Nitric Oxide Formation Contributes to β-adrenergic Dilation of Epicardial Coronary Arteries in Response to Intravenous Administration of Dobutamine in Dogs~

Summary To examine the role of nitric oxide in the β-adrenergic vasodilation of epicardial coronary arteries in dogs, 12 dogs were instrumented for measurement of left anterior descending coronary artery diameter by transthoracic echocardiography before and after dobutamine (5 μg/kg/min IV) with and without intracoronary infusion of N^G-monomethyl-L-arginine (L-NMMA) (1 mg/kg). In all 12 dogs, the diameter of left anterior descending coronary artery increased significantly from 2. 35±0.25 mm to 2.59±0.24 mm (P<0.001) after dobutamine administration. In 6 of the 12 dogs, the percent change in left anterior descending coronary artery diameter induced by dobutamine decreased significantly from 12.5%±8.6% to −1.5%±5.4% (P<0.05) after the administration of intracoronary L-NMMA (1 mg/kg for 5 min) to block nitric oxide synthesis from L-arginine. The study demonstrated that nitric oxide formation contributes to the β-adrenergic dilatory response of epicardial coronary arteries to dobutamine in dogs. YANG Haoyi, male, born in 1971, M. D., Ph. D. This study was supported by a grant from the National Natural Science Foundation of China (No. 30270560).     

Value of Quantitative Tissue Velocity Imaging in the Detection of Regional Myocardial Function in Dogs with Acute Subendocardial Ischemia

This study evaluated the application of quantitative tissue velocity imaging （QTVI） in assessing regional myocardial systolic and diastolic functions in dogs with acute subendocardial ischemia. Animal models of subendocardial ischemia were established by injecting microspheres （about 300 μm in diameter） into the proximal end of left circumflex coronary artery in 11 hybrid dogs through cannulation. Before and after embolization, two-dimensional echocardiography, QTVI and real-time myocardial contrast echocardiography （RT-MCE） via intravenous infusion of self-made microbubbles,were performed, respectively. The systolic segmental wall thickening and subendocardial myocardial longitudinal velocities of risk segments before and after embolization were compared by using paired t analysis. The regional myocardial video intensity versus contrast time could be fitted to an exponential function： y=A·（1-exp-β·t）, in which the product of A and β provides a measure of myocardial blood flow. RT-MCE showed that subendocardial normalized A·β was decreased markedly from 0.99±0.19 to 0.35±0.11 （P〈0.05） in 28 left ventricular （LV） myocardial segments after embolization, including 6 basal and 9 middle segments of lateral wall （LW）, 8 middle segments of posterior wall （PW） and 5 middle segments of inferior wall （IW）. However, there was no statistically significant difference in subepicardial layer before and after embolization. Accordingly, the ratio of A·β of subendocardial myocardium to subepicardial myocardium in these segments was significantly decreased from 1.10±0.10 to 0.31±0.07 （P〈0.05）. Although the systolic wall thickening did not change 5 min after the embolization in these ischemic segments （29%±3% vs 31%±5%, P〉0.05）, the longitudinal peak systolic velocities （Vs） and early-diastolic peak velocities （Ve） recorded by QTVI were declined significantly （P〈0.05）. Moreover, the subendocardial velocity curves during isovolumic relaxation predominant     

Effects of WIN 55,212-2 on IK Current in Cultured Trigeminal Ganglion Neurons of Rat

Summary To investigate the effects of WIN 55, 212-2 onI _K in cultured rat trigeminal ganglion (TG) neurons, whole-cell patch clamp techniques were used to record theI _K before and after WIN 55,212-2 perfusion at different concentrations. 30 μmol/L WIN 55,212-2 markedly (35.7%±7.3%P<0.01,n=8) inhibitedI _K currents, and the currents were partially recovered after washing. 30 μmol/L WIN 55, 212-2 also induced a significant depolarizing shift in conductance-voltage parameters (control: V_0.5=10.43±4.25 mV, k=16.27±3.86; WIN 55,212-2: V_0.5=24.71±3.91 mV, k=16.69±2.75;n=8,P<0.01 for V_0.5). 0.01 μmol/L WIN 55,212-2 slightly (27.0%±7.9%,P<0.05,n=7) increasedI _K currents, but had no significant change in conductance-voltage parameters (control: V_0.5=10.74±5.27 mV, k=17. 33±2.96; WIN 55, 212-2: V_0.5=11.06±2.05 mV, k=19.69±6.60;n=7,P>0.05 for V_0.5 and k). These results suggested that WIN 55, 212-2 has dual action, which might be through different receptors. MING Zhangyin, male, born in 1968, Doctorial Candidate This project was supported by a grant from National Natural Sciences Foundation of China (No. 30271500).     

多巴酚丁胺及其合用硝酸甘油超声心动图检测冬眠心肌的临床研究

目的　 对比多巴酚丁胺 (Dob)及其合用硝酸酯二维超声心动图 (2DE)试验识别冬眠心肌的敏感性、特异性和安全性。方法　 选择 6 0例冠心病心肌梗死患者 ,术前分别测定心率、血压及室壁节段运动指数 (WMSI) ,行Dob及其合用硝酸甘油 2DE试验 ,行经皮穿刺冠状动脉成形术 (PT CA) ,术后 1月复查。用 16节段半定量法将左心室各节段收缩运动和增厚情况分级记分 ,将两实验检出的冬眠心肌节段与PTCA术后相应节段收缩改善的实际对比 ,计算识别冬眠心肌的敏感性、特异性和安全性。结果　Dob合用硝酸甘油 2DE检出冬眠心肌节段 6 9.4 % ,与Dob组比较差异无显著性 ,但其中收缩改善 2分节段百分比有显著差异 (P <0 .0 0 1) ,其识别冬眠心肌敏感性、特异性和安全性分别为 88.2 %、82 %、86 .6 % ,Dob组分别为 82 .7%、6 6 .37%、78.1%。结论　Dob合用硝酸甘油 2DE识别冬眠心肌比单独应用Dob更安全可靠。     

多巴酚丁胺超声负荷试验结合组织多普勒定量检测冠心病人存活心肌

目的在超声多巴酚丁胺负荷试验（DSE）中应用组织多普勒（DTI）技术,定量检测存活心肌运动速度的变化,提高存活心肌的检出率。方法25例研究对象均经定量冠状动脉造影（QCA）检查确诊为冠心病,均采用标准的DSE方案（0～40μg/kg·min）,左室室壁节段按照美国超声心动图学会16节段划分法,用目测半定量四级分法观测室壁运动的情况,逐级进行记分,计算室壁运动记分指数（WMSI）。使用DTI技术,分别于静息状态、小剂量（10μg/kg·min）及峰值剂量时观察16个节段心肌运动速度的变化,记录各室壁节段的收缩期（S）、舒张早期（E）及舒张晚期（A）的峰值速度V,将检出结果与冠脉介入性治疗（Percutaneous transluminal intervention,PCI）后的结果作对照,分别计算2D-DSE、DTI-DSE检出存活心肌的敏感度、特异度、阳性预测值、阴性预测值和准确性。结果δVs和δVE≥35%作为判断双相反应的标准：DTI-DSE方法存活心肌的检出率为76%;与2D-DSE相比有显著性差异（76%vs66%,P〈0.05）。两种方法检测存活心肌的敏感度、特异度、阳性预测值、阴性预测值和准确性分别为：2D-DSE：68%、80%、73%、87%和82%;DTI-DSE：82%、88%、86%、84%和85%。结论DTI-DSE技术可定量评价CAD患者存活心肌的运动,对CAD存活心肌的诊断具有较高的应用价值。     

Influence of Contractility on Myocardial Ultrasonic Integrated Backscatter and Cyclic Variation in Integrated Backscatter

Integrated ultrasonic backscatter( IB) ,themeasurement of ultrasonic energy backscatteredfrom the myocardium,has been previously demon-strated to reflect physiological and pathologicalchanges in the myocardium[1] .The calibrated my-ocardial IB depends on the structure of the my-ocardium.It is greater in the damaged myocardi-um such as myocardial infraction,myocardial fi-brosis when compared with the normal myocardi-um.IB in the normal myocardium has cardiac cy-cle- dependentvariation with th…     

The Effect of Hypercapnic Acidosis Preconditioning on Rabbit Myocardium

This study observed the protective effect of hypercapnic acidosis preconditioning on rabbit heart suffered from ischemia-reperfusion injury. Hypercapnic acidosis was established in animals with mechanical hypoventilation before ischemia-reperfusion. Thirty-two rabbits were randomly divided into 4 groups, with each having 8 aminals in term of the degree of acidification： hypercapnic acidosis group A （group A）, hypercapnic acidosis group B （group B）, hypercapnic acidosis group C （group C）, ischemia and reperfusion group （group IR）. Animals in group IR were ventilated normally （tidal volume： 15 mL/kg, breathing rate 35 bpm）. The PETCO2 was maintained at the level of 40-50 mmHg for 30 min. Animals in groups A, B, C received low-frequency, low-volume ventilation to achieve hypercarbonic acidosis and the target levels of PETCO2 were 75-85 ,65-75, 55-65 mmHg, respectively, with levels being maintained for 5 min. The animals then were ventilated normally to lower PETCO2 to 40-50 mmHg. The left anterior branch artery of all the animals was ligated for 30 min and reperfused for 180 min. Then the infarct size was calculated. The cardiomyocytes were morphologically observed and ECG and hemodynamics were monitored on continuous basis. Acid-base balance was measured during procedure. Our results showed that the infarct size was （48.5±11.5）% of the risk area in the control group and （42.4±7.9）% in group C （P〉0.05）. Mean infarct size was significantly smaller in group B （34.5%±9.4%） （P〈0.05 vs control group） and group A （31.0%±9.1%） （P〈0.01 vs control group）. It is concluded that HA-preconditioning can effectively protect the myocardium.     

Shenmai Injection (参麦注射液) inhibiting the extracellular signal regulated kinase-induced human airway smooth muscle proliferation in asthma

Objective： To investigate the relationship between the proliferation of sensitized human airway smooth muscle cells （HASMCs） and the expression of extracellular signal regulated kinase （ERK） and the effect of Shenmai Injection （参麦注射液, SMI） on HASMCs. Methods： The HASMCs cultured in vitro were divided into three groups： （1） control group; （2） sensitized group： containing 10% asthmatic serum; （3） SMI group： further divided into three different concentration subgroups interferred with 10 μL/mL, 50 μL/mL, and 100 μL/mL SMI, respectively. The proliferation of HASMCs was detected using MTT method, the expression of proliferating cell nucleus antigen （PCNA） in HASMCs was detected using immunocytochemical staining, and the expression of phosphoration-ERK1/2 （p-ERK1/2） protein was detected using Western-blot. Results： After passive sensitization, the optical density value （A49o value） of HASMCs was significantly increased from 0.366± 0.086 to 0.839 ± 0.168 （P〈0.05）. In addition, the expression of PCNA was significantly increased from 28.7% ± 5.9% in the control group to 69.8% ±7.5% in the sensitized group （P〈0.05）. At the same time, the expression of p-ERK1/2 in passively sensitized HASMCs was significantly increased compared with the control group （all P〈0.05）. Affer application of 10 μL/mL, 50 μL/mL, and 100 μL/mL SMI to the cultured media of passively sensitized group, the A570 value was significantly decreased from 0.839 ±0.168 to 0.612 ±0.100, 0.412 ± 0.092, and 0.339 ± 0.077, respectively （P〈0.05）. Moreover, the expression of PCNA was significantly decreased from 69.8% ±7.5% to 57.8% ± 6.2%, 40.7%±5.4%, and 26.1% ± 5.2%, respectively. At the same time, the expression of p-ERK1/2 in each SMI group was significantly decreased compared with the sensitized group （all ,P〈0.05）. Conclusion： ERK signal transduction pathway may be involved in the airway remodeling in asthma. The expression of ERK can be inhibited by SMI in a dose-dependent manner, thus preventing the proliferation of HASMCs.     

左乳腺癌保乳术后瘤床同步加量静态调强放射治疗与断层定野放射治疗的剂量学研究

目的 探讨左乳腺癌保乳术后瘤床同步加量静态调强放射治疗(sIMRT)与断层定野放射治疗(TD)的剂量学特点。方法 选取2016年5月—2018年5月云南省肿瘤医院左乳腺癌保乳术后瘤床银夹标记患者24例,对同一患者分别采用sIMRT计划设计(Monaco5.11.03治疗计划系统)和TD计划设计(TomoTherapy治疗计划系统),比较两种计划的剂量学参数。结果 两组计划的肿瘤计划靶区(PGTV)的D_2%、D_98%、适形指数(CI)、均匀性指数(HI)比较,差异均有统计学意义(P <0.05),sIMRT的CI(0.75±0.05)高于TD的CI(0.61±0.13),TD的HI(0.04±0.01)低于sIMRT的HI(0.05±0.00)(P <0.05)。D_50%组间差异无统计学意义(P >0.05)。两组计划的乳腺计划靶区(PTV)的D_98%、CI、HI比较,差异均有统计学意义(P <0.05),sIMRT的CI(0.82±0.04)高于TD的CI(0.68±0.05...     

Effects of Phorbol-12,13-dibuterate on Sodium Currents and Potassium Currents in Rat Trigeminal Ganglion Neurons

The effects of phorbol-12,13-dibuterate (PDBu) on total sodium current (INa-total), tet-rodotoxin-resistant sodium current (INa-TTXr), 4-AP-sensitive potassium current (IA) and TEA-sensitive potassium current (IK) in trigeminal ganglion (TG) neurons were investigated. Whole-cell patch clamp techniques were used to record ion currents in cultured TG neurons of rats. Results revealed that 0.5 μmol/L PDBu reduced the amplitude of INa-total by (38.3±4.5)% (n=6, P<0.05), but neither the G-V curve (control: V0.5 =-17.1±4.3 mV, k=7.4±1.3; PDBu: V0.5=-15.9±5.9 mV, k=5.9±1.4; n=6, P>0.05) nor the inactivation rate constant (control: 3.6±0.9 ms; PDBu: 3.6±0.8 ms; n=6, P>0.05) was altered. 0.5 μmol/L PDBu could significantly increase the amplitude of INa-TTXr by (37.2± 3.2)% (n=9, P<0.05) without affecting the G-V curve (control: V0.5=-14.7±6.0 mV, k=6.9± 1.4; PDBu: V0.5=-11.1±5.3 mV, k=8.1±1.5; n=5, P>0.05) or the inactivation rate constant (control: 4.6±0.6 ms; PDBu: 4.2±0.5 ms; n=5, P>0.05). 0.5 μmol/L PDBu inhibited IK by (15.6±5.0) % (n=16, P<0.05), and V0.5 was significantly altered from - 4.7±1.4 mV to -7.9 ±1.8 mV (n=16, P<0.05). IA was not significantly affected by PDBu, 0.5 μmol/L PDBu decreased IA by only (0.3±3.2)% (n=5, P>0.05). It was concluded that PDBu inhibited INa-total but enhanced INa-TTXr, and inhibited IK without affecting IA. These data suggested that the activation of PKC pathway could exert the actions.     

幕上高血压脑出血不同手术方式的疗效对比分析

目的 探讨神经内镜微创手术与常规骨瓣开颅血肿清除术、血肿穿刺引流术治疗高血压脑出血疗效的区别。 方法 收集经手术治疗的幕上高血压脑出血患者90例,分为常规骨瓣开颅手术组(开颅组)、血肿穿刺引流组(穿刺组)和神经内镜手术组(内镜组),每组30例。通过手术时间、血肿清除率、术后格拉斯哥评分(GCS)、住院时间、术后并发症和术后6月改良Rankin量表(mRS)进行评分,比较3组患者的手术疗效。 结果 90例患者均接受持续随访,随访时间>6月。内镜组、穿刺组及开颅组的手术时间分别为(1.5±0.4),(0.79±0.2)及(3.75±0.61)h,3组间比较,差别有统计学意义(P<0.05); 3组的术后第1天血肿清除率分别为(87.34%±3.42%),(52.81%±6.67%)及(86.62%±4.45%),3组间比较,差别有统计学意义(P<0.05); 3组的术后第7天GCS评分分别为(2.90±1.45),(13.07±1.80)及(11.73±2.48),3组间比较,差别有统计学意义(P<0.05); 入院时血肿量>60 mL患者的6月改良mRS评分,3组分别为(4.25±0.95),(3.25±0.50)及(2.67±0.71),3组间比较,差别有统计学意义(P<0.05); 入院时GCS评分为5～8分的患者的6月改良mRS评分,3组分别为(4.50±0.54),(3.00±0.53)及(2.80±0.78),3组间比较,差别有统计学意义(P<0.05)。 结论 对于幕上高血压脑出血患者,特别是血肿量>60 mL或GCS评分为5～8的患者,神经内镜治疗相较于其他两种外科手术,可更安全、有效地清除血肿,神经功能的改善也更大。     

Postconditioning＇s Protection of THSG on Cardiac Ischemia-reperfusion Injury and Mechanism

Summary 2,3,5,4′-tetra-hydroxystilbene-2-O-glucoside (THSG), the water-soluble active components extracted from dried tuber root ofPolygonum multi florum (Polygonaceae), can promote the release of nitric oxide (NO) from vascular endothelial cells and has strong antioxidation. The post-conditioning's protection of THSG on cardiac ischemia-reperfusion injury and the mechanism were investigated. After reperfusion for 3 h following occlusion of rat left anterior descending coronary artery (LAD) for 30 min. SαT recovery speed, arrhythmia and cardiac infarct size were observed. The ischemic size and infarct size was identified by using Evans blue and TTC staining methods re-spectively. The results showed that the infarct size in THSG 7. 5 mg/kg postconditioning group was significantly decreased from 43.6%±9.1% in mode group to 16.5%±6.5% (P<0.01). SαT recovery was quicker and the incidence of arrhythmia (55.6% vs 100%,P<0.05) was significantly lower than in control group. The infarct size in THSG+glybenclamide group was greater than in THSG group, but equivalent to that in control group (46.8%±9.8% vs 43.6%±9.1%,P>0.05), SαT recovery speed slower and the incidence of arrhythmia also lower (33.3% vs 100%,P<0.01), suggesting that glybenclamide could abolish the effects of THSG postconditioning reducing the cardiac infart size. It was concluded that THSG administration before reperfusion could effectively alleviate the cardiac reperfusion injury and possessed the postconditioning effects of reducing cardiac infarct size, which might be related with the K_ATP channel opening. YE Shaojian, female, born in 1963, Associate Professor, M. D., Ph. D.     

Protective effects of API0134 on myocardial ischemia and reperfusion injury

Summary Previous studies have demonstrated that a crude extract from Chinese medicinal herbAndrographis Paniculata Nees (APN) could prevent myocardial ischemia and reperfusion injury. A refined extract API₀₁₃₄ was studied further. LAD was ligated for 90 min in 20 dogs and then reperfused for 120 min. The animals were randomly divided into 2 groups, API₀₁₃₄ treated group(n = 10), 45 min after ischemia receiving a slow i. v. bolus of 1 mg/kg and then an infusion of 80 μg D kg⁻¹/min for 60 min and control group (n=10) which was given only 5% glucose in saline. Result showed that the hemodynamics in API₀₁₃₄ treated group showed better effects of preventing the increase of the LVEDP and maintaining relatively normal CO as compared with control group. Ischemic ECGs were significantly milder. Malignant arrhythmia did not appear in API₀₁₃₄ treated group. After reperfusion, the infarct size was smaller (5. 06±2. 67% vs 10. 45±3. 11%,P < 0. 01), the damages found in myocardial ultrastructure were significantly milder. It is concluded that API₀₁₃₄ may protect the myocardium from ischemic reperfusion injury.     

Effects of Dendritic Cells Transfected with Full Length Wild Type P53 and Modified by Gastric Cancer Lysate on Immune Response

Dendriticcells (DCs)arethemostpotentanti gen presentingcellsandareactivelyusedincancerimmunotherapy .Thewild typep5 3,asanantigen ,caninducespecificcytotoxicTlymphocytes (CTLs)inthehostbody .Itisaneffectivemethodtoimmu nizebodywith p5 3in p5 3 overexpress…     

Efficacy and Safety of Risedronate Sodium in Treatment of Postmenopausal Osteoporosis

With the aging of the population,the inci-dence of pri mary osteoporosis is getting higher andhigher,among which post menopausal osteoporosis(PMOP)is the most commontype.As an effectivemedicine to inhibit bone absorption,bisphospho-nates has become the main medicationtotreat oste-oporosis.In this clinical trial,we investigated theefficacy of residronate sodium,the third-generationbisphosphonates made in China,in the treat mentof PMOP by exploring its effect on bone mineraldensity(BMD)and b…     

Effects of Electro-Acupuncture at Zusanli, Guanyuan for Sepsis Patients and Its Mechanism through Immune Regulation

Objective:To evaluate the effect of electro-acupuncture on Zusanii(ST 36),Guanyuan(RN 4)in patients with sepsis,and explore its mechanism in term of immune regulation.Methods:In this prospective randomized controlled trial,60 patients with sepsis were randomly assigned to the control group and the intervention group equally by block randomization.Patients in the control group received routine treatment and those in the intervention group received electro-acupuncture at bilateral Zusanii and Guanyuan in addition to routine treatment,respectively.The mortality at 28 days,Acute Physiology and Chronic Health Evaluation(APACHE)-Ⅱ score were compared to evaluate the effect,and the levels of T cell subsets(CD3+,CD4+,CD8+,CD4+/CD8+) and monocytes of human leukocyte antigen(HLA)-DR using flow cytometry were compared to explore the mechanism of this combined treatment.Results:Fifty-eight patients completed the trial with29 in each group.There was no significant difference of mortality in the 28 th day between the two groups,with 5 death of 29 patients in the intervention group(17.2%) and 9 of 29 in the control group(31.0%).After treatment,APACHE- II score of both groups was significantly decreased,however,score of the intervention group was lower than the control group(13.28 ±7.07 vs.17.10 ±5.83;P0.01).The levels of CD3+,CD4+,CD8+ and CD4+/CD8+ ratio of the intervention group improved after treatment and were higher than the control group(59.71%±11.94%vs.52.54%± 11.86%;36.46%±7.60%vs.31.58%±10.23%;18.40%±8.82%vs.23.07%±7.30%;2.38±1.14 vs.1.54±0.80,respectively;all P0.05).The expression of HLA-DR significantly increased after treatment in the intervention group than that in the control group(7.28%± 9.26%vs.1.27%±7.00%;P0.01).Conclusion:Electro-acupuncture at Zusanii and Guanyuan could improve clinical curative effect in patients with sepsis,which might be achieved by regulation of the immune system.     

虚拟现实技术联合仿真情景模拟训练在妇产科实习教学中的应用分析

目的 观察虚拟现实（virtual reality,VR）技术联合仿真情景模拟训练在妇产科实习教学中应用效果。方法 选取2021年6月至2022年5月在妇产科实习的98名实习生为研究对象,其中对照组49人给予常规妇产科临床实习教学,观察组49人给予VR技术联合仿真情景模拟训练实习教学,比较两组实习生考核成绩、学习能力[自我导向学习评定量表（SRSSDL）]、岗位胜任能力和教学质量满意度。数据采用SPSS 20.00进行卡方检验和t检验。结果 观察组实习生考核成绩[理论知识（35.51±2.21）分 vs. （32.17±3.22）分;病例分析（16.52±1.51）分 vs. （13.37±2.03）分;实践操作技能]均高于对照组（P<0.05）;教学后,两组实习生学习能力、岗位胜任能力均提高（P<0.05）,且观察组高于对照组（P<0.05）;观察组实习生教学满意度高于对照组（P<0.05）。结论 VR技术联合仿真情景模拟训练有助于提高教学质量,增强医学生学习能力和岗位胜任能力,教学质量满意度较高,值得推广应用。     

磁共振多技术扫描与超声心动图检测心肌活性的比较

目的: 评估磁共振多技术扫描和小剂量多巴酚丁胺负荷超声心动图(LDDSE)检测心肌活性的价值.方法: 建立猪慢性心肌缺血模型25只,分别于模型制作前和制作后1～2个月进行磁共振多技术联合应用扫描及LDDSE检查,判断心肌缺血区和坏死区的大小,并与病理结果对照评估各种方法的敏感性、特异性.结果: 共有20只动物顺利完成所有检查,静息时MRI电影扫描共有16个节段(5.00%)运动丧失,9个节段(2.81%)运动减弱;负荷后电影扫描共有16个节段(5.00%)运动丧失为坏死心肌;负荷前后室壁运动计分指数(WMSI)有统计学差异(P<0.01);心肌灌注扫描见53个节段(16.56%)缺血;心肌活性扫描见23个节段(7.19%)坏死.静息时超声心动图检查共有16个节段(5.00%)运动丧失,13个节段(4.06%)运动减弱;负荷后共有16个节段(5.00%)运动丧失为坏死心肌,1个节段(0.31%)运动减弱,负荷前后WSMI有统计学差异(P<0.01).TTC染色见24个节段(7.50%)为无红染的苍白色梗死区.以TTC染色结果为金标准,MRI活性扫描、MRI电影、LDDSE检出无活性心肌的敏感性、特异性、准确性分别为95.80%、100%、99.70%;66.70%、100%、97.50%;66.70%、100%、97.50%. 结论: MRI心脏检查可结合形态、功能及灌注多种方法检测心肌活性,清晰显示心肌梗死的位置、程度,并可对左室室壁运动进行直观显示;LDDSE可通过评价异常心肌节段的收缩功能间接判断心肌损伤及其性质,其准确性较高且方法简便,但不能直接检测心肌灌注情况和心肌梗死的透壁程度.     

Expression of CD40 and CD40L on Peripheral Blood Mononuclear Cells in Patients with Condyloma Acuminatum

The initiation,development and transforma-tion of condyloma acuminatum(CA)bear a closerelation to the cellular i mmune function ofhost[1-3].The CD40and CD40ligands,a couple ofi mportant costi mulatory molecules of the specifici mmune systemin vivo,play an i mportant role inthe activation of Tlymphocytes and the secretionof effective cytokines.To obtaintheinformation a-bout the expression level and explore the clinicalsignificance of CD40and CD40L on peripheralblood mononuclear cells(PMBC…     

气囊面罩结合气管插管通气对急救心肺复苏结局及预后的影响

目的 探讨气囊面罩结合气管插管通气对急救心肺复苏结局及预后的影响。方法 选取2015年1月—2017年5月在重庆医科大学附属大学城医院接受急救心肺复苏患者102例，采用随机数字表法将分为观察组和对照组，每组51例。对照组给予气管插管通气治疗，观察组给予气囊面罩结合气管插管通气治疗。比较两组患者治疗前后的pH、氧分压（PO₂）、二氧化碳分压（PCO₂）水平变化；记录两组患者治疗后气道开放、呼吸恢复、心跳恢复及意识改善时间；比较两组患者治疗后生命体征指标恢复情况、复苏成功率、最终存活率及满意度情况。结果 治疗前，两组患者的pH、PO₂、PCO₂比较无统计学意义（P >0.05）。治疗后，两组患者的pH、PO₂均有所升高，但是观察组pH（7.29±0.12）mmHg低于对照组（7.53±0.22）mmHg（P <0.05），观察组PO₂（89.34±7.69）mmHg高于对照组（71.56±6.98）mmHg （P <0.05）；两组患者的PCO₂均有所降低，但是观察组的PCO₂（37.43±5.25）mmHg低于对照组（44.32±6.51）mmHg （P <0.05）。观察组气道开放、呼吸恢复、心跳恢复及意识改善时间都短于对照组（P <0.05）。观察组血氧饱和度（85.32±11.76）%高于对照组（43.54±9.12）% （P <0.05），平均动脉（72.32±9.56）mmHg高于对照组（36.78±7.32）mmHg （P <0.05）。观察组复苏成功率（52.94% VS 25.49%）、最终存活率均高于对照组（33.33% VS 11.76%） （P <0.05）。观察组总满意率高于对照组（86.27% VS 62.75%） （P <0.05）。结论 采用气囊面罩与气管插管通气结合进行急救心肺复苏，能有效改善患者的pH、PO₂、PCO₂，促进患者的各项生命体征的恢复，缩短患者气道开放、呼吸恢复、心跳恢复及意识改善时间，提高复苏成功率及最终存活率，从而提高患者的满意度。治疗效果显著，值得推广使用。