冠心病心律失常的动态心电图与常规心电图诊断效果的应用对比分析

目的分析动态心电图与常规心电图对冠心病心律失常的诊断效果。方法选取2017年4月-2019年3月在我院接受心电图检查的患者为研究对象,均进行常规心电图与动态心电图检查,比较两种心电图对心肌缺血(阳性)检出率以及心律失常检出结果。结果动态心电图阳性检出率为72.2%,明显高于常规心电图阳性检出率的54.2%(P<0.05)。在心律失常检出结果中,动态心电图对室性早搏单发、室性早搏二三联律、成对性室性早搏、短阵室性心动过速、房性早搏单发、房性早搏二三联律、成对性房性早搏、短阵室上性心动过速、交界性早搏单发、交界性早搏二三联律、成对性交界性早搏的检出率明显高于常规心电图(P<0.05),而两种心电图对房室传导阻滞的检出率无明显差别(P>0.05)。结论动态心电图对冠心病及心律失常检出率高,具有推广应用价值。     

动态心电图在诊断心律失常中的临床意义

目的 分析在诊断心律失常中应用动态心电图的临床意义.方法 随机选择2019年12月-2020年2月期间本院收治的45例心律失常患者当做研究对象,并对所有研究对象进行动态心电图检查,同时行常规心电图检查当做对比,比较两种检查的效果.结果 动态心电图检查的房性早搏二三联律、室性早搏二三联律、房性早搏成对、室性早搏成对、短阵室速及窦性停搏检出率均显著高于常规心电图(P<0.05),但动态心电图与常规心电图检查的房性早搏、室性早搏及房颤检出率均无显著差异(P>0.05).结论 动态心电图检查在诊断心律失常时具有更高的诊断准确率.     

动态心电图与常规静态心电图诊断冠心病及心律失常的比较

目的探究冠心病心律失常患者应用常规静态心电图与动态心电图诊断的的临床效果与特点。方法从我院2013年11月至2015年6月接收并治疗的冠心病心律失常患者中随机性抽取124例,并将抽取的研究对象分别采用常规静态心电图与动态心电图诊断检查,对比并分析两组冠心病心律失常患者应用不同方法诊断的效果与特点,包括监测的阳性率等指标。结果抽取的124例冠心病心律失常患者分别通过常规静态心电图诊断与动态心电图诊断后,结果显示,动态心电图诊断检测的阳性人数占89例,阴性人数占35例,检测的阳性率占71.77%;应用静态心电图检测阳性人数占65例,阴性人数占59例,阳性率占52.42%,两组数据的差异性较大(P0.05),具有统计学研究价值。且动态心电图诊断检查的心律失常(如:房性早搏二/三联律、房性早搏成对、短阵性房性心动过速,室性早搏二/三联律、室性早搏成对、短阵室性心动速,应该要增加房颤、束支传导阻滞,房室传导阻滞等)的检出率与常规静态心电图检测的检出率差异性较大(P0.05),具有统计学研究价值。而动态心电图与静态心电图诊断对单纯性房性早搏、生理性房室传导阻滞与单纯性室性早搏检出率无明显差异(P0.05),无统计学研究价值。结论针对冠心病心律失常患者应用动态心电图进行诊断可以起到较好的效果,尤其是针对冠心病引起的房性早搏二/三联律、房性早搏成对、短阵性房性心动过速,室性早搏二/三联律、室性早搏成对、短阵性室性心动过速的检出率明显高于传统静态心电图的诊断效果,值得在冠心病心律失常患者的诊断中应用和推广。     

常规心电图与动态心电图在冠心病心律失常临床诊断中的应用效果观察

目的观察常规心电图与动态心电图在冠心病心律失常临床诊断中的应用效果分析。方法回顾性分析(2017年9月-2019年9月)于我院就诊的75例冠心病心律失常患者的临床资料,分析常规心电图与动态心电图对心电图异常的检出率,及对疾病的诊断准确率。结果24 h动态心电图检测中,室性早搏二、三联律,房性早搏二、三联律,室性早搏成对,房性早搏成对,短阵室上速发生率均高于常规心电图检查(P<0.05)。24 h动态心电图的传导阻滞、早搏早发检出率明显高于常规心电图检查(P<0.05)。24 h动态心电图冠心病心率失常诊断检出率为90.67%,明显高于对照组的76.00%(P<0.05)。结论在冠心病心律失常患者的相关诊断中,采取心电图与动态心电图均可检出心电图的异常,其中动态心电图,可获得更高的诊断准确率。     

动态心电图与常规心电图诊断冠心病心律失常的临床分析

目的探讨冠心病心律失常诊断中动态和常规心电图中的应用比较。方法选取我院2012年7月至2014年9月间收治的冠心病心律失常患者86例,所有患者均行常规心电图和动态心电图检查,比较两种方法阳性检出率及诊断结果。结果动态和常规心电图对冠心病心律失常的阳性检出率分别为58.14%和51.16%,差异无统计学意义（P〉0.05）;动态心电图短阵室上速,房性早搏二、三联律和室性早搏二、三联律,以及室性早搏成对和房性早搏成对等的检出率明显高于常规心电图（P〈0.05）;患者心率6：00~12：00较高,0：00~6：00较低。结论动态心电图诊断冠心病患者心律失常可获得的检出率,且能够一定程度上评估患者的心律失常严重程度,具有一定的临床应用价值。     

12导联动态心电图诊断冠心病心律失常的价值分析

目的探讨12导联动态心电图诊断冠心病心律失常的价值。方法选取2013年4月至2014年12月在我院就诊的冠心病患者92例为研究对象,分别采用常规心电图和12导联动态心电图检测患者的心律失常情况,比较两种检测方法心律失常的检出率,房性早搏、心房颤动、室性早搏、短阵性房性早搏、房室传导阻滞的检出率。结果常规心电图检查心律失常检出率为36.95%;12导联动态心电图检查心律失常检出率为65.22%;两种检查方法的心律失常检查率比较差异有统计学意义(P0.01)。常规心电图检查检出1种心律失常的检出率显著高于12导联动态心电图检查,12导联动态心电检查检出2、3种心律失常的检出率显著高于常规心电图检查,差异有统计学意义(P0.05)。12导联动态心电图检查房性早搏、室性早搏、短阵性房性早搏、房室传导阻滞的检出率显著高于常规心电图检查,差异有统计学意义(P0.01)。结论采用12导联动态心电图诊断冠心病心律失常的效果明显优于常规心电图检查。     

动态心电图临床应用体会

我院1983—1992年对1500例患者进行了24小时动态心电图的记录分析,体会如下: 一、动态心电图的临床应用:1,动态心电图对心律失常的分析,本组对1500例病人进行Holter检查中发现几乎都有不同程度的心律失常,其检出率优于心电图和运动试验,其中1000例冠心病患者中发现凡在动态心电图上有频发室性早搏短阵室性心动过速或多源性室性早搏者,其心律失常的猝死率明显增高。2.对冠心病无痛性心肌缺血病人的监测可以反映在     

动态心电图与常规心电图对冠心病患者心律失常的诊断价值比较

目的：探讨常规心电图与动态心电图在诊断冠心病心律失常疾病方面的应用价值。方法选取我院心内科收治的冠心病患者60例,均符合冠心病诊断标准,先用常规心电图对所有患者进行检查;然后采用动态心电图系统再次进行检查,24 h监测患者的心率变化。采用计算机分析比较两种诊断方法的检查结果。结果常规心电图检测心律失常阳性34例（56．67％）,低于动态心电图的检出率71．67％（43／60）,差异有统计学意义（P＜0．05）。动态心电图对房性早搏二、三联律,室性早搏二、三联律,房性早搏成对,室性早搏成对和短阵室上速的检出率高于常规心电图,差异有统计学意义（P＜0．05）。结论与常规心电图相比,动态心电图具有明显优势,它可检测出患者任一时间点的冠脉缺血情况、心律失常发作时间和频率,能够更准确、更精细地监测患者心电信号,值得在临床中广泛应用。     

妊娠期动态心电图心律失常临床分析

目的探讨妊娠期动态心电图心律失常临床分析。方法选择2017年4月-2018年4月收治的150例妊娠期患者纳入研究,作为本次研究工作对象,按照妊娠期情况进行分组,分为孕早期组(怀孕<12周,50例)、孕中期组(怀孕12-28周,50例)、孕晚期组(怀孕>28周,50例)。三组均接受常规心电图检查与动态心电图检查,并作比较分析。结果动态心电图检查方法的房性早搏发生率、室性早搏发生率、窦性心动过速发生率均明显高于常规心电图检查方法(P<0.05);孕早期组患者的房性早搏发生率、室性早搏发生率、窦性心动过速发生率均明显低于孕中期组、孕晚期组(P<0.05);孕中期组患者的房性早搏发生率、室性早搏发生率、窦性心动过速发生率均明显低于孕晚期组(P<0.05);三组的阵发性短暂房速发生率、阵发性短暂室速发生率无明显差异(P>0.05)。结论妊娠期间给予孕妇实施动态心电图检查,可以有助于早期发现其心律失常等心脏功能异常,从而给予临床诊断治疗提供有效参考辅助依据。     

12导联动态心电图对心律失常的诊断价值

目的探讨12导联动态心电图(DCG)对心律失常的诊断价值。方法将本院近两年来1206例DCG进行回顾性分析。结果房性早搏总检出率男性59.52%、女性65.68%。其中偶发房性早搏检出率最高,男性55.97%、女性61.7%,室上速检出率男性17.61%、女性23.31%。心房颤动检出率男性3.13%、女性1.79%,室性早搏总检出率男性38.62%、女性42.22%,其中偶发室性早搏检出率较高,男性31.10%、女性35.85%,短阵室性心动过速检出率男性2.13%、女性2.39%,三度房室阻滞检出率男性0.85%、女性0.38%,窦性停搏检出率男性1.70%、女性0.79%。结论 12导联DCG对心律失常性质的判定能进行定性、定量分析,尤其捕捉一过性心律失常有独到之处。对评价一些可能由于心律失常引起的心悸、头昏、昏厥、猝死,以及观察心律失常和日常活动之间关系,都具有很高的价值,并可针对抗心律失常药物疗效和安全性作出评价。     

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.     

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.     

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.     

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.