平衡针单针疗法对抗心血管疾病的多重危险因素

心血管疾病(Cardiovascular disease,CVD)被认为是全球范围内疾病死亡的主要原因之一,心血管疾病的危险因素常常有共存的时候,如高血压常合并高血脂、高血糖等,使心血管疾病的发病率成倍提高,故有必要将血压、血糖、血脂控制在合理范围内,平衡针特色针刺疗法是防治心血管疾病的一种快速且经济的方法.文章就平衡...     

公共项目代建人激励的关键治理因子:一个实证研究

我国公共项目企业代建模式面临着自身制度效率的改善,其关键在于解决以代建人为核心的代理型治理问题,实现对代建人的有效激励。本文在公共项目治理范式下首先归纳出公共项目治理的关键治理因子集,然后通过问卷调查和结构方程模型对此进行验证,结果表明项目所有权配置、风险分担、代建人报酬、市场声誉、代建人选择、代建人项目管理绩效评价及代建人问责等治理机制共同构成了代建人激励的关键治理因子集,且它们之间存在四组显著的相互关系:项目所有权配置-风险分担、风险分担-代建人报酬、市场声誉-代建人选择、代建人项目管理绩效评价-代建人问责,从而为代建人激励制度的设计提供了新思路。     

连续还是不连续:企业国际化过程选择的一个分析框架

本文通过企业国际化相关文献的回顾，讨论了企业国际化过程中的连续和不连续两种模式，提出了一个以知识、战略和网络为前因的企业国际化连续或不连续过程选择的分析框架和三个有待检验的命题：（1）企业的国际化知识越少，越倾向于选择连续的国际化道路，反之则会较多地选择不连续的国际化道路；（2）企业的国际化战略越不清晰，越倾向于选择连续的国际化道路，反之则会较多地选择不连续的国际化道路；（3）企业嵌入的网络越少，越倾向于选择连续的国际化道路，反之，则会较多地选择不连续的国际化道路。     

蔡国龙:ICU的幕后英雄

<正>在2003年以前,很多人都不知道ICU,当年的SARS让更多的人认识了ICU,也让ICU从幕后走到了台前。I C U的学名是重症监护病房(intensive care unit),收治的病人主要是一些在普通病房中没办法救治,同时病情十分危重的病人,因而,救治任务非常艰巨。在这条医疗救治前线冲锋了18年的浙江医院重症医学科主任医师蔡国龙,每天面对重症病人,用自己精湛的医术和仁心厚爱拯救生命。1991年,温州医学院临床医学出身的他进入浙江医院心内科。在该领域小     

Lipoprotein (a): a Unique Independent Risk Factor for Coronary Artery Disease

The current epidemic affecting Indians is coronary artery disease (CAD), and is currently one of the most common causes of mortality and morbidity in developed and developing countries. The higher rate of CAD in Indians, as compared to people of other ethnic origin, may indicate a possible genetic susceptibility. Hence, Lp(a), an independent genetic risk marker for atherosclerosis and cardiovascular disease assumes great importance. Lp(a), an atherogenic lipoprotein, contains a cholesterol rich LDL particle, one molecule of apolipoprotein B-100 and a unique protein, apolipoprotein (a) which distinguishes it from LDL. Apo(a) is highly polymorphic and an inverse relationship between Lp(a) concentration and apo(a) isoform size has been observed. This is genetically controlled suggesting a functional diversity among the apo(a) isoforms. The LPA gene codes for apo(a) whose genetic heterogeneity is due to variations in its number of kringles. The exact pathogenic mechanism of Lp(a) is still not completely elucidated, but the structural homology of Lp(a) with LDL and plasmin is possibly responsible for its acting as a link between atherosclerosis and thrombosis. Upper limits of normal Lp(a) levels have not been defined for the Indian population. A cut off limit of 20 mg/dL has been suggested while for the Caucasian population it is 30 mg/dL. Though a variety of assays are available for its measurement, standardization of the analytical method is highly complicated as a majority of the methods are affected by the heterogeneity in apo(a) size. No therapeutic drug selectively targets Lp(a) but recently, new modifiers of apo(a) synthesis are being considered.     

Fibrinogen,Lp(a), Microalbuminuria and Left Ventricular Mass Index: Cardiovascular Disease Risk factors in Diabetes

The present work was undertaken to study interrelation of Fibrinogen, Lp(a) and LVMI in Type II diabetes patients with or without nephropathy. 100 Type II Diabetic patients attending OPD/IPD of DMC&H, Ludhiana were included. They were divided in two groups. Group I: 50 patients without microalbuminuria (MAU). Group II: 50 patients with MAU. Fibrinogen (Clauss method), Lp(a) and MAU were estimated on Multichannel Autoanalyzer Hitachi-911 (Roche). LVMI was estimated by echocardiography using formula of Devereux and Reicheck. Type II diabetes patients with MAU had significantly raised levels of Fibrinogen, Lp(a), and LVMI as compared to normoalbuminuric diabetics (P < 0.01). Group II patients had positive correlation between Lp(a) and LVMI but no relation between Fibrinogen and LVMI. MAU, marker of microangiopathy, is associated with higher Fibrinogen and Lp(a) levels. This becomes basis of increase cardiovascular risk as demonstrated by higher mean LVMI in Group II patients.     

Plasma Fibronectin Concentration in Obese/Overweight Pregnant Women: A Possible Risk Factor for Preeclampsia

Plasma fibronectin (FN) levels in obese/overweight and non-obese pregnant women were evaluated as a possible risk factor for preeclampsia. A total of one hundred and sixty three pregnant women attending antenatal clinic at University of Calabar Teaching Hospital participated in the study and sixty non-pregnant women served as control. About 77 (47.24%) of the pregnant women were followed up for any subsequent development of preeclampsia during the pregnancy. Fibronectin levels in plasma were measured by ELISA assay and serum total protein, urea and creatinine were determined spectrophotometrically. The mean plasma FN concentration of non-obese pregnant women in first trimester was lower than those of the non-pregnant women by 24%, but however, increased to the non-pregnant level in second and third trimesters. Obese/overweight pregnant women had significantly (P < 0.05) higher values than non-obese pregnant women in second and third trimesters. FN in obese/overweight pregnant women correlated positively with mean arterial blood pressure (MAP: r = 0.414, P = 0.04). About 28.57% of the pregnant women with FN above cut off point of 330 μg/ml at 18–24 weeks of gestation developed preeclampsia. This value increased to 40.0% when only the obese/overweight women were considered. On analysis of both fibronectin >330 μg/ml and MAP > 90, the predictive value increased to 66.7%. We therefore conclude that elevated FN may be regarded as a risk factor of preeclampsia especially among the obese women.     

Microalbuminuria in Obese Young and Middle Aged Population: A Potential Marker of Cardiovascular Risk

Microalbuminuria is an established cardiovascular risk indicator in diabetes, hypertension and the general population. There is lack of information on MAU in healthy obese Indian adults and an ongoing debate whether obese adults deserve targeted identification and clinical intervention for MAU and prediabetes. We aimed to screen the healthy obese, young (group I) and middle aged (group II) adults for prevalence of MAU and prediabetes and study its association with Framingham risk score. The study included 50 healthy obese young (20–30 years) and middle aged adults (31–50 years), attending the outpatient clinic of Dept. of Medicine for a duration of 2 months (July–August). The patients were screened for fasting blood sugar, lipid profile and MAU. Of the total patients 28 % had MAU, 32.14 % of which had prediabetes and 33.33 % had diabetes whereas 10 % were normoglycemic. The group I patients had 50 % cases of MAU and group II had 25 % patients with MAU. Group II 63.63 % pre-diabetics. The values of MAU obtained were correlated with age, gender, body mass index, systolic and diastolic blood pressure, FBS, waist to hip ratio using Pearson’s Coefficient (p < 0.05). The 10 year CVD risk calculated using FRS in subjects with MAU was higher as compared to those without MAU. Thus we conclude that Indian, young and middle aged obese adults to be at a risk of prediabetes, MAU and CV risk warranting their routine screening for better clinical outcomes.     

Lead as a Risk Factor for Osteoporosis in Post-menopausal Women

Lead exposure is increasingly becoming an important risk factor for osteoporosis. In adults, approximately 80–90 % of absorbed lead is stored in the bones. These bone lead deposits are released into the blood during periods of enhanced bone resorption like menopause, forming a potential endogenous source of lead exposure. Postmenopausal women are at a higher risk for bone lead release because of hormonal and age related changes in bone metabolism. Estrogen deficiency is associated with increase in osteoclasts number and activity leading to both the early and late form of osteoporosis. Hence, high blood lead level coupled with concomitant environmental exposure exposes women in this age group to lead related adverse outcomes like hypertension, reduced kidney and neurocognitive functions as well as increased risk of atherosclerosis and cardiovascular mortality. A few studies have also identified coexisting variates like ethnicity, occupation, residence, education, smoking, alcohol medications, water etc. as significant determinants of bone and blood lead in women, thus increasing the magnitude of postmenopausal bone changes. Hence, interventions focused on reducing the intensity of bone resorption during menopause will help decrease exposure to endogenous lead. This would play a significant role in decreasing the morbidity and mortality associated with menopause. Also, identification of modifiable factors that prevent bone lead release will reduce the risk of chronic lead exposure and improve the health outcomes of post-menopausal women.     

基于承包商视角的IT服务外包项目风险因素的辨识

提出IT服务外包项目的全新分类视角,利用文献资料法和专家访谈法,收集整理57个风险因素,针对承包商企业高管收集调研数据,采用分层聚类和T检验,从不同的角度对57个风险因素的重要程度进行辨识,为我国承担IT服务外包项目的承包商在评估风险、规避风险时提供依据.     

信息不对称情况下寡头市场决策的动态博弈

本文首先探讨了寡头垄断市场的特点,然后通过对该市场古诺模型和斯塔克博格模型的博弈分析,证明了这样一个事实:信息较多者不一定得益较多。最后指出这两种模型都不是最有效的。     

A Novel Material for Oil-water Separation

<正>Oil products such as petroleum have greatly benefited the human society.However,they may lead to safety and health problems if not handled properly.For example,the oil spillage in the Gulf of Mexico caused serious ocean contamination and ecosystem damage in 2010.There is an urgent need,therefore,to develop materials that can effectively adsorb and transfer spilled oil     

Hyperhomocysteinemia, as an Independent Risk Factor for Retinal Venous Occlusion in an Indian Population

Total plasma homocysteine was analysed in 64 cases of retinal vein occlusion (RVO) of which 24 cases of central retinal vein occlusion (CRVO) and 40 cases of branch retinal vein occlusion (BRVO) and compared with 45 age and sex matched control. Homocysteine was significantly increased in RVO cases in respect to control (P < 0.001). Analysis also revealed that prevalence of rise of plasma homocysteine was more in cases of CRVO (OR = 13) than that of BRVO (OR = 5.03).