249例性病患者流行病学调查分析

目的:了解和掌握新疆博尔塔拉蒙古自治州三年来性病流行特征,以便进一步采取相应预防控制措施。方法:收集博尔塔拉蒙古自治州两县一市249例性病患者报告资料,并通过卡方检验进行统计分析。结果249例性病患者中,男性占72.69%(181/249),女性占27.31%(68/249),男女之比为1∶0.38;21～40岁组发病占61.04%(152/249);职业分布中不详者占49.79%(124/249),无业者占24.49%(61/249);汉族发病121例(占48.59%),蒙古族66例(26.51%);已婚者发病占67.87%(169/249);文盲、小学和初中文化水平感染率为77.51%(193/249)。从时间分布统计分析,除了梅毒从2007年的2例上升到2009年的25例外,淋病、尖锐湿疣、非淋菌性尿道炎三年发病处于下降趋势。来自国外、内地经商的流动人口发病164例,占65.86%,本地户口发病85例(占34.14%)。性病病种的感染状况统计分析:三年尖锐湿疣占26.92%,非淋菌性尿道炎占全部病例的24.89%,淋病占总病例的23.69%,其次是梅毒病例占18.07%,生殖器疱疹只占全部病例的6.43%。结论:根据调查结果看,应进一步加强本地区道德和精神文明建设,加强对低文化流动人口的培训教育,提高公民的自我防护意识。     

Considerations in the use of psychotropic drugs in elderly mentally retarded persons

ABSTRACT. Elderly people tend to be large consumers of medication in general and psychotropic drugs in particular. Sedative/hypnotics, anxiolytics, antidepressants, and neuroleptic drugs tend to be the most commonly used psychotropic medications among elderly people who are not developmentally disabled. These drugs are probably commonly employed among elderly mentally retarded people as well; although the rank order of use probably differs. A number of physiological changes which accompany greater age are described and the impact on pharmacokinetic variables outlined. Other factors associated with aging, which influence drug actions, are also outlined. The net effect appears to be that most drugs are more potent, more toxic, or longer lasting among the elderly. Data are also presented on tardive dyskinesia insofar as aging is concerned. This is followed by overall conclusions and some suggested guidelines for the use of these drugs in older mentally retarded persons.     

Changing Trends in Acute Renal Failure in Third-world Countries -- Chandigarh Study

The pattern of acute renal failure in third-world countriesis changing albeit at a slower pace compared to that in developedcountries. Of the 1862 patients with acute renal failure requiringdialysis between 1965 and 1986 in a north Indian centre, 60,15 and 25 per cent were related to medical, obstetrical andsurgical conditiom respectively. Among the medical patients,diarrhoea1 diseases which caused 23 per cent of the total numberof cases of acute renal failure in the period 1965 to 1974 causedonly 10 per cent in 1981 to 1986. In the same period, acuterenal failure due to sepsis and drugs increased while that dueto copper sulphate poisoning and intravascular haemolysis showeda downward trend. Obstetrical acute renal failure declined from22 per cent in 1965 to 1974 to 9 per cent during the period1981 to 1986. This decline was chiefly due to a fall in casesof septic abortion, puerperal sepsis a d postpartum haemorrhage.Surgical acute renal failure increased from 11 per cent duringthe period 1965 to 1974 to 31 per cent in the 1980s, predominantlydue to an increase in patients with obstructive uropathy. Despitethese favourable trends, the pattern of acute renal failurein the third world continues to be different from that in thedeveloped countries.     

Prevalence of Fever in Patients Undergoing Left Atrial Ablation of Atrial Fibrillation Guided by Barium Esophagraphy

Background: Real-time esophageal imaging is critical in avoiding esophageal injury. However, the safety of esophageal imaging with barium has not been specifically explored.
Methods: Three hundred seventy consecutive patients underwent left atrial (LA) ablation of atrial fibrillation (AF) under conscious sedation. One hundred eighty-five patients (50%) underwent the ablation procedure with, and 185 patients (50%) underwent the procedure without administration of barium. Fever, as a surrogate for aspiration, was defined as a maximal temperature ≥100°F within the first 24 hours following the ablation procedure.
Results: Thirty of the 370 patients (8%) developed fever within 24 hours after LA ablation. The prevalence of fever was 9% (17/185) among patients who received barium and 7% (13/185) among those who did not receive barium (P = 0.6). Evaluation revealed the following causes of fever in 14 of the 30 patients (47%) with no difference in prevalence between the 2 groups: pericarditis, venous thromboembolism, hematoma, and infiltrate on chest radiography. Multivariate analysis failed to reveal any factors associated with development of fever. None of the patients experienced serious complications such as respiratory failure or atrioesophageal fistula.
Conclusions: Fever may occur in approximately 10% of patients undergoing LA ablation of AF. Administration of barium is not associated with fever or other complications such as aspiration pneumonia. Real-time imaging of the esophagus with barium administration in conjunction with conscious sedation appears to be safe.     

Hormone Sensitive Idiopathic Ventricular Tachycardia Associated With Pregnancy: Successful Induction With Progesterone and Radiofrequency Ablation

Successful Induction With Progesterone and Radiofrequency Ablation. Verapamil‐sensitive idiopathic left ventricular tachycardia in pregnancy is a rare diagnosis. We report a case of a primigravida female with new onset fascicular ventricular tachycardia that was managed with oral verapamil. Post pregnancy, the tachycardia was not inducible in the electrophysioplogy lab. Progesterone, a hormone associated with pregnant state, was used to successfully induce the tachycardia, which was ablated. This is the first reported case of an idiopathic ventricular tachycardia associated with pregnancy that could be induced later by recreating the hormonal milieu associated with pregnant state. (J Cardiovasc Electrophysiol, Vol. 22, pp. 95‐98, January 2011)     

新疆维吾尔族慢性乙型肝炎患者HBV基因型分布及其特点

目的探讨新疆维吾尔族慢性乙型肝炎患者HBV基因型分布及其特点。方法采用型特异性引物巢式PCR法对127例维吾尔族慢性乙型肝炎患者进行基因分型,并测序验证。结果基因D型占39．4%（50/127）,基因B型占22．0%（28/127）,基因C型占16．5%（21/127）,基因BD混合型占9．4%（12/127）,基因CD混合型占8．7%（11/127）,基因BCD混合型占3．9%（5/127）; HBeAg阳性与HBeAg阴性的维吾尔族慢性乙型肝炎患者基因型分布,差异无统计学意义（x^2= 6．033,P＞0．05）;不同年龄维吾尔族慢性乙型肝炎患者HBV基因型分布差异无统计学意义（x^2= 3．137,P＞0．05）;不同性别维吾尔族慢性乙型肝炎患者HBV基因型分布差异亦无统计学意义（x^2= 8．058,P＞0．05）。结论新疆维吾尔族慢性乙型肝炎患者HBV基因型以D型占优势,其次可见B、C型及BD、CD、BCD混合型。同一疾病谱的慢性HBV感染者基因型分布可能与宿主HBeAg状态、年龄、性别无明显关系。     

Radiofrequency Ablation Guided by Mechanical Termination of Idiopathic Ventricular Arrhythmias Originating in the Right Ventricular Outflow Tract

Mapping of Idiopathic Ventricular Arrhythmias. Background: Termination of ventricular tachycardia (VT) by mechanical pressure has been described for fascicular and postinfarction VT. Mechanical interruption of idiopathic ventricular arrhythmias (VT/premature ventricular complexes [PVCs]) arising in the right ventricular outflow tract (RVOT) has not been described in systematic fashion. Methods: Eighteen consecutive patients (13 females, age 49 ± 13 years, ejection fraction 0.55 ± 0.12) underwent mapping and ablation of RVOT VT or PVCs. In 7 patients, 9 distinct VTs (mean cycle length 440 ± 127 ms), and in 11 patients, 11 distinct PVCs originating in the RVOT were targeted. Mechanical termination was considered present if a reproducibly inducible VT was no longer inducible or if frequent PVCs suddenly ceased with the mapping catheter at a particular location. Endocardial activation time, electrogram characteristics, and pace‐mapping morphology were assessed at this location. Radiofrequency energy was delivered if mechanical termination was observed. Results: All targeted arrhythmias were successfully ablated. In 7 of 18 patients (39%), catheter manipulation terminated the arrhythmia with the mapping catheter located at a particular site. Local endocardial activation time was earlier at sites of mechanical termination (?31 ± 7 ms) compared with effective sites without termination (?25 ± 3 ms, P = 0.04). The 10‐ms isochronal area was smaller in patients with mechanical interruption (0.35 ± 0.2 cm²) than in patients without mechanical termination (1.33 ± 0.9 cm², P = 0.01). At all sites susceptible to mechanical trauma, the pace map displayed a match with the targeted VT/PVC. All sites where mechanical termination of VT or PVCs occurred were effective ablation sites. Conclusions: Mechanical suppression at the site of origin of idiopathic RVOT arrhythmias frequently occurs during the mapping procedure and is a reliable indicator of effective ablation sites. Mechanical termination of RVOT arrhythmias may be indicative of a more localized arrhythmogenic substrate. (J Cardiovasc Electrophysiol, Vol. 21, pp. 42–46, January 2010)