晕动病的心电图改变

晕动病称为“海洋病”或晕船,海上航行时,由于船体颠簸及振动、噪音、高温等各种因素的综合刺激,能诱发晕船。患者出现恶心、呕吐、冷汗等晕动病症状。本研究用动态心电图（DCG）对海训官兵航海时进行心电监测,观察晕船发生时心电图的变化,心律失常的发生情况,探讨其发生的机制及临床意义。     

老年冠心病患者心率变异性的临床意义

目的分析49例老年冠心病患者的动态心电图,探讨心率变异性（HRV）的临床意义.方法对49例老年冠心病患者进行动态心电图检查,检测其心律失常、心肌缺血的发生率和心率变异性,并与30例非冠心病老年人对比.结果冠心病组室性心律失常和心肌缺血的发生率显著高于非冠心病组,冠心病组心率变异性指标SDNN低于非冠心病组,冠心病组中有恶性室性心律失常的患者SDNN较低.结论老年冠心病患者心脏自主神经功能紊乱,并可能因此诱发恶性室性心律失常.     

海军水面舰艇编队环球航行中晕船者24小时动态心电图分析

目的: 观察海军水面舰艇编队环球航行对晕船者动态心电图变化的影响。方法: 对参加环球航行第1～5天、第65～70天及第125～130天的晕船人员行动态心电图检查，进行心率、心律改变及心率变异性的时域、频域和非线性分析，与非晕船人员进行对照。结果: 与非晕船人员比较，晕船人员心率加快；早搏增多； 心率变异性指标SDNN、SDANN、SDNNindex、RMSSD、NN50、PNN50、三角指数、VLF、HLF、VAI及 VLI明显降低；晕船程度越重，动态心电图变化越明显。结论: 海军水面舰艇编队环球航行中晕船对心脏的影响主要是自主神经系统平衡协调受到破坏。     

扩张型心肌病病人动态心电图特征分析

目的观察扩张型心肌病24 h 12导联动态心电图改变。方法选择60例经心脏超声检查诊断为扩张型心肌病病人,并行24 h 12导联动态心电图监测。结果所有病例动态心电图均有异常改变,其中以室性早搏为最常见(100.0%),其次是房性早搏(66.7%)及ST-T改变(50.0%),其心率变异性值随着心功能的降低而明显降低。结论扩张型心肌病的心律失常发生率高且多样,复合心律失常的病人需进行心脏超声心动图检查排除扩张型心肌病。扩张型心肌病合并心力衰竭病人心率变异性的变化,可能反映病人病情严重程度。     

美托洛尔对阵发性心房颤动患者的心率变异性影响研究

目的观察美托洛尔对老年特发性阵发性心房颤动（IPAF）患者心率变异性的影响。方法选取我院未服用抗心律失常药物的老年IPAF患者50例,给予酒石酸美托洛尔治疗2周,治疗前、后分别进行24h动态心电图检测和HRV分析。结果治疗后老年IPAF患者的心率变异性明显升高。结论美托洛尔可以提高老年IPAF患者的心率变异性。     

肺癌患者放化疗及手术后心律失常监测

目的 研究肺癌患者放化疗或手术后心律失常及心率变异性的变化,为临床提供参考依据.方法 选择我院150例肺癌放化疗或手术后的患者进行常规心电图和24 h动态心电图监测,捕捉心脏损伤的早期心电图改变及心率变异性的变化.结果 其中125例肺癌患者放化疗或手术后出现心律失常（83.33％）;心率变异性正常者45例（30％）,降低者105例（70％）.但是无论肺癌患者是进行放疗、化疗还是手术治疗,都可引起心律失常的发生,且不同治疗方法下的发生率比较,差异无统计学意义（P＞0.05）.结论 早期发现心脏放化疗或术后损伤的心电图改变,有利于后续治疗方案的及时调整,及时实施干预,可预防肺癌患者放化疗或手术后引起的心脏并发症,以改善患者生活质量.     

胃镜检查术患者的动态心电图、心率变异性变化

对119例行纤维胃镜检查术患者（观察组）进行动态心电图、心率变异性（HRV）检查，并与对照组进行比较。结果显示，观察组诱发HRV降低、心律失常、心肌缺血患者多于对照组（P〈0．01）。提示对行胃镜检查术者应引起高度重视，对年龄大、有心脏疾病的患者提倡术中监测动态心电图及HRV。     

50例老年2型糖尿病患者心率变异性与心律失常关系的探讨

目的:探讨老年2型糖尿病心律变异与心律失常的关系。方法:观察组50例老年2型糖尿病患者,对照组40例进行全程24h动态心电图检查,进行心率变异性(HRV)时域指标(SDNN、SDANN、PNN50三角指数)分析。结果:老年2型糖尿病病人心率变异时域指标SDNN、SDANN、PNN50及三角指数低于正常人(P<0.01),同时心律失常的发生率却明显高于正常人(P<0.01)。结论:老年2型糖尿病病人心率变异性越低,心律失常的发生率就越高。     

小儿动态心电图不同时段参数与心率变异性的相关性分析

目的观察小儿动态心电图不同时段参数与心率变异性的相关性分析。方法选取本院收治的700例患儿,分析不同时段患儿动态心电图的参数对比。结果不同时间段参数在SDNN、rMSSD以及PNN50水平均有明显差异(P<0.05);当监测的时间增长之后,患儿在SDNN、rMSSD以及PNN50水平则会随着时间而下降,通过秩相关分析表明,小儿动态心电图不同时段参数与心率变异性主要表现为负相关关系。结论小儿动态心电图监测中不同时间段参数的心率变异性相关指标均有所不同,在监测开始4h以内心率变异性最为明显,可作为临床心血管疾病的重要诊断依据。     

不同部位急性心肌梗死患者的心律失常及心率变异性分析

目的研究不同部位急性心肌梗死(AMI)患者的心律失常表现特征及其心率变异性。方法纳入2015年1月至2016年6月就诊于兰卅大学第一医院的AMI患者,根据心电图结果分为非ST段抬高型心肌梗死(NSTEMI)组、下壁组及前壁组。分析各组住院期间动态心电图(DEC)资料,对比心律失常发生情况及心率变异性指标。结果共纳入239例AMI患者。在NSTEMI组、下壁组及前壁组间,频发室性早搏、Lown≥3级室性早搏及房性心律失常的发生率差异无统计学意义(P0.05),但NSTEMI组和下壁组的缓慢性心律失常发生率高于前壁组,差异有统计学意义(P0.05)。前壁组全部窦性心搏RR间期的标准差(SDNN)、RR间期平均值的标准差(SDANN)、RR间期标准差的平均值(ASDNN)均显著低于NSTEMI组和下壁组,差异有统计学意义(P0.05)。结论与前壁心肌梗死相比,NSTEMI和下壁心肌梗死缓慢性心律失常发生率较高,但心率变异性损害程度较轻。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.