国内期刊心电学文献目次索引(1992年7—9月)

中华内科杂志心电图、收缩间期和心肌酶谱对柔红霉素诱发心衰的预测作用(陈书长等)1992;31:弓。9. 中华心血管病杂志射频消蚀术治疗阵发性心动过速的评价(顾复生)1992:2。,4。射频消蚀术的临床应用i、剔频消蚀房室旁路治疗预激综合征皿、射频消蚀慢径路治疗房室靖折返性心动过速(胡 大一等)1092;20,207。射频消蚀左侧房室旁路治疗室上住心动过速(任自文等)工992;20:212.射频消蚀左侧房室旁路治疗折返性室上性心动过速的初步体会(蓝志强)1992;20:2巧.应用埋置式自动复律除颤器四例综合报道(中华心血管病杂志编辑委员会)1992;20:217。经冠状动…     

射频消融术治疗室上性心动过速80例体会

用射频消融术治疗室上性心动过速80例.其中,房室折返性心动过速64例(65条旁路),56条左侧旁路中52条(92.9%)和9条右侧旁路中7条(77.8%)被阻断.14例房室结折返性心动过速(消融慢径)及2例房性心动过速和心房纤颤(消融房室结)均成功.比较初期30例和以后34例房室旁路病人的消融,显示了射频消融术开展过程中的学习曲线.此外,本文对预激综合征体表心电图旁路定位误差的原因,作了初步探讨.     

射频消融治疗多条房室旁路和多种机制并存的窄QRS心动过速

射频消融术已成为根治室上性心动过速的首选方法 ,对多条房室旁路和多种机制并存的窄 QRS心动过速也同样有效。本文总结 15例复杂性窄 QRS心动过速的射频消融结果和体会。　　资料与方法　 15例患者 (男性 6例 ,女性 9例 ) ,平均( 39± 10 )岁。因反复发作窄 QRS心动过速而入院行射频消融治疗。术中发现 :双房室旁路 9例 ,其中左、右侧均存在 1条房室旁路者 8例 ,右侧双房室旁路者 1例。房室旁路合并典型房室交界区折返性心动过速 5例 ,房室旁路合并典型和非典型房室交界区折返性心动过速 1例。除 1例双房室旁路患者仅诱发出一种窄 QRS…     

射频消蚀治疗预激综合征81例报告

以射频电流对81例预激综合征伴阵发性室上性心动过速患者的房室旁路进行消蚀。76例(93.8％)患者的83条旁路(94.3％)被阻断。平均放电12次,平均消蚀时程2.3小时,随访7个月,2例(2.5％)复发但成功地进行第二次消蚀,无严重并发症。     

射频消融术治疗房室折返性心动过速

目的 报告射频消融术治疗房室折返性心动过速的经验.方法 回顾性分析经心内电生理检查,明确诊断为房室折返性心动过速275例患者接受射频消融术的临床资料.结果 房室折返性心动过速275例,其中左侧旁路168条,右侧旁路113条.消融总成功率为99.2%.结论 射频消融术是治疗房室折返性心动过速的安全有效手段.     

射频消融治疗阵发性室上性心动过速62例体会

目的总结室上性心动过速(PSVT)射频消融治疗的经验。方法左房室旁路消融二尖瓣室侧，右房室旁路消融三尖瓣房侧；房室结双径路通过下位能量递增消融法改良房室结慢径。结果房室折返型心动过速38例，左侧旁道30条右侧旁道9条，消融成功37条，成功率95％，房室结折返型心动过速24例，房室结双径路改良全部成功，成功率100％，总成功率97％。无1例复发。结论射频消融治疗室上速安全、有效、复发率低。’     

低功率射频消蚀治疗心动过速的初步经验

低功率(15～25W)射频消蚀治疗心动过速20例,其中10例房室折返性心动过速,旁道均在左侧,9例成功.7例房室结折返性心动过速消蚀慢径路与2例起搏器术后快速性房颤消蚀房室结均成功.1例室性心动过速消蚀不成功,总成功率90%.低功率射频消蚀是一种安全、有效的方法.     

在诱发房室折返性心动过速(AVRT)时用导管射频消蚀旁路

本文对存在隐匿性旁道的4例患者,通过心室起搏诱发心动过速,在心动过速中确定旁路的位置并用导管射频消蚀旁路。 方法 4例患者中,2例患者旁道位于左侧房室沟、2例位于右侧房室沟的右侧。将4根4极导管经皮穿刺分别送至冠脉窦、右房、希氏束和右室心尖部。诱发AVRT时,在左、右房室沟附近不同的部位记录心电图,确定心房最早激动点的位置。诱发AVRT     

多房室旁路的导管射频消蚀治疗

本研究旨在对多房室旁路的术前判断、电生理特点及射频消蚀方法进行探讨。预激综合征伴房室折返性心动过速的多房室旁路患者共１５例，其中平时心电图有预激波１０例，心电图正常５例。只有７例为术前判断或怀疑有多旁路存在。采用先逐条消蚀显性旁路，之后在心室刺激下逐条消蚀隐匿性旁路的方法进行射频消蚀治疗。结果证实，本组共３１条旁路，其中双旁路１４例，三旁路１例。旁路组合以同侧、同性（指显性或隐匿性）多见。射频消蚀均成功地阻断了全部旁路，成功率１００％。本研究表明，多数多房室旁路是在心内电生理检查及射频消蚀术中发现，但详细的术前资料分析亦能发现有某些线索存在。采用“剥笋法”逐条消蚀房室旁路是避免遗漏旁路的可靠方法。     

穿房间隔途径左侧游离壁旁路消融致心包填塞原因分析

目的:分析穿房间隔途径左侧游离壁旁路消融致心包填塞的发生率及可能原因。方法:分析2014年1月～2018年12月3个中等手术量电生理中心的1 332例室上性心动过速患者,其中男性723例,女性609例,中位年龄52 (35～61)岁。经电生理检查证实为房室结双径路折返性心动过速、左侧旁路参与的房室折返性心动过速或右侧旁路参与的房室折返性心动过速,然后再行房室旁路或者房室结双径路消融。分析左侧旁路参与的房室折返性心动过速患者,经主动脉逆行途径或者穿房间隔途径消融左侧旁路消融过程中心包填塞发生情况及可能原因。结果:1 332例患者接受1 440次射频消融术。左侧旁路参与的房室折返性心动过速453(34%)例,其中经主动脉逆行140例(31%)和穿房间隔途径313例(69%)。穿房间隔途径心包填塞发生3例(0.9%),靶点位置在左侧游离壁或左前游离壁。经心包穿刺引流后心包填塞症状缓解,无外科开胸修补发生。结论:左侧旁路射频消融相关的心包填塞发生率相对较低,原因可能与过度消融、机械操作损伤和误消融毗邻结构相关。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.