麻醉状态下WHBE兔的心电图观测

目的探讨WHBE兔作为实验性心电图观察的应用前景。方法取成年WHBE兔、日本大耳白兔和青紫兰兔,经戊巴比妥钠溶液耳静脉注射麻醉后固定,应用多道生理记录仪描记了实验兔的心电图。结果WHBE兔心电图的基本波形与人类相似,均为窦性心律。其心率较快,288．89±28．14次／min;P波通常出现在T波的降支上;其Q—T间期,K值较日本大耳白兔和青紫兰兔小;心电轴为40．00±36．93度。结论WHBE兔胸导联的波形明显而有规律,所测得的电压比较高,因此胸导联在临床上实际意义较大,提示它适于做临床心电图的实验研究。     

氟哌啶醇致兔心律失常的心电图研究

目的:观察不同剂量氟哌啶醇对新西兰兔心电图QT间期、PR间期以及QRS波群的影响.方法:采用体表心电图技术,观察不同剂量氟哌啶醇对新西兰兔心电图的影响,通过BL-410生物机能实验系统动态记录Ⅱ导联心电图的变化.结果:氟哌啶醇能引起的QT间期延长、PR间期延长以及QRS波群变宽,剂量越大延长越明显.1 mg/kg、2 mg/kg氟哌啶醇能延长QT间期,但对PR间期以及QRS波群的影响无统计学意义;4 mg/kg氟哌啶醇能明显延长QT间期、PR间期,同时使QRS波群明显增宽.氟哌啶醇对QT间期的影响主要发生在给药后0～120 min,360 min后基本恢复正常;对PR间期以及QRS波群的影响主要发生在给药后0～30 min,30 min后基本恢复正常.结论:氟哌啶醇可使QT间期延长,随着剂量的增加,能明显延长PR间期,导致QRS波群增宽,从而增加发生室性心律失常的潜在危险性.     

QRS综合波早期改变及临床意义诊断急性心梗的临床价值

目的:研究QRS综合波早期改变及临床意义诊断急性心梗的临床价值。方法:将急性心肌梗死(AMI)的患者100例,根据胸痛开始5h内,连续记录常规的12个导联心电图,测定各导联的R波、S波以及ST的变化,与发病之前正常的心电图的波形进行对比,比较两者之间的变化。结果:心肌梗死后100例患者中有95例患者的心电图显示S波消失,在所有的导联中Ⅱ导联、Ⅲ导联、a VF导联的QRS综合波S波消失,出现高尖的R波,在a VL导联中S波加深。a VF导联在心肌梗死后R波振幅增高(0.35±0.11)m V,a VL导联在心肌梗死后R波振幅增高(0.26±0.09)m V,Ⅲ导联在心肌梗死后R波振幅降低(0.125±0.15)m V,经过统计学检验心肌梗死后与心肌梗死前R波振幅相比差异具有统计学意义(P<0.05),Ⅲ、a VF导联R波的改变与a VL导联S波的改变两者之间存在密切的正相关关系,导联中S波的改变也有重要的临床意义。由图2得出心肌梗死后ST段抬高,平均振幅为(0.20±0.24)m V,差异无统计学意义(P>0.05)。结论:QRS综合波早期改变是急性心肌梗死诊断的证据,心电图的改变可作为急性心肌梗死的一个新指标。     

房早二联律伴交替性束支传导阻滞

患者女,32岁,因患“感冒”后心悸、气短、胸闷两周而就诊。体检除心律不整外其他无明显异常,心电图V_1导联连续记录(附图)示:主导节律为窦性心律。窦性P-P间期0.60s,V_1导联P波直立,P-R间期0.16s。窦性心搏之后可见提前出现宽大畸形的QRS波群,时间0.12s,主波与T波方向相反,代偿间歇不完全。宽大畸     

心内膜下心肌梗塞并发间歇性预激综合征一例报告

朱某,女,63岁,平时体健。突感剑突下疼痛,急诊入院。查心电图为窦性心律,P—R间期0.12秒,Ⅱ、Ⅲ,aVF导联呈Qrs型,Q波时限为0.06秒,ST—T无改变(见图1)。心电图诊断:下壁心肌梗塞。第二天心电图复查:aVF导联出现两种波形(见图2)。前为Qrs型,P—R间期为0.12秒,T波直立;后为R型,P—R间期0.16秒,T波倒置。第三天心电图复查:ⅡⅢ、avF导联Qrs波转为R型,T波由直立转为倒置,胸导V_4—V_7T波倒置,ST段压低0.05毫伏。心电向量图,也呈现两种图形(见图3)。H面初始20毫秒的预激向量指向左前,初始向量运行缓慢,QRS环体均位于X轴之前。5分钟后描记,QRS环体出现     

健康人Tp-Te间期和Tp-Te/QT比率的探讨

目的比较健康人标准心电图Tp-Te间期和Tp-Te/QT比率并探讨其临床意义。方法随机抽取36～75岁健康人60例,做标准12导联心电图,分别测量V2和V6导联的QT间期、Q-Tp间期（即QRS波的起点至T波顶点的时间间期）,按QT间期减Q-Tp间期的差值计算Tp-Te间期,按Tp-Te间期/QT间期计算其比率,并分别比较2个导联以及不同性别之间的Tp-Te间期和Tp-Te/QT比率。结果①V2导联的Tp-Te间期和Tp-Te/QT比率大于V6导联,并且差异有统计学意义[分别为（93±15）比（69±55）ms,P〈0.05;（0.24±0.04）比（0.17±0.06）ms,P〈0.05]。②V2导联的Tp-Te间期和Tp-Te/QT比率均为男性比女性长（P〈0.05）。结论提供健康人Tp-Te间期和Tp-Te/QT比率重要信息供临床参考。     

酷似窦性心动过缓的未下传房性早搏二联律2例

例1 男,70岁.临床诊断:冠心病,心律失常.心电图V3、V1导联示:窦性P-QRS-T规则,频率44次/分.P-R间期0.16 s,QRS间期0.10 S0V1呈rsr′型(r′＞r),余导联S波粗挫.各导联QRS-T波群的T波中均隐藏有提前未下传的P′波,未见基本窦性周期(见图1).心电图诊断:窦性心律,持续性未下传的房性早搏二联律,不完全性右束支传导阻滞.     

宽QRS波心动过速体表心电图诊断线索的评价

目的：评价体表心电图线索对宽QRS波心动过速的鉴别诊断价值。方法：回顾性分析192例（208份）经心内电生理检查确诊的宽QRS波心动过速体表心电图资料。结果：诊断室速的主要心电图线索是：（1）房室分离；（2）无人区心电轴；（3）胸导联QRS波正向或负向同向性；（4）胸导联均无RS波；（5）RBBB型心动过速时V1导联呈qR或RS型或左兔耳征、V6导联呈OS或OR或R型；LBBB型心动过速时V1或V2导联呈RS型并伴有R波宽度〉30ms或RS间期〉60ms或S波降支有钝挫、V6导联呈QS或QR或qR型；（6）窦性心律时有与宽QRS波心动过速同形态室性早博。窦性心律呈显性预激综合征或有与宽QRS波心动过速同形态房性早搏对宽QRS波室上性心动过速诊断价值高。结论：体表心电图是宽QRS波心动过速鉴别诊断的重要手段，在临床实践中有较高的应用价值。     

正常豚鼠清醒状态心电图分析

目的：取148例正常白化豚鼠雌雄各半,测定清醒状态下的心电图并对其进行分析。方法：使豚鼠保持自然的俯卧位,把微型针状电极植入豚鼠的右前肢和左后肢,用多导生理记录仪记录豚鼠肢体Ⅱ导联心电图。采用ADinstruments心电图分析软件对其进行分析。结果：①148例豚鼠均为窦性心律。②正常豚鼠心电图的波形与人极为相似,有明显的T波和S-T段。③148例豚鼠的平均心率为（264.57±27.70）次/min,P波持续时间平均（0.0272±0.0037）s,P-R间期平均（0.0629±0.0055）s,平均QRS间期（0.0315±0.0034）s,平均Q-T间期（0.1284±0.0160）s,校正Q-T间期平均（0.2678±0.0251）s,P波波幅平均（0.1075±0.0553）mV。④各指标雌雄之间无显著性差异。     

高血压性心脏病心脏B超与心电图的对比研究

目的:对比分析心电图与B超的肢体导联ST-T抬高、压低或T波形方向、振幅的改变情况,观察其对临床的指导意义,以指导对于冠脉综合征﹑高血压心脏病、心律失常等疾病的治疗。方法:选取本院于2010年1月至2012年12月收治心血管疾病患者40例为研究对象,分别对患者采取B超及心电图进行动态的监测,对比分析两种心电图导联ST-T抬高、压低或T波形方向、振幅的改变情况。结果:(1)B超组Ⅰ、Ⅱ导联振幅的总和、肢导联振幅的总和、胸导联振幅的总和以及全部导联振幅的总和变化与心电图相比均具有显著差异(P0.05),QRS波时限≥120ms与QRS波时限120ms相比,QRS波振幅具有统计学差异(P0.05),时限越长QRS波振幅越低。结论:B超与心电图均能反应心血管疾病患者心律的变化,但与B超相比,心电图QRS振幅、T波、心向量更加稳定,不容易受到体位的影响。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.