小檗碱对大鼠再灌心律失常及钙调节的作用

小檗碱（Ｂｅｒ，１０ｍｇ·ｋｇ－１）使缺血／再灌后ＶＴ发生率明显降低，持续时间明显缩短，无１例发生ＶＦ及死亡，与对照组比较差异有显著性。离体实验表明：小檗碱（３０μｍｏｌ·Ｌ－１），能抑制高钙条件下Ｃａ２＋内流，而增加低钙条件下的Ｃａ２＋内流。结果表明：小檗碱具有预防再灌心律失常作用；不同Ｃａ２＋浓度能够影响心肌４５Ｃａ内流；小檗碱对心肌Ｃａ２＋内流有双向调节作用，尤其在高Ｃａ２＋条件下，降低４５Ｃａ内流可能是其抗心律失常作用机制之一。     

脑卒中患者下丘脑─垂体─肾上腺皮质轴功能改变及临床意义

观察了１７２例脑卒中患者血清促肾上腺皮质激素（ＡＣＴＨ）、皮质醇的变化，发现ＡＣＴＨ、皮质醇水平明显高于正常对照组，脑出血组高于脑梗塞组；病情轻重与ＡＣＴＨ、皮质醇的变化明显相关。治疗前后ＡＣＴＨ、皮质醇水平明显不同，治疗后明显降低（Ｐ＜０．０１）。说明治疗后可改善下丘脑－垂体－肾上腺皮质轴（Ｈ／Ｐ／Ａ）功能紊乱。     

大鼠局灶性脑缺血再灌注模型的建立及其组织形态改变

目的：建立大鼠脑缺血2h再灌注不同时程实验动物模型，探讨其病理形态学HE染色特点。方法：线栓法行大鼠大脑中动脉闭塞(MCAo)造成局灶性脑缺血2h再灌注模型，假手术组不插入线栓。HE染色观察病理组织形态学特点。结果：所有局灶性脑缺血再灌注模型在麻醉苏醒后均表现为局灶性神经功能缺陷。再灌注后3h，神经功能缺陷部分恢复。这些表现与临床局灶性脑缺血再灌注溶栓治疗的病人相似。HE染色可见胞浆均质红染、细胞核固缩以及细胞膜和细胞结构破坏的嗜伊红的死亡神经元。结论：Wistar大鼠局灶性脑缺血再灌注模型的神经功能缺损与人类缺血性脑血管病相近，是研究脑缺血再灌注损伤的病理形态学机制的良好模型。     

急性缺血性卒中抗凝治疗研究进展

急性缺血十牛卒中的抗凝治疗存在着很大的争议。本文综述了常用抗凝药物如肝素、低分子肝素的作川机制，并从循证医学角度对近年来发表的一些关于急性缺血性卒中抗凝治疗的大型临床试验进行了总结。     

多糖硫酸脂(PSS)治疗缺血性脑血管病临床观察和实验室研究

应用PSS治疗270例缺血性脑血管病并进行了临床、实验室以及动物试验的观察.总有效率为92.27%;显效率65.24%,与对照组相比较有显著性差异(P<0.005).实验室观察发现PSS有显著的抗凝血、降低血粘度,降低血脂及血管扩张作用.动物实验也说明了这一点.     

Changes in cardiovascular function induced by verapamil in healthy subjects and in patients with ischemic heart disease

Alterations in cardiovascular function induced by the acute intravenous administration of verapamil (5 or 10 mg) in 52 patients (29 with ischemic heart disease and 23 without heart disease) were evaluated with use of invasive techniques (right and left heart catheterization, left ventricular cineangiography, and coronary arteriography). The most significant changes were represented by a decrease in systemic vascular resistance and systemic arterial pressure, and an increase in heart rate and cardiac output. Contractility indexes were not depressed in either group, and altered ventricular wall motion tended to improve to a slightly smaller degree than in patients treated with nitroglycerin. The use of verapamil in patients with ischemic heart disease appears to be safe, and concern about the negative inotropic influences in humans no longer seems justified.     

尼莫地平复方丹参注射液治疗新生儿缺氧缺血性脑病疗效观察

目的观察尼莫地平联合复方丹参注射液治疗新生儿缺氧缺血性脑病(HIE)的疗效.方法 128例HIE患儿随机分为复方丹参注射液组32例,尼莫地平组,尼莫地平加复方丹参注射液,与对照组.结果复方丹参注射液组、尼莫地平组、尼莫地平加复方丹参注射液治疗组总有效率分别为81.3%(26/32)、80.0%(24/30)、97.1%(34/35),对照组总有效率为51.6%(16/31),P＜0.05.结论尼莫地平与复方丹参注射液在治疗HIE时有协同作用,疗效显著,未见副作用发生.     

缺血后处理与心肌保护

随着心脏外科手术和介入治疗的增加，人们越来越重视其中的主要病理生理过程——心肌缺血再灌注损伤（myocardium ischemic-reperfusion injury，MIRI）。MIRI是指心肌缺血一定时间后即使恢复血液灌注，仍将引起心肌功能障碍和结构损害，表现为致死性再灌注损伤、心肌顿抑、心律失常和能量代谢改变。其发病机制仍未完全阐明，通常认为与氧自由基、钙超载、中性粒细胞、微血管损伤和能量代谢障碍等有关。近年来对其发生机制和防治方法的研究越来越深入，发现缺血后处理（ischemic postconditioning，IPO）。有很好的心肌保护作用。现就IPO对心肌缺血和再灌注损伤的保护作用、可能机制及其意义作一综述。     

Prostaglandin E1‐effective,transient‐type ischemic colitis developed after surgical resection of sigmoid colon cancer. A case report

A 55‐year‐old‐man had a laparoscopic resection of the sigmoid colon due to colon cancer with submucosal invasion. After the surgery he suffered ileus and had a laparotomy. Six months later he complained of frequent defecation. Colonoscopy confirmed a circular ulcer extending from the anal side of the anastomosis in the sigmoid colon to the mid rectum. Endoscopic ultrasound demonstrated thickening of all layers of the diseased colon and rectum. We diagnosed ischemic colitis. After intravenous drip infusion of prostaglandin, symptoms and colonic stricture gradually improved. Although abdominal angiography revealed a narrowing of the peripheral sigmoid branch of the inferior mesenteric artery, blood flow was unrestricted. Colonoscopy performed 84 days after discharge revealed an ulcer scar.     

Comparison of Asymmetry in Cerebral Blood Flow Between Brain Hemispheres Using Digital Subtraction Angiography

BACKGROUND AND PURPOSE: Recently, endovascular techniques have gained significant therapeutic potential for both treatment and prevention of stroke. Cerebral angiography, which is an essential component of these procedures, has been used to provide morphological information regarding condition of blood vessels. In this study, we propose to determine the possibility of acquiring information regarding cerebral blood flow (CBF) in addition to morphologic information from data routinely available during angiography. METHODS: Digital subtraction angiography sequences were obtained for eight patients having occlusive disease in internal carotid artery (ICA) territories. Two regions-of-interest (ROIs) corresponding to the two brain hemispheres on AP view were delineated. For each image, the average pixel value within each ROI was calculated and used to generate time-density curves. Indices obtained from each curve were compared with each other and with the results obtained from the single photon emission computed tomography (SPECT) studies performed a pre- or postangiography procedure. RESULTS: Comparison between ICA stenosis and cerebral perfusion measurements revealed that cerebral perfusion deficit can be independent of arterial occlusive disease. The indices obtained from the time-density curves exhibit a correlating trend with the results from SPECT studies. However, lack of sufficient sample data prevented any meaningful statistical analysis to be conducted. CONCLUSIONS: We have developed a technique for utilizing the angiographic data for the important task of routinely and easily measuring CBF. Availability of CBF measurements during cerebral angiography may favorably impact upon the appropriate use of endovascular procedures and potentially contribute to the reduction of morbidity and mortality associated with stroke.