The acute response of left ventricular filling dynamics to intravenous verapamil predicts the changes in exercise tolerance after oral verapamil therapy in patients with hypertrophic cardiomyopathy

We studied the correlation between changes in left ventricularfilling dynamics induced by acute intravenous administrationof verapamil and the changes in exercise tolerance induced byoral administration of the agent in 30 patients with hypertrophiccardiomyopathy. Diastolic cardiac function was measured by meansof a nuclear stethoscope before and 10 min after intravenousadministration of verapamil, 0.15mg. kg^–1 over 2 min.Treadmill exercise tests using a modified Bruce protocol wereperformed before the initiation of oral verapamil treatmentand after 4 weeks of oral therapy at a dose of 320–360mg. day^–1 (mean±SD 332±17mg. day^–1). Peak filling rate (PFR) increased in 21 patients, 18 of whom(86%) also had an increase in exercise duration. PFR showedno increase in nine patients, eight of whom (89%) had no changein exercise duration (sensitivity 95%, specificity 73%, predictivevalue of the positive result 86%, predictive value of the negativeresult 89%). Acute changes in time from the beginning of rapidfilling to PFR (t-PFR) and in left ventricular end-diastolicvolume (EDV) were less useful in predicting improvement in exercisetolerance. In 19 patients the changes in PFR and EDV parallelled.Twelve of the 13 patients (92%) will an increase in both parametersalso had an increase in exercise duration, whereas all six inwhom these parameters were reduced showed no increase in exerciseduration (sensitivity 100%, specificity 86%, predictive valueof positive results 92%, and predictive value of negative results100%). In conclusion, the response of PFR, and even more so the combinedresponse of PFR and EDV to intravenous verapamil, accuratelyidentify patients with hypertrophic cardiomyopathy who are likelyto show improvement in exercise tolerance after oral verapamiltherapy.     

Radioisotope assessment of heart damage in hypertransfused thalassaemic patients

Twenty-five thalassaemic patients treated with repeated blood transfusion (BT) and intensive iron removal therapy were studied by echocardiography and rest/stress equilibrium gated radionuclide angiocardiography (EGNA). Stress left ventricular ejection fraction (LVEF) showed an important negative correlation with number of BTs (r = –0.75). Abnormal values of stress LVEF were measured after 200 BTs: these data demonstrate the effectiveness of stress LVEF in the follow-up of patients who have undergone repeated BTs and the clinical importance of intensive chelation therapy. Peak filling rate did not show diagnostic value in the early detection of iron cardiotoxicity. However, its inverse correlation with BT (r = –60) indicates that iron overload depresses the diastolic parameters.     

Uptake and localisation of O-(β-hydroxyethyl)-rutosides in the venous wall,measured by laser scanning microscopy

Summary The uptake and localisation of O-(-hy-droxyethyl)-rutosides (HR) in the venous wall was studied in 8 patients undergoing crossectomy for a varicose long saphenous vein. The fluorescence of cross-sections of the vein wall was measured by laser scanning microscopy, based on the autofluorescence of HR. Four patients (treated group) received 2 × 1.5 g HR IV before surgery, and four (untreated patients) served as controls.Uptake of HR into the veins from treated patients was seen, with a mean fluorescence intensity of 80.9 units compared to 49.4 units in the untreated veins. The increase in fluorescence was clearly demarcated on the endothelial side of the vein wall.It is concluded that HR passes into the vascular wall, where it is localised in the endothelial and sub-endothelial areas.     

机械传动系统的模糊分析设计

用线性隶属函数、二元相对比较级等确定特征因素的隶属度,构造了不同机械传动类型的模糊子集,取其与待识别模糊子集向量空问的距离均数为贴近度。根据择近原则选择确定机械传动类型。     

金匮要略硕士研究生教育模式初探

对金匮要略硕士研究生阶段教育模式进行反思,探索更合理的教学方法.认为一名合格的金匮要略硕士研究生要具备以下3点:①必须有利于继承传统中医,能使中医理论知识巩固和提高.②必须有利于提高临床诊治的能力和水平.③其研究课题要有中医的理论特色.方法可以有多种,但必须养成实事求是、脚踏实地的科学态度.故研究生教育必须有利于中医事业的继承和发展,又要具有社会效益.     

保留颈外静脉同期双侧颈淋巴结清除术治疗头颈部癌

自１９８９年１月至１９９４年１２月对１９例头颈部癌并双侧颈淋巴结转移的病人采取保留颈外静脉同期双侧颈淋巴结清除术（以下简称颈清术）治疗。包括喉癌、下咽癌、舌癌、口底癌、甲状腺癌及双侧原发灶不明的颈部转移癌。本文对其手术指征及手术方法作了简单介绍，并对其意义及可行性进行了讨论。     

浅静脉离心穿刺留置套管针应用观察

目的 探索浅静脉离心穿刺留置套管针应用的可行性。方法 采用自身对照法，选择100例18-76岁患者左右手背浅静脉血管作为研究对象。对照组（右手）采用向心穿刺留置套管针；观察组（左手）采用浅静脉离心穿刺留置套管针。比较两组平均最大输液流速、最长置管时间、静脉炎发生次数等。结果 观察组平均最大输液流速明显快于对照组，最长置管时间明显长于对照组（P均〈0．05）；静脉炎发生次数少于对照组，但两组间差异无显著意义（P〉0．05）。结论 浅静脉离心穿刺留置套管针是一种可行、有效的穿刺方法。     

口服葡萄糖酸钙提质生产注射葡萄糖酸钙的探讨

目的：生产注射葡萄糖酸钙。方法：以口服葡萄酸钙为原料，通过提高其澄明度和降低其杂质含量使其达到注射葡萄糖酸钙的质量要求。结论：本工艺方法具有投入设备少、副反应少、产品质量好等特点。     

影响急诊满意度因素分析

目的了解急诊患者满意度的影响因素.方法通过问卷方式对急诊患者满意度进行调查,并予统计描述及回归分析,建立数学模型.结果满意度与患者是否再就诊、医务人员是否告诉患者等待时间、是否给予帮助、是否告诉返回复诊时间、是否对疾病已经解释清楚、是否解释化验结果、是否告诉正常生活时间等有相关性.结论患者满意度与多个因素有关,急诊医护人员应加强服务方式的培训.     

龙葵碱对H22荷瘤小鼠肿瘤细胞膜唾液酸和封闭度的影响

目的研究龙葵碱对H22荷瘤小鼠肿瘤细胞膜唾液酸(SA)水平和封闭度的影响。方法建立H22荷瘤小鼠模型,荷瘤小鼠分别sc生理盐水、环磷酰胺、龙葵碱(9.375、18.75、37.5mg/kg)。采用比色法测定H22小鼠肿瘤细胞膜SA水平和封闭度。结果龙葵碱可剂量依赖性地降低荷瘤小鼠肿瘤细胞膜SA水平和肿瘤细胞膜封闭度。结论龙葵碱通过降低H22荷瘤小鼠肿瘤细胞膜SA水平和肿瘤细胞膜封闭度起抗肿瘤作用。