Clinical Evaluation of Atrial Synchronous Ventricular Inhibited Pacemakers

The technical specifications and the operation of two atrial synchronous ventricular inhibited (ASVIP) pacemaker designs are described along with the results of clinical evaluation of these pacemakers in 30 patients. Clinical advantages of such pacemakers are contrasted with the performance of A-V sequential (DVI) and atrial synchronous (VAT) systems.     

Methyl Vitamin B12 but not methylfolate rescues a motor neuron-like cell line from homocysteine-mediated cell death

Homocysteine is an excitatory amino acid implicated in multiple diseases including amyotrophic lateral sclerosis (ALS). Information on the toxicity of homocysteine in motor neurons is limited and few studies have examined how this toxicity can be modulated. In NSC-34D cells (a hybrid cell line derived from motor neuron-neuroblastoma), homocysteine induces apoptotic cell death in the millimolar range with a TC₅₀ (toxic concentration at which 50% of maximal cell death is achieved) of 2.2 mM, confirmed by activation of caspase 3/7. Induction of apoptosis was independent of short-term reactive oxygen species (ROS) generation. Methyl Vitamin B12 (MeCbl) and methyl tetrahydrofolate (MTHF), used clinically to treat elevated homocysteine levels, were tested for their ability to reverse homocysteine-mediated motor neuron cell death. MeCbl in the micromolar range was able to provide neuroprotection (2 h pretreatment prior to homocysteine) and neurorescue (simultaneous exposure with homocysteine) against millimolar homocysteine with an IC₅₀ (concentration at which 50% of maximal cell death is inhibited) of 0.6 μM and 0.4 μM, respectively. In contrast, MTHF (up to 10 μM) had no effect on homocysteine-mediated cell death. MeCbl inhibited caspase 3/7 activation by homocysteine in a time- and dose-dependent manner, whereas MTHF had no effect. We conclude that MeCbl is effective against homocysteine-induced cell death in motor neurons in a ROS-independent manner, via a reduction in caspase activation and apoptosis. MeCbl decreases Hcy induced motor neuron death in vitro in a hybrid cell line derived from motor neuron-neuroblastoma and may play a role in the treatment of late stage ALS where HCy levels are increased in animal models of ALS.     

贾英杰教授基于“血不利则为水”辨治癌性腹水经验

"血不利则为水"出自《金匮要略·水气病脉证并治第十四篇》,是张仲景首次提出从血瘀论治水气病的指导思想,而癌性腹水常常出现在肿瘤患者病情发展的中晚期,属于中医学"鼓胀"等疾病范畴,其发病机制与"血不利则为水"的思想有着密切的关系。贾英杰教授将癌性腹水的基本病机归纳为阳虚寒凝,瘀水互结,认为阳虚、气滞、血瘀、水湿是疾病病机的关键,临床上常以温阳、行气、活血、利水为治疗的基本法则,取得了良好的疗效。     

A Shorter R-R Interval Causes a Larger Endocardial R Wave Amplitude in Cases with Atrial Fibrillation

Endocardial electrograms were recorded with a Medtronic programmer (model 9742A) in 15 patients with implanted pacemakers required for bradycardia and atrial fibrillation. Telemetered unipolar ventricular endocardial electrograms were recorded for 2 minutes, and the R wave amplitudes of the shortest R-R intervals were compared to that of the longest R-R intervals. Eleven of the 15 cases showed R wave amplitudes of the shortest R-R intervals an average of 2.1 mV larger than the R wave amplitudes of the longest R-R intervals. Three cases showed no difference, and one the opposite condition. In all four, the average recorded R-R interval exceeded 670 ms. The shortest R-R interval among the 11 cases with a larger R wave amplitude was 545 ± 100 ms. The endocardial R wave amplitude of the shortest R-R intervals were larger than the R wave amplitudes of the longests R-R intervals. Shorter intervals were followed by larger endocardial R wave amplitudes (P < 0.005 with the Wilcoxon's rank sum test).     

辛基酚和三羟异黄酮联合作用对乳腺癌MCF-7细胞增殖的影响

目的观察辛基酚(octylphenols,OP)、三羟异黄酮(gen iste in,GEN)联合作用对乳腺癌MCF-7细胞增殖的影响,并探讨其分子机制。方法以MTT试验、流式细胞分析、免疫细胞化学和RT-PCR等方法观察辛基酚、三羟异黄酮对MCF-7细胞增殖、细胞周期、雌激素受体α(estrogen receptor,αERα)及磷酸化酪氨酸蛋白、ERα及乳腺癌共激活因子1(amp lified in breast cancer 1,AIB1)mRNA的影响。结果8×10-6mol/L OP、5×10-5mol/L GEN及其两者联合作用MCF-7细胞72 h时,其增殖率分别为114.82%、65.98%和56.90%,G2/M期细胞分别为12.98%、46.16%和36.44%,细胞凋亡率分别为3.57%、11.41%和8.24%,磷酸化酪氨酸蛋白表达量荧光值分别为(62.84±9.80)、(26.75±5.09)、(39.15±7.83)。OP能增加细胞核中AIB1 mRNA的表达。GEN及其与OP联合组均降低ERα蛋白的表达,抑制细胞核中AIB1 mRNA的表达。结论OP能促进MCF-7细胞增殖,GEN及其与OP联合均抑制MCF-7细胞增殖,其机制可能是通过调节细胞中ER、AIB1、磷酸化酪氨酸蛋白的表达来作用的。     

Novel variant in the KCNK9 gene in a girl with Birk Barel syndrome

Birk Barel syndrome also known as KCNK9 imprinting syndrome is a rare developmental disorder associated with a loss-of-function variant in KCNK9, an imprinted gene with maternal expression on the 8th chromosome encoding the TASK3 (TWIK-related acidity inhibited K + -channel 3). Only two variants of KCNK9 have been associated with this condition before, both of them leading to the same amino-acid exchange p.Gly236Arg (Barel, 2008, Graham, 2016). We describe a case of a 17-year-old girl presenting with very similar phenotype and pure motor neuropathy with a novel variant c.710C > A: p.Ala237Asp (NM_001282534.1) in KCNK9 found by whole exome sequencing. Our case suggests that Birk Barel syndrome may not be caused only by variants leading to amino-acid exchange p.Gly236Arg but also by other missense variant in this gene and that peripheral motor neuropathy might be a feature of this syndrome.     

妇科外洗方自煎剂与颗粒剂的体外抑菌活性的比较

目的：比较妇科外洗方自煎剂与颗粒剂对假丝酵母菌的体外抑菌活性。方法：采用纸片扩散法（K-B）测定自煎剂与颗粒剂体外抑菌圈的直径。结果：将两种药液的抑菌圈半径的数据进行t检验,t0．05=0．0295,其差异有统计学意义（P〈0．05）。结论：自煎剂因中药饮片批次不同与自煎方法的不确定性,较质量标准相对稳定的颗粒剂比效而言,颗粒剂的抑菌效果较为理想,且优势明显。     

漂浮疗法干预二醋吗啡依赖脱毒者内分泌物质变化的观察

目的:研究漂浮疗法对二醋吗啡(海洛因)依赖脱毒者甲状腺功能、胰腺分泌及睾酮变化的影响。方法:用放免法测定20例单纯用美沙酮脱毒海洛因成瘾者与19例美沙酮同时应用漂浮治疗海洛因成瘾者及30例正常对照组的促甲状腺素(TSH)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、胰岛素及睾酮含量。结果:美沙酮脱毒加漂浮疗法组与正常对照组比较,T3下降及T4升高差异均有显著性意义(t=2.478,4.777,P<0.01);TSH、睾酮下降及胰岛素增高,差异均无显著性(t=1.450,0.052,0.253,P>0.05)。美沙酮脱毒加漂浮疗法组与单纯美沙酮脱毒组比较,T4升高显著(t=3.911,P<0.01);TSH,T3,睾酮升高及胰岛素下降,差异无显著性(t=0.779,0.745,0.607,0.444,P>0.05)。美沙酮单纯治疗与对照组比较,TSH及T3下降,差异均有显著性(t=2.473,2.903,P<0.05);T4下降及胰岛素增高差异无显著性(t=1.280,0.880,P>0.05)。结论:漂浮疗法应用于海洛因成瘾者的脱毒,能够提高垂体甲状腺的分泌功能,睾酮分泌升高,胰岛素分泌下降。     

祛风化痰、肺鼻同治法治疗鼻后滴流综合征240例临床疗效观察

目的 观察祛风化痰、肺鼻同治法治疗鼻后滴流综合征的临床疗效.方法 将确诊为鼻后滴流综合征且属风痰留恋、肺鼻不利证的360例患者,随机分为治疗组240例、对照组120例.治疗组予中药川芎茶调散合苍耳子散加减治疗,对照组予西药美敏伪麻溶液治疗,疗程均为7d.比较2组中医证候疗效、症状积分变化及复发情况.结果 治疗组240例中,临床痊愈32例（13.30％）,显效83例（34.58％）,有效103例（42.92％）,无效22例（9.17％）,总有效率为90.83％;对照组120例中,临床痊愈7例（5.83％）,显效31例（25.83％）,有效56例（46.67％）,无效26例（21.67％）,总有效率为78.33％.经Ridit分析,U=3.63,P=0.00049,P＜0.05,说明治疗组疗效优于对照组.2组治疗前咳嗽、咳痰、咽痒、鼻涕、鼻塞积分比较差异均无统计学意义（P＞0.05）.治疗后治疗组咳嗽、咳痰、咽痒、鼻涕、鼻塞积分较对照组降低明显,差异均有统计学意义（P＜0.05）,治疗组优于对照组.停药后2周对2组临床痊愈、显效、有效病例进行随访,治疗组共218例,复发29例,复发率为13.30％,对照组共94例,复发26例,复发率为27.66％,治疗组复发率低于对照组（P＜0.05）.结论 祛风化痰、肺鼻同治法治疗鼻后滴流综合征风痰留恋、肺鼻不利证有较好的疗效,且停药后复发率较低.