高血压病左室肥厚与QTc离散度关系的研究

目的 探讨高血压病病左室肥厚（ＬＶＨ）与非在室肥厚（ＮＬＶＨ）患者ＱＴｃｄ的关系及临床意义。方法 用分层抽样法测定１０３例原发性高血压病患者住院首次１２导联心电图ＱＴｃ离散度（ＱＴｃｄ）其中合并ＬＶＨ患者５７例，合并ＮＬＶＨ患者４６例，并与２０例健康人作对照，结果 ＱＴｃｄＬＶＨ组分别与ＮＬＶＨ组，对照组比较均有非常显著性差异（Ｐ〈０．０１）ＮＬＶＨ组与对照组比较无显著性差异（Ｐ〉０．０５）。结论     

50岁以上正常人左室舒张期彩色多普勒血流频谱参数变化的研究

目的探讨５０岁以上正常人左室舒张期脉冲多普勒频谱的参数变化情况。方法选择一年半时间内受检的所有５０岁以上正常人４７５例，按每１０岁为一组分４组进行分析。受检者取左侧卧位，常规显示心尖四腔心切面，取样容积置于二尖瓣尖，使声束与二尖瓣血流方向夹角＜１５°，以连续三个心动周期的平均值分别测量Ｅ峰、Ａ峰、Ｅ／Ａ及Ｅ峰减速时间并统计。结果发现Ｅ峰高于正常值低限的例数、平均Ｅ峰血流速度以及Ｅ／Ａ均随着年龄的增加而下降，Ｅ峰减速时间则随着增龄而增加。结论左室舒张期血流频谱的所有参数与年龄有显著的相关性，明显随着增龄而变化，并且有其规律性。     

动脉数字减影血管造影的临床应用

本文报告８０例动脉数字减影血管造影（ＩＡＤＳＡ）的初步经验，特别着重影像质量的评价。在本组病例，ＩＡＤＳＡ主要用于头颅、颈部、肺、腹部以及先天性心脏病的诊断。本组未发生重大并发症。ＩＡＤＳＡ的优点是：（１）影像质量好；（２）用于ＩＡＤＳＡ的剂量和浓度以及导管的直径均较用于常规血管造影的小得多，因此其副作用和并发症显著减少；（３）检查时间显著缩短，因此，ＩＡＤＳＡ对介入放射学治疗特别有用；（４）ＩＡＤＳＡ现已大部取代常规血管造影来诊断多种疾病。     

主动脉内球囊反搏在小儿中的应用

主动脉内球囊反搏(intraaortic balloon pump，IABP)已广泛应用于成年人心源性休克和围手术期低心排血量综合征的治疗，并取得良好的治疗效果，但在小儿中的应用仍较局限。现就有关IABP在小儿中的应用进行综述，着重分析IABP的适应证和影响在小儿中应用的技术困难和其他因素，介绍小儿IABP应用的技术要点，可能的并发症和治疗效果。在无体外膜式氧合器(ECMO)和左心辅助设备的情况下，小儿心脏直视手术后如不能脱离体外循环机或发生严重低心排血量综合征等，应用IABP治疗可收到较好的效果。     

Radionuclide venography vs Tc-99m-RBC equilibrium angiography: A comparative paired study

Combined direct injection venography (DIV) and equilibrium angiography (EA) were performed in 13 patients, by injecting in vitro labeled ^99mTc autologous RBC, via pedal veins, and imaging the first pass and the equilibrium phase. This paired comparative study of DIV with EA shows that DIV has advantages over EA because it provides selective information on the deep venous system from the calves to the inferior vena cava. DIV provides information on the flow dynamics and the high contrast first pass images provide better definition of non filling venous segments as well as visualization of collaterals. When using ^99mTc-MAA, lung perfusion can also be imaged. DIV is recommended as the procedure of choice for the diagnosis of DVT and EA should be employed only when pedal vein injection is not possible.     

裂隙灯致视网膜损伤的眼底实验观察与阈值探讨

本文用苏州产裂隙灯对3只猕猴双眼黄斑周围视网膜共36个部位进行随机持续光照,视网膜辐照度为226.8mW/cm~2。照射时间分别为30、45、60、90、120、150、180min。用检眼镜、眼底荧光血管造影对光照即刻到2个月的受照区视网膜进行观察。结果:持续光照120min以上,出现视网膜损伤。经统计学计算,本文提出:裂隙灯使用的相对安全时间阈值为98min。并提出多部位投照方法。     

Effects of Right Ventricular Failure on Renal Function During Pneumatic Left Ventricular Assist

Abstract: In an experimental dog model of acute biventricular failure, the effects of left ventricular (LV) assist on renal hemodynamics and function were evaluated. After the induction of severe cardiac failure by multiple ligation of the coronary arteries, LV assist with a 40 ml pneumatic pulsatile pump was initiated, and the aortic flow was maintained at control values. The right atrial pressure (RAP) rose to 21.3 mm Hg with the appearance of profound right ventricular (RV) failure. Renal arterial blood flow (RAF) decreased to about 60% of the control value after 2 h of LV assist. The urine volume decreased and renal function deteriorated progressively. RV assist decreased the RAP to 4.8 mm Hg, and the reduced RAF recovered. After 3 h of RV assist, the RAF returned to initial values and the urine volume increased, but renal function did not recover. Advanced biventricular failure with elevated RAP during LV assist reduced renal perfusion and impaired renal function and may be an indication for early RV assist     

视盘血管炎——关于混合型的研讨

对６０例（６３眼）视盘血管炎的临床分型进行了探讨，结果表明，除分为Ⅰ、Ⅱ两型外，尚存在混合型，当视盘睫状血管炎性病变波及中央静脉，或两个血管系统同时受炎症侵犯时，即可再现混合型的临床表现，视盘明显水肿，视网膜静脉迂张，散在渗出，出血，动脉狭细。眼底荧光血管造影可见视盘荧光早期充盈明显迟缓，后期渗漏面积〉２．０ＰＤ，视网膜循环时间延长，混合型兼有Ⅰ，Ⅱ两型的临床特征，应作为一个独立类型存在，同时观察     

Rest-injected thallium-201 redistribution and resting technetium-99m methoxyisobutylisonitrile uptake in coronary artery disease: relation to the severity of coronary artery stenosis

To compare rest-injected thallium-201 (Tl) redistribution and resting technetium-99m methoxyisobutylisonitrile (^99mTc-MIBI) myocardial uptake in chronic coronary artery disease (CAD), 15 patients with angiographically proven CAD and left ventricular (LV) dysfunction (ejection fraction 34%±9%) were studied. All patients underwent rest-redistribution Tl and resting ^99mTc-MIBI cardiac imaging. Gated ^99mTc-MIBI images were also acquired to assess regional LV wall motion (WM). Myocardial segments (n=225) were divided into three groups on the basis of the degree of coronary artery stenosis: group 1 (total occlusion, n=82), group 2 (50%–99% of stenosis, n=84) and group 3 (<50% of stenosis, n=59). WM was significantly worse in groups 1 and 2 compared to group 3 (P<0.001), but no difference was observed between groups 1 and 2. TI and ^99mTc-MIBI uptake were significantly lower in groups 1 and 2 compared to group 3 (P < 0.001), and in group 1 compared to group 2 (P<0.001). When TI and ^99mTc-MIBI uptake were directly compared, TI uptake was higher than ^99mTc-MIBI uptake in group 1 (P<0.001), while no significant difference was observed in groups 2 and 3. Thus, both rest-injected TI redistribution and resting ^99mTc-MIBI uptake reflected the severity of coronary artery stenosis in CAD. However, in myocardial segments with total coronary occlusion T1 uptake was significantly higher than ^99mTc-MIBI uptake. Our data suggest that rest-injected Tl redistribution cardiac imaging may identify, more accurately than resting ^99mTc-MIBI imaging, the presence of viable myocardium in chronic CAD, particularly when the coronary blood flow is severely impaired.     

TCD结合TCCD与DSA对脑动脉狭窄的一致性分析及对治疗方案的指导价值

目的 探究经颅多普勒超声(transcranial Doppler sonography, TCD)结合经颅彩色多普勒超声(transcranial color-coded duplex, TCCD)与数字减影血管造影(digital subtraction angiography, DSA)对脑动脉狭窄的一致性分析及对治疗方案的指导价值。方法 选取缺血性脑血管病患者100例,均行TCD、TCCD及DSA检查,以DSA检查结果作为“金标准”,分析脑动脉狭窄程度,观察不同狭窄程度患者TCD、TCCD超声表现,采用Kappa检验分析TCD结合TCCD诊断脑动脉狭窄程度与DSA检查结果的一致性,比较不同狭窄程度患者收缩期峰流速(systolic velocity, Vs)、平均峰流速(mean velocity, Vm)、搏动指数(pulsatility index, PI),采用Spearman相关系数模型分析Vm、PI与脑动脉狭窄程度的相关性,所有患者均行药物或手术治疗,比较不同治疗方法患者入院时、治疗后6个月Vs、Vm、PI。结果 100例缺血性脑血管病患者,轻度狭窄42例,中度狭窄3...