鼻内镜下等离子低温射频治疗常年性变应性鼻炎的临床观察

目的探讨鼻内镜下等离子低温射频治疗常年性变应性鼻炎(PAR)的疗效及其优越性。方法在鼻内镜下用等离子低温射频治疗PAR48例,按照海口会议修订的“过敏性鼻炎诊断和疗效评定标准”,用计分法分别评定其疗效。结果该组48例术后随访半年进行评价,其中显效27.1%(13/48),有效58.3%(28/48),无效14.6%(7/48),总有效率为85.4%。疗效评分显示治疗前平均总分为(9.58±1.69)分,治疗后为(5.63±1.15)分(P<0.05)。结论鼻内镜下等离子低温射频烧灼筛前神经终末区域治疗PAR,具有简便、安全等优点,短期效果显著,特别适用于临床上应用抗组胺类药物及鼻内应用糖皮质激素治疗效果不甚理想及由于各种原因不能长期接受抗组胺类药物及鼻内应用糖皮质激素治疗的患者;但长期疗效有待进一步研究。     

血清纤维结合蛋白的酶免疫检测法

目的建立血清纤维结合蛋白(Fn)含量的酶免疫分析(EIA)检测方法。方法利用现有Fn检测试剂盒建立Fn的EIA测定法,并对所建立的方法从灵敏度、精密度、特异性、重复性等方面进行方法学评价。结果该法灵敏度为11．69ml／L,线性范围为50～300mg／L,批内变异系数为 3．82％,批间变异系数为5．10％,回收率97．7％。肺结核组及正常对照组血清Fn含量分别为 (188．82±5．51)mg／L和(275．25±18．11)mg／L,两组间差异有显著性意义(P<0．01);肺结核稳定期患者血清Fn显著高于进展期及好转期(P<0．05)。结论该方法线性范围适宜,准确度、精密度较好,符合临床检验工作要求。     

雷米普利降低高血压患者心房颤动发生率以及改善左心房内径临床观察

目的观察血管紧张素转换酶抑制剂(ACEI)雷米普利降低高血压患者心房颤动(AF)发生率及对左心房内径的影响。方法将180例原发性高血压患者分为治疗组(90例)和对照组(90例)。治疗组给予雷米普利(2.5～15)mg/d口服,连服50个月。对照组苯磺碳氨氯地平(2.5～10)mg/d口服,连服50个月。结果治疗50个月后治疗组AF发生率3.4%,对照组AF发生率为8.05%;治疗组左心房内径缩小(2.0±1.5)mm,对照组左心房内径缩小(0.0±1.6)mm。2组相比P<0.05,有统计学意义。结论雷米普利可降低高血压患者AF的发生率并缩小左心房内径。     

维甲酸对原发性高血压大鼠心肌血管平滑肌增殖的作用及其机制

目的:探讨维甲酸对自发性高血压大鼠(SHR)心肌、血管平滑肌增殖的影响和肾素-血管紧张素-醛固酮系统(RAS)所起的作用。方法:18只SHR大鼠随机分为全反式维甲酸治疗组、对照组、卡托普利治疗组,每组6只。分别予治疗组和对照组皮下注射全反式维甲酸(ATRA)10mg/Kg体重或溶媒,高血压药物治疗组予卡托普利0.25mg/Kg体重管饲,每天一次,均疗程4周。疗程结束后观察各组SHR大鼠心肌、血管平滑肌(VSMC)增殖细胞核抗原(PCNA)的变化以及心肌ACE-mRNA、ACE2-mRNA的表达。结果:维甲酸治疗组心肌、血管平滑肌增殖细胞核抗原(PCNA)表达显著低于对照组(P<0.01),卡托普利治疗组的PCNA表达也显著低于对照组(P<0.01),但维甲酸治疗组与卡托普利组比较也有显著差异(P<0.01);维甲酸治疗组ACE-mRNA的表达低于卡托普利组及对照组(P<0.01),卡托普利组ACE-mRNA的表达也低于对照组(P<0.01);而维甲酸组ACE2-mRNA的表达则高于对照组及卡托普利组(P<0.01),后两组之间则无显著差异(P>0.05)。结论:维甲酸能抑制SHR模型心肌、血管平滑肌PCNA的表达,并在增加ACE2-mRNA表达的同时减少ACE-mRNA的表达,从而有可能干预增殖性血管疾病的病程。     

Demonstration of Right and Left Atrial Dissociation by Atrial Rapid Pacing or Extrastimulation During Fast-Slow (Uncommon) Form of Atrioventricular Nodal Reentrant Tachycardia

Some recent works suggest that extranodal atrial fibers may form part of the reenlry circuit in the atrioventricular (AV) nodal reentrant tachycardia (AVNRT). This hypothesis is based on the fact that the perinodal dissection successfully abolished AVNRT while preserving intact AV conduction. Apart from the surgical success, the electrophysiological evidence supporting this hypothesis has not been demonstrated, especially in the uncommon (fast-slow) form of AVNRT. We present some electrophysiological evidence suggesting atrial participation in eight patients with the fast-slow form of AVNRT. During the tachycardia, rapid pacing or extrastimulation was done from the orifice of the coronary sinus (CS) and the right atrium (RA), while recording the electrograms of the CS and the low septal RA. In seven patients, right and left atrial dissociation was demonstrated during pacing from the RA, while in the remaining one this was demonstrated from the CS. The interatrial dissociation will be unlikely if the intranodal reentry circuit connects with the atria via a single upper common pathway. This suggests that the upper turnaround of the reentry circuit involves atrial tissue and that the extranodal accessory pathway with long conduction times may form the ascending limb of the circuit (atrionodal reentry). Alternatively, the reentry circuit is entirely intranodal and two or more connecting pathways are present between the atria and the circuit.     

Regulation of fluid intake in dogs following water deprivation

Whereas water loss in land living animals occurs continuously, water intake takes place discontinuously. At the normal operating set point of plasma osmolality, urine is more concentrated than plasma due to secretion of vasopressin. Thus animals operate around a state of mild dehydration. As water loss occurs, the severity of dehydration and thirst increase in intensity and at some point water intake occurs. Sufficient water is consumed to return plasma osmolality to the normal operating set point. Food intake and water balance are interdependent as food provides the osmoles which determine obligatory renal solute excretion. When dry food with the same osmotic content was substituted for canned food (water content 74%), dogs increased water intake from 24.2 +/- 4.3 to 62.2 +/- 8.8 ml/kg. Urine output and urine osmolality were unchanged, as under conditions of normal hydration, near maximal urine concentration is achieved. Changing water intake is the only available variable to maintain water balance. During water deprivation, the major renal mechanism appears to be natriuresis. In rehydration, satiety mechanisms ensure appropriate water intake and renal sodium conservation restores sodium balance.     

内皮素-1对高血压病患者肠系膜动脉平滑肌细胞钙激活钾通道活性的影响

目的　探讨内皮素 1(ET1)对高血压病患者血管平滑肌细胞KCa通道活性的影响。方法　选择高血压病患者 18例 ,血压正常者 17例 ,两组患者均于腹部手术时取肠系膜动脉小分支用酶消化法获得单个血管平滑肌细胞。以膜片钳技术检测KCa通道的活性 ,记录不同钳制电压下单通道电流的平均开放时间 (To)、平均关闭时间 (Tc)、平均开放概率 (Po)、电流幅值 (Am) ,并绘制成电流 电压关系曲线。再分别加入Ca2 + (10 -8、10 -7、10 -6mol/L)、ET1(2× 10 9mol/L、4×10 9mol/L、6× 10 9mol/L、8× 10 9mol/L)后检测To、Tc、Po、Am等参数变化。结果　①高血压病患者KCa通道活性变化 :于细胞内面向外膜片下 ,在对称性高钾液中 ,高血压病组KCa通道平均开放概率增加 ,关闭时间延长、开放时间缩短。在浴液中分别加入Ca2 + 后 ,两组KCa通道均被明显激活 ,但血压正常组Po的增加显著高于高血压病组 (P <0 .0 0 1)。②ET1对高血压病患者KCa通道活性的影响 :血压正常者在内面向外式膜片下 ,Po、Tc均先增加后降低 ,显示低浓度时兴奋、高浓度时抑制 ,然而高血压病患者肠系膜血管平滑肌KCa通道对ET1则缺乏反应。结论　高血压病患者肠系膜动脉平滑肌细胞KCa通道活性明显高于血压正常者 ,但对Ca2 + 的敏感性降低。ET1对高血压病人KC     

The synchronization of respiration and swallow sounds with videofluoroscopy during swallowing

Simultaneous recording of adult subjects sipping small amounts of fluid from a cup have been obtained by videofluoroscopy together with feeding respiratory patterns and swallow sounds from the Exeter Dysphagia Assessment Technique (EDAT). These allowed visual representations of respiration and swallow sounds to be superimposed on a videofluoroscopy recording using a split-screen technique. Sequentially numbered, 1/50 sec, half-frame photographic prints were examined and schematic drawings of the relevant radiographs were made. These were superimposed on to the actual EDAT printed chart of the same swallow event, theri exact time relationship with respiration and cervical swallow sounds being preserved. The results allow events in the barium videofluoroscopy to be related to events in the feeding respiratory pattern and swallow sounds recorded by EDAT.     

彩色多普勒超声血流图在心脏手术中的应用(附19例病例分析)

在心脏手术中应用多普勒彩色超声心动仪直接探测和观察19例患者,其中风湿性心瓣膜病11例、先天性心脏病7例、左心房粘液瘤1例。风心病及左房粘液瘤患者手术前、中检查的结果基本一致;先心病术前诊断符合率为84.2％(5/7),术中诊断符合率为100％。本文对检查结果作了分析讨论,并提出符合我国情况的有关检查设想。