pear-shaped polished black stones, exposed in the library of the child home of the famous poet Giacomo Leopardi, at Recanati (Italy), were carried out. They are characterized by different sizes: two with the same weight of 16.9 kg and the two smaller ones of 5.6 kg each, corresponding to multiples of standard roman weights (drachma and scrupulum). These features and the presence of some grooves on the rock artefacts, probably for grappling hooks, suggest an original use as counterweight for the four black stones herein classified as amphibole-bearing serpentinites whose lithologies are far away from Recanati (probably coming from geological outcrops in Tuscany). The four serpentinite stones closely match with the so-called Lapis Aequipondus used in antiquity by the Romans as counterweights. Due to the presence of lead rings or iron hooks in these stones, Lapis Aequipondus were also used for martyrdoms during the persecution of Christians in the Roman period, attached to the necks of martyrs that were then thrown in the wells or attached to the ankles of hanging bodies. This is the reason why these stones are also known as Lapis Martyrum, venerated with the relative martyrs, in several churches of Rome. The four black stones investigated probably arrived at Recanati from Rome after the middle of the 19th century. In the past, Christians also called Lapis Martyrum the “devil’s stones” (Lapis Diaboli). This could also be the reason for the popular belief that black stones cannot be touched by people, except those of the Leopardi dynasty. This work contributes to the cultural heritage of Leopardi’s child home, as the four black stones had never been investigated.     

Epi-LASIK新进展

Epi-LASIK拓宽了角膜屈光手术的矫治范围,避免了LASIK的常见瓣并发症,并减少了与PRK或LASEK相关的并发症的发生。随着角膜创伤愈合反应机制研究的深入,波前像差技术的不断进步,抑制haze的最佳药物疗法的研制,角膜表面切削术尤其是Epi-LASIK将成为新的趋势。     

两种电子教材开发方式的对比研究

介绍了移动学习领域以iBook Author为依托和基于Web的两种电子教材开发方式,并将两种开发方式进行对比、总结出各自的优缺点,为今后的电子教材开发人员提供参考。     

Determination of diagnostic threshold in harmonization and comparison of clinical utility for five major antiphospholipid antibody assays used in Japan

BackgroundAnticardiolipin antibodies (aCL) and anti‐β₂‐glycoprotein I antibodies (aβ₂GPI) are essential in diagnosing antiphospholipid syndrome (APS) according to the international APS guideline. Five commercial assays for aCL and aβ₂GPI are available in Japan, but their test results are quite discordant. For harmonization of diagnosing APS, upper reference limit (URL) and diagnostic accuracy of each assay were evaluated and compared by testing common sets of specimens across all assays.MethodsWe evaluated two manual and three automated assays for aCL and aβ₂GPI of IgG‐ and IgM classes. 99%URL (the upper limit of reference interval: as per guideline) together with 97.5%URL were determined by testing sera from 198 to 400 well‐defined healthy subjects. Both URLs were compared with the cutoff values, which were determined based on ROC analysis by testing 50 each of plasma specimens from patients with/without APS. Diagnostic accuracy was evaluated as area under curve (AUC) of the ROC curve.ResultsA variable degree of discrepancy between URLs and the cutoff values was observed, which was partly attributable to between‐year assay variability. 97.5%URLs were set lower and closer to the cutoff values than 99%URLs. For all assays, diagnostic accuracies of both aβ₂GPI‐IgG and aCL‐IgG were generally high (AUC: 0.84−0.93); whereas those for IgM‐class assays were low (AUC: 0.57−0.67), implicating its utility is limited to rare IgG negative APS cases.ConclusionTo ensure harmonized APS diagnosis, the diagnostic thresholds of the five assays were evaluated by common procedures. Contrary to the guideline, 97.5%URL is rather recommended for diagnosing APS, which showed a closer match to the cutoff value.     

开胸手术与胸腔镜手术治疗自发性气胸的效果比较

目的：开胸手术与胸腔镜手术治疗自发性气胸的效果比较。方法选自2009年10月-2014年12月该院收治的自发性气胸进行手术的患者作为研究对象,共收集105例,分别为开胸组(n=60)和胸腔镜组(n=45)这两组。对两组患者均使用静脉吸入复合麻醉,并让患者呈90o侧卧位。对开胸组患者使用开胸手术,对胸腔镜组患者采用胸腔镜手术。结果相比于开胸组,胸腔镜组患者在手术时间、术中出血量、切口长度、引流管留置时间和住院天数方面的指标均明显要低,差异有统计学意义(P<0.05);开胸组的60例患者并发症的发生率为36.67%;胸腔镜组的45例患者并发症的发生率为8.89%。胸腔镜组的治疗效果明显高于开胸组(P<0.05);开胸组患者的病情复发率为3.33%,胸腔镜组患者的病情复发率为2.22%,两组比较差异无统计学意义(P>0.05)。结论和开胸手术相比较,胸腔镜手术治疗自发性气胸,患者出血少、恢复快、手术时间短、术后并发症和复发率低,值得医师和患者优先选择,但手术材料费用偏高。     

A Complex Negotiation: Women's Experiences of Naming and Not Naming Premenstrual Distress in Couple Relationships

ABSTRACT

Recent research has demonstrated the importance of family relationships in women's experience of premenstrual changes, their construction of these changes as “PMS.” However, the discursive process by which women take up the subject position of “PMS” sufferer through the explicit naming of “PMS” to an intimate partner has received little research attention. Drawing on 60 individual interviews with Australian women, conducted between 2004 and 2006, we examined accounts of naming “PMS” in intimate relationships, women's explanations for naming or not naming, their experiences of their partner naming them as premenstrual. The analysis process identified an overarching theme of naming “PMS,” which was made up of three themes: naming to explain; “PMS” becoming the only explanation for distress; “PMS” as not a legitimate explanation for distress. The findings suggest that clinicians need to be aware of women's complex, often ambivalent, experiences of naming “PMS” within their relationships, when working with women, couples, seeking treatment or support for premenstrual distress.