Assessment of baroreceptor-cardiac reflex sensitivity using time domain analysis in patients with IDDM and the relation to left ventricular mass index

Autonomic dysfunction in insulin-dependent diabetic (IDDM) patients has been associated with abnormalities of left ventricular function and an increased risk of sudden death. A group of 30 patients with IDDM and 30 age, sex and blood pressure matched control subjects underwent traditional tests of autonomic function. In addition, baroreceptor-cardiac reflex sensitivity (BRS) was assessed using time domain (sequence) analysis of systolic blood pressure and pulse interval data recorded non-invasively using the Finapres beat-to-beat blood pressure recording system. 'Up BRS' sequences-increases in systolic blood pressure associated with lengthening of R-R interval, and 'down BRS' sequences-decreases in systolic blood pressure associated with shortening of R-R interval were identified and BRS calculated from the regression of systolic blood pressure on R-R interval for all sequences. We also assessed heart rate variability using power spectral analysis and, after expressing components of the spectrum in normalised units, assessed sympathovagal balance from the ratio of low to high frequency powers. IDDM subjects underwent 2-D echocardiography to assess left ventricular mass index. Standard tests of autonomic function revealed no differences between IDDM patients and control subjects, but dramatic reductions in baroreceptor-cardiac reflex sensitivity were detected in IDDM patients. 'Up BRS' when supine was 11.2 +/- 1.5 ms/mmHg (mean +/- SEM) compared with 20.4 +/- 1.95 in control subjects (p < 0.003) and when standing was 4.1 +/- 1.9 vs 7.6 +/- 2.7 ms/mmHg (p < 0.001). Down BRS when supine was 11.5 +/- 1.2 vs 22 +/- 2.6 (p < 0.001) and standing was 4.4 +/- 1.9 vs 7.3 +/- 2.5 ms/mmHg (p < 0.003). There were significant relations between impairment of the baroreflex and duration of diabetes (p < 0.001) and poor glycaemic control (p < 0.001). From a fast Fourier transformation of supine heart rate data and using a band width of 0.05-0.15 Hz as low-frequency and 0.2-0.35 Hz as high frequency total spectral power of R-R interval variability was significantly reduced in the IDDM group for both low-frequency (473 +/- 62.8 vs 746.6 +/- 77.6 ms2 p = 0.002) and high frequency bands 125.2 +/- 12.9 vs 459.3 +/- 89.8 ms2 p < 0.0001. When the absolute powers were expressed in normalised units the ratio of low frequency to high frequency power (a measure of sympathovagal balance) was significantly increased in the IDDM group (2.9 +/- 0.53 vs 4.6 +/- 0.55, p < 0.002 supine: 3.8 +/- 0.49 vs 6.6 +/- 0.55, p < 0.001 standing). Thus, time domain analysis of baroreceptor-cardiac reflex sensitivity detects autonomic dysfunction more frequently in IDDM patients than conventional tests. Impaired BRS is associated with an increased left ventricular mass index and this abnormality may have a role in the increased incidence of sudden death seen in young IDDM patients.     

Enhancement Effect of Gold Nanoparticles on the Bioactivity of Hydrogen-producing Microbe

1 IntroductionGold nanoparticles have attracted considerable atten-tionin manyfields duetotheir some special properties al-though goldis very popularfor beingchemicallyinert[1-3].For example ,gold nanoparticles as amplificationtags havebeenthe subject of research directed at gene analysis[4]and antibody or antigen detection[5-7]due to the large di-electric constant ,ease of preparation,andits biocompati-bility[8].Nanoparticles in the range of 1-10 nmin diameterwould display electronic structur…     

河北省张承地区风沙现状及治理对策

在分析张家口、承德地区风沙形成原因及发展趋势的基础上,提出了河北省防沙治沙工作中存在的问题,根据河北省不同类型区的自然、地理及社会经济条件,提出了风沙治理模式和建议。     

大空域机动巡航导弹的模糊PID控制器设计

针对大空域机动巡航导弹下降转平飞过程中出现的强非线性特点．在俯仰通道设计了模糊PID双模控制方案。以高度误差和该误差变化量为输入．以高度误差为阀限．在高度误差较大时采用响应迅速的模糊控制器．较小时采用稳态精度较高的PID控制器。最后通过仿真表明通过该方案所控制的弹道符合方案弹道．满足设计指标要求。     

偏高岭土及其对油井水泥性能的影响

综述了偏高岭土特性及其在水泥混凝土领域中的应用情况,初步研究了偏高岭土对油井水泥性能的影响。结果表明,偏高岭土能显著提高油井水泥的抗压强度,表现出很强的火山灰活性,完全可以作为新一代的油井水泥掺合料。     

深基坑施工安全的监测与实例

从明确深基坑施工安全监测的关键出发，确定了监测内容和相关极限报警值，用工程实例进行了阐述。     

五号桩—长堤地区沙河街组砂体储集性及控制因素研究

沙河街组是沾化凹陷东部五号桩-长堤地区重要的储油层系，主要目的层段为沙三段和沙二段。沙三段和沙二段主要发育有浊积扇、水下冲积扇和滩坝沉积体系，在浊积扇、水下冲积扇中发育辫状水道、扇中前缘、辫状水道间以及扇根、扇缘等沉积微相类型，其中辫状水道、扇中前缘砂体物性好，原生孔隙及次生孔隙均较发育，辫状水道间以及扇根砂体物性较差。其储集特征主要受岩性、沉积微相、成岩作用等因素控制，结合该地区实际情况，将沙二段、沙三段储集层划分为好、中、差3种类型。图4表1参7     

Attitudes and beliefs of Canadian infection control decision-makers towards 'borderline' methicillin-resistant Staphylococcus aureus

'Borderline' methicillin-resistant Staphylococcus aureus (MRSA) strains are inhibited by drug concentrations of 2 to 8 micrograms/mL. This type of resistance is usually mediated by 'hyper beta-lactamase' production which is detectable in vitro by susceptibility to combinations of a beta-lactam and a beta-lactamase inhibitor (ie, amoxicillin and clavulanic acid). A survey of Canadian infection control experts was performed to assess the knowledge, attitudes and beliefs regarding the containment requirements for borderline MRSA strains in acute health care facilities. Twenty-three of 38 Canadian infection control experts (61%) (members of the Canadian Hospital Epidemiology Committee [CHEC] or the Society for Healthcare Epidemiology of American [SHEA]) returned a questionnaire about a fictional patient with a postoperative wound infection with such a strain. Eleven respondents (48%) considered the isolate as an MRSA, 11 did not and one was unsure. All who did not believe the strain to be MRSA would not have isolated or cohorted the patient. Four in the latter group would have isolated the patient if he or she were on a neurosurgery or cardiovascular surgery unit, indicating a desire to restrict spread of this isolate on those units. Seven of the 12 individuals who had managed at least one patient with a borderline MRSA did not advocate patient isolation or cohorting, and five did. This survey has supported the belief that there are discrepancies among infection control decision-makers in Canada regarding the approach, precautions and therapy of patients infected with borderline strains of MRSA. Further data on virulence of and effective therapy for these isolates are needed to assess whether the additional cost is warranted in controlling the nosocomial spread of these isolates.