济宁地区21-三体综合征患儿致家庭负担情况调查

目的 调查济宁地区21-三体综合征患儿致家庭经济负担及精神负担情况。方法 2013年1-8月对济宁市78例21-三体综合征患儿的170名陪护人（试验组）及同期济宁市年龄与患儿相仿的、近期无任何重大疾病的100例健康儿童的190名陪护人（对照组）进行问卷调查。采用生活满意度评定量表（LSR）及生活满意度指数A（LSIA）评定两组陪护人生活满意度,采用症状自评量表（SCL-90）评定两组家庭负担情况。结果 试验组农村地区和城镇地区患儿治疗支出占家庭收入的68.56%、55.91%。试验组陪护人LSR、LSIA评分均低于对照组（P＜0.05）|试验组农村地区陪护人LSIA评分低于城镇地区,差异有统计学意义（P＜0.05）|试验组陪护人SCL-90中躯体化、人际关系、抑郁、焦虑及精神病性5个因子评分均低于对照组,差异均有统计学意义（P＜0.05）|试验组农村地区陪护人SCL-90中仅人际关系因子评分高于城镇地区,差异有统计学意义（P＜0.05）。结论 21-三体综合征患儿不仅会给家庭带来经济负担,更影响陪护人的生活质量及精神健康状况,应该引起足够的重视。     

精神发育迟滞患儿及其父母染色体脆裂性的遗传学分析

选择智力低下患儿及其父母共20个核心家庭,就4个有意义的c-fra的表达及遗传性进行了进一步的研究。结果是低叶酸培养,染色体的平均断裂频率是16.8641%,加叶酸培养,染色体的断裂频率2.9057%,4个c-fra的表达频率及表达阳性率男女有显著差别,其断裂占染色体总断裂的35.62%,未检出三射体。     

单导联心电图机学习机的研制

目的：研制一种供医疗仪器维修专业学生学习《心电图机的原理与维修》课程的辅助实验、实训仪器。方法：以经典的6511型单导联心电图机为基础进行改进，学习机电路板面积增大，元器件布局宽松合理，标注清楚，元器件的位置和连接、信号的走向、整体的布局等与原理图完全一致：采用高分辨率热点阵输出系统：配备240×128的图形液晶显示波形；用独特的高精度数字滤波器消除基线漂移；全触摸式彩色识别键盘控制。结果：记录频响可达150Hz，方便观察及波形判读，方便操作。结论：方便了学生对照原理图学习实际电路，提高了学生的学习效率，满足了《心电图机的原理与维修》这门课实验、实训的基本要求。     

Prevalence and Correlates of Ischemic ECG Findings among Adults With and Without HIV in Tanzania

Introduction:HIV confers increased risk of myocardial infarction (MI), but there has been little study of ischemic electrocardiogram (ECG) findings among people with HIV in sub-Saharan Africa.Objectives:To compare the prevalence of ischemic ECG findings among Tanzanians with and without HIV and to identify correlates of ischemic ECG changes among Tanzanians with HIV.Methods:Consecutive adults presenting for routine HIV care at a Tanzanian clinic were enrolled. Age- and sex-matched HIV-uninfected controls were enrolled from a nearby general clinic. All participants completed a standardized health questionnaire and underwent 12-lead resting ECG testing, which was adjudicated by independent physicians. Prior MI was defined as pathologic Q-waves in contiguous leads, and myocardial ischemia was defined as ST-segment depression or T-wave inversion in contiguous leads. Pearson’s chi-squared test was used to compare the prevalence of ECG findings among those with and without HIV and multivariate logistic regression was performed to identify correlates of prior MI among all participants.Results:Of 497 participants with HIV and 497 without HIV, 272 (27.8%) were males and mean (sd) age was 45.2(12.0) years. ECG findings suggestive of prior MI (11.1% vs 2.4%, OR 4.97, 95% CI: 2.71–9.89, p < 0.001), and myocardial ischemia (18.7% vs 12.1% OR 1.67, 95% CI: 1.18–2.39, p = 0.004) were significantly more common among participants with HIV. On multivariate analysis, ECG findings suggestive of prior MI among all participants were associated with HIV infection (OR 4.73, 95% CI: 2.51–9.63, p = 0.030) and self-reported family history of MI or stroke (OR 1.96, 95% CI: 1.08–3.46, p = 0.023).Conclusions:There may be a large burden of ischemic heart disease among adults with HIV in Tanzania, and ECG findings suggestive of coronary artery disease are significantly more common among Tanzanians with HIV than those without HIV.     

银川市老年人空腹血糖受损与心电图ST段压低的相关性研究

目的：研究宁夏银川市老年人空腹血糖受损与心电图ST段压低的相关性。方法对城市社区958例60岁以上老年人通过调查问卷的方式收集信息和进行临床检查,内容包括询问病史、测量身高、体质量、心电图,实验室检查内容包括空腹血糖（FPG）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL－C）、低密度脂蛋白胆固醇（ LDL－C）,对空腹血糖受损与心电图ST段压低的相关性进行分析。结果958例受检人群中,血糖正常788例,其中ST段压低40例,占5％（40／788）;空腹血糖受损者有170例,其中ST段压低者有29例,占17％（29／170）,差异有统计学意义（P＜0?05）。空腹血糖受损组血脂代谢紊乱明显,与血糖正常人群比较 TC、TG、LDL－C明显升高（P＜0?05）,HDL－C低于正常水平（P＜0?05）,肥胖（体质量指数）增高人数于正常血糖组（P＜0?05）。吸烟与空腹血糖受损差异无统计学意义。结论空腹血糖受损组心电图ST压低发生率明显高于正常血糖组,与糖代谢异常和脂代谢异常、冠状动脉粥样硬化有关。     

ECG abnormalities and stroke incidence

In this review, the authors discuss the role of ECG in prediction of stroke. ECG plays an important role in detection of several stroke risk factors/predictors including atrial fibrillation and left ventricular hypertrophy; both are components of the Framingham Stroke Risk Score. Multiple other ECG traits have also emerged as potential predictors of stroke, namely cardiac electrical/structural remodeling – Q wave, QRS/QT duration, bundle blocks, P wave duration/amplitude/dispersion, other waveform angles and slopes; higher automaticity – ectopic beats; and re-entry – atrial tachyarrhythmia; and higher vulnerability to arrhythmia – heart rate and its variability. Most of these predictors are not ready for prime time yet; however, further research focusing on their role in risk stratification and prevention of stroke may be useful. In this article, the authors discuss the prevalence, mechanisms and clinical applications of traditional and novel ECG markers in the prevention and treatment of stroke.     

子宫畸形伴处女膜闭锁和一侧肾脏缺如1例

患儿女,13岁,主因“腹痛,逐渐加重5天,排尿困难1天”急诊人院.既往史及家族史无异常,月经初潮未至.查体:腹部平软,下腹部压痛,无反跳痛及腹肌紧张;外阴阴毛女性分布,未见阴道开口,相应部位处女膜闭锁并轻度膨出,黏膜颜色正常.肛门指诊:直肠前壁扪及约10 cm×8cm质中包块,压痛明显.超声;右肾体积轻度增大(图1),形态饱满,包膜光滑,皮质回声低匀,锥体较清,肾窦呈复合回声,盏盂无异常分离;左肾区未见明显肾脏回声;子宫前位,形态、大小正常,包膜光滑,肌层回声均匀,官腔线清晰、居中,内膜无增厚;阴道明显扩张,约112 mm×73 mm×78 mm,内充满浮点状弱回声液性暗区(图2).超声提示:阴道积液(考虑处女膜闭锁可能);左肾缺如;右肾代偿性增大.于局麻下行处女膜切开引流术,排出黏稠血液约80 ml.     

环球航行不同气温对24 h动态心电图变化的影响

目的：观察海军水面舰艇编队环球航行不同气温对24h动态心电图变化的影响。方法：98名参加环球航行人员在气温〈30℃和≥30℃时的24h动态心电图监测，分析窦性心律、对早搏、ST段、QT间期离散度和心率变异性的时域、频域和非线性指标变化进行分析。结果：与气温〈30℃时比较，气温≥30℃时的平均心率加快，最高心率减慢，最低心率加快，停搏次数增多，最长停搏时间延长，早搏增多，MV5导联ST段明显压低、压低持续时间延长，QTd、QTc、QTcd明显增高，SDNN、SDANN、SDNN指数、RMSSD、NN50、PNN50、三角指数、VLF、HLF、VAI及VLI明显降低（P〈0．01）。结论：气温≥30℃时海军水面舰艇编队环球航行时，对人体有支配心脏的自主神经功能可能有影响。