老年男性心肌缺血患者心率变异分析（附67例报告）

采用正常搏动ＲＲ间期的标准差（ＳＤ）及心率变异指数（ＨＲＶ ｉｎｄｅｘ）作为指标，分析６７例老年男性心肌缺血患者的心率变异，并与正常老年男性组及正常青壮年男性组进行了对比，发现前组的ＲＲ间期ＳＤ、ＨＲＶｉｎｄｅｘ均明显低于后两组，其结果有显著性差异（Ｐ均〈０．０１）。提示心肌缺血可破坏交感与迷走神经的均衡性，造成心率变异降低。     

胎儿声振动刺激反应的研究

目的：了解不同孕龄胎儿对声振动刺激的反应。方法：对４３５例次正常中、晚期妊娠妇女进行声振胎心试验（ＶＡＳ－Ｔ）、声振胎动试验（ＳＰＦＭ），并对声振动刺激前、后胎心率变化规律进行前瞻性研究。结果：（１）从２４周开始，胎儿对声振刺激有反应，但大部分未能达到ＶＡＳ－Ｔ诊断标准，而胎动反应良好。（２）妊娠２８周开始，声振刺激后，９０％以上的胎儿出现显著的胎动、胎心率加速反应，足月胎儿反应率在９８％以上。（３）ＳＰＦＭ阳性率的显著提高早于ＶＡＳ－Ｔ。提示：２８周后胎儿神经系统发育已趋完善。胎儿运动神经的发育成熟早于植物神经。     

左心室舒张(充盈)功能的影响因素

本文用X线电影摄影方法评价了49例左室舒张(充盈)功能的影响因素。冠心病(CAD)组23例,高血压病组12例,正常对照组14例。左室充盈功能或顺应性主要受冠脉病变严重程度的影响。冠脉狭窄程度越重,并有陈旧性心肌梗塞、室壁运动异常、EF下降,则充盈功能受损愈明显。血压、年龄因素对舒张充盈功能的影响较小。在CAD组中,心率与1/3充盈分数呈负相关,与正常化高峰充盈率(NPFR)不相关,而EF则与NPFR相关良好。     

烟台市区风疹爆发的流行病学调查

本文报告了1987年2~5月间烟台市区幼儿园、小学等集体机构发生的一起出疹性疾病。经调查和血清学检测证实为风疹。总罹患率为23.99%,有的班级高达83.33%。具有流行迅速、发病集中、临床表现较重等特征。其中一例于发疹后期并发脑炎死亡。     

三七粉末透皮吸收研究

目的 :研究三七粉末的透皮吸收性及选择最佳促透剂。方法 :设计体外离体透皮试验法 (即用离体鼠皮在单室扩散池中进行试验 ) ,测定不同时间三七粉末中有关成分的透皮总量 (以三七皂苷为对照 ) ,计算透皮吸收率及促透剂的促透倍数。结果 :三七粉末的丙二醇溶液有一定透皮吸收能力 ,不同浓度的氮酮 (Azone)对其具有显著的促透作用 ,但Azone的促透效果与其剂量不呈直线关系 ,5 %Azone效果好于 7%Azone。结论 :本方法简便、易于操作、重现性较好 ,可用于制剂工艺研究中促透剂的选择     

Regulation of local sweating in sleep-deprived exercising humans

Summary Thermoregulatory sweating [total body (m _sw,b), chest (m _sw,c) and thigh (m _sw,t) sweating], body temperatures [oesophageal (T _oes) and mean skin temperature (T _sk)] and heart rate were investigated in five sleep-deprived subjects (kept awake for 27 h) while exercising on a cycle (45 min at approximately 50% maximal oxygen consumption) in moderate heat (T _air andT _wall at 35° C. Them _sw,c andm _sw,t were measured under local thermal clamp (T _sk,1), set at 35.5° C. After sleep deprivation, neither the levels of body temperatures (T _oes,T _sk) nor the levels ofm _{sw, b},m _{sw, c} orm _{sw, t} differed from control at rest or during exercise steady state. During the transient phase of exercise (whenT _sk andT _sk,1 were unvarying), them _{sw, c} andm _{sw, t} changes were positively correlated with those ofT _oes. The slopes of them _{sw, c} versusT _oes, orm _{sw, t} versusT _oes relationships remained unchanged between control and sleep-loss experiments. Thus the slopes of the local sweating versusT _oes, relationships (m _{sw, c} andm _{sw, t} sweating data pooled which reached 1.05 (SEM 0.14) mg·cm^–2·min^–1°C^–1 and 1.14 (SEM 0.18) mg·cm^–2·min^–1·°C^–1 before and after sleep deprivation) respectively did not differ. However, in our experiment, sleep deprivation significantly increased theT _oes threshold for the onset of bothm _{sw, c} andm _{sw, t} (+0.3° C,P<0.001). From our investigations it would seem that the delayed core temperature for sweating onset in sleep-deprived humans, while exercising moderately in the heat, is likely to have been due to alterations occurring at the central level.     

Factors related to renal haemodynamics in young type-1 diabetes mellitus patients

The influence of metabolic control (HbA_1c), noradrenaline (NA) and insulin-like growth factors (IGF-I and IGF-II) on renal function and size was investigated in 11 insulin-dependent diabetes mellitus patients aged 11–17 years. Renal function was evaluated in terms of glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). Renal size was determined as renal parenchymal volume (RPV) by ultrasonography. The patients' HbA_1c values ranged from 8.2% to 12.9% (normal range 5.5–8.5%) and their GFR and ERPF were higher than normal. Their IGF-II values were higher, and NA and IGF-I levels were lower than those of healthy controls. Inverse correlations between NA and GFR (r=–0.66) and NA and ERPF (r=–0.63) were found. No correlation was found between serum IGF-I and renal functional parameters. The IGF-II values correlated with GFR and HbA_1c (r=0.63,r=0.70 respectively). There were linear correlations between RPV and GFR, RPV and ERPF, HbA_1c and GFR, and ERPF and RPV. Decreased NA concentrations and increased IGF-II values appear to be factors contributing to renal hyperfunction in these patients.     

THE INFLUENCE OF CAPTOPRIL AND NALOXONE ON THE VALSALVA MANOEUVRE AND SYSTOLIC TIME INTERVALS IN HEALTHY VOLUNTEERS

1. The aim of the study was to ascertain whether the inhibition of the sympathetic nervous system by angiotensin-converting enzyme (ACE) inhibitors is mediated by endogenous opioids. Naloxone was used to evaluate the effects of the latter on systolic time intervals (STI) and Valsalva manoeuvre-induced blood pressure and heart rate changes. 2. Baseline recordings were done in 12 healthy male volunteers and repeated 2h after oral administration of 75 mg of captopril and again after naloxone 0.4 mg/kg was administered intravenously over 10 min. 3. After captopril there was a significant reduction in systolic (P<0.02) and mean blood pressure (P<0.04) without any changes in heart rate. Furthermore, captopril increased the Valsalva ratio (P<0.06) but did not influence inotropism as indicated by STI. Naloxone did not influence any of these findings. 4. The changes in the Valsalva ratio after captopril were mediated by an increase in the maximum bradycardia in nine of the 12 subjects. 5. The results indicate that endogenous opioids do not play a role in the putative sympatholytic effect of ACE inhibition.     

Heart rate analysis in 24 patients treated with 150 mg amitriptyline per day

Twenty-four patients treated with 150 mg amitriptyline per day for an episode of major depression underwent a standardized heart rate analysis (HRA) before therapy and after 14 days. The battery of cardiovascular reflex tests included the determination of the coefficient of variation (CV) while resting and during deep respiration, a spectral analysis of heart rate, the heart rate response to standing, and the Valsalva manoeuvre. The results of the initial HRA did not differ from a group of 24 normal control subjects matched for age and sex. On day 14 of treatment the patients showed significantly reduced values of heart rate variability in all tests (P<0.0001), probably due to the anticholinergic side effects of amitriptyline. Heart rate increased form 78.1 to 93.6 bpm on average (P<0.0001). Abnormal CV at rest was registered in 96% of the patients; during deep respiration 29% showed abnormal CV results. An abnormal spectral analysis was found in 100% of the cases (low frequency peak: 42%, mid-frequency peak: 100%, high frequency peak: 79%). The heart rate response to standing was abnormal in 75% and the Valsalva test in 33% of the cases. Eighty-eight percent of the patients fulfilled the criteria of a cardiovascular autonomic neuropathy under the conditions of amitriptyline therapy. As yet, the consequences of these changes for the patients have not been sufficiently elucidated.     

一次采样测定人体咖啡因清除率的研究

咖啡因主要经肝细胞色素Ｐ４５０ＩＡ２代谢，测定其药代动国学参数可反映该Ｐ４５０亚型的活性。本研究显示咖啡因清除相为一级动力学；唾液和血浆的药代动力学参数有良好的相关性；含体重因素的清除率的变异系数比半减期小；用一次采样测定其清除率以８ｈ时点为宜。