急性非ST段抬高型心肌梗死的特点及超声新技术的应用进展

急性非ST段抬高型心肌梗死（NSTEAMI）是急性心肌梗死的一种。它与传统的ST段抬高型心肌梗死（STEAMI）不同,好发于老年人,常累及多支血管,引起不完全闭塞,并容易形成侧支循环。目前临床的误诊和漏诊率都较高。超声二维斑点追踪技术（STD及其衍生出来的自动功能成像技术（AFI）等超声新技术克服了角度依赖性,能够通过斑点追踪,获取评价室壁运动的数据并以牛眼图显示。本文综述了NSTEAMI的特点和超声新技术的应用进展．     

The clinical evaluation and treatment of female precocious puberty

One in 180 American girls has precocious puberty. Accordingly, as a primary care physician, the obstetrician/gynecologist must be knowledgeable about the clinical evaluation and management of this disorder. Pubertal precocity has numerous causes and may be classified broadly as being central or peripheral in etiology. A meticulous history and physical examination, the judicious choice and interpretation of laboratory tests, and the selective use of radiological studies are the cornerstones of the evaluation. The initial approach should focus on identifying life-threatening tumors of the brain, adrenal gland, or ovary. The management goals include reducing the gonadotropin secretion and sex steroid effects and maximizing the eventual adult height. Because the child and her parents are frequently extremely distressed, the treating physician’s sensitivity and reassurance are paramount. The obstetrician/gynecologist, as both primary care physician and consultant, is in an ideal position to investigate, diagnose, and treat female precocious puberty.     

西罗莫司对减轻小口径移植血管材料内膜增生的作用

目的：将脱细胞联合肝素处理的小口径异种移植血管进一步结合西罗莫司,以观察术后移植血管内膜增生的情况。方法：将脱细胞联合肝素处理的犬颈动脉进一步结合西罗莫司,并分为A组（对照组,脱细胞并结合肝素）和B组（西罗莫司组,脱细胞并结合肝素＋西罗莫司处理）两组。取健康家兔16只,随机分为两组（每组8只）,利用兔颈动脉旁路移植模型,分别移植A组和B组的血管进行比较。术后分别于1、2、4、8周采血采用HPLC法检测B组移植血管中西罗莫司的含量。术后3个月超声检测移植血管通畅情况,并取血管样本经免疫组织化学和HE染色观察内膜增生程度。结果：B组8周后仍可检测到两罗莫司,且含量呈逐渐降低趋势。术后3个月超声显示,A组部分血管（2／8）斑块形成、管腔狭窄,B组血管无明显狭窄（P〈0．05）。免疫组织化学检测显示,A、B两组血管管壁均可见新生的内皮细胞和平滑肌细胞。HE染色提示,B组内膜增生程度较A组轻［A、B两组内膜／中膜厚度比分别为（1．63±0．04）μm、（0．43±0．04）μm]（P〈0．05）。结论：在脱细胞结合肝素的小口径异种移植血管上进一步结合西罗莫司可以有效减轻内膜增生。     

微创经胸非体外循环室间隔缺损的封堵治疗

目的总结微创经胸非体外循环(CPB)下室间隔缺损(VSD)封堵治疗的临床经验。方法 2011年8月至2012年7月,35例VSD患者接受了微创经胸非CPB下VSD封堵治疗,年龄3个月至6岁,体重6.0～31.0kg,VSD直径3～12mm。手术经胸部微创小切口在非CPB下进行,于右心室表面选择适当的穿刺点,在食道超声(TEE)实时引导下,建立输送轨道并完成VSD封堵。术后密切随访1个月至1年。结果 35例中32例封堵成功(91.4%),3例(8.6%)术中改为常规CPB手术。32例患者均无心律失常、残余分流等并发症发生,2例患者发生轻度三尖瓣关闭不全(5.7%)。32例患者均于术后2h内拔除气管插管,3～5d痊愈出院。术后随访无主动脉瓣反流、心律失常、残余分流等并发症发生。结论微创经胸非CPB下VSD封堵治疗是一种安全有效的治疗方法,但远期结果需进一步观察。     

Right Ventricle Function in Patients With Anterior Myocardial Infarction: Are We Sure it Is Not Involved?

The right and left ventricle of heart are intimately connected by anatomical and functional links. Hence, acute changes in cardiac geometry and function can modify the performance and physiology of both sides of the heart, influencing each other. After a brief overview of the anatomy and related imaging techniques for the study of right ventricular function, we report a review-on the interesting correlation of acute anterior myocardial infarction and right ventricular function, very often underestimated.     

Health-related information needs and preferences for information of individuals with cardiovascular disease from underserved populations: A systematic review

ObjectiveThis systematic review aimed to identify the information needs and preferences of individuals with CVD from underserved populations.MethodsFive databases were searched from data inception to February 2022. Pilot and case report studies, non-peer-reviewed literature, and studies published in a language other than English, Portuguese, or Spanish were excluded. Structured and thematic analysis of all included studies were performed. The Critical Appraisal Skills Program and the Downs and Black Checklist were used to assess the quality of the qualitative and quantitative studies, respectively.ResultsOf 35,698 initial records, 19 studies were included, most in observational design and classified as “fair” quality. Underserved populations – women, people living in rural areas, ethnic minority groups, older people, and those with low socioeconomic status – presented unique needs in four main groups, with some similarities across them: information about CVD, primary and secondary prevention of CVD, CVD management, and health care, policies and practices. Across the studies there was a lack of standardization on how individuals’ needs were assessed and reported.ConclusionUnderserved populations with CVD have unique information needs and preferences that should be address during their care.Practical implicationInformation from this study may assist health care professionals with the development of comprehensive strategies to improve their provision of care for specific CVD patient groups.     

Radiofrequency ablation for the pre-excitation syndrome of functionally corrected transposition of great arteries

We reported a 57-year-old female patient who had functionally corrected transposition of the great arteries, severe tricuspid insufficiency, enlarged left atrium and functional right ventricle, which were successfully performed radiofrequency ablation.