Asystole from tetanic stimulation of the accessory nerve

An asystolic cardiac arrest is reported which occurred at the same time as supramaximal tetanic stimulation over the accessory nerve in order to evoke contractions in the trapezius and sternocleidomastoid muscles. The cause may have been the inadvertent stimulation of one or more of the cranial nerves of the carotid sheath at the base of the skull: the cranial root of the accessory nerve, the vagus, the sino-carotid branch of the glossopharyngeal nerve or the hypoglossal nerve. The most likely culprit, if not the vagus itself, was the cranial root of the accessory nerve which both functionally and anatomically should be seen as an integral part of the vagus. It is suggested that stimulation of any nerve in the carotid sheath should be approached with caution and that a tetanic stimulus to this area might best be avoided.     

Effects of calcium in continuous cardioplegia on myocardial protection

The effects of calcium (Ca) on a hyperkalemic cardioplegic solution for continuous cardioplegia were examined in an isolated perfused working rat heart model. The coronary arteries were perfused with a modified Krebs-Henseleit bicarbonate buffer (K-H) solution, containing various concentrations of Ca(0.1, 0.6, 1.2, and 2.5 mmol/l) and a high concentration of potassium (20 mmol/l), for 180 min, after which cardiac arrest was induced at 37°C for 180 min. Cardiac function and creatine kinase (CK) were measured. In the control group, K-H solution was infused in place of the cardioplegic solution, and cardiac arrest was not induced. No significant differences were observed between the groups infused with the K-H solution containing Ca concentrations of 0.6, 1.2, and 2.5 mmol/l in the percent recovery of aortic flow (82.1±2.9%, 80.6±2.0%, and 71.5±3.7% (mean±SEM) respectively) or in the recovery of other indices of cardiac function, or in CK leakage. There were also no significant differences in the recovery of cardiac function and CK leakage between these groups and the control group. In the Ca 0.1 mmol/l group, however, the characteristic Ca paradox was observed. These findings suggest that if the Ca concentration in a cardioplegic solution is higher than 0.6 mmol/l during continuous cardioplegia, excellent cardioprotective effects will be achieved.     

以心跳骤停为首发症状的蛛网膜下腔出血共同特征研究

<正>心跳骤停（cardiac arrest,CA）和蛛网膜下腔出血（subarachnoid hemorrhage,SAH）均是急诊科常见的急危重症,CA可见于多种疾病的各个阶段,复苏成功率不高,甚至造成CA的病因不甚明确。SAH典型表现为剧烈头痛、呕吐、脑膜刺激征,诊断并不困难。而以CA为首发症状的SAH,由于心肺复苏无法常规进行头颅CT检查,给诊断增加了困难。本文通过对16例以CA为首发症状的SAH患者进行回顾性研究,来提高SAH-CA的快速病因诊断,避免漏诊误诊。     

肝素涂层体外循环管道抗凝血性能的研究

目的 评测3种离子键肝素涂层体外循环管道的抗凝血性能和稳定性。方法 用PT和APTT对不同浓度肝素—氯烃基二甲基代苯甲胺(HBC)复合物涂层体外循环管道的凝血性能进行评测，同时测试体外转流对3种肝素涂层管道抗凝血性能的影响。结果 3种肝素涂层方法均能够将肝素分子结合于材料表面并具有抗凝活性，其中HBC复合物和肝素—聚乙烯亚胺复合物处理的体外循环管道经体外转流96h后仍具有较佳的抗凝血活性。结论 离子键肝素涂层因结合物质不同其稳定性也不同；HBC复合物和肝素—聚乙烯亚胺复合物处理的体外循环管道肝素分子结合较牢固，能够满足临床短期使用需要。     

Failure of oocyte maturation: possible mechanisms for oocyte maturation arrest

For human IVF, the patient's ovaries are hormonally stimulated to ensure the collection of fully matured oocytes that are at the metaphase II stage. Only these oocytes can be successfully fertilized either when mixed with sperm or after ICSI. Nevertheless, in some cases immature or maturing oocytes are recovered from follicles. Surprisingly, sometimes these oocytes do not complete maturation when cultured in vitro, for unknown reasons. In this article we discuss some possible mechanisms that may be responsible for those atypical arrests.     

碱性成纤维细胞生长因子对卵巢癌CAOV3细胞cyclin D1及GADDl53表达的影响

目的:研究碱性成纤维细胞生长因子(bFGF)对人卵巢癌CAOV3细胞细胞周期调节蛋白cyclinD1及GADD153表达的影响,探讨bFGF促进人卵巢癌CAOV3细胞增殖、抑制凋亡的信号机制。方法:利用无血清饥饿诱导卵巢癌CAOV3细胞凋亡。分为对照组、bFGF组。分别应用MTT、流式细胞术、琼脂糖凝胶电泳观察25、50、75μg/L bFGF对CAOV3细胞增殖率、细胞周期及细胞凋亡的影响。利用Western blotting检测bFGF对CA-OV3细胞cyclin D1、GADD153以及转录因子(c-Fos、c-Jun)表达的影响。结果:与对照组相比,bFGF呈剂量依赖性加速CAOV3细胞细胞周期进程,促进细胞增殖,抑制饥饿诱导的凋亡(P<0.01);呈时间依赖性促进cyclinD1、c-Fos、c-Jun,抑制GADD153蛋白表达(P<0.01)。结论:bFGF可能通过上调cyclin D1、c-Fos、c-Jun,下调GADD153表达促进细胞增殖,抑制饥饿诱导的卵巢癌CAOV3细胞凋亡。     

Central tolerance: Clonal deletion or clonal arrest?

Studies in various experimental animals have shown that developing T cells with specificity for self antigens can be prevented from maturation at an early stage of development. While several in vitro and in vivo experiments have shown that the mechanism of silencing autospecific T cells is the deletion of immature CD4⁺8⁺ thymocytes other experiments were interpreted to indicate that tolerance could also result from developmental arrest of more immature CD4^?8⁺ thymocytes not involving cell death. Here we show that immature CD4^?8⁺ cells when confronted with T cell receptor ligands in vitro neither survive nor differentiate into cells which cannot be deleted, indicating that clonal elimination rather than developmental arrest is the mechanism of central tolerance of all immature T cells.