钆标记抗入肺癌单抗的磁共振免疫成像研究

目的：探讨Ｇｄ标记抗肺癌单抗对荷瘤裸鼠的定向增强效应。材料与方法：用ＤＴＰＡ环二酸杆与抗肺癌单抗３Ｄ３和Ｇｄ＾３＋分别偶联,制备出Ｇｄ－ＤＴＰＡ－ＩｇＧ;建立６只荷瘤裸鼠模型;将Ｇｄ－ＤＴＰＡ－ＩｇＧ按２ｍｇ单抗／只的剂量从尾部脉内淳入;观察平扫扩注药后６小时瘤体磁共振信号。结果：Ｇｄ－ＤＴＰＡ－ＩｇＧ能选择性增加瘤灶的信号强度。结论：磁共振免疫成像为肺癌定性提供一种潜在新的方法。     

两种剂量辛伐他汀治疗115例高脂血症的疗效比较

目的：探讨不同辛伐他汀剂量的调脂疗效、安全性和预防心脏性事件的作用。方法：将１１５例高脂血症随机单盲分为２组：１０ｍｇ组５７例,辛伐他汀１０ｍｇ／ｄ;２０ｍｇ组５８例,辛伐他汀２０ｍｇ／ｄ,均观察１年,观察调脂效果、不良反应及心脏性事件发生情况。结果：２０ｍｇ组治疗后总胆固醇（ＴＣ）、甘油三酯（ＴＧ）Ｇ、ＬＤＬ－Ｃ、载脂Ｂ均明显下降,ＨＤＬ－Ｃ、ＡｐｏＡ１均显著升高,疗效明显优于１０ｍｇ组。调脂总     

消化道磁共振造影剂GD-DTPA临床应用研究(附30例分析)

消化道磁共振造影剂ＧＤ－ＤＴＰＡ临床应用研究（附３０例分析）赵涛①肖江喜蒋学祥我们选用国产ＭＲ口服造影剂Ｇｄ－ＤＴＰＡ，通过其在上腹部及盆腔的临床应用，观察其临床应用价值，报告如下。１材料与方法随机选择住院或门诊病人３０例，年龄１８～７０岁。需做腹部...     

腹部MRI中几种口服胃肠对比剂的比较应用

合理选择和应用ＭＲ胃肠对比剂。材料与方法：５６例分别口服四种,对比剂（０．１％ｒＧｄ－ＤＴＰＡ,市售加糖牛奶,１５０％硫酸钡混悬液,温开水）后对胃壁、肝胆、肾脏、胰腺、主动脉旁淋巴结的显示效果进行分析。结果：四种对比剂对各解剖结构的优质显示率分别为：Ｇｄ－ＤＴＰＡ（８０％）,硫酸钡（７８．６％）,水（６７．２％）,牛奶（６５．７％）。结论：对胖者使用阴性对比剂（首选１５０％的硫酸钡）,瘦者使用阳性对比剂（首先０．１％的Ｇｄ－ＤＴＰＡ）。 磁共振在腹部检查中的应用价值之所以受到限制。其重要原因之一…     

一氧化氮在烧伤大鼠心脏损害中作用的研究

目的：研究一氧化氮（ＮＯ）在防治烧伤早期心肌缺血缺氧性损害中的变化及意义。方法：动态观察大鼠３０％体表面积Ⅲ度烧伤后血浆及心脏ＮＯ、内皮素（ＥＴ）含量变化，应用外源性ＮＯ供体ＳＩＮ１以观察其对烧伤早期心脏损害的影响。结果：大鼠烧伤后心脏明显受损，烧伤后血浆及心肌组织ＮＯ－２、ＥＴ含量明显升高，由于ＮＯ－２升高幅度相对较低，ＥＴ／ＮＯ－２比值也显著增加；烧伤后在液体复苏下应用ＳＩＮ１可在一定程度上增加心肌组织超氧化物歧化酶（ＳＯＤ）、Ｎａ＋Ｋ＋ＡＴＰ酶活性及ＡＴＰ、ＡＤＰ含量，减少丙二醛（ＭＤＡ）、ＡＭＰ含量，减轻心肌组织水肿。结论：烧伤后由于心脏内源性ＮＯ的相对不足，导致心脏血管收缩，造成心肌组织缺血缺氧性损害，继而发生能量代谢紊乱及脂质过氧化损害；补充外源性ＮＯ则可在一定程度上逆转烧伤后心脏损害。     

前列腺素E1对犬缺血心肌的保护作用

探讨前列腺素Ｅ１对缺血心肌的保护作用。将２０只左冠状动脉前降支结扎犬分成２组，Ｉ组在ＬＡＤ结扎后静滴ＰＧＥ１，Ⅱ组静滴一时卤水作为对照组。２组犬均于ＬＡＤ结扎前，结扎后３０分钟、４小时，２４小时和４８小时采集周围静脉血，检测血浆血小板表面α－颗粒膜蛋白和血栓素Ｂ２含量；ＬＡＤ结扎４８小时后处死动物，取出心脏检测心肌组织内髓过氧化物酶活性，并将心肌切片后行氯化三苯基四氮唑染以，确定梗塞面积大小。     

磁共振成像诊断垂体瘤的探讨

磁共振成像诊断垂体瘤的探讨卢光明，张福琛，沈复兴本文分析了垂体瘤的ＭＲ表现及ＭＲ在垂体瘤诊断上的价值，并根据磁共振增强剂Ｇｄ－ＤＴＰＡ在垂体及垂体瘤的强化特点进行了垂体瘤ＭＲ扫描时Ｇｄ－ＤＴＰＡ增强方法的研究，以期建立一种高度准确且经济、省时的ＭＲ诊...     

高HDL—C个体CETP基因14内含子＋1位G：A突变的检测及其临床意义

用聚合酶链反应-限制性内切酶酶切片断长度多态性分析的方法检测高ＨＤＬ－Ｃ（ＨＤＬ－Ｃ≥１．７ｍｍｏｌ／Ｌ）个体胆固醇酯转移蛋白（ＣＥＴＰ）基因１４内含子＋１位Ｇ：Ａ突变的阳性率。共检测５０例高ＨＤＬ－Ｃ个体,发现杂合子１２例,纯合子１例,而对照组７０例中无一例发生突变、据此认为ＣＥＴＰ基因１４内含子＋１位Ｇ：Ａ突变是导致高ＨＤＬ－Ｃ的重要因素。     

L—精氨酸对异丙肾上腺素致害心肌的影响

目的研究Ｌ－精氨酸（Ｌ－Ａｒｇ）对异丙肾上腺素（ＩＳＰ）致害心肌的影响。方法大鼠分四组;①ＩＳＰ组ＩＳＰ４０ｍｇ／ｋｇ／ｄａｙ×２,皮下注射;②对照组体重匹配的大鼠注射同容量的生理盐水;③Ｌ－Ａｒｇ组腹腔注射Ｌ－Ａｒｇ１５ｇ／ｋｇ／ｄａｙ×２;④ＩＳＰ＋Ｌ－Ａｒｇ组。结果ＩＳＰ处理的大鼠心重／体重比值、心肌内ＮＯ、钙的水平以及血清ＬＤＨ水平高于对照组（Ｐ＜００１）,而心肌中ＧＳＨ－ＰＸ及Ｌ－Ａｒｇ水平低于对照组（Ｐ＜００１）结论Ｌ－Ａｒｇ可部分逆转ＩＳＰ致心肌肥厚,心肌中ＮＯ、钙、Ｌ－Ａｒｇ、ＧＳＨ－ＰＸ及血清ＬＤＨ水平的变化     

术后短期使用ALG预防移植肾60例急性排斥反应的效应评估

目的：探索抗淋巴细胞球蛋白（ＡＬＧ）的合理使用方案。方法：随机选择肾移植患者６０例，根据使用ＡＬＧ的时间不同分两组，观察病人外周血ＣＤ３细胞数变化，急性排斥反应及并发症发生率，结果：两组病人急性排斥反应率，术后５天内ＣＤ３细胞数无统计学差异，但Ｂ组（ＡＬＧ３００ｍｇ／ｄ，７天以上）的巨细胞病毒病及一般感染率明显高于Ａ组（ＡＬＧ３００ｍｇ／ｄ，３～６天）结论：术后连续３～６天使用常规剂量ＡＬＧ是一种     

Magnetic resonance quantitative myocardial perfusion reserve demonstrates improved myocardial blood flow after angiogenic implant therapy

Purpose The purpose of this study is to follow myocardial angiogenesis temporally using quantitative magnetic resonance first pass perfusion imaging and compare this with the “gold standard“ of radioactive microspheres in a random subset of animals. Materials and Methods Ameriod constrictors where placed around the left circumflex in 15 pigs to induce an ischemic area. Two groups were randomized to receive either a sham operation or treatment with angiogenic implants inserted into myocardium in the distribution of the left circumflex artery (LCX). These implants are designed to induce myocardial angiogenesis. Magnetic resonance first pass perfusion imaging was performed at baseline and also after treatment with either sham or implant therapy by using first pass perfusion imaging with a TurboFLASH sequence. Absolute myocardial blood flow was derived by applying a quantitative Fermi function model. Radioactive microspheres were also injected into a random subset of animals to measure myocardial blood flow. Results Angiogenic implant therapy increased absolute myocardial blood flow in the left circumflex territory relative to baseline and sham treated groups during adenosine infusion. Myocardial blood flows measured with radioactive microspheres was increased significantly in both the LCX and LAD territories during stress. Myocardial Perfusion reserve was also significantly increased in both the LCX and left anterior descending territories relative to baseline. Ejection Fraction during stress with dobutamine infusion increased significantly in the implant therapy group while that in the sham group was not affected. Conclusion Quantitative MR myocardial first pass perfusion imaging can be used to track the development of angiogenesis as corroborated by radioactive microspheres. Angiogenic implant therapy is a new device based therapy that has potential to protect an ischemic region by accelerating angiogenesis although further research is necessary with this device.     

Evaluation of myocardial perfusion in patients with hypertrophic cardiomyopathy in comparison with clinical and echocardiographic data

AIM: To study peculiarities of myocardial perfusion in patients with hypertrophic cardiomyopathy (HCMP) in correlation with clinical and echocardiographic data. MATERIAL AND METHODS: 62 patients with HCMP (23 females and 39 males, mean age 44.4 +/- 11.2 years, the disease duration 13.0 +/- 10.4 years) have undergone ECG, 24-h ECG monitoring, echocardiography, perfusion scintigraphy of the myocardium with 99m-TcMIBI at rest and in combination with bicycle ergometry. The patients were divided into two groups: 35 patients of group 1 had moderate left ventricular hypertrophy (the septal thickness in diastole under 20 mm; 27 patients of group 2 had severe hypertrophy (the thickness was over 20 mm). RESULTS: Dyspnea and syncopal states occurred more frequently in patients from group 2. They also had a higher functional class of heart failure (2.0 +/- 0.8 and 1.2 +/- 0.7 for group 1 and 2, respectively, p < 0.05). Cardiac performance was significantly higher in patients of group 1. The size of the left atrium, left ventricular myocardium mass, the septal thickness and thickness of posterior wall of the left ventricle, gradient of pressure in the outflow tract of the left ventricle proved higher in patients of group 2. Deep stable defects of myocardial perfusion were detected in 5 (15%) patients of group 1 and 10 (37%) patients of group 2. Transient defects of myocardial perfusion were found in 9 (26%) patients of group 1 and 12 (44%) patients of group 2. The index of myocardial ischemia in group 1 patients was significantly lower than in patients of group 2 (3.5 +/- 2.2 and 8.3 +/- 2.5, respectively, p < 0.05). CONCLUSION: Patients with severe hypertrophy of the left ventricle had severe clinical picture, low exercise tolerance, marked hemodynamic changes, more frequent defects of left ventricular perfusion defects compared to patients with moderate hypertrophy of the left ventricular myocardium.     

肥厚性心肌病的冠状动脉造影分析

目的：了解肥厚性心肌病患者冠状动脉及其特征。方法：25例肥厚性心肌病患者行冠状动脉造影,观察其冠状动脉分布及特点,测量其各分支中段内径,并与同期行冠状动脉造影的正常人相比。结果：肥厚性心肌病患者冠状动脉供血呈左优势者占20％,各亚型间无明显判别：5例发现合并冠心病,其中1例行PTCA及冠脉内支架术,另1例植入永久性DDD起搏器治疗,1例左前降支中段发现冠脉肌桥;无冠状协脉病变的19例患者左主干,回旋支及右冠脉中段内径较正常者明显粗大（P＜005）,结论：肥厚性心肌病患者冠脉供血呈左优势者比较较高,其冠状动脉内径较正常者粗大,疑有合并冠心病者须行冠状动脉造影,对指导治疗有一定意义。     

The relationship between regional myocardial perfusion at rest and arteriographic lesions in patients with coronary atherosclerosis.

Measurements of mean left ventricular (LV) and regional myocardial blood flow rates were made at rest in 161 patients with 133Xe and a multiplecrystal scintillation camera. Myocardial perfusion rates were correlated with assessments of the degree of coronary artery disease made from the arteriograms obtained during the same studies. In patients with normal coronary arteries without heart failure, the presence of hypertension, aortic stenosis, or aortic insufficiency was not associated with changes in mean LV perfusion from the control value of 61+/-7 ml/100 g-min. However, mean LV perfusion was significantly reduced in patients with normal coronary arteries who had cariomyopathy and impaired ventricular performance. Mean LV perfusion was not significantly different from control values in patients with "mild" coronary artery disease (less than 50% obstruction) or in patients with significant isolated disease (greater than 50% obstruction) of the left anterior descending (lad) artery. Significant reductions in mean LV perfusion were found in patients with greater than 50% obstruction of two coronary arteries (LAD + right or LAD + circumflex) and in patients with triple-vessel disease. The average perfusion rate for regions distal to LAD obstructions in patients with isolated LAD disease was not lower than the LAD perfusion in control patients, but was significantly reduced in patients with LAD + right coronary artery disease (43+/-14 ml/100 g-min). In the latter group average perfusion distal to the LAD lesion was significantly lower than the average regional perfusion rate for the remainder of the LV. However, the mean blood flow rate for the remainder of the LV was also significantly lower than control values despite the lack of significant circumflex disease. The data demonstrate that the presence of radiographically "mild" or significant isolated LAD coronary disease is not associated with reductions in mean LV perfusion at rest, but that mean LV perfusion is reduced in the presence of significant disease of two or three coronary artieries. None of the patients experienced angina during the resting studies and most had clinical evidence of ventricular failure. The observation of depressed LV perfusion in this group, as in the patients with cardiomyopathy, raises the possibility that a lowered resting blood supply may be adequate for a reduced level of performance of a diseased ventricle. The lack of selective reductions of regional perfusion at rest in the majority of the patients with LAD lesions suggests that regional myocardial blood flow must be measured during an intervention which increases myocardial oxygen consumption in order to assess the physiological significance of lesions which are observed at coronary arteriography.     

多普勒组织成像研究缺血心肌等容收缩期运动变化

目的　应用多普勒组织成像技术研究犬心肌缺血前后等容收缩期运动频谱的变化。方法2 3条犬分为A、B两组 ,A组为开胸实验组 ,冠脉左旋支后壁分支结扎前、后分别记录左室后壁短轴方向组织多普勒运动频谱 ;B组为经胸实验组 ,手术结扎冠脉左旋支后壁分支 ,术前及术后 1周经胸记录左室后壁短轴方向组织多普勒运动频谱 ;对照分析正常与缺血室壁收缩期运动频谱。结果　A、B两组正常室壁收缩期频谱包括前向等容收缩波 (IVC1)、后向等容收缩波 (IVC2 )和射血波 (S)。结扎冠脉后IVC1、S峰值显著降低 ,持续时间显著缩短 (P <0 .0 5 ) ;IVC2 峰值显著增大 ,持续时间显著延长 (P <0 .0 5 )。结论　缺血心肌收缩期运动频谱发生了显著变化 ,等容收缩期的频谱改变有可能作为检测心肌功能状态的指标     

Coronary artery function and myocardial perfusion in patients with ischemic heart disease isolated and in combination with arterial hypertension

AIM: To characterize coronary arteries and myocardial perfusion in isolated ischemic heart disease (IHD) and IHD combined with blood hypertension (BH). MATERIALS AND METHODS: 20 patients with isolated IHD and 25 patients with combined IHD have undergone coronarography, scintigraphy of the myocardium with Tc-99m, echocardiography. RESULTS: In the combined IHD, overall involvement of the heart arteries appeared less than in isolated IHD (33.40 +/- 7.07% versus 41.40 +/- 8.9%). In the combined IHD and left ventricular hypertrophy (LVH) overall involvement of the heart arteries was less while occurrence of perfusion disorders higher than in the absence of LVH (35.98 +/- 4.73% vs 47.21 +/- 5.91%, and 33.7 vs 25.0%, respectively). Defects in the myocardial perfusion both in right and left coronary artery, isolated and combined IHD were of the same type location. CONCLUSION: Disturbed myocardial perfusion is an essential factor in the onset of coronary insufficiency.     

超声心动图评价犬急性心肌梗死早期左心室重构的实验研究

目的 采用超声心动图检测犬急性心肌梗死(AMI)后左心室重构发生时间及6 h内左心室重构变化.方法 对14只健康成年犬麻醉后开胸结扎左冠状动脉左前降支制备AMI模型,成功制备8只AMI模型,超声心动图分别于术前,术后1、2、3、4、5及6 h观察梗死心肌室壁厚度(WIT)、室壁运动积分指数(WMSI)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF).检查结束后处死实验犬,取梗死区心肌组织行病理学检查.结果 与术前比较,术后1 h实验犬WMSI、LVESV(P<0.01)和LVEDV(P<0.05)增大,LVEF和WIT减小(P<0.01);WMSI术后3、4、5、6 h高于术后1 h(P<0.05);术后4、5、6 h和术后2 h比较,LVEDV和LVESV增高,LVEF降低.病理检查显示:梗死区心肌细胞发生肿胀,肌浆呈颗粒状凝集而分布不均,出现核固缩.结论 犬AMI后1 h即可出现左心室重构,超声心动图可评估AMI后早期左心室重构.     

Basic fibroblast growth factor improves myocardial function in chronically ischemic porcine hearts.

The effect of basic fibroblast growth factor (bFGF) administration on regional myocardial function and blood flow in chronically ischemic hearts was studied in 26 pigs instrumented with proximal circumflex coronary artery (LCX) ameroid constrictors. In 13 animals bFGF was administered extraluminally to the proximal left anterior descending (LAD) and LCX arteries with heparin-alginate beads and 13 other animal served as controls. bFGF-treated pigs showed a fourfold reduction in left ventricular infarct size compared to untreated controls (infarct size: 1.2 +/- 0.4% vs. 5.1 +/- 1.3% of LV mass, mean +/- SEM, P < 0.05). Percent fractional shortening (% FS) in the LCX area at rest was reduced compared with the LAD region in both bFGF and control pigs. However, there was better recovery in the LCX area after rapid pacing in bFGF-treated pigs (% FSLCX/% FSLAD, 22.9 +/- 7.3%-->30.5 +/- 8.5%, P < 0.05 vs. prepacing) than in controls (16.0 +/- 7.8%-->14.3 +/- 7.0%, P = NS). Furthermore, LV end-diastolic pressure rise with rapid pacing was less in bFGF-treated than control pigs (pre-pacing; pacing; post-pacing, 10 +/- 1; 17 +/- 3; 11 +/- 1* mmHg vs 10 +/- 1; 24 +/- 4; 15 +/- 1 mmHg, *P < 0.05 vs. control). Coronary blood flow in the LCX territory (normalized for LAD flow) was also better during pacing in bFGF-treated pigs than in controls. Thus, periadventitial administration of bFGF in a gradual coronary occlusion model in pigs results in improvement of coronary flow and reduction in infarct size in the compromised territory as well as in prevention of pacing-induced hemodynamic deterioration.     

急性心肌梗塞及再灌注的MRI实验研究

目的 探讨急性心肌梗塞及再灌注的ＭＲＩ征象及其病理学基础以及再灌注对心肌梗塞后左室重构的影响,材料和方法 １３只小型猪开胸结扎冠状动脉左前降支制备心肌梗塞动物模型（６只）和民裔缺血再灌注动物模型（７只）于术前,术后７小时,５－７天,１３－１７天和１个月进行ＭＲＩ检查,心脏标本进行病理检查,结果;梗塞组和再灌注组均见左心室前壁及室间胆部Ｔ２ＷＩ上信信号,部分出现心腔内流动信号升高（其中梗塞组５例,再     

Effects of the serotonin-antagonist ketanserin on the function of ischaemic and normally perfused myocardium and modification by β-1-blockade in anaesthetized normotensive dogs

The 5-HT-2 antagonist ketanserin (KAS) has been successfully used to treat acute hypertension in coronary bypass surgery. The present study was performed to investigate the effect of KAS on ischaemic myocardium. In 11 anaesthetized (piritramide) dogs, systolic contraction (sdL) and end-diastolic length (edL) of myocardium supplied by the left descending coronary artery (LAD) and the left circumflex coronary artery (LCX) were measured by sonomicrometry simultaneously with aortic pressure (AoP), left ventricular dP/dtmax and end-diastolic pressure (LVedP), heart rate (HR), stroke volume, and LAD flow (QLAD). Regional ischaemia to decrease sdLLAD (−48%) was achieved by LAD stenosis (QLAD −47%). Concomitantly, edLLAD increased by 8%. However, the other variables did not change. Then KAS was given i.v. (0.15+ 0.15+0.30+0.6mg/kg) at 15-min intervals. Following KAS, prestenotic sdLLAD recovered in a dose-dependent manner. LVedP and edLLAD decreased, sdLLCX increased, and the other variables were not affected. This functional recovery of ischaemic myocardium was attenuated by pretreatment with metoprolol (MET, 1 mg/kg) prior to LAD stenosis. The ischaemic area was not irreversibly damaged, however, as proven by the recovery of prestenotic sdLLAD values after release of the stenosis. The improved systolic shortening of ischaemic myocardium following KAS did not result from restored QLAD due to post-stenotic vasodilation or break up of platelet aggregates (QLAD did not increase) or from reduced afterload (AoP did not decrease). Obviously, it was mediated by β-1-receptors, as shown by the attenuation of the beneficial effect of KAS by pretreatment with MET.