1.6-二磷酸果糖治疗小儿心肌炎对左室收缩功能的影响

目的:探讨1.6-二磷酸果糖(FDP)治疗小儿心肌炎对左室收缩功能的影响;方法:静点FDP按100～250mg/kg.d,2周为一个疗程,应用彩色多普勒超声测定左室射血分数(EF)、短轴缩短率(FS)、心脏指数(CI);结果:治疗前EF减低0.59±0.04、FS减低0.30±0.02、CI减低3.48±1.10(L/min.m~2),应用FDP治疗上述指标明显好转(P<0.01);结论:心肌炎存在左室收缩功能障碍FDP可改善左室功能。     

慢性肺原性心脏病对左心室功能的影响

目的研究慢性肺原性心脏病(肺心病)右心功能损害对左心室功能的影响。方法分析21例慢性肺心病的超声心动图,以二尖瓣A/E比值为指标观察左心室舒张功能;测量EF、CO、SV、CI、FS作为观察左心室收缩功能的指标;并测量左室心腔内径及计算左室心肌重量指数。结果研究发现肺心病组二尖瓣A/E比值为1.14±0.14,与对照组比较P<0.01。EF、CO、SV、CI、FS分别为61.90±11.82,4.47±0.89,56.71±13.70,63.20±0.58,与对照组比较P>0.05。心肌重量指数83.76±19.10,与对照组无统计学差异。结论慢性肺心病①左室舒张早期充盈受损;②本研究未发现左室收缩功能减退;③不伴有左心腔扩大或左室心肌肥厚。     

心先安对犬缺血心肌功能的影响

目的 :观察心先安对犬缺血心肌收缩和舒张功能的影响。方法 :实验犬缝扎左冠状动脉前降支远端 1/ 3 ,于缺血即刻及缺血后 10～ 3 0min应用左心导管技术测量缺血状态心功能的变化 ;之后缓慢静脉注射心先安 3mg·kg 1,注毕 10～ 60min ,每隔 10min重复一次心导管测量。结果 :应用心先安后左室收缩压升高 ,左室舒张末压下降 ,左室松驰时间常数明显缩短 ,同时心率减慢 ;其作用高峰在注射后 2 0～ 3 0min左右。结论 :心先安可改善犬缺血心肌的收缩与舒张功能 ,但作用时间较短     

用超声心动图观察急性心肌炎左室功能

目的 应用超声心动技术评价急性心肌炎治疗过程中左室功能的恢复状态。方法 用二维、M型及多谱勒方法测量左室收缩和舒张功能指标进行左室功能评价。结果 12例心肌炎患者均有不同程度的心腔扩大,LVEF,FS均有降低,二尖瓣充盈频谱表现为限制型充盈障碍(8例)或“假性正常”(4例)。结论 急性心肌炎患者早期均出现左室收缩功能和舒张功能减低,治疗过程中左室的收缩功能恢复较快,舒张功能恢复较慢。超声心动图技术对急性心肌炎患者心功能评价有重要作用。     

卡托普利与地高辛治疗充血性心力衰竭的疗效对比

充血性心力衰竭患者65例(男性42例,女性23例;年龄58±9a),其中33例用卡托普利25-50mg, po, tid;32例用地高辛0.125-0.25mg,bid-fid;症状控制后减量均治疗4-12wk。结果:总有效率前者为91％,后者为78％;左室泵功能指标(FS, EF, SI, CI)2组均显著改善(P<0.01);左室舒张功能指标(A峰,A/E, AI/TVI, PFR, NPFR)前者显著改善,(P<0.01),后者无变化(P>0.05)。     

卡维地洛对慢性心力衰竭心功能的影响

目的　探讨卡维地洛对慢性心力衰竭患者心功能的影响。方法 :将 6 0例慢性心力衰竭患者双盲随机分为两组 ,卡维地洛组 (A组 ) 30例 ,美托洛尔组 (B且 ,对照组 ) 30例。两组病人基础临床特征相似 ,应用彩色超声心动图测量病人治疗前、后 6个月射血分数 (EF)左室短轴缩短分数 (FS)及左心室腔径容积变化 ,并观察患者的 NYHA心动能、血压的变化。结果　治疗 6个月后 ,A组的 EF和 FS比 B组明显增高。 (EF:0 .4 6± 0 .2 3%比 0 .39± 0 .18% ,P<0 .0 1) (FS:2 5 .0± 1.6 4 %比 2 2 .3± 1.36 % ,P<0 .0 1)左室舒张末径 (L VDd)和左室收缩末径 (L VDs)均比治疗前缩短分别为 (L VDd:5 0 .0± 0 .76 m m比 37.0± 0 .34mm) (L VDs:5 3.0± 0 .4 7mm比 4 0 .0± 0 .15 mm) ,P均 <0 .0 1。左室舒张末期容积 (L VEDV)和左室收缩末期容积 (L VESV)均比治疗前缩小分别为 [10 4± 0 .15 ) ml比 (31.15±0 .77) ml和 (119± 0 .19) ml比 (34.17± 0 .6 7) ml,均 P<0 .0 1],治疗 6个月后两组患者的 NYHA心功能分级改善。治疗期间 ,卡维地洛组无心衰恶化 ,美托洛尔组有 2例因心衰恶化住院。结论　卡维地洛与美托洛尔对慢性心力衰竭均有较好的疗效 ,前者更优于后者。     

M-型彩色多普勒测量儿童舒张早期左室血流传播速度

目的 :探讨M_型彩色多普勒测量舒张早期左室血流传播速度评价儿童左室舒张功能的价值及正常儿童各年龄组的舒张早期左室血流传播速度值范围。方法 :对照组为120例正常儿童 ,观察组为18例扩张型心肌病患儿 ,分别测量舒张早期左室血流传播速度 (Vp)、E波峰值流速 (EV)、A波峰值流速 (AV)、E波压差半降时间(P1/2t)、E波斜率(Slope)。结果 :正常儿童舒张早期左室血流传播速度为 (36 74±6 06)cm/s ,扩张型心肌病患者的舒张早期左室血流传播速度为 (22 06±6 20)cm/s(E/A>1组 )、(21 87±7 80)cm/s(E/A<1组 ) ,后者明显低于正常儿童的最低值 (P<0.01)。结论 :应用M_型彩色多普勒测量舒张早期左室血流传播速度 ,在儿科心脏超声检查中能准确、简单、快速、无创地评价左室舒张功能     

麝香保心分散片对冠脉结扎犬血流动力学的影响

目的研究麝香保心分散片对冠脉结扎犬血流动力学的影响。方法采用麻醉犬开胸结扎左冠状动脉前降支 (LAD)产生急性心肌梗死 (AMI)模型 ,测定AMI 3h犬的心脏血流动力学参数。结果十二指肠给予麝香保心分散片 ,能明显增加心输出量 (CO)和搏出量 ,增加心肌血流量 ,降低冠脉阻力 ,增加左室收缩内压 (LVSP)及室内压最大上升和下降速率 (±dp/dtmax) ,轻度减慢心率 ,明显降低左室舒张末期压 (LVEDP) ,增加冠脉结扎犬心脏指数 (CI)及搏功 ,降低总外周阻力 ,对平均动脉压有下降趋势。结论麝香保心分散片主要以改善心肌收缩和舒张功能 ,增加缺血心肌供血等环节 ,发挥抗心肌缺血作用     

超声技术评价太极拳对心脏功能的影响

目的评价太极拳对心脏功能的影响。方法采用超声多普勒成像技术,对43例太极拳锻炼的老年人和43例未经任何规范化锻炼的老年人的心脏功能指标进行检查比较。结果实验组与对照组比较,左室舒张末内径(LVDD)、左室收缩末内径(LVSD)未见显著差异(P>0.05),左室射血分数(EF)、左室短轴缩短率(FS)、E/A值有非常显著增高(P<0.01)。结论长期太极拳锻炼对老年人心脏功能有保健作用。     

氨氯地平倍他乐克合用对慢性充血性心力衰竭患者心功能的影响

目的 :探讨单用氨氯地平或与倍他乐克合用对慢性充血性心力衰竭患者左室功能的影响。方法 :将 5 8例慢性充血性心力衰竭 (NYHAⅡ～Ⅲ )患者随机分为 2组 ,一组 2 9例单独应用氨氯地平治疗 ,另一组 2 9例给予合用倍他乐克治疗 ,于治疗前及治疗后 4周分别进行超声心动图检查以评价心功能指标的变化。结果 :氨氯地平组反映收缩功能的指标左室射血分数LVEF( % )、左室短轴缩短率LVFS( % )、心输出量CO、心输出指数CI明显增加 (P <0 .0 1) ,而反映舒张功能的指标舒张早期E峰流速与舒张晚期A峰流速的比值VE/VA无明显增加 (P >0 .0 5 ) ;氨氯地平合用倍他乐克组以上指标均显著增加 (P <0 .0 1)。结论 :氨氯地平倍他乐克合用更有利于慢性充血性心力衰竭患者收缩功能及舒张功能改善。     

Hepatic (dys-)function during inflammation

It is an understatement to say that the liver is an important organ. Each of the liver cells goes through thousands of complex biochemical interactions that influence all of the other organs in the body. Since the liver is involved with almost all biochemical processes it is no wonder that there are many different diseases that will affect it. A process known to impair liver function, including hepatic drug metabolism, is an infection induced inflammatory response. Infection induced alterations in liver function involve various cell types and their continuous cross-talk, as well as several circulating or locally secreted inflammatory mediators. Three main hepatic cell types contribute to the liver response during inflammation: hepatocytes, Kupffer cells and sinusoidal endothelial cells. In addition, activated neutrophils, which are also recruited in the liver and produce potentially destructive enzymes and oxygen-derived radicals, may further enhance liver injury. This review will focus on the pathway by which Kupffer cells and hepatocytes are activated and how this affects liver function, in particular hepatic drug metabolism.     

MicroRNAs and vascular (dys)function

MicroRNAs (miRNAs) are small non-coding RNAs, that control diverse cellular functions by either promoting degradation or inhibition of target messenger RNA translation. An aberrant expression profile of miRNAs has been linked to human diseases, including cardiovascular dysfunction. This review summarizes the latest insights in the identification of vascular-specific miRNAs and their targets, as well as their roles and mechanisms in the vasculature. Furthermore, we discuss how manipulation of these miRNAs could represent a novel therapeutic approach in the treatment of vascular dysfunction.     

Immuno-modulation of human lymphocyte function by desferroxamine (Desferal)

Desferroxamine inhibits lectin-stimulated proliferation of human lymphocytes. Inhibition is not due to toxic effect of the drug as it could be completely reversed by iron. It is found that the drug impairs the expression of both the total and high-affinity interleukin-2 (IL-2)-binding receptors on lymphoid cells in response to the mitogen phytohaemagglutinin. IL-2 production by mitogen-stimulated T4+T8- and T8+T4- populations is also markedly reduced by desferroxamine treatment. Decreased secretion of macrophage inhibition factor and macrophage activation factor is also observed as the result of the lymphocytes of the helper/delayed hypersensitivity subset being exposed to the drug. Collectively, our results suggest that desferroxamine interferes with the early activation events of human lymphokine-producing lymphocytes.     

13C-breath tests in hepatology (cytosolic liver function)

13C-phenylalanine (PheBT) and 13C-galactose breath tests (GBT) explore non invasively the hepatic functional mass by measuring two enzymatic activities localized into the cytosol of liver cells: the phenylalanine hydroxylase (which converts phenylalanine into tyrosine) and the galactose kinase (which catalyzes the ATP-dependent phosphorylation of galactose to galactose 1-phosphate). Both BTs are safe and accurate in predicting the severity of liver cirrhosis showing a good correlation with the Child-Pugh score. PheBT is also used in predicting postoperative complications and monitoring liver regeneration in patients undergoing partial hepatectomy. GBT has been also used to assess liver fibrosis in patients with chronic hepatitis C. PheBT and GBT could be used in the diagnosis of two inborn errors of metabolism, phenylketonuria and galactosemia, respectively. Both BTs are not affected by enzymatic induction due to drugs which may interfere with the results of the classic "microsomial" BTs (such as the aminopyrine or caffeine BTs).     

Effects of AVS (1,2-bis(nicotinamido)propane) on platelet function and vascular endothelium

The effects of 1,2-bis(nicotinamido)propane (AVS) on platelet function and vascular endothelium were investigated using various experimental thrombosis and vascular endothelial injury models. Neither in vitro platelet aggregation induced by ADP, collagen or arachidonate nor ex vivo platelet aggregation by ADP or collagen could be antagonized by AVS. On the other hand, AVS prevented mice, rats and rabbits from death induced by acute cerebral or pulmonary thromboembolism following the injection of arachidonate or collagen. These activities were as potent as those of acetylsalicylic acid. The disrupting actions of citrate and/or lipidperoxide (13-hydroperoxy linoleic acid) on endothelium were well inhibited by the pretreatment of AVS. AVS did not inhibit cyclooxygenase, increased prostacyclin (PGI2)/thromboxane A2 (TXA2) ratio in the coupled system of platelets and aortic microsomes. In conclusion, AVS inhibited thrombus formation in vivo while it was ineffective in vitro platelet alone system, which may result from the actions of this agent on both platelets and vascular endothelium. The above-mentioned results clearly show that AVS may be a new potent anti-vascular damaging agent with both endothelium stabilizing and PGI2 enhancing activities.     

(--)-alpha-Acetylmethadol effects on alcohol and diazepam use, sexual function and cardiac function

Selected behavioral and physiological effects of maintenance on (--)-alpha-acetylmethadol (LAAM) were examined for 67 men beginning LAAM maintenance. Thirty-four began LAAM maintenance after 1 month or more on methadone; 33 others were using street heroin immediately before beginning LAAM. Subjects were followed for 20 weeks on LAAM; assessment focused on changes in alcohol and diazepam use, sexual behavior and testicular function, and cardiovascular function. There was a trend toward increased alcoholism-related behaviors, but not consumption of alcohol, when on LAAM. Use of diazepam remained low. Subjects reported slightly enhanced sexual activity: reported number of ejaculations tended to increase, although interest in sexual activity remained constant. Semen volume values remained in the low normal range. In contrast to an earlier published report of reduced sperm motility in methadone and heroin users, normal motility was noted in this sample. The incidence of abnormal sperm morphology decreased from baseline to the end of the study. Cardiovascular function, as assessed by response to standard exercise, was unchanged during LAAM maintenance. Electrocardiograms revealed minor abnormalities prior to beginning LAAM maintenance; but these abnormalities did not consistently change during treatment. There is little evidence that the effects of LAAM maintenance differ from the effects of methadone maintenance on these behavioral and physiological functions.     

Hypothalamo-pituitary-adrenocortical (HPA) function in the morphine dependent rat (author's transl)]

Morphine dependence was induced by ten daily administrations of morphine with gradually increasing dosage (40--160 mg/kg/day s.c.) to male Sprague-Dawley rats, the dosage being divided in 2/day for the first 8 days and 4/day for the last 2 days. Diurnal variation in body weight in morphine dependent rats was the same as in naive rats. Although body temperature in the naive rats showed a diurnal variation with the highest at 3:00 and the lowest at 15:00, in the morphine dependent rats there was no distinct variation. Plasma corticosterone level (PC) in naive rats showed diurnal variation with the peak at 21:00 and the trough at 9:00. PC in morphine dependent rats showed the same diurnal variation as did the naive rats, while such disappeared following pentobarbital anesthesia (80 mg/kg i.p. for 45 min) and PC was low all during the day. The PC increase following formalin administration to morphine dependent rats was higher than in naive rats. 0.1 mg/kg s.c. of dexamethasone completely inhibited PC increase after formalin in naive rats, but the dexamethasone inhibition in morphine dependent rats was not complete even with a larger dose, i.e. 10 mg/kg s.c. Diurnal variations and other differences were not detected in the adrenal response to ACTH (in vivo, in vitro) between naive and morphine dpendent rats. These results suggest that HPA function takes part in the development of morphine dependence.