新媒体时代地方电视台新闻编辑应具备的素养和能力探究

在新媒体快速发展的背景下,各种全新的媒体形式不断涌现出来,这些全新的媒体形式具备较强的时代性特征,更加符合当前人们对于信息的需求方式,因此传统媒体受到了巨大的冲击,如何不断提高新闻编辑能力,适应新媒体时代的发展趋势,成为当前地方电视台发展过程中面临的主要问题。本文将对地方电视台新闻编辑应具备的素养和能力进行详细分析。

成年人先天性冠状动脉瘘:手术治疗及结果

Background: Congenital coronary artery fistulas, a subgroup of anomalies of the coronary arteries, are an extremly rare cardiac defect. Most patients are asymptomatic, and if symptoms are presented, they depend on the underlying anatomy. Knowledge of those fistulas is important for prognosis and management. Methods: Thirteen adult patients with congenital coronary fistulas(8 male, 5 female) were operated in our department during the last decade(1990-1999). Mean age was 61.5±10.8 years. Diagnosis was made by coronary angiography, and 15 congenital coronary artery fistulas were found. Results: All patients were symptomatic with clinical symptoms depending on the associated cardiac disorder. Coronary artery fistulas originated from the proximal left descending artery(n=10), left main stem(n=3), circumflex artery(n=1), right coronary artery(n=1), and drained into the main pulmonary artery(n=14) and left ventricle(n=1). Nine fistulas(60%) were interrupted on the outside of the heart, and six fistulas(40%) were closed through the opened pulmonary artery. There was no surgical death and no fistula-related complication. Conclusions: Surgical closure of congenital coronary artery fistulas in adults can be performed with a very low risk, and closure is recommended to prevent complications.

稳定型和不稳定型心绞痛患者血清白介素-18水平的比较

Recent evidence suggests that atherosclerosis is an inflammatory disorder in which cytokines appear to play an important role. Special attention centered over the possible contribution of cytokines to the destabilization of the plaque. IL-18 is a proinflammatory cytokine of the IL-1 family, recognized for its ability to promote IFN-γsecretion. It has recently been detected in human plaques and its administration was associated with increased atheros-clerosis in apolipoprotein E(apoE) mice concomitant with an increase in plaque infiltrating inflammatory cells. In our study, we investigated whether patients with established atherosclerosis, with either stable or unstable angina, possessed high levels of IL-18. Patients with stable angina(n=48) were from the outpatient clinic whereas patients with unstable angina(n=73) were recruited upon admission and prior to performance of coronary angiography. Control patients(n=19) were healthy subjects with no evidence of coronary artery disease. Serum levels of IL-18 were assayed by ELISA. Patients with stable and unstable angina exhibited higher serum levels of IL-18(77.1±7.2 and 61.5±5.1 pg/ml, respectively) in comparison to control subjects(p=0.002 and p=0.02, respectively). However, levels of IL-18 did not differ significantly between patients with stable and unstable angina. No differences were evident in the serum concentrations of IL-18 in patients with unstable angina(n=17) upon admission and 1-3 months later when the angina was already controlled. Although IL-18 serum levels appear elevated in the presence of coronary atherosclerosis, there is no evidence to associate this progression towards plaque instability.

C反应蛋白和微量蛋白尿与房颤有关

Background: Atrial fibrillation(AF) is associated with an increased risk for cardiovascular disease. It is important to detect AF at an early stage and to search for new pathophysiological pathways to intervene. We hypothesized that microalbuminuria and C-reactive protein(CRP), a marker of generalized vascular damage and inflammation, respectively, are associated with AF. Methods: Standard 12-lead electrocardiograms were recorded in 7546 subjects(mean age 49±13 years, 51%male). AF was defined according to Minnesota codes. The urinary albumin excretion rate was measured as the mean of two 24-h urine collections and microalbuminuria was defined as an albumin excretion rate between 30 and 300 mg per 24 h. High-sensitive CRP was dichotomized(low: three lowest quartiles, CRP< 2.87 mg/l vs. high: highest quartile, CRP >2.87 mg/l). Data are expressed as odds ratios(95%confidence intervals). Results: AF was present in 75(1.0%) subjects. In multivariate analysis, an age >60 years, the presence of ischemic heart disease, left ventricular hypertrophy, elevated CRP level(1.79 [1.07-2.97], p=0.03) and microalbuminuria(1.93 [1.10-3.37], p=0.02) were significantly associated with AF. Surprisingly, the combination of elevated CRP and the presence of microalbuminuria showed an even higher association with AF after adjusting for all cardiovascular risk factors(3.80 [1.89-7.63], p< 0.001). Conclusions: An elevated CRP level and microalbuminuria are associated with AF. Moreover, the combination of both indicates a fourfold higher association with the presence of AF in a population at large.

经食管心动超声引导下对持续性房颤患者进行心脏复律:使用低分子量肝素的结果

Background: Transesophageal echocardiography(TEE) gui-ded cardioversion to restoration of sinus rhythm is a therapeutic option in patients with atrial fibrillation(AF). Anticoagulation at the time of and after cardioversion is necessary to prevent formation of new thrombus during atrial stunning period. We aimed to evaluate the efficacy and safety to TEE guided cardioversion with low molecular weight heparin(LMWH)in patients with atrial fibrillation. Methods: We followed up 208 patients with persistent AF(mean age: 65.5±10.2 years) who were attempted TEE guided cardioversion. LMWH were used as an anticoagulant and warfarin therapy was continued. Results: Cardioversion were performed in 183 patients. Sinus rhythm restored in 144 patients(78.7%). Mean follow up duration was 155 days. No cardiac death occurred. In the early follow up period(within 30 day) one thromboembolic event(0.54%) occurred in a patient who was cardioverted. Two patients who had not been cardioverted because of left atrial thrombus presented embolic stroke, one in early and another in late followup period. All embolic complications occurred in patients who had been taking warfarin and whose INR level was subtherapeutic at the time of stroke. Sinus rhythm was maintained in 64%and total hemorrhagic complications occurred in 4.8%of the patients in long-term follow-up. Conclusion: TEE guided cardioversion with a short-term anticoagulation protocol using low molecular weight heparin is a safe and effective method in restoring and maintaining sinus rhythm and enables us to make earlier cardioversion in atrial fibrillation.

在电生理检查结果阴性的有症状患者中,可植入性循环事件记录仪可检测出快速心律失常

Background: Implantable loop recorders(ILR) are a valuable tool in the investigation of syncope and compare favourably with non-invasive and intracardiac electrophysiological assessment of bradycardia. They are known to detect tachyarrhythmias but have not been shown to add to the diagnostic yield of electrophysiological testing in symptomatic patients. Methods: We prospectively studied the first 41 patients(aged 48±19 years) in whom ILR were used at our institution after negative electrophysiological studies(EPS).All patients were symptomatic with palpitations(11), syncope(22)-or both(8). Nine patients had known structural heart disease(two ischaemic, four cardiomyopathy, two valvular and one congenital). Patients were assessed according to demographic factors, symptoms and investigations. Loop recordings were analysed and assessed according to conventional criteria. Results: Among 41 patients in whom electrophysiological studies had failed to demonstrate arrhythmias, six were found to have clinically significant tachyarrhythmias(four ventricular and two supraventricular). Conclusion: ILR diagnose prognostically significant tachyarrhythmias in symptomatic patients with negative electrophysiological studies.

2型糖尿病及高血压患者的循环黏附分子水平

Background: Risk factors for atherosclerosis such as hypertension, type 2 diabetes, obesity and dyslipidemia affect endothelial function and stimulate adhesion molecules expression. The aim of the study was to examine endothelial activation in type 2 diabetes and hypertension as indicated by adhesion molecule levels and further to investigate whether the coexistence of the above conditions has a different effect. Methods: Serum levels of soluble E-selectin, ICAM-1 and VCAM-1 were measured in 17 hypertensive type 2 diabetic patients(DM-HY), 32 normotensive type 2 diabetic patients(DM), 11 hypertensive nondiabetic patients(HY) and 15 healthy subjects. Results: In diabetic patients(either DM-HY or DM), soluble E-selectin levels were significantly increased compared to healthy subjects(p< 0.001). In HY patients, both sE-selectin(66.44±71.59 vs. 29.42±15.56 ng/ml, p=0.033) and sVCAM-1(1529±433.33 vs. 1027±243.56 ng/ml, p=0.03) levels were found significantly higher compared to healthy subjects(p< 0.05). The coexistence of diabetes and hypertension(DM-HY) did not have an additive effect on circulating adhesion molecules levels compared with the levels observed in either diabetes or hypertension. Systolic and diastolic blood pressure(BP) were independent factors correlated respectively with sE-selectin and sVCAM-1 levels(R=0.454, p=0.034 and R=0.578, p=0.005) in nondiabetic subjects(hypertensive and normotensive). Conclusions: Type 2 diabetes mellitus and hypertension induce endothelial activation as indicated by elevated levels of soluble adhesion molecules. This effect is not different when comorbidity is present.