高血压病左室肥厚与QT离散度分析

目的：探讨高血压病左室肥厚（ＬＶＨ）与ＱＴ离散度（ＱＴｄ）的关系。方法：测量６４例高血压病非ＬＶＨ患者（组Ⅰ）、５８例高血压病ＬＶＨ患者（组Ⅱ）和７６例健康人（组Ⅲ）的ＱＴｄ与较正的ＱＴｄ（ＱＴｃｄ）,并对各组进行比较分析。结果：组ⅡＱＴｄ、ＱＴｃｄ较组Ⅰ、组Ⅱ显著延长（Ｐ均〈０．０１）。结论：高血压病ＬＶＨ的发生及其易出现各种并发症的原因可能与其ＱＴｄ、ＱＴｃｄ的延长有关。     

高血压病左室肥厚与QTc离散度关系的研究

目的 探讨高血压病病左室肥厚（ＬＶＨ）与非在室肥厚（ＮＬＶＨ）患者ＱＴｃｄ的关系及临床意义。方法 用分层抽样法测定１０３例原发性高血压病患者住院首次１２导联心电图ＱＴｃ离散度（ＱＴｃｄ）其中合并ＬＶＨ患者５７例，合并ＮＬＶＨ患者４６例，并与２０例健康人作对照，结果 ＱＴｃｄＬＶＨ组分别与ＮＬＶＨ组，对照组比较均有非常显著性差异（Ｐ〈０．０１）ＮＬＶＨ组与对照组比较无显著性差异（Ｐ〉０．０５）。结论     

原发性高血压左室重量与Q简期离散度的关系

观察７９例原发性高血现人的血压、左重量指数（ＬＶＭＩ）和ＱＴ间期离散度（ＱＴｃｄ）及ＱＴｃｄ％的变化,以探讨ＱＴｃｄ与ＬＶＭＩ及左室肥厚（ＬＶＨ）４ 关系。结果显示,高血压伴ＬＶＨ组的ＱＴｃｄ及ＱＴｃｄ％均明显高于无ＬＶＨ组;ＱＴｃｄ及ＱＴｃｄＴ随ＬＶＭＩ增高而增高（ｒ＝０．７７２０,ｒ＝０．６７９８）,与血压均无明显相关,提示ＱＴｃｄ的增加不是血压变化所引起,而系左室肥厚所致。     

QT离散度与室性心律失常及心室肥厚的关系

目的：探讨ＱＴ离散度与室性心律失常（ＶＡ）及心室肥厚的关系。方法：运用同步十二导联心电图机检测１１４例有或无心室肥厚患的ＱＴ离散度及校正值（ＱＴｄ、ＱＴｃｄ）。结果：ＶＡ检出率为２８．９５％;ＶＡ的ＱＴｄ、ＱＴｃｄ与无心律失常有显性差异（Ｐ〈０．０５）;室上性心律失常的ＱＴｄ、ＱＴｃｄ与无心律失常无显性差异（Ｐ〉０．０５）;１１４例中,心室肥厚或扩大患的ＱＴｄ、ＱＴｃｄ与心室正常有显     

QT间期离散度与心肌梗塞预后的关系

目的探讨ＣＴ间期离散度对急性心肌梗塞近期预后的预测价值．方法计算方法：每导联均测ＱＴ间期３～５个．取均值．则ＱＴ间期离散度（ＱＴｄ）＝ＱＴｍａｘ－ＱＴｍｉｎ，用心率校正后的ＱＴ间期（ＱＴｃ）的离散度（ＱＴｃｄ）＝ＱＴｃｍａｘ－ＱＴｃｍｉｎ．结果急性心肌梗塞组与对照组ＱＴｃ、ＱＴｄ．ＱＴｃｄ值比较有显著差异（Ｐ＜０．００１）．梗塞组有无恶性心律失常及猝死者ＱＴｃ、ＱＴｄ、ＱＴｅｄ对比有显著差异（Ｐ＜０．０１）．当ＱＴＣ≥４４０ｍｓ，ＱＴｄ、ＱＴＣｄ≥６０ｍｓ时发生恶性心律失常及猝死的诊断正确指数ＱＴｃｄ与ＱＴＣ、ＱＴｄ比较有明显差异（Ｐ＜０．０５）．但ＱＴｄ与ＱＴＣ比较无明显差异（Ｐ＞０．０５）．结论ＱＴ离散度能更好反映心室复极过程，尤其是用心率校正后的ＱＴ离散度，对判断急性心肌梗塞近期预后具有重要指导价值．     

急性心肌梗死再灌注心律失常与心室复极离散度的关系

为探讨再灌注心律失常与心室复极离散度的关系，对急性心肌梗死溶栓患者（３１例）再灌注前、后和未溶栓患者（３４例）间进行心室复极各参数对比分析后发现：溶栓再通组的ＱＴｄ，ＱＴｃｄ，ＱＴ１ｃｄ，ＪＴｄ，ＪＴｃｄ及ＪＴ１ｃｄ明显长于溶栓前、未再通组和未溶栓组（Ｐ＜０．０１），再通组室性心律失常明显多于未溶栓组（Ｐ＜０．０１）；前壁心肌梗死再灌注组的ＱＴｄ长于下、后壁组（Ｐ＜０．０５），而前者的ＱＴｃｄ、ＱＴ１ｃｄ则明显长于后者（Ｐ＜０．０１）。结果表明：再灌注后室性心律失常的多发和心室复极离散度增加有关。     

高血压性左心室肥厚与QTc间期关系

研究了４１例高血压性左心室肥厚患者超声心动图左心室舒张末期内径（ＬＶＤｄ）和心电图ＱＴｃ间期的关系。结果显示：①左心室肥厚者ＱＴｃ间期延长（ｘ２＝１１．７０１，Ｐ＜０．０１），②左心室肥厚程度与ＱＴｃ间期延长呈直线性相关关系（ｒ＝０．４０，Ｐ＜０．０１）。     

不同病因致左室肥厚的QT离散度

目的 对比观察各种病因引起的左室肥厚的ＱＴ离散度。方法 二维超声心动图同高血压左室最组（ＥＨ）３０例,肥厚型心肌病组（ＨＣＭ）１５例,主动脉瓣狭窄组（ＡＳ）１５例,正常组３０例。比较４组体表心电图ＱＴ离散度（ＱＴｃ）和校正的ＱＴ度苴度（ＱＴｃｄ）。结果 病理性左室肥厚三组的ＱＴｄ和ＱＴｃｄ均明显大于对照组（Ｐ〈０．０１）;ＨＣＭ组和ＡＳ组且明显增大（Ｐ〈０．９５,Ｐ〈０．０１和Ｐ〈０．０５,Ｐ〈０     

左心室肥厚对高血压病患者QT离散度的影响

目的：观察左心室肥厚（ＬＶＨ）对高血压病（ＥＨ）患者ＱＴ离散度（ＱＴｄ）的影响。方法：对７０例高血压病患者和３０例正常人行常规１２导联心电图和心脏超声检查。用心脏超声检测法求得左心室重量。从心电图上测得ＱＴｄ与较正后ＱＴｄ（ＱＴｃｄ）。对３３例ＬＶＨ患者行２４ｈ动态心电图检查,将Ｌｏｗｎ氏分级三级以上定为有室性心律失常者。结果：ＥＨ合并ＬＶＨ组（ＥＨ＋ＬＶＨ组）患者ＱＴ与ＱＴｃｄ明显大于ＥＨ无合并     

高血压的昼夜节律及降压治疗对QT离散度的影响

目的：探讨高血压病降压治疗及降压治疗后血压的昼夜节律对ＱＴ离散度的影响。方法：选择４０例已临床确诊为高血压病的患者,行２４小时动态血压监测（ＡＢＰＭ）血压升高且昼夜节律异常的患者,给于降压治疗,将治疗后ＡＢＰＭ昼夜节律正常（杓型）的２２例为一组及昼夜节律异常（非杓型）１８例为一组,治疗前后分别行常规１２导联心电图,比较服药前后及两组间ＱＴ离散度（ＱＴｄ）及心率校正ＱＴ离散度（ＱＴｃｄ）的变化。结果：降压治疗前全部病例的ＱＴｄ＝（７２．８±２１．２）ｍｓ、ＱＴｃｄ＝（８３．３±２４．３）ｍｓ;降压治疗后ＡＢＰＭ为非杓型组的ＱＴｄ＝（６０．６±２０．１）ｍｓ、ＱＴｃｄ＝（６８．７±２３．０）ｍｓ,与治疗前比有减少（Ｐ＜０．０５;）治疗后ＡＢＰＭ为构型组的ＱＴｄ＝（４７．７±１７．６）ｍｓ、ＱＴｃｄ＝（５３．１±１８．６）ｍｓ,与治疗前比有显著差异（Ｐ＜０．０１）;与非杓型组亦有统计学差异（Ｐ＜０．０５）。结论：高血压病的降压治疗及恢复血压正常的昼夜节律可缩短ＱＴ离散度。     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.     

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.