营养心肌治疗对QT间期离散度的影响

目的：采用营养心肌治疗方法（含镁极化液）对心绞痛患者QT间期离散度（QTd）及校正QT间期离散度（QTcd）的影响。方法：采取随机单盲方法，将78例心绞痛患者随机分为营养心肌（含镁极化液）治疗组与常规治疗对照组，治疗两周后测定两组的QTd及QTcd，对两组进行对照分析。结果：治疗组QTd及QTcd治疗分别为（41.61±13.01）ms与（48.35±15.56）ms，对照组分别为（52.68±20.31）ms与（60.59±7.35）ms，两组差别有统计学意义（P〈0.05）。结论：营养心肌治疗方法能减少心绞痛患者的QTd及QTcd，从而可能减少恶性心律失常的发生。     

冠状动脉成形术对不稳定型心绞痛患者QT间期离散度的影响

目的　探讨冠状动脉成形术对不稳定型心绞痛患者QT间期离散度的影响。方法　 47例不稳定型心绞痛患者于冠状动脉成形术前后记录标准 12导联同步心电图 ,计算QT间期离散度QTd及心率效正的QT间期离散度QTcd并进行比较。结果　冠状动脉介入治疗后的QTd及QTcd较治疗前有明显下降 ,分别从 5 8.7± 15 .1和 64 .1±17.1ms下降至 47.6± 10 .1和 5 2 .6± 11.1ms(P均 <0 .0 1)。术前多支血管病变者的QTd及QTcd均显著大于单支血管病变者 ,且治疗后多支血管病变的QTd及QTcd的下降程度均较单支血管病变更加显著。结论　通过冠状动脉成形术改善心肌供血能够明显减少不稳定型心绞痛患者的QTd及QTcd     

联用冠心宁极化液对急性心梗QT离散度的影响

目的 研究联用冠心宁极化液治疗急性心梗(AMI)前后QT散度(QTd)及校正QT间期离散度(QTcd)的改变,及严重室性心律失常的发生率.方法 将55例患者随机分为治疗组和对照组,测定治疗前后的QTd和QTcd,记录严重心律失常的发生率.结果 治疗前后两组的QTd和QTcd均显著降低(P＜00.5),治疗组心律失常发生率显著低于对照组(P＜0.05).结论 联用冠心宁和极化液能降低AMI的QTd及严重室性心律失常发生率.     

倍他乐克对冠心病劳累性心绞痛患者QT离散度的影响

目的：探讨倍他乐克对冠心病劳累性心绞痛患者QT离散度的影响。方法：将40例冠心病劳累性心绞痛患者随机分成两组，试验组给予倍他乐克50－150mg/ld，对照组不给倍他乐克，其它抗心肌缺血治疗同试验组，测定治疗前及治疗2周后两组心率，最大QT间期（QTmax），最小QT间期（QTmin），QT离散度（QTd）及心率校正QT离散度（QTcd）。结果：对照组各项观察指标无显著变化（P＞0．05）。试验组QTd,QTcd显著缩小（P＜0．01）。结论：倍他乐克在控制冠心病劳累性心绞痛患者症状的同时，显著减少QTd及QTcd，从而减少室性心律失常的发生，改善预后。     

葛根素对不稳定型心绞痛患者QT离散度的影响

目的　探讨葛根素注射液对不稳定型心绞痛 (UA)患者QT离散度 (QTd)的影响。方法　 92例UA患者随机分为常规治疗组 (43例 )和葛根素组 (49例 )。治疗前及治疗后 2周分别测量 12导联心电图不同导联 (>8个导联 ,其中胸导联不得少于 3个 )的QT间期 ,得到最大QT间期 (QTmax)及最小QT间期 (QTmin)及其两者差值QTd ,按Bazett公式校正心率后求出QTcmax、QTcmin及QTcd。结果　治疗后两组QTcd均明显缩短 (P <0 0 5 ,P <0 0 1) ,但葛根素组QTcd缩短幅度大于常规治疗组 (P <0 0 1)。结论　葛根素注射液能有效缩短UA患者QT离散度 ,改善心室肌复极均一性和电活动稳定性。     

心绞痛患者QT离散度变化

目的 :探讨冠心病心绞痛患者与QT离散度 (QTd)的关系。方法 :选择稳定性心绞痛患者 10 8例 ,不稳定性心绞痛患者 134例 ,非心脏病患者 2 94例 ,从心电图上计算出QTd和校正的QTcd。结果 :不稳定性心绞痛组的QTd( 54 .6± 18.2 )ms、QTcd( 6 5.5± 2 0 .1)ms ,均大于不稳定性心绞痛组QTd( 38.2± 14 )ms、QTcd( 42 .2± 17.1)ms ;两组均大于非心脏病组QTcd( 34 .1± 9.4 )ms、QTd( 34 .4± 10 .6 )ms ;治疗后稳定性心绞痛和不稳定性心绞痛组的QTd和QTcd均有明显下降。结论 :心绞痛可引起QTd和QTcd增大 ,它们可评估心肌缺血程度     

舒冠滴丸对冠心病不稳定型心绞痛QT离散度的影响

目的 观察舒冠滴丸对冠心病不稳定型心绞痛患者QT离散度(QTd)的影响,探讨该药抗心律失常的机制.方法 对100例患者采用随机数字表法分为观察组80例与对照组80例.两组给予相同的常规基础治疗,治疗组在此基础上加用舒冠滴丸,5粒/次,3次/d.观察两组治疗前后QTd及校正后QT间期(QTcd)的变化.结果 与治疗前相比,两组患者治疗后QTd、QTcd均显著缩小,治疗组QTd、QTcd分别为(40.4±16.8)ms和(38.6±14.7)ms;对照组分别为(49.6±17.3)ms和(41.2±15.5)ms,与本组治疗前相比,差异有统计学意义(P＜0.01);其中,治疗组缩小幅度更明显,与对照组降幅比较差异有统计学意义(P＜0.05).结论 舒冠滴丸可有效缩小QTd和QTcd,提示QT离散度的降低可能是该药防治不稳定型心绞痛室性心律失常的作用机制.     

倍他乐克对冠心病心绞痛患者QT间期离散度的影响

目的 研究倍他乐克对冠心病劳力性心绞痛患者QT间期离散度(QT dispersion)的影响.方法 46例劳力性心绞痛患者经随机抽样分为治疗组(n=24)和对照组(n=22),治疗组给予倍他乐克50～150 mg/d,对照组不给倍他乐克治疗,两组其它的抗心肌缺血治疗相同或相似.两组患者分别在治疗前及治疗后2周做12导联同步心电图检查,测量心率,最大和最小QT间期,计算QT间期离散度(QTd)及心率校正后QT间期离散度(QTcd).比较治疗组与对照组治疗前后的QTd变化,用t检验进行统计学处理.结果 倍他乐克可以使劳力性心绞痛患者的QTd和QTcd明显缩短(76.5±9.2 vs 64.5±7.3和74.9±9.2 vs 63.7±7.3,P＜0.01),而对照组患者的QTd和QTcd无显著变化(78.3±4.2 vs 76.8±5.6和76.7±7.4 vs 74.7±6.2,P＞0.05).结论 倍他乐克在改善心肌缺血的同时可以明显的缩短QTd,从而减少室性心律失常的发生,改善预后,QTd的缩短是β-受体阻滞剂能够有效地改善冠心病预后的一个重要电生理机制.     

倍他乐克对冠心病心绞痛患者QT间期离散度的影响

目的 研究倍他乐克对冠心病劳力性心绞痛患者QT间期离散度(QT dispersion)的影响.方法 46例劳力性心绞痛患者经随机抽样分为治疗组(n=24)和对照组(n=22),治疗组给予倍他乐克50～150 mg/d,对照组不给倍他乐克治疗,两组其它的抗心肌缺血治疗相同或相似.两组患者分别在治疗前及治疗后2周做12导联同步心电图检查,测量心率,最大和最小QT间期,计算QT间期离散度(QTd)及心率校正后QT间期离散度(QTcd).比较治疗组与对照组治疗前后的QTd变化,用t检验进行统计学处理.结果 倍他乐克可以使劳力性心绞痛患者的QTd和QTcd明显缩短(76.5±9.2 vs 64.5±7.3和74.9±9.2 vs 63.7±7.3,P＜0.01),而对照组患者的QTd和QTcd无显著变化(78.3±4.2 vs 76.8±5.6和76.7±7.4 vs 74.7±6.2,P＞0.05).结论 倍他乐克在改善心肌缺血的同时可以明显的缩短QTd,从而减少室性心律失常的发生,改善预后,QTd的缩短是β-受体阻滞剂能够有效地改善冠心病预后的一个重要电生理机制.     

胺碘酮对心房纤颤患者QT离散度的影响

目的评价胺碘酮对心房纤颤患者QT离散度(QTd)的影响。方法比较治疗组66例患者治疗前后QT间期、QTc间期、QTd及校正QT离散度(QTcd),并与正常成人对照组60例作对比。结果治疗组治疗后与治疗前相比QT及QTc间期均明显延长,而QTd、QTcd反而降低(P<0.05);治疗组治疗前后与健康成人对照组相比,QTd及QTcd均明显增大(P<0.01)。结论胺碘酮可使心房纤颤患者QT及QTc间期延长,使QTd及QTcd降低。     

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.