老年原发性高血压患者血压晨峰与早期肾损害的临床观察

目的:探讨老年原发性高血压患者血压晨峰与早期肾损害的关系。方法:选择我院收治的94例老年原发性高血压患者进行24小时动态血压监测,并根据监测结果,将患者分为晨峰组62例和非晨峰组32例,检测和比较两组的血肌酐和尿素氮、12小时尿微量蛋白、尿β2微球蛋白、空腹血糖、血脂等指标。结果:老年高血压患者晨峰组12小时尿微量蛋白、尿β2微球蛋白均显著高于非晨峰组(P0.05);晨峰血压与12小时尿微量白蛋白(r=0.374)、尿β2微球蛋白(r=0.456)呈显著正相关。结论:老年原发性高血压患者血压晨峰与早期肾损害有关,治疗高血压的同时重视控制晨峰血压有重要意义。     

个性化护理干预对老年原发性高血压患者清晨血压的影响

目的探讨个性化护理干预对老年原发性高血压晨峰(MBPS)现象的影响。方法将86例经24h动态血压监测确定有晨峰现象的老年原发性高血压患者随机分为干预组46例和对照组40例。干预组患者实施个性化护理(健康教育、心理护理、饮食关注、用药监测),对照组给予常规护理。结果干预组收缩压清晨峰值<35mmHg 30例(65.2%),对照组收缩压清晨峰值<35mmHg 14例(35%),两组差异有统计学意义(P<0.05)。结论个性化护理干预对降低老年原发性高血压晨峰(MBPS)现象有积极意义。     

动态心电图对无症状性心肌缺血的诊断价值

目的:研究动态心电图对无症状性心肌缺血的临床诊断价值。方法:收集我院2014年6月-2015年6月我院接受诊治的冠心病(CAD)患者120例作为研究对象,采用动态心电图仪检测记录24h心电图信息,将动态心电图检测为心肌缺血的患者分为A组(无症状心肌缺血)、B组(有症状心肌缺血),比较两组患者基本信息、心肌缺血发作阵次、ST段下降幅度、ST段下降持续时间、心肌缺血阈变异性、心率及心率失常发生率。结果:120例CAD患者中有95例患者出现心肌缺血,其中A组66例(占69.47%),B组29例(占30.53%),差异显著(P0.05)。A组ST段阵次改变明显高于B组,A组ST段下降幅度、ST段下降持续时间、心肌缺血阈变异性明显低于B组(P0.05)。A、B两组患者心肌缺血发作表现出昼夜节律,在时间段6:00-12:00最高,在时间段0:00-6:00最低(P0.05)。A组患者平均心率显著低于B组患者,心律失常发生率显著高于B组(P0.05)。结论:动态心电图能够准确的诊断出无临床症状心肌缺血,使患者得到及时的治疗,值得临床推广应用。     

老年高血压患者颈动脉内膜中膜厚度与动态血压参数的相关性

目的:探究老年高血压患者颈动脉内膜中膜厚度(IMT)与动态血压参数间的相关关系,为老年高血压患者的临床治疗提供理论基础。方法:选取2015年1月至2016年1月在我院接受治疗的老年高血压患者204例,根据超声检查结果分为A、B、C三组,每组68例。24 h无创检测患者动态血压参数,包括24h平均收缩压(24h SBP),24 h平均舒张压(24h DBP)、白天平均收缩压(d SBP)、白天平均舒张压(d DBP)、夜间平均收缩压(n SBP)、夜间平均舒张压(n DBP),24h脉压(24h PP)及白天脉压(d PP)、夜间脉压(n PP),记录冠心病的发生率、杓型与非杓型高血压比例,利用Person相关性分析IMT与冠心病发生率及动态血压参数的相关性。结果:收缩压和脉压比较差异均有统计学意义(P0.05),其中B组、C组高于A组,C组高于B组,差异具有统计学意义(P0.05)。非杓型高血压在A组占54.41%,B组占60.29%,C组占79.41%,各组间差异有统计学意义(P0.05);A组、B组、C组冠心病发病率分别为41.18%、54.41%和91.18%,组间比较差异有统计学意义(P0.05)。IMT同冠心病发生率和24h SBP、d SBP、n SBP、24h PP、d PP、n PP呈正相关(r=0.876,0.448,0.378,0.476,0.443,0.491,0.438,P0.05)。结论:老年高血压患者收缩压,脉压升高以及非杓型高血压是造成颈动脉内膜中膜厚度增加的主要原因,同时,IMT与冠心病发病率和动态血压参数间呈正相关关系。     

原发性高血压患者血压昼夜节律与靶器官损害的关系研究

目的:研究原发性高血压患者血压昼夜节律异常是否与靶器官损害存在关联。方法:将2015年2~11月份在我院治疗的94例原发性高血压病人按照血压昼夜节律是否正常分为节律正常组52例和异常组42例。比较两组患者的24h、白天、夜间的收缩压(SBP)与舒张压(DBP)及血压负荷,并且比较两组患者心脏、脑、肾损伤相关指标。结果:异常组全天24h、白天、夜间SBP及DBP,血压负荷均高于正常组,差异具有统计学意义(P0.05)。异常组患者左室重量(LVM)和左室重量指数(LVMI)、发生心肌缺血次数及持续时间、发生脑梗死几率均明显高于正常组,差异有统计学意义(P0.05)。异常组尿微量白蛋白(MAU)、尿酸(UA)水平均高于正常组,差异有统计学意义(P0.05)。结论:原发性高血压患者出现昼夜节律异常,可能对相关靶器官造成损伤。     

2 型糖尿病患者血糖波动与心律失常的相关性分析

目的:探讨2型糖尿病患者血糖波动与心律失常的相关性。方法:收集2型糖尿病住院患者410例为研究对象,连续3d对患者给予动态血糖监测,平均血糖水平(MBG)及标准差(SD)、日内平均血糖波动幅度(MAGE)以及日间血糖平均绝对差(MODD);按照患者住院期间的心电图检查分为心律失常组(n=112例)和非心律失常组(n=298例),分析两组患者血糖波动指标的差异。结果:410例住院的2型糖尿病患者中112例患者发心律失常,发生率为27.3%,心律失常中以房性早搏为主、其次为窦性心动过速。心律失常组患者收缩压(SBP),LDL-C、Hb A1c、HOMA-IR高于非心律失常组(P0.05);而MBG及SD、MAGE以及MODD亦高于非心律失常组(P0.05);Logistic回归分析提示,MAGE(OR=2.478,CI 1.632~5.145,P0.05)与心律失常的发生呈现独立相关。此外糖尿病病程、SBP、Hb A1c、HOMA-IR亦是心律失常的发生的独立危险因素(P0.05)。结论:2型糖尿病患者发生心律失常的比例较高,且与血糖波动具有一定的相关性,合理控制血糖波动水平对于降低心律失常的发生具有临床意义。     

2型糖尿病合并原发性高血压患者动态血压昼夜节律的研究

目的:探讨观察2型糖尿病(T2DM)合并原发性高血压患者动态血压昼夜节律的的变化。方法:采用动态血压监测(ABPM)仪,测定50例T2DM合并原发性高血压患者(观察组)和原发性高血压患者(对照组)的24h血压、日间血压及夜间血压,计算血压昼夜差值。结果:观察组24h血压平均值、日间血压平均值、夜间血压平均值及血压昼夜差值均显著高于对照组,相比较均有显著性差性(P0.05)。结论:T2DM合并原发性高血压时对患者的昼夜血压调节功能损害较大。改善T2DM合并原发性高血压患者体内糖代谢状况,可能有助于改善T2DM合并原发性高血压患者心血管系统血流动力学,从而减少心血管并发症。     

江苏北部某村农民高血压的危险因素及控制情况分析

目的:研究江苏北部某村农民高血压的危险因素及控制情况,为农村高血压疾病的防控提供更多的参考依据。方法:选择2018年1月~2018年12月江苏北部某村124名农民高血压患者作为观察组,124名非高血压人群作为对照组,通过应用单因素和多因素分析方法分析其高血压发病的主要危险因素,并统计其血压控制情况。结果:单因素分析结果显示超重或肥胖(OR=6.038,P<0.001)、高盐饮食(OR=6.167,P<0.001)、高油饮食(OR=9.626,P=0.002)、家族史(OR=8.008,P<0.001)、缺乏体育锻炼(OR=4.202,P<0.001)、吸烟(OR=3.067,P<0.001)等因素与该村农民高血压发生显著相关。多因素分析结果显示超重或肥胖(Exp(B)=3.931,P<0.001)、家族史(Exp(B)=6.212,P<0.001)、高盐饮食(Exp(B)=2.257,P<0.001)、缺乏体育锻炼(Exp(B)=3.393,P=0.007)、吸烟(Exp(B)=2.513,P=0.018)是该村农民高血压发生的危险因素。124例高血压患者的血压控制率为47.58%(59/124),不同性别和年龄段农民高血压患者的血压控制率比较无统计学差异(P>0.05)。结论:高血压发病是遗传因素和生活习惯共同作用的结果,超重或肥胖、高盐饮食、缺乏体育锻炼、吸烟是农村地区高血压发病的危险因素。农村高血压的控制情况一般,需引起重视。     

替米沙坦与贝那普利治疗原发性高血压的疗效分析

目的:分析替米沙坦片与贝那普利片两种药物治疗轻中度原发性高血压的降压疗效与安全性。方法:把2013年3月至9月期间在我院治疗的90例轻中度原发性高血压患者平均分为A组和B组(每组45人),在高血压知识宣教,饮食控制,运动等常规治疗的基础上,A组给予替米沙坦治疗,B组给予贝那普利治疗,对比两组患者的治疗效果及安全性。结果:两组均能有效降低血压(P0.01),A组总有效率为94.52%,B组总有效率为89.87%,二者差别无统计学意义(P0.05)。结论:替米沙坦和贝那普利治疗轻中度高血压均具有良好的降压效果和安全性,但替米沙坦的降压效果优于贝那普利,安全性更高,是一种长效、安全、有效的降压药,值得临床推广。     

比较两种测量方法获得的血压波动对老年颈动脉斑块的影响

目的:比较两种不同血压波动测定方法测定的血压波动与颈动脉斑块发生的关系。方法:以1456名患有动脉硬化老年男性患者为研究对象,监测患者24 h动态血压,根据有无颈动脉斑块将入选患者分为2组:颈动脉斑块组(n=1012)和无颈动脉斑块组(n=444),分别采用经典的标准差方法(SD法)和个体血压波动测定方法(个体法)分别测定每位患者的血压波动,回顾性分析这两种方法测定的血压波动与颈动脉斑块形成的关联性。结果:SD法测定颈动脉斑块组24 h收缩期血压波动(SBPV)、白天SBPV、夜间SBPV以及24 h舒张期血压波动(DBPV)水平均明显高于无颈动脉斑块组(P0.05);而白天和夜间DBPV差异无统计学意义。个体法测定颈动脉斑块组24 h SBPV、白天SBPV、24 h DBPV以及白天DBPV水平较无颈动脉斑块组均明显升高(P0.05);夜间SBPV和夜间DBPV差异无统计学意义(P0.05)。比较颈动脉斑块组SBPV值出现次数,SD法测定SBPV最多的是10-15 mmHg(n=541),其次是大于15 mmHg(n=399);个体法测定颈动脉斑块组SBPV值出现次数最多的是0-8 mmHg(n=490),其次是8-10 mmHg(n=350)。结论:在老年男性动脉硬化相关疾病患者中,血压波动与颈动脉斑块的形成有着密切的关系,两种方法均可测定血压波动,但以个体血压波动测定方法更加敏感。     

白蚁与动物及微生物的共生类型及其机制

综述了白蚁螱客的主要种类、共生关系及相关机制的研究进展。白蚁螱客中,已报道的动物种类达170种。在与动物的共生关系中存在偏利共生（宾主共栖和异种共栖）、互利共生和无关共生三种;在与微生物的共生关系中,存在与内生菌（原生动物、细菌、真菌和放线菌）和外生菌（蚁巢伞菌等）间的互利关系。指出了白蚁与螱客研究中存在的问题,给出了解决方案,并提出了今后可能的研究热点或方向,为白蚁的综合利用（如纤维素酶）及今后研究物种间的协同进化提供了基础资料。     

New amino-dithiaphospholanes and phosphoramidodithioites and their rhodium and iridium complexes

New sulfur derivatives of phosphoramidite ligands were synthesized and the impact of the sulfur unit on the spectroscopic properties of their rhodium and iridium complexes was investigated. The new ligands Bn₂NPSCH₂CH₂S^a(P-S^a) (Bn = benzyl, 4), Bn₂NPSCHCHS^a(CH₂)₃C^aH₂(P-S^a)(C^a-S^a) (6) and Bn₂NP(4-XC₆H₄OMe)₂ (X = S, 7a; X = O, 7b) were converted to the rhodium and iridium complexes trans-[Rh(CO)Cl(L)₂] (L = 4, 6, 7), [RhCl(COD)(L)] (L = 4, 6, 7), [IrCl(COD)(7a)] and [IrCl₂Cp∗(6)]. For comparison, some phosphoramidite complexes of these formulations also were synthesized. The new metal complexes were spectroscopically analyzed. For the carbonyl complexes, the ν_CO IR stretching frequencies were lower than for the corresponding phosphite and phosphoramidite ligands. The ¹J_PRh coupling constants for the rhodium complexes with the new ligands were also smaller than for the respective phosphoramidite and phosphite complexes. Finally, the ¹J_PSe coupling constants of the selenides of the new ligands were lower than those of the phosphoramidite ligands but higher than for PPh₃. The spectroscopic data reveal that the new thio ligands 4, 6 and 7a are more electron donating than phosphites and phosphoramidites but less electron donating than PPh₃.     

Astrocytes and Synaptosomes Transport and Metabolize Lactate and Acetate Differently

Astrocytes transport the monocarboxylate acetate, but synaptosomes do not. The reason for this is unknown, because both preparations express monocarboxylate transporters (MCT). The transport and metabolism of lactate, another monocarboxylate, was examined in these two preparations, and the results were compared to those for acetate. Lactate transport is more rapid in astrocytes than in synaptosomes, but of lower affinity (Kms of 17 and 4 mM, respectively). Lactate (0.2 mM) is metabolized to CO2 more rapidly in synaptosomes than in astrocytes (rates of 0.37 and 0.07 nmol x mg protein(-1) x min(-1), respectively). The reason for this is unclear, but cellular differences in lactate dehydrogenase isotype expression may be involved. Acetate is metabolized to CO2 more rapidly in astrocytes than in synaptosomes (rates of 0.43 and 0.02 nmol x mg protein(-1) x min(-1), respectively). This is likely due to cellular differences in the expression of monocarboxylate transporter subtypes.     

Rapporteur report: Basics and technology and metrology and standards

The first and second sessions of the Workshop focussed on the basics of ultrasound and infrasound, their applications in both industry and medicine, and metrology and protection standards for ultrasound applications.     

Relative and combined effects of ethanol and protein deficiency on strontium and barium bone content and fecal and urinary excretion

To elucidate accumulation of minerals in human iliac arteries with aging, the content of minerals was analyzed by inductively coupled plasma atomic emission spectrometry. Bilateral common, internal, and external iliac arteries of 16 men and 8 women, ranging ages from 65 to 93 yr, were examined. It was found that an extremely high accumulation of calcium and phosphorus occurred in the common iliac artery at old age, being higher than that of the internal and external iliac arteries. It should be noted that the accumulation of calcium and phosphorus is the highest in the common iliac artery among the human arteries examined to date. Regarding sexual differences, the content of calcium and phosphorus in the common and internal iliac arteries was higher in women than in men, whereas their content in the external iliac artery was lower in women than in men.     

Prostaglandin and thromboxane production by human and guinea-pig macrophages and leucocytes

The ability of partially purified human and guinea-pig haematogenous cell populations, when cultured in vitro, to metabolise arachidonic acid (AA) has been studied. Supernatants from 24 hour cell culture have been subjected to analysis for products of AA metabolism by gas chromatography with electron-capture detection.The cell types studied were human peripheral blood monocytes (both glass adherent and non-adherent), neutrophils, eosinophils and leukemic leucocytes; thoracic duct lymphocytes and lung alveolar macrophages. From the guinea-pig, induced and non-induced macrophage or neutrophil enriched peritoneal exudate populations, lymph node cells, peritoneal eosinophils and peripheral blood platelets were examined. Supernatants were assayed for the presence of PGE₂, PGD₂, PGF_2α, TXB₂ and 6-keto-PGF_1α. In all types studied PGE₂ and TXB₂ were the major products formed. The identification of PGE₂ and TXB₂ was confirmed by GC/MS with multiple ion monitoring.The results have been compared with other reports and their possible significance discussed in relation to the proposed role of prostaglandins as mediators and modulators in immunopathology.     

Chemokines and cytokines: axis and allies in asthma and allergy

Allergic asthma can be precipitated by many factors. For the atopic person, fungus, pollen, dust mites, cockroach antigens, and diesel exhaust are all agents that may trigger an allergic attack. Cytokines and chemokines are integral mediators of fungal asthma. From the earliest time points, they recruit and activate the cells required for the clearance of fungus as well as being critical factors involved in the immunopathology of this disease. In the final analysis, it is clear that these mediators can act to the benefit or the detriment of the host.     

Oxidation and nitration of ribonuclease and lysozyme by peroxynitrite and myeloperoxidase

In spite of the many studies on protein modifications by reactive species, knowledge about the products resulting from the oxidation of protein-aromatic residues, including protein-derived radicals and their stable products, remains limited. Here, we compared the oxidative modifications promoted by peroxynitrite and myeloperoxidase/hydrogen peroxide/nitrite in two model proteins, ribonuclease (6Tyr) and lysozyme (3Tyr/6Trp). The formation of protein-derived radicals and products was higher at pH 5.4 and 7.4 for myeloperoxidase and peroxynitrite, respectively. The main product was 3-nitro-Tyr for both proteins and oxidants. Lysozyme rendered similar yields of nitro-Trp, particularly when oxidized by peroxynitrite. Hydroxylated and dimerized products of Trp and Tyr were also produced, but in lower yields. Localization of the main modified residues indicates that peroxynitrite decomposes to radicals within the proteins behaving less specifically than myeloperoxidase. Nitrogen dioxide is emphasized as an important protein modifier.