家兔在体心脏希氏束电图26例分析

对26例家兔在体心脏希氏束电图进行统计分析,结果如下:P-A时间11±7ms;A-H时间36±6ms;H-V时间20±3ms;H波时间7±3ms。通过对比人和家兔P-R间期中各个相应成分所占的比例,发现两者A-H以及H-V时间占的比例非常接近。     

消旋四氢巴马汀在兔体内的药动学和药效学研究

观察了消旋四氢巴马汀静脉注射对在体家兔希氏束电图的影响,在获取效应指标的同时布点采血,用高效液相色谱法测定因药浓度,以探讨消旋四氢巴丁汀效应动力学及其随血药浓度的经时变化规律。结果表明用药后Ａ－Ｈ间期明显延长,且呈剂量依赖性,效应的变化与浓度的变化呈线性正相关（ｒ大＝０．９５６３,ｒ小＝０．９４７３）,与对照且比较有显著性差异（Ｐ〈０．０５）,用药后Ｈ－Ｖ间期无变化。提示消旋四氢巴马汀静脉制剂可能     

逐搏体表希氏束电图的临床研究

目的探讨逐搏体表希氏束电图测定值特征。方法用逐搏体表希氏束检测仪检测615例正常人体表希氏束电图,测量AH、H、HV间期等指标,进行统计学分析。结果①各指标测定值范围(x±s):AH间期(64.11±6.37)ms,H时限(28.85±2.89)ms,HV间期(60.25±6.37)ms。②随年龄的增加,AH,HV间期有逐渐延长的趋势(P<0.05),H间期与年龄无关(P>0.05)。③随心率增加,各指标则逐渐缩短(P<0.05)。结论逐搏体表希氏束电图技术的使用使临床建立正常值范围数据成为可能,正常人的AH、HV间期随年龄增长而延长,随心率增快而缩短。H间期受年龄、心率影响较小,性别对希氏束电图各指标均无明显影响。     

急性心肌梗死早期溶栓治疗效果与QT间期离散度的关系

[目的]探讨急性心肌梗死早期溶栓治疗效果与QT间期离散度(QTd)的关系.[方法]226例急性心肌梗死患者分为溶栓成功组(63例);溶栓失败组(52例);非溶栓组(111例).所有研究对象分别在人院当时(平均7.1h±1.6h),发病后第2天、第1周末及第2周末记录标准12导联心电图.QT间期的测量从QRS波起点至T波终点,同一导联测量3个心动周期,取其平均值.不同导联最大QT值减去最小QT值为QTd值.[结果]3组QTd入院当时无差异(P＞0.05),但起病后第2日、第1周末及第2周末溶栓成功组QTd[分别为(48±17)ms,(43±15)ms,(36±14)ms]较溶栓失败组[分别为(65±18)ms,(55±16)ms,(47±15)ms]和非溶栓组[分别为(67±16)ms,(54±14)ms,(49±13)ms]小,P＜0.01;后2组比较,P＞0.05.[结论]急性心肌梗死成功的早期溶栓治疗能使QTd值减小,提示急性心肌梗死早期梗死相关冠状动脉再通能提高心肌电稳定性.     

Na99mTcO4示踪温度对微血管术后血供影响的实验研究

目的通过Na99mTcO4示踪显像(TTI)探讨温度对家兔微血管术后血供的影响.方法后肢施行断肢再植术的30只健康成年家兔和6只正常对照家兔置于室温中30min,由耳缘静脉注射Na99mTcO4 74MBq 1min后TTI,计算并分析再植部分和正常肢对应部分的放射性摄取比值(T/NT).根据术肢放射性聚集程度将显像结果分为0、Ⅰ、Ⅱ三级(T/NT分别为＜0.25,0.25～0.65,＞0.65).将Ⅰ、Ⅱ级家兔随机平分为A、B、C组,0级为D组;A组在伤口局部冷敷(＜10℃)、B组和D组局部热敷(40～45℃)、C组继续置于室温;30min后再次TTI.结果①30只术后家兔TTI为0、Ⅰ、Ⅱ级分别有6、15、9只,6只对照全为Ⅱ级,四组的T/NT分别为0.589±0.074、0.602±0.092、0.594±0.068、0.128±0.058,A、B、C三组间无显著性差异(P＞0.05),均明显高于D组(P＜0.01);②再次TTI,四组的T/NT分别为0.192±0.086、0.924±0.168、0.481±0.116、0.372±0.124;A组最低(P＜0.01),B组最高(P＜0.01),C、D组间无显著性差异(P＞0.05);各组与首次TTI均有显著性差异(P＜0.01).结论温度为微血管术后血供的重要影响因素,保暖对防治微血管术血管危象具有重要的临床意义.     

毛冬青甲素对家兔希氏束电图的影响

本文为了解毛冬青甲素对心传导系统的作用,进而探讨其抗心律失常的作用机理。实验将家兔分成两组,正常对照组(10只)和用药组(10只),用RM—6000四导生理记录仪同步描记希氏束电图(HBE)、心电图(ECG)和血压。本实验统计学处理后,结果表明:用药组注射毛冬青甲素后HBE的A—H间期为63.5±6.00ms,与静注前(47.3+8.22ms)比较P<0.001,与对照组比较P<0.001;注药后5～10分钟,心率248±13.0降至203±13.7次/分(P<0.05);多数家兔注药后5～10分钟收缩压平均下降2.85kPa(P<0.05),舒张压平均下降1.50kPa(P<0.05)。提示毛冬青甲素能使房室传导时间延迟,降低心传导系统的兴奋性,从而消除了异位搏动以及使心率减慢,血压下降,产生抗心律失常的效应。     

氨固酮和慢心律对房室传导影响的比较

左心插管法记录麻醉家兔希氏束电图(HBE)和ECG,静脉注射(iv)氨固酮(4.0,5.6,8.0,11.2和16mg/kg)和慢心律(2.5,3.5,5.0,7.0和10.0mg/kg)都有剂量依赖的P-R,A-H和H-V时间的延长,氨固酮的作用较慢心律弱。两药延长P-R、A-H和H-V的回归系数并无显著差别(P>0.5)。氨固酮对房室传导的抑制可能系药物的直接作用。     

电极间距对家兔在体希氏束电图记录结果的影响

[目的 ]探讨不同电极间距的导管对在体家兔希氏束电图记录结果的影响。 [方法 ]30只家兔均经左颈总动脉插管记录希氏束电图 ;所用电极导管A间距 2mm ,电极导管B间距 5mm。 [结果 ]电极导管A成功率为 93.33% ,电极导管B成功率为 6 0 .0 0 % ,P <0 .0 0 5 ;两种电极导管插入深度无差异 ,P >0 .0 5。 [结论 ]采用 2mm电极间距的导管可以明显提高家兔在体希氏束电图记录的成功率     

中药升降胶囊对大鼠胃排空的影响

[目的]观察中药升降胶囊对大鼠胃排空的影响,并从红细胞乙酰胆碱酯酶活性和血浆胃动素(Mot)、生长抑素(SS)方面探讨其作用机制。[方法]将8周龄的SD大鼠随机分成B组(升降胶囊高剂量组),C组(升降胶囊低剂量组),D组(枳壳白术组),A组(正常对照组)和E组(西沙比利组)。用药10d后用同位素法检测其胃排空功能,微量羟胺法检测其红细胞乙酰胆碱酯酶活性,放免法检测其血浆Mot和SS。[结果]B、C、D组30min胃排空率分别为(51.44±6.38)%、(40.82±7.24)%和(40.22±7.16%,均高于八组的(33.18±6.32)%;3组红细胞乙酰胆碱酯酶活性、MOT和SS分别为:B组(0.856±0.128)μmol/h,(124.26±25.94)ng/L和(39.42±7.%)ng/L,C组(0.726±0.164)μmol/h,(119.86±29.38)ng/L和(38.33±7.64)ng/L,均高于A组的(0.576 ± 0.150)μmol/h,(91.28±26.84)ng/L和(28.22±7.68)ng/L。[结论]升降胶囊可促进胃排空,其机制可能与增强胆碱能神经功能及提高血浆Mot和SS水平有关。     

右美托咪定对头低位腹腔镜直肠癌根治术患者QTc间期和Tp-e间期的影响

目的 探讨右美托咪定对头低位腹腔镜直肠癌根治术患者校正QT间期(QTc)和T波峰值至终点时间(Tp-e间期)的影响.方法 选择择期行腹腔镜直肠癌根治术患者60例,年龄45~60岁,ASAⅠ或Ⅱ级,采用随机数字表法分为右美托咪定组(D组)和对照组(C组),每组30例.从麻醉诱导开始至头低位结束,D组静脉持续泵注右美托咪定0.3 μg/(kg·h),C组持续泵注同等剂量的生理盐水.记录麻醉诱导前平卧位(T0)、人工气腹头低位后30 min(T1)、60 min(T2) 、90 min(T3)、解除气腹平卧位后15 min(T4)、 60 min(T5)各时点QTc间期、Tp-e间期的变化,以及心率(HR)、平均动脉压(MAP)、两组患者手术结束至拔管时间,苏醒期躁动发生率等.结果 C组T1~T5时QTc(ms)间期分别为(390.7±4.2)、(397.3±4.0)、(395.4±5.2)、(407.5±4.4)、(406.1±4.4),与T0比较,T1~T5时QTc间期明显延长(P<0.05).D组T2~T5时QTc(ms)间期分别为(377.9±4.7)、(376.6±5.1)、(385.4±4.3)、(378.7±4.2),与T0比较,仅T4时QTc间期有所延长,差异有统计学意义(P<0.05),其余各时点差异均无统计学意义(P>0.05).与C组比较,D组T2~T5时QTc间期明显缩短,差异有统计学意义(P<0.05).D组T1~T4时HR(bpm)分别为(69.1±13.7)、(67.0±12.6)、(65.4±11.9)、(64.6±12.2),与T0比较,T1~T4时HR明显减慢(P<0.05).与C组比较,D组HR在T1~T4时亦明显减慢(P<0.05).两组患者组内、组间比较Tp-e间期、MAP均未见明显变化(P>0.05).两组患者手术结束至拔管时间差异无统计学意义(P>0.05).D组苏醒期躁动发生率明显低于C组(P<0.05).两组患者术中低血压、心动过缓发生率比较差异无统计学意义(P>0.05),未见严重心血管不良事件发生.结论 右美托咪定可以明显缩短头低位腹腔镜直肠癌根治术患者的QTc间期、降低心血管不良事件的发生,减少苏醒期躁动的发生.     

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.