美丽李原产美国,由日本引入我国,在我国已有几十年的栽植历史,现在辽宁、河北、山东、云南、贵州等地均有分布.美丽李果皮粉红,果肉黄色,果汁丰富,口感香甜,个头大,平均单果质量88克,最大果质量达160克(图1),极丰产.该品种成熟早,在河北衡水地区6月中旬即可上市,相比于其他李品种甜度高,果肉细软,在市场上广受欢迎.

夏季衡水地区桑葚采收完成,经过一段时间的生长发育,果桑慢慢进入休眠阶段,在这一时期做好果桑管理,对来年提高桑葚产量及质量具有重要意义.

李树是重要的经济林木,在我国种植范围较广,适应性强.李园病虫害的发生常使叶片发黄早落,影响果实品质,降低产量,导致树势衰弱,减少李树盛果年限,有时几种病虫害同时发生,若不能及时防控,将对果农造成较大经济损失.

Background Dipeptidyl peptidase-4 inhibitors (DPP-4i) decrease glucose levels by regulating incretin peptides in type 2 diabetes mellitus (T2DM). This study aimed to determine the modulatory effect of DPP-4i on brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) in patients with T2DM. Methods PubMed, Embase and the Cochrane Library were systematically searched to identify randomized controlled trials (RCTs) evaluating the impact of DPP-4i on BNP or NT-pro-BNP. A fixed- or random-effects model was used for quantitative analysis, according to the heterogeneity. Sensitivity analysis and publication bias were performed using standard methods. Results Nine trials with 3056 patients with T2DM were included. Meta-analysis revealed that DPP-4i did not significantly modulate the BNP (0.21 pg/mL, 95% CI − 2.36–2.79) or NT-pro-BNP level (− 7.34 pg/mL, 95% CI − 24.27–9.59). DPP-4i demonstrated no stronger effect on modulating BNP (5.17 pg/mL, 95% CI − 7.48–17.82) or NT-pro-BNP (− 9.95 pg/mL, 95% CI − 44.61–24.71) than active comparators. Pooled analysis was robust and stable after sensitivity analysis. Conclusions DPP-4i exhibits no significant effect on modulating BNP or NT-pro-BNP and shows no stronger effect than traditional antidiabetic agents in T2DM.

目的 分析老年患者血浆氧化三甲胺(TMAO)水平与颈动脉斑块负荷的关系.方法 入选2013年1月～2016年12月首都医科大学附属北京天坛医院就诊的可疑心脑血管疾病的老年患者79例,根据颈动脉斑块是否形成富脂质坏死脂核(LRNC)分为无LRNC组23例和LRNC组56例.应用高效液相色谱法测血浆TMAO水平,进行MRI检查,计算颈动脉斑块的LRNC大小和总管壁体积(TWV),用多因素logistic回归分析和相关性分析.结果 与无LRNC组比较,LRNC组血浆TMAO水平明显升高[(7.00±6.29)μmol/L vs(3.29±1.99)μmol/L,P<0.05].多因素logistic回归分析校正性别、年龄、体质量指数和高脂血症以及合并疾病等因素后,血浆TMAO水平依然是LRNC形成的危险因素(P<0.05).所有患者血浆TMAO水平与颈动脉斑块的TWV呈正相关(r=0.295,P<0.05);LRNC组患者血浆TMAO水平与LRNC大小呈正相关(r=0.576,P<0.01).结论 老年患者血浆TMAO水平与颈动脉斑块的LRNC形成及大小密切相关,且与TWV也密切相关.

石榴在我国有较长种植历史,但多为零星种植,相比苹果、梨等大宗水果,规模化种植较少.随着人们生活水平提高,对各种小众果品需求量越来越大,石榴种植产业迅速发展,成为林果农增收的重要经济树种.石榴繁殖能力强,实生繁殖和无性繁殖均能成活,生产中为了保持品种优良特性、满足苗木大量供应的需求,常采用硬枝扦插法繁育,笔者总结了石榴硬枝扦插育苗经验,供林果农借鉴参考.

Objectives To investigate the relationship between small reductions in estimated glomerular filtration rate (eGFR) and cardiac structure and function in patients with essential hypertension. Methods The study group included 565 patients with essential hypertensive. eGFR was calculated by EPI equation and cardiac structure and function were assessed using echocardiography. The participants were divided into three groups: eGFR ≥90 mL/min /1.73 m2, 60-89 mL/min/1.73 m2, and 30-59 mL/min /1.73 m2. Pearson correlation analysis and multiple stepwise linear regression analysis were performed to evaluate associations between eGFR and echocardiogram parameters. Results Compared with patients with eGFR ≥ 90 mL/min/ 1.73 m2, those with eGFR 60-89 mL/min/ 1.73 m2 and 30-59 mL/min/ 1.73 m2 had higher left ventricular end-diastolic diameter (LVEDD) (p=0.019), mitral valve E wave (p=0.004), left atrial diameter (LAD) (p=0.001), right atrial diameter (RAD) (p=0.001), right ventricular diameter (RVD) (p=0.001) and lower left ventricular ejection fraction (LVEF) (p=0.01). After further adjustment for traditional cardiovascular risk factors including systolic and diastolic blood pressure, BMI, diabetes, dyslipidemia and smoking, eGFR was still associated with LVEF (p＜0.001), LAD (p＜0.001) and RAD (p=0.003). Conclusion Among patients with essential hypertension, even mildly reduced renal function is independently associated with greater cardiac remodeling, indicated by left atrial and right atrial enlargement, and worse left ventricular systolic function.

试验以白蜡2 a生试验林中长势一致,无病虫害的8个优良无性系当年生枝条为试验材料,利用电导法(EL)及电阻抗图谱法(EIS)结合Logistic方程,拟合出8个白蜡优良无性系的半致死温度,并对其进行相关性分析.结果 表明,随着温度的降低,8个白蜡无性系的相对电导率均成上升趋势,由相对电导率拟合出的8个白蜡无性系的半致死温度由高到低依次为衡蜡2号、衡蜡9号、衡蜡7号、衡蜡11号、衡蜡3号、衡蜡6号、衡蜡4号、衡蜡1号;由3个电阻抗参数拟合出的8个白蜡无性系的半致死温度由高到低依次为衡蜡2号、衡蜡9号、衡蜡7号、衡蜡11号、衡蜡3号、衡蜡6号、衡蜡4号、衡蜡1号.与电导法(EL)得到的顺序相同,弛豫时间分布系数(ψ)与相对电导率、胞外电阻率(re)及胞内电阻率(ri)均成极显著相关,相关系数分别为0.931、0.930、0.970.弛豫时间分布系数(ψ)可作为测定白蜡抗寒性的最佳参数.

目的 探讨血浆中氧化三甲胺(TMAO)水平与体质量指数(BMI)的相关性.方法 选取2014年1月 ～2016年12月北京天坛医院心内科可疑冠心病(CHD)患者86例.利用稳定同位素液相色谱/质谱法测定患者血浆TMAO水平,并计算患者的BMI,根据BMI将患者分为体重正常组、超重组和肥胖组.双变量Correlate分析血浆TMAO水平与BMI的相关性,并比较不同BMI组间血浆TMAO水平的差异.结果 血浆TMAO水平和机体BMI具有显著的相关性(r=0.404,P<0.001);与BMI正常组相比,超重组、肥胖组(7.47±6.23)μmol/L vs.(3.28±2.44)μmol/L,(10.64±6.96)μmol/L vs.(3.28±2.44)μmol/L具有较高的血浆TMAO水平,差异有统计学意义(P<0.05).结论 血浆TMAO的水平与机体BMI之间具有显著的正相关关系.

Background Atherosclerosis is one of the leading contributors to cardiovascular diseases. Subclinical atherosclerosis could occur long time before the presence of clinical symptoms and may have predictive value for future cardiovascular events. Existing carotid subclinical atherosclerotic markers have limited value. Subjects and Methods Patients admitted to the cardiac vascular center of Beijing Tiantan Hospital due to essential hypertension were prospectively consecutively enrolled. Those with histories of coronary artery disease (CAD), cerebrovascular diseases, and significant stenosis of main arteries were excluded. Patients diagnosed with carotid and/or subclavian artery stenosis were also excluded after admission. All participants received a series of routine blood test at admission into hospital and ultrasonic examinations of bilateral carotid arteries and right subclavian artery. All data were recorded. After discharged from hospital all participants were followed up with cardiovascular events, including death, hear failure, myocardial infarction, unstable angina pectoris and stroke. Results 473 participants were finally involved in the study, including 284 men and 189 women.9/473 (8.2%, 95%C.I. [5.9-11.1%] participants suffered from endpoint events, including 19(4.0%) cases of myocardial infarction (15 undergoing PCI and 5 death), 4(0.8%) heart failure (all also involved in the myocardial infarction group), 3(0.6%) ischemic stroke (1 death), and 17(3.6%) angina pectoris (7 undergoing PCI). No death due to other reasons was recorded. After the adjustment of potential risk factors based on the results of univariate analyses, the prevalence of right subclavian plaque (RSP) (OR=2.428, 95%C.I. [1.098, 5.370], p=0.028) and both carotid and subclavian plaques (MPs) (OR = 3.539, 95%C.I. [1.547, 8.096], p = 0.003) were both significantly associated with endpoint events. Globulin and albumin had significantly correlations with future events despite the atherosclerotic marker used in the regression model. Conclusion The prevalence of right subclavian plaques was independently significantly associated with the incidence of future cardiovascular events in the cohort. Higher level of globulin and lower level of albumin tended to be predictors for future events. Combination of both right subclavian artery and carotid artery atherosclerotic plaques may have strongest predictive value for future cardiovascular events in the hypertensive cohort without clinical atherosclerotic diseases.

目的 探索血浆中氧化三甲胺(trimethylamine N-oxide,TMAO)及其前体物质的浓度与冠状动脉粥样硬化性心脏病(以下简称冠心病)(coronary heart disease,CHD)的关系.方法 选取首都医科大学附属北京天坛医院心内科可疑CHD患者88例,根据冠状动脉造影结果将患者分为CHD组和对照组.利用高效液相法测患者血浆TMAO及其前体物质胆碱、肉碱、三甲胺乙内酯和三甲氨基丁内盐的浓度,分析两组患者血浆TMAO浓度及其前体物质与CHD的关系.结果 CHD组患者血浆TMAO浓度明显升高,差异有统计学意义[(6.20±3.57)μmol/L vs(3.90±2.26)μmol/L,P<0.05];两组血浆中胆碱、肉碱、三甲胺乙内酯和三甲氨基丁内盐浓度差异均无统计学意义(P>0.05).多因素Logistic回归分析,血浆TMAO浓度与CHD有关联(OR=1.35,P<0.05),血浆TMAO浓度升高,CHD的危险性增加.结论 血浆中TMAO的浓度与CHD密切相关,而与TMAO前体物质浓度无显著相关性.

背景 急性冠脉综合征(ACS)患者纤维蛋白原升高与患者预后不良有关,但其对ACS患者冠状动脉病变严重程度的影响尚不清楚.目的 探讨纤维蛋白原与ACS患者冠状动脉病变严重程度的关系.方法 选取2019年1—5月首都医科大学附属北京天坛医院重症监护病房收治的ACS患者108例,根据SYNTAX评分分为轻度病变组(SYNTAX评分<23分,n=74)和中重度病变组(SYNTAX评分≥23分,n=34).比较两组患者一般资料〔包括性别、年龄、体质指数(BMI)、高血压发生情况、糖尿病发生情况、脑血管疾病发生情况、冠心病病史、吸烟史〕、实验室检查指标〔包括脑钠肽(BNP)、总胆固醇、粒细胞/淋巴细胞比值、平均血小板体积、纤维蛋白原、同型半胱氨酸、估算的肾小球滤过率〕;纤维蛋白原与ACS患者SYNTAX评分的相关性分析采用Pearson相关分析;ACS患者冠状动脉病变严重程度的影响因素采用多因素Logistic回归分析.结果 (1)两组患者男性比例、年龄、BNP、纤维蛋白原比较,差异有统计学意义(P<0.05);两组患者BMI、高血压发生率、糖尿病发生率、脑血管疾病发生率、有冠心病病史及吸烟史者所占比例、总胆固醇、粒细胞/淋巴细胞比值、平均血小板体积、同型半胱氨酸、估算的肾小球滤过率比较,差异无统计学意义(P>0.05).(2)Pearson相关分析结果显示,纤维蛋白原与ACS患者SYNTAX评分与呈正相关(r=0.348,P<0.05).(3)多因素Logistic回归分析结果显示,年龄〔OR=1.119,95％CI(1.021,1.226)〕、纤维蛋白原〔OR=3.458,95％CI(1.038,11.523)〕是ACS患者冠状动脉病变严重程度的影响因素(P<0.05).结论 纤维蛋白原与ACS患者冠状动脉病变程度呈正相关,是ACS患者冠状动脉病变严重程度的独立影响因素.

目的 探讨急性冠状动脉综合征(acute coronary syndrome,ACS)患者糖化血红蛋白(glycated hemoglobin,HbA1 c)水平与冠状动脉病变SYNTAX评分的相关性.方法 选取2019年1～5月在笔者医院心脏中心重症监护病房住院的ACS患者108例,采用SYNTAX评分评定冠状动脉病变程度,分为两组,即冠状动脉轻度病变组(SYNTAX评分≤22,n=74)和中重度病变组(SYNTAX评分≥23,n=34),分别检测两组患者HbA1 c水平,比较两组间HbA1 c水平及其他临床资料,分析上述指标与SYN-TAX评分的独立相关性.结果 在ACS患者中,冠状动脉中重度病变组HbA1 c水平明显高于轻度病变组(7.50％ ±2.17％vs 6.56％ ±1.34％,P=0.009),差异有统计学意义.Spearman相关分析结果 显示,HbA1 c水平与SYNTAX评分呈正相关(r=0.235,P<0.05).多因素Logistic回归分析结果 显示,HbA1 c是ACS患者冠状动脉中重度病变的独立预测因子(OR=2.004,95％CI:1.063～3.777,P<0.05).结论 HbA1 c水平与ACS患者的SYNTAX评分独立且显著相关,有助于判断冠状动脉狭窄病变的危险分层.

目的 探讨卵圆孔未闭(patent foramen ovale,PFO)相关缺血性卒中的临床和神经影像学特征,并根据不同的PFO解剖特点,确定其缺血性病变类型是否存在差异.方法 本研究为单中心回顾性研究,入选2015年5月-2019年9月在首都医科大学附属北京天坛医院心血管内科连续住院接受PFO介入封堵治疗的缺血性卒中患者.所有患者均接受颅脑MRI检查,并通过TCD确定右向左分流(right-to-left shunt,RLS)量,经食道超声检查确定PFO诊断及其解剖结构.总结PFO相关缺血性卒中的影像学特征,并根据不同的PFO解剖特点,确定其缺血性病变类型是否存在差异.结果 共入组1 08例患者,平均年龄46±11岁,其中男性78例(72.2％).PFO直径(静息状态)平均1.5±1.1 mm,雨帘状RLS 75例(69.4％),原发隔活瓣长度平均9.5±3.7 mm,长隧道型PFO 37例(34.3％),PFO伴过间隔血流76例(70.4％).PFO相关缺血性卒中患者MRI显示梗死血管累及前循环42例(38.9％)(单侧前循环29例+双侧前循环1 3例),后循环39例(36.1％),皮层梗死22例(20.4％),皮层下梗死7例(6.5％),深部梗死44例(40.7％),皮层、皮层下梗死+深部梗死35例(32.4％);单一梗死31例(28.7％),多发梗死77例(71.3％).不同的RLS量、PFO大小之间比较,脑梗死分布、梗死部位和梗死数量方面未发现影像学差异.长隧道组和非长隧道组的梗死部位(P=0.037)和梗死数量(P=0.016)差异均有统计学意义,其中长隧道组更多见皮层梗死(35.1％vs12.7％)和单一梗死(43.2％vs21.1％).有过间隔血流组和无过间隔血流组在梗死分布上差异有统计学意义(P=0.014),有过间隔血流组后循环梗死发生率更高(43.4％vs16.8％).结论 PFO相关缺血性卒中患者影像学上梗死血管累及前循环和后循环的比率相似,梗死部位以深部梗死和多发梗死为主.长隧道型PFO与非长隧道型相比,皮层梗死和单一梗死更多见.伴有过间隔血流的PFO多发生后循环梗死.

目的 探讨急性冠脉综合征(acute coronary syndrome,ACS)患者血浆B型钠尿肽(brain natriuretic peptide,BNP)与冠状动脉病变严重程度的关系.方法 回顾性分析首都医科大学附属北京天坛医院心脏重症监护病房2019年1～5月连续收治的115例ACS患者,根据冠脉造影结果,应用SYNTAX评分评定冠状动脉病变严重程度,根据SYNTAX评分将ACS患者分为两组,即冠状动脉轻度病变组(SYNTAX评分≤22)和中重度病变组(SYNTAX评分≥23),分别检测两组患者血浆BNP水平,分析其与SYNTAX评分的相关性及其对冠脉严重程度的预测作用.结果 在ACS患者中,冠状动脉中重度病变组血浆中BNP水平明显高于轻度病变组(411.13±357.40pg/ml vs 151.68±191.09pg/ml,P=0.000),血浆BNP水平与SYNTAX评分呈正相关(r=0.465,P=0.000),冠状动脉病变的严重程度随着BNP的升高而增加.进一步分析显示,两组患者之间冠状动脉血管病变支数的比例差异有统计学意义,冠状动脉中重度病变组患者三支病变的比例显著高于轻度病变组患者(P＜0.05).在多因素Logistic回归分析中显示,BNP仍然是ACS患者冠状动脉中重度病变的独立预测因子(OR=1.51,95％ CI:1.30～2.61,P=0.000).结论 在ACS患者中,血浆BNP水平与冠状动脉病变严重程度呈正相关,血浆BNP水平是冠状动脉中重度狭窄的独立预测因素.

The aim of this study was to determine whether the polymorphism of aldosterone synthase (CYP11B2) –344C/T and angiotensin-converting enzyme (ACE) insertion/deletion (I/D) were associated with the response of blood pressure (BP) to telmisartan treatment. After a two-week single-blind placebo run-in period, 148 patients with mild-to-moderate primary hypertension received monotherapy of telmisartan with 80 mg/day and then were followed up for eight weeks. Polymorphisms of CYP11B2 –344C/T and ACE I/D gene were determined through polymerase chain reaction-restriction fragment polymorphism analysis. The relationship between these polymorphisms and changes in BP was monitored and evaluated after eight weeks of treatment. With respect to the polymorphism of CYP11B2 –344C/T, the reduction in diastolic BP was significantly greater in patients carrying the C allele (CC+CT) compared with those carrying the TT genotype. There was no significant differences between ACE I/D polymorphism and BP reduction after treatment. We concluded that the aldosterone synthase –344C/T polymorphism was related to the antihypertensive treatment with telmisartan in hypertensive patients.

The aim of this study was to determine whether the polymorphism of aldosterone synthase () -344C/T and angiotensin-converting enzyme () insertion/deletion (I/D) were associated with the response of blood pressure (BP) to telmisartan treatment. After a two-week single-blind placebo run-in period, 148 patients with mild-to-moderate primary hypertension received monotherapy of telmisartan with 80 mg/day and then were followed up for eight weeks. Polymorphisms of -344C/T and I/D gene were determined through polymerase chain reaction-restriction fragment polymorphism analysis. The relationship between these polymorphisms and changes in BP was monitored and evaluated after eight weeks of treatment. With respect tothe polymorphism of -344C/T, the reduction in diastolic BP was significantly greater in patients carrying the C allele (CC+CT) compared with those carrying the TT genotype. There was no significant differences between I/D polymorphism and BP reduction after treatment. We concluded that the aldosterone synthase -344C/T polymorphism was related to the antihypertensive treatment with telmisartan in hypertensive patients.

Introduction: This study aimed to investigate whether mononucleotide polymorphisms of the angiotensinogen gene at promoter were associated with the blood-pressure-lowering response to telmisartan treatment. Materials and methods: After a two-week single-blind placebo run-in period, 148 patients with mild-to-moderate primary hypertension received monotherapy with 80 mg/day of telmisartan and then were followed up for eight weeks. The -6A/G and -20A/C polymorphisms of the angiotensinogen gene at promoter were determined through polymerase chain reaction and restriction fragment length polymorphsim analysis. The relationship between these polymorphisms and changes in blood pressure was observed and evaluated after eight weeks of treatment. Results: There were no significant differences between -6A/G, -20A/C polymorphisms of the angiotensinogen gene and blood pressure reductions after treatment, p> 0.05. Conclusion: It is suggested that angiotensinogen-6 A/G and angiotensinogen-20 A/C polymorphisms were not associated with the antihypertensive response to telmisartan treatment in Chinese patients with hypertension.

目的 观察高负荷量瑞舒伐他汀配合复方丹参滴丸对ST段抬高型心肌梗死(STEMI)经皮冠状动脉介入治疗(PCI)后心电图ST段回落不良患者血管内皮功能及预后的影响.方法 将90例STEMI经PCI后心电图ST段回落不良患者随机为观察组和对照组,每组45例.2组均接受常规治疗,对照组在常规治疗基础上给予瑞舒伐他汀20 mg/d口服,观察组在对照组基础上给予复方丹参滴丸(10丸/次,3次/d)口服,2组均治疗2周.记录2组的临床疗效,并比较2组治疗前后心肌酶谱[血浆肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、天门冬氨酸氨基转移酶(AST)]、心功能指标[左室射血分数(LVEF)、缩短分数(FS)、左室舒张末期内径(LVEDD)、E/A和血浆N端脑钠肽前体(NT-proBNP)]、血管内皮功能指标[肱血流介导的血管扩张功能(FMD)、非内皮依赖性舒张功能(NMD)及血浆内皮素(ET-1)、一氧化氮(NO)、一氧化氮合酶(NOS)]的变化及2组PCI后30 d的主要心脏不良事件(MACE)发生率.结果 观察组临床总有效率显著高于对照组(P＜0.05);2组治疗后血浆心肌酶谱各指标水平均显著降低(P均＜0.05),且观察组治疗后以上指标水平均显著低于对照组(P均＜0.05);2组治疗后LVEF、FS、E/A、FMD、NMD及血浆NO、NOS水平均较治疗前显著升高(P均＜0.05),LVEDD及血浆NT-proBNP、ET-1水平均较治疗前显著降低(P均＜0.05),观察组治疗后以上指标改善情况均显著优于对照组(P均＜0.05).2组PCI后均随访30 d,观察组MACE发生率显著低于对照组(P＜0.05).结论 高负荷量瑞舒伐他汀配合复方丹参滴丸可有效促进STEMI患者PCI后的心电图ST段回落,减轻心肌缺血损害程度和改善心功能,降低MACE发生率,其机制可能与改善血管内皮功能,从而改善心肌微循环状态有关.

1施肥时期 核桃全年大致可分为3个生长时期,即花芽分化期、果实生长期和树体恢复期.因此核桃树宜施3次肥,即2月底至3月初的促花肥、5月中下旬到6月初的果实生长肥、8月底到9月初的恢复肥.