冠脉内注射重组人脑利钠肽对AMI合并心衰患者PCI术后心功能的影响

目的 研究冠脉内注射重组人脑利钠肽对AMI合并心衰患者PCI术后心功能的影响.方法 将急性前壁心肌梗死合并心力衰竭的患者皆接受PCI治疗,并随机分为脑利钠肽组和对照组,脑利钠肽组予冠脉内注射脑利钠肽后予脑利钠肽连续静滴72h,其余同常规治疗,对照组给予常规治疗,随诊8周观察两组患者临床疗效、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)情况.结果 两组临床疗效比较,治疗组较对照组疗效更佳(P<0.05);两组左室舒张末直径(LVEDD)同治疗前比较均无显著性差异(P>0.05),两组左室射血分数均较治疗前明显改善(P<0.05),但治疗组更优.结论 冠脉内注射重组人脑利钠肽可明显改善AMI患者PCI术后近期心功能.     

醛固酮及其受体拮抗剂对大鼠主动脉平滑肌TGF-β1表达的影响

目的 观察醛固酮及其受体拮抗剂对大鼠主动脉平滑肌转化生长因子-β1(TGF-β1)表达的影响,初步探讨原发性醛固酮增多症发生血管重构的可能机制.方法 采用皮下给药的方法建立醛固酮增多症模型,其中醛固酮组经微量渗透泵持续释放醛固酮(1 μg/h);拮抗组除给予等量醛固酮外,每日行螺内酯灌胃100 mg/(kg·d);对照组仅泵空白溶剂.尾套法检测大鼠血压,4周后处死所有大鼠,测定血钾、钠、醛固酮浓度及血浆肾素活性.分别采用RT-PCR、Western印迹检测主动脉平滑肌TGF-β1基因的表达.结果 ① 醛固酮组大鼠血压明显升高,血钾下降,血浆肾素活性降低,与对照组相比差异具统计学意义(P<0.01);② 醛固酮组主动脉平滑肌TGF-β1基因的表达水平明显高于对照组(P<0.01).螺内酯可抑制醛固酮的上述作用(P<0.01).结论 醛固酮及其受体拮抗剂螺内酯可能通过调节血管平滑肌TGF-β1的表达,从而影响血管重构的发生.     

参附注射液联合磷酸肌酸钠治疗冠心病合并急性左心衰的临床研究

目的:探究参附注射液联合磷酸肌酸钠治疗冠心病合并急性左心衰的临床疗效。方法:将我院96例冠心病并急性左心衰患者随机分为观察组与对照组各48例。均予以常规治疗,对照组加以磷酸肌酸钠治疗,观察组在对照组基础上加以参附注射液治疗,比较其治疗前及治疗7d后的心脏彩超指(左室射血分数(LVEF)、左室舒张末期内径(LVDd)、左室收缩末期内径(LVSd))、心功能生化指标(可溶性生长刺激表达基因2蛋白(sST2)、心肌肌钙蛋白I(cTnI)、脑钠肽(BNP))水平变化,比较治疗后的6 min步行试验(6MWT)及不良反应发生情况的区别等。结果:治疗7d后,两组患者LVEF水平均较治疗前提高(P<0.05),而LVSd、LVDd、sST2、cTnI、BNP水平则较治疗前明显下降(P<0.05),且观察组上述指标变化幅度大于对照组(P<0.05);治疗7d后,观察组患者6WMT距离明显高于对照组(P<0.05),两组不良反应总发生率比较无统计学意义(P>0.05)。结论:参附注射液联合磷酸肌酸钠可明显改善冠心病急性左心衰患者临床症状,长期可提升其心功能与运动耐力,值得推广。     

冻干重组人脑利钠肽联合环磷腺苷对慢性心衰患者 NT-proBNP 水平及心功能的影响

目的:探讨冻干重组人脑利钠肽(rhBNP)联合环磷腺苷对慢性心衰患者N-末端B型脑钠肽前体(NT-proBNP)水平及心功能的影响.方法:选取2018年11月-2021年11月于我院治疗的82例慢性心衰患者,按随机数字表法分为观察组(41例)与对照组(41例).对照组采用环磷腺苷治疗,观察组在对照组基础上加用rhBNP治疗.分析比较两组临床疗效、NT-proBNP水平、心功能及不良反应情况.结果:观察组治疗总有效率明显高于对照组(P<0.05);治疗后观察组NT-proBNP水平及左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)明显低于对照组,左室射血分数(LVEF)明显高于对照组(P<0.05);两组总不良反应发生率无明显差异(P>0.05).结论:慢性心衰患者采用rhBNP与环磷腺苷联合治疗是安全可行的,有利于降低NT-proBNP水平,改善患者心衰症状及心功能,控制患者病情.     

妊高症患者血浆BNP及D-二聚体联合检测的临床意义

目的通过对妊高症患者血浆脑钠肽(BNP)联合D-二聚体的检测和相关性分析,为临床妊高症患者分期以及心肌损害程度的判断提供依据。方法采用西门子SYSMEX(CA-700)全自动凝血分析仪检测D-二聚体,采用罗氏Cobas e601电化学发光仪检测BNP。结果 67例妊高症患者(轻度27例,中度23例,重度17例)与正常妊娠对照组45例BNP和D-二聚体的检测值比较差异有统计学意义(P0.05),以重度妊高症患者的检测值最高。结论 BNP联合D-二聚体的检测有助于临床及早判断妊高症患者的心肌损害程度,以利于早期预防和治疗。     

慢性心衰合并房颤患者血清胱抑素C和血浆N端B型脑钠肽前体的变化

目的观察慢性心力衰竭合并房颤患者血清胱抑素(Cys C)、血浆N端B型脑钠肽前体(NTproBNP)变化,并探讨其意义。方法 2014年11月至2015年1 1月在锦州市中心医院心内科住院的慢性心衰患者154例,其中慢性心衰合并房颤患者80例为观察组,对照组为慢性心衰窦性心律者74例。入选后采用超声心动图测定左房内径(LA)、左室舒张末期内径(LVDD)和左心室射血分数(LVEF);乳胶增强免疫比浊法测定胱抑素C(Cys C)水平;ELISA法测定血浆NT-proBNP水平。结果与对照组相比,观察组LA和LVDD值显著增大,LVEF值显著降低,Cys C和NT-proBNP水平均显著增高,Cys C浓度与LA和LVDD值呈正相关(r=0.328,P0.05;r=0.406,P0.05),而与LVEF值呈负相关(r=-0.47,P0.C5)。结论慢性心衰合并房颤患者Cys C、NT-proBNP水平明显升高,心肌重构明显,预后不良。     

螺内酯、氯沙坦及两者合用对急性心肌梗死大鼠心肌胶原重建、醛固酮合成酶基因及胶原mRNA表达的影响

目的：对比螺内酯、氯沙坦及两者合用对急性心肌梗死(AMI) 大鼠左心室重构的影响。方法:通过结扎冠状动脉左前降支诱导大鼠心肌梗死，心肌梗死术后存活48 h的大鼠随机分成①假手术组（sham组）和心肌梗死组。心肌梗死组随机分为：②AMI对照组（AMI组，自来水2 mL/d灌胃）、③螺内酯组（螺内酯20 mg·kg^-1·d^-1灌胃）、④氯沙坦组（氯沙坦50 mg·kg^-1·d^-1灌胃）、⑤合用组（螺内酯20 mg·kg^-1·d^-1+氯沙坦50 mg·kg^-1·d^-1灌胃）。观察治疗后第2周、第6周心肌胶原各项指标、非梗死区心肌醛固酮合成酶（CYP11B₂）mRNA、Ⅰ型胶原mRNA及Ⅲ型胶原mRNA的含量。结果:AMI对照组非梗死区胶原含量、梗死区胶原含量、Ⅰ/Ⅲ胶原比值、PCNA阳性细胞数、CYP11B₂ mRNA水平、Ⅰ型胶原mRNA水平、Ⅲ型胶原mRNA水平均显著高于sham组（均P<0.01）。螺内酯组、氯沙坦组及合用组第2周、第6周以上各指标除梗死区胶原含量外均显著低于AMI对照组（均P<0.01）。氯沙坦组以上各指标在第2周、第6周与螺内酯组相比均无显著差异（均P>0.05）。合用组以上各指标除梗死区胶原含量外在第6周均显著低于螺内酯组及氯沙坦组（均P<0.01） 。结论：螺内酯、氯沙坦及其联合治疗均可显著降低非梗死区心肌胶原沉积及Ⅰ/Ⅲ型胶原比值，抑制胶原的增生，两种药物合用效果优于螺内酯或氯沙坦单用。     

利尿钠肽在诊断心力衰竭中的应用价值

探讨利尿钠肽的水平对心力衰竭（心衰）早期诊断的应用价值。采用放免法、ELISA法检测了129例心衰患者血浆中的心房利尿钠肽（ANP）、脑利尿钠肽（BNP）、N末端脑钠肽前体蛋白（NT-proBNP）水平,并与30例健康对照者进行了比较分析。结果显示,心衰患者血浆中的ANP、BNP、NT-proBNP显著高于健康对照组,且均随着NYHA分级的升高而逐渐增加,其含量在NYHA Ⅳ级时到达最高,心衰患者的血浆ANP、NT-proBNP水平与LVEF呈明显负相关。检测血浆中的ANP、BNP、NT-proBNP含量简便、快捷,可用于心衰诊断及NYHA分级判断。     

冻干重组人脑利钠肽在救治急诊急性心力衰竭伴高血压患者中的价值分析

目的:探究急诊急性心力衰竭伴高血压患者采用冻干重组人脑利钠肽辅助治疗的效果.方法:随机将我院2018年11月至2020年11月急性心力衰竭伴高血压急诊患者97例分为2组,对照组48例使用沙库巴曲缬沙坦,辅助治疗组49例于其基础上联合冻干重组人脑利钠肽进行辅助治疗,对比两组治疗1 m后临床疗效、血清相关指标以及心室重构指标.结果:辅助治疗组总有效率较对照组高(P<0.05),辅助治疗组治疗1 m末,左室质量指数、左室舒张期末期容积指数、左室收缩期末期容积指数水平均较对照组高(P<0.05),可溶性生长刺激表达基因2蛋白、肌钙蛋白T和N端脑钠肽前体血清含量均低于对照组(P<0.05).结论:急诊急性心力衰竭伴高血压患者在常规治疗基础上接受冻干重组人脑利钠肽辅助治疗,可有效的调节患者相关血清指标,改善心室重构状态,值得推广.     

依那普利联合氯沙坦治疗早期2型糖尿病肾病合并高血压的疗效与安全性

目的讨论研究依那普利联合氯沙坦共同治疗早期二型糖尿病肾病合并高血压的临床疗效及其安全性。方法选取我院内科早期二型糖尿病肾病合并高血压患者100例。随机分为单一组与联合组各50例。单一组患者仅适用氯沙坦进行治疗;联合组在单一组基础上联合依那普利共同治疗。比较两组患者治疗前后血压控制情况、24h尿蛋白定量指标以及总有效率等。结果两组患者治疗前后血压值比较显示治疗后联合用药组血压控制情况显著优于单一组患者(P<0.05),治疗效果比较显示联合组患者治疗后总有效率98.0%显著高于单一组84%(P<0.05)。治疗后联合组24h尿微量白蛋白指标(67.2±11.3)μg/min显著优于单一组(92.3±25.6)μg/min且联合组不良反应发生率显著低于单一组(P<0.05)。结论临床应用依那普利联合氯沙坦治疗早期二型糖尿病肾病合并高血压疗效显著。可通过阻断血管紧张素与受体结合达到降压目的,同时有效改善身血流动力学,降低分子通透性以减少蛋白尿。联合使用能够有效提高疾病治疗效率,可降低蛋白尿及血尿酸指标且不良反应少,安全系数高。     

Modes of reinforcement and gender and culture of experimenter and subject: effects of "alien" and external reinforcement for Japanese and American men and women

In this study, we examined external and "alien" reinforcement (ER and AR. respectively) as a factor in social learning, and studied the combined effects of culture and reinforcement mode. A female (Experiment 1) and a male (Experiment 2) experimenters conducted experimental sessions. Both men and women, who grew up in the same culture as the experimenter, participated and performed the experimental task. A three-way interaction effect of experimenter gender, culture, and reinforcement mode was found on task performance. And the effect was more pronounced for a Japanese experimenter. A female and a male experimenters conducted Experiments 3 and 4, respectively; however participants this time were men and women who grew up in different cultures than the experimenter. Results indicated that the pattern of the subject gender and reinforcement mode interaction effect, when the experimenter was Japanese with American subjects, was exactly opposite to that when the experimenter was American. These experiments showed that AR was as effective for social learning as ER, and that the cultural backgrounds of experimenter and subject influenced AR and ER effectiveness.     

Rates of oxygen consumption and of anaerobic glycolysis in renal cortex and medulla of adult and new-born rats and guinea-pigs

1. Rates of oxygen uptake and of anaerobic glycolysis were estimated in slices from the renal cortex and medulla (a) of adult rats and guinea-pigs, (b) of new-born (1-, 5- and 21-day-old) rats and of guinea-pigs of 1, 12, 21, 24 and 120 hr age.2. In the adult rat, Q(O2) values for the cortex were 12.55 +/- 0.20 (22) and for the medulla: 8.56 +/- 0.17 (22) mul./hr.mg dry weight, while in the new-born rat (24 hr old) they were 10.99 +/- 0.46 (12) and 9.33 +/- 0.18 (9) mul./hr.mg dry weight respectively.3. Values for Q(CO2) (N2) (anaerobic glycolysis) in the 14 hr old new-born rat were in the renal cortex 9.65 +/- 0.35 (5) and in the medulla 7.39 +/- 0.43 (5) mul./hr.mg dry weight; while in the adult they were 2.25 +/- 0.08 (16) and 5.76 +/- 0.14 (16) mul./hr.mg dry weight, respectively.4. In the adult guinea-pig values for Q(CO2) (N2) were of the same order as in the adult rat, though the rate of O(2) uptake was for the cortex 8.12 +/- 0.22 (12) and for the medulla 5.02 +/- 0.23 (11) mul./hr.mg dry weight.5. Though the Q(O2) values in the renal cortex and medulla were smaller in the 1 hr old new-born guinea-pig, they were already increasing in the 12 hr old neonate.6. The results are discussed in the light of enzyme changes occurring during the process of maturation of the nephron as indicated by histochemical observations.     

Timing and intensity of early fevers and the development of allergies and asthma

BACKGROUND: Early childhood fevers appear to protect against later allergies and asthma. What is not known is the time in which fevers exert this effect and whether the degree of temperature increase is important. OBJECTIVE: We sought to examine the relationship between the time and degree of early fevers and later allergies and asthma. METHODS: Eight hundred thirty-five children from southeast Michigan were enrolled at birth. Clinic records from their first 2 years were abstracted for episodes of fever. At age 6 to 7 years, children underwent allergy testing. We examined fevers occurring within 6-month intervals in the first 2 years of life and outcomes at age 6 to 7 years. The primary outcome measures were allergic sensitization, asthma, asthma with allergic sensitization, and asthma without allergic sensitization. RESULTS: In the unadjusted analysis each episode of fever between 7 and 12 months of age was associated with a lower odds of allergic sensitization (odds ratio [OR], 0.71; 95% CI, 0.54-0.93) and asthma with allergic sensitization (OR, 0.43; 95% CI, 0.21-0.90) at age 6 to 7 years. Likewise, every 1 degrees C increase in the maximum temperature between 7 and 12 months was associated with a lower odds of allergic sensitization (OR, 0.77; 95% CI, 0.61-0.96) and asthma with allergic sensitization (OR, 0.62; 95% CI, 0.40-0.94). After adjusting for potential confounders, each episode of fever between 7 and 12 months was associated with a lower likelihood of asthma with allergic sensitization (adjusted OR, 0.33; 95% CI, 0.11-0.94) at age 6 to 7 years. CONCLUSIONS: Both the timing and intensity of childhood fevers appear to be important factors in the development of allergies and asthma.     

纳米水平分子成像与诊疗一体化研究进展与挑战

分子成像能以非侵入性的方式重现活体细胞的生理功能和生物学过程,提高疾病的早期和特异性诊断水平。纳米颗粒/材料具有物理性质可控性高、易于表面修饰、血液循环时间长和可功能化等优点,在疾病诊断与治疗中显示出巨大潜力。但如何阐明纳米材料多功能间的内在联系、解决其代谢及安全性等关键机制难题、实现纳米颗粒/材料多功能性到临床多功能...