Totally Occluded Coarctation of the Aorta in a Young Adult

We report the case of a 20-year-old female patient presenting with a totally occluded coarctation of the aorta. The patient was admitted for the evaluation of resistant grade III high blood pressure. The physical examination revealed a blood pressure gradient between the upper and lower limbs, absent femoral pulses, a diffuse continuous murmur over the chest, and hyperpulsatility of the carotid arteries and sternal notch. A transthoracic echocardiography outlined a narrowing in the caliber of the isthmic aorta without acceleration of flow or gradient. Thoracic CT angiography revealed a complete aortic coarctation with interruption of continuity between segment 3 and the descending aorta.

Transitioning to Automated Microbiologic Era: Blood Culture Isolates in Children and Adults in Federal Teaching Hospital in Gombe, North East Nigeria 2016-2020

Introduction: Automated blood culture systems for incubation and growth monitoring have become the standard in high-income countries (HICs), but are still relatively expensive and not universally available for implementation in most low- and middle-income countries (LMIC). We aimed to report blood culture isolates using Automated technique in children and adults admitted into the Federal Teaching Hospital Gombe from 2016 to 2020. Materials and Methods: Blood Culture Isolates in children (0 - 18 years) and adults (>19 yrs) by Bactec 9050 Automated culture system from 2016-2020 were retrieved from the medical and laboratory register. Information analyzed included, age, sex, month, and year and culture growth and reported antibiotic sensitivity. A Bactec Blood culture tests is $20 in this facility. In Nigeria, the minimum monthly wage is $70 (Official currency exchange rate is N423/US Dollar). Results: Of the 1713 blood cultures performed, children 0 - 18 years were 1322 (77.2%) and adult (19 years above) (22.8%). Overall positivity was 733 (42.2%) with males 385 (52.5%). Of the 1322 Blood cultures (BC) in children 615 (46.5%) were positive for isolates and adults 118 (30.2)%. Blood culture positivity decreased with increasing age with newborns 251 (34.5%) and adults > 65 years 18 (2.5%). Staphylococcus aureus constituted 61.3% of all isolates and was the leading isolates in all age groups;Alkaligenes (9.1%);Citrobacter 8.1%, Klebsiella 6.7%;Pseudomonas 6.1%;E. coli 2.7%;Enterococcus 2%;Proteus 1%. Of the Antimicrobial resistance priority isolates E. coli susceptibility ranged from 71% to Gentamycin and 100% to Cefixime;Klebsiella from 25% sensitivity to Amikacin to 78% each to chloramphenicol and ciprofloxacin;Salmonella was 100% sensitive to chloramphenicol, ciprofloxacin and cefuroxime. Klebsiella was 100% sensitive to Cefoxitin;Proteus sensitivity ranged from 35% to ampicillin and 100% to ciprofloxacin and cefuroxime. Staph aureus sensitivity was 35% to cefoxitin, 70% to amoxicillin/clavulanate and 70% to cefuroxime. Conclusion: Blood culture yield by Automated method was high. Staph aureus was the predominant pathogen and bacterial yield reduced with increasing age. Antibiotic sensitivity was variably reduced against gram negative bacteria.

Older Adults’ Explanatory Models of High Blood Pressure

Shared Explanatory Models (EM) of High Blood Pressure (HBP)/Hypertension (HTN) were explored using systematic data collection and analysis methods from cognitive anthropology. Older adults who were members of a Medicare HMO in Los Angeles were asked to list all the illnesses experienced by older adults that they could recall, and those listing HBP or HTN were asked to further list and discuss its symptoms, causes, treatments and prevention. Responses were tape recorded, transcribed, and analyzed to develop a systematic “sentence completion by card sort” follow-up procedure. Consensus Analysis (CA) of the systematically collected data identified shared EM for HBP/HTN. The model presented here is similar to models of HBP/HTN described by researchers working with patients from different regions and different ethnic groups, suggesting that there is a widely shared lay or popular model for this disease. Stress, lifestyle (diet, exercise, weight, and substance use), heredity and aging are thought to be the major causes of HBP/HTN. Physicians are thought to be the appropriate source of care, as HTN/HBP is serious, life threatening, and potentially disabling. The study of cultural understandings and shared EM of disease has direct relevance for clinical practice and public health education. For a disease such as HTN/HBP, knowing where and how such explanations differ systematically between patients and clinicians, and what impact this may have on patterns of adherence to prescribed treatment is a crucial area of concern.

The predictive value of childhood blood pressure values for adult elevated blood pressure

Because of the paucity of serial blood pressure data on the same individuals, little is known about the accuracy of elevated blood pressure (BP) in childhood for predicting hypertension (HBP) later in life. The availability of long-term serial BP data from the Fels Longitudinal Study (FLS) presents the opportunity to link HBP in adulthood directly to BP measured decades earlier in the same individuals as children. We analyzed serial data from 965 men and 1114 women in the FLS. We used an autoregressive-moving average (1, 1) [ARMA (1, 1)] longitudinal model to predict adult HBP from childhood values. For 15-year-old boys with SBP 15 mmHg and 30 mmHg above the average SBP of 90 mmHg, the probabilities of having HBP at age 35 are 0.18 and 0.33, respectively. The corresponding probabilities for 15-year-old girls are only 0.04 and 0.08. This striking sex difference in risk of HBP at age 35 between 15-year-old boys and girls indicates that the risk of developing HBP in women is low regardless of their childhood blood pressure at any age from 2 to 17 years. Men are about 4.25 times more likely to have HBP at age 35 than women over a range of SBP of 90 - 140 mmHg at age 15. The ARMA (1, 1) model allows the identification of boys at risk for HBP as adult men.

ABO Blood Groups and Their Relationship with Coagulation Factor VIII in Healthy Adults

Background: ABO blood group distribution defers with racial and geographic variations. They are related to diseases like cardiovascular diseases, cerebral thromboembolism. ABO blood group system may influence coagulation factor VIII which may increase the future risk of thrombosis. Aim: To assess the relation of ABO blood group with coagulation factor VIII in healthy adults. Material and Methods: A prospective type of analytical cross-sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka from July 2019 to June 2020. After obtaining ethical clearance, a total of 190 healthy adults were selected from different areas of Dhaka city based on inclusion and exclusion criteria, with ages ranging from 18 - 45 years. The subjects were interviewed and detailed history regarding personal, family, medical and drug were taken. Prior to sample collection, informed written consent was taken from the participants. Individuals of blood group A were selected as group A, blood group B as group B, blood group AB as group AB and blood group O as group O. Coagulation factor VIII was measured in the Department of Hematology and BMT Unit, Dhaka Medical College Hospital, Dhaka. Blood grouping was done in the Department of Physiology, Dhaka Medical College, Dhaka. Statistical Analysis: For statistical analysis, ONE way ANOVA followed by Bonferroni test were considered using SPSS 25.0 version. Results: In this study, blood group B was most common (33.2%). Coagulation factor VIII was significantly higher (p < 0.001) in blood group A (105.76% ± 11.82%), B (112.00% ± 15.02%), AB (109.80% ± 11.93%) than blood group O (82.00% ± 12.86%). No significant difference was observed among A, B and AB blood groups regarding coagulation factor VIII. Conclusions: It can be concluded that blood group A, B, AB individuals may have more chance of thrombosis due to significantly higher coagulation factor VIII than blood group O individuals.

iRoot BP plus对成人龋源性露髓治疗疗效及对牙髓血流的影响

目的:探讨iRoot BP plus对成人龋源性露髓治疗疗效及对牙髓血流的影响。方法:选择2020年1月—2022年1月收治的成人龋源性露髓患者126例(156颗恒牙),采用信封法将患者分为试验组(63例、79颗恒牙)和对照组(63例、77颗恒牙),试验组给予iRoot BP plus治疗,对照组给予矿物三氧化聚合体治疗,观察2组治疗效果、操作时间、牙变色等情况。采用SPSS 22.0软件包对数据进行统计学分析。结果:试验组和对照组术后3、6和12个月治疗成功率相比,差异无统计学意义(P>0.05)。试验组每颗牙操作时间为(2.53±0.41)min,显著少于对照组(P<0.05)。试验组术后12个月牙变色发生率为3.80%,显著低于对照组(P<0.05)。试验组术后12个月咬合力和咀嚼效率分别为(16.65±1.14)Ibs和(94.45±5.65)%,显著高于对照组(P<0.05)。结论:iRootBPplus在成人龋源性露髓治疗中疗效较好,具有操作便利、牙变色少、牙髓血流下降后维持平稳、炎症反应程度轻等优点。

教育机器人在空巢老年糖尿病患者延续护理中的应用

目的 探讨空巢老年糖尿病患者运用教育机器人实施延续护理的效果。方法 选取118例空巢老年糖尿病患者作为研究对象,按入院时间分为观察组和对照组各59例,对照组接受常规延续护理方案,观察组应用教育机器人进行延续护理。6个月后对两组血糖相关指标、自我管理行为得分、糖尿病特异性生存质量得分进行比较。结果 出院后6个月复查时观察组自我管理行为得分、血糖相关指标、糖尿病特异性生存质量得分显著优于对照组(均P<0.05)。结论 应用教育机器人对空巢老年糖尿病患者进行延续护理,能够提升空巢老年糖尿病患者自我管理能力,改善血糖指标,提升生活质量。

2020—2022年甘肃地区血培养临床分离菌分布及耐药性

目的 了解甘肃地区血培养临床分离菌的构成、耐药性及在不同年龄人群中分布。方法 采用WHONET 5.6软件,依据CLSI M100 2022年标准判读分析2020年1月—2022年12月甘肃地区细菌耐药监测网数据合格成员单位血培养临床分离菌的分布及耐药性。结果 3年共检测出非重复分离菌12818株,其中革兰阳性菌占40.4%,革兰阴性菌占59.6%。儿童患者、成年患者和老年患者分离菌分别占总分离菌的14.2%、51.5%和34.3%。MRSA和MRCNS分别占金黄色葡萄球菌和CNS的35.5%和71.7%,儿童患者MRSA的检出率远低于成年患者和老年患者分离株,3组患者MRSA的检出率依次为22.2%、38.1%和38.3%,均未检出万古霉素、替考拉宁和利奈唑胺耐药菌株。除万古霉素、替考拉宁和利奈唑胺外,屎肠球菌对其他受试药物的耐药率均高于粪肠球菌。肺炎链球菌中未发现青霉素G耐药菌株,对万古霉素和利奈唑胺均敏感。大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌和黏质沙雷菌对碳青霉烯类耐药率分别为0.2%~0.4%、5.2%~6.0%、7.6%~8.1%和3.2%~11.0%,成年和老年患者大肠埃希菌分离株分别对近1/2受试药物和1/3受试药物的耐药率高于儿童分离株(P<0.05),而儿童患者肺炎克雷伯菌分离株对近2/3受试药物的耐药性高于成年和老年患者分离株(P<0.05)。铜绿假单胞菌和鲍曼不动杆菌对碳青霉烯类的耐药率分别为12.2%~15.1%和68.5%~68.8%。结论 2020—2022年甘肃地区血培养临床分离菌耐药情况严重,不同年龄人群常见分离菌的分布和耐药性存在差异,尤其儿童患者与成年及老年患者部分革兰阴性杆菌分离株的检出率和耐药性差异明显。

自体血回输技术在体外循环下成人瓣膜置换术中的临床应用

目的:分析自体血回输技术在体外循环下成人瓣膜置换术中的临床应用效果。方法:调阅蚌埠医科大学第一附属医院心脏外科病例,选出在2020年3月—2023年1月进行瓣膜置换术的成年患者共104例。均采取择期体外循环下瓣膜置换术治疗,以输血方式不同分组,其中52例实施异体输血,另外52例采取自体血回输。对比两组相关指标。结果:观察组术后凝血功能较对照组高(P<0.05);观察组输血不良反应低于对照组(P<0.05);观察组术中、术后RBC、血浆用量及总用量均少于对照组,输血费用更低(P<0.05);观察组术后机械通气时间、ICU停留时间、术后住院时间均短于对照组,24 h引流量低于对照组(P<0.05)。结论:自体血回输技术能够有效维持体外循环下成人瓣膜置换术患者的凝血功能,耗时短,可避免大量输血,能够降低输血费用,促使患者术后尽早康复。

成人退变性脊柱侧凸后路手术患者隐性失血的影响因素及护理策略

目的探讨成人退变性脊柱侧凸(ADS)后路手术患者隐性失血(HBL)的影响因素及护理策略。方法选取行脊柱后路手术治疗的80例ADS患者为研究对象。回顾性收集患者人口学特征和围术期失血相关指标。采用多因素线性回归分析法分析HBL的影响因素。结果手术时间长、肌肉厚度大和接受异体输血是ADS患者HBL升高的独立危险因素(P<0.05);女性、使用自体血回输和术中使用保温毯是HBL升高的独立保护因素(P<0.05)。结论针对上述HBL升高的独立危险因素,护理人员应做好术前准备,加强术中ADS患者的体温管理,进而加快患者的康复,减少术后并发症的发生。

夏氏当归止痒方治疗血虚风燥型成人特应性皮炎的疗效观察

目的观察当归止痒方治疗成人血虚风燥型特应性皮炎的临床疗效及安全性。方法2021年7月—2022年1月该院皮肤科就诊的成人特应性皮炎患者中纳入符合血虚风燥证型患者,共76例。随机分入试验组和对照组,每组38例。对照组口服润燥止痒胶囊,试验组口服当归止痒方,两组皆外用纽强倍润型润肤露。治疗8周,对两组瘙痒面积及严重度指数(Eczema Area and Severity Index,EASI)评分、患者主观湿疹评分(Patient-Oriented Eczema Measure,POEM)评分、皮肤病患者生活质量量表(Dermatology Life Quality Index,DLQI)评分、研究者整体评估(Investigator′s Global Assessment,IGA)评分、瘙痒数值评分(Itch-Numerical Rating Scores,Itch-NRS)评分、血清总IgE、血清嗜酸性粒细胞计数(EOS)、中医症状积分及安全性指标等方面进行评价。结果(1)试验组总有效率91.89%(34/37),高于对照组61.76%(21/34)(P<0.05);试验组中医症状积分改善有效率86.49%(32/37),高于对照组47.05%(16/34)(P<0.05)。(2)试验组EASI评分(17.81±6.06)分、POEM评分(11.19±3.76)分、DLQI评分(14.16±3.03)分、IGA评分(2.24±0.68)分、Itch-NRS评分(4.73±1.37)分的下降均较对照组明显(P均<0.05)。(3)两组血清EOS水平在治疗后均有所下降(P<0.05);血清IgE水平两组均无明显干预效果。结论当归止痒方治疗成人血虚风燥型特应性皮炎的临床疗效显著优于润燥止痒胶囊,没有使用首乌的情况下也能够有效改善患者瘙痒症状,提高患者生活质量,同时能够改善患者血虚、便秘、皮肤干燥、瘙痒等中医伴随症状,且没有不良反应发生。

胫骨后肌腱解剖学研究进展

胫骨后肌腱(posterior tibial tendon,PTT)是下肢的稳定装置,对维持足弓和踝关节内后方的动态稳定起重要作用,其收缩可完成足内翻和跖屈^([1])。PTT收缩时,控制中足的跗骨,使前、中、后足相协调,前足内收,抬高内侧纵弓,保护弹簧韧带,并支持后足内翻,协助维持内侧纵弓^([2,3])。当PTT功能出现障碍(posterior tibial tendon dysfunction,PTTD),使足内侧纵弓进行性塌陷,前足外展,距下关节、中跗关节活动受限。

成人乙型肝炎疫苗接种后无应答的影响因素及与外周血滤泡T细胞的关联研究

目的分析成人乙型肝炎(乙肝)疫苗接种后无应答的影响因素,及与外周滤泡T细胞的关联。方法回顾性分析2022年1月至2022年12月至信阳市平桥区疾病预防控制中心接受乙肝疫苗接种的129例患者的临床资料,依据接种后乙型肝炎病毒表面抗体(HBsAb)水平,将接种后HBsAb≥10 mIU/mL的100例患者列为应答组,将接种后HBsAb<10 mIU/mL的29例患者列为无应答组。收集、对比两组患者的一般资料及临床资料,经统计学单因素分析、Logistic多因素回归分析归纳可导致成人乙肝疫苗接种后无应答的影响因素。比较两组患者外周血滤泡T细胞间的差异,经Spearman相关性系数检验外周血滤泡T细胞与乙肝疫苗接种后无应答的关联。结果统计学单因素分析结果显示,无应答组内男性、年龄≥60岁、体重指数(BMI)≥24 kg/m^(2)、有吸烟饮酒史、肌肉注射、按10μg 0-1-6月程序接种、有造血干细胞移植治疗史、合并人类免疫缺陷病毒(HIV)感染、Toll样受体(TLRs)高表达、外周血滤泡辅助性T细胞(Tfh)低表达、白细胞介素-12(IL-12)低表达、外周血滤泡调节性T细胞(Tfr)高表达、趋化因子受体5(CXCR5)高表达占比均高于应答组(P<0.05)。Logistic多因素回归分析结果显示,肌肉注射、按10μg 0-1-6月程序接种、Tfh低表达、IL-12低表达、Tfr高表达、CXCR5高表达为成人乙肝疫苗接种后无应答的主要影响因素。无应答组的Tfh、IL-12分别为(17.44±3.25)%、(70.33±10.21)ng/mL,均低于应答组[(19.25±3.16)%、(75.45±10.23)ng/mL];Tfr、CXCR5分别为(7.32±1.41)%、(33.49±5.18)ng/mL,均高于应答组[(6.65±1.24)%、(30.23±5.22)ng/mL],P<0.05。经Spearman相关性系数检验,Tfh、IL-12与HBsAb应答水平呈正相关,Tfr、CXCR5与HBsAb应答水平呈负相关。结论乙肝疫苗接种方式、程序不当以及个人免疫功能紊乱均是导致成人乙肝疫苗接种后无应答或应答低的重要因素。Tfh、IL-12与HBsAb应答水平呈正相关,Tfr、CXCR5与HBsAb应答水平呈负相关。

血流限制训练对老年人肌肉力量、质量和躯体能力改变影响的Meta分析

目的:通过系统评价目前应用于老年人群不同方式血流限制训练对肌肉力量、肌肉质量及躯体能力的综合影响,旨在为科学应用血流限制训练防治老年性肌减症提供理论依据。方法:计算机检索PubMed,Embase,Cochrane Library及中国知网、万方、维普和CBM数据库,搜索并收集关于血流限制训练对老年人肌肉力量、肌肉质量和躯体能力影响的随机对照试验,文献发表时间为各数据库建库至2021年8月,至少2名评价员利用Cochrane协作网推荐的偏倚评估工具对纳入的文献进行文献质量评估,采用RevMan 5.4软件对相关数据进行Meta分析。评价指标包括肌肉力量、肌肉质量和躯体能力3个连续性变量,对纳入文献中结局指标的不同测试方法进行亚组分析。结果:①共纳入16项随机对照试验,共348例受试者,文献质量分级依据Cochrane协作网偏倚风险评价工具,结果显示有11篇研究为B级,其他5篇为C级。②Meta分析结果显示:与高负荷抗阻训练相比较,低负荷血流限制训练对提高老年人的肌肉力量(SMD=-0.14,95%CI:-0.34-0.06,P=0.17)和肌肉质量(SMD=0.08,95%CI:-0.23-0.40,P=0.60)具有相同的效果;与低负荷抗阻训练相比,低负荷血流限制训练显著提高肌肉力量(SMD=0.57,95%CI:0.28-0.87,P=0.0002);与步行训练相比,血流限制-步行显著提高肌肉力量(SMD=0.62,95%CI:0.32-0.91,P<0.0001),但肌肉质量(SMD=0.28,95%CI:-0.01-0.57,P=0.06)和躯体能力(SMD=0.61,95%CI:-0.04-1.26,P=0.07)没有显著变化。③亚组分析结果显示:异质性降低,采用最大自主收缩(SMD=0.95,95%CI:0.25-1.65,P=0.008)和等速力矩(SMD=0.80,95%CI:0.16-1.45,P=0.01)测试肌肉力量时,低负荷血流限制训练明显优于低负荷抗阻训练;应用躯体功能(SMD=0.94,95%CI:0.35-1.52,P=0.002)评估躯体能力,血流限制性步行较步行训练显著提升。结论:现有的16项随机对照试验证据表明,与传统抗阻训练和步行相比,低负荷血流限制训练和血流限制性步行可增加老年人肌肉力量和肌肉质量。尽管对躯体能力的改善还需大样本量试验进一步深入研究,但低负荷血流限制训练和血流限制性步行可作为延缓老年性肌减症的有效手段。

Defining umbilical cord blood stem cells

Umbilical cord blood is the blood found in the vessels of the umbilical cord and placenta. It has been shown that this blood contains at least three populations of stem cells, each with unique features and properties. Due to the absence of standardized criteria for characterizing and naming cord blood stem cells, different terms and acronyms have been introduced to describe certain cell populations. Besides the confusion caused by the introduction of these different names, some of the terms used by different groups are inaccurate and misleading when considering the molecular and cellular properties of such cells. Hence, in this review we provide simple and direct descriptions of different populations of stem cells in umbilical cord blood in an attempt to clarify the confusion caused by the existence of multiple names given to certain cord blood stem cells. We also discuss the potential use of umbilical cord blood stem cells as a therapeutic tool for several diseases and disorders in light of ongoing clinical trials.

Study on acid-base disorders in patients with adult respiratory distress syndrome

Arterial blood gases and electrolytes were determined in 159 cases of adult respirato-ry distress syndrome(ARDS).It was found that disordered acid-base balance was a commonfinding in various kinds of ARDS.In mild ARDS,respiratory alkalosis and the combination ofrespiratory alkalosis plus metabolic alkalosis or metabolic acidosis were usually encounted,whilein moderate and severe cases of ARDS,triple acid-base disorders,respiratory acidosis,and thecombination of respiratory acidosis plus metabolic acidosis were commonly seen.Severe alkalosiswas one of the factors to result in death.

长期运动对健康老年人群血脂影响的系统评价及Meta分析

目的:评价长期运动对健康老年人群血脂的影响,探讨长期运动是否可以影响老年人群低密度脂蛋白。方法:检索Pub Med、Cochrane library、EBSCO、中国知网数据库,收集长期运动对健康老年人血脂影响的随机对照试验。应用Cochrane偏倚风险评估工具对纳入文献进行方法学质量评价,采用Stata 14.0软件进行异质性分析和潜在发表偏倚分析。结果:共纳入9篇文献,包括409名受试者,其中实验组226名,对照组183名。(1)Meta分析结果显示,与对照组相比,长期运动可以降低老年人三酰甘油(SMD=-0.67,95%CI:-1.14至-0.20,P=0.006)、总胆固醇(SMD=-0.42,95%CI:-0.82至-0.02,P=0.04),并提高高密度脂蛋白(SMD=0.71,95%CI:0.08-1.33,P=0.026),但运动干预后老年人低密度脂蛋白没有发生显著性变化(SMD=-0.17,95%CI:-0.36-0.02,P=0.085)。(2)亚组分析结果显示,每周运动时间≥150 min的运动可以有效改善血脂状况,并且总的效应量大于每周<150 min的运动。结论:长期运动可以有效改善健康老年人群三酰甘油、总胆固醇、高密度脂蛋白水平,但尚未确定对低密度脂蛋白的改善作用,这可能与多种因素相关。建议进行运动改善血脂时不应只关注于对总低密度脂蛋白的影响,还应关注于运动对不同健康状况成年或老年人的健康效益。同时为了更好地提高运动健康效应,建议老年人需要每周运动至少150 min。但是,由于纳入研究的异质性比较明显,该结论尚需要开展更多的高质量研究进行验证。

成年男性健康体检者血红蛋白水平与中性粒细胞/淋巴细胞、中性粒细胞/清蛋白及血脂的关系

目的 探讨成年男性健康体检人群血红蛋白(Hb)水平与中性粒细胞/淋巴细胞(NLR)、中性粒细胞/清蛋白(NAR)及血脂的关系。方法 选取2022年10-12月在广西医科大学第一附属医院健康体检的264例成年男性为研究对象,131例为Hb升高组(Hb>160 g/L),133例为Hb正常组(120 g/L≤Hb≤160 g/L)。对研究对象的中性粒细胞绝对值(ANC)、清蛋白(Alb)、NLR、NAR、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)水平进行检测与分析。结果 Hb升高组的ANC、Alb、NLR、NAR、TG、TC、LDL-C水平高于Hb正常组,HDL-C水平低于Hb正常组,差异均有统计学意义(P<0.05)。Hb升高组的ANC、TG、TC、LDL-C、HDL-C的异常发生率及血脂异常发生率均高于Hb正常组,差异均有统计学意义(P<0.05)。二元Logistic回归分析结果显示,TC、LDL-C水平升高和HDL-C水平下降是成年男性体检者Hb水平升高的独立危险因素(P<0.05)。结论 当成年健康男性Hb>160 g/L时,需要检查评估血脂及心脑血管状况,及早采取预防干预措施,防止心脑血管疾病的发生。

非职业性成人患者176例血铅水平及其与高血压患病的关联分析

目的调查非职业性成人血铅水平及其分布特点,分析血铅超标的影响因素和其与高血压患病情况的关系。方法采用石墨炉原子吸收光谱法检测血铅浓度,同时采用问卷调查的方式收集影响血铅水平的潜在因素和高血压的患病情况。采用秩和检验、卡方检验、Logistic回归,限制性立方样条(restrictive cubic spline,RCS)的Logistic回归模型的方法分析血铅超标的影响因素和其与高血压患病的关系。结果非职业性成人血铅含量中位数和四分位间距(M±Q)为(0.031±0.020)mg/L,血铅超标率为13.07%。单因素Logistic回归分析结果显示:非职业性成人年龄>60岁比年龄≤60岁血铅超标的概率降低88%(P<0.05);饮酒比不饮酒的血铅超标的概率增加3.014倍(P<0.05);血铅超标将导致高血压的患病率增加2.87倍(P<0.05);限制性立方样条模型结合多因素Logistic回归分析结果显示:血铅超标将会导致高血压发生的概率增加7.66倍(P<0.05),当血铅值≥0.031 mg/L,血铅常用对数值(lgpb)与高血压间存在明显的非线性剂量-反应关系(整体关联性检验χ2=10.26,P=0.001,非线性检验χ2=8.87,P=0.012),并随血铅含量的增加,高血压患病率呈明显上升趋势。结论非职业性成人血铅水平超标将增加高血压的患病率,高危人群应定期体检,加强对铅超标高危因素的认识,减少接触,减轻血铅超标的损害。

血流限制训练在老年群体中的应用进展

衰老导致的身体各方面能力下降是造成老年人慢性病和死亡的重要因素,运动训练是维持健康、延缓衰老的有效途径之一,例如有氧运动、阻力运动。在常规的训练方法中,往往需要中等至高等的运动强度才能显现效果,老年人由于身体素质下降且伴有部分基础疾病,常常无法忍受剧烈运动,轻度的运动又无法满足维持健康所需的运动强度,因此在血流限制条件下运动作为一种安全新颖的运动方法进入人们的视野。在该条件下进行运动训练,即使是低强度的运动强度也可以达到与传统中高等运动强度类似的训练效果,并且较传统训练也更安全,或许是更适合老年运动者的运动方案。本文针对目前已有的研究总结该训练方法对老年人各个方面功能和能力的影响,希望日后在临床中能够更高效地为老年群体提供帮助。