急性心肌梗死急诊介入治疗后早期T波倒置与Q—T离散度的关系

目的观察急性心肌梗死急诊介入治疗后早期T波倒置与Q—T离散度的关系。方法观察65例急性心肌梗死行急诊介入治疗患者,根据其是否在介入治疗后24h内出现T波倒置,将患者分为T波倒置组45例,未倒置组20例,分别观察肌酸激酶同工酶（CK—MB）、室性心律失常发生率、Q—T离散度及预后。结果T波倒置组肌酸激酶同工酶峰值减低、达酶峰时间提前、QTd及QTcd显著缩短,随访6个月,T波倒置组较未倒置组患者心功能改善明显,心血管事件发生率低。结论Q—T间期离散度变化和介入治疗后是否早期T波倒置均为心肌组织水平再灌注的简易临床指标,与临床预后有密切关系。     

重组人酸性成纤维细胞生长因子皮肤用药的长期毒性研究

目的：研究重组人酸性成纤维细胞生长因子（rhaFGF)皮肤用药的长期毒性。方法：对新西兰兔破损皮肤连续给药28d,剂量分别为3600,1800,900U／cm^2,观察rhaFGF用药期间和停药后对动物血液学、血液生化学、组织学等方面的影响。结果：rhaFGF的无毒剂量为900U／cm^2;rhaFGF1800U/cm^2用药可见个别动物出现淋巴结、脾白髓、圆小囊固有层及胸腺滤泡增生;3600U／cm^2用药可见半以上动物淋巴结出现淋巴等器官滤泡增生,偶见大脑血管周围出现少量淋巴细胞浸润,个别动物睾丸生精小管精子细胞数量增加。停药2周,上述病理改变减轻。未观察到rhaFGF的延迟性毒性反应。结论：rhaFGF在有效剂量及大于有效15倍的剂量下皮肤外用是安全的。     

A new functional data‐based biomarker for monitoring cardiovascular behavior

Cardiac safety assessment in drug development concerns the ventricular repolarization (represented by electrocardiogram (ECG) T‐wave) abnormalities of a cardiac cycle, which are widely believed to be linked with torsades de pointes, a potentially life‐threatening arrhythmia. The most often used biomarker for such abnormalities is the prolongation of the QT interval, which relies on the correct annotation of onset of QRS complex and offset of T‐wave on ECG. A new biomarker generated from a functional data‐based methodology is developed to quantify the T‐wave morphology changes from placebo to drug interventions. Comparisons of T‐wave‐form characters through a multivariate linear mixed model are made to assess cardiovascular risk of drugs. Data from a study with 60 subjects participating in a two‐period placebo‐controlled crossover trial with repeat ECGs obtained at baseline and 12 time points after interventions are used to illustrate this methodology; different types of wave form changes were characterized and motivated further investigation. Copyright © 2012 John Wiley & Sons, Ltd.     

Aging and Counseling:

Counselors are needed to help meet the mental health needs of older person; yet, to be effective they must understand fully the special needs of the older population. Counseling, an applied psychological science, is thus a field of study where gerontology curricula can be implemented optimally in a partnership manner. This article reviews the historical evolvement of gerocounselors and includes resources for special training of these professionals. Suggestions and resources for development of training programs and integration of gerontology and counseling curricula are provided.     

ECG abnormalities and stroke incidence

In this review, the authors discuss the role of ECG in prediction of stroke. ECG plays an important role in detection of several stroke risk factors/predictors including atrial fibrillation and left ventricular hypertrophy; both are components of the Framingham Stroke Risk Score. Multiple other ECG traits have also emerged as potential predictors of stroke, namely cardiac electrical/structural remodeling – Q wave, QRS/QT duration, bundle blocks, P wave duration/amplitude/dispersion, other waveform angles and slopes; higher automaticity – ectopic beats; and re-entry – atrial tachyarrhythmia; and higher vulnerability to arrhythmia – heart rate and its variability. Most of these predictors are not ready for prime time yet; however, further research focusing on their role in risk stratification and prevention of stroke may be useful. In this article, the authors discuss the prevalence, mechanisms and clinical applications of traditional and novel ECG markers in the prevention and treatment of stroke.