Asian-Indian Parents’ Attributions About the Causes of Child Behavior: A Replication and Extension With Parents From Chennai,India

Using hypothetical vignettes, 152 parents of children 10–17 years old living in Chennai, India, made attributions about whether the origins of 2 positive and 2 negative behaviors performed by their own child or another child were due to the child's personality or the situation, or to parenting or nonparenting influences based on the frequency, intensity, and cross-situational consistency of the behavior. Parents attributed the positive behaviors of all children to the personality of the child and to parenting. Parents attributed negative behavior of their own children to situational influences and nonparenting effects, but attributed the negative behavior of other children to their personality and to parenting, a pattern that enhances and reinforces parent self-esteem. Results were discussed in terms of the self-serving bias and the actor–observer bias, cognitive distortions that protect and enhance parents’ views of themselves and their children.     

Aggression,self-confidence,and cardiovascular reactions in competitive performance in adolescent boys

Interactions between suggested risk factors for the development of coronary heart disease (namely aggression, competitive performance, and cardiovascular reactions) were studied in 36 adolescent boys. Different manifestations of aggression were measured using a structured interview, the aggression-impatience factor of the MYTH test, and observation. Self-confidence was assessed by means of an interview. The performance tests used were the Stroop Color Word test and the P-factor test. Cardiovascular reactions were measured using an automatic noninvasive sphygmomanometer with a continuous recording system. Results showed that the significance of aggression in performance or competition cannot be evaluated separately; aggression in itself had an injurious effect on performance, but when combined with high self-confidence it resulted in a high level of performance. High cardiovascular reactivity was related to competitiveness rather than aggression. The results emphasize that before intervention programs for behavioral risk factors of coronary heart disease are planned, there are many questions to answer.     

高尿酸血症与冠心病之间的关系

高尿酸血症是一种嘌呤代谢障碍性疾病,早期人们主要关注高尿酸血症对关节及肾脏的影响,但随着尿酸水平的升高,患心血管疾病的风险也相应的增加,近年来越来越多的研究用于证明高尿酸血症与心血管疾病之间的相互作用,人们才逐渐关注高尿酸血症对心血管疾病的影响,并且一直是学者关注的焦点之一,高尿酸血症是否为冠心病的独立危险因素？高尿酸血症是否直接和冠心痛的预后相关？两者之间的关系一直存在争议,本文就高尿酸血症与冠心病关系、高尿酸血症对冠心痛影响的可能机制作一综述.     

冠状动脉介入治疗的合理应用

近年来我国的冠心病介入治疗迅速发展,但有许多问题必须引起注意。本文讨论了我国目前冠脉介入治疗存在的问题;如何正确选择冠心病介入治疗、冠状动脉搭桥和药物治疗;重视冠脉介入手术病人的综合治疗等问题。     

依那普利叶酸片与依那普利片改善动脉硬化效果比较

探讨马来酸依那普利叶酸片对冠心病患者血清同型半胱氨酸（Hcy）及脉搏波传导速度（PWV）的影响。选取108例冠心痛患者随机分为依叶组（口服马来酸依那普利叶酸片1片,每日1次）和依苏组（口服依那普利片1片,每日1次）,疗程6个月,另选取冠状动脉造影为非冠心病患者40例作对照。检测各组患者治疗前后血清Hcy水平及PWV,并进行比较。冠心病患者血清Hcy水平及PWV较非冠t心病患者明显升高（P〈o．01）,治疗6个月后,两组冠心病患者血清Hcy水平及PWV均较治疗前降低（P〈o．05,P〈o．01）,而依叶组血清Hcy水平及PWV较依苏组降低更为显著（P〈0．05,P〈0．01）。冠心病常规治疗的基础上联用叶酸可进一步降低患者血清Hcy水平及PWV,从而改善患者内皮功能及动脉硬化。     

冠心病患者的抑郁和焦虑

许多临床研究表明,冠心病患者常发生抑郁及焦虑。而在严重精神症状（如抑郁或/和焦虑）者中有较高的冠心病发生率。抑郁增加冠心病患者的不良心血管事件发生率,影响预后。其机制有如下几个方面：对医疗措施及生活方式改变的依从性差、血小板功能异常、血管内皮功能紊乱以及心率变异性降低。选择性5-羟色胺再摄取抑制剂由于其较好的耐受性且无明显的心血管副作用而应用于冠心病合并抑郁及焦虑的药物治疗并改善患者的生活质量。但仍需要更大规模的临床研究以确定抑郁及焦虑对冠心病预后的影响。临床上应更加关注焦虑对冠心病的影响,进一步探讨焦虑能否作为冠心病的危险因素。     

激素替代治疗对绝经妇女心脏保护效应的重新认识

激素替代疗法（HRT）已有数十年历史,但是否具有心脏保护效应一直存在争议。早期研究提示HRT可维持血管正常功能,但大样本随机对照研究却发现服用雌激素和孕激素妇女的心血管疾病较安慰剂组增加22％,这导致了HRT应用的急剧减少。而2007年妇女健康启动计划——冠状动脉钙化研究（WHI—CACS）却证实HRT能显著降低冠状动脉钙化,再次提起了人们对HRT心脏保护效应的关注。     

冠心病患者微量白蛋白尿与C反应蛋白的关系

研究冠心病患者微量白蛋白尿与血清C反应蛋白(CRP)相关性.研究对象为接受冠状动脉造影确诊为冠心病的住院患者87例,检测其尿白蛋白/肌酐浓度值(ACR)、血清C反应蛋白水平及其他指标,并与35例冠状动脉造影为非冠心病的患者进行比较.冠心病组lgACR及lgCRP水平明显高于正常对照组(P＜0.05).lgACR与lgCRP呈正相关(r=0.275,P=0.005),且均为冠心病的独立预测因素.冠心病患者微量白蛋白尿与血清C反应蛋白均明显增加.ACR、CRP均为冠心病的独立预测因素.在微量白蛋白尿的发生过程中可能有低度炎症(CRP)的参与.     

遵循指南，恰当进行冠心病的介入治疗

如何遵循指南,结合冠心痛患者实际情况和具体病变,恰如其分地为患者实施经皮冠状动脉介入治疗（PCI）,使获益最大化,而风险最低化,是每一位心血管介入医生的追求和面临的问题。应正确和严格选择冠心病患者PCI适应证,合理运用PCI的各种手段,牢固树立冠心病全面治疗观念。PCI仅仅是冠心病全面治疗的一个组成部分,必要的介入、外科治疗和合理药物治疗的联合应用,是心血管疾病治疗的发展方向。     

胰岛素：是“天使”还是“魔鬼”？——胰岛素引起血管损伤的哲学思考

随着社会经济和医疗技术的发展进步,胰岛素在2型糖尿病患者的治疗地位越来越高.然而,胰岛素的使用却好比一把＂双刃剑＂,既可以扮演着控制血糖的＂天使＂角色,又有导致血管损伤的＂魔鬼＂一面.那么,如何理解胰岛素的＂天使＂或＂魔鬼＂的这两种截然不同的角色呢？在这里,我们将从哲学的角度来辩证的分析,从理性的角度来合理规范化用药,充分强调整体观念,并为日后临床工作中科学的使用胰岛素提出理性与科学的指导意见.     

遵循指南,恰当进行冠心病的介入治疗

如何遵循指南,结合冠心病患者实际情况和具体病变.恰如其分地为患者实施经皮冠状动脉介入治疗(PCI).使获益最大化,而风险最低化,是每一位心血管介入医生的追求和面临的问题.应正确和严格选择冠心痛患者PCI适应证,合理运用PCI的各种手段,牢固树立冠心病全面治疗观念.PCI仅仅是冠心病全面治疗的一个组成部分,必要的介入、外科治疗和合理药物治疗的联合应用,是心血管疾病治疗的发展方向.     

丹红注射液对冠心病患者血清CRP及FG影响的Meta分析

通过检索中国期刊全文数据库（CNKI）、维普中文科技期刊数据库和万方电子期刊数据库,采用系统方法评价丹红注射液对冠心病患者血清C反应蛋白（CRP）和纤维蛋白原（FG）的影响。结果显示：与对照组相比,丹红治疗组能显著降低患者血清CRP;丹红治疗组与对照组治疗效果比较差异无统计学意义;丹红治疗组与对照组相比能显著降低患者血清FG水平。提示丹红注射液可显著降低冠心病患者血清CRP及FG水平。     

危重冠心病患者介入治疗的法学思考——从法律学的角度探讨介入治疗的临床适应症

冠心病是目前严重威胁我国人民健康的一种常见病,由于种种原因一部分晚期冠心病患者,来诊时已经失去介入手术和外科搭桥的最佳时机,而且对于这部分病人来讲,药物治疗往往无效,他们的治疗应何去何从,是目前医学界极具争议的话题。试从法律学的角度,探讨危重冠心病患者介入治疗的可能性及必要性,为临床工作提供法律指导。     

The impact of cognitive interventions on cognitive symptoms in idiopathic Parkinson’s disease: a systematic review

This systematic review addressed efficacy of cognitive stimulation (CS), cognitive training (CT), and cognitive rehabilitation (CR) to improve cognitive functions in Parkinson’s disease (PD) with (PD-MCI) and without mild cognitive impairment (PD-H). Five databases were searched. Twelve CT, four CS, and a combination of CT with CR were found. PD-H benefited from CT or CS compared to active or passive controls in 42.1% of cognitive tests, and in 33.3% of psychological and functional measures. PD-MCI alone, compared with controls, only improved in 6.9% of cognitive measures after CT. PD-H and PD-MCI, alone or together, somehow improved information processing speed, attention, working memory, executive functions, and visual episodic memory. PD-MCI improved better than PD-H in global cognition and planning abilities. The outcomes suggest some efficacy of cognitive interventions in PD. However, small samples, lack of information regarding standardization of interventions, and poor methodological quality limit results validity and prevent firm conclusions.     

合理应用运动平板试验与冠脉CT诊断冠心病临床策略分析

本文针对临床诊断冠心病的两种常用手段即运动平板试验和冠脉CT进行分析,鉴于目前临床普遍存在重视采用冠脉CT,甚至达到滥用的地步,而逐渐忽视平板运动试验的现象,紧密结合临床,客观分析两者的特点,阐述各自优缺点。希冀通过本文以帮助临床医师正确选择应用,避免偏颇,最终达到将两者有机的结合,真正适合临床需要,提高冠心病患者的检出率,有利于更好地对冠心病进行二级预防。     

养老机构冠心病患者服药依从性现状及影响因素

采用Morisky推荐的MAQ对锦州市养老机构中153名冠心痛患者的服药依从性进行测评,探讨冠心病患者的服药依从性现状及影响因素.结果显示,养老机构冠心病患者服药依从性差的比率为81.7％,影响服药依从性的因素为文化程度、服药种类、医疗背景、入住年限.养老机构的护理人员应对上述因素给予更多的关注,从而提高其服药依从性,进而提升其临床治疗效果.     

从循证医学看目前冠心病的药物治疗

为使冠心病患者尽可能达到最优化的药物治疗,结合最近几年出现的大型临床研究,分析了不同冠心病患者应采取的合理药物治疗措施及可能带来的益处,并针对我国现状,提出了相应的解决方案。