一种筛选抗心律失常药物新模型的建立

目的　建立一种细胞水平的心律失常模型 ,以用于抗心律失常药物的筛选和评价。方法　酶解法分离单个大鼠心室肌细胞 ,在细胞水平给予传统诱发心律失常药物乌头碱 ,应用膜片钳技术观察记录应用乌头碱后心肌动作电位时程 (APD)、钠电流(INa)、L 型钙电流 (ICa L)、内向整流钾电流 (IK1 )及瞬时外向钾电流 (Ito)的变化。结果　应用乌头碱 1μmol·L- 1 使大鼠单个心室肌细胞 90 %复极化动作电位时程 (APD90 )从给药前的 (15 0 .2 3± 7.0 2 )ms延长至 (2 36 .0 3± 2 3.2 2 )ms(n =8,P <0 .0 1)。应用奎尼丁 10 μmol·L- 1 后动作电位…     

甲醇对豚鼠单个心室肌细胞动作电位的影响

目的　研究甲醇对正常豚鼠心室肌细胞跨膜动作电位影响 ,旨在探讨甲醇对心肌细胞的电生理作用。方法　酶解法分离豚鼠单个心室肌细胞 ,应用全细胞膜片钳技术记录甲醇对豚鼠单个心室肌细胞动作电位的影响。结果　应用 0 .2 %甲醇使豚鼠单个心室肌细胞动作电位复极 5 0 %时程 (APD50 )从给药前 (12 92 .6 8± 2 98.0 3)ms缩短到 (75 0 .2 5± 6 8.0 5 )ms (n =6 ,P <0 .0 5 ) ;动作电位复极 90 %时程 (APD90 )从给药前 (132 8.13± 2 89.91)ms缩短到(783.2 5± 6 3.4 4 )ms (n =6 ,P <0 .0 5 ) ;动作电位幅度 (APA)从给药前 (12 6 .35± 3.2 0 )mV减少到 (113.2 0± 6 .0 8)mV(n =6 ,P <0 .0 5 )。结论　甲醇降低动作电位幅度 ,缩短动作电位时程 ,影响心肌正常工作 ,可能与它对心肌细胞钾通道的作用有关。     

自发性高血压大鼠左心室肌细胞电生理研究

目的　研究自发性高血压大鼠 (SHR)左心室肌细胞的电生理特性。方法　以正常血压Wistar大鼠左心室肌细胞作为对照 ,采用玻璃微电极技术记录动作电位 ,应用膜片钳全细胞技术记录膜离子流 ,观察SHR左心室肌细胞动作电位及膜离子流的改变。结果　①SHR和Wisar大鼠的心脏 /体重比分别为 5 .6 6± 0 .46mg/g(n =2 0 )和 3.7± 0 .2 9mg/g(n =2 8) (P <0 .0 0 1) ,平均细胞膜电容分别为 2 80 .6 8± 6 7.98pF(n =91)和 189.94± 5 6 .5 9pF(n =137) (P <0 .0 5 )。②SHR左心室肌细胞动作电位时程较Wistar大鼠明显延长 [APD50 :2 1.33± 1.5 6ms(n =6 ) ,vs 14.91± 2 .95ms(n =11) ,P <0 .0 0 1;APD90 :16 4.6 7± 4ms ,vs 93.2 7± 10 .5 9ms ,P <0 .0 0 1]。③内向电流 :SHR左心室肌细胞的ICa -L密度与Wistar大鼠间无差异 [6 .93± 1.71pA/pF(n =2 0 ) ,vs 6 .19± 2 .85pA/pF(n =37) ],但前者的慢失活时间常数显著延长 (5 6 .0 1± 13.36ms,vs 43.6 3± 17.89ms,P <0 .0 0 1)。SHR左心室肌细胞的INa密度与Wistar大鼠间无差异 [2 4.6 1± 6 .72 pA/pF(n =16 ) ,vs 2 4.95± 6 .99pA/pF(n =18) ]。④外向电流 :SHR左心室肌细胞IK1内向电流密度显著小于Wistar大鼠 [- 12 0mV时 ,11.3± 2 .2 6 pA/pF(n =17) ,v     

丹皮酚对豚鼠心肌细胞动作电位及钙通道电流的影响

目的 :研究丹皮酚对分离的单个豚鼠心肌细胞动作电位及钙通道电流 (ICa)的影响。方法 :单个细胞膜片钳技术。结果 :①丹皮酚 40 0 μg/ml可使动作电位时程 (APD)明显缩短。APD50 和APD90 分别由给药前的 (35 2±2 7)ms和 (416± 33)ms缩短至 (16 8± 2 0 )ms和 (2 6 5± 2 3)ms(P <0 .0 5 ,n =5 ) ,分别缩短了 5 2 .2 %和 35 .6 % ,而静息电位和动作电位幅值无明显改变 ;② 5 0～ 40 0 μg/ml丹皮酚浓度依赖性阻滞ICa,使其最大峰值由 (916 .7± 197.3)pA分别降至 (5 83 .3± 10 8.8)pA和 (2 5 0 .0± 12 0 .0 )pA(P <0 .0 1) ,抑制率分别为 36 .4%和 72 .7% ,并使ICa的I V曲线上移 ,但不使I V曲线发生偏移。结论 :丹皮酚对ICa的阻滞作用为其抗心律失常作用的主要机制之一     

维拉帕米对豚鼠离体心肌动作电位3相的影响

研究维拉帕米对豚鼠心肌动作电位3相的影响。将14只豚鼠按维拉帕米灌流和先尼可地尔灌流，然后同时加维拉帕米继续灌流两组，结果：维拉帕米灌流后豚鼠心肌细胞动作电位APD20由86±16ms缩短为对71±14ms（n＝7，P＜0．01），APD50由152±24ms缩短为140±26ms（n＝7，P＜0.01），APD90由182±28ms变为183±26ms（n＝7,P＞0．05）；尼可地尔灌流后豚鼠心肌细胞动作电位APD50由154±33ms缩短为122±34ms（n＝7，P＜0．01），APD90由186±37ms缩短为154±36ms（n＝7，P＜0．01）；在尼可地尔灌流后继续同时灌流维拉帕米，可见APD50由121±35ms进一步缩短为96±32ms（P＜0．01），APD90由153±37ms缩短成115±34ms（P＜0．01）。结论：结果提示维拉帕米能相对延长豚鼠心肌细胞动作电位3相时程，尼可地尔能抑制这种作用。     

哇巴因诱发大鼠心律失常作用靶点的研究

目的　观察哇巴因对大鼠心室肌细胞动作电位时程、钾通道的作用 ,探讨哇巴因诱发心律失常的作用机制 ,为寻找新的抗心律失常药物提供依据。方法　应用全细胞膜片钳技术记录哇巴因对大鼠心肌细胞动作电位时程 (APD)、内向整流钾电流 (Ik1 )、瞬时外向钾电流 (Ito)的作用。结果　①哇巴因 5μmol/L使大鼠心室肌细胞动作电位时程从给药前的 86 .3ms± 2 5 .2ms(APD90 ) ,缩短至 58.9ms± 2 0 .8ms(n =5 ,P <0 .0 1 ,给药 1 0min) ;②哇巴因 5μmol/L可增加大鼠心室肌细胞内向整流钾电流 ,使Ik1 从 - 1 868pA± 1 88pA增加到 - 2 393pA± 367pA(刺激电压 - 1 2 0mV ,n=1 0 ,P <0 .0 1 ) ;③哇巴因 5μmol/L可增加大鼠心室肌细胞瞬时外向钾电流 ,使Ito从 1 2 73pA± 31 8pA增加到 1 70 7pA± 486pA(刺激电压 +60mV ,n =5 ,P <0 .0 1 )。结论　哇巴因诱发室性心律失常可能与它缩短心室肌细胞动作电位时程有关 ,而Ito的增加使二期平台期缩短 ,Ik1 的增加使三期复极加快 ,均参与了动作电位时程缩短的过程。同时增加Ik1 将影响静息膜电位 ,可能使膜反应性增强     

阵发性房颤与左、右心房肌复极关系的实验研究(摘要)

目的　心房肌的复极对阵发性房颤的诱发及维持起着重要的作用。本研究使用单相动作电位技术(MAP)对在体犬左、右心房肌的复极时间进行研究 ,以探讨阵发性房颤发生与维持的潜在机制。方法　记录基础心律、非程序刺激及早搏刺激 (SR、S1、S2 )时 14只犬左、右心房的MAP和有效不应期 (ERP) ,测量每个动作电位的幅度和动作电位时程 (APD90、APD80、APD5 0 ,复极达 90 %、80 %、5 0 %时的动作电位时程 ,ms)。并在记录过程中同时观察房颤的诱发情况。结果　记录满意MAP信号 12例 ,共标测 2 6点 (右房 17点 ,左房 9点 ) ,MAP振幅平均 (6.98±1.76)mv,右房各点平均振幅明显大于左房 (8.2 4± 2 .2VS 5 .73± 0 .63 ,P <0 .0 5 ) ,左心房APD90和ERP小于右心房(13 9.6± 2 4vs 172 .4± 2 9.2 ,P <0 .0 5 ;78± 9.43vs 10 4± 15 .78,P <0 .0 5 )。左、右心房肌APD90差值大于 3 0ms的 5只犬共诱发房颤 5 1阵 ,而其余的 7只犬共诱发出 2 5阵房颤 ,(P <0 .0 5 )。结论　左心房及右心房的复极时程差异的增大对房颤的发生和维持起着重要的作用     

缬沙坦对豚鼠心室肌细胞动作电位的作用

目的:观察缬沙坦对豚鼠心室肌细胞动作电位的直接作用,以探讨其可能的抗心律失常作用。方法:采用Langendorff主动脉逆行灌流酶解分离法分离单个心室肌细胞。采用全细胞膜片钳记录,电流钳模式记录单个心室肌细胞的动作电位。实验分3组:对照组(n=5),普通细胞外液灌流,不含缬沙坦;缬沙坦5μM组(n=5);缬沙坦100μM组(n=5)。结果:缬沙坦5μM对豚鼠心室肌细胞静息膜电位、动作电位幅度、动作电位时程均无明显影响。缬沙坦100μM可延长心室肌细胞动作屯位时程,尤其是APD50从(334.2±14.4)ms延长至(375.2士12.0)ms(P<0.01)及APD30从(395.4士13.3)ms延长至(451.4±9.5)ms(P<0.01),对细胞静息膜电位、动作电位幅度无显著影响。结论:高浓度缬沙坦延长心室肌细胞动作电位时程APD50及APD90,而不影响动作电位的静息膜电位及动作电位幅度。适度延长动作电位时程,从而延长心室有效不应期,有助于折返引起的快速室性心律失常的防治,类似Ⅲ类抗心律失常药物的作用。提示缬沙坦可能通过此机制起抗心律失常的作用。     

银杏叶提取物对家兔心室肌细胞瞬时外向钾电流和动作电位的影响

目的:探讨银杏叶提取物(Egb761)对家兔心室肌细胞瞬时外向钾电流(Ito)和动作电位的作用,揭示其抗心肌缺血及缺血引起的心律失常的离子机制。方法:酶解法分离家兔的心室肌细胞。全细胞膜片钳技术记录心肌细胞的Ito和动作电位及其被Egb761作用后的变化。结果:①在电压钳制方式下,60μg/L Egb761作用心室肌细胞5 min后,各个钳制电位下的Ito均明显增大,在钳制电位为+50 mV时,Egb761使Ito的电流密度由对照组的(7.59±0.19)pA/pF增加到(11.18±0.89)pA/pF(P<0.01,n=8),Egb761还使Ito的I-V曲线比对照组Ito的I-V明显抬高,但I-V曲线方向没有发生改变,表明Egb761引起了心肌细胞Ito的明显外流。②在电流钳制下,对照组心室肌细胞动作电位都具有从0期到4期的动作电位形态,60μg/L Egb761使心肌细胞动作电位形态呈三角形尖锥锋形,动作电位时程(APD)明显缩短,其复极化50%时程(APD50)和复极化90%时程(APD90)分别由(83.6±4.3)ms缩短为(51.3±3.2)ms和由(168.7±4.1)ms缩短为(93.8±4.4)ms(分别与对照组相比,P<0.01,n=8),尽管Egb761使动作电位幅度(APA)和静息电位(RP)降低,但与对照组相比,没有显著性差异(P>0.05)。结论:Egb761可使心室肌细胞Ito显著增加和APD明显缩短,从而减轻心肌缺血时细胞内阳离子超载对心肌造成的损伤和心肌缺血引起的心律失常的发生,以及增加心脏泵血功能。     

腺苷对离体豚鼠心房肌细胞动作电位与收缩力的脱敏与反跳

目的 :研究腺苷 (Adenosine,Ado)对离体豚鼠心房肌细胞动作电位时程 (Actionpotentialduration ,APD)及收缩力的脱敏与反跳。方法 :采用标准玻璃微电极细胞内记录动作电位和肌力换能器记录心肌收缩力的方法 ,观察了Ado(1、10、10 0 μmol·L-1对离体豚鼠心房肌细胞动作电位 (Actionpotential,AP)的影响及对APD、收缩力的脱敏与反跳。结果 :(1) 1、10、10 0 μmol·L-1Ado缩短心房肌细胞APD的变化率分别为 9.5 8± 1.40 %、13.80± 2 .2 6 %、2 4.80±3.19% ,(2 ) 1μmol·L-1Ado对心房肌细胞APD无脱敏 (P >0 .0 5 ) ,10 μmol·L-1Ado与 10 0 μmol·L-1Ado对心房肌细胞APD均有脱敏 ,脱敏持续时间分别为 1min和 5min(P <0 .0 5 ) ;(3) 10 μmol·L-1Ado对心房肌收缩力有明显的脱敏现象 ,与对照值相比 ,收缩力的减小由 31.40± 16 .0 4% (2min)变为 5 0 .6 0± 15 .87% (4min) ;(4 )当洗脱Ado后 ,出现收缩力的反跳现象 ,与正常值相比 ,1、10、10 0 μmol·L-1Ado增加收缩力分别为 12 .38± 7.5 0 %、19.2 0± 8.44 %、2 7.6 0± 13.44 %。结论 :Ado可缩短心房肌细胞APD ;Ado对心房肌APD有脱敏现象 ,且呈浓度依赖性和时间依赖性 ;Ado对心房肌收缩力存在脱敏与反跳现象     

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.