抗N-甲基-D-天冬氨酸受体脑炎患者脑电图特点的研究进展

抗N-甲基-D-天冬氨酸（NMDA）受体脑炎是一种针对NMDA受体NR1亚基的自身免疫性疾病,早期以功能性损伤为主,脑电图检查通过记录脑电信号的变化,可以敏感地反映脑功能异常。抗NMDA受体脑炎较为常见的脑电图特点为慢波性异常、癫痫样放电、大量β活动、极度δ刷状波等。本文从上述脑电图模式的波形特点、起源部位、发生机制、临床价值等方面,综述抗NMDA受体脑炎患者的脑电图特点研究概貌。     

低强度脉冲电磁场对兔动脉粥样硬化斑块中MMP-9及TIMP-1表达的影响

目的探索低强度脉冲电磁场对大白兔动脉粥样硬化（AS）斑块中基质金属蛋白酶-9（MMP-9）及组织金属蛋白酶抑制物-1（TIMP-1）表达的影响。方法将大白兔随机分成常规饮食（ND）组、高脂饮食（HD）组及高脂饮食＋磁场（HM）组,ND及HD组分别给予常规饮食及高脂饮食,HM组动物在给予高脂饮食的同时,加用低强度脉冲电磁场进行干预。干预7 w后,取主动脉根部行常规石蜡切片及HE染色后,计算AS斑块的面积,采用免疫组化及蛋白免疫印迹法检测AS斑块中MMP-9和TIMP-1的表达。结果高脂饮食可显著增加主动脉根部AS斑块的面积（P〈0.05）,低强度脉冲电磁场干预能显著削弱高脂饮食诱导的AS斑块形成（P〈0.05）;高脂饮食能显著增加AS斑块中MMP-9和TIMP-1的表达（P〈0.05）,而低强度脉冲电磁场干预能显著抑制高脂饮食诱导的MMP-9和TIMP-1表达水平的增加（P〈0.05）,且可显著降低MMP-9与TIMP-1的比值。结论低强度脉冲电磁场抗AS的作用机制可能与降低MMP-9与TIMP-1的比值有关。     

冲击波与地塞米松对自体血清培养的骨髓间充质干细胞成骨分化的比较研究

[目的]观察冲击波(shock waves)与地塞米松对自体血清培养的人骨髓间充质干细胞(human mesenchyreal stem cells,hMSCs)体外成骨分化的影响比较.[方法]选择10名健康志愿者,每名健康志愿者抽取骨髓60 ml,抽取外周静脉血100 ml,然后分离出自体血清.把每名志愿者的骨髓分别...     

Shear Wave Elastography of Peripheral Muscle Weakness in Patients with Chronic Congestive Heart Failure

Forty-five study participants (28 chronic heart failure [CHF] patients and 17 control participants) were prospectively enrolled in this study to investigate the clinical potential of ultrasound shear wave elastography (SWE) in identifying peripheral muscle weaknesses in chronic heart failure patients. Muscle stiffness in the gastrocnemius muscle during extension (stretch) and the lower arm flexor muscles during flexion was assessed via shear wave elastography, measuring the shear modulus (kPa) for the resting and contractile states in a range of 0–300 kPa. Resting kPa revealed no significant difference between CHF and CP, but exercise kPa for extension and flexion was significantly lower in CHF than CP. The area under the receiver operating characteristic curve of the denominator kPa-Exercise stretch was 0.916, associated with a sensitivity of 89%, a specificity of 71% and a corresponding cutoff value of 81.1 kPa. Shear wave elastography is thus a reproducible and sensitive ultrasound method for evaluating peripheral muscle deficits in patients with CHF.     

A case of electromagnetic interference between HeartMate 3 LVAD and implantable cardioverter defibrillator

Implantable cardioverter defibrillators (ICDs) have been shown to have a significant benefit in reducing sudden cardiac death (SCD) in patients with systolic heart failure. Additionally, cardiac devices as a bridge to transplant or destination therapy are often used in patients with end‐stage systolic heart failure. As a result, most patients with left ventricular assist devices (LVADs) also have an ICD. Here, we present an electromagnetic interference (EMI) between HeartMate 3 LVAD and ICD. This issue might be critical for both electrophysiologists and advanced heart failure cardiologists to understand prior to implantation of ICD/LVADs in these patients.     

Combining electromagnetic navigation and 3‐D mapping to reduce fluoroscopy time and achieve optimal CRT response

Implantation of cardiac resynchronization therapy (CRT) devices can be challenging, time consuming, and associated with high‐dose x‐ray exposure. We present the technique in which an electromagnetic navigation system (MediGuideTM, St. Jude Medical) and an electroanatomical three‐dimensional mapping system (EnSite NavX, St Jude Medical) are usefully combined for implanting implantable cardioverter defibrillator CRT devices with strong reduction of x‐ray exposure, and for targeting the most delayed regions in the activation maps avoiding scars for optimal CRT response.     

An unusual source of electromagnetic interference

A 62‐year‐old male presented to his treating cardiologist for routine interrogation of his implantable cardiac defibrillator on the background of severe ischemic cardiomyopathy and end‐stage kidney disease on hemodialysis. The device log revealed multiple paroxysms of atrial fibrillation; however, upon scrutinizing these episodes it was evident that they always corresponded to episodes of hemodialysis while dialyzing through a chronic dialysis catheter, but not while dialyzing via an arteriovenous fistula. We report the novel finding of inappropriate sensing of current leak from the catheter by a lead with a floating atrial dipole.