FEASIBILITY OF CONDUCTING CARDIOVASCULAR OUTCOME RESEARCH IN AUSTRALIAN GENERAL PRACTICE: RESULTS FROM THE ANBP2 PILOT STUDY

1. The present study aimed to determine the feasibility of conducting a 5 year cardiovascular outcome trial of the treatment of 6000 elderly hypertensive patients in Australian general practices. 2. General practitioners (GPs) were invited to participate by mail and personal follow-up. Patient records were reviewed to identify subjects for a blood pressure (BP) screening programme. Blood pressure was measured on three occasions and eligible subjects were included if the average BP was 160 mmHg systolic or 90 mmHg diastolic if systolic BP was 140 mmHg. 3. Seven hundred and forty-one GPs were approached and 89 were enrolled in the study (12% of mail invites and 75% of those receiving a personal contact). In 16 practices where screening was completed, 82 000 records were reviewed to identify 4% patients eligible for screening. Twenty-two per cent of eligible subjects attended screening. Of 1938 subjects screened, 180 (9%) had BP 5=160/90 mmHg. Forty-seven percent of subjects (n = 916) were receiving antihypertensive therapy and 184 (20%) were withdrawn from therapy. One hundred and sixteen (63%) of these subjects had BP return to study entry levels within 6 weeks. Fifty-seven newly diagnosed and 81 previously treated subjects were randomized (7% of the screened population). 4. Based on the high participation rate of GPs, the response rate of patients to attend a BP screening programme and the 7% randomization to screening ratio for entry into the study, the ANBP2 pilot study has demonstrated that it is feasible to recruit subjects from Australian general practices to a cardiovascular outcome trial.     

Serum fructosamine in diabetic pregnancy

Serum fructosamine was measured in 275 blood donors, in 559 subjects with a normal pregnancy, in 32 gestational diabetics being treated with insulin and 69 being treated by diet only, and in 53 pregnant subjects with established diabetes. In none of the pregnant subgroups did the mean fructosamine concentration exceed that of the donor group. The concentration in normal pregnant subjects showed a modest but significant decrease with gestational age and an increase with maternal age. Hyperglycemic non-pregnant subjects (n = 24) had significantly increased serum fructosamine concentrations, and 96% of these subjects exceeded the upper 95% confidence limit for fructosamine in the donor group. A highly significant correlation was demonstrated between serum fructosamine and preprandial plasma glucose in the hyperglycemic subjects. A weak, but significant, correlation was shown for the entire population sample of antenatal patients, while this was non-significant within each of the sub-groups comprising established diabetics and gestational diabetics, respectively.     

Influence of timing in the fructosamine assay

The fructosamine assay, based on the measurement of the reducing activity in serum at alkaline pH, provides an index of protein glycation. The reducing activity is expressed in equivalents of 1-deoxy-1-morpholinofructose (DMF) by direct comparison with the activity either of this synthetic compound or with a secondary protein standard calibrated against DMF. This study reports the influence of assay timing on the apparent serum fructosamine concentration. The kinetics of alkaline reducing activity in serum differed from that in both DMF and a secondary protein standard. When compared with DMF, activity in serum increased but decreased relative to the protein standard as the pre-incubation interval of the assay was shortened. The use of secondary protein standards results in underestimation of serum fructosamine concentrations when the pre-incubation phase of the assay is shorter than that used for the calibration of the secondary standard. Ascorbate exerted an inhibitory effect in fructosamine assays with pre-incubation times exceeding 5 min. The inhibition increased with both the concentration of ascorbate and the duration of the pre-incubation.     

溴莫尼定对视网膜缺血性损伤神经保护作用的实验研究

目的：探讨溴莫尼定(brimonidine)对视网膜缺血性损伤神经的保护作用。方法：新西兰大耳白兔32只，随机分为正常对照组、生理盐水治疗组、噻吗心安(timolol)治疗组、brimonidine治疗组，每组8只。后3组为损伤治疗组，通过生理盐水前房高压灌注的方法，制成视网膜缺血动物模型，在视网膜缺血前lh其结膜囊内分剐给予生理盐水、0．5％timolol眼液或0．2％brimonidine眼液局部治疗。在灌注后7d，观察图形视网膜电图(P-ERG)b波振幅变化，并进行组织形态学观察和视网膜神经节细胞(RGC)计数分析。结果：灌注后7d，3个损伤治疗组相对b波振幅恢复率为：7％、11％和64％，RGC标准丢失率为：43％、38％和12％，brimori-die治疗组视网膜组织形态结构接近正常对照组，而生理盐水治疗组和timolol治疗组视网膜内层组织结构损伤明显。结论：Brimonidine局部治疗对缺血诱导的视网膜结构和功能的损害有明显的神经保护作用。     

Herpetic croup: two case reports and a review of the literature

Croup is an acute infectious illness usually occurring in children; it is characterized by brassy cough and stridor. The main pathogens include mainly parainfluenza and influenza viruses. Recently there have been reports of prolonged croup caused by the herpes simplex viruses. We report two cases of prolonged croup due to herpes simplex types 1 and 2. We also review and summarize the reported pediatric cases of herpetic croup.     

Ramification of the portal vein at the porta hepatis in humans

The ramification of the portal vein at the porta hepatis was studied by anatomic dissection performed in 32 formalin fixed human livers. In all the specimens there were branches which ran towards the caudate lobe, arising from the portal vein and either from the left or the right portal branches. Tri-and quadrifurcation of the portal vein was observed. In 5 cases (16%) there were branches arising from left portal branch or portal vein and directed anteriorly to the quadrate lobe or to the region of the gall-bladder sulcus. These branches ranged from 1.0 to 6.0 mm in diameter. The portal caudate branches were divided into 3 groups.Group 1: Branches to the papillary process; 1 or 2 branches in 26 cases (82%), 3 or 5 branches in 3 cases (9%) and no branches in 3 cases (9%);     

核辐射对机体的影响

机体受到一定剂量核辐射后会出现多个器官结构和功能的改变.本文综述了机体受到低剂量核辐射后出现的免疫细胞数量和功能变化,包括淋巴细胞总数和部分亚群数量、淋巴细胞转化率、血清免疫球蛋白含量以及单核细胞功能等变化.同时还综述了核辐射对内分泌及遗传的影响.