抑郁对冠心病患者心率变异性的影响

目的:研究冠心病并抑郁症患者心率变异性(HRV)的变化.方法:将临床确诊为冠心病的120例患者分为抑郁组与非抑郁组以及急件冠脉综合征(ACS)组与非ACS(Non-ACS)组,了解抑郁与非抑郁冠心病患者的HRV变化,比较不同冠心病分型中HRV改变,以及抑郁与HRV的相关性.结果:冠心病并抑郁患者中抑郁组时域指标SDNN、SDANN、SDNNDX、RMSSD及PNN50均显著低于非抑郁组(P<0.01或0.05);抑郁组频域指标VLF及LF显著高于非抑郁组(P<0.01),而HF显著低于非抑郁组(P<0.05).ACS组时域指标SDNN、SDANN、SDNNDX、RMSSD及PNNS0均显著低于Non-ACS组(P<0.05);ACS组频域指标VLF、LF显著高于Non-ACS组(P<0.05).抑郁严重度指数与心率变异性各指标相关.结论:冠心病合并抑郁患者心率变异性发生改变且抑郁与心率变异性相关.     

参松养心胶囊对抑郁症患者心率变异性的影响

目的观察抑郁患者心率变异性的特点及参松养心胶囊对抑郁患者心率变异性的影响。方法选取武汉大学人民医院精神卫生中心就诊的焦虑抑郁患者,分别为抑郁症对照组(抑郁组)和参松养心胶囊治疗组(参松组),同时选择无心、肺、脑、肝、肾等疾病者作为正常对照组(正常组)。以时域、频域指标全程正常窦性R-R间期的标准差(SDNN)、全程5min平均R-R间期的标准差(SDANN)、全程内差值超过50ms的连续正常R-R间期所占的百分率(PNN50)、全程相邻RR间期之差的均方根值(RMSSD)、高频(HF)、低频(LF)、高频和低频的比率(LF/HF)作为心率变异性的评价标准评价抑郁症患者的心率变异性。结果抑郁组患者的心率变异性时域、频域指标SDNN、SDANN、PNN50、RMSSD、HF、LF、LF/HF明显低于正常组(P0.05),参松组时域、频域指标较抑郁组有所提高(P0.05),差异有高度统计学意义。结论参松养心胶囊可提高抑郁患者心率变异性,对临床治疗有指导性意义。     

焦虑障碍患者自主神经功能特点及抗焦虑治疗对心电图变异的影响

目的 探讨焦虑障碍患者自主神经功能特点及抗焦虑治疗对心电图变异的影响.方法 选取本院2018年2月至2019年11月收治的焦虑障碍患者80例作为焦虑组,并选取本院同期收治的80例无焦虑障碍患者作为对照组.两组均接受24 h动态心电图监测,观察分析两组心率变异情况.焦虑障碍患者采用舍曲林治疗,比较两组及焦虑组治疗前后心率(HR)、心率变异系数(HRV1)、NN间期平均值标准差(SDANN)、相邻正常R-R间期差值>50 ms的百分比(PNN50)、相邻NN间期差值均方根(rMSSD)及N间期标准差(SDNN)情况.结果 治疗后,焦虑组HR明显高于对照组,HRV1、SDANN、PNN50、rMSSD、SDNN均明显低于对照组,差异有统计学意义(P<0.05);与治疗前比较,焦虑组治疗后HR明显降低,HRV1、SDANN、PNN50、rMSSD、SDNN均明显升高,差异有统计学意义(P<0.05).结论 焦虑障碍患者存在明显的自主神经功能降低,给予抗焦虑治疗能显著改善焦虑障碍患者自主神经功能.     

福辛普利对原发性高血压患者HRV的影响

目的探讨福辛普利对改善原发性高血压患者心率变异性的作用。方法将我院2010年8月-2012年10收治的211例原发性高血压患者作为观察组,另选同期150例健康体检者作为对照组,观察组采取福辛普利治疗,比较观察组患者治疗前后的心率变异性情况。结果治疗后观察组SDNN、SDANN、PNN50、rMSSD、HF较治疗前均有明显上升（P〈0.05）,LF、LF/HF较治疗前均明显下降（P〈0.05）,且治疗后患者PNN50、rMSSD、LF、HF、LF/HF与正常人无明显差异（P〉0.05）。结论福辛普利治疗原发性高血压患者疗效显著,对改善患者心率变异性具有一定作用,值得临床推广应用。     

260例急性心肌梗死的心率变异性分析

目的:观察260例急性心肌梗死的心率变异性。方法:选择进行AMI治疗的患者260例作为观察组,选择同期、同年龄段行健康体检者100例作为对照组,所有人员均进行24 h心电监测,进行心率变异性分析。结果:观察组患者SDNN、SDANN、r MSSD、PNN50、TP、LF、HF均明显低于对照组,LF/HF明显高于对照组;260例AMI患者根据梗死面积分为广泛梗死组87例和局限梗死组173例,经过心率变异性分析发现广泛梗死组患者在极早期和稳定期SDNN、SDANN、PNN50、r MSSD、LF、HF均明显低于局限梗死组。结论:心率变异性对于心肌梗死的诊断和梗死面积的判定具有重要的临床诊断价值。     

抗焦虑抑郁对室性心律失常患者的治疗意义

目的:分析抗焦虑抑郁对室性心律失常患者的临床疗效及意义。方法:选择室性心律失常合并焦虑抑郁状态的患者132例随机分为治疗组65例和对照组67例,对照组行常规治疗,治疗组在常规治疗基础上加服抗抑郁焦虑药物治疗,6周后观察治疗前后两组汉密尔顿焦虑抑郁量表评分、早搏数量以及心率变异性变化。结果:治疗组控制率、控制+显效率高于对照组,无效率低于对照组;比较治疗前后,治疗组心率变异性时域指标PNN50(相邻NN间期差值超过50ms的心搏数所占百分比)、RMSSD(相邻NN间期差值的均方根),以及频域指标LF/HF(低频功率与高频功率的比值)高于治疗前、同期对照组;治疗组HAMD、HAMA水平低于治疗前、同期对照组,差异具有统计学意义(<0.05)。结论:对室性心律失常患者伴发的焦虑抑郁症状进行抗抑郁抗焦虑治疗,有助于增进抗心律失常药物疗效,提高心率变异性,改善自主神经功能紊乱,减轻抑郁与焦虑症状,提高其生活质量。     

2型糖尿病合并原发性高血压患者的心率变异性特点

目的：探讨心率变异性（HRV）对早期发现2型糖尿病合并原发性高血压心脏植物神经病变的意义。方法：应用24h动态心电图（Holter）监测84例2型糖尿病患者和84例2型糖尿病合并原发性高血压患者,并与84名正常人对照,比较三组SDNN、SDANN、RMSSD、PNN50、HRVI、TP、LF、HF和LF/HF。结果：T2DM组和EH＋T2DM组的SDNN、SDANN、RMSSD、PNN50、HRVI、TP、LF和LF/HF均明显低于对照组（P＜0.05）。EH＋T2DM组较T2DM组也有明显变化。结论：T2DM＋EH组与T2DM组相比自主神经功能受损害程度更加明显,发生心源性猝死的危险性增加,应定期检查,密切随访。     

300例高龄冠心病患者心率变异性分析

目的探讨高龄(≥70岁)冠心病患者心率变异性(HRV)的变化。方法对高龄冠心病组(300例)与正常对照组(198例)的电信号进行研究,观察比较时域指标:连续24 h内正常RR间期的标准差(SDNN)、全程记录中每5分钟正常RR间期平均值的标准差(SDANN)、相邻正常RR间期差值的均方根(RMSSD)、相邻RR间期差值>50 ms百分比(PNN50);频域指标:总功率(TP)、低频功率(LF)、高频功率(HF)。结果冠心病组HRV的SDNN、SDANN、RMSSD、PNN50、HF显著低于正常对照组(P<0.01),TP、LF比较差异无统计学意义(P>0.05)。结论高龄冠心病患者存在自主神经功能紊乱,迷走神经活性降低,交感神经活动相对增强。     

病毒性心肌炎患儿室性早搏负荷量与心率变异性的关系

目的探讨病毒性心肌炎患儿室性早搏负荷量与心率变异性(HRV)的关系。方法选取2017年3月至2018年10月郑州大学第一附属医院收治的140例病毒性心肌炎合并室性早搏患儿,纳入观察组。选取同期于该院体检的46名健康儿童纳入对照组。根据室性早搏负荷量将观察组患儿分为低负荷组(77例)、中负荷组(40例)与高负荷组(23例)。比较观察组和对照组HRV相关指标,包括全部正常窦性RR间期标准差(SDNN)、每5 min的正常窦性RR间期的标准差(SDANN)、全部相邻RR间期差值的均方根(RMSSD)、相邻RR间期差值大于50 ms的百分数(PNN50)、低频功率(LF)、高频功率(HF)和LF/HF。比较不同负荷组HRV相关指标的差异。分析病毒性心肌炎患儿室性早搏负荷量与HRV的相关性。结果观察组患儿SDNN、SDANN、RMSSD、PNN50、HF、LF、LF/HF值均低于对照组,差异有统计学意义(均P<0.05)。中负荷组SDNN、SDANN、PNN50、LF值均低于低负荷组,差异有统计学意义(均P<0.05)。高负荷组SDNN、SDANN、RMSSD、PNN50、HF、LF、LF/HF值均低于低负荷组,差异有统计学意义(均P<0.05)。高负荷组SDANN、PNN50值均低于中负荷组,差异有统计学意义(均P<0.05)。病毒性心肌炎患儿室性早搏负荷量与SDNN、SDANN、RMSSD、PNN50、HF、LF、LF/HF均呈负相关(均P<0.05)。结论病毒性心肌炎合并室性早搏患儿的自主神经系统调节受损,自主神经系统调节受损程度随室性早搏负荷量的增加而加重。     

原发性高血压脉压与心率变异性相关性探讨

目的：探讨原发性高血压患者脉压与心率变异性改变的关系。方法：对高血压宽脉压组75例,高血压正常脉压组63例和正常血压脉压组（对照组）40例的心率变异性时域和频域参数进行分析。结果：①高血压宽脉压组与正常脉压组、对照组比较,SDNN、SDANN、SDNNI、rMSSD、PNN50降低,LF、HF也降低,LF／HF增大,均有显著性差异（P〈0．05）。②高血压正常脉压组与对照组比较。SDNN、SDANN、SDNNf、rMSSD、PNN50均降低,有显著性差异（P〈0．05）。结论：高血压患者自主神经功能均有不同程度的损害,高血压宽脉压组与高血压正常脉压患者自主神经功能均有损害,但高血压宽脉压组损害更明显。表明高血压患者脉压宽窄与心脏自主神经功能的调节有关。     

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.     

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.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.