V1与V3R～V6R导联QRS波群相关性分析

目的探讨右胸导联正常QRS波群的内在规律。方法观察220例健康大学生常规12导联和V3R-V6R导联心电图，分析V1QRS波群呈不同形态时V3R-V6R导联QRS形态和q波时间、电压及q／R比值。结果V3R-V6R与V1QRS形态相似率逐导联降低；V3R-V6Rq及Qs波出现率逐导联增高（1．82％、6．82％、23．64％、47．27％）；V1呈Rs时V3R、V4R无q或QS波，V1呈QS时V3R、V4R均呈QS型；V3R、V4R或V5R出现q或QS波，则其右侧导联也出现q或QS波（即不会单个导联出现q或QS波）；V3R-V6Rq波时间〈0．04s，q／R比值可〉1／4。结论正常人右胸导联可出现q或QS波，孤立导联的q或QS波有临床意义。     

健康人右胸导联QRS波和T波形态分析

目的探讨健康人右胸导联心电图QRS波和T波形态及临床意义。方法测量867名健康人右胸导联心电图,分析QRS波和T波形态。结果右胸导联Q波的发生率与V1导联R波的幅度有密切关系,V1呈QS型、V3R～V5R多数有Q波。V1呈rS型,则R波幅度越小,V3R～V5R出现Q波的机会越大;右胸导联V1→V3R→V5R直立T波出现逐渐减少,倒置T波出现逐渐增多。结论健康人右胸导联心电图V1、V3R～V5R出现Q波和T波倒置不能作为诊断合并右室心肌梗（RVMI）的可靠依据。     

右胸导联心电图诊断右室梗塞的价值综述

近年来右室梗塞(RVI)日益受到重视,为进一步掌握右胸导联心电图的诊断,本文将有关研究综述如下。 1 正常人右胸导联心电图 1.1 QRS波群 多数作者认为,正常成人右胸导联心电图有一定变化规律。即QRS呈rS型,以V_3R出现率最高,V_3R以右导联r波振幅依次递减或消失,S波振幅亦依次降低,QRS演变为qr或QS型。对于右胸导联Q波的研究,各家报导略有不同Andensen等强调正常人不应在全部右胸导联出现Q波,否则应疑及RVI;但有作者却认为,正常人V_3R—v_6R均可呈QS     

300名正常人右胸导联心电图分析(摘要)

对300名(男女各150名,年龄21—90岁,21—60岁每10岁各30名,60岁以上各30名)正常人右胸导联心电图V_(3R)、V_(4R)、V_(5R)、V_(6R)进行分析。其结果为: 1.V_(3R)—V_(6R)均可呈QS型,除V_(3R)不出现Q(q)波外,QS及Q(q)波出现率逐导联增多。QS型V_(3R)、V_(4R)在50岁以上显著增多。     

正常人V1呈QS型的发生率及其右胸导联心电图分析

为了解正常人群中V1呈QS型的发生率及其右胸导联心电图变化，我们在5395例正常人中检出所有V1呈QS型者，并加作右胸导联心电图，总结分析如下。     

急性右室心肌梗死的心电图分析

目的　探讨急性右室心肌梗死 (ARVI)的心电图特征。方法　选择急性心肌梗死 (AMI) 5 0例 ,进行心电图回顾性分析。结果　 5 0例AMI中合并ARVI 18例 ,发生率为 3 6%。下壁、正后壁AMI 2 3例中合并ARVI 12例 ,发生率 5 2 2 %。V3R～V5R导联QRS波呈QS型 ,其后ST T有动态改变。部分病例有Ⅰ、aVL、V5、V6 导联Q波消失 ,STⅢ /Ⅱ 抬高 >1,STⅡ 抬高≥ 1mm ,V1 ～V5导联ST段抬高呈递减性 ,STV2 ↓ /STaVF↑≤ 5 0 %等表现。结论　AVRI多合并下壁、正后壁AMI。右胸导联异常Q波 ,动态ST T改变是ARVI诊断依据 ,常规 12导联心电图上述改变可作为ARVI诊断线索     

正常人右胸导联心电图P波形态及性别差异

目的 探讨正常人右胸导联心电图男女P波形态差异及变化规律.方法 测量900名正常人右胸导联心电图,男女对半,分析P波形态及变化规律.结果 右胸导联心电图P波以直立和正负双相P波为主.V1导联直立P波的发生率明显多于正负双相P波的发生率(P<0.01).从V1～V6R直立P波的发生率依次减少,正负双相P波的发生率依次增多...     

正常人V2导联R/S＞1的心电图分析

目的探讨正常人心电图单纯出现V2导联R/S>1的发生情况。方法随机抽取健康体检中正常人3987名(男性2108名,女性1879名,年龄范围20～60岁),常规心电图检出V2导联R/S>1共计349名(男性206名,女性143名),按性别分男、女2组,按年龄分为4个年龄组,并对V2导联的R波及V6导联的q波的波形、振幅及时限进行分析。结果正常的健康人群中9.8%男性和7.6%女性出现V2导联R/S>1。40～50岁的年龄组最高,达10.2%。95.1%V2导联R波时限在0.4～0.5s。V6导联无q波或有q波时限均<0.02s,93.4%振幅<0.10mV。结论V2导联作为移行区导联出现R/S>1现象较常见,考虑为生理性改变。     

房性Q波与心房梗死

常规12导联心电图诊断心房梗死非常罕见,下面报告1例。患者女性,41岁。咳嗽、喘息、呼吸困难30余年,加重并胸闷1周就诊。图1右心房梗死图形临床诊断:支气管哮喘,可疑心肌梗死。心电图示:P波顺序发生,Ⅱ、Ⅲ、aVF导联P波呈负正双相,即出现房性Q波,aVR导联P波呈正负双相,胸导联也存在不同程度的房性Q波,P R间期0.10s,QRS波和ST T均无异常发现。加作右胸导联,V3R～5R呈rs型,V6R呈QS型,ST T亦无改变。心电图诊断:短P R综合征,房性Q波。讨论不伴随心室肌梗死的单纯性心房梗死几乎不可能从心电图上独立进行诊断。临床上心房梗死诊断率…     

中国健康人群心电图Q波参数正常范围的调查

目的 :调查中国健康人群 12导联心电图Q波参数的正常范围 ,评估传统的Q波标准。方法 :采集5 36 0例 (男 36 14例 ,女 174 6例 )健康人心电图资料 ,并按性别分为 5个年龄组 ,计算各年龄组Q波时限、振幅和Q/R比例的中位数和正常上限值 ,以及各导联上QS波类型的发生率。结果 :男性Q波时限稍长于女性 ,性别差异为 2～ 5ms。Q波时限正常范围在Ⅰ、V5和V6导联≤ 2 5ms ,在aVL导联≤ 4 5ms ;在下壁导联中 ,Q波时限正常范围在Ⅲ导联 <4 0ms,在Ⅱ和aVF导联 <30ms。各导联的Q波振幅正常上限值在不同年龄组间显示较大的变异。Q/R比例的正常上限值在Ⅰ、Ⅱ导联一般 <2 5 % ,而在V5和V6导联 <15 % ;aVL、Ⅲ和aVF导联的Q/R比例正常上限值在不同年龄组间显示较大的变异。QS波类型在V1导联的发生率为 1.5 % (80 / 5 36 0 ) ,在V2 导联的发生率为 0 .2 % (9/ 5 36 0 )。除Ⅲ和aVL导联外 ,传统的Q波标准的诊断特异性可达到 99%～ 10 0 %。结论 :Q波参数的正常值标准有明显的导联依赖性。适当调整传统的Q波标准 ,可望提高心电图诊断的准确率     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Variabilité des concentrations plasmatiques de l’angiotensinogène et risque d’hypertension artérielle chez le rat transgénique

Aim

Genetic polymorphisms of the human angiotensinogen gene are frequent and may induce up to 30% increase of plasma angiotensinogen concentrations with a blood pressure increase of up to 5 mmHg. Their role for the pathogenesis of human arterial hypertension remains unclear. High plasma angiotensinogen levels could increase the sensitivity to other blood pressure stressors.

Methods

Male transgenic rats with a 9-fold increase of plasma angiotensinogen concentrations and male non-transgenic rats aged 10 weeks were treated or not with NG-Nitro-L-arginine-methyl ester for 3 weeks in their drinking water (n = 3/group). Systolic blood pressure and body weight were measured at baseline and at the end of the study when left ventricular weight and ventricular expression of angiotensin I-converting enzyme and procollagen Iα1 were determined (polymerase chain reaction).

Results

At baseline, transgenic rats had +18 mmHg higher bood pressure and –8% lower body weight compared to non-transgenic rats (P < 0.05) without significant changes for the vehicle groups throughout the study (P > 0.05). NG-Nitro-L-arginine-methyl ester increased blood pressure, left ventricular weight and left ventricular weight indexed for body weight by +41%, +17.6% and +18.6% (P < 0.05) in transgenic and +25%, +5.3% and +6.7% (P > 0.05) in non-transgenic rats compared to untreated animals, respectively. Cardiac gene expression showed no differences between groups (P > 0.05).

Conclusion

Increased plasma angiotensinogen levels may sensitize to additional blood pressure stressors. Our preliminary results point towards an independent role of angiotensinogen in the pathogenesis of human hypertension and associated end-organ damage.