心理社会因素,行为形式与高血压的研究

本文用流行病学回顾性调查法探讨了心理社会因素，行为形式与原发性高血压的关系，１３８例患者的调查资料表明：家族史，劳动强度，人际关系，左心功能，皮肤由阻潜伏期和体重指数等因素在高血压组和对照组之间有明显的差异。在高血压患者中具有Ａ型性格者占１６．８％，而对照组占１０％，Ｂ型性格则有相反的趋势，相关分析表明：家族史，劳动强度，人际关系，左心功能，皮肤电阻潜伏期，体重指数，住房条件，神经质性格与高血压呈     

经皮肺动脉去交感神经冷冻消融术治疗犬肺动脉高压疗效评价

摘要:目的 通过野百合碱诱导的犬肺动脉高压模型,观察肺动脉去交感神经冷冻消融术后 6 个月的肺动脉平均压力( mPAP) 、肺毛细血管楔压( PCWP)及内皮素受体-1( ET-1)变化,评估冷冻消融去比格犬肺动脉交感神经的安全性和有效性。 方法 将 15 只比格犬随机分为 A 组(冷冻消融组) 、B 组(假手术组) 及 C 组( 对照组) ,对比观察比格犬手术前后 mPAP、PCWP 及 ET-1 水平变化。 结果 A、B 和 C 各组术后 6 个月,mPAP、PCWP 和 ET-1 值均低于术前水平,差异有统计学意义( P<0. 05) 。 结论 犬肺动脉高压经皮肺动脉去交感神经冷冻消融术安全且有效,术后表现出延续性降肺动脉压力效果。     

高血压病患者血浆中分子物质含量及其临床意义

本文对42例高血压病患者进行血浆中分子物质(Middle Molecular Substance,MMS)含量观察,发现本组高血压病Ⅰ、Ⅱ、Ⅲ期中的MMS平均值分别为251.6、281.5及334.8u/dl,均明显高于健康人正常值的220±17u/dl,且各期之间也有明显差异,同时也发现本组高血压病的MMS含量随着病情的加重程度呈正相关,即分期越高,其含量也越高,与文献报道一致。     

Plasma adenosine concentrations are elevated in Dahl salt-sensitive rats

We measured plasma levels of adenosine in Dahl salt-sensitive rats (DS) and Dahl salt-resistant rats (DR) to examine the potential role of adenosine in cardiovascular regulation in this type of hypertension. Plasma adenosine concentrations were significantly higher in DS than in DR. The NaCl content in the diet did not affect plasma adenosine concentration in either DS or DR. Significant positive correlation was found between adenosine concentrations and systolic blood pressure when the data for DS and DR were analyzed together. These results suggest that adenosine may play an important role in the pathophysiology of hypertension in DS.     

Study of Treating HAPE with HBO in Situ at the Altitude of 4636 m

Study Objective ： To evaluate the treatment effect of HAPE with HBO in situ at an extreme altitude of 4636 m. To investigate the relationship between pulmonary hypertension （PH） and HAPE. To emphasize the importance of the treatment in situ. Methods： The 32 patients from the plateau of 4636 - 5130 m （the barometric pressure： 57.41 - 53.28 kPa/431.6 - 400.6 mmHg（1 mmHg = 133.3224 Pa）, the partial pressure of oxygen： 12.0 - 11.6 kPa/90.0 - 87.0 mmHg） were treated in situ of 4636 m altitude with HBO. Before and after the treatment, the clinical symptoms / signs, radiographic evidence, SaO2, and MPAP were compared. Results： The clinical symptoms/signs, and all the targets of the patients were improved dramatically （p 〈 0.001）. Conclusions： Treating HAPE with HBO is the most effective method among various therapies in situ at an extreme altitude. The pulmonary -artery pressure was significantly decreased. All eases showed improved immediately. Among the subjects, 11 eases （34.3 %） were cured at once. The therapy made it possible for patients to get further treatment at a lower altitude area with prospective good results. We suggested that treating HAPE with HBO should be the first choice in situ. There must be PH in the patients of HAPE, but the reverse is not the true. The PH is a mechanism of normal compensation of the body exposing in the hypoxie environment. It is very necessary for us to explore the threshold of PH when a HAPE happens.     

西藏地区首例妊高征并发HELLP综合征的诊治体会

HELLP综合征是妊高征的一种特殊形式或并发症，国内仅见个案报道，临床表现极不典型，可严重危害母儿生命，及时诊断处理能取得较好预后，应引起广大临床工作者的重视，以免延误诊治。     

肝硬化门脉血流的彩色多普勒检测

应用彩色多普勒对肝硬化门脉高压患者进行门脉血流动力学检测，结果表明治疗前门脉血流量增加，治疗１个月后重复检测门脉血流量明显下降，前后测值比较差异极显著（Ｐ〈０．００１）。彩色多普勒检测门脉血流动力学变化简单易行、无创，值得临床推广。     

原发性肝癌的腹腔镜分型(60例报告)(英文)

原发性肝癌的发病率在亚非洲远高于欧美,同样反映于国内外腹腔镜文献中,对其腹腔镜检查的介绍皆少而简略。本文就武汉市四个医院内科自1960年12月至6月经腹腔镜检查而最后确诊为原发性肝癌者60例进行了分析。按照腹腔镜下所观察到的肝脏形态试分作6型,大块型9例,多结节型21例,单结节型5例,(氵弥)漫小结节型(或肝硬化型)16例,非结节型(或肝炎型)3例,大网膜包果型6例。与经典的病理学分型相比较,这一分型对诊断、鉴别、处理与预后似有一定价值。有癌肿的肝叶与未发现癌肿的肝叶在同时并存的病理改变有显著较大且有不一致,对于原发性肝癌以肝硬变或病毒性肝炎作为前驱病的学说提出了疑问,本组病例未能说明日本位血吸虫病为原发性肝癌的病因。认为原发性肝癌患者肝脏的结节及肝炎等改变可能为癌肿的后果而不一定为原因。腹腔镜检查对于原发性肝癌的价值在于诊断符合率高,免除许多病例不必要的剖腹;直视下肝穿刺阳性率高,对于手术可能性的决定似有相当价值,比剖腹探查经济,住院日短而较安全。     

Maternal influences on cardiovascular pathophysiology

Elevated blood pressure (BP) is of special clinical significance because of its association with pathophysiologies such as heart disease, renal failure, and stroke. We described the development of a protocol for use with hypertensive rats in which prepubertal exposure to a high salt (8% NaCl) diet results in a pathophysiological syndrome including rapid increase in BP, failure to maintain normal weight gain, renal damage, cerebrovascular lesions, and early mortality. These phenomena are described for the inbred spontaneously hypertensive rat (SHR), and for reciprocal F₁ hybrids of a cross between SHR and the Dahl salt-sensitive (SS/Jr) inbred strain. The study with reciprocal F₁s revealed striking effects of maternal environment on pathophysiological response to a high salt diet. F₁s nurtured by SHR mothers weighed less at 35 days of age, and after exposure to the high salt diet suffered more rapid BP increases, greater incidence of stroke, body weight loss, and mortality, than F₁s nurtured by SS/Jr dams. These results suggest that maternal mediation of the nutritional status of the animal may play an important role in determining susceptibility to elevated BP and subsequent pathophysiology associated with exposure to a high salt diet. The implication of these findings for human hypertension is briefly discussed.     

社区高血压患者疲劳影响因素的通径分析

为了解社区高血压患者疲劳的影响因素,采用疲劳严重度量表、匹兹堡睡眠质量指数量表、抑郁自评量表、焦虑自评量表、家庭关怀度指数和婚姻满意度问卷调查528名社区高血压患者。45.3%高血压患者有疲劳问题。Logistic回归分析,年龄、睡眠质量、焦虑、抑郁、家庭功能和婚姻满意度与疲劳有关（OR=1.031、2.198、4.003、4.805、1.693、2.230）。通径分析,抑郁、焦虑、睡眠质量和年龄是导致疲劳的直接因素,家庭功能、婚姻满意度和家庭经济通过中间变量间接影响疲劳。结果表明,诸多因素导致高血压患者疲劳,应采取综合措施防治。