组织多普勒显像技术检测缺血心肌的局部舒张功能

目的 :评价组织多普勒显像 （TDI）技术检测缺血心肌局部舒张功能的价值。方法 :应用超声心动图分别记录心肌缺血组 （2 8例 ）和对照组 （30例 ）舒张期二尖瓣血流频谱 （TMF）及左室基底部、中部和心尖部 3个水平面 15节段心肌 TDI。结果 :两组间左室射血分数相近 （6 2 %± 9% vs 6 6 %± 8% ,P>0 .0 5 ）。心肌缺血组与对照组比较 ,TMF舒张早期减速度时间 （2 82± 17m s vs 2 0 1± 11m s,P<0 .0 5 ）和等容舒张时间 （92± 18ms vs 6 1± 10 m s,P<0 .0 1）延长 ;E/A比值增加 （0 .6 7± 0 .2 vs 1.6± 0 .5 ,P<0 .0 1）。对照组 TDI示左室基底部与中部心肌舒张早期舒张速度 （Em ）高于心尖部 （P<0 .0 5 ） ,缺血节段 Em降低 ,局部早期舒张减速度时间和等容舒张时间延长。结论 :TDI可无创检测左室局部舒张功能。     

核潜艇艇员远航后心脏超声心动图随访观察

目的 :利用二维、M型超声心动图随访核潜艇艇员远航后心脏形态、功能的变化及其规律。方法 :采用美国HP10 0 0型彩色超声诊断仪对 49名长航前后的核潜艇艇员进行超声心动图追踪观察。测量左室舒张末内径（L Vd）、左室收缩末内径 （L Vs）及心电图 R-R间期 ,计算左室舒张末容量 （ESV）、收缩末容量 （EDV）、射血分值（EF）、小轴缩短率 （FS）、心输出量 （CO）及每搏量 （SV） ;分别测量舒张早期房室平面位移值 （T）及左房收缩引起的房室平面位移值 （A）。结果 :49名艇员远航返航后 2 4h内左房 （L A）及主动脉 （AO）内径增大 （3 .2 1± 0 .3 0 vs 3 .10± 0 .2 1cm ,P<0 .0 5;3 .19± 0 .19vs 3 .0 5± 0 .3 0 cm,P<0 .0 1） ,EDV和 SV增加 （10 8± 16vs 98± 15ml,P<0 .0 1;69± 10 vs 63± 10 ml,P<0 .0 1） ,A值明显增大 （0 .64± 0 .12 vs 0 .56± 0 .11cm,P<0 .0 1） ,T值明显变小 （1.3 4±0 .2 3 vs 1.49± 0 .2 4cm,P<0 .0 1）。返航后 3个月末 ,除了 T值尚未完全恢复外 ,其余各项指标均恢复如前。结论 :核潜艇长航可引起艇员短期内心脏形态改变和舒张功能轻微受损 ,但该损伤系可复性改变 ,超声心动图可对其变化规律进行追踪观察     

核潜艇远航时艇员心功能的变化

目的 :评价核潜艇艇员远航前后心功能的变化。方法 :艇员 49名 ,采用美国 HP10 0 0型彩色超声诊断仪。于胸骨旁左室长轴切面 ,M型取样线置于 2 a区 ,测量左室舒张末内径 （LVd）、左室收缩末内径 （LVs）及心电图 R-R间期 ,计算左室舒张末容量 （ESD）、收缩末容量 （ESV ）、射血分值 （EF ）、小轴缩短率 （FS）、心输出量 （CO）及每搏量（SV） ;于心尖四腔切面 ,将 M型取样线置于室间隔左室面边缘与左室房室平面 （即二尖瓣环 ）交界处 ,分别测量舒张早期房室平面位移值 （T）及左房收缩引起的房室平面位移值 （A）。结果 :本组人员远航后血压升高 （P<0 .0 5 ） ,心率加快 （P<0 .0 1）。EDV和 SV值增加 （10 8± 16vs98± 15 ,P<0 .0 1;69± 10 vs63± 10 ,P<0 .0 1） ,主要收缩功能指标包括 EF,FS及 CO与远航前无明显差异 （P>0 .0 5 ） ;房室平面位移值 A增大 （0 .64± 0 .12 vs 0 .5 6± 0 .11,P<0 .0 5 ） ,T值明显变小 （1.3 4± 0 .2 3 vs 1.49± 0 .2 4,P<0 .0 1）。结论 :核潜艇远航可引起艇员血压升高 ,心率加快以及随之而来的心脏舒张功能减低 ,但收缩功能无明显变化     

妊娠高血压综合征患者分娩前后左室舒张功能的超声心动图研究

目的 :评价妊娠高血压综合征 （PIH）患者分娩前后左室舒张功能变化。方法 :临床诊断为重度 PIH患者 32例 ,正常妊娠 （NP） 2 4例。采用美国 Acuson12 8XP/ 10彩色电脑声像仪 ,采用 M型超声心动图记录二尖瓣舒张早期活动情况 ,测量 E- F斜率。多普勒超声心动图测量二尖瓣血流峰值速度 （E,A）及速度时间积分 ,计算 E/ A比值及快速充盈分数 （RFF）。产后 2个月内复查。结果 :PIH组同 NP组相比 ,二尖瓣 E- F缓慢 （6 .4± 2 .9vs9.3± 4.5cm/ s,P<0 .0 5 ） ,E/ A明显下降 （1.2± 0 .2 vs1.4± 0 .2 ,P<0 .0 1） ,RFF减低 （5 6 %± 5 % vs6 0 %± 5 % ,P<0 .0 5 ）。产后复查时 ,PIH组 E/ A明显升高 （1.2± 0 .2 vs1.5± 0 .3,P<0 .0 1） ,接近正常产后水平 （1.5± 0 .3vs1.6±0 .3,P>0 .0 5 ） ;RFF,E- F下降速度与正常产后无显著差别 （P>0 .0 5 ）。结论 :重度 PIH患者孕晚期可出现左室舒张功能受损 ,除个别病例外 ,大多数患者产后 2个月内恢复正常     

急性心肌梗死患者入院时Killip分级与预后的关系

分析 413例急性心肌梗死患者入院时 Killip分级与临床预后的关系。结果 :Killip 级组和 Killip 级以上组性别及既往史无差异。但 Killip 级以上组较 级组年龄大 （6 7± 12 vs 6 0± 10 ）、血清肌酸磷酸激酶 （CK）峰值高（34 6 9± 175 7vs 196 6± 1795 ,P<0 .0 1）、左室舒张未期容积大 （185± 16 vs 12 5± 47,P<0 .0 1） ,住院病死率高（4 7.9% vs 11.2 % ,P<0 .0 1）。多元 L ogistic回归分析发现 Killip分级与住院病死率 （回归系数为 2 .34 ,OR值 5 .43,P<0 .0 1）和左室舒张末期容积 （回归系数为 0 .6 75 ,OR值 4.5 1,P<0 .0 5 ）相关 ,但与年龄、CK峰值相关不明显。结论 :急性心肌梗死入院时 Killip分级为住院病死率及左室扩张的独立相关因子。     

腹式呼吸对血压及呼吸性窦性心律不齐的影响

目的 :研究腹式呼吸对血压及呼吸性窦性心律不齐 （RSA）的影响。方法 :采用反馈型腹式呼吸训练仪 ,分析2 5例正常人腹式呼吸训练前后血压及呼吸性窦性心律不齐 （RSA）的动态变化。结果 :腹式呼吸训练 10min ,2 0min后RSA比静息状态显著减少 （ms,4 7± 13vs 36± 10 ,P <0 .0 1;4 8± 16vs 36± 10 ,P <0 .0 1） ,RSA在停止训练后较训练时降低 ,但较训练前显著减少 （ms,4 1± 16vs 36± 10 ,P <0 .0 1） ;训练 10min、2 0min后血压显著下降 ,收缩压更为明显 （kPa,14 .5± 1.5vs 14 .9± 1.3,P <0 .0 5 ;14 .5± 1.2vs 14 .9± 1.3,P <0 .0 5 ） ,舒张压无明显变化。结论 :腹式呼吸能降低血压、增强心副交感神经的兴奋性。     

舒张性心力衰竭动物模型建立的方法学研究

目的 :建立舒张性心力衰竭动物模型。方法 :应用心导管和超声心动图同步检查技术控制实验条件 ,通过缝扎冠状动脉造成心肌缺血使左室松弛、充盈功能减低、左室舒末压升高 ,而保持 L VEF≥ 4 5 %的实验状态。结果 :缺血即刻左室舒张末压从静息对照状态的 5 .3± 2 .8m m Hg（ 1mm Hg=0 .13 3 k Pa）升高到 7.1± 2 .8m m Hg（ P<0 .0 5 ） ,平均升高了 3 2 .4 %± 2 .8% ,左室松驰时间常数延长 ,左室舒张早期充盈速度减慢 ,L VEF从 5 7%± 6%减少到5 0 %± 8% （ P<0 .0 5 ）。结论 :通过控制实验条件可建立舒张性心力衰竭的动物模型     

老年心力衰竭患者血浆可溶性TRAIL和受体DR5水平的变化

目的 :观察老年充血性心力衰竭 （CHF）患者血浆可溶性 TNF相关的凋亡诱导配体 （s TRAIL）、死亡受体（s DR5 ）水平与心功能状态的关系。方法 :用酶联免疫吸附法 （EL ISA）检测 4 1例老年 CHF患者和 2 0例健康老年人（对照组 ）血浆 s TRAIL 和 s DR5水平 ,用多普勒超声心动图测定 CHF患者左室射血分数 （L VEF）。结果 :1CHF患者血浆 s TRAIL 水平较健康对照组升高 （1.4 5± 0 .5 2 ng· m L- 1 vs0 .93± 0 .12 ng· m L- 1 ,P>0 .0 5 ） ;CHF患者血浆 s DR5水平 （41± 8pg· m L- 1 ）较对照组 （<6 pg· m L- 1 ）明显升高 ,且随心功能损害程度加重而升高 ,心功能 级者显著高于 , 级 （P<0 .0 5 ,P<0 .0 1）。 2 L VEF和 s DR5水平呈显著的负相关 （r=- 0 .5 2 ,P<0 .0 1） 3高血压心脏病 CHF患者血浆 s DR5水平明显高于其它病因 CHF患者。结论 :血浆 s DR5水平可能是反映老年 CHF心功能和评价心肌细胞凋亡状态有价值的指标之一     

老年阵发性房颤患者体表心电图f-f间期变化与房颤持续时间及心房电重构的关系

目的 :研究老年阵发性房颤 （PAF）患者体表心电图 f- f间期变化与房颤持续时间及心房电重构的关系。方法 :选择无心房扩大 ,患有初发或新近发生的 PAF的老年人 ,于随访期前后分别进行 2 4 h Holter监测 ,同意者行心脏电生理检查测右房有效不应期 （ERP） ,随访半年。结果 :入选 32例 ,有 9例于随访期前后行心电生理检查 ,5例失访。采集到以下数据 :2 4 h房颤发作次数 （N）较基线没有显著变化 （2 4± 4 vs 2 4± 4 ,P>0 .0 5 ） ;2 4 h房颤发作累计时间 （TT）显著延长 （2 36± 32 m in vs 2 89± 31min,P<0 .0 1） ;最长一次发作持续时间 （L T）无显著差异 （4 2± 12min vs 4 5± 12 min,P>0 .0 5 ） ;2 4 h平均持续时间 （MT）显著延长 （8.1± 1.2 m in vs 10 .2± 1.6 min,P<0 .0 1） ;平均 f- f间期 （Mf- f）显著缩短 （0 .15± 0 .0 2 s vs0 .11± 0 .0 1s,P<0 .0 5 ）。ERP与对照相比显著缩短 （2 0 8± 11ms vs191± 8ms,P<0 .0 1）。Δ ERP与 Δf- f呈直线正相关 :r=0 .8839,P<0 .0 1,Δ TT与 Δ f- f直线正相关 :r=0 .76 0 4 ,P<0 .0 1,ΔMT与 Δ f- f直线正相关 :r=0 .76 0 ,P<0 .0 1。结论 :老年 PAF患者体表心电图 f- f间期缩短可作为预测老年人 PAF持续时间延长和反映心房发生电重构的有效指标。     

应用门电路核素心室断层显像测量左室容量和功能—与X线左室造影对比

48例病人行门电路核素心室断层显像,测定左室舒张末期容量（EDV）,收缩末期容量（ESV）和左室射血分数和（LVEF）。核素心室断层显像测定结果和X线左室造影结果对比,两者具有良好的相关性:左室舒张末期容量的测定,相关系数0.91（P<0.001,SEE=32.55ml）,左室收缩末期容量相关系数0.95（P<0.001,SEE=24.99ml）,LVEF相关0.90（P<0.001,SEE=8.89％）。我们的研究结果表明,门电路核素心室断层显像能够无创伤性直接准确地测定左室容量。     

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.     

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.     

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.     

Morphological and immunocytochemical heterogeneity of cultured pinealocytes from one-week-and two-month-old rats: Planimetric and densitometric investigations

Abstract: In vitro preparations of rat pinealocytes are widely used for biochemical analyses of signal transduction processes. This paper deals with morphological and immunocytochemical features of such preparations. Special attention was paid to the problems of whether pinealocytes represent a heterogeneous cell population and how such heterogeneity may develop during ontogeny. The investigations were performed with cells which were obtained from the pineal organ of one-week-and two-month-old rats, attached to synthetic peptide-coated coverslips or tissue culture chamber slides, and maintained under in vitro conditions overnight. The attached cells were then fixed with paraformaldehyde. These preparations yielded monolayers of spherical cells of different sizes; most cells were isolated, but some of them were aggregated and formed small clusters. On the average, the cells from the one-week-old animals were smaller than the cells from the two-month-old animals. Immunocytochemical demonstration of S-antigen, a pinealocyte-specific marker, showed that the majority of the cells from two-month-old animals were intensely or moderately labelled. Pinealocytes from one-week-old animals were less S-antigen immunoreactive. Only very few cells (less than 1% displayed glial fibrillary acidic protein (GFAP)-immunoreactivity. Planimetric investigations of the cell size and semiquantitative densitometric investigations of the intensity of the S-antigen immunoreaction revealed that (i) pinealocytes kept in vitro form a heterogeneous cell population, and that (ii) this heterogeneity increases during postnatal development from one-week-old to two-month-old animals. Two groups of pinealocytes can be distinguished based on their developmental fate: pinealocytes of one group grow dramatically, but show only a moderate increase in S-antigen immunoreactivity, and pinealocytes of the other group retain their size, but display a distinct increment in S-antigen immunoreacti vitv.     

Effects of pinealectomy and melatonin administration on certain indices of ovarian hyperplasia and/or hypertrophy in rats with both ovaries intact or after unilateral ovariectomy

Abstract: In earlier studies from other laboratories it was shown that melatonin decreased ovarian weight in rats and inhibited compensatory hypertrophy of the remaining ovary after unilateral ovariectomy. This study was designed to examine the influence of melatonin on certain indices of ovarian hyperplasia and/or hypertrophy in adult female rats with both ovaries preserved and with either an intact pineal gland or with the pineal gland removed (pinealectomy, PX) or, finally, in sham-PX animals. Similar studies were conducted on rats after unilateral ovariectomy, referring the examined parameters to the remaining intact ovary. The studies included mitotic activity of granulosa layer cells and corpus luteum cells, ovarian weight, ovarian cross-sectional area, cross-sectional area of the granulosa layer of all the Graafian follicles and the cross-sectional areas of the corpora lutea, visible on the ovarian cross-section. On the basis of results, we conclude that: 1) the effect of PX on the processes of ovarian hyperplasia and hypertrophy may vary; analogously, exogenous melatonin administration may influence ovarian hyperplasia and hypertrophy in different ways; 2) PX and exogenous melatonin may, under certain conditions, exert similar biological effects, even synergistic effects; 3) melatonin inhibits ovarian growth processes, while the effects of PX are variable; 4) the results indicate that in experiments performed on rats, with the use of two control groups, i.e., intact and sham-PX, melatonin effects on these two groups may differ.