无糖尿病史心肌梗死患者血糖应激性升高对心肌功能及预后的影响

目的分析无糖尿病史心肌梗死患者血糖应激性升高对心肌功能及预后的影响,为心肌梗死的临床诊治和改善预后提供参考依据。方法以某医院2013年2月-2015年5月收治的120例无糖尿病史心肌梗死患者为对象,根据急诊血糖检查结果将患者分为血糖升高组(78例,随机血糖≥11.1 mmol/L)和血糖正常组(42例,随机血糖11.1mmol/L),比较2组患者肌钙蛋白Ⅰ(c TnⅠ)、肌酸激酶同工酶峰值(CK峰值)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室舒张末期容积(LVEDV)及不良心血管事件发生率。结果血糖升高组LVEF、c TnⅠ、CK峰值分别为(55.5±6.8)%、(3.78±0.51)μg/L、(185.0±14.7)U/L,血糖正常组分别为(68.5±5.9)%、(0.73±0.15)μg/L、(113.2±85.3)U/L,2组比较差异有统计学意义(P0.01)。血糖升高组严重心律失常、心功能不全、心源性猝死发生率分别为25.6%、44.9%、14.1%,显著高于正常组(分别为9.5%、23.8%、2.4%),差异有统计学意义(P0.05)。结论无糖尿病史心肌梗死患者血糖应激性升高对其心肌功能造成不良影响,增加不良心血管事件发生几率,预后较差。     

Real-world cost-effectiveness of drug-eluting stents vs. bare-metal stents for coronary heart disease—A five-year follow-up study

Objective

To evaluate the cost-effectiveness of using drugeluting stents (DES) compared to bare-metal stents (BMS) for coronary heart disease (CHD).

噻托溴铵粉吸入剂治疗148例支气管扩张症的效果评定

目的观察噻托溴铵粉吸入剂应用于临床治疗支气管扩张症的效果。方法选取我院治疗的148例支气管扩张症患者,随机分为观察组和对比组,对比组给予常规的支气管扩张症治疗;观察组在进行常规治疗的同时给予噻托溴铵粉吸入剂进行治疗。结果治疗后观察组和对比组的BODE指数和临床症状均有改善,但观察组优于对比组,P0.05,差异具有统计学意义。结论使用噻托溴铵粉吸入剂治疗支气管扩张症疗效显著。     

Prevalence of heterophoria in a population of school children in central China:the Anyang Childhood Eye Study

AIM:To investigate the prevalence of heterophoria and the relationship between heterophoria and refractive error in a school-based study conducted in central China.METHODS:A total of 23637 th-grade children were recruited into the cross-sectional school-based Anyang Childhood Eye Study(ACES)by cluster sampling method.Heterophoria was examined using alternate cover and cover-uncover testing.The Maddox rod and prism test were conducted at 33 cm and 6 m distance fixation.Uncorrected viual acuity(UCVA)and best-corrected viual acuity(BCVA)were recorded as logarithm of the minimum angle of resolution(logM AR)with cycloplegic autorefraction by administrating of Mydrin-P and 1.0%cyclopentolate.Hyperopia was defined as the spherical equivalent(SE)refraction of+0.50 D or greater,and higher hyperopia was defined as+2.00 D or greater.Emmetropia was defined as the SE refraction in the range of-0.49 to+0.49 D,and myopia was in the SE refraction range from-0.50 D to less.RESULTS:Totally 2260 students in grade 7 were examined.Response rate among eligible children was 95.64%.Totally 486 children,22.66%of the population,were diagnosed with heterophoria in which 479 were diagnosed with exophoria at near distance,and 6 with esophoria.Totally 89(4.15%)children were diagnosed with heterophoria in which 82 had exophoria,and 7 had esophoria at far distance.Exophoria was common at near fixation(22.33%).Myopia was examined to be related to exophoria at near distance(OR 3.03,95%CI 2.33-3.95)and far distance fixation(OR 1.90,95%CI 1.09-3.32).CONCLUSION:Exophoria is a predominant heterophoria for 7 th-grade junior school in central China.Significant associations are discovered between heterophoria and refractive error.Hyperopia is associated with esophoria,and myopia is associated with exophoria.     

短暂性全面遗忘相关危险因素的临床研究

目的探讨短暂性全面遗忘(transient global amnesia,TGA)患者脑血管危险因素、临床特点、影像学特征、预后及与短暂性脑缺血发作(TIA)的相关性。方法回顾性分析大连医科大学附属第一医院神经内科收治的TGA患者61例为TGA组和TIA患者61例为TIA组,对比2组脑血管危险因素、临床特点及影像学特征,TGA组随访6个月。结果与TIA组比较,TGA组高血压、糖尿病、冠心病、吸烟、血脂异常、高同型半胱氨酸血症及TG水平明显降低(P<0.05,P<0.01),症状持续时间明显延长[300.0(150.0,480.0)min vs 20.0(5.0,60.0)min,P=0.000]。TGA组6个月内无缺血性脑卒中发生,TGA组复发患者9例(14.75%),复发患者与未复发患者年龄、性别、高血压、糖尿病、冠心病、血脂异常、高同型半胱氨酸血症及同型半胱氨酸水平等脑血管危险因素比较,无统计学差异(P>0.05)。TGA组发作前有潜在诱发因素或事件15例(24.59%)。TGA组颈动脉、颅内动脉粥样硬化发生率明显低于TIA组(9.84%vs 80.33%,P<0.01;32.79%vs 59.02%,P<0.05)。结论 TGA与脑血管危险因素不相关,其发病与病前应激因素及潜在诱发因素或事件相关。TGA是一个良性病程,预后较好,可能不是TIA的一种特殊亚型。     

An assessment of weight change associated with the initiation of a protease or integrase strand transfer inhibitor in patients with human immunodeficiency virus

Abstract

Objective

Evidence suggests that integrase strand transfer inhibitors (INSTIs) are associated with greater weight gain than other antiretrovirals. This real-world study compares weight/body mass index (BMI) change between insured US patients with human immunodeficiency virus (HIV-1) initiating a protease inhibitor (PI) or INSTI.