Relation of uric acid levels to aortic root dilatation in hypertensive patients with and without metabolic syndrome

Objective:Uric acid(UA) is considered to be a powerful predictor of cardiovascular risk and hyperuricemia might be involved in the metabolic syndrome(MS).This study aims to investigate the relation between UA levels and aortic root dilatation.Methods:A total of 348 hypertensive patients [age(67.5±9.8) years] with or without MS were included in the study.The aortic root diameters at the aortic annulus,the sinuses of Valsalva,the sinotubular junction,and the proximal part of the ascending aorta were measured using a two-dimensional(2D) echocardiography.Serum UA levels were also measured for all patients.Results:A high UA level is independently associated with aortic root diameters at the sinuses of Valsalva(P=0.001) and the proximal ascending aorta(P0.0001) in the hypertensive patients without MS.In contrast,aortic root diameters were not significantly related to UA levels in the hypertensive patients with MS.Furthermore,increased UA levels were associated with an increased risk for aortic root dilatation in the patients without MS(sex-adjusted hazard ratio 1.75,95% confidence intervals(CI) 1.27-2.41),but not in those with MS.Conclusions:This study demonstrated an independent relationship between the aortic root dimensions and increased levels of serum UA in the hypertensive patients without MS.Further understanding of the mechanisms underlying these associations may allow a clearer interpretation of the potential value of specific urate-lowering treatment on cardiovascular disease.     

经导管主动脉瓣置入术在中国人群二叶式主动脉瓣重度狭窄中的安全性和有效性评估(英文)

目的:评估经导管主动脉瓣置入术在中国人群二叶式主动脉瓣重度狭窄中的安全性和有效性。创新点:首次在中国人群比较经导管主动脉瓣置入术在二叶式和三叶式主动脉瓣重度狭窄中的安全性和有效性。方法:选取2013年3月至2014年9月行经导管主动脉瓣置入术的40位主动脉瓣狭窄的患者,分二叶式和三叶式主动脉瓣两组,比较基线水平、手术以及随访1月结果的差别。结论:经导管主动脉瓣置入术在中国人群中二叶式主动脉瓣重度狭窄中的应用是安全有效的。     

彩超与TCD联合检查头臂型大动脉炎的价值

目的：探讨经颅多普勒与彩色多普勒超声联合检查头臂型大动脉炎的价值。方法：应用彩超和TCD检查7例头臂型大动脉炎患者的颅内和颅外动脉．分析二维及血流动力学指标。结果：头臂型大动脉炎病变多位于颅外动脉起始段或近心端（84％）；颅外段动脉狭窄程度与颅内动脉流速呈大致负相关；结论：彩超与TCD联合检查头臂型大动脉炎，对于了解动脉炎所致血管狭窄的分布情况及分析颅外动脉狭窄或闭塞对颅内循环的影响具有重要诊断价值。     

Assessment of internal mammary artery injury after blunt chest trauma: a literature review

The occurrence, bleeding, and treatment of internal mammary artery (IMA) injury after blunt chest trauma have not been well described in the literature. We reviewed articles published from July 1977 to February 2014 describing IMA injury after blunt chest trauma in 49 patients. There was a predominant incidence in males and on the left side. Blunt trauma to the IMA can cause anterior mediastinal hematoma, hemothorax, pseudoaneurysm, arteriovenous fistula, and extra-pleural hematoma. Of the 49 patients studied, 20 underwent embolization, 22 underwent surgical operation, 4 were managed by clinical observation, and 3 had undescribed treatment. Different parts and extents of IMA injury, adjacent vein injury, as well as the integrity of the pleura determined differences in bleeding modality. Prompt diagnosis, complete hemostasis, aggressive resuscitation, and multidisciplinary teams are recommended for patients with IMA injury.     

矿物质代谢紊乱与钙化性主动脉瓣疾病的发生和严重性相关（英文）

目的:探讨在肾功能正常或轻度受损(肾小球滤过率≥60 ml/(min·1.73 m2))人群中矿物质代谢紊乱与钙化性主动脉瓣疾病的发生和严重性是否相关。创新点:以具有代表性和临床价值的肾功能正常或轻度受损人群为研究对象,首次尝试通过骨转换生物标志物检测探讨钙化性主动脉瓣疾病的可能机制。方法:入选260例经超声心动图诊断钙化性主动脉瓣疾病患者(164例钙化性主动脉瓣硬化,96例钙化性主动脉瓣狭窄)和164例年龄及性别匹配对照组人群,检测矿物质代谢和骨转换生化标志物,应用多因素回归分析矿物质代谢与钙化性主动脉瓣疾病的发生和严重性的关系,并初步探讨可能机制。结果显示,从对照组到钙化性主动脉瓣硬化至狭窄患者,血钙、血磷、碱性磷酸酶和甲状旁腺素(i PTH)水平进行性升高,25羟-维生素D(25-OHD)水平进行性降低,各组间差异具有统计学显著性(P<0.001);同样,骨转换生化标志物骨钙素(BGP)、I型前胶原N端前肽(PINP)和β-胶原特殊序列(β-CTx)水平进行性升高,各组间差异具有统计学显著性(P<0.001)。在钙化性主动脉瓣狭窄患者中,i PTH水平与跨瓣峰值流速和平均跨瓣压差显著正相关,25-OHD则显著负相关。经校正相关因素后,多因素回归分析显示,血钙、血磷、碱性磷酸酶和i PTH水平升高及25-OHD水平下降和钙化性主动脉瓣疾病的发生和严重性密切相关。结论:矿物质代谢紊乱与钙化性主动脉瓣疾病的发生和严重性密切相关,异常骨转换可能是其发生机制。     

Successful tubes treatment of esophageal fistula

Aim: To discuss the merits of "tubes treatment" for esophageal fistula (EF). Methods: A 66-year-old female who suffered from a bronchoesophageal and esophagothoratic fistula underwent a successful "three tubes treatment" (close chest drainage, negative pressure suction at the leak, and nasojejunal feeding tube), combination of antibiotics, antacid drugs and nu-tritional support. Another 55-year-old male patient developed an esophagopleural fistula (EPF) after esophageal carcinoma operation. He too was treated conservatively with the three tubes strategy as mentioned above towards a favorable outcome. Results: The two patients recovered with the tubes treatment, felt well and became able to eat and drink, presenting no complaint. Con-clusion: Tubes treatment is an effective basic way for EF. It may be an alternative treatment option.     

Asian achievement,brain size,and evolution: Comments on A. H. Yee

Asian achievement is now recognized to be global in manifestation. Yet most explanations of group differences remain narrowly focused on one country (the U.S.A.), on one character (test scores), and from one viewpoint (environmentalism). I offer an evolutionary perspective. Genetic distance estimates indicate an African origin for humans about 200,000 years ago, a dispersal event out of Africa about 110,000 years ago, and a Mongoloid-Caucasoid split about 41,000 years ago. This racial succession is matched by cranial capacities, IQ test scores, speeds of decision time, and numerous other life-history variables including rate of physical maturation, family functioning, testosterone level, law-abidingess, and frequency of dizygotic twinning. Evolutionary selection pressures are more cognitively demanding in the cold arctic where mongoloids evolved than in the hot savanna where Africans evolved. Genetic theories are needed to explain the proportionate group differences.     

维持性血液透析患者动静脉内瘘闭塞原因分析及防治对策

目的探讨维持性血液透析患者动静脉内瘘闭塞的原因及其预防护理措施,有效地延长内瘘使用寿命。方法回顾性分析我院22例自体动静脉内瘘闭塞患者的临床资料,分析内瘘闭塞的主要原因,并采取了相应的护理措施。结果采取护理措施后,22例患者中3例内瘘再通畅,血流量≥200mL/min,重新造瘘10例,进行内瘘修补术5例,改为永久性颈内静脉置管4例。结论合理使用和保护内瘘,在血液透析患者中起着重要的作用。     

炎黄年代及“三皇五帝”历史研究的新进展

最近几年,以炎黄历史和年代研究为核心的＂三皇五帝＂传说历史研究发生了根本性转折。2003年以前,认为炎黄距今四五千年、考古学的＂龙山时代＂相当于古史传说的＂五帝时代＂一直是学界主流认识,而主张炎黄距今六七千年、其历史和文化在考古学的＂仰韶时代＂仅是极少数学者的认识。2003年王先胜在网络发表《＂中国古代文明探源工程＂细思量》后开始发生根本性转折,现在＂炎黄距今四五千年＂已经式微,而＂炎黄距今六七千年＂已成为学界主流观点和认识。关于中国史前史的轮廓与框架,目前可以通过《中国史前史（＂三皇五帝＂古史体系）简表》等几个简表来了解与把握。     

关于洛南猿人生活时代研究的回顾与展望

洛南猿人自1977年被发现以来,我国学术界对其生活时代的认定,存在着三种相差十分悬殊的观点,即:距今100万年以上;距今50万年左右;距今30多万年以内。本文认为这是不正常的现象,因此,呼吁学术界有关专家组成“合议庭”对此悬案进行“终审”。     

我国赫哲族、鄂伦春族研究综述

赫哲族和鄂伦春族是我国东北地区一支古老的、人口较少的民族,我国较早即对其开展了相关的研究。文章主要对我国自上世纪20年代以来的关于赫哲族、鄂伦春族的研究状况进行了简要的概述,以期为进一步对赫哲族、鄂伦春族开展有关历史、社会、经济、文化和宗教等研究提供资料。     

中俄茶文化之管窥

中国是茶文化的发祥地.与中国相比,俄罗斯人接触茶的历史虽不算太长,但茶在俄罗斯民族文化中却占有想当重要的位置.千百年来,中华民族和俄罗斯民族在饮茶的历史、饮茶习俗、茶具等方面,都形成了独具特色的茶文化.     

真诚的回报

1. Many years ago, on a storm night,an old couple went into a hotel and asked the assistant behind the counter for a room.     

中华文字——文明古国源远流长的语言符号

文字是记录语言的符号,中国是世界上最早创造和使用文字的国家。我国的象形文字比较及致少要早二千余年。殷墟甲骨文并不是最早的文字,我国文字已有八千年以上的历史。从距今七八千年的甘肃大地湾刻划符号到距今六千年前的西安半坡刻划符号,再到五六千年前的良渚文化、龙山文化等等象形文字符号……,中国文字源远流长,是世界上唯一从古至今仍在流行、通用并充满生机和活力的古老文字。中国文字是中华各民族的先民共同创造的,不应称作“汉字”。     

Celebrate Birth!—The Empowered Pregnancy That Changed My Life

Midwifery led care transforms the experience of Naima Beckles, a Black woman who gave birth for the first time over a decade ago. Here she describes how an empowered birth laid the groundwork for a career as a birth worker.     

胆道手术后胆漏32例诊治分析

为探讨胆道手术后发生胆漏的原因、处理方法及预防措施。对1989年6月至2000年6月间2367例胆道术后发生胆漏的32例临床资料作回顾性分析。保守治疗24例，再手术治疗8例。除3例因胆系肿瘤晚期出现恶液质放弃治疗主动出院外，余均痊愈出院。提示胆漏多发生于胆囊切除术及拔T管后，主要原因系肝床毛细胆管或细小副肝管损伤、局部炎症、胆道梗阻、操作失误等。胆漏发生后应根据腹膜炎轻重、胆道有无梗阻以及腹腔引流是否通畅等选择保守治疗或再手术治疗．     

牢记历史教训维护世界和平--为纪念抗日战争暨世界反法西斯战争胜利60周年而作

今年是中国人民抗日战争暨世界反法西斯战争胜利60周年,我们今天为在60年前这场战争的伟大胜利而举行各种纪念和庆祝活动,并不是要算60年前的旧帐,而是要牢记60年前的血泪教训,自救图强,和平崛起,以免60年前的历史悲剧重演。     

美国公民教育的目标、内容、途径与方法综述

美国是最早实施公民教育的国家之一。公民教育在促进美国民主制度的发展和完善方面发挥了不可忽视的作用。在概括介绍美国公民教育的目标、内容、途径和方法的发展变化的基础上，以期给我们启示。     

胆道手术后胆瘘的原因及防治

目的:探讨胆道手术后胆瘘的原因及防治措施。方法:回顾性分析我院近10年经治的胆道手术后胆瘘18例。结果:8例采用非手术疗法治愈。10例再次手术,9例治愈,另1例经再次引流治愈。结论:胆瘘的原因多为手术方法选择不当、术中操作不仔细及术后处理失当。治疗首选非手术疗法,如胆汁漏出量大及腹膜炎弥漫宜选择手术治疗。预防上应加强围手术期处理,术中仔细操作,术后常规放置腹腔引流,拔管时要轻柔并合理掌握拔管指征。     

试论古代彝族在黔西北的迁徙发展

彝族在黔西北地区有数千年延续不断的分布历史可追溯,在彝族早期的历史中,各部落氏族为寻找迁移的生存环境,不断的往返迁徙,其延续不断的分布历史证明,黔西北地区既是彝族的居住地之一,更是彝族的发祥地之一。