Mechanism of change in cardiac function after mitral valve replacement

Left ventricular contractility was measured using Doppler echocardiography in 37 pa-tients with rheumatic mitral valve disease.Myocardial pathological lesions were studied quanti-tatively by means of the image analysis system and light microscopic examination.The resultsshowed that attenuated cardiac function is due to pathological change of the mitral valve andpathological lesions of the left ventrieular myocardium including increased interstitial fibrosis,thickened intramyocardial arterial wall leading to concentric narrowing of the lumen,hyper-trophic myocardial fiber and endocardial proliferation.Since mitral valve replacement can notcorrect the irreversible myocardial pathological lesions,perioperative protection of the my-ocardium should be emphasized,and intraoperative injury to the myocardium should be mini-mized as far as possible.     

宁夏枸杞煎剂对家兔离体子宫的影响

通过11只家兔离体子宫实验,检测了宁夏枸杞果两种不同稀释度的浓煎液对子宫自动节律收缩运动的影响。结果,应用稀释50倍的W液前后,子宫角的收缩运动频率平均增加了19.58频次/10分钟,P<0.02;张力平均增强了7.14毫米,P<0.05;收缩运动强度(以幅度表示)平均增大2.17毫米,P>0.05,<0.1。此外,在三次实验中,用药前子宫角自动节律收缩波不明显,加药后即明显表现出来。以上检测结果提示,枸杞果煎液具有兴奋子宫和促进子宫自动收缩运动的作用。     

三维斑点追踪成像对高血压患者左心室心肌应变能力的评价

目的：探讨三维斑点追踪成像技术（3D-STI）对静息状态下高血压患者心肌收缩功能异常的评判价值.方法：选取高血压患者38例,正常健康对照组33例,采集实时左心室全容积图像,应用3D-STI软件进行分析,得出左心室射血分数（LVEF）、左心室纵向收缩期峰值应变值、左心室面积收缩期峰值应变值;比较两组之间各应变指标的差异,分析3D-STI对高血压患者左心室心肌应变特征评价的可行性.结果：高血压组左心室纵向及面积收缩期峰值应变值较对照组减低（P＜0.05）,对照组左室纵向收缩期峰值应变从基底段至心尖段呈逐渐增大趋势;Pearson相关分析表明,高血压组左室整体纵向、面积收缩期峰值应变与LVEF相关（1=0.758,P1=0.000;r2 =0.567,P2=0.000）.结论：3D-STI可通过测量心肌应变值,客观地评价高血压患者左心室收缩功能.     

郑州地区支气管哮喘的病因学和临床实验研究

目的：进行郑州地区支气管哮喘的病因学和临床实验研究。方法：通过曝片调查本地区气传致敏花粉散布规律；经皮试了解致敏原与哮喘发病的关系；采用ＥＬＩＳＡ法测定不同病型、病期哮喘病人的血清ＩｇＥ水平；检测实验性哮喘豚鼠血和肺组织ＬＰＯ、ＳＯＤ水平变化及ＰＧＥ１和氨茶硷的影响，并对２例顽固性哮喘患者静脉点滴ＰＧＥ１观察疗效。结果：郑州地区空气中全年均有花粉散布并出现两次飘散高峰，导致哮喘的季节性发病或加重。９０９％的外源性哮喘患者皮试阳性，花粉、霉菌、屋尘和螨为主要致敏原。外源性哮喘及发作期患者血清ＩｇＥ水平明显高于内源性哮喘及缓解期病人。ＰＧＥ１能抑制哮喘豚鼠肺组织ＬＰＯ水平升高，对顽固性哮喘患者静脉点滴ＰＧＥ１疗效显著。结论：支气管哮喘与花粉飘散及致敏原消长密切相关，血清ＩｇＥ含量肺组织ＬＰＯ水平的升高对支气管哮喘发病有重要意义。ＰＧＥ１对治疗顽固性哮喘是一种具有发展前景的药物。     

自体内皮前体细胞移植对急性心肌梗死大鼠微血管新生及心功能的影响

目的探讨外周血来源的内皮前体细胞自体移植,对大鼠急性心肌梗死后微血管新生与心功能的影响。方法抽取SD大鼠外周动脉血,应用Ficoll密度梯度离心法获取单个核细胞。应用含有VEGF和bFGF的特定培养基体外培养,得到内皮前体细胞;结扎SD大鼠冠状动脉左前降支,建立急性心肌梗死模型;然后将得到的自体内皮前体细胞植入缺血心肌局部区域。对照组动物注入细胞培养液。结果与对照组比较,细胞移植组大鼠心功能明显改善,心肌收缩力显著优于对照组;梗死心肌微血管新生更为明显。结论急性心肌梗死心肌局部移植外周血来源的自体内皮前体细胞,能够促进血管新生;对局部梗死心肌组织结构有一定的保护作用,并可在不同时点不同程度恢复心肌收缩力,显著改善心功能。     

圆利针疗法治疗腰椎间盘突出症30例临床观察

目的 观察圆利针疗法治疗腰椎间盘突出症(lumbar disc herniation,LDH)的疗效.方法 将60例LDH患者随机分为治疗组及对照组,每组各30例.治疗组患者接受圆利针针刺腰肌拮抗肌群(竖脊肌和腰大肌)疗法;对照组患者接受常规针刺疗法,穴位选取肾俞、大肠俞、委中等.6次为1个疗程,共2个疗程.采用日本骨科学会(Japanese orthopedic association,JOA)腰痛量表评定腰椎功能,并观察两组临床疗效.结果 两因素混合设计的方差分析结果显示,因素内(时点)的主效应具有统计学意义(F=572.19,P＜0.01),治疗前、第1个疗程结束时、第2个疗程结束时,两组患者JOA评分均较前一时点显著升高(P＜0.05);因素间(组别)的主效应无统计学意义(F=2.317,P=0.133).第1个疗程结束时,治疗组临床疗效显著优于对照组(P=0.037);第2个疗程结束时,两组临床疗效分布的差异无统计学意义(P=0.259).结论 圆利针疗法的短期疗效优于常规针刺,长期疗效与常规针刺相当.     

不同用途的心室肌细胞的分离

目的 :建立适合于不同用途的心室肌细胞的酶解分离方法。方法 :恒流 Langendorff灌流 ,I型胶原酶酶解分离 ,应用膜片箝技术记录离子电流、双波长显微荧光光度术检测细胞内游离钙离子浓度及视频跟踪系统测定心肌单细胞收缩。结果 :采用不同分离技术参数获得的心肌细胞能满足上述三种实验条件下的要求。酶解分离的单个心室肌细胞静息电位为 (- 74 .0 6± 4 .5 4 ) m V,记录到心室肌细胞典型的钾、钠、钙离子电流和稳定的心室肌细胞内游离钙比值 ,心室肌单细胞收缩特性稳定。结论 :通过调整分离技术参数获得的心室肌细胞性能稳定 ,具有正常的电 -机械生理特性和耐钙性。     

Andersen-Tawil 综合征1例报告并文献复习

目的探讨Andersen-Tawil综合征(ATS)的发病机制及临床特点。方法回顾性分析1例ATS患者的临床表型。结果本例患者男,17岁,表现为低位耳,反复发作运动、饱食或无明显诱因下非对称性肌无力,入院期间肌无力发作时伴血钾降低;动态ECG提示频发室性期前收缩;EMG检查显示复合肌肉动作电位波幅在运动诱发试验运动后即刻上升6%,30 min下降17%,60min下降25%,90min下降35%;头颅MRI Flair示左侧额顶叶交界区脑白质内点状高信号影;基因检测(NGS)提示染色体17q24的KCNJ2基因出现错义突变:c.224C>T(p.Thr75Met),诊断为ATS。予补钾治疗后患者肌力恢复正常,出院后继续服用醋钾唑胺片,随访发现患者周期性麻痹的发作频率、严重程度及持续时间明显改善。结论 ATS作为一个多系统累积的离子通道病,其临床表现高度变异,临床上要更加关注患者临床表型,从而有利于表型及机制的完善。     

Fetal Skin Organ Culture

The fetal response to cutaneous injury has been investigated in a variety of models; most have studied the differences between fetal and adult healing mechanisms in vivo and in cell culture. Further disclosure of the cellular and biochemical events requires a model that can be manipulated to study single factors influencing fetal tissue repair without the complex interactions that occur in vivo, but in a system that more closely approximates normal skin than cell culture models. This paper presents a method for the organ culture of fetal skin and its advantages as a model to help elucidate fetal healing mechanisms. Skin sections (1 × 1 cm) excised from the backs of fetuses of New Zealand white rabbits on day 27 gestation (term = 31 days) were placed eccentrically in 65-mm culture dishes and fed daily with 2.5 mL of DMEM containing 10% fetal calf serum, antibiotics, and 10 mM ascorbic acid. A separate group, treated similarly, received 4-mm punch wounds to assess the in vitro response to wounding. Thespecimens were incubated at 37° Cin humidified room air on a rocker platform to provide alternate exposure of the skin to air and medium. Gross observation at 3 weeks showed cells extending into the central wound, indicating that viable cells were proliferating and/or migrating from the tissue. Skin was examined histologically and was viable over the 3-week period studied. Organ culture, by maintaining tissue in the natural extracellular matrix, allows cell-to-cell contact and communication to be maintained while allowing controlled environmental manipulation. In addition, the procedure is reproducible and assessment of tissue viability can be determined easily using histology. These advantages make fetal skin organ culture a valuable adjunct in the study of fetal skin and its response to wounding.     

Modeling heart failure in animal models for novel drug discovery and development

Introduction: When investigating drugs that treat heart diseases, it is critical when choosing an animal model for the said model to produce data that is translatable to the human patient population, while keeping in mind the principles of reduction, refinement, and replacement of the animal model in the research.

Areas covered: In this review, the authors focus on mammalian models developed to study the impact of drug treatments on human heart failure. Furthermore, the authors address human patient variability and animal model invariability as well as the considerations that need to be made regarding choice of species. Finally, the authors discuss some of the most common models for the two most prominent human heart failure etiologies; increased load on the heart and myocardial ischemia.

Expert opinion: In the authors’ opinion, the data generated by drug studies is often heavily impacted by the choice of species and the physiologically relevant conditions under which the data are collected. Approaches that use multiple models and are not restricted to small rodents but involve some verification on larger mammals or on human myocardium, are needed to advance drug discovery for the very large patient population that suffers from heart failure.