重庆市城市居民原发性高血压的病例对照研究

本研究采用１：４配比的方法，收集了３７０例确诊高血压病例与１４８０例对照，进行了病例对照研究。经条件ｌｏｇｉｓｔｉｃ回归模型分析发现与高血压有关的危险因素有以下五个：体重指数、吸烟年限、脉率、卫生知识水平和家族史。     

急性脑卒中患者应激性高血糖危险因素分析

目的 探讨重症监护室（ICU）急性脑卒中患者应激性高血糖的危险因素。方法对50例急性（发病5d内1非糖尿病脑卒中患者监测血糖7-14d，比较高血糖及正常血糖两组患者年龄、糖皮质激素、临床肺部感染评分等对血糖的影响。结果高血糖组临床肺部感染评分（CPIS）为4．77±2．11，显著高于正常血糖组的3．36±2．36（P〈0．05），急性生理学及慢性健康状况评分（APACHEⅡ）高血糖组为16．23＋5．40，也显著高于正常血糖组的12．43±3．83，有显著性差异（P〈0．01）。结论CHS和APACHEⅡ升高可能是ICU非糖尿病卒中后应激性高血糖的危险因素。     

急性缺血性卒中患者发生院内消化道出血的危险因素分析

目的 分析急性缺血性卒中患者（acute ischemic stroke，AIS）住院期间消化道出血（gastrointestinal
bleeding，GIB）的发生率、发生时间及危险因素。
方法 本研究纳入首都医科大学附属北京天坛医院急性卒中院内并发症队列（inhospital medical
complication after acute stroke，iMCAS）研究中AIS患者。收集患者临床信息，根据住院期间是否发生
GIB分为GIB组和无GIB组，采用多因素Logistic回归模型，分析AIS患者发生GIB相关危险因素。
结果 共纳入1129例AIS患者，平均年龄58.7±12.5岁，女性230例（20.4%）。47例住院期间发生GIB，
发生率为4.2%，卒中发作至GIB确诊时间为5（3～13）d。合并肝硬化（OR 10.06，95%CI 2.44～41.38）、
高入院NIHSS评分（OR 1.13，95%CI 1.08～1.19）、高白细胞计数（OR 1.25，95%CI 1.13～1.38）、住院时
间长（OR 1.05，95%CI 1.01～1.10）是AIS患者发生消化道出血的独立危险因素。
结论 本单中心研究数据提示合并肝硬化、高入院NI HSS评分、高白细胞计数、住院时间长是AI S患
者住院期间发生GIB的独立危险因素。     

卒中高危人群糖化血红蛋白与颈动脉粥样硬化斑块的关系研究

目的 分析卒中高危人群糖化血红蛋白与颈动脉粥样硬化斑块的关系。
方法 2018年5-6月由孝感市中心医院按整群随机抽样方法，随机抽取孝感市城乡各1个社区居民
进行筛查，通过问卷调查、体格检查、实验室检查、颈部血管超声检查筛选卒中高危人群纳入研究。
根据颈动脉超声检测结果将卒中高危人群分为非斑块组和斑块组（颈动脉）。分别采用单因素和多
因素Logistic回归，分析糖化血红蛋白与颈动脉斑块的关系，并根据年龄（60岁）、BM（I 24 kg/m2）、是
否有高血压对研究人群进行分层分析，研究不同特征的卒中高危人群中糖化血红蛋白与颈动脉斑块
的关系。
结果 最终纳入卒中高危人群629例，男性338例（53.74%），平均54.85±8.97岁，糖化血红蛋白平
均浓度为4.70%±1.02%。其中斑块组患者215例（34.18%），非斑块组患者414例（65.82%）。与非斑
块组患者相比，斑块组患者男性、卒中、TIA、高血压、超重患者比例更高，年龄更大，BMI、血压、空
腹血糖、糖化血红蛋白、TC水平更高（均P＜0.01）。校正其他危险因素后，糖化血红蛋白是颈动脉
粥样硬化斑块发生的独立影响因素（每升高1%，OR 1.16，95%CI 1.01～1.31，P =0.018）。分层分析显
示，年龄≥60岁（OR 1.48，95%CI 1.09～2.01，P =0.016）、BMI≥24 kg/m2（OR 1.97，95%CI 1.07～3.64，
P =0.030）、高血压人群（OR 1.31，95%CI 1.06～1.62，P =0.013）中糖化血红蛋白均是颈动脉斑块发生
的独立危险因素。
结论 卒中高危人群糖化血红蛋白与颈动脉斑块的发生密切相关，特别是在年龄≥6 0岁、
BMI≥24 kg/m2和高血压人群中。     

Maturation of executive function in autism.

BACKGROUND: Executive dysfunction has been reported at different ages in autism. It is not clear however, when this impairment emerges or how its expression is affected by development. METHODS: 61 non-mentally retarded autism participants (AUT) and 61 age, gender, and IQ matched typically developing participants (CON) were assessed with two oculomotor executive function tasks, the oculomotor delayed response task (ODR) and the antisaccade task (AS), as well as a visually-guided saccade sensorimotor task (VGS). RESULTS: The AUT group demonstrated impairments in response inhibition and spatial working memory at all ages tested. Developmental improvements in speed of sensorimotor processing and voluntary response inhibition were similar in both groups indicating sparing of some attentional control of behavior. Developmental progression in the speed of initiating a cognitive plan and maintaining information on line over time, however, was impaired in the AUT group indicating abnormal development of working memory. CONCLUSIONS: These results indicate that while executive dysfunction is present throughout development, there is evidence for both typical and atypical developmental progression of executive functions in autism. The plasticity suggested by the developmental improvements may have implications regarding appropriate developmental epochs and types of interventions aimed at enhancing cognitive capacities in individuals with autism.     

Inter-cohort differences in coronary heart disease mortality in the 25-year follow-up of the seven countries study

Sixteen cohorts of men aged 40–59 years at entry were examined with the measurement of some risk factors and then followed-up for mortality and causes of death for 25 years. These cohorts were located in the USA (1 cohort), Finland (2), the Netherlands (1), Italy (3), the former Yugoslavia (5), Greece (2), and Japan (2), and included a total of 12,763 subjects.Large differences in age-adjusted coronary heart disease (CHD) death rates were found, with extremes of 45 per 1000 in 25 years in Tanushimaru, Japan, to 288 per 1000 in 25 years in East Finland. In general, higher rates were found in the US and Northern European cohorts as compared to the Southern European and Japanese cohorts. However, during the last 10 years of follow-up large increases of CHD death rates were found in some Yugoslavian areas. Out of 5 measured entry characteristics treated as age-adjusted levels (serum cholesterol, systolic blood pressure, cigarette smoking, body mass index and physical activity at work), only serum cholesterol was significant in explaining cohort differences in CHD death rates.Over 50% of the variance in CHD death rates in 25 years was accounted for by the difference in mean serum cholesterol. This association tended to decline with increasing length of follow-up, but this was due to the great changes in mean serum cholesterol in the two Jugoslavian cohorts of Velika Krsna and Zrenjanin. When these two cohorts were excluded the association increased with time.Changes in mean serum cholesterol between year 0 and 10 helped in explaining differences in CHD death rates from year 10 onward.It can be concluded that this study suggests that mean serum cholesterol is the major risk factor in explaining cross-cultural differences in CHD.     

Neurologic outcome after heart transplantation in Chagas' disease

Objective - To evaluate the neurologic morbidity after orthotopic heart transplantation (OHT), we examined consecutive Chagas' (Ch) and non-Chagas' (NCh) patients, before and after surgery. Material and methods - We undertook neurological and neuropsychological evaluations in Ch and NCh patients with end-stage cardiac failure, from September 1993 to September 1995. Results - Of 10 Ch patients (mean age=33.6 years; 7 male; mean follow-up=10.8 months) and 13 NCh patients (mean age=50.9 years; 12 male; mean follow-up=15 months) 3 died (rejection and sepsis) without neurologic symptoms. Neurologic complications occurred in 4 Ch and 5 NCh patients. Two Ch patients had skin and myocardial Chagas' reactivation successfully treated, without CNS involvement. NPS performance and return to work rates were similar in both groups. Conclusions - Although Ch patients are potentially at a higher risk of Trypanosoma cruzi reactivation, in addition to all known neurologic complications of OHT, early neurologic complications detected in this sample were similar in Ch and NCh patients and could not be specifically related to Chagas' disease.     

Risk-Taking among Adolescents Who Say They Can Get a Handgun

In a survey of 5657 community-residing adolescents, those who said they could get a handgun in two days reported similar and those who said they could not get a handgun reported fewer risk behaviors and less violence perpetration and victimization than adolescents who have their own handgun. Adolescents who said they could get a handgun reported more exposure to and experience with firearms than those who said they could not get a handgun. Risk reduction efforts regarding adolescents should be expanded to include adolescents who say they can get a handgun.     

Failure of oral implants: aetiology, symptoms and influencing factors

The use of oral implants opened a wide range of prosthetic treatment possibilities in edentulous patients. Although the reported success rates of oral implants are high, failures do occur. This paper reviews the current knowledge about the aetiology, the signs and symptoms and the possible influencing factors of implant failure. Possible causes of implant failure are thought to be infection of the periimplant tissues, occlusal overload, or a combination of both. Nevertheless, pinpointing one of these as the aetiological factor in a particular case is difficult and should be handled reluctantly. Although the cause might seem obvious, influencing factors could play a role as well. Gaining insight into these processes might stimulate the adoption of preventive action and therefore increase the predictability of the treatment outcome with oral implants. Received: 4 April 1997 / Accepted: 27 November 1997