先天性心脏病与柯萨奇病毒B3,B4感染的关系

采用配对病例对照研究，探讨先心病与柯萨奇病毒B3、B4感染的关系，结果显示：病例组与对照组患儿CVB3、CVB4．IgG抗体阳性率分别为59．3％、54．3％和53．6％、45．7％，差异天显著性（P值均＞0．05）；经单因素和多因素回归分析均未发现CVB3、CVB4感染与先心病有病因学联系（P＞0．05）     

ELECTRICAL REMODELLING OF CHRONIC ATRIAL FIBRILLATION

1. It is now recognized that atrial fibrillation (AF) is not a benign condition, as it is associated with a 40% increase in mortality and a doubling of the risk of stroke. 2. The development of AF leads to mechanical, electrophysiological and cellular changes in the atria that tend to sustain AF. This process is known as atrial remodelling. 3. The three electrophysiological elements in the atria that initiate and sustain AF are: (i) shortening of the refractory period and an increase in dispersion; (ii) slowing of conduction velocity; and (iii) the presence of triggerin. foci. 4. As AF is a heterogeneous disorder, therapeutic strategies include the use of devices (pacemakers and atrial defibrillators), radiofrequency ablation (focal ablation or the creation of linear lines) and drug therapy that may reverse a remodelle. atrium.     

Incremental Value of Three-Dimensional Echocardiography Over Transesophageal Multiplane Two-Dimensional Echocardiography in Qualitative and Quantitative Assessment of Cardiac Masses and Defects

In the present study, we compared three-dimensionally (3-D) reconstructed images with multiplane two-dimensional (2-D) transesophageal echocardiographic (TEE) images in 17 patients with various cardiac masses and defects. To overcome the problem of making measurements from 3-D reconstructed images, we carefully "dissected" the 3-D dataset using paraplane and anyplane 2-D sections, which were then used to obtain the maximum sizes of the cardiac masses and defects. Of the 15 vegetations and 9 abscesses detected by 3-D TEE in 7 patients, only 8 (53%) vegetations and 4 (44%) abscesses were detected by multiplane 2-D TEE (P < 0.02). Also, the exact anatomical location, shape, geometry, and extent of various cardiac masses and defects were more clearly delineated by 3-D than 2-D TEE. The maximum dimensions of cardiac masses and defects were larger by 3-D than by 2-D TEE in 17 (89%) of the 19 lesions available for comparison (P < 0.002). In addition, 3-D TEE correlated more closely than 2-D TEE when compared to surgical measurements in three patients in whom they were available. Thus, it would appear that in several instances, the exact size of the cardiac lesion could only be assessed by analysis of the 3-D volumetric dataset. Out preliminary study has demonstrated the superiority of transesophageal 3-D reconstruction over multiplane 2-D TEE in both qualitative and quantitative assessment of various cardiac mass lesions and pathological defects.     

Vasodilator effects of C-type natriuretic peptide on cerebral arterioles in rats

The vasodilator effects of C-type natriuretic peptide (CNP) were investigated in isolated rat cerebral arterioles. CNP caused dose-dependent vasodilation, maximally by 10.0±2.2% at 10⁻⁶ M. The median effective concentration (EC₅₀) was 5.2×10⁻¹⁰ M. In contrast, atrial natriuretic peptide and B-type natriuretic peptide, other members of the natriuretic peptide family, produced little or no vasodilation. Pretreatment with methylene blue (10⁻⁴ M) abolished CNP-induced vasodilation, whereas pretreatment with N^G-monomethyl-

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-arginine or indomethacin did not inhibit vasodilation. Thus, CNP is suggested to cause significant vasodilation in cerebral arterioles via a cyclic guanosine monophosphate-dependent mechanism. © 1997 Elsevier Science B.V. All rights reserved.     

超声心动图监测经导管心脏间隔缺损关闭术

应用超声心动图监测，经导管关闭先天性心脏间隔缺损９例。术中监测的主要内容有：（１）确定关闭器在心内的位置；（２）显示残余分流和瓣膜返流；（３）观察房间隔缺损球囊探测的过程。结果表明：超声心动图在显示心内结构、关闭器位置，残余分流和瓣膜流等方面有其独特性，同时可结合声学造影或术中需要进行多方面的监测。     

头皮缺损颅骨外露的修复

我科1980～1991年收治外伤性或颅面部肿瘤切除后头皮缺损颅骨外露9例,分别应用吻合血管的游离大网膜结合中厚皮片移植、游离皮瓣或轴型皮瓣转位结合皮片移植修复。讨论了修复时机、修复方法以及手术注意事项。认为双侧股前外侧游离皮瓣是修复全头皮缺损颅骨外露的可取方法,而吻合血管的游离大网膜移植修复颅骨外露的方法应尽量避免。     

Recurrence risk for major congenital heart defects in Sweden: A registry study

During the period 1981–1986, 1605 infants presenting a major congenital heart defect (CHD) were identified in Sweden. Using the personal identification numbers of the mothers, 1507 of them could be linked to the Medical Birth Registry and two controls were selected for each infant. For this total of 4521 infants, 2686 postoccurrence sibs born during the period 1981–1989 were identified from the Medical Birth Registry. The tendency to have one or more sibs was higher among cases than among controls and was correlated to the life status of the proband. This tendency did not vary according to the type of CHD when controlling for life status. The prevalence at birth of CHD was almost four times higher among sibs of CHD infants than among sibs of normal infants. The tendency to have a sib with an extracardiac malformation did not differ between CHD probands and normal probands. The importance of only including births occurring after the proband when evaluating recurrence risks is stressed. © 1994 Wiley-Liss, Inc.     

室间隔缺损的介入封堵治疗

对介入封堵治疗室间隔缺损的应用情况以及适应症、并发症等作一综述．     

高血压患者左室舒张功能与左室肥厚的关系及随龄改变

为探讨原发性高血压 (以下简称高血压 )患者的左室舒张功能和左室肥厚的关系及其随龄改变 ,抽取 1995年 2月至 2 0 0 2年 7月间门诊高血压患者 4 81例为高血压组 ,以同期体检健康者 2 54 3例为对照组 ,年龄 10～ 80岁 ,并将原发性高血压患者分为 3级 ,每级中按性别分 2组。采用惠普 2 50 0彩色多普勒超声诊断系统检测 2组的室间隔厚度、左室后壁厚度、E/A等指标。使用SPSS软件进行统计学处理分析。结果 :高血压和正常对照组相比E/A显著下降 ,室间隔和左室后壁显著增厚 (P <0 .0 1)。 2个组的E/A均随年龄下降 ,而室间隔厚度随年龄增厚 ,且室间隔厚度和E/A呈显著负偏相关 (P <0 .0 1)。在高血压分级组中 ,Ⅰ～Ⅲ级高血压组中男性的室间隔厚度均厚于女性 (均P <0 .0 1) ,Ⅰ、Ⅱ级高血压组中男性的左室后壁厚度厚于女性 (P <0 .0 5,P <0 .0 1) ,Ⅰ级高血压组中女性的E/A低于男性 (P <0 .0 5)。提示 :左室舒张功能随着年龄的增加而降低 ,而且和高血压左室肥厚呈负偏相关关系 ,性别对其也有一定的影响     

生物衍生骨复合骨髓基质干细胞修复山羊胫骨缺损的血管化研究

目的研究生物衍生骨与骨髓基质干细胞(marrow stromal stem cells, MSCs)复合修复山羊胫骨缺损的血管化过程,了解其修复长段管状负重骨缺损的血管化情况. 方法制备生物衍生骨作为支架材料,培养、诱导MSCs作为种子细胞,二者在体外复合构建组织工程骨.20只山羊双侧胫骨中段制备成20 mm长的骨-骨膜缺损模型,采取自身左右侧对照,实验侧(右侧)缺损处植入组织工程骨,对照侧(左侧)植入单纯支架材料,采用钢板内固定.术后2、4、6及8周用墨汁灌注透明标本及血管面积图像分析方法观察血管化过程,组织学观察血管形成及成骨情况. 结果术后2、4周,实验侧血管形成较对照侧少(P<0.05);术后8周,两侧均完全血管化,差异无统计学意义(P>0.05).实验侧于术后6、8周新骨形成逐渐增加,材料降解吸收较对照组快;对照侧术后8周材料孔隙内仍无明显新骨形成. 结论生物衍生骨作为骨组织工程的支架材料,能够较快发生血管化;组织工程骨成骨能力较单纯支架材料强.