郑州妇幼保健院激光点痣价钱费用指导助手

来源:搜狐娱乐
原标题: 郑州妇幼保健院激光点痣价钱费用
A drunk醉汉A police officer pulls over a guy who has been weaving in and out of the lanes.有一位警官把一个在车道上穿进穿出,迂回蛇行的男子拦到路边。He goes up to the guy#39;s window and says ;Sir,I need you to blow into this breathalyzer tube.;他走到这名男子的车窗旁边说:“先生,我要你对着这个酒精测试管吹一口气。”The man says,;Sorry officer I can#39;t do that.I am an asthmatic.If I do that I#39;ll have a really bad asthma attack.;这名男子说:“对不起呀,警官,我不能吹呀。我是个气喘病患者呀。如果我吹的话,我就会真的患很严重的气喘病。”;Ok,fine.I need you to come down to the station to give a blood sample.;“ 好, 好。我要你到警察局进行血液检验。”;I can#39;t do that either.I am a hemophiliac.If I do that,I#39;ll bleed to death.;“我也能抽血检验呀。我是个血友病患呀。如果我抽血检验,我就会流血过多而死呀。”;Well ,then we need a urine sample.;“嗯,那我们就要你进行尿液检验吧。”;I am sorry officer I can#39;t do that either.I am also a diabetic.If I do that I#39;ll get really low blood sugar.;“对不起呀 ,警官,我也不能验尿呀。我也是一个糖尿病患者呀。如果我验尿的话,我的血糖就真的会变得很低。”;Alright then I need you to come out here and walk this white line.;“好吧,那我要你出来到这边,走这条白线。”;I can#39;t do that,officer.;“警官,我办不到呀。”;Why not? ;“为什么办不到?”;Because I am too drunk to do that.;“因为我喝得太醉了,所以不能那么做呀。” /201504/361484

AUSTIN, Ind. — She became addicted to painkillers over a decade ago, when a car wreck left her with a broken back and doctors prescribed OxyContin during her recovery. Then came a new prescription opiate, Opana, easily obtained on the street and more potent when crushed, dissolved in water and injected. She did just that, many times a day, sometimes sharing needles with other addicts.印第安纳州奥斯汀——十年前,她开始对镇痛剂上瘾。当时,她在一次车祸中脊柱受伤,医生在她康复期间给她开了奥施康定(OxyContin)。然后,又出现了一种新的处方麻醉剂Opana,这种药在外面很容易买,碾碎后效力更强,可溶于水,还可以用于注射。她就是那样做的,而且每天要用很多次,有时还会与其他上瘾者共用针头。Last month, the thin, 45-year-old woman learned the unforgiving consequences. She tested positive for H.I.V., one of nearly 150 cases in this socially conservative, largely rural region just north of the Kentucky border. Now a life long hobbled by addiction is, like so many others here, consumed by fear.上个月,这个瘦削的45岁女人得知,这样做造成了不可挽回的后果。她的艾滋病毒(HIV)检测结果呈阳性,是靠近肯塔基州北部边界这个民风保守、以农业为主的地区的近150例艾滋病毒携带者之一。现在,与这里的许多人一样,因为上瘾而长期受到困扰的生活已经被恐惧吞噬。She is afraid to start antiretroviral therapy because she does not want to be spotted entering the clinic on Main Street, she says, and afraid to learn her prognosis after hearing a rumor — false, it turns out — that someone else with the virus was given six months to live. Other drug users have refused to be tested at all.她说,她不敢开始抗逆转录病毒治疗,因为她不想被人看到走进主街那家诊所,在听到有个病毒携带者经诊断只剩六个月时间后(后经明是谣言),她甚至不敢去了解自己的预后。还有些药物使用者完全拒绝接受测试。“I thought it was just a homosexual disease,” the woman said one recent evening, twisting a tissue in her manicured hands as tears filled her eyes. She asked that her name not be published out of concerns about being stigmatized. “I didn’t ever think it would be in my small hometown.”“我还以为这是同性恋才会得的病,”她在近日的一个晚上说,她做过美甲的双手揉捏着一张纸巾,眼中噙满泪水。因为担心被人歧视,她要求对自己的姓名保密。“我从没想过,这种事会发生在我家乡的小镇。”The crisis would test even a large metropolis; Austin, population 4,200, is overwhelmed despite help from the Centers for Disease Control and Prevention, the state and nonprofit groups like the AIDS Healthcare Foundation. H.I.V. had been all but unknown here, and misinformation is rife. Attempts to halt the outbreak have been hindered by strong but misguided local beliefs about how to address it, according to people involved in the response.这个危机甚至还会考验一个大都市;尽管有疾病控制与预防中心(Centers for Disease Control and Prevention,简称CDC)、州和艾滋病健康护理基金会(AIDS Healthcare Foundation)等非营利组织的帮助,人口仅4200的奥斯汀还是有些不知所措。这里几乎对HIV一无所知,而且错误信息也很多。相关人士表示,在如何应对它的问题上,当地一些强烈而具有误导性的观念,对阻止HIV蔓延的工作造成了阻碍。Gov. Mike Pence reluctantly authorized a needle exchange program last month, but local officials are not running it according to best practices, outside experts say. Austin residents still must wait for addiction treatment, even though they have been given priority. And getting those who are H.I.V.-positive on medication, and making sure they adhere to the protocol, has been difficult.外界有专家称,上个月州长迈克·彭斯(Mike Pence)不情愿地批准了一个针头更换项目,但当地官员的执行不力。本应得到优先待遇的奥斯汀居民仍然必须等待接受药物上瘾治疗。此外,让那些HIV检测呈阳性的人接受药物治疗,并保他们能遵守规定,也并非易事。Officials here say the need for education is urgent and deep; even local health workers are learning as they go. Brittany Combs, the public health nurse for Scott County, said she was stunned to discover from talking to addicts that many were using the same needle up to 300 times, until it broke off in their arms. Some were in the habit of using nail polish to mark syringes as their own, but with needles scarce and houses full of people frequently shooting up together, efforts to avoid sharing often failed.这里的官员表示,对教育的需求迫切而深刻;连当地的医务人员都摸索着工作。斯科特县(Scott County)的公共卫生护士布里特妮·库姆斯(Brittany Combs)说,她在与上瘾者交谈的过程中发现,很多人会使用同一个针头达300次,直到针头断在胳膊里,她对此感到震惊。有些人还习惯用指甲油标示出自己的注射器,但是由于针头不多,再加上屋子里满是经常一起进行注射的人,所以往往很难避免共用针头的情况。After the needle exchange program started last month, Ms. Combs also learned that many addicts were uncomfortable visiting a needle distribution center that opened April 4 on the outskirts of town. So she started taking needles directly to users in their neighborhoods.库姆斯还了解到,上个月针头更换项目开始后,许多上瘾者都不愿意去往针头分发中心。4月4日,该中心在城郊开放。所以,她开始直接把针头拿到社区,给那里的药物使用者。At the same time, H.I.V. specialists from Indianapolis — who have evaluated about 50 people with the virus here so far and started about 20 of them on antiretroviral drugs — are fighting a barrage of misinformation about the virus in Scott County, where almost all residents are white, few go to college and one in five live in poverty, according to the census.同时,来自印第安纳波利斯的HIV专家正在与斯科特县大量关于HIV的错误信息作斗争。据调查,这里几乎所有居民都是白人,上过大学的很少,五分之一的人生活在贫困之中。目前,这些专家已经对这里的大约50名病毒携带者进行了检查,并开始对其中20人使用抗逆转录病毒药物。“There are still a significant proportion of people in Austin who have biases about H.I.V. and are contributing to the stigma and subsequent fear,” said Dr. Diane Janowicz, an infectious disease specialist at Indiana University, who is treating H.I.V. patients here. “I have to reassure them — if your grandkid wants a sip of your drink, you can share it. It’s O.K. to eat at the same table. You can use the same bathroom.’”“奥斯汀仍然有很多人对HIV存在偏见,而且正在对与之相伴的耻辱感和恐惧起到推波助澜的作用,”在这里治疗HIV患者的印第安纳大学(Indiana University)传染病专家黛安娜·扬诺维茨士(Dr. Diane Janowicz)说。“我得反复告诉他们——如果你的孙子想喝一口你的饮料,你可以给孩子喝。在同一张桌子上吃饭也没有问题。你们还可以共用一个卫生间。”Many of the newly diagnosed here have strikingly high amounts of the virus in their blood, Dr. Janowicz said, and in one patient the H.I.V. has progressed to AIDS. Nonetheless, she said, “if they take their medicine for H.I.V., this is a chronic disease, not something they have to die from.”扬诺维茨说,这里许多近期确诊者的血液病毒含量都高得惊人。还有一位患者的HIV已经发展成了艾滋病(AIDS)。她说,不过,“如果他们使用针对HIV的药物,这就是一种慢性疾病,不见得一定会死于这个病。”Another complication is that the needle exchange has faced strong local resistance. Mr. Pence, a Republican, generally opposes such programs, saying they perpetuate drug use. Many residents here feel the same.另一个问题是,针头更换项目在当地遭到了强烈抵制。身为共和党人的彭斯对此类项目基本上持反对态度,说这样会使药物滥用的行为延续下去。这里的许多居民也这样认为。“If you would have asked me last year if I was for a needle exchange program, I would have said you’re nuts,” Ms. Combs said. “I thought, just like a lot of people do, that it’s enabling — that you’re just giving needles out and assisting them in their drug habit. But then I did the research on it, and there’s 28 years of research to prove that it actually works.”“如果你去年问我是否持针头更换项目,我会说你疯了,”库姆斯说。“与许多人一样,我认为这是在给药物使用提供方便——你把针头分发出去,为他们使用药物的习惯提供帮助。但是,我随后我做了一些了解,有28年的研究可以明这样做真的有用。”But researchers say that Scott County’s hastily created exchange has several features that could sharply curb its effectiveness. To get clean needles, drug users have to register, using their birth date and a few letters from their name to create an identification number that goes on a laminated card. But the police are arresting anyone found with needles but no card, saying it will prod more people to participate.但研究人员称,斯科特县匆忙创建的更换项目有几个地方会严重影响它的效果。要获得干净的针头,药物使用者必须登记,用出生日期和名字中的几个字母来创建一个识别码,这个码会印到一张塑封的卡片上。然而,任何有针头但没有卡片的人,一经发现就会被警察逮捕,理由是这样会促使更多人参与更换项目。Dr. Don Des Jarlais, the director of research for the chemical dependency institute at Mount Sinai Beth Israel hospital in New York, said the most successful needle exchange programs let participants pass out syringes to peers who remain in the shadows instead of requiring everyone to sign up. Arresting drug users who are not officially enrolled in the program “makes it hard to build trust,” Dr. Des Jarlais said, adding, “You’re not going to be able to get enough syringes out to really stop the epidemic if you have those types of restrictions.”纽约西奈山以色列堂医院(Mount Sinai Beth Israel)化学品依赖研究所的研究负责人唐·德夏莱(Don Des Jarlais)说,最成功的针头更换项目会让参与者把注射器传递给身边那些仍然躲在暗处的人,而不是要求每个人去登记。逮捕那些没有在这个项目中正式登记的药物使用者,“会导致很难建立起信任”,德夏莱说。他还表示,“如果设定这些限制,你就无法把足够多的注射器分发出去,从而真正阻止病毒的传播。”Local supporters of the needle exchange say a limited program is better than none, and believe that improvements will come with time. Last week, the state legislature sent a bill to Mr. Pence that would allow communities to create needle exchange programs for up to a year if they are experiencing an epidemic of H.I.V. or hepatitis C because of intravenous drug use. Mr. Pence said he would sign the measure, noting in a statement that it would allow only “limited and accountable” needle exchange programs, and only “where public health emergencies warrant such action.”当地持针头更换项目的人表示,有限制的项目总比完全没有这类项目好,而且他们认为随着时间流逝,事情将出现改善。上周,州立法机构向彭斯提交了一个提案。根据该提案,当一个社区因为静脉药物注射而出现HIV或丙型肝炎的广泛传播时,可以创立一个长达一年的针头更换项目。彭斯称,他将签署这一提案,并在一项声明中指出,它将只批准“有限且可问责的”针头更换项目,而且只在“出现公共健康危机的前提下”进行。For now, the program here is giving out a maximum of 140 clean needles per user per week to whoever comes to the outreach center or accepts them from the roaming minivan. Ms. Combs said some people told her they injected as often as 15 times a day, and the exchange is erring on the side of providing slightly more than people need. She has passed out needles at a house where the owner, an older woman known as Momma, sits on the porch while a steady stream of visitors comes to shoot up inside. She has knocked on the door of a trailer where, she said, “multiple family members live and the daughters all prostitute themselves out and everyone is doing drugs.” One recent afternoon, on a street fragrant with lilacs, a young woman on a bicycle declined Ms. Combs’s offer of clean needles, saying she aly had some — and H.I.V.目前,这里的项目每周最多向每个药物使用者发放140个干净针头,发放对象是每个来到推广中心,或者从流动的小型货车上拿针头的人。库姆斯说,有人告诉她,他们每天会注射多达15次,而这个更换项目宁愿提供略微超出人们需求的数量。她曾去一户人家发放针头,这家的主人是一个年纪稍大的女性,名叫莫玛(Momma);莫玛坐在门廊上,有人不停地来到这里,到里面进行注射。库姆斯还曾敲过一个拖车式活动房屋的门,她说,“好几个家庭成员都住在里面,家里的女儿都会去卖淫,每个人都在用毒品。”近日的一天下午,在一条弥漫着紫丁香香味的街道上,一名骑自行车的年轻女性拒绝了库姆斯提供的干净针头,她说自己已经有了一些,而且自己已是HIV携带者。“I know I need the medicine to slow it down,” she murmured.她低声说道,“我知道我需要药物来延缓病情发展。”One unexpected benefit of the H.I.V. outbreak, according to the woman who tested positive and fears starting treatment, is that the men who used to stream into town daily, seeking young female addicts who would prostitute themselves in exchange for drug money, have all but disappeared.这名检测呈阳性,而且害怕开始治疗的女性表示,HIV的蔓延带来了一个意想不到的好处:那些曾经每天涌入城里,寻找年轻的女性用药上瘾者的男性几乎都消失了。他们之所以来这里,是因为上瘾者会用性务来换取毒品钱。“It took H.I.V. to change our town,” she said. “Those of us who are affected are devastated, but I’m glad H.I.V. is here.”“最终HIV改变了我们的城镇,”她说。“我们这些受感染的人被毁了,但我很高兴HIV来到了这里。” /201505/373927

Huaping specialty—Panzhihua- legend of kapok (the first version)华坪特色菜—攀枝花-木棉传说(版本一) In ancient times, a legend has it that a hero named Ji Bei led people of Li people to resist foreign aggression and distinguished himself many times at the risk of his life for which he won the heartfelt support of the general public. Later on, he was betrayed by a traitor and trapped in the mountains. Although hit by a few arrows, he stood erect on the peak and became a kapok tree. The arrows and blood turned into branches and blackish red flowers respectively. In memory of him, the later generation called kapok tree “Ji Bei” and tree of hero respectfully. To further express their love for the ethnic hero, people of Li will plant a kapok tree with much care on every wedding day.相传古时有位英雄叫吉贝,他多次率领黎族人民抗御外敌,屡建战功,得到人民的爱戴。后因叛徒出卖,被敌人围困在大山上,身中数箭,仍屹立山巅,身躯化为一株木棉树,身上的箭变为树枝,鲜血化成殷红的花朵。后人为纪念他将木棉换做“吉贝”也尊称木棉英雄树。黎族人民为了表示对民族英雄的爱戴,每逢男女结婚之日,都要精心种植一株木棉树。 /201505/374438

Street art, perhaps contrary to popular belief, isn#39;t about vandalizing buildings – it#39;s about self expression, and getting a message out to the world that can often be thoughtful and provoking. It can take on many forms: rather than being limited to paintings, it can work its magic in such mediums as yarn bombing, lego, and even ice sculptures. Here are some good examples of what the best street artists can do:提到街头艺术,大家也许会认为这是对建筑物的一种肆意破坏。然而恰恰相反,街头艺术是一种自我表达,是对这个既深沉又疯狂的世界的一种领悟,我们从中可以得到诸多启发和思考。它并不拘泥于绘画艺术,针织涂鸦、乐高甚至冰雕都可以称为街头艺术而发挥其神奇的力量。下面就让我们步入杰出的街头艺术家们为我们营造的艺术殿堂吧。1.Ice Men1.冰雕男人These are men created from ice, and water is trickling down from them as the rising sun is melting them away. This piece symbolizes that nothing is permanent, and everything will fade away eventually.正如你看到的那样,这些人都是冰雕刻成的,当太阳升起,阳光融化了寒冰,这些冰雕终会化为水滴流走。这组艺术作品告诉我们:万物没有永恒,一切终将消逝。2.LEGO2.乐高积木In the nooks and crannies of many a city, you can find bits of LEGO filling up cracks and brightening walls, much like the yarn bombing creations. It is a very creative form of street art, and anyone can do it – all you need is a handful of LEGO!也许你觉得乐高积木只是孩童的玩具,可是在街头艺术家眼里它们却大有用途:只要有足够的乐高积木。你瞧,这边灰色的角落,那边颓败的墙头裂缝,都变成了斑斓的色绽放在城市街头……看到这些,你是不是心动了?犹如针织涂鸦,乐高积木其实无处不在,那么就让我们一起行动吧,城市更美丽,只在你我!3.Chalk Alien3.粉笔外星人This is a chalk creation that was drawn by David Zinn. It features a cute alien raking up the leaves and putting them under the pathway; real leaves are scattered around it to add to the effect.当你走在街头,偶遇这么个可爱的小精灵,你一定会感到惊喜吧,原来单调枯燥的城市瞬间充满了生气,这就是街头艺术家大卫·辛的粉笔涂鸦作品之一。图片中可爱的小外星人Sluggo正忙着用耙子往小路上扒拉树叶,而这些散落一地的树叶可不是画上去的哦,那可是真正的落叶!聪明的大卫就是巧妙地利用了这些树叶从而达到了意想不到的艺术效果。4.“刷子和涂鸦模板?不,是喷漆?”4.;No brushes or stencils, just spray;This amazing picture is by David Walker, and as the title suggests, he did not use any brushes or stencils. This is very unusual for a street artist to do, mostly because it is so difficult. The girl is made up of vibrant colors, while still remaining amazingly realistic – making the overall effect quite incredible.正如标题中所写的那样,大卫·沃克的这幅街头涂鸦画作全是用喷漆绘出来的!如果你对绘画有一定了解,你便会觉得这是多么不可思议。柔美纤细的线条勾勒出一幅精致的画面,鲜艳的颜色让画中的人儿更加真实灵动,忧郁的眼神、高挺的鼻梁、散落的头发,无一不在倾诉着这幅惊世之作的无穷魅力。译者:王亚 来源:listverse.com /201507/384319Consumers who take cash to the shops and leave their debit cards at home are more likely to leave junk food on the shelves, U.S. scientists have discovered。根据美国科学家的研究,用刷卡购物的人比用现金购物的更容易购买垃圾食品,也就是说,更容易发胖啦!The study carried out by Cornell University and the University at Buffalo analysed the shopping behaviour of 1,000 households. They found that supermarket trolleys had a larger proportion of junk food items when the shopper was using credit or debit cards rather than cash。根据康奈尔大学和水牛城大学对美国1000户普通家庭的调查,研究人员发现,当人们刷卡付钱的时候,购物车里垃圾食品的比率大大高于用现金购物的人。#39;Two factors contribute to this intriguing effect,#39; the authors explained. #39;First, there is a correlation between unhealthiness and impulsiveness of food items: unhealthy food items tend to elicit impulsive responses。研究人员说:“造成这个有趣现象的原因很多,首先不健康是和对食物的冲动紧密相连的,不健康的食物种类可以引发冲动的反应;第二,使用现金付款比用信用卡付款给人心理上造成的痛苦更多,因此用现金消费引发的痛苦会抑制大家购买垃圾食品的冲动性。”#39;Second, cash payments are psychologically more painful than card payments, and this pain of payment can curb the impulsive responses to buy unhealthy food items.#39;美国科学家甚至认为,造成西方人普遍肥胖的原因之一就是他们都刷卡付钱,这个方式造成了人民的肥胖——根据2008年英国的数据统计,1/4的英国人都体重超标——如果改变一下消费方式呢?They even suggested that there may even be a connection between rising obesity levels in western countries and changing modes of payment。大家可以观察一下,是不是瘦人一般用现金比较多?而胖子一般都刷卡? /201507/386117

For the first time since statins have been regularly used, a large study has found that another type of cholesterol-lowering drug can protect people from heart attacks and strokes.自从他汀类成为常规药物以来,专家首次在一项大规模研究中发现,另一种降胆固醇的药物,也可以预防心肌梗死和脑卒中。The finding can help millions at high risk of heart attacks who cannot tolerate statins or do not respond to them sufficiently. And it helps clarify the role of LDL cholesterol, the dangerous form. Some had argued that statins reduced heart attack risk not just by lowering LDL levels but also by reducing inflammation. The new study indicates that the crucial factor is LDL, and the lower, the better.无数患者可能会从该发现中受益。这些人心肌梗死的风险较高,但又不能耐受他汀,或者摄入他汀的效果不明显。这一发现还有助于研究者进一步认识危险的低密度脂蛋白(LDL)胆固醇的作用。一些人认为,他汀类药物之所以能减少心肌梗死的风险,是因为它不仅降低了LDL水平,而且还减少了炎症。而这项新的研究表明,LDL才是关键因素,并且它的水平越低越好。The six year study, reported Monday at the annual meeting of the American Heart Association, involved 18,000 people who had had heart attacks or episodes of chest pain so severe they went to a hospital. They were randomly assigned to take a statin or a combination of a statin and the alternative drug to further reduce LDL levels. Both groups ended up with very low LDL levels – those taking the statin, simvastatin, had an average LDL of 69, and those taking simvastatin and the other drug, ezetimibe, or Zetia, in a combination pill sold as Vytorin, had an average LDL of 54. No clinical trial had ever asked what happened when LDL levels get below 70 because, said Dr. Robert Califf, a Duke cardiologist and the study chairman, ;many people were nervous about going this low and imagined a lot of possible toxicities.;本周一,相关研究人员在美国心脏协会(American Heart Association)的年会上做了报告。这项研究耗时六年,涵盖1.8万名患者。他们均曾经历过心肌梗死,或者严重到需要到医院就诊的胸痛发作。研究人员随机向他们分配了他汀,或者他汀和替代药物组成的复方药,以便进一步降低他们的LDL水平。结果两组患者的LDL都减至非常低的水平——用他汀类药物辛伐他汀的患者,LDL的平均水平为69,而用复方药的患者,LDL的平均水平为54。该复方药的商品名为葆至能(Vytorin),由辛伐他汀和依折麦布组成,而后者又称为艾泽庭(Zetia)。这项研究的主管、杜克大学的心脏病学家罗伯特·卡里夫(Robert Califf)士说,之前没人通过临床试验来研究LDL水平低于70时会发生什么状况,因为“LDL降到这么低的水平令很多人感到紧张,觉得可能会产生很多坏处。”Statins lower LDL by preventing it from being made. Ezetimibe lowers LDL by preventing cholesterol from being absorbed in the gut.他汀降低LDL的方式是防止它生成,而依折麦布降低LDL的方式是防止肠道吸收胆固醇。The drugs were so effective that there were few cardiac events among the participants but eventually a difference emerged: 6.4 percent fewer heart disease deaths, heart attacks, strokes, bypass surgery, stent insertion and severe chest pain leading to hospitalization in those assigned to take Vytorin. The amount corresponded to what was predicted from the extra degree of cholesterol lowering with the combination drug.两种药物均非常有效,参与实验的患者出现心血管意外的次数不多,但差别最终浮现了出来:在心脏疾病死亡、心肌梗死、脑卒中、搭桥手术、架置入和导致住院的严重胸痛方面,摄入葆至能的患者相对低6.4%。考虑到葆至能可以把胆固醇水平降得更低,据此预测的水平与以上实验数据相符。Those results translate into 2,742 events in those taking simvastatin and 2,572 in those taking the combination drug. That means, said Dr. Christopher Cannon, a principal investigator and cardiologist at Brigham and Women’s Hospital, that two out of every 100 people who would have had a heart attack or stroke by taking the statin avoided those outcomes by taking the combination drug.这些结果对应的数据是,用辛伐他汀的患者中出现了2742次心血管意外,而用葆至能的患者中有2572次。布莱根妇女医院(Brigham and Women’s Hospital)的首席研究员、心脏病学专家克里斯托弗·坎农(Christopher Cannon)士说,这意味着,在100个用了他汀但仍会心肌梗死或中风的患者,如果用的是复方药,本来应该可以避免2例这种情况。And, adds Dr. Califf, the study found absolutely no side effects from ezetimibe — no excess cancer, no muscle aches no headaches. “It looks like placebo,” he said.卡里夫士称,该研究还发现,依折麦布完全没有副作用——不会增加罹患癌症的风险,不会造成肌肉酸痛或头痛。“看上去就像安慰剂,”他说。The study was sponsored by Merck, the maker of Vytorin, but the investigators had the right to publish what they wanted, with final say over what they wrote.这项研究由葆至能的生产商默克公司(Merck)赞助,但研究人员有权按照自己的意愿来发布内容,对报告的撰写拥有最后决定权。“Fantastic,” said Dr. Sekar Kathiresan of the Broad Institute and Massachusetts General Hospital who studies the genetics of heart disease but had no part in the study. “A truly spectacular result for patients.”“这项研究太棒了,对于患者来说,这是一大福音,”在德研究所(Broad Institute)和马萨诸塞州综合医院(Massachusetts General Hospital)研究心脏疾病基因的谢卡尔·卡斯瑞斯安(Sekar Kathiresan)士说。他本人并未参与这项研究。Dr. Harlan M. Krumholz, a Yale cardiologist not associated with the study, said he wished there was a peer-reviewed journal article instead of a presentation of the results at a meeting — the data analysis was completed just last week — but, assuming the result holds up, “this is the result we were hoping for.”耶鲁大学心脏病学专家哈伦·M·克鲁姆霍尔茨(Harlan M. Krumholz)士也没有参与该研究。他表示,希望这项成果以同行评议的期刊文章方式发表,而不是在会议上做演示——研究的数据分析上周刚刚完成——但是,假设这个结果经得起推敲,“这会是我们希望看到的结果。”At the same time, and by sheer coincidence, two other groups of researchers reported genetic studies that supported the trial’s conclusions. One, led by Dr. Brian A. Ference of Wayne State University School of Medicine found that gene mutations mimicking the effect of ezetimibe and ones mimicking the effect of statins had the same effect on heart disease risk for a given reduction in cholesterol. The implication, he said, is that “lowering cholesterol with ezetimibe, or a statin, or both, should each lower the risk of heart disease by about the same amount.”纯属巧合的是,另外两个研究团队也在同时发布了遗传学领域的成果,持了该临床研究的结论。其中一个团队由韦恩州立大学(Wayne State University)医学院的布莱恩·A·费伦斯(Brian A. Ference)领导。他们发现,对于给定的胆固醇减少量,模仿依折麦布效果的基因突变,和模仿他汀效果的突变,对心脏疾病风险产生了相同的效果。这意味着,“用依折麦布降低胆固醇,或者用他汀,或两者都用,应该都可以同等程度地降低心脏疾病风险,”他说。The other, led by Dr. Kathiresan, examined mutations that disabled one copy of the cholesterol absorption gene, producing the same effect as ezetimibe. The result was a 50 percent reduction in cholesterol absorption — the same as produced by ezetimibe — and an LDL reduction of 12 milligrams per deciliter of blood, also the same amount as produced by ezetimibe. The mutation, which gave people the equivalent of a lifelong exposure to ezetimibe, reduced the heart attack rate by 50 percent.另外一个团队则在卡斯瑞斯安士的领导下,研究了让一个胆固醇吸收基因拷贝无法发挥作用的突变,获得了和使用依折麦布相同的效果。他们的结论是,胆固醇吸收量减少了50%——与依折麦布效果相同——每100豪升血液的LDL降低了12毫克,也与依折麦布的效果相同。这个突变相当于终生摄入依折麦布,可让心肌梗死几率降低50%。The study’s results are making many wonder about the latest cholesterol guidelines, which did not mention any drug other than a statin. And instead of providing goals for cholesterol levels, they simply advised those at high risk to take a statin. Period.得知这项研究的结果后,很多人对最新的胆固醇指南产生了困惑。文中没有提及他汀之外的任何药物,也没有提供胆固醇水平的目标值,只是劝高风险人群摄入他汀。别无其他。“The guidelines didn’t say they didn’t believe in cholesterol, but they made it clear that the evidence is for a statin, not for any agent that lowers cholesterol,” said Dr. Eugene Braunwald, a study chairman who is a cardiologist at Brigham and Women’s and a longtime leader in the field.“指南没有说他们不相信胆固醇的作用,但他们明确表示,相关据只涉及他汀,不涉及其他降胆固醇的药物,”该领域长期以来的领军人物尤金·布朗瓦德(Eugene Braunwald)士说。他是一个研究会的主席,也是布莱根妇女医院的心脏病学专家。Dr. Neil Stone, the head of the guidelines committee and a cardiologist at Northwestern University, has a more nuanced view of what the guidelines say, but adds that the study result “gives doctors another option if they have a patient who can’t tolerate a high-intensity statin.”西北大学(Northwestern University)心脏病学专家尼尔·斯通(Neil Stone)士是胆固醇指南委员会的主管。对于指南内容的含义,他认为比布朗瓦德的说法更为微妙。但他也表示,“如果遇到无法耐受大剂量他汀的患者”,这项研究结果“给医生提供了另一个选择”。 /201411/343584Premature delivery is tied to increased heart risks in the mother, a review of studies has found.一项研究综述称,母亲心脏病风险增加与早产有关。Pregnancy complications such as pre-eclampsia, pregnancy-induced hypertension and gestational diabetes are recognized risk factors for cardiovascular disease in the mother. But this analysis, published in The European Journal of Preventive Cardiology, found that preterm delivery itself also increases the risk.妊娠并发症,如先兆子痫、妊娠高血压综合征(妊高征)和妊娠期糖尿病是公认的母亲心血管疾病风险因素。但《欧洲预防心脏病学杂志》(The European Journal of Preventive Cardiology)上发表的一项分析表明,早产本身也会增加母亲心血管疾病发作的风险。Researchers reviewed 10 large pregnancy studies, with sample sizes ranging from 3,706 to 923,686 women and follow-up periods ranging from 12 to 35 years. All compared women who had premature babies spontaneously — that is, a birth before 37 weeks’ gestation that was not induced for medical reasons — to women who gave birth to full-term babies. All studies either excluded cases of pre-eclampsia and intrauterine growth restriction, or adjusted for hypertension and pre-eclampsia.研究人员检视了10项大规模的妊娠期研究,样本量在3706至923686人之间,随访期从12至35年不等。这些研究比较了有自发性早产史(定义为并非因医学原因引产而在妊娠37周前分娩)的妇女与足月生产的妇女,而且,均排除了先兆子痫和宫内发育迟缓病例,或针对妊高征和先兆子痫进行了校正。Women with a history of preterm delivery had double the risk for ischemic heart disease, stroke or other cardiovascular disease compared with those without such a history, and the association was independent of other risks. The reasons remain unclear.具有早产史的妇女发生缺血性心脏病、中风和其他心血管疾病的风险是无早产史的妇女的两倍,且该相关性与其他风险因素无关。个中原因尚不清楚。“I don’t want to scare women who have a premature baby,” said the lead author, Dr. Karst Y. Heida, a gynecology resident at the University Medical Center Utrecht. “But it’s important that we are aware of women who are at increased risk. We’re not saying that if you have a premature baby it means you’re going to have a cardiac event.”“我无意吓唬那些有早产史的妇女,”该研究的主要作者,荷兰乌特勒大学医学中心(University Medical Center Utrecht)的妇产科住院医师士卡斯特·Y·海达(Karst Y. Heida)说。“但了解哪些妇女风险较高非常重要。我们的研究结果并不代表只要你有早产史就一定会发生心脏问题。” /201503/366463;I just got promoted again.It#39;s easy to succeed if everyone likes you!;我又升迁了。如果每个人都跟你一样,那么成功很容易啊! /201507/385527

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