羊心淋巴流阻断后血清生化指标的改变

为给临床心脏术后监测心淋巴管损伤程度及可能出现的并发症提供参考指标，以手术方法阻断羊心淋巴流并对其血清相关成份进行了测定。实验发现，实验组术后谷草转氨酶（ＳＧＯＴ）、谷丙转氨酶（ＳＧＰＴ）、碱性磷酸酶（ＡＫＰ）、乳酸脱氢酶（ＬＤＨ）均有不同程度的增高，以ＳＧＯＴ增高最为明显，术前均值为４７．５３Ｕ，术后２天增至１０４．２０Ｕ，高峰出现时间最早，多在术后２４小时。血清离子改变中低钾最为突出，血钾在术后２天明显降低（Ｐ＜０．０１），术后７天逐渐恢复，术后１４天恢复至术前水平。血清蛋白改变以球蛋白降低、白蛋白／球蛋白比值升高为主。提示心淋巴循环郁滞可导致心肌细胞损伤、毛细血管通透性和结构的改变。不同酶活性的变化对郁滞的敏感度存在着差异。     

Evaluation of non-invasive blood pressure measurement by the Finapres method at rest and during dynamic exercise in subjects with cardiovascular insufficiency

The accuracy and precision of the Finapres in recording rest and exercise blood pressure compared with the intra-arterial (aortic and brachial) and random-zero sphygmomanometer methods was assessed in 84 ischaemic patients in three different studies. Firstly, comparison at rest with the aortic intraarterial pressure in 50 ischaemic patients demonstrated that the Finapres systolic (136.5 ± 21.1 vs. 129.3 ± 19.0 mmHg;p < 0.001) and mean (92.4 ± 13.4 vs. 90.7 ± 11.4 mmHg;p < 0.001) arterial pressures were higher and diastolic pressures lower (70.4 ± 11.5 vs. 71.5 ± 9.8 mmHg;p < 0.001). The reproducibility of the Finapres and invasive method was similar for systolic (4.6% vs. 4.0%), diastolic (2.8% vs. 2.7%) and mean (3.3% vs. 3.0%) blood pressures. Second, in seven subjects studied twice at rest and during 4 min supine bicycle exercise, the exercise increase in blood pressure was greater on the Finapres compared with the brachial intra-arterial pressure (systolic +10.2 ± 6.3 vs. +3.6 ± 9.8 mmHg; diastolic +9.6 ± 11.1 vs. +0.2 ± 2.1 mmHg;p = 0.02 for each); however, at steady-state the peak/trough differences in pressure between the methods were similar. Thirdly, compared under rest conditions, to random zero sphygmomanometer (RZO), the Finapres systolic pressure was higher (6.8 ± 3.5 mmHg) and diastolic pressure lower (–6.0 ± 1.9 mmHg). During upright bicycle exercise, the difference between the Finapres and RZO in systolic blood pressure increased at each level of exercise (+14.3 ± 4.2, +17.9 ± 4.0 and +22.2 ± 4.1 mmHg respectively at each exercise stage:p < 0.01). For RZO, diastolic blood pressure fell as exercise workload increased whereas Finapres diastolic blood pressure increased on exercise (3.1 ± 2.6, 7.0 ± 2.1 and 8.1 ± 2.0 mmHg respectively:p < 0.01). Thus there were systematic differences between the values recorded by the Finapres and proximal blood pressure methods and limited agreement in the rest to exercise increments related to light exercise. Calibration of the Finapres values in terms of the other methods is limited by the variable relationship to these related changes in arterial distensibility.     

Induction of type II collagen-specific antibody production in blood lymphocyte cultures of rhesus monkeys (Macaca mulatta) with collagen-induced arthritis using the immobilized native antigen.

Peripheral blood mononuclear cells (PBMC) from Rhesus monkeys previously immunized with bovine type II collagen to induce arthritis were cultured with the same antigen. Because the native protein is poorly soluble in culture medium a heating step is often used. The antigen in this form induced PBMC proliferation, but epitopes for the induction of antibody production and arthritis were lost. To keep the native protein intact it was coated on affigel beads. With the immobilized antigen specific antibody production could be induced.     

Reduction in Internal Carotid Arterial Blood Flow Velocity in Children During Antiepileptic Drug Therapy with Clinical Dosages

Summary: We studied the effect of antiepileptic drugs (AEDs) on internal carotid artery (ICA) blood flow velocity, as an index of total cerebral blood flow (CBF). The subjects were 45 newly diagnosed children with febrile convulsion or epilepsy who were seizure-free for a period long enough not to affect the results. They had no neurologic deficit, received fixed monotherapy, and were examined by a noninvasive Doppler ultrasound method, in comparisonwith 13 age-matched normal volunteers with no AED. In 30 patients, the measurements were performed before and after AED administration [10 with phenobarbital (PB), 10 with carbamazepine (CBZ), and 10 with valproate (VPA)], and performed before and after AED discontinuation in the remaining 15 patients (all with PB). Normal volunteers underwent the two consecutive examinations with a mean interval equal to that of the entire patient group, and there was no difference in velocity values between the measurements. In patients receiving CBZ or VPA, a significant reduction was noted in blood flow velocity after drug administration. Although velocity values in the patients receiving PB did not change after drug administration, they were significantly increased after complete discontinuation. In the present study, a slight but significant reduction in CBF caused by AED administration at therapeutic doses in children was suggested.     

心脏搭桥术对糖尿病人降糖治疗方案的影响

目的 :通过观察 型糖尿病 (DM- )行心脏冠脉搭桥术 (CABG)术后血糖水平的升高到恢复至术前状态的过程 ,从而判断 CABG对 DM- 降糖治疗的影响。方法 :选择 36例 DM- 合并冠心病病人 ,均于体外循环 (CPB)下行心脏搭桥术 ,从术前监测血糖 ,直至术后第七天 ,于术中及术后根据血糖水平适当应用胰岛素 ,观察其对降糖治疗效果及血糖趋于稳定的过程 ,从而判断 CABG对 DM- 血糖的影响。结果 :术中及术后 1～ 3d血糖会较术前明显升高 ,需加用胰岛素助降糖 ,术后 3d血糖渐降 ,第六天趋于稳定 ,第七天恢复至接近术前水平。结论 :DM- ,病人行 CABG术 ,只要围术期有效控制血糖 ,术后血糖基本会逐渐恢复至术前状态 ,对其今后的降糖治疗不会造成严重影响     

A porcine model for sequential assessments of cerebral haemodynamics and metabolism

We present a physiologically stable porcine model designed for sequential assessments of pharmacological effects on mean hemispheric cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRO2) at sustained normocapnia. The dynamic influence of continuously administered fentanyl (0.040 mg.kg-1.h-1 i.v.), nitrous oxide (70%) and pancuronium (0.30 mg.kg-1.h-1 i.v.) on these variables was studied in eight normoventilated pigs. CBF was reliably assessable at 10-min intervals by clearance of intra-arterially injected 133Xe, monitored by an extracranial scintillation detector. CMRO2 was calculated from CBF and the simultaneously measured cerebral arteriovenous difference in blood oxygen content. The intracerebral distribution of a contrast medium injected into the external and internal carotid arteries was studied by angiography, and the cerebral venous outflow was investigated by measurements of the distribution of an intra-arterially administered non-diffusible tracer, [99mTc]pertechnetate, to the internal and external jugular veins. After a 3-h equilibration period, CBF and CMRO2 were determined on six occasions over a study period lasting 1 h 40 min. The mean ranges of these variables were 56-60 and 1.9-2.0 ml.100 g-1.min-1, respectively. We conclude that the model enables repeated assessments of CBF and CMRO2 under stable physiological background conditions and thus valid cerebral pharmacodynamic investigations of drugs given for anaesthesia.     

主动吸入药物烟对大鼠一氧化氮的影响

目的　探讨主动吸入药物烟对大鼠NO的影响。方法　制备大鼠主动吸烟模型 ,采用硝酸还原酶法测定各组大鼠血清、肺、心肌及脑组织的NO含量。结果　非药物烟组大鼠血清、肺、心肌及脑组织中NO含量明显低于非给烟对照组 ,药物烟高、中剂量组NO含量明显高于非药物烟组 ,接近非给烟对照组。结论　吸烟对大鼠血液、肺、心肌及脑组织有不同程度的损伤作用 ,使NO含量降低 ;药物烟具有一定的保护和防止NO含量降低的作用。     

静脉血气分析及其临床应用进展

动脉血气分析是严重心肺疾病和许多代谢性疾病的重要检测手段，在血流动力学稳定状态下，动、静脉血气的CO2气体含量和酸碱参数非常接近，但在循环功能衰竭等情况下，动、静脉血气出现分离现象，此时可能需同时作静脉血气。静脉血气分析对危重患者特别是循环衰竭的患者可以提供组织氧合和酸碱状态更切实的评价，并可能对有效复苏提供更好的指导。     

Intensity-dependent regional cerebral blood flow during 1-Hz repetitive transcranial magnetic stimulation (rTMS) in healthy volunteers studied with H215O positron emission tomography: I. Effects of primary motor cortex rTMS.

BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) affects the excitability of the motor cortex and is thought to influence activity in other brain areas as well. We combined the administration of varying intensities of 1-Hz rTMS of the motor cortex with simultaneous positron emission tomography (PET) to delineate local and distant effects on brain activity. METHODS: Ten healthy subjects received 1-Hz rTMS to the optimal position over motor cortex (M1) for producing a twitch in the right hand at 80, 90, 100, 110, and 120% of the twitch threshold, while regional cerebral blood flow (rCBF) was measured using H(2)(15)O and PET. Repetitive transcranial magnetic stimulation (rTMS) was delivered in 75-pulse trains at each intensity every 10 min through a figure-eight coil. The regional relationship of stimulation intensity to normalized rCBF was assessed statistically. RESULTS: Intensity-dependent rCBF increases were produced under the M1 stimulation site in ipsilateral primary auditory cortex, contralateral cerebellum, and bilateral putamen, insula, and red nucleus. Intensity-dependent reductions in rCBF occurred in contralateral frontal and parietal cortices and bilateral anterior cingulate gyrus and occipital cortex. CONCLUSIONS: This study demonstrates that 1-Hz rTMS delivered to the primary motor cortex (M1) produces intensity-dependent increases in brain activity locally and has associated effects in distant sites with known connections to M1.     

臀上血管深上支的应用解剖

本文观察了52侧(男46,女6)成人尸体臀上动、静脉深上支进入髂嵴情况.臀上动、静脉深上支分为前、中、后支;本文测量了臀上动、静脉深上支的外径及各分支进入髂嵴的距离.臀上动、静脉深上支的分支在髂嵴前部及中部分布较多,前支的分支为3～8支,其中以4～6支者为多见,占78.8±5.5％;中支的分支1～4支,其中以2～3者为多见,占73.1±6.1％.因此,臀上动脉深上支作为游离髂骨移植术取髂嵴的前部和中部较宜.