Central and Regional Hemodynamics and Plasma Volume Distribution During the Development of Spontaneous Hypertension in Rats

In this study, we investigated the central as well as the regional hemodynamics of spontaneous hypertension in different phases using the reference sample microsphere method in conscious, unrestrained spontaneously hypertensive rats (SHR) using age-matched progenitor Wistar Kyoto rats (WKy) as controls. Moreover, in order to study the role of intravascular fluid volumes and their regional distribution in the early hemodynamics of spontaneous hypertension, we measured albumin distribution spaces at different ages in SHR and WKy.

Microsphere studies showed an increase of cardiac output in 5 weeks old SHR when compared to age-matched WKy. This increased flow was mainly transmitted to the muscular and skin vascular bed. The kidney vascular resistance was increased significantly already in 5 weeks old SHR. In 7-8 weeks old animals, cardiac output was not significantly different in SHR and WKy. The increase in blood pressure was then characterized by a generalized increase in vascular resistance in almost all tissues. Plasma volume (PV) measurements indicate a significantly higher PV in 5 weeks old SHR when compared to age-matched WKy. At later ages (7-16 weeks), PV was lower in SHR than in WKy. Regional measurements show a consistently lower PV in gut, muscle, testes, and skin in SHR.     

金纳多对突发性耳聋患者血流动力学的影响

目的:探讨金纳多对突发性耳聋患者血清hs-CRP、HMGB1、ADP、RES及血流动力学的影响。方法:将2009年8月～2012年5月收治的78例突发性耳聋患者随机分为对照组(常规治疗组)和观察组(加用金多纳组),每组各39例,将两组不同严重程度者治疗前及治疗后10d、20d血清hs-CRP、HMGB1、ADP、RES及血流动力学指标进行比较。结果:观察组轻度、中度及重度者治疗后基底动脉血流动力学指标异常率低于对照组,hs-CRP、HMGB1、ADP、RES改善幅度大于对照组,P均<0.05。结论:金纳多可有效改善突发性耳聋者的hs-CRP、HMGB1、ADP、RES及血流动力学。     

茚甲新治疗顽固性颅内高压的效果观察

目的探讨茚甲新治疗重型颅脑创伤后顽固性颅内高压的临床效果及可行性。方法选择36例重型颅脑创伤后出现顽固性颅内高压的患者，应用茚甲新治疗，比较治疗前后ICP、CCP以及大脑中动脉平均血流速率（VmMCA）的变化，并对患者进行随访评估预后。结果用药30、60、120min后的ICP水平低于用药前，CCP、VmMCA水平均高于用药前，差异均有统计学意义（P〈0．05），且持续静脉点滴期间平均ICP和CCP水平较之首剂量后变化不明显，6例患者应用茚甲新后ICP和CCP变化不明显，随访6个月生存率为为61．1％，预后良好率为27．8％。结论茚甲新对于顽固性颅内高压患者，可显著降低其ICP、增高CCP，对于改善此类患者的预后有积极的作用。     

起搏后体位性低血压

观察7条狗起搏前后从卧位变为站位时的血流动力学变化。起搏后起立时平均动脉压平均下降28％,是正常时(13％)的二倍,并且恢复时间明显延长(P<0.01)。实验表明起搏前后狗的体位性低血压代偿机制不同,正常时起立时心输出量增加20％左右,心率平均增加24％,而每搏输出量在开始阶段常减少,有的在整个站立过程中减少。心率在提高心输出量,代偿体位性低血压中起着重要作用。起搏后由于心率固定不变,因而出现明显的体位性低血压。提高起搏频率可改善体位性低血压。     

超声评估急重症患者容量状态研究进展

循环不稳定是急重症患者常见急症之一,快速评估其容量状态是指导治疗的关键。检测中心静脉压（CVP）是目前临床评估容量负荷的较常用方法,但为有创操作,且存在较多近远期并发症。超声作为无创检查已广泛应用于监测血流动力学,近年来,采用急诊超声评估患者容量状态并指导液体治疗日益普及。本文对超声评估急重症患者容量状态的应用进展进行综述。     

创伤性肺栓塞应用华法林治疗前后的血流动力学变化研究

目的：探讨创伤性肺栓塞患者使用华法林治疗后,血流动力学变化特征。方法将该院2013年10月—2014年10月收纳的36例创伤性肺栓塞患者设为观察组;另选取同期于该院接受体检的36名健康体检者设为对照组。对比两组研究对象不同时期的血流动力学变化值。结果相较于对照组,观察组患者治疗前MAP、CI、SV、SI、PAWP明显更低,HR、SVR、TFC、PVR明显更高,组间对比差异有统计学意义（P＜0.05）。结论华法林治疗创伤性肺栓塞会引起血流动力学变化,临床可根据该监测指标对患者对患者病情与治疗紧张进行准确评估。     

重组人心钠肽治疗急性心力衰竭的临床研究

目的：探讨重组人心钠肽治疗急性心力衰竭疗效。方法：对自2011年5月～2013年2月我院收治的急性心力衰竭患者应用重组人心钠肽治疗,于用药前后监测患者的血流动力学参数。结果：66例患者59例症状缓解,显效27例,有效32例,无效7例,有效率89．39％。结论：重组人心钠肽是治疗急性心力衰竭疗效可靠的药物,安全性高。     

瑞舒伐他汀对脑梗塞患者脑血流动力学的影响

目的 探讨瑞舒伐他汀对脑梗塞患者脑血流动力学的影响效果.方法 选择我院2013年8月至2014年2月收治的80例脑梗塞患者为研究对象,随机分为对照组40例,观察组40例,对照组行常规抗血小板聚集、营养脑神经药物治疗,观察组在常规治疗基础上,加用瑞舒伐他汀治疗,对两组患者行多普勒超声检查,对比两组患者的脑血流动力学状况.结果 观察治疗后双侧大脑动脉Vm为(62.35±15.68) cm·s-1,双侧大脑动脉Vs为(88.62±25.31)cm·s-1,双侧大脑动脉PI为(0.63±0.31),对照组治疗后双侧大脑动脉Vm为(57.51±12.56) cm·s-1,双侧大脑动脉Vs为(80.51±21.54) cm·s-1,双侧大脑动脉PI为(0.73±0.51),差异有统计学意义(P＜0.05).结论 对脑梗塞治疗时,加用瑞舒伐他汀,可显著改善患者脑血流动力学,能帮助患者的病情恢复,值得临床进一步推广使用.     

Cardiovascular Effects of Medical Marijuana: A Systematic Review

Utilization of marijuana as a medicinal agent is becoming increasingly popular, and so far, 25 states have legalized it for medical purposes. However, there is emerging evidence that marijuana use can result in cardiovascular side effects, such as rhythm abnormalities, syncope/dizziness, and myocardial infarction, among others. Further, there are currently no stringent national standards or approval processes, like Food and Drug Administration (FDA) evaluation, in place to assess medical marijuana products. This review includes the largest up-to-date pooled population of patients with exposure to marijuana and reported cardiovascular effects. Although purported as benign by many seeking to advance the use of marijuana as an adjunctive medical therapy across the country, marijuana is associated with its own set of cardiovascular risks and deserves further definitive study and the same level of scrutiny we apply in research of all other types of medications. When used as a medicinal agent, marijuana should be regarded accordingly, and both clinical providers and patients must be aware of potential adverse effects associated with its use for early recognition and management.     

Astragalus polysaccharide attenuates isoproterenol-induced cardiac hypertrophy by regulating TNF-α/PGC-1α signaling mediated energy biosynthesis

We previously reported that Astragalus polysaccharide (APS) extracted from Chinese medicine Astragalus membranaceus (Fisch.) Bge, attenuates hypertrophy of neonatal rat ventricular myocytes (NRVMs) induced by isoproterenol (Iso). The present study was designed to investigate the effects and the possible mechanism of APS on Iso-induced hypertrophy in rats and NRVMs with focus on tumor necrosis factor α (TNF-α)/peroxisome proliferator-activated receptor-γ coactivator 1α (PGC-1α) signaling mediated energy biosynthesis. 36-Week old rats were randomly divided into 3 groups: (1) Control, rats received vehicle; (2) Iso, rats received isoproterenol injections; (3) Iso+APS, rats received isoproterenol injections and APS. NRVMs were divided into similar groups as rats. The results showed that combination of APS with Iso significantly attenuated the pathological changes, reduced the ratios of heart weight/body weight (HW/BW) and left ventricular weight/BW (LVW/BW), improved the cardiac hemodynamics, down-regulated mRNA and protein expression of atrial natriuretic peptide (ANP), increased the ratios of ATP/ADP and ATP/AMP, and decreased the content of free fatty acid (FFA) in heart tissue of rats compared with Iso alone. In addition, pretreatment with APS significantly decreased the surface area and protein content, down-regulated mRNA and protein expression of ANP, increased the ratios of ATP/ADP and ATP/AMP, and decreased the content of FFA in NRVMs compared with Iso alone. Furthermore, APS increased the protein expressions of ATP5D, the σ subunit of ATP synthase, PGC-1α and pyruvate dehydrogenase kinase 4 (PDK4) in tissue and NRVMs respectively and inhibited the production of TNF-α in serum and culture medium compared with Iso alone. The results suggested that APS attenuates Iso-induced cardiac hypertrophy through regulating TNF-α/PGC-1α signaling mediated energy biosynthesis.