目的 探究心脏康复对心脏X综合征(CSX)患者的效果研究.方法 选择12例CSX患者,心脏康复前对患者进行全面评估,给予冠心病二级预防药物,并根据患者的缺血阈或无氧阈制定个性化心脏康复方案.心脏康复治疗1疗程(25次)后,比较治疗前后焦虑、抑郁评分、生活质量、心绞痛发作频率及心脏参数变化,心脏参数包括:诱发缺血的运动强度、峰值氧耗量、氧脉搏等.结果 治疗后,患者诱发缺血的运动强度、峰值氧耗量、氧脉搏均高于治疗前,差异均有统计学意义(t分别=3.99、2.12、3.90,P均<0.05);患者的生活质量评分高于治疗前,心绞痛发作频率低于治疗前,焦虑评分低于治疗前,差异均有统计学意义(t分别=19.13、7.78、12.92,P均<0.05).治疗前后患者的抑郁评分比较,差异无统计学意义(t=0.89,P>0.05).结论 CSX患者常规治疗基础上联合以有氧运动为核心的心脏康复可明显改善患者运动耐力,降低患者心绞痛发作频率,缓解焦虑情绪,提升生活质量.

The pathogenesis of visual dysfunction in stroke remains unclear. The objective of this study was to explore retinal damage in stroke spontaneously hypertensive rats (SHR) and evaluate the role of curcumin in the retinal injury after stroke. Mature male SHR were used as the animal model for hypertension and age-matched male Wistar-Kyoto (WKY) rats as the normotensive controls. The rat model of stroke was made by bilateral vertebral artery electrocoagulation combined with transient bilateral common carotid artery ligation. The animals were randomly divided into sham group, ischemia/reperfusion group, solvent control group, and curcumin treatment group. Each group was subdivided into 2 h, 6 h, 24 h, 72 h, and 7 day after reperfusion. Blood pressure was measured in SHR and WKY rats. Eye fundus was examined in living animals, and then, tissue specimens were collected for histologic examination, terminal deoxynucleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate nick end labeling, and immunohistochemistry. Retinopathy, induced by I/R, was more serious in rats with hypertension than that in normotensive rats (retinal thickness index, p = 0.004). The number of apoptosis in retinal capillary cells and neurons reduced significantly in the curcumin-treated groups. Curcumin treatment inhibited phosphorylated c-Jun N-terminal kinase (JNK) expression in SHR after retinal I/R injury. Thus, hypertension aggravated retinal I/R injury after stroke. Curcumin, a specific inhibitor of JNK, can prevent the development of hypertensive retinopathy after I/R injury by inhibiting apoptosis in retinal capillary cells and neurons.

目的:探讨参麦注射液联合阿托伐他汀治疗急性心肌梗死临床疗效观察.方法:将符合标准的148例老年急性脑梗死患者随机分成观察组和对照组各74例,对照组给予阿托伐他汀治疗,观察组给予参麦注射液和阿托伐他汀联合治疗.观察两组患者血脂水平、血清生化指标、临床疗效以及不良反应.结果:治疗2个疗程后,观察组TC、TG、LDL-C、HDL-C及apoB水平较治疗前和对照组均显著下降(P＜0.05),而apoA与LpA水平较治疗前和对照组均显著上升(P＜0.05),观察组血清hs-CRP、ET和MMP-9水平水平较治疗前和对照组均显著下降(P＜0.05),观察组住院期间病死率、心衰发生率、休克发生率、再梗发生率显著低于对照组,而冠脉再通率显著高于对照组(P＜0.05).结论:参麦注射液联合阿托伐他汀治疗急性心肌梗死疗效肯定,值得临床推广.

WTCCC ［1］（the Wellcome Trust Case Control Consortium）等发现人类9号染色体上的9p21.3区域上的基因和冠心病发病显著相关。为探讨与中国浙江汉族人群冠心病的相关性，本文对354例冠状动脉造影检查患者进行了9p21区域多态位点rs2383207上的基因进行多态性测定，以探讨其是否与中国浙江汉族人群中的冠心病发病相关。现报告如下。

目的研究浙江温州地区汉族人群中染色体9p21上的rs1333049位点上的单核苷酸多态性（single nucleotide polymorphism ，SNP）与冠心病的相关性。方法对冠心病组（至少1支主要冠状动脉内径狭窄≥50.00％）181例和对照组173例，采用聚合酶链反应和基因测序方法，检测染色体9p21上rs1333049位点基因多态性。结果3种基因型均可在rs1333049位点上检测到，并且其基因型的分布亦符合Hardy Weinberg平衡定律。冠心病组rs13330149位点的CC、CG基因型分布及C等位基因频率均高于对照组，差异有统计学意义（均 P＜0.01）。结论 rs1333049位点G/C基因的多态性与冠心病发病相关，其中的C等位基因亦可能是浙江温州地区汉族人群冠心病患者的易感性标志之一。

OBJECTIVES:Apolipoprotein C3 (ApoC3) polymorphisms have been suggested to be associated with risk of coronary heart disease (CHD). However, the results of relevant studies were inconsistent. We aimed to systematically evaluate this issue. DESIGN:PubMed, EMBASE and Cochrane library databases (up to March 2013) were systematically searched to identify studies evaluating the association between ApoC3 polymorphisms and CHD risk. Two reviewers independently identified studies, extracted and analysed the data. Either a fixed-effects or a random-effects model was adopted to estimate overall ORs. STUDIES REVIEWED:Finally, 20 studies comprising 15 591 participants were included in this systematic review. Fifteen studies with 11 539 individuals were included in the meta-analysis of Sst I polymorphism, four studies comprising 3378 individuals assessed T-455C polymorphism, four studies with 3070 participants evaluated C-482T polymorphism and C1100T polymorphism was assessed by three studies comprising 4662 participants. RESULTS:Under dominant model, Sst I polymorphism was borderline significantly associated with CHD risk (S1S2+S2S2 vs S1S1, pooled OR=1.19, 95% CI 1.00 to 1.42). Subgroup analyses suggested that Sst I polymorphism was significantly associated with myocardial infarction (MI) risk (pooled OR=1.42, 95% CI 1.06 to 1.91), and Sst I polymorphism was statistically associated with CHD risk among Asian population (pooled OR=1.35, 95% CI 1.08 to 1.69) and in retrospective studies (pooled OR=1.30, 95% CI 1.04 to 1.61). A significant association was observed between T-455C polymorphism and CHD risk (TC+CC vs TT, pooled OR=1.22, 95% CI 1.06 to 1.42). A borderline significant association was suggested between T-455C polymorphism and MI risk (pooled OR=1.21, 95% CI 1.00 to 1.46). C-482T and C1100T polymorphisms were not indicated to be associated with CHD risk or MI risk. CONCLUSIONS:ApoC3 Sst I and T-455C polymorphisms might be associated with CHD risk.

Objective: To identify the difference of left ventricular and interventricular synchronicity found on echocardiogram between patients with ischemic cardiomyopathy (ICM) accompanied with complete left bundle branch block (CLBBB) and those with isolated left bundle branch block.Methods: Thirty-two patients with ICM accompanied with CLBBB (the study group) and 30 patients with isolated left bundle branch block (the control group) were enrolled. The standard deviation of systolic peak time (Ts-SD) in 12 segments along the long axis of left ventricular motion, including the left ventricular septal, the lateral wall, the anterior wall, the inferior wall, the posterior wall of basal segment and the middle segment were evaluated by quantitative tissue velocity imaging (QTVI). The septal-to-posterior wall motion delay (SPWMD) in parasternal long axis was as-sessed by M-mode echocardiogram. The interventricular mechanical delay (IVMD) of left and right ventricle was measured by pulse Doppler.Results: Compared with the control group, Ts-SD, SPWMD and IVMD in the study group were increased signiifcantly (P<0.001). The results of linear correlation analysis indicated that the left ven-tricular and interventricular synchronicity was positively correlated with the size of ventricle, the width of QRS wave and N terminal pro brain natriuretic peptide (NT-proBNP).Conclusion: Patients with ICM accompanied with CLBBB have obvious left ventricular and interventricular dyssynchrony. Echocardiogram is valuable in the assessment of ventricular dyssynchrony.

Objective To observe the curative effect of realgar on cervical HPV DNA and CIN I.Methods All cases had been treated with realgar(1g) on the surface of cervix in every three days once time and in a menstruation period.Three courses were given during the treatment period.26 women with positive infection with HPV and CIN I were treated with realgar.3 days after the fifth menstruation,TCT,HPV-DNA,colposcopy,cervical biopsy and the variety of liver and kidney function all were reexamined.Results After treatment,the number of the patient in treatment group with normal TCT report increased significantly compared with that in the control group(P<0.05);The HPV-DNA negative rate of post-treatment(53.39%) increased significantly compared with the control group(P<0.05);the mean viral load quantity of HPV(74.71±22.01)reduced obviously as compared with the control group(161.32±96.10)(P<0.05);the number of the patient with smooth cervix increased significantly compared with that in the control group(P<0.05);In the pathology report,the reversal rate of CIN I(50.0%) in treatment group was decreased also compared with that of centroled group(12.0%) and there was obviously significant difference between the two group(P<0.05).Conclusion Realgar can cure the cervical erosion,reduce the viral load of HPV,enhance the HPV-DNA negative rate and reverse the pathology changes of CIN I.This method shows safe and efficient without any side-effect with short-term application.

目的了解社区居民慢性病的患病情况及对健康的影响,为慢性病的有效防治提供依据。方法慢性病资料来自该社区所在疾病控制中心(CDC)的健康档案;死亡资料由疾病控制中心根据该社区居民死亡医学证明书核实后,按ICD-10分类获得。结果社区居民慢性疾病患病率为29.31%。慢性病患病率有随年龄增长而增高的趋势;骨骼与关节疾病患病率女性高于男性,消化道疾病患病率男性高于女性,差异有统计学意义(P<0.05),其他疾病患病率的差异均无统计学意义(P>0.05)。死因顺位与全国顺位基本一致。结论慢性病是社区居民主要健康危害因素,必须加强健康教育,加大防治力度,保障和提高居民健康水平。

Marx,in his book On Capital,did a scientific research on the dual ownership theory under the economic system in new society.Actually,the economic system created by Chinese peasants happened to have the same view as Marx's dual ownership theory.But Traditional Economics did not make a profound study on dual ownership theory stated in On Capital,which caused some imperfections of socialist ownership system and problems in socialist countries.So the study of On Capital should be deepened.

OBJECTIVE To reduce the incidence of nosocomial infections in patients with refractory heart failure and to improve the survival quality.METHODS The clinical data during Jan 2005-Jan 2010 of 88 cases with refractory heart failure and 732 cases with general heart failure were analyzed retrospectively,the incidence of hospital infection statistics,site of infection and pathogenic bacteria test results were stated.RESULTS The hospital infection occurrence rate and multi-site infection occurrence rate in patients with refractory heart failure was higher than patients with general heart failure.Respiratory tract infection(59.6%) was the commonest.Logistic regression analysis suggested that the hospital infection was related to age,hospital stay,combined with diabetes,chronic obstructive pulmonary disease and renal dysfunction.CONCLUSION We should strengthen the surveillance to hospital infection in patients with refractory heart failure.According to the risk factors,early diagnosis and treatment must be regarded.

Objective:To investigate the use of different doses of simvastatin treatment of cerebral infarction clinical effect. Method:120 patients with cerebral infarction were randomly divided into 2 groups were given different doses of simvastatin treatment, the clinical results were retrospectively analyzed.Results:2 patients neurological deficit scores after treatment than before treatment were improved,the observation group than the control group(P<0.05).Basic clinical observation group cured 23 cases,38.3%;effective in 20 cases,33.3%;10 cases,accounting for 16.7%;ineffective in 5 cases,8.3%,worse in 2 cases,3.3%,total effective rate was 88.3%.In control group cured 19 cases,31.7%,effective in 16 cases,accounting for 26.7%,effective in 11 cases,accounting for 18.3%,9 cases,15%; deterioration in 5 cases,8.3%,total effective rate was 76.7%,the observation group than the control group(P<0.05).Concluslon:High doses of simvastatin effect is more significant,and has a certain security,clinical statins in patients with contraindications,may increase the dosage to improve clinical efficacy.

Objective: To observe the apoptosis of retinal capillary cells in spontaneously hypertensive rats and study the relationship between apoptosis and hypertensive retinopathy,in order to provide morphological evidence of hypertensive retinopathy.Methods: Experiments were performed on retinas from 13-week-old,18-week-old male SHR (n =10) as experimental group(SHR13 W,SHR18 W) and sex-and age-matched Wistar-Kyoto rats (WKY)(n =10) as control group.Specimens were obtained using terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) methods to detect the apoptosis of retinal capillary cells,using hematoxylin and eosin (HE) staining to observe the changes of retinal microvascular in morphology and determinate the retinal capillary area density.Results: ① Apoptotic cells labelled by TUNEL were emerged in SHR groups,including 13-week-old and 18-week-old.Apoptotic cells in 18-week-old SHR were significantly more than in 13-week-old SHR.No cell apoptosis was noted in each of WKY group.② The level of apoptosis gradually increased as the weeks of age increasing in SHR,HE showed that some of capillary was occlusion,endothelial cells and pericytes lost,a large area of cell-free capillary was emerged.Compared with control group,the retinal capillaries area density of SHR was significantly lower than that of the WKY groups.Conclusion: Apoptssis of the endothelial cells and pericytes of the retinal capillary all can occur in the development process of hypertension,at the same time microvascular rarefaction can accompany.Apoptosis may play an important role in the development of hypertensive retinopathy.

To study on the regulation of sludge multiplication in MBR to treat anaerobically digested piggery wastewater,according to the characters of MBR,a kinetic model for prediction MLVSS in MBR was ascertained.To obtain the kinetic constants in the model,experiments were carried out.Three MBRs with same configuration were adopted during experiments.A MBR consists of intermittent aeration zone and membrane separation zone.The total volume of 120 L.Nine tests were arranged at different HRTs(15,20,and 24 h) and SRTs(70,30 and 50 d) respectively.The influent and effluent COD were 12401830 mg/L and 208811 mg/L respectively in experiments.The kinetic constants were calculated using the data from experiments.A kinetic model was satisfactorily employed to predict MLVSS in reactors during experiments.

目的 探讨姜黄素对大鼠视网膜缺血再灌注后细胞凋亡及凋亡相关基因p53 表达的影响.方法 作大鼠视网膜缺血再灌注模型,并随机分为假手术组(SH组)、缺血再灌注组(IR组)、姜黄素处理组(CU组)和对照组(SC组),分别于再灌注后2、6、24、72h和7d时观察大鼠视网膜和视网膜毛细血管细胞的凋亡情况,并检测视网膜Caspase-3 酶的表达活性及p53基因的表达情况. 结果 各组模型均制作成功,细胞组织学检查可见CU组损伤明显轻于其他组.CU组视网膜和视网膜毛细血管的细胞凋亡数量均显著多于SH组(均P<0.01),但显著少于IR组(P<0.01);CU组p53表达水平及Caspase-3 酶活性均显著强于SH组(均P<0.01),但显著弱于IR组(P<0.01).结论 姜黄素对大鼠视网膜缺血再灌注损伤具有保护作用,调控凋亡相关基因p53 蛋白的表达可能是其作用机制之一.

<正>天塔五号由郓城县种子公司从天津市种子公司引进,2007年通过审定,株型紧凑,全株叶片数20～21片,幼苗叶鞘紫色,花丝粉红色,花药黄色。区域试验结果:生育期102d,株高244cm,穗位97cm;果穗筒形,穗长17cm,穗粗5.2cm,穗行数平均16.0行,穗粒数

Objective To investigate the effect of apoptosis-related gene p53 on the apoptosis of retinal capillary cells in rats with spontaneously hypertensive (SHR) after ischemic reperfusion injury. Methods A total of 60 SHR rats were randomly divided into sham group (SHR-SH) and retinal ischemie reperfusion group (SHR-RIR), which were subdivided into 5 subgroups according to the time after RIR: 2, 6, 24, and 72 hours and 7 days, with 6 rats in each subgroup. Another 60 Wistar-Kyoto (WKY) rats were divided into the same groups as the SHR rats as the control. The RIR model was set up. The apoptosis of retinal capillary cells was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) methods and the expression of p53 was determined by streptavidin-perosidase (SP) immunohistochemistry. Results The apoptosis rate of retinal capillary cells in the 5 SHR-RIR groups was (8.64±0.56)%, (14.92±0.99)%, (24.72±2.98)%, (16.53±1.80)%, and (7.12±1.10)%,respectively. The expression of p53 in SHR-RIR groups increased at the 2nd hour after RIR, reached the peak at the 24th hour, kept the high level at the 72nd hour, and remained a little at the 7th day, which was significantly different from which in the SHR-SH groups (P<0. 01). The expression of p53 were higher in SHR-IR groups than that in the WKY-RIR groups (P<0. 01). Conclusions p53 may play a part in RIR injury by inducing or promoting apoptosis. The apoptosis of retinal capillary cells after RIR is more severe under the hypertension, and reaches the peak at the 24 hour after RIR.

Background and Objective Sustained hypertension induces retinal blood vessels injury associated with endothelial cells disfunction and apoptosis.Angiotensin Ⅱ receptor has been reported to induce apoptosis of endothelial cells.However,there is scant data regarding whether losartan improves the microcirculation such as retinal vascular morphology and function in retinopathy and the effect on retinal microvascular apoptosis is not unknown.This study was aimed to determine the effects of losartan on apoptosis in retinal capillary in spontaneously hypertensive rats(SHR).Methods Sex and age matched SHR were randomized to receive following approaches: losartan treatment(30 mg/kg·d by gavage,n=10) or placebo(n=10),Wistar-Kyoto rats(WKY)(n=10) as control groups.Systolic blood pressures were measured by a tail-cuff method before and every four weeks during experiment.Retina was study histologically by using hematoxylin and eosin(HE) staining and transmission electronic microscope.Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL) methods were used for assessment of cell apoptosis Bax and bcl-2 by immunochemistry.Results A large area of cell-free capillary was occurred in SHR.The chromatin of nuclei labeled by the TUNEL method was distributed unequally,displaying apoptosis characteristics.Losartan significantly decreased SBP in SHR(P0.01).Losartan significantly decreased the apoptosis index in retina(SHR: 28.9%±7.2% vs SHR-Los: 7.3%±5.5% vs WKY: 2.4%±1.9%,P0.01).Transmission electron microscopy showed early sign of apoptosis in SHR,while losartan alleviate the abnormal alteration.Conclusion Our data showed losartan prevent the cell apoptosis of retinal capillary in the development of hypertensive retinopathy.

Objective To investigate the effects of primary percutaneous coronary intervention(PCI), delayed PCI and drug treatment on heart rate turbulence after acute myocardial infarction (AMI). Methods 102 patients with AMI were divided into primary PCI group (n=40), delayed PCI group (n=40) and drug group (n=40). Turbulence onset (TO), turbulence slope (TS), standard deviation of normal to normal intervals (SDNN) of time-domain heart rate variability and left ventricular ejection fraction (LVEF) were analyzed 1 to 3 weeks after AMI. Results TO was significantly lower in primary PCI group(-2.32%±3.17%) than delayed PCI group(-1.47%±1.29%) and drug group(0.17%±2.68%). TS was significantly higher in primary PCI group(10.36±7.16 ms / R-R) than latter two groups(8.87±3.54ms / R-R and 4.87±2.91 ms / R-R)(all P0.01). TO was significantly lower and TS significantly higher in delayed PCI group than drug group (P0.05). SDNN(120.26±30.21ms) and LVEF (63.21%±10.62%) were significantly higher in primary PCI group than delayed PCI (90.26±35.68ms,58.42%±14.13%) and drug groups (80.38±25.37ms,52.62%±12.45%)(all P0.05). Conclusion Primary and delayed PCI are superior to drug treatment in improving heart rate turbulence after AMI.