含不同启动子的腺病毒载体介导的人β2肾上腺素能受体基因在心肌细胞的表达

目的：观察不同的启动因子cmv,mlc-2v对腺病毒载体介导的人β2肾上腺素能受体（β2－AR）基因在大鼠心肌细胞中表达,方法：分别构建cmv,mlc-2v启动子并携带人β20－AR基因的重组腺病毒Adcmvβ2AR,Admlc,β2AR,用以感染心肌细胞,并检测心肌细胞对人β2－AR基因的表达及cAMP的含量,结果：经RT－PCR,Western免疫印迹分析证帝感染的心肌细胞均表达人β2－AR,放射性配基检测显示含mlc-2v启动子Admlcβ2AR感染的心肌细胞β2－AR密度低于含cmv启动子的A β2AR感染组（P＜0．01）,经10umol/L异丙肾上腺素作用,感染组的心肌细胞内cAMP含量明显高于对照组,感染组间存在明显差异（P＜0．01）,结论：含不同启动子的腺病毒载休感染心肌细胞后均可表达具有生物活性的人β2－AR,但两者存在差异。     

参麦注射液对缺血大鼠心肌内钙超载的影响

目的：观察参麦注射液对大鼠缺血心肌细胞内钙超载的影响及其心肌保护作用。方法：用异丙肾上腺素制备大鼠心肌缺血模型,Ｆｕｒａ－２ 法测定大鼠红细胞胞浆游离钙浓度（ＥｒｙＣａｉ）;生化法测定红细胞膜钙泵（Ｃａ－ｐｕｍ ｐ）、钠泵（Ｎａ－ｐｕｍ ｐ）活性,同步观察大鼠心肌组织病理变化。结果：参麦注射液治疗后ＥｒｙＣａｉ较缺血组显著降低（１．６８±０．１０ Ｆ３３５／Ｆ３８５ ｖｓ１．５６±０．１５ Ｆ３３５／Ｆ３８５ Ｐ＜ ０．０５）,但仍高于对照组（１．５６±０．１５ Ｆ３３５／Ｆ３８５ ｖｓ１．３６±０．１０Ｆ３３５／Ｆ３８５ Ｐ＜ ０．００１）;钙泵（１０５．１±２９．４ μｍ ｏｌＰｉ·ｇＨｂ－ １ ·２ｈ－ １ｖｓ １２６．８±３０．７ μｍ ｏｌＰｉ·ｇＨｂ－ １ ·２ｈ－ １ Ｐ＞ ０．０５）及钠泵（３５．１±１８．２ μｍ ｏｌＰｉ·ｇＨｂ－ １·２ｈ－ １ ｖｓ ４３．３±１０．２ μｍ ｏｌＰｉ·ｇＨｂ－ １·２ｈ－ １ Ｐ＞ ０．０５）活性较缺血组有所增高,但无统计学意义,且钙泵（１２６．８±３０．７ μｍ ｏｌＰｉ·ｇＨｂ－ １ ·２ｈ－ １ ｖｓ １６８．６±３９．６ μｍ ｏｌＰｉ·ｇＨｂ－ １ ·２ｈ－ １ Ｐ＜ ０．０１）及钠泵（４３     

Jervell and Lange-Nielsen syndrome: neurologic and cardiologic evaluation

Recurrent syncope, malignant ventricular arrhythmias, and sudden death are complications of the long QT syndrome (LQTS). Two well-known syndromes with long QT intervals are known. The Jervell and Lange-Nielsen syndrome (JLNS) is characterized by prolongation of the QT interval, deafness, and autosomal-recessive inheritance, and the Romano-Ward syndrome is characterized by a prolonged QT interval, autosomal-dominant inheritance, and no deafness. In the present study assessment was performed of the diagnostic importance of the ventricular derepolarization parameters, clinical features, and prevalence of JLNS among 132 children with congenital hearing loss (CHL). In the CHL group the mean QT, QTc, JT, and JTc intervals and the dispersion values (QT-d, JT-d, QTc-d, and JTc-d) were significantly longer than those of control subjects (n = 96) (P < 0.05). Patients with CHL and JLNS (n = 5) had significantly longer mean values of QT, QTc, JT, and JTc intervals and dispersion values than those of CHL without JLNS (n = 127) and control subjects (P < 0.05). The results suggest that assessment of ventricular derepolarization parameters in children with CHL will be helpful in the early detection of JLNS because infants with CHL cannot accurately describe the symptoms of syncope.     

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目的探讨首次丙种球蛋白静脉注射(IVIG)无反应性川崎病(KD)的发生率及危险因素,及其再治疗方法的选择。方法总结2000—2004年北京45家医院KD患儿的临床资料,IVIG无反应性定义为首次IVIG治疗36h后体温仍超过38·5℃。结果1107例患儿纳入研究对象,1092例有急性期治疗资料,1052例(96·3%)接受IVIG治疗,135例对首次IVIG治疗无反应,发生率12·8%(135/1052)。Logistic回归分析发现血沉、GPT、WBC、发病至用IVIG的时间、血浆白蛋白及IVIG治疗剂量,是IVIG无反应性的独立危险因素(P<0·05)。对IVIG无反应者8例给第2剂2g/kg IVIG,5例热退;114例给1g/kg剂量IVIG治疗,35例(30·7%)热退;11例给400~600mg/kg IVIG,1例(9·1%)热退;2例给糖皮质激素,2例均热退。4种再治疗方法间比较,差异有统计学意义(P=0·015)。第2剂2g/kg IVIG治疗较其它再治疗所需进一步IVIG或激素治疗次数少,体温恢复快。结论约12·8%KD患儿对初次IVIG治疗无反应。血沉、WBC和GPT、血浆白蛋白、IVIG使用方法及起病至用IVIG的时间,是IVIG无反应的独立危险因素。对初次IVIG无反应患儿推荐使用第2剂2g/kgIVIG,对2次2g/kgIVIG治疗仍无效者可以选用糖皮质激素治疗。     

静脉丙种球蛋白无反应性川崎病的治疗及危险因素分析

目的探讨首次丙种球蛋白静脉注射(IVIG)无反应性川崎病(KD)的发生率及危险因素，及其再治疗方法的选择。 方法总结2000—2004年北京45家医院KD患儿的临床资料，IVIG无反应性定义为首次IVIG治疗36h后体温仍超过38.5℃。 结果1107例患儿纳入研究对象，1092例有急性期治疗资料，1052例(96.3%)接受IVIG治疗，135例对首次IVIG治疗无反应，发生率12.8%(135/1052)。Logistic回归分析发现血沉、GPT、WBC、发病至用IVIG的时间、血浆白蛋白及IVIG治疗剂量，是IVIG无反应性的独立危险因素(P<0.05)。对IVIG无反应者8例给第2剂2g/kg IVIG，5例热退；114例给1g/kg剂量IVIG治疗，35例(30.7%)热退；11例给400~600mg/kg IVIG，1例(9.1%)热退；2例给糖皮质激素，2例均热退。4种再治疗方法间比较，差异有统计学意义(P=0.015)。第2剂2g/kg IVIG治疗较其它再治疗所需进一步IVIG或激素治疗次数少，体温恢复快。 结论约12.8%KD患儿对初次IVIG治疗无反应。血沉、WBC和GPT、血浆白蛋白、IVIG使用方法及起病至用IVIG的时间，是IVIG无反应的独立危险因素。对初次IVIG无反应患儿推荐使用第2剂2g/kgIVIG，对2次2g/kg IVIG治疗仍无效者可以选用糖皮质激素治疗。     

无创中心动脉脉压与高血压合并动脉粥样硬化性心血管疾病的相关性研究

背景 动脉粥样硬化性心血管疾病(ASCVD)是心血管疾病致残、致死的主要原因,在高血压患者中应尽早进行诊断和干预.研究发现中心动脉压(CAP)对心血管事件的预测价值高于周围动脉压.但目前对于高血压合并ASCVD患者无创CAP的研究鲜有报道.目的 探讨高血压合并ASCVD患者及不合并ASCVD患者间无创中心动脉收缩压(S...     

On the IVUS plaque volume error in coronary arteries when neglecting curvature

Plaque volume determined by common linear 3-D IVUS analysis systems will show under- or overestimation in curved vessel segments because these systems approximate the true 3-D transducer pull-back trajectory by a straight line. We developed a mathematical model that showed that the error is primarily dependent on the curvature of the pull-back trajectory and not on vessel tortuosity. Furthermore, we measured this error in vivo in the coronary arteries of 15 patients, comparing the plaque volume using a true 3-D reconstruction method with that of the linear approach. The in vivo plaque volume error ranged from 2.3% to −1.2% for 15 coronary segments with lengths ranging from 38.8 to 89.1 mm (62.2 ± 13 mm). The volume error introduced by linear 3-D IVUS analysis systems is dependent on the curvature of the pull-back trajectory. The error measured in vivo was small and inversely related to segment length.     

冠状动脉粥样硬化病变与血浆血管性血友病因子和α颗粒膜蛋白水平的关系

目的　探讨不同冠状动脉粥样硬化病变患者中血浆血管性血友病因子 (vWF)及α 颗粒膜蛋白 (GMF 14 0 )水平的临床意义。方法　 74例接受选择性冠状动脉造影的患者根据冠脉硬化病变形态分为S组 (光滑斑块组 )和C组 (复杂病变斑块组 )。C组患者根据病变支数分为Ⅰ组 (单支病变组 ) ;Ⅱ组 (双支病变组 )和Ⅲ组 (3支病变组 )。根据狭窄段数将C组患者分为x组 (≤ 3段组 ) ;y组 (≥ 4段组 )。所有患者于冠脉造影前采血测定血浆vWF、GMP 14 0水平。结果　①C组血浆、vWF、GMP 14 0水平显著高于S组。②Ⅲ组血浆vWF、GMF 14 0水平显著高于Ⅰ、Ⅱ组 ,Ⅱ组血浆vWF水平显著高于Ⅰ组。③y组血浆vWF、GMP 14 0水平显著高于x组。结论　①冠脉造影表现为复杂形态病变者属于高危不稳定性病变。②血浆vWF、GMP 14 0水平可作为判断冠状动脉粥样硬化病变的程度、范围及是否存在不稳定病变的间接指标。     

Allostatic load and women’s brain health: A systematic review

Allostatic load represents the ‘wear and tear’ of chronic stress on the brain and body that may differ between men and women. A small but growing number of studies are assessing allostatic load in relation to mental health. The objective of this systematic review was to (1) assess sex differences in allostatic load and (2) identify allostatic load associations that are specific to women. We systematically searched for allostatic load studies that included psychosocial causes and/or psychiatric consequences. Our search focused on allostatic load studies that disaggregated by sex and that include women. Sixty-two studies were included in this systematic review. First, men appear to have higher allostatic load than women. Second, women show gender-specific variation for numerous factors such as age, race/ethnicity, adversities, social support, and health behaviors that influence associations between allostatic load and mental health. Recommendations are made to guide researchers advance sex and gender approaches.