从不同高血压防治指南的比较看高血压治疗策略的变化

为减少因高血压造成的各种心血管事件,世界不同地区制定或修订了适合自己的高血压防治指南.通过对JNC7、ESH/ESC及2004年中国高血压防治指南的比较及分析,以便能更全面、正确地理解和发展我国新的高血压指南,并将该指南灵活运用于实际工作.     

从不同高血压防治指南的比较看高血压治疗策略的变化

为减少因高血压造成的各种心血管事件,世界不同地区制定或修订了适合自己的高血压防治指南。通过对JNC7、ESH/ESC及2004年中国高血压防治指南的比较及分析,以便能更全面、正确地理解和发展我国新的高血压指南,并将该指南灵活运用于实际工作。     

从JNC高血压指南的演变史看盐与高血压的关系

高血压是当今世界上最大的流行病,是脑卒中、心脏病及肾脏病最主要的危险因素。通过回顾比较不同时期的JNC高血压指南,了解对盐与高血压关系认识的发展过程,体会限盐对高血压防治的重要性及发展前景。     

高血压治疗:百年历程、日益细化

人类对高血压的治疗是百年以来医学的重要成就.越来越多的证据表明,有效控制高血压是降低相关疾病发病、死亡、致残的重要手段.医学对高血压治疗药物、手段、方案的探索尚未止步,许多正在进展中.     

高血压治疗：百年历程、日益细化

人类对高血压的治疗是百年以来医学的重要成就。越来越多的证据表明,有效控制高血压是降低相关疾病发病、死亡、致残的重要手段。医学对高血压治疗药物、手段、方案的探索尚未止步,许多正在进展中。     

老年高血压治疗决策的个体化和系统化

高血压是严重危害老年人健康的常见病,老年人高血压临床症状及特点与中青年高血压有显著不同,在诊断治疗中应注重老年人血压升高的病理生理特点及机制,在老年高血压的治疗决策中运用个体化和系统论的原则,选择个体最优化综合治疗决策,启思和引导老年高血压研究水平的纵深发展,积极有效地改善老年人的生活质量.     

中美欧高血压指南之比较

通过高血压的定义、分类,危险因素评估,危险分层及治疗,比较了中国、美国、欧洲高血压治疗指南相同和不同,这对于我国高血压的防治有十分重要的意义.     

关注降压药物的选择,促使更有效的降压达标

我国成人高血压患病率高达18.8%,全国有高血压患者约1.6亿.合理的药物治疗是降压达标的主要措施,如何进行正确选择成为摆在我们面前的难题.目前,降压药物主要包括利尿剂、β受体阻断剂、血管紧张素转换酶抑制剂、血管紧张素Ⅱ受体拮抗剂、钙拮抗剂和α受体阻断剂6类.因降压治疗的收益主要来自于降压本身,为了提高降压达标率及高血压患者的用药依从性,目前多主张低剂量联合治疗.     

浅议辩证思维方法在高血压预防及治疗中的应用

辩证思维方法是最普遍适用、最重要的科学思维方法之一.高血压的预防及治疗中的各个方面无不渗透着丰富的哲学思想,理解和把握哲学思想对高血压的防治具有重要的指导意义.     

焦虑抑郁与高血压的研究进展

焦虑抑郁不仅是高血压的促发因素,也是影响高血压发生及预后的不良因素之一.抗焦虑抑郁治疗不仅可以有效消除高血压患者焦虑抑郁的情绪,还可以减少降压药的用药剂量,增强降压药的疗效,而且明显改善高血压患者的预后,降低心脑血管事件的发生率.现就有关焦虑抑郁和高血压的研究进展做一综述.     

Children's preference for mixed‐ versus fixed‐ratio schedules of reinforcement: A translational study of risky choice

Laboratory research has shown that when subjects are given a choice between fixed‐ratio and bi‐valued mixed‐ratio schedules of reinforcement, preference typically emerges for the mixed‐ratio schedule even with a larger ratio requirement. The current study sought to replicate and extend these findings to children's math problem completion. Using an ABCBC reversal design, four fourth‐grade students were given the choice of completing addition problems reinforced on either a fixed‐ratio 5 schedule or one of three mixed‐ratio schedules; an equivalent mixed‐ratio (1, 9) schedule, a mixed‐ratio (1, 11) schedule with a 20% larger ratio requirement, and an equally lean mixed‐ratio (5, 7) schedule without the small fixed‐ratio 1 component. This was followed by a reversal back to the preceding phase in which preference for the mixed‐ratio schedule had been observed, and a final reversal back to the mixed‐ratio (5, 7) phase. Findings were consistent with previous research in that all children preferred the mixed‐ratio (1, 9) schedule over the equivalent fixed‐ratio 5 schedule. Preference persisted for the leaner mixed‐ratio (1, 11) schedule for three of the four children. Indifference or preference for the fixed‐ratio 5 alternative was observed in phases containing the mixed‐ratio (5, 7) schedule. These results extend previous research on risky choice to children's math problem completion and highlight the importance of a small ratio component in the emergence of preference for bi‐valued mixed‐ratio schedules. Implications of these results for arranging reinforcement to increase children's academic responding are discussed.     

A sensitive rank test for comparing the effects of two treatments on a single group

By taking advantage of an experimental design which increases the number of observations per subject, the sensitivity of the proposed test is increased. In the first of a series of subexperiments, the score of a randomly selected experimentalS is ranked with the scores of the remaining (control)Ss, and the experimentalS is discarded. This procedure is repeated until oneS remains. The test criterion,R _n , is the sum of ranks of the experimentalSs; its exact sampling distribution, a normal approximation, and the sensitivity of the test relative to the WilcoxonT, are described. Because of the large number of scores obtained, the test is particularly useful when preparingSs is more costly than testing them, e.g., in tests following involved conditioning procedures. Since eachS is discarded after experimental treatment, the test fills a real need in studies involving radiation, ablation, or other irreversible treatments.The test criterion, the associated experimental procedure, and the measure of sensitivity are due to SHR; the generating function, tables, and large sample approximation are due to JNC.     

The effect of support ratio on infants' perception of illusory contours

We used a preferential looking technique to investigate the effect of support ratio (a ratio of the physically specified contours to the total edge length) on the perception of Kanizsa illusory contours in infants aged 3-8 months. Previous work has shown that for adult observers the illusory-contour strength increases proportionally with the support ratio. When the support ratio was relatively high (66%), infants preferred illusory contours to non-illusory figures by 3-4 months of age (experiment 1). In contrast, only infants 7-8 months old showed this preference for illusory contours when the support ratio was reduced to 37% (experiment 3). Further, infants showed no preference for an outline version of the illusory-contour figure, which produced no illusory contours (experiment 2). This result confirms that the infants' preference reflects their perception of illusory contours. Our results show that (i) illusory-contour perception emerges at around 3-4 months of age, but (ii) that this ability is very limited until around 7-8 months of age.     

Digit ratio as an indicator of numeracy relative to literacy in 7‐year‐old British schoolchildren

A great deal of recent research has focused upon the relationship between a hypothesized index of prenatal testosterone exposure, digit ratio and health, social and cognitive functioning. Many inconsistencies within the pattern of findings have been identified in the relationship between digit ratio and absolute levels of cognitive ability. Recent research has identified a relationship between digit ratio and basic numeric competency. This basic numerical competency has been argued to be influenced by biological factors. The present study extended this finding to academic assessment, namely the Standardized Assessment Tests undertaken in numeracy and literacy by children in the UK at the age of 7. The present study hypothesized that digit ratio would correlate with the relative difference between numeracy and literacy abilities. Digit ratios were calculated for 75 (mainly Caucasian) children aged between 6 and 7 attending a state funded infant school. The digit ratios were then correlated with the results from their National Standard Assessment Tests (SATs). A significant correlation was found as hypothesized. Additionally, there was a negative correlation between digit ratio and numeracy for males (indicating higher prenatal testosterone exposure related to higher numeracy SAT scores) and a positive correlation between digit ratio and literacy for females (indicating lower prenatal testosterone exposure related to higher literacy SAT scores). These effects were small and the implications for using digit ratio to facilitate understanding of hormonal influences upon academic attainment are discussed.     

Perception–production relationships and phase correction in synchronization with two-interval rhythms

Two experiments investigated the effects of interval duration ratio on perception of local timing perturbations, accuracy of rhythm production, and phase correction in musicians listening to or tapping in synchrony with cyclically repeated auditory two-interval rhythms. Ratios ranged from simple (1:2) to complex (7:11, 5:13), and from small (5:13 = 0.38) to large (6:7 = 0.86). Rhythm production and perception exhibited similar ratio-dependent biases: rhythms with small ratios were produced with increased ratios, and timing perturbations in these rhythms tended to be harder to detect when they locally increased the ratio than when they reduced it. The opposite held for rhythms with large ratios. This demonstrates a close relation between rhythm perception and production. Unexpectedly, however, the neutral “attractor” was not the simplest ratio (1:2 = 0.50) but a complex ratio near 4:7 (= 0.57). Phase correction in response to perturbations was generally rapid and did not show the ratio-dependent biases observed in rhythm perception and production. Thus, phase correction operates efficiently and autonomously even in synchronization with rhythms exhibiting complex interval ratios.     

Constraints on infants' musical rhythm perception: effects of interval ratio complexity and enculturation

Effects of culture-specific experience on musical rhythm perception are evident by 12 months of age, but the role of culture-general rhythm processing constraints during early infancy has not been explored. Using a habituation procedure with 5- and 7-month-old infants, we investigated effects of temporal interval ratio complexity on discrimination of standard from novel musical patterns containing 200-ms disruptions. Infants were tested in three ratio conditions: simple (2:1), which is typical in Western music, complex (3:2), which is typical in other musical cultures, and highly complex (7:4), which is relatively rare in music throughout the world. Unlike adults and older infants, whose accuracy was predicted by familiarity, younger infants were influenced by ratio complexity, as shown by their successful discrimination in the simple and complex conditions but not in the highly complex condition. The findings suggest that ratio complexity constrains rhythm perception even prior to the acquisition of culture-specific biases.     

Limits to preference and the sensitivity of choice to rate and amount of food

Studies of choice holding food‐amount ratio constant while varying food‐rate ratio within sessions showed that local changes in preference depend on relative amount of food. The present study investigated whether sensitivity of choice to food‐rate ratio and sensitivity to food‐amount ratio are independent of one another when food‐rate ratios are varied across sessions and food‐amount ratios are varied within sessions. Food deliveries for rats’ presses on the left and right levers were scheduled according to three different food‐rate ratios of 1:1, 9:1, and 1:9; each food‐rate ratio lasted for 106 sessions and was arranged independently of seven food‐amount ratios (7:1, 6:2, 5:3, 4:4, 3:5, 2:6, and 1:7 food pellets) occurring within sessions in random sequence. Each amount ratio lasted for 10 food deliveries and was separated from another by a 60‐s blackout. Sensitivity to rate ratio was high (1.0) across food deliveries. Sensitivity to amount ratio was low when food rates were equal across alternatives, but was high when rate ratio and amount ratio opposed one another. When rate ratio and amount ratio went in the same direction, choice ratio reached an elevenfold limit which reduced sensitivity to approximately zero. We conclude that three factors affect sensitivity to amount: (1) the limit to preference, (2) the equal effect on preference of amounts greater than four pellets, and (3) the absence of differential effects of switches in amount in the equal‐rates (1:1) condition. Taken together, these findings indicate that rate and amount only sometimes combine independently as additive variables to determine preference when amount ratios vary frequently within sessions.     

Resting-state theta/beta EEG ratio is associated with reward- and punishment-related reversal learning

Prior research has shown that the ratio between resting-state theta (4–7 Hz)-beta (13–30 Hz) oscillations in the electroencephalogram (EEG) is associated with reward- and punishment-related feedback learning and risky decision making. However, it remains unclear whether the theta/beta EEG ratio is also an electrophysiological index for poorer behavioral adaptation when reward and punishment contingencies change over time. The aim of the present study was to investigate whether resting-state theta (4–7 Hz)-beta (13–30 Hz) EEG ratio correlated with reversal learning. A 4-min resting-state EEG was recorded and a gambling task with changing reward-punishment contingencies was administered in 128 healthy volunteers. Results showed an inverse relationship between theta/beta EEG ratio and reversal learning. Our findings replicate and extend previous findings by showing that higher midfrontal theta/beta EEG ratios are associated with poorer reversal learning and behavioral adaptive responses under changing environmental demands.