环原黄杨星A对抗哇巴因诱发心律失常的作用

环原黄杨星A(CPB-A)1～4 mg·kg~(-1)iv对抗哇巴因(Oua)诱发豚鼠心律失常。其作用比Ami和CVB-D强,且不受利血平、切断迷走神经或毁脊髓的影响。提示CPB-A的抗心律失常作用可能与神经系统无关。CPB-A 3μmol·L~(-1) 降低Oua所致豚鼠离体心肌振荡后电位(OAP)幅度,阻止触发活动产生。30μmol·L~(-1)     

关附甲素对心肌细胞电生理特性的影响

用细胞内微电极术结合微机自动分析,研究关附甲素(GFA)对豚鼠乳头状肌快反应动作电位的影响。结果表明GFA(2.6～260μmol/L)可依浓度降低APA和V_(max),增加V_(MT),且使V_(max)恒定出现在膜电位除极至-27 SD6 mV水平。GFA(2.6～26μmol/L)使APD_(50)、APD_(90)和ERP延长,82～260μmol/L时,APD_(50)、APD_(90)缩短,而ERP/APD_(90)增大。GFA对V_(max)的抑制作用呈明显的频率依赖性和电位依赖性,并使心肌细胞的兴奋性降低。表明GFA主要是通过对快Na通道阻滞而发挥其抗心律失常作用的。     

芬太尼对正常和缺氧心肌细胞动作电位的影响

本文报道了芬太尼对正常和缺氧心肌细胞动作电位的影响。浓度为60μg/L和100μg/L的芬太尼使正常心肌细胞动作电位之APD_(90)增宽,ERP延长。3μg/L、60μg/L和100μg/L的芬太尼使缺氧心肌细胞动作电位之APA和RMP增大,APD和ERP延长,ERP/APD_(90)比值增大。结果表明,芬太尼对缺氧心脏可能具有一定的抗心律失常作用。     

多非利特与维拉帕米联合应用对豚鼠乳头肌动作电位的影响

目的 研究钾通道拮抗剂多非利特与钙通道拮抗剂维拉帕米联合应用对豚鼠乳头肌动作电位各参数的影响.方法 应用标准微电极技术记录离体豚鼠乳头肌动作电位,观察在不同刺激频率下(0.2,0.5 ,1.0,1 25,2.0 Hz),不同浓度的胺碘酮(1,5,10 μmol/L)、多非利特(10,50,100 nmol/L)或100 nmol/L多非利特与1 μmol/L 维拉帕米联合应用对乳头肌动作电位的影响.结果 胺碘酮浓度依赖性的延长动作电位复极50%(APD50)和90%(APD90)的时程,其作用不表现为频率依赖性;多非利特延长APD具有明显的浓度依赖性,刺激频率增加时,延长APD的作用明显减弱,表现为明显的负性频率依赖性;100 nmol/L多非利特与1 μmol/L维拉帕米联用后,上述频率依赖性得到改善.结论 胺碘酮和多非利特均能浓度依赖性地显著延长动作电位时程,但复合性Ⅲ类抗心律失常药物胺碘酮对频率的依赖性明显低于纯Ⅲ类抗心律失常药物多非利特,而多非利特与维拉帕米联合应用达到一定的平衡状态时可以减少这种负性频率依赖性作用.     

氧化苦参碱抗心律失常作用

氧化苦参碱给小鼠静注,LD_(50)为144.2±22.8mg/kg。给大鼠静注OMT15,30mg/kg显著对抗乌头碱,BaCl_2和结扎冠脉诱发的心律失常。使大鼠的心率减慢,P-R和Q-T间期明显延长。OMT 590μmol/L与心得安0.34μmol/L的作用相似,使Iso诱发心率加快的量效曲线平行右移。使离体结肠段在高K~+去极化后,随着Ca~(2+)剂量的累加而张力逐渐上升。     

西咪替丁对豚鼠正常和缺氧心室肌细胞跨膜电位的影响

本文研究西咪替丁(Cim)对正常和缺氧豚鼠心室肌细胞跨膜电位的影响.结果显示,Cim 2.1×10~(-5)mol/L使豚鼠心室乳头肌APD_(50)和APD_(90)从对照的166.4±1.1和200.6±1.1ms分别延长至189.5±1.2和231.3±1.1ms;使缺氧60min时APD_(50)和APD_(90)由119.7±1.4和158.6±1.2分别延长至152.3±1.3和195.7±1.2ms,并使缺氧心肌动作电位其他参数均有所改善.提示Cim对缺氧心室肌具有保护作用,并有抗心律失常作用,其机理可能与Cim减少Ca~(2 )内流入心肌细胞有关     

碘杂环化合物对离体豚鼠心乳头肌动作电位和收缩力的作用

采用细胞内微电极记录技术,同步观察了3,6-[二甲氨基]-二苯并碘因甲酸盐(IHC-64)对豚鼠心乳头肌细胞动作电位和收缩力的作用。50μmol/L IHC-64抑制心肌收缩力,而不影响快反应动作电位。增加IHC-64浓度,动作电位0相最大峰值(APA)、除极速率(dp/dt_(max))和复极50％和90％时程(APD_(50)、APD_(90))被明显抑制。IHC-64抑制慢反应动作电位,提高细胞外钙浓度可拮抗这种抑制。结果提示,IHC-64主要抑制慢Ca~(2+)内流,同时也部分抑制快Na~+内流,它可能是一种新型B类钙通道阻滞剂。     

静脉胺碘酮应用问答

胺碘酮最初作为冠状动脉扩张剂应用 ,以后发现胺碘酮具有显著的抗心律失常作用 ,1970年口服胺碘酮开始作为抗心律失常药物应用。 1995年美国ＦＤＡ批准静脉胺碘酮用于治疗常规药物无效的复发性ＶＴ/ＶＦ(室性心动过速 /心室颤动 )。静脉胺碘酮具有Ｉ类抗心律失常药物的Ｎａ通道阻断作用 ,ＩＩ类抗心律失常药物的非竞争性抗交感作用 ,ＩＩＩ类抗心律失常的钾通道阻滞作用和ＩＶ类抗心律失常药物的钙通道阻滞作用。1　静脉胺碘酮的电生理作用是什么 ?静脉胺碘酮的电生理作用是延长房室结传导(心房 希氏束 ,ＡＨ)和房室结不应期 (ＥＲＰＡＶＮ…     

环巴胺对胃癌细胞MC增殖凋亡的影响

目的 研究Hedgehog信号通路阻断剂(环巴胺)对MC细胞增殖凋亡的影响.方法 取对数生长期MC细胞分为环巴胺处理组及阴性对照组,以1、5、10μmol/L环巴胺处理MC细胞,分别在24、48、72h后采用M TT法检测其生长抑制率;流式细胞术检测对照组和10μmol/L环巴胺实验组对细胞周期的影响.结果 环巴胺对MC细胞的抑制作用呈时效和量效依赖关系.1、5、10μmol/L浓度组对细胞的生存率分别为(50.03±14.02)%、(49.76±14.14)%和(37.87±19.53)%,组间比较差异有统计学意义(P<0.001).流式细胞术检测发现,环巴胺浓度达10μmol/L,干预24h后G1期细胞比例明显升高.对照组、10μmol/L浓度实验组的G1期细胞百分比分别为:33.94%、49.83%;细胞凋亡率对照组和10μmol/L浓度实验组分别为1.34%、7.09%.讨论环巴胺可以抑制MC细胞的增殖能力和诱导MC细胞凋亡的作用,其机制与抑制Hedgehog信号通路有关.     

传统抗心律失常药物及苦参碱对家兔心室肌细胞快速延迟整流钾电流作用的比较

目的 比较传统的抗心律失常药物和苦参碱时心肌细胞快速延迟整流钾电流(IKr)的作用,以及其诱发QT间期延长和致心律失常作用发生的危险性.方法 采用酶解法急性分离单个家兔心室肌细胞,全细胞 膜片钳技术观察并比较奎尼丁、普萘洛尔、胺碘酮及苦参碱等药物对心肌细胞IKr的作用.结果 胺碘酮(0.1、1和10μM)及苦参碱(1、10和100μM)剂量依赖性抑制家兔心室肌细胞IKr,而苦参碱的抑制作用明显弱于胺碘酮;几种传统的抗心律失常药物中,在相同药物浓度下(1μM),奎尼丁和胺碘酮均表现为明显的IKr电流抑制作用,而普萘洛尔对IKr电流的抑制作用明显减轻(n=12,P<0.05).结论 中药苦参碱及β受体阻断药普荼洛尔对IKr电流的抑制作用较奎尼丁和胺碘酮为弱,其临床应用不易诱发QT间期延长和心律失常.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.