QT Dispersion Level and Its Clinical Significance.in Dilated Cardiomyopathy

［1］Richardson CP, Mckenna RM, Bristow CM, et al.Report of the 1995 Word Health Organization/International Society and Federation of Cardiology Task Force on the definition and classification of cardiomyopathies. Circulation, 1996,93: 841 ［2］Barr CS, Naas A, Freeman M, et al. QT dispersion and sudden unexpected death in chronic heart failure. Lancet, 1994,343:327 ［3］Martin AB, Garson A, Perry JC, et al. Prolonged QT interval in hypertropic and dilated cardiomyopathy in children. Am Heart J, 1994,127(1):64 ［4］Pye M, Quinn AC, Cobble SM. QT dispersion: a non-invasive marker of susceptibility to arrhythmia in patients with sustained ventricular arrhythmias?Br Heart J, 1994,71(5):51 ［5］Berger RD, Kasper EK, Baughman KL, et al. Beat to beat QT interval variability: novel evidence for repolarization lability in ischemic and non ischemic dilated cardiomyopathy. Circulation, 1997, 96 (5):1557 ［6］Wolfram G, Ulrike S, Volker M, et al. QT dispersion and arrhythmic events in idiopathic dilated cardiomyopathy. Am J Cardiol, 1997,78: 458 ［7］Fei L, Goldman JH, Prasal K, et al. QT dispersion and RR variations on 12-lead ECGs in patients with congestive heart failure secondary to idiopathic dilated cardiomyopathy. Eur Heart J, 1996,17: 258 ［8］Pan YZ, Guo NS, Xing ZF, et al. The relation between QT dispersion and ventricular arrhythmia of dilated cardiomyopathy. Chin J Inter Medi, 1996,35(11):73 ［9］Galinier M, Vialette JC, Fourcade J, et al. QT interval dispersion as a predictor of arrhythmic events in congestive heart failure. Importance of aetiology. Eur Heart J, 1998,19(7) :1054     

双侧咽部副神经节瘤一例

患者女，22岁，因发现咽部肿块1年于2004年9月14日收住昆明医学院第一附属医院。患者于1年前无明显诱因发现咽部肿块。入院检查，患者一般情况尚可，生命 体征平稳。专科检查：双侧鼻咽部隆起从鼻咽侧壁至口咽部，双侧咽隐窝消失，咽后壁可见约鸡蛋大小样肿块，表面光滑，无溃疡及菜花样病变。     

双镜联合胆总管探查切开取石术治疗胆石症引起的急性胆源性胰腺炎68例疗效观察

[目的]探讨腹腔镜联合胆道镜胆总管探查切开取石术（laparoscopic common bile duct exploration,LCBDE）治疗胆石症引起的急性胆源性胰腺炎（acute biliary pancreatitis,ABP）的临床效果。[方法]选择我院行LCBDE的68例胆石症引起的ABP患者为实验组,同期行开腹胆总管切开取石T管引流术（open choledocholithotomy T-tube drainage,OCTD）的87例胆石症引起的ABP患者为对照组。比较两组手术时间、术后恢复情况、取石结果及并发症情况。[结果]实验组68例均成功完成LCBDE,无中转开腹;取净胆管内结石61例,T管拔除为术后4周;残余结石7例于术后6周经T管窦道胆道镜再次取残余结石。对照组87例行OCTD成功79例,失败8例6周后经胆道镜取尽石;OCTD术中取净结石者71例,T管拔除为术后6周,未取尽者于术后6周经T管窦道胆道镜再次取尽残余结石。两组在术后恢复、并发症发生方面,实验组优于对照组（P〈0.05,P〈0.01）。[结论]LCBDE一期治疗胆石症引起的ABP安全可行,创伤小,恢复快,疗效好。     

Transforming growth factor-beta 1 bifunctionally regulates murine macrophage proliferation.

Transforming growth factor-beta (TGF-beta) is a family of polypeptide growth factors with multiple functional activities. Recent studies suggest that TGF-beta is a selective inhibitor of hematopoietic cells. In this report, we study the effect of TGF-beta 1 on the proliferation of murine peritoneal exudate macrophages (PEM) in response to purified murine recombinant granulocyte-macrophage colony-stimulating factor (rMuGM-CSF) and human recombinant M-CSF (rHuM-CSF). In mice, PEM and other types of tissue macrophages display multiple types of receptors for CSFs and respond to them, either alone or in combination, to undergo extensive proliferation in vitro. Recombinant human TGF-beta 1 (rHuTGF-beta 1) (0.1 to 1.0 ng/mL) markedly enhanced the growth of PEM in response to rMuGM-CSF but inhibited their responsiveness to rHuM-CSF. Similar effects of rHuTGF-beta 1 were also detected using murine pulmonary alveolar macrophages (PAM) and bone marrow-derived macrophages (BMDM). Receptor binding assays using iodinated rMuGM-CSF and rHuM-CSF showed that rHuTGF-beta 1 treatment greatly enhanced the expression of GM-CSF receptors in PEM, in a time- and dose-dependent manner, suggesting a possible mechanism for the synergistic effect of TGF-beta 1. On the other hand, the expression of M-CSF receptors was not affected by TGF-beta 1 treatment. Analysis by mRNA PCR showed that the synergistic effect of TGF-beta 1 is not due to autocrine CSFs produced by treated cells. Our results suggest that TGF-beta 1 is an important regulator of macrophage proliferation. Depending on the types of CSFs present, TGF-beta 1 may act either as a growth promoter or inhibitor.     

规范颅颈联合CT血管成像照相格式的临床意义

目的探讨规范颅颈联合CT血管成像（CTA）后处理图像对临床的意义。方法收集30例河南省三门峡市中心医院影像科（A组）和30例河南省人民医院影像科（B组）的颅颈联合CTA后处理图像,分别对图像的次序、表述、快速准确定位等方面进行主观评价,以上各项得分的两组间比较采用t检验。结果两组图像在照片格式满意度和血管定位快速准确度方面的差异均有统计学意义（t=6.30和7.01,均P < 0.01）,说明采用A组的颅颈联合CTA照相格式较B组在快速准确定位某一血管病变方面有明显的优点。结论规范颅颈联合CTA照相格式对提高临床包括介入科医师的判读效率、减少差错率的效果明显。