氨茶碱治疗心动过缓2例

氨茶碱是甲基黄嘌呤类药物，溶于水，碱性，具有较强的松驰气管平滑肌的作用及抗炎作用，还具有促进气管纤毛运动，改善呼吸功能作用。极易吸收．生物利用度近100％，但部分药物及疾病影响其药物的血液浓度。临床应用于支气管哮喘、喘息型支气管炎、急性心功能不全、心源性哮喘和水肿、胆绞痛、肾性水肿、冠状动脉功能不全。[第一段]     

Effects of Astragalus Membranaceus on oxygen consumption of intestine

ＥｆｅｃｔｓｏｆＡｓｔｒａｇａｌｕｓＭｅｍｂｒａｎａｃｅｕｓｏｎｏｘｙｇｅｎｃｏｎｓｕｍｐｔｉｏｎｏｆｉｎｔｅｓｔｉｎｅＬＩＳｈａｏＺｈｉ１ａｎｄＴＡＮＸｉａｏＨｏｎｇ２ＳｕｂｊｅｃｔｓｈｅａｄｉｎｇｓＡｓｔｒａｇａｌｕｓＭｅｍｂｒａｎａｃｅｕ...     

Intraspinal Adenosine Induces Spinal Cord Norepinephrine Release in Spinal Nerve-ligated Rats but not in Normal or Sham Controls

Background: Intrathecal adenosine is antinociceptive under conditions of central sensitization, but not in response to acute stimuli in normals. The reasons for this selective circumstance of action remain unclear, but some evidence links adenosine's antinociceptive effects to release of norepinephrine by terminals in the spinal cord. The purpose of this study was to test whether spinal adenosine induces norepinephrine release selectively in settings of hypersensitivity.

Methods: Rats randomly assigned to spinal nerve ligation, sham operation, or no operation were anesthetized. A microdialysis fiber was implanted in the spinal cord dorsal horn at the L5-L6 level and perfused with artificial cerebrospinal fluid. After washout and a baseline sample period, adenosine at various concentrations was infused through the fiber for 150 min, and samples were collected every 15 min.

Results: In ligated, but not in sham or normal animals, adenosine perfusion increased norepinephrine in spinal cord microdialysates in a concentration-dependent manner. The effects of adenosine plateaued after 75 min and remained stable until the end of the experiment. Intravenous injection of selective adenosine A1 and A2 receptor antagonists revealed that adenosine's effect on spinal norepinephrine release was A1 receptor mediated.     

心力衰竭的发病机理与药物治疗进展

心力衰竭是指在有适量静脉血回流的情况下，由于心肌舒张或，和收缩功能障碍，心排血量不足以维持组织代谢需要的一种临床综合征。临床上以心排血量降低、组织液灌流减少以及肺循环和，或体循环静脉淤血为特征，故又称充血性心力衰竭（CHF）或心功能不全。随着人口老龄化以及心肌梗死存活率的提高，心力衰竭已成为发病率增长最快的心血管疾患，全世界每年新增病例数近100万，而且整体预后不佳。在过去的五年中，心衰恶化住院率增加了3倍，首次住院后五年内死亡率上升为75％。然而其治疗前景尚好。在一些国家（英国、美国、瑞典），心衰的死亡率正逐渐下降，这主要归功于最近五年心衰治疗和心脏猝死（SCD）预防方面的进展，例如药物治疗和植入性装置。下面就心衰的发病机理与药物治疗进展简要综述。     

酒泉市孕龄妇女孕期及孕早期增补斯利安对预防出生缺陷知晓情况与投服情况的调查分析

目的了解酒泉市孕龄妇女孕期及孕早期增补斯利安对预防出生缺陷知晓情况以及投服情况。方法对酒泉市7个县、市自2002年10月至2005年10月间孕期及孕早期增补斯利安的孕龄妇女21790人进行追踪随访调查。结果21790名孕期及孕早期孕龄妇女知晓服用斯利安的人数为21417人，占98．3％；不知晓的人数为373人，占1．7％。21790孕龄妇女中孕期及孕早期增补斯利安的人数为14264人，占65％；未增补人数为7526人，占35％。21790名新生儿中出现出生缺陷的为111人，其中未增补斯利安的出生缺陷人数为103人，发生率为1．37％，增补斯利安后出现出生缺陷的人数为8人，发生率为0．06％。结论孕龄妇女孕期及孕早期增补斯利安预防出生缺陷这项“工程”已经在酒泉市得到广泛宣传和普及，孕期及孕早期增补斯利安对预防出生缺陷有重要的意义。     

沂蒙人民的健康卫士——记临沂市人民医院心内科主任侯子山

2005年12月22日是冬至，数九天的寒冷对于欢呼雀跃的人们没有多少影响，济南南郊宾馆俱乐部多功能厅里掌声阵阵。[第一段]     

Endovascular Stents in Arterial Injury after Radiotherapy

We evaluated preliminary success and patency of stenting for the treatment of radiation-induced arterial diseases. Thirteen stents were placed in 8 patients to treat occlusion (n=3), aneurysm (n=1), residual stenosis (n=2),multiple stenoses (n=1), and delayed restenosis after previous balloon angioplasty (n=1). Interventional procedure was successfully performed in 8 patients for their arterial lesions after radiotherapy. Six patients underwent interventional procedure once or twice. Two patients underwent PTA 4 times. Five of these patients demonstrated primary patency with relief of clinical symptoms with a mean follow-up of 2 years (range: 8-60 months). Clinical improvement was noted in the other patients. Our results suggest that stent placement by single or multiple techniques may have immediate effect on arterial lesions caused by radiation and can be considered as a therapeutic option of choice in these cases.     

神功卢保良(续)

车主是个留着小胡子的青年，姓李，是个浪荡公子，这一带做生意的人，几乎没有不识他的。成天拉帮结伙、这家吃，那家拿，专门敲诈个体户，是个有名的“小霸王”，谁也惹不起。这不，他小子把人家货摊碰倒，不但不说句赔礼道歉的话，还两手腰里一叉，吹胡子、瞪眼睛，硬说是老汉的货摊，把他摩托车碰掉了“皮”，看在大过年的份上，得赔他50元。良心何在，公理何在，天底下哪有这等无赖之举！老人被气得浑身发抖，望着眼前这伙光天化日之下，强取豪夺惯了的“害人虫”，气不打一处来。早把“畏惧”二字抛得于干净净，如同一头天不怕、地不怕…     

Role of Endogenous Histamine in Altered Lung Mechanics in Rabbits

Background: Unlike the effects of exogenous histamine, those of endogenous histamine on the lung mechanics have not yet been characterized. The site of endogenous histamine liberation by mivacurium was determined, as were the effects of this histamine on the airway and parenchymal mechanics in control rabbits (group C) and rabbits pretreated with H1 and H2 receptor blockers (group AH). The effectiveness of the receptor blockade was ensured by challenges with exogenous histamine.

Methods: Pulmonary input impedance at low frequencies (ZL) was measured in anesthetized mechanically ventilated open-chest rabbits under control conditions and every minute after administration of an intravenous bolus of mivacurium (2 mg/kg) and exogenous histamine (10 [mu]g/kg). Histamine levels were determined in serum samples taken from the carotid artery and jugular vein before and 1, 3, and 6 min after mivacurium injection. Parameters of airway resistance (Raw) and inertance and parenchymal damping (G) and elastance (H) were extracted from ZL spectra.

Results: Mivacurium induced significant increases in plasma histamine levels, with the venous concentrations being significantly higher than those in the artery. The mivacurium-induced increase in Raw (28.7 +/- 2.3%; mean +/- SD) in group C was significantly higher than that in group AH (6.6 +/- 3.4%), whereas the responses in G were not inhibited significantly (23.9 +/- 6.9%vs. 15.5 +/- 3.0%). The significant increases in Raw (70.6 +/- 12.6%) and G (21.0 +/- 4.9%) after exogenous histamine administration were virtually completely abolished by antihistamine pretreatment (3.6 +/- 3.7% and 0.3 +/- 2.6%).     

Ⅲ度房室传导阻滞孕妇在临时起搏下分娩一例

<正> 患者女,28岁,因怀孕38~+周伴心肌炎后遗症,Ⅲ度房室传导阻滞(AVB)入院。平素常有胸闷、心悸、头昏、乏力。查体:T37℃,Bp20/12kPa,心界稍扩大,心尖搏动在左第五肋间锁骨中线上,心率40bpm,律尚齐,心音低钝。胎儿监护仪示:胎儿宫内窘迫.临床诊断:(1)孕38~+周;(2)胎儿宫内窘迫;(3)心肌炎后遗症,Ⅲ度AVB。因胎儿处于严重缺氧状态,胎盘已老化,及患者胸闷、头昏、乏力等症状加剧,而于1992年6月5日上午在500mA的普通