Experimental coronary arterial occlusion and release: Effects on enzymes,electrocardiograms, myocardial contractility and reactive hyperemia

After less than 1 hour of coronary arterial occlusion, the myocardium suffers irreversible changes as revealed by electron microscopy. Yet, the earliest clinical laboratory indexes of myocardlal infarction—elevated serum enzyme levels and significant Q waves on the electrocardiogram—are not detected until at least 6 hours after coronary occlusion. To study the early period after coronary occlusion in the dog, occlusion of the left anterior descending coronary artery for 1 to 3 hours was followed by release, and coronary sinus and venous enzyme levels, the electrocardiogram and myocardial contractility from the infarcted area, and reactive hyperemia were monitored. Coronary sinus enzyme levels rose within 15 minutes after release of occlusion in half of the experiments with $\text{1}\text{to}\text{1}\text{1}\text{2}$ hours and in all of those with 2 to 3 hours of occlusion, and this rise preceded the rise in venous levels by only 10 to 20 minutes. Significant Q waves appeared 15 to 30 minutes after release of occlusion as the serum enzymes were increasing. Thus, clinically, the delayed appearance of increased serum enzymes and significant electrocardiographic Q waves is probably largely due to a lack of circulation in the infarcted area rather than to prolonged survival time. Also, the venous enzyme level reflects the coronary sinus level minutes later. The presence of viable myocardium in the infarcted area was suggested by elevation of the S-T segment upon reclamping, and by residual myocardial contractility and retained capacity for reactive hyperemia. These findings occurred in some experiments even In the presence of a significant Q wave.     

百年船山学的变迁、困境与出路

20世纪对船山的评价呈现为历史的三调 :作为民族主义者、唯物主义思想家和启蒙思想家的王船山。当历史演进到二十一世纪之际 ,一些船山研究者开始了试图回到王船山本身的努力。然而问题是 ,如何回到王船山本身 ?或许所谓的“王船山本身”这样的提法本身就是“非法”的 ?这一问题折射出中国学术界所普遍面临的困境。我们实际上处于这样一种诠释学处境之中 :一方面 ,我们应当承认中国哲学与中国文化的独特价值 ,不再用西学的框架肢解和宰割中学 ,避免将中学西方化 ;另一方面 ,西学的存在已经是一个无法回避的事实———我们已经“被抛”在西学面前。可能的出路或许在于 :在中国学术与西学达成“视域融合”(thefusionofhorizons)之后的“大视域”———借用王船山的话来说 ,“合往来古今而成纯”     

《素问》王冰注使用祖本探讨

根据王冰序,王冰在整理《素问》时使用了不同的版本,但并未说明以何本作祖本。根据对王冰序、《素问》新校正等提供的有关材料进行的分析,认为王冰所用祖本虽源自梁代传本,但不是全元起本,似应是张公秘本;今存《素问》中有些篇文结构应是祖本旧貌;祖本与全元起本、《针灸甲乙经》及《太素》应属不同传本系统。     

《素问·痹论》藏府痹小考

<素问·痹论>中"凡痹之客五藏者"至"痹聚在脾"一段,林亿认为是王冰次注<素问>将其他篇章移至<痹论>中,张琦等以为王氏所移过于轻率.通过考察巢元方<诸病源候论>,对上述观点提出不同看法<病源>中已把此段文字与<痹论>痹久入藏的论述相联系.王冰次注<素问>,或受<病源>影响,或出自临床经验,似非轻率之举.而且,从"凡痹之客五藏者"一段出现在<内经>中的不同篇章,从古人对五藏痹的前后认识的不同,恰体现出古代对疾病认识是逐渐深入的.     

王少华用消补兼施法治药流后恶露不止的经验

王少华用消补兼施法治药流后恶露不止。此立法依据为药流后恶露不止的病理机制在于虚中有瘀 ,瘀中有虚。所创二黄胶艾汤具有补气养血 ,活血化瘀之功 ,对于药物流产后体虚证实的恶露不止患者 ,用之有标本兼顾的效果。此外 ,二黄胶艾汤可加减应用于多种内科疾病中。故认为二黄胶艾汤的治疗效果胜于西药抗生素加止血剂 ,且值得进一步研究探讨。     

SMAD2/3蛋白在沙鼠脑缺血再灌注及氟桂利嗪干预后脑内表达的研究

目的 研究smad2/3在沙鼠脑缺血再灌注脑内表达及氟桂利嗪干预后对其表达的影响.方法 35只沙鼠随机分假手术组、缺血再灌注组和氟桂利嗪治疗组3组,采用夹闭双侧颈总动脉制作沙鼠脑缺血再灌注模型,于缺血10 min再灌注1 d、3 d、7 d各时间点处死动物,用免疫组化方法检测各组沙鼠脑内smad2/3的表达情况.结果 假手术组沙鼠脑内smad2/3弱阳性表达,而缺血再灌注1 d,3 d,7 d后沙鼠脑内呈阳性或强阳性表达,两者比较差异有统计学意义(P<0.01);氟桂利嗪治疗组smad2/3的表达低于缺血再灌注组,2组比较差异有统计学意义(P<0.05).结论 沙鼠脑内有smad2/3表达,脑缺血再灌注后,脑内smad2/3表达上调;氟桂利嗪干预后,其表达下调.     

《痧症全书》及其主要传本

《痧症全书》为清初痧书名著，影响到此后痧书的痧症分类及病名等。该书在流传中屡经改编删补，传本异常混乱，致使其书形式、内容几经变迁，不利于书目著录及医书传承与学术源流的研究。经比较研究该书数十种传本，归纳出4类主要传本系统。其中张本最早，于原编者王凯完成此书4年后刊行，最能反映王书真貌。沈本将张本改编重组，有多种单行本，内容、书名、作者名改变较大。何本将张本删订重编，流传最广，后世多误将何本当作王氏原本。胡本在何本基础上再加删节，增入《痧疫论》。     

峨嵋翠雀花中生物碱成份的再研究

目的 进一步研究峨翠雀花根中生物碱成分。方法 硅胶层析法，结果 从中又分得8个已知C91－二萜生物碱，且由光谱法鉴定为cardiopetalicdine 1 ,ajacine,2,browniine,3 delcaroline,4,6-demethyldelphatine5,takaosamine 6,omeieline 7和印乌碱8。结论 这些化合物均为首次从该植物中分离得到。     

National trends in admissions,repair, and mortality for thoracic aortic aneurysm and type B dissection in the National Inpatient Sample

Objective

The advent of endovascular repair for both thoracic aortic aneurysm and type B dissection has transformed the management of these disease processes. This study was undertaken to better define, compare, and contrast the national trends in hospital admissions, invasive treatments, and inpatient mortality of patients with thoracic aortic aneurysm and type B dissection in the National Inpatient Sample.