A COMPARATIVE STUDY OF INTRAVENOUS ACCELERATED STREPTOKINASE DOSE REGIMEN WITH CONVENTIONAL DOSE REGIMEN FOR CORONARY THROMBO

ＡＣＯＭＰＡＲＡＴＩＶＥＳＴＵＤＹＯＦＩＮＴＲＡＶＥＮＯＵＳＡＣＣＥＬＥＲＡＴＥＤＳＴＲＥＰＴＯＫＩＮＡＳＥＤＯＳＥＲＥＧＩＭＥＮＷＩＴＨＣＯＮＶＥＮＴＩＯＮＡＬＤＯＳＥＲＥＧＩＭＥＮＦＯＲＣＯＲＯＮＡＲＹＴＨＲＯＭＢＯＬＹＳＩＳＸｕＣｈｅｎｇｂｉｎ...     

COMPARISON OF FOUR METHODS TO GENERATE IMMUNOREACTIVE FRAGMENTS OF A MURINE MONOCLONAL ANTIBODY OC859 AGAINST HUMAN OVARIAN E

ＣＯＭＰＡＲＩＳＯＮＯＦＦＯＵＲＭＥＴＨＯＤＳＴＯＧＥＮＥＲＡＴＥＩＭＭＵＮＯＲＥＡＣＴＩＶＥＦＲＡＧＭＥＮＴＳＯＦＡＭＵＲＩＮＥＭＯＮＯＣＬＯＮＡＬ　ＡＮＴＩＢＯＤＹＯＣ８５９ＡＧＡＩＮＳＴＨＵＭＡＮＯＶＡＲＩＡＮＥＰＩＴＨＥＬＩＡＬＣＡＮＣＥＲＡ...     

A NEW METHOD OF DIGESTIVE TRACT RECONSTRUCTION OF ESOPHAGEAL CANCER IN POST─SUBTOTALGASTRECTOMYAREPORTOF3─CASES

ＡＮＥＷＭＥＴＨＯＤＯＦＤＩＧＥＳＴＩＶＥＴＲＡＣＴＲＥＣＯＮＳＴＲＵＣＴＩＯＮＯＦＥＳＯＰＨＡＧＥＡＬＣＡＮＣＥＲＩＮＰＯＳＴ─ＳＵＢＴＯＴＡＬＧＡＳＴＲＥＣＴＯＭＹＡＲＥＰＯＲＴＯＦ３─ＣＡＳＥＳＷａｎｇＰｅｎｇ（Ｔａｉａｎｃｅｎｔｒａｌｈｏｓｐ...     

DIFFEKENTIAL CALCIUM－BINDING ABILITY OF FREE AND BOUND PROTEINS－SUGGESTIONOFAN0VELPROTEINS／C4B－BINDINGPKOTE

ＤＩＦＦＥＫＥＮＴＩＡＬＣＡＬＣＩＵＭ－ＢＩＮＤＩＮＧＡＢＩＬＩＴＹＯＦＦＲＥＥＡＮＤＢＯＵＮＤＰＲＯＴＥＩＮＳ－ＳＵＧＧＥＳＴＩＯＮＯＦＡＮ０ＶＥＬＰＲＯＴＥＩＮＳ／Ｃ４Ｂ－ＢＩＮＤＩＮＧＰＫＯＴＥＩＮ－ＢＩＮＤ－ＩＮＧＦＡＣＴＯＲＩＮＨＵＭＡＮＰ...     

IMPLANTATION OF AUTOLOGOUS SKIN FIBROBLAST GENETICALLY MODIFIED TO SECRETE CLOTTING FACTOR IX PARTIALLY CORRECTS THE HEMORRHA

ＩＭＰＬＡＮＴＡＴＩＯＮＯＦＡＵＴＯＬＯＧＯＵＳＳＫＩＮＦＩＢＲＯＢＬＡＳＴＧＥＮＥＴＩＣＡＬＬＹＭＯＤＩＦＩＥＤＴＯＳＥＣＲＥＴＥＣＬＯＴＴＩＮＧＦＡＣＴＯＲＩＸＰＡＲＴＩＡＬＬＹＣＯＲＲＥＣＴＳＴＨＥＨＥＭＯＲＲＨＡＧＩＣＴＥＮＤＥＮＣＩＥＳＩＮ...     

IMPROVEMENT OF A DIRECT DTNB ASSAY OF GLUTATHIONE PEROXIDASE AND EFFECT OF SELENIUM RICH YEAST IN MICE BLOOD GLUTATHIONE PERO

ＩＭＰＲＯＶＥＭＥＮＴＯＦＡＤＩＲＥＣＴＤＴＮＢＡＳＳＡＹＯＦＧＬＵＴＡＴＨＩＯＮＥＰＥＲＯＸＩＤＡＳＥＡＮＤＥＦＦＥＣＴＯＦＳＥＬＥＮＩＵＭＲＩＣＨ　ＹＥＡＳＴＩＮＭＩＣＥＢＬＯＯＤＧＬＵＴＡＴＨＩＯＮＥＰＥＲＯＸＩＤＡＳＥＡＣＴＩＶＩＴＹＢａｏＪ...     

BONE REMODELING AFTER INTERNAI FIXATION WITH PLATES OF VARYING DEGREES OF STIFFNESS：A QUANTITATIVE HISTOLOGICAL ANALYSIS

ＢＯＮＥＲＥＭＯＤＥＬＩＮＧＡＦＴＥＲＩＮＴＥＲＮＡＩＦＩＸＡＴＩＯＮＷＩＴＨＰＬＡＴＥＳＯＦＶＡＲＹＩＮＧ　ＤＥＧＲＥＥＳＯＦＳＴＩＦＦＮＥＳＳ：ＡＱＵＡＮＴＩＴＡＴＩＶＥ　ＨＩＳＴＯＬＯＧＩＣＡＬ　ＡＮＡＬＹＳＩＳＣｈｅｎＹｏｎｇｑｉａｎｇ；（陈...     

A NEW METHOD OF EARLY DIAGNOSIS OF FAT EMBOLISM SYNDROME

ＡＮＥＷＭＥＴＨＯＤＯＦＥＡＲＬＹＤＩＡＧＮＯＳＩＳＯＦＦＡＴＥＭＢＯＬＩＳＭＳＹＮＤＲＯＭＥＡＮＥＸＰＥＲＩＭＥＮＴＡＬＳＴＵＤＹＯＦＴＨＥＰＵＬＭＯＮＡＲＹＭＩＣＲＯＶＡＳＣＵＬＡＲＣＹＴＯＬＯＧＹＴｅｎｇＱｉｎｇｓｈａｎ滕青山，ＺｈａｎｇＢｏｘ...     

OSTEOCLASTIC RESORPTION OF HAVERSIAN SYSTEMS IN CORTICAL BONE OF FEMORAL NECK IN AGED WOMEN A SCANNING ELECTRON MICROSCOPIC S

ＯＳＴＥＯＣＬＡＳＴＩＣＲＥＳＯＲＰＴＩＯＮＯＦＨＡＶＥＲＳＩＡＮＳＹＳＴＥＭＳＩＮＣＯＲＴＩＣＡＬＢＯＮＥＯＦＦＥＭＯＲＡＬＮＥＣＫＩＮＡＧＥＤＷＯＭＥＮＡＳＣＡＮＮＩＮＧＥＬＥＣＴＲＯＮＭＩＣＲＯＳＣＯＰＩＣＳＴＵＤＹＣｈａｉＢｅｎｆｕ柴本甫，Ｔ...     

CHANGES OF PLASMA DYNORPHIN LEVELS BEFORE AND AFTER PERCUTANEOUS BALLOON MITRAL COMMISSUROTOMY IN PATIENTS WITH MITRAL STENOS

ＣＨＡＮＧＥＳＯＦＰＬＡＳＭＡＤＹＮＯＲＰＨＩＮＬＥＶＥＬＳＢＥＦＯＲＥＡＮＤＡＦＴＥＲＰＥＲＣＵＴＡＮＥＯＵＳＢＡＬＬＯＯＮＭＩＴＲＡＬＣＯＭＭＩＳＳＵＲＯＴＯＭＹＩＮＰＡＴＩＥＮＴＳＷＩＴＨＭＩＴＲＡＬＳＴＥＮＯＳＩＳＹｉｎＲｕｉｘｉｎｇ；（尹瑞...     

经皮球囊导管治疗二尖瓣狭窄的近期疗效

目的：总结经皮球囊导管治疗二尖瓣狭窄的疗效。方法：实施１１４例经皮球囊导管治疗二尖瓣狭窄，观察血液动力学和临床心功能疗效。结果：术后左心房压、肺动脉收缩、经二尖瓣压力阶差减低，心排量和二尖瓣瓣口面积增加，临床心功能明显改善。超声心动图与心导管血液动力学测值有显著相关性。结论：经皮球囊导管治疗是一种非开胸治疗二尖瓣狭窄的有效方法，超声惊心动图可作为术后随访的重要手段。     

风心病单纯二尖瓣狭窄与合并心房颤动患者左心房压力变化的观察

目的探讨风湿性心脏病(风心病)单纯二尖瓣狭窄(rheumatic pure mitral stenosis,RMS)左心房压力变化。方法回顾分析242例RMS成功行经皮二尖瓣球囊扩张术(PBMV)患者资料,按有无心房颤动分为窦性心律组(122例)与心房颤动组(120例),分别对两组病程、心功能状态、左心房内径、瓣口面积、左心房最大压力、左心房最小压力、左心房平均压进行统计分析。结果两组二尖瓣口面积差异无统计学意义(P>0.05),心房颤动组年龄大于窦性心律组,差异有统计学意义(P<0.01),病程明显长于窦性心律组,差异有统计学意义(P<0.05),心功能亦明显差于窦性心律组,差异有统计学意义(P<0.01),心房颤动组左心房内径较窦性心律组明显增大,差异有统计学意义(P<0.01),心房颤动组左心房最大压力、左心房最小压力、左心房平均压均低于窦性心律组,差异有统计学意义(P<0.05)。结论单纯二尖瓣狭窄患者发生心房颤动后左心房压力下降,左心房内径进一步扩大可能是主要原因。     

球囊二尖瓣扩张术后心房纤颤复律的临床研究

目的探讨二尖瓣狭窄合并心房纤颤患者在球囊二尖瓣扩张后,转复心房纤颤的临床效果及影响心房纤颤转复后窦性心律维持的相关因素.方法 206例二尖瓣狭窄合并心房纤颤患者在球囊扩张术后,采用口服胺碘酮及电复律治疗心房纤颤,对复律成功的患者给予小剂量胺碘酮维持窦性心律并随访1年.结果服用胺碘酮者58例,17例转复成功(29.3%);189例行电转复,178例转复成功(94.2%),电转复成功率明显高于胺碘酮转复(P＜0.01).心房纤颤复发组与保持窦性心律组相比,左心房内径明显扩大(P＜0.01),心房纤颤持续时间明显长(P＜0.01),中度二尖瓣关闭不全人数的比率明显高(P＜0.05).随访1年,有45例患者心房纤颤复发.影响心房纤颤转复后维持窦性心律的相关因素有左心房内径扩大、心房纤颤持续时间长及明显的二尖瓣关闭不全.结论对左心房内径明显扩大、心房纤颤持续时间过长及有明显的二尖瓣关闭不全的患者,在选择心房纤颤转复时应慎重.     

房颤与心房大小的相关性研究

本研究测定房颤和窦性心律的风心病二尖瓣狭窄、冠心病及特发性房颤5组病人的左右心房直径,并与健康组对照及作组间对比分析。对心房大小和有关影响因素,包括年龄、房颤、二尖瓣口直径,PEP/LVET、CI作单相关分析和多元回归分析。结果提示:冠心病组与风心病二狭组的左右心房直径与年龄,PEP/LVET、房颤呈正相关,与CI呈负相关,与二尖瓣口大小前者无显著相关,后者呈负相关。多元标准回归方程则显示:房颤是促进心房增大的主要因素,房颤和心房增大互为因果关系;而在不同的心脏疾病中房颤等诸因素对心房大小的影响所占比重大同。     

多普勒超声和心导管同步测定左房压

应用多普勒超声和心导管同步测定左房压,探讨无创性测定心内压力的方法。方法应用连续波多普勒超声和心导管对54例二尖瓣返流患者的血流动力学进行了研究。结果肱动脉收缩压减去多普勒测定的二尖瓣返流最大压差所获得的左房压,与心导管测定的平均肺毛压之间存在高度相关(r=0.933,SEE=0.39kPa,P<0.001);两种技术测定的收缩期左室房间压差亦存在高度相关(r=0.91,SEE= 0.8kPa,P<0.001);肱动脉与左室收缩压之间亦高度相关(r=0.93,SEE=0.67kPa,P<0.01)。结论多 普勒超声为无创性测定左房压提供一种可靠而准确的新途径。     

The effect of transient balloon occlusion of the mitral valve on left atrial appendage blood flow velocity and spontaneous echo contrast: a comparison in sinus rhythm and atrial fibrillation patients

Objective To investigate the relationship between spontaneous echo contrast (SEC) and left atrial appendage (LAA) blood flow velocity using transesophageal echocardiography (TEE) during percutaneous balloon mitral valvotomy (PBMV) in patients with atrial fibrillation and sinus rhythm.Methods Thirty-five patients （21 in sinus rhythm and 14 in atrial fibrillation ） with rheumatic mitral stenosis underwent PBMV with intraoperative transesophageal echocardiography monitoring. We measured LAA blood flow velocities and observed the left atrium for various grades of SEC (from 0=none to 4=severe), before and after each balloon inflation. Results Left atrial appendage maximal emptying velocity (LAA MEV) was reduced from 35±14 cm/s to 6±2 cm/s at peak balloon inflation and increased to 40±16 cm/s after balloon deflation. Comparison of the values before balloon inflation and after balloon deflation showed that LAA velocities were significantly lower (P&lt;0.001).During balloon inflation, both maximal emptying velocity (MEV) and maximal filling velocity (MFV) were significantly decreased, compared to those before inflation and after balloon deflation (P&lt;0.01).And both MEV and MFV were significantly higher after balloon deflation relative to those before balloon inflation. Patients with atrial fibrillation had significantly lower MEV and MFV before and during balloon inflation and after balloon deflation than patients with sinus rhythm.At peak balloon inflation, new or increased SEC grades were observed during 54 of 61 (88%) inflations and unchanged during 7 (12%) inflations.SEC grades were reduced after 55 balloon deflations (90%), completely disappeared after 18 deflations (30%) and remained unchanged after 6 deflations (10%). At peak balloon inflation,left atrium spontaneous echo contrast (LASEC) grade 4 was observed during 14 of 27 (93%) inflations in the atrial fibrillation patients, significantly higher than in patients with sinus rhythm (8 of 34, 24%; P&lt;0.05). LASEC completely disappeared after 16 of 34 deflations (47%) in the patients with sinus rhythm, significantly higher than in the atrial fibrillation patients (2 of 27 deflations; P&lt;0.01). The mean time to achieve maximal SEC grade (2.5±1.2 s) correlated with the mean time to trough LAA velocities (2.3±1.1 s ) after balloon inflation. Both the time to lowest LAA velocity and the time to highest LASEC were significantly longer in the patients with sinus rhythm than in the atrial fibrillation patients (2.6±1.1 s vs 1.7±1.0 s, P&lt;0.05 and 2.8±1.4 s vs 1.9±1.3 s, P&lt;0.05, respectively).Upon deflation, the mean time to lowest SEC grade (2.9±1.8 s) correlated with the mean time to achieve maximal LAA velocities (2.7±1.6 s).Both intervals are significantly shorter in the patients with sinus rhythm than in the atrial fibrillation patients (2.0±1.6 s vs 3.5±1.5 s, P&lt;0.01 and 2.2±1.7 s vs 3.6±1.6 s, P&lt;0.05). Conclusion Reducing the blood flow velocity in the human left atrium by balloon occlusion of the mitral valve may enhance SEC, whereas restoring blood flow after balloon deflation would cause enhanced echogenic blood to disappear or decrease in both groups of patients.Patients with atrial fibrillation demonstrate more severe blood stagnation of the left atrial body and appendage during transient balloon inflation at mitral valve orifice and slower recovery from the stagnation, decreasing to a lesser extent after balloon deflation, when compared to patients with sinus rhythm.     

二尖瓣病变患者左房心肌总蛋白激酶C活性及亚类含量的变化

目的　探讨二尖瓣病变患者左房心肌总蛋白激酶 C(PKC)活性及 PKCα、β亚类含量与心房颤动(AF)之间可能存在的关系。方法　 35例患者分为四组 ,A组 :二尖瓣狭窄 (MS)伴 AF;B组 :为窦性心率 (SR)的二尖瓣狭窄 ;C组 :二尖瓣关闭不全 (MR)伴 AF;D组 :为 SR的二尖瓣关闭不全。分别检测各组总 PKC活性及 PKCα、PKCβ亚类含量。结果　各组间总 PKC活性无明显差异 (P>0 .0 5 )。伴有 AF的二尖瓣病变患者 (MS或 MR)其左房心肌 PKCα含量低于 SR的二尖瓣病变患者 (MS或 MR) ;而 PKCβ含量却高于 SR的二尖瓣病变患者 ,但上述差异尚未达到统计处理的显著性水平 (P>0 .0 5 )。结论　左房心肌总 PKC活性与二尖瓣病变患者 AF发生的关系不明显 ,但左房心肌 PKC亚类含量水平的变化与 AF的关系值得进一步研究     

二尖瓣病变伴心房颤动患者左房心肌肌球蛋白ATP酶活性的改变

目的:观察不同类型二尖瓣病变伴心房颤动(atrial fibrillation,AF)患者左房心肌肌球蛋白ATP酶活性的改变。方法:24例二尖瓣病变患者,其中二尖瓣狭窄12例(窦性心律6例,AF 6例)、二尖瓣关闭不全12例(窦性心律6例,AF 6例),于术中体外循环转流前结扎左心耳切取部分左心耳组织,并以4例意外死亡窦性心律者左心耳组织作为对照组。比色法检测心肌肌球蛋白ATP酶(myosin ATPase)活性。结果:与对照组相比,二尖瓣病变各组患者肌肌球蛋白ATP酶活性无明显变化(P>0.05)。与窦性心律患者相比,二尖瓣病变伴AF患者其心房肌肌球蛋白ATP酶活性无明显变化(P>0.05)。结论:二尖瓣病变患者伴AF患者心房肌肌球蛋白ATP酶活性无明显变化。     

二尖瓣手术同期房颤射频消融在不同左房大小的近中期结果对比

目的评价不同左心房直径(LAD)大小(LAD>45 mm或≤45 mm)的慢性瓣膜性房颤(AF)患者行外科改良双极射频消融术(BRFA)的近中期消融效果。方法回顾性分析2016年5月至2019年1月在中国人民解放军总医院心血管外科共完成心脏手术同期行改良双极BRFA共264例患者的临床资料,制定纳入及排除标准,并对两组患者不同LAD进行倾向性评分,共纳入A组(左心房直径LAD>45 mm)75例,B组(左心房直径LAD≤45 mm)75例;分析比较两组患者的术前一般资料、手术相关指标、术后病死率、并发症及窦性心律恢复情况。结果A组术后1周、半年、1年及2年窦性心律转复率分别为:84.0%、81.3%、73.3%和69.3%;B组术后1周、半年、1年及2年窦性心律转复率分别为:90.7%、88.0%、86.7%和84.0%,两组比较差异有统计学意义(P<0.05)。术后按标准华法林抗凝,两组患者术后近中期随访均未新发脑血管事件。结论二尖瓣手术同期采用改良MazeⅣ行BRFA治疗慢性长程持续性瓣膜性AF手术效果好,窦性心律转复成功率高。然而,手术后随时间延长,LAD越大越不容易维持窦性心律。     

208例风湿性心脏病房颤因素分析

总结２０８例风心病人，二尖瓣病变占９８．５％，主动脉瓣病变占８．７％，其中房颤１１４例（５４．８％），窦律９４例（４５．２％）。房颤组年龄、病史、左房内径与窦律组相比差异有高度显著性（Ｐ＜０．００１），二狭与二狭二闭的房颤率相比差异有显著性（Ｐ＜０．０５），不同性别和不同职业的房颤率相比差异无显著性（Ｐ＞０．０５）。