在体犬心肌M区单相动作电位研究

目的比较在体犬M区(心肌中层)与心内膜层和心外膜层心肌的单相动作电位(MAP).方法应用Franz MAP接触电极记录技术.结果(1)心率为110次/分时体表心电图基本正常.M区和心外膜MAP,在复极早期有典型的"峰和园顶".此时心内膜层单相动作电位时程(MAPD)与M细胞相似均比心外膜层MAPD90长,分别为213±18ms、210±35ms和201±41ms(P＜0.01,n=9).(2)内膜层激动时间最短,M区的次之,外膜层的最长,它们分别为4.3±2.1ms、8.2±4.3ms和15.9±5.0ms(P＜0.01,n=9).结论在体情况下,心内膜层MAPD与M细胞相似均比心外膜层的长.     

东莨菪碱对豚鼠心肌细胞动作电位的影响(文摘)

用玻璃微电极记录豚鼠心室肌单个细胞的跨膜电活动,观察到50μg/ml的东莨菪碱可使细胞动作电位时程(APD)延长。在东莨菪碱作用30min后,APD_(50)和APD_(100)分别从对照的91±31ms和142±39ms延长至115±35ms和179±50ms(P<0.001),同时,复极化后不应期(PRP)则从对照的     

心梗大鼠离体心脏的动作电位和不应期电生理研究

目的对比观察正常大鼠和心梗大鼠离体心脏动作电位和有效不应期的特点。方法用离体灌流吸附电极记录单向动作电位,常规电生理方法测量最大动作电位幅度(APA)、复极90%(MAP90)、复极50%(MAP50)、复极20%(MAP20)、有效不应期(ERP)。结果(1)和正常大鼠相比,心梗大鼠离体心脏左心房电生理参数MAP90(56.3±2.7vs.64.5±8.7,P<0.05)显著延长,ERP MAP90(0.89±0.2vs.0.78±0.3,P<0.05)减小,基础周期为250ms;右心室的电生理参数MAP90(67.6±14.1vs.134.1±26.7,P<0.001),ERP(55.0±3.53vs.69.0±8.9,P<0.05)明显延长,ERP MAP90(0.79±0.1vs.0.60±0.1,P<0.05)减小,基础周期为250ms;左心室的电生理参数MAP90(87.2±15.7vs.168.8±31.2,P<0.001)也呈显著延长,ERP(59.0±4.2vs.90.0±17.7,P<0.001),ERP MAP90(0.65±0.081vs.0.54±0.090,P<0.05)呈显著减小基础周期为250ms;(2)与正常大鼠相比,心梗大鼠的MAP90离散度[(LVMAP90-RVMAP90)(17.0±6.5vs.51.4±28.7,P<0.001)]、ERP离散度[(LVERP-RVERP)(4.0±2.2vs.20.0±7.9)P<0.001]显著增加,基础周期为250ms。结论心梗大鼠心脏不同部位的MAP的复极时间都显著性延长,MAP90和ERP离散度增加,这些电生理特点是促进折返形成、造成心律失常的主要原因。     

心肌梗死前后心室肌细胞单相动作电位的变化及其意义

目的:运用单相动作电位(monophasicactionpotential,MAP)记录方法,探讨心肌梗死后数周发生单形性室性心动过速(ventriculartachycardia,VT)的电生理机制。方法:运用非开胸球囊堵闭猪的左前降支造成心肌梗死,通过MAP记录电极记录猪左心室心内膜多个部位MAP,比较心肌梗死前和梗死后数周出现VT猪的MAP各电生理参数的变化。这些参数包括动作电位时程(actionpotentialduration,APD)从激动开始至复极50%的时间APD50,复极90%的时间APD90;激动时间(activationtime,AT)、复极时间(repolarizationtime,RT)和AT、APD50、APD90、复极时间(RT)的离散度(dispersion),即ATd、APDd1、APDd2、RTd。结果:在心肌梗死前后分别记录了各40个部位MAP,测量各参数结果显示,猪心肌梗死后左心室肌细胞复极时间APD50和APD90虽略有延长,但与心肌梗死前比较无明显差异(P>0.05)。分析各参数的离散度,无论是APDd,还是心室激动时间及复极时间离散度均明显增加犤APDd1:(26±7)ms比(39±9)ms;APDd2:(34±11)ms比(48±13)ms;ATd:(32±9)ms比(52±17)ms,RTd:(29±10)ms比(50±15)ms,P<0.01犦。结论:心肌梗死数周后心室复极离散度增大,激动传导差异性增加是心肌梗死后产生室性心动过速的重要电生理机制之一。     

犬左心室肌细胞钙电流异质性

目的研究犬左心室壁外膜层、中层(M细胞)及内膜层细胞的L型钙电流大小,观察氯化镉阻断钙电流后,三层心肌单个细胞跨膜动作电位的变化。方法应用膜片钳全细胞记录技术。结果去极电压为 10mv时,I_(Ca,L)电流的峰值达最大,在心外膜、M细胞及心内膜细胞间存在显著差异,分别为-4.0±1.2、-5.3±0.4及-4.3±1.2pA/pF,(P<0.05)。在其它去极电压,三层细胞钙电流值无显著差异。氯化镉(0.2mM)使三层细胞动作电位均缩短,心内膜、M细胞及心外膜细胞APD_(90)分别由用药前的436.4±39.0ms,511.6±48.7ms,431.8±42.36ms缩短至用药后的293.4±41.7,296.7±50.3,295.2±40.9ms,APD_(90)分别缩短32.8％,42.0％,31.6％(P<0.05)。结论犬心室外膜、中层(M细胞)及内膜细胞的L型钙电流分布的差异性。     

犬在体心肌跨室壁复极不均一性的实验研究

目的 :探讨犬在体心肌是否存在跨室壁复极不均一性。方法 :40 %的甲醛溶液 0 1～ 0 3ml注入房室结 ,制备完全性房室传导阻滞模型 ,心室起搏控制心室率。应用单相动作电位记录技术 ,同步记录犬在体心外膜 (epi cardium ,Epi)、中层 (midmyocardium ,Mid)及心内膜 (endocardium ,Endo)心肌单相动作电位 (MAP) ,测量单相动作电位时程 (MAPD)并比较其差异。结果 :在心动周期 (cyclelength ,CL) 30 0ms时 ,Epi、Mid、Endo的MAPD90 分别为 2 0 8 6 7± 44 37ms、2 0 9 17± 38 6 2ms、2 0 3 5 0± 33 84ms(n =10 ) ,在体三层心肌单相动作电位时程无明显差异 ,CL增加至2 0 0 0ms时 ,三层心肌MAPD呈慢频率依赖性延长 ,Epi、Mid、Endo的MAPD90 分别为 32 9 90± 31 90ms、36 9 90±35 0 9ms、317 2 0± 40 2 7ms ,其中Mid的MAPD90 延长最为显著 ,与Epi及Endo相比 ,差异有显著性意义 (P <0 0 5 )。结论 :犬在体心肌存在明显慢频率依赖性的跨室壁复极不均一性     

苄基四氢巴马汀对缺血-复灌与单相动作电位的影响

本文观察了苄基四氢巴马汀(BTHD)对缺血-复灌与单相动作电位(MAP)的影响。实验结果:iv BTHP10mg/kg后,MAPD50和MAPD90明显延长,分别从214±14ms和274±14ms延长到240±10ms、298±16ms (P<0.05)。MAPA和HR分别从56.4±7.4mV、64±5次/min下降到44.8±6 mV (P<0.05)、58±3次/min。T波和S-T段变化不大。iv Pra、Ver、Pro后,对MAP的变化均无影响;但它们对冠脉结扎-复灌所致的心律失常却都有对抗作用,使心律失常和室颤发生数及死亡数均有明显减少,其中     

24小时快速起搏右心房对兔心房单向动作电位的影响

目的 应用心内电生理技术研究心房快速起搏(RAP)对兔心房单向动作电位(MAP)的影响.方法 成年新西兰兔20只随机分为二组:假手术组、模型组各10只.经颈内静脉将电极置入右心房.以600次/分行RAP,同时分析在0、4、8、12和24 h的单向动作电位时程(MAPD).结果 假手术组在实验的时间段内右房游离壁MAP复极90%时程(MAPD90)无明显差别.RAP 8 h,起搏组右房游离壁MAPD90较P0有明显缩短,从起搏前(112.50±9.57)ms至起搏8 h分别缩短到(51.25±4.79)ms,分别缩短了61.25 ms.结论 房颤(AF)时心房MAPD90缩短.MAP技术可安全地用于研究AF时的电重构(ER),能提供准确的电生理改变的信息.     

应用接触电极记录心肌单相动作电位的研究

作者使用接触电极记录了在位家兔心脏左室外膜单相动作电位。单相动作电泣在同一部位稳定记录较之以前可达3小时以上。发现接触电极的压力与波形的形态有关,并测量了形成单相动作电位波形的最低压力。当接触电极在心外膜上压迫至25分时,心肌切片显示出组织学改变,但单相动作电位波形并无变化。作者报道了MAP参数:ERP92.97±7.4mS;ERP/APD0.75±0.02;Vmax4.54±1.5V/S。MAP的参数如MAPA、MAPD50、MAPD90与以前的报道相同。     

重组人脑钠肽(rhBNP)对兔血流动力学和电生理的影响

目的:观察短期静脉滴注重组人脑钠肽(rhBNP)对家兔的血流动力学和组织电生理作用的影响.方法:健康家兔12只,以0.09 μg/(kg·min)静脉滴注rhBNP,应用单相动作电位记录技术,同步记录用药前后心外膜、中层及心内膜心肌单相动作电位(MAP)及体表心电图,分析相关参数的变化;颈总动脉插管,记录动脉血压曲线、左心室内压力曲线变化.结果:用药前后,血流动力学指标动脉收缩压(SAP),舒张压(DAP)和平均动脉压(MAP)下降;左室舒张末压(LVEDP),左室收缩压(LVSP)下降(P＜0.05). 左室内压最大上升、下降速率 (±dp/dt)max用药前后比较无显著差异. 电生理指标3层心肌单相动作电位时程,体表心电图指标无显著差异.结论:在健康家兔,短期静脉滴注重组人脑钠肽对电生理指标没有影响,可改变血流动力学指标.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.