冠心病患者心肌缺血和心律失常实施动态心电图和常规心电图诊断的临床对比

目的探讨动态心电图对冠心病患者心律失常和心肌缺血的诊断价值。方法选取2015年5月～2017年5月我院接收的40例冠心病患者,均行12导联动态心电图(AECG),再选取同期仅行常规心电图的40例患者,选用12导联心电图机MECG-200(北京麦迪克斯科技有限公司)进行常规心电图检查,12导联组选用MAECG-200动态心电图检测仪进行检测,观察检测结果。结果 12导联组对心律失常及心肌缺血的检出率较常规组明显要高,差异有统计学意义(P <0.05),且对于心肌缺血无症状,12导联检出率明显高于常规组,差异有统计学意义(P <0.05);12导联组对房性早搏二三联律、右束支阻滞、室性早搏二三联律、左束支阻滞及房室传导阻滞的检出率较常规组明显要高,差异有统计学意义(P <0.05),两组在早发性房性早搏、房颤、早发性室性早搏及房性逸博、房扑的检出率比较,差异无统计学意义(P> 0.05);12导联相比于常规组对侧壁、下壁的检出率明显要高,差异有统计学意义(P <0.05),对ST段压低、抬高的检出率亦较常规组明显要高,差异有统计学意义(P <0.05)。结论 12导联动态心电图能够提高冠心病患者心律失常及心肌缺血的检出率,且对心律失常分型的诊断效果较好,具有临床推广价值。     

动态心电图在心律失常患者诊断中的应用效果观察

目的:分析动态心电图在心律失常患者诊断中的应用效果。方法:选取在某院就诊的冠心病患者130例,根据数字随机表法分为对照组和观察组两组,每组65例,对观察组和对照组患者分别采用动态心电图、常规心电图诊断。结果:观察组室性期前收缩二三联律、室性早搏成对、房性期前收缩二三联律、房性早搏成对,房室阻滞、左右束支阻滞心律失常检出率高于对照组。观察组12导联、3导联对室性心动过速、心房颤动、短阵室上速心律失常比较,P0.05;其余类型数据差异比较,P0.05。结论:动态心电图对心律失常患者有着较高检出率,快速准确,临床价值高。     

常规心电图与动态心电图诊断冠心病心律失常的比较分析

目的探究常规心电图与动态心电图在诊断冠心病心律失常方面的差异性。方法选取2012年3月至2014年3月于我院诊治的冠心病患者70例,随机分为动态心电图组和常规心电图组,每组35例,动态心电图组采用动态心电图进行检测,常规心电图组运用常规心电图组进行检测,后比较两种方法冠心病检出率及冠心病心律失常检出率的差异。结果两组方法冠心病检出率比较,阳性率分别为68.57%、57.14%,P>0.05,差异无统计学意义;两组方法在房性早搏二、三联律、室性早搏二、三联律、房性早搏成对、室性早搏成对、短阵室上速方面检出率比较,差异具有统计学意义(P<0.05);在房性早搏早发、室性早搏早发、房室传导阻滞方面差异无统计学意义(P>0.05)。结论动态心电图在诊断冠心病心律失常方面较常规心电图检出率高,值得临床推广使用。     

常规心电图与动态心电图诊断冠心病伴心律失常的价值

目的观察常规心电图与动态心电图诊断冠心病伴心律失常的价值。方法数字随机法抽取2017年6月至2018年6月期间我院收治的冠心病患者61例,均行常规心电图与动态心电图诊断,对比两种诊断方法心律失常的检出率。结果动态心电图检测室性和房性早搏二、三联,室性和房性早搏成对,短阵室上速等的检出率高于常规心电图(P <0.05)。结论相较于常规心电图,动态心电图诊断冠心病伴心律失常的价值显著,可推广。     

动态心电图与常规心电图诊断冠心病患者心律失常的比较

目的对比研究动态心电图与常规心电图诊断冠心病患者心律失常的不同,为临床治疗和诊断提供可参考依据。方法抽取我院2013年1月至2015年1月心内科收治冠心病患者200例,为研究对象,分别进行动态心电图和常规心电图检查。统计两种心电图检查方法心律失常诊断结果。结果动态心电图诊断冠心病心律失常阳性84例,阳性率684%,常规心电图诊断冠心病心律失常阳性58例,阳性率58%(χ2=3.33,P=0.07)。动态心电图检出室性早搏二联或三联、房性早搏二联或三联、室性早搏成对、房性早搏成对、阵发性室上速的检出率显著高于常规心电图检出率(P<0.05)。动态心动图检出房室传导阻滞、室上性早搏、房性早搏检出率与常规心电图检出率比较不具有统计学意义(P>0.05)。结论应用动态心动图诊断冠心病患者心律失常检出率高,临床效果好,及时发现患者病情,可以在临床诊断和治疗中推广应用。     

动态心电图在老年冠心病心肌缺血和心律失常诊断中的价值

目的:探究动态心电图在老年冠心病心肌缺血和心律失常诊断中的价值。方法:选取100例2016年8月到2017年8月医院接收的老年冠心病患者作为本次研究的观察对象。按照随机性的原则平均分为观察组和对照组,每组50例老年冠心病患者。采用常规心电图为对照组的老年冠心病患者进行检查,观察组的老年冠心病患者则采用动态心电图来检查,对比两组老年冠心病患者最终的检查效果。结果:观察组患者心律失常和心肌缺血的检出率要明显高于对照组患者,两组数据差异具有统计学意义(P0.05)。结论:动态心电图在老年冠心病心肌缺血和心律失常的诊断中具有重要的价值,值得被临床推荐和应用。     

动态心电图与常规心电图诊断冠心病患者心肌缺血及心律失常的临床效果比较

目的探讨动态心电图与常规心电图在冠心病患者心肌缺血及心律失常诊断中的临床效果对比。方法选择我院在2014年9月至2015年9月收治的64例冠心病患者作为研究对象,并将其随机分成观察组与对照组,其中观察组患者给予动态心电图诊断,对照组患者给予常规心电图诊断,分别对比两组患者的心肌缺血及心律失常的诊断准确性。结果观察组患者的心肌缺血检出率明显高于对照组患者的心肌缺血检出率,观察组患者的心律失常检出率明显高于对照组患者的心律失常检出率,P<0.05为差异具有统计学意义。结论动态心电图诊断冠心病患者心肌缺血及心律失常临床效果显著,值得临床的推广及应用。     

动态心电图与常规心电图诊断冠心病患者心肌缺血及心律失常的临床效果比较分析

目的探讨动态心电图与常规心电图诊断冠心病患者心肌缺血及心律失常的临床效果比较情况。方法分析我院2010年1月至2013年3月收治的150例冠心病患者心电图诊断资料,均通过常规心电图和动态心电图进行检查。观察两种心电图检查监测心肌缺血发生情况和监测心律失常发生情况。结果动态心电图检查冠心病患者心肌缺血阳性率明显高于常规心电图检查结果,动态心电图检查冠心病患者房性心律失常、室性心律失常、短阵室上速、房室传导阻滞等检出率明显高于常规心电图检查检出率,P<0.05,差异均有统计学意义。结论动态心电图对冠心病患者的观察,可以对早期心肌缺血进行诊治,并对心绞痛型、隐匿型及心律失常型冠心病进行及时的诊断和预后评价。     

动态心电图在冠心病心肌缺血与心律失常诊断中的价值分析

目的 分析动态心电图在冠心病心肌缺血、心律失常诊断中的应用价值.方法 选取2018年4月—2019年5月我院收治的102例冠心病为研究对象,其中行动态心电图检查者52例纳入观察组,50例行常规心电图检查者纳入对照组,比较2组检出结果及诊断价值.结果 观察组心肌缺血总检出率较对照组高,无症状心肌缺血检出率高于对照组(P<0.05,P<0.01);观察组心律失常总检出率高于对照组(P<0.05),且频发、二三联律、成对型房性早搏,二三联律、成对型室性早搏,室上性心动过速,房室传导阻滞,左右束支传导阻滞检出率高于对照组(P<0.05,P<0.01).动态心电图诊断冠心病心肌缺血的敏感度较常规心电图高,诊断冠心病心律失常的敏感度、准确度均较常规心电图高(P<0.05).结论 动态心电图诊断冠心病心肌缺血、心律失常有较高的临床价值,能较好地检出无症状心肌缺血、判断心律失常类型.     

动态心电图与常规心电图诊断冠心病的临床对比分析

目的对比分析动态心电图与常规心电图诊断冠心病的临床价值。方法选取冠心病患者180例,随机分为标准组和对照组,每组90例,标准组患者采用动态心电图进行临床诊疗,对照组患者采用常规心电图进行临床诊疗,对比分析两组患者冠心病的检出率。结果标准组心律失常及心肌缺血检出率显著高于对照组检出率,差异有统计学意义（P〈0.05）。结论动态心电图与常规心电图相比在诊断冠心病时,检出率更高,具有更高的临床价值,值得推广。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.