冠心病患者血压控制水平现况

目的：评估目前我国冠心病患者血压控制水平,为冠心病的二级预防及进一步治疗提供指导依据。方法：收集2011~2014年在解放军总医院及海南分院心内科住院治疗的1 230例冠心病患者,分析不同手术方式：经皮冠状动脉介入治疗（PCI）、冠状动脉旁路移植术（CABG）、二级预防用药情况（阿司匹林、氯吡格雷、硝酸酯类、曲美他嗪、尼可地尔、降压药、降糖药、降脂药）及不同生活方式（吸烟、饮酒、锻炼）下血压控制率的差异。结果：①手术方式对血压影响：CABG组男性收缩压及舒张压均低于PCI组及对照组,CABG组女性舒张压低于PCI组。②二级预防药物的使用情况：血压不达标组在曲美他嗪、利尿剂、钙拮抗剂、β受体阻滞剂、ACEI/ARB使用率上显著高于血压正常组。③生活方式情况：吸烟的冠心病患者血压达标率显著低于不吸烟的冠心病患者,是否饮酒及锻炼在血压达标率上没有表现显著差异。结论：冠心病患者血压控制仍不理想,CABG术较PCI术可能更有利于冠心病患者血压的控制,戒烟及提高冠心病二级预防药物的使用率仍是血压控制主要手段。     

Characterization of a Heterobasidion irregulare endo‐rhamnogalacturonase that mediate growth on pectin

Heterobasidion irregulare is one of five Heterobasidion annosum sensu lato (s.l.) species, which are destructive pathogens in boreal and temperate forests of the northern hemisphere that causes root and butt rot in conifer. A gene encoding endo‐rhamnogalacturonase (HIRHG), which belongs to the glycoside hydrolase family 28 (GH28), was found in a quantitative trait loci (QTL) region for virulence in Heterobasidion. In this study, we showed that HIRHG is highly upregulated during necrotrophic infection of Norway spruce compared with growth in liquid culture and that the HIRHG encoded protein is produced during fungal growth on complex carbon sources. Phylogenetic analysis of endo‐rhamnogalacturonases revealed that rhamnogalacturonase genes have been lost in most of the biotrophic and hemibiotrophic plant pathogens investigated but were common in necrotrophic pathogens and saprophytic fungi. Heterologous expression of the HIRHG gene in the hemibiotrophic fungus Magnaporthe oryzae increased its capacity to grow on pectin; however, the transformed M. oryzae isolates showed significant less infection of rice leaves compared to the wild type.     

Genetics and personal responsibility for health

Advances in genetic medicine may have implications for how we should think about personal responsibility for health, because they may show how it is possible to exert some control over risk factors that were previously thought as beyond the individual's control. Although we cannot control the genes that we are born with, we can often make decisions concerning genetic testing, disease prevention, and treatment. One might argue, therefore, that individuals should be treated as morally responsible for taking effective action in response to genetic risks factors, since genetically based health risks are similar to other health risks. While this argument makes sense as an abstract, philosophical position, it is not a useful guide to public policy. Given these concerns, there is little society can or should do to encourage individuals to address their genetic risk factors, other than praising those who make prudent choices.     

Salutogenic factors that may enhance lifelong oral health in an elderly Japanese population

Objectives: The objective of this study was to assess which factors affected the maintenance of more than 20 teeth in Japanese patients aged 80 years and older, using a life‐course perspective. Subjects and methods: The oral examination was carried out by dentists. The questionnaire asked about family background, background during various stages of growing up, tooth brushing, snacking, job history, health examination, war experience, number of children, oral health condition and dietary preferences. Some of the questions asked about conditions when they were a primary school student, 20 years old, 40 years old and 60 years old. Multivariable logistic‐regression analysis was used to adjust for sex at significant life stages. Results: The group with mothers who did not prefer sweet food had an approximately four times greater chance of having ≥20 teeth compared with the group with mothers who preferred sweet food. Those participants who did not prefer sweet food themselves were approximately three to five times more likely to be in the ≥20 tooth group compared with those who preferred sweet food at all stages of their life course. Non‐smokers and those who quit smoking were three times more likely to be in the ≥20 tooth group than those who smoked throughout the years from 20 to 60 years of age. Conclusions: Factors associated with the maintenance of a sufficient number of functioning teeth were: not having a mother with a preference for sweet food, not having a preference for sweet food themselves and not smoking over a long period.     

广东湛江鲤鱼墩遗址人骨的C、N稳定同位素分析:华南新石器时代先民生活方式初探

相对于长江流域和黄河流域而言,华南地区先民生活方式的了解一直较为缺乏。广东湛江鲤鱼墩遗址人骨的C和N稳定同位素分析,显示此遗址的先民主要以海生类资源为食,陆生资源(包括可能的块茎类原始农业和动物)只占次要地位。通过与约同时代黄河流域、长江流域先民的稳定同位素数据比较,可以看出,早在6000年前,我国先民的生活方式就已出现3大类型。     

The Look AHEAD study: a description of the lifestyle intervention and the evidence supporting it

The Look AHEAD (Action for Health in Diabetes) study is a multicenter, randomized controlled trial designed to determine whether intentional weight loss reduces cardiovascular morbidity and mortality in overweight individuals with type 2 diabetes. The study began in 2001 and is scheduled to conclude in 2012. A total of 5145 participants have been randomly assigned to a lifestyle intervention or to an enhanced usual care condition (i.e., diabetes support and education). This article describes the lifestyle intervention and the empirical evidence to support it. The two principal intervention goals are to induce a mean loss >or = 7% of initial weight and to increase participants' moderately intense physical activity to > or =175 min/wk. For the first 6 months, participants attend one individual and three group sessions per month and are encouraged to replace two meals and one snack a day with liquid shakes and meal bars. From months 7 to 12, they attend one individual and two group meetings per month and continue to replace one meal per day (which is recommended for the study's duration). Starting at month 7, more intensive behavioral interventions and weight loss medication are available from a toolbox, designed to help participants with limited weight loss. In Years 2 to 4, treatment is provided mainly on an individual basis and includes at least one on-site visit per month and a second contact by telephone, mail, or e-mail. After Year 4, participants are offered monthly individual visits. The intervention is delivered by a multidisciplinary team that includes medical staff who monitor participants at risk of hypoglycemic episodes.     

Innovative biomarkers in psychiatric disorders: a major clinical challenge in psychiatry

Introduction: Currently, the diagnosis of psychiatric illnesses is based upon DSM-5 criteria. Although endophenotype-specificity for a particular disorder is discussed, the identification of objective biomarkers is ongoing for aiding diagnosis, prognosis, or clinical response to treatment. We need to improve the understanding of the biological abnormalities in psychiatric illnesses across conventional diagnostic boundaries. The present review investigates the innovative post-genomic knowledge used for psychiatric illness diagnostics and treatment response, with a particular focus on proteomics.

Areas covered: This review underlines the contribution that psychiatric innovative biomarkers have reached in relation to diagnosis and theragnosis of psychiatric illnesses. Furthermore, it encompasses a reliable representation of their involvement in disease through proteomics, metabolomics/pharmacometabolomics and lipidomics techniques, including the possible role that gut microbiota and CYP2D6 polimorphisms may play in psychiatric illnesses.

Expert opinion: Etiologic heterogeneity, variable expressivity, and epigenetics may impact clinical manifestations, making it difficult for a single measurement to be pathognomonic for multifaceted psychiatric disorders. Academic, industry, or government’s partnerships may successfully identify and validate new biomarkers so that unfailing clinical tests can be developed. Proteomics, metabolomics, and lipidomics techniques are considered to be helpful tools beyond neuroimaging and neuropsychology for the phenotypic characterization of brain diseases.     

Red Imported Fire Ant in Australia: What if we lose the war?

In Australia, a national eradication programme for the Red Imported Fire Ant (Solenopsis invicta Buren), one of the world's most invasive species, has been in operation since 2001 when the pest was first detected in Brisbane, Queensland. Since that time, four separate incursions of this ant have been successfully eradicated from this country, but the main Brisbane population remains. Cost‐benefit analyses already conducted put the likely impact of Red Imported Fire Ant in Australia, if not eradicated, at between A$8.5 and A$45 billion. Despite this, ongoing funding for the eradication programme is not assured. A recent external review has concluded that it remains technically feasible, cost beneficial and in the national interest to eradicate. In support of previous analyses, our study highlights some of the potential impacts of Red Imported Fire Ant in Australia in more detail and provides case examples. Results show that adverse impacts are likely in most sectors of the economy, and will be felt not only by agricultural industries, but also the building and construction, tourism, electrical and communications industries. In addition to industry effects, there will also be negative impacts on public health and lifestyle, the environment and infrastructure such as main roads, airports and schools. Our estimates of potential cost impacts in the case examples where extrapolation was possible exceed A$1.65 billion/year and support previous predictions. We conclude that increased spending is justified to avert ‘invasion debt’ – the future cost of battling pests that escape today. This is a war that Australia cannot afford to lose.