Effects of Pharmacological Autonomic Blockade on Dual Atrioventricular Nodal Pathways Physiology in Patients with Slow-Fast Atrioventricular Nodal Reentrant Tachycardia

The purpose of this study was to investigate the atrioventricular AV nodal physiology and the inducibility of AV nodal reentrant tachycardia (AVNRT) under pharmacological autonomic blockade (AB). Seventeen consecutive patients (6 men and 11 women, mean age 39 ± 17 years) with clinical recurrent slow-fast AVNRT received electrophysiological study before and after pharmacological AB with atropine (0.04 mg/kg) and propranolol (0.2 mg/kg). In baseline, all 17 patients could be induced with AVNRT, 5 were isoproterenol-dependent. After pharmacological AB, 12 (71 %) of 17 patients still demonstrated AV nodal duality. AVNRT became noninducible in 7 of 12 nonisoproterenol dependent patients and remained noninducible in all 5 isoproterenol dependent patients. The sinus cycle length (801 ± 105 ms vs 630 ± 80 ms, P < 0.005) and AV blocking cycle length (365 ± 64 ms vs 338 ± 61 ms, P < 0.005) became shorter after AB. The antegrade effective refractory period and functional refractory period of the fast pathway (369 ± 67 ms vs 305 ± 73 ms, P < 0.005; 408 ± 56 ms vs 350 ± 62 ms, P < 0.005) and the slow pathway (271 ± 30 ms vs 258 ± 27 ms, P < 0.01; 344 ± 60 ms vs 295 ± 50 ms, P < 0.005) likewise became significantly shortened. However, the ventriculoatrial blocking cycle length (349 ± 94 ms vs 326 ± 89 ms, NS) and effective refractory period of retrograde fast pathway (228 ± 38 ms vs 240 ± 80 ms, NS) remained unchanged after autonomic blockade. Pharmacological AB unveiling the intrinsic AV nodal physiology could result in the masking of AV nodal duality and the decreased inducibility of clinical AVNRT.     

文化与适合华人的心理治疗

1心理治疗配合文化时需要考虑的层面文化精神医学的发展,帮助临床专家或学者们开始注意并意识到,心理治疗的施与要考虑患者的民族背景及文化习俗。过去临床专家或学者们论述配合文化的心理治疗时,只偏重技术上如何调整的     

关于英汉翻译及有关问题——与曾文星先生商榷:曾文星回复

首先我要向《中国心理卫生杂志》社表示感谢,邀请我书写与文化有关的"心理治疗与心理咨询"一系列的述评,还邀请学者们书写对述评的反应文章。这样可以起到抛砖引玉,督促学术的讨论,提高学术交流的效果,甚为令人感到高兴。关于许教授所提的诸问题里,我赞同社会里长久被使用的文辞,不管如何,不用去勉强更改,只有必要时,可以采取逐渐的方式去更正。至于在我的述评原文里,提出若干例子,并不是提议一定要更改,而是用来说明并指出有些名词有其问题,特     

湿法活性炭(胶状活性炭)的制法及吸附性能的研究

从前在工业上所用的脱色炭,一般多以骨炭或其他的动物炭(如血炭,角蹄炭等)为主,很少使用植物炭,因为当时尚不知植物炭经活化后能变为优良的脱色炭。第一次世界大战爆发后,各国因制造防毒面具,需要大量的对气体有优良吸附性的活性炭,经研究结果,发现植物炭用适当方法处理后,除对各种毒气有优良的吸附作用外,它的脱色作用亦相当良好。随后又经不断的研究及改进,植物炭在工业上的重要性于是日渐增加。     

Arrhythmogenic Effects of Quinidine on Catecholamine-Induced Delayed Afterdepolarizations in Canine Atrial Fibers

Arrhythmogenic Effects of Quinidine on Catecholamine-induced Delayed Afterdepolarizations. We studied the effects of quinidine and tetrodotoxin (TTX), two drugs that block Na⁺ channels, on delayed afterdepolarizations (DAD) caused by norepinepbrine in atrial fibers of the canine coronary sinus. At long stimulus cycle lengths of 10 seconds, quinidine increased the amplitude of the afterdepolarizations and caused triggered activity within 1–2 minutes. Simultaneously, action potential duration (APD) was lengthened but upstroke velocity was not decreased. Prolonged exposure to quinidine eventually decreased upstroke velocity but DAD amplitude remained larger than control and triggered activity was still induced more easily. The effects of quinidine to increase afterdepolarizations was partially related to its prolongation of the APD since shortening APD with repolarizing current decreased DAD amplitude. However, DAD amplitude remained larger than control indicating that quinidine caused triggering by other mechanisms as well. TTX, on the other hand, which blocks Na⁺ channels but shortens APD, decreased DAD amplitude and triggered activity. Part but not all of these effects resulted from the shortening of APD by TTX since prolongation of APD with depolarizing current only partially restored DAD amplitude. Anti-arrhythmic drugs, therefore, may have effects on DADs that partly result from changes in the APD. Quinidine may cause cardiac arrhythmias by virtue of its effects to potentiate triggered activity.     

跨文化翻译与专业名词的适当翻译与使用

在中国科学技术协会第八次全国代表大会上,温家宝总理在所作的关于科技发展问题的报告中强调:"科技不仅是知识和技能,更是一种文化、一种精神","在科技领域,大力营造敢为人先、敢于创造、敢冒风险、敢于怀疑批判和宽容失败的环境,鼓励自由探索,发扬学术民主,提倡学术争鸣。"纵观科学技术的发展历程,可以说没有学术民主、学术争鸣,就没有真正意义上的科学发展。在积极营造科技界健康学术环境的过程中,科技学术期刊的作用十分重要甚至是不可或缺的。本刊自2010年来,主要以约稿的方式,先后刊登了关于"共情(empathy)"、"精神分裂症治疗指南"等学术讨论性文章。本刊顾问美国夏威夷大学曾文星教授以"文化与心理治疗"为主题的系列述评,引发了国内几位知名学者就有关学术问题的评论和讨论,本文就是这批文章的最后几篇。我们借此机会,向曾文星教授、许又新教授、赵旭东教授等应本刊邀请撰写相关文章的作者,表达诚挚的谢意。我们期待和欢迎有更多的读者、作者,针对本刊发表的论文或自己研究领域的热点问题,以学术评论、讨论以及争鸣的形式发表自己的学术观点,以期形成我国心理(精神)卫生领域的学术民主风气,从而促进这一领域学术水平的提高。     

Diagnosis and Ablation of Multiform Fascicular Tachycardia

Ablation Multiform Fascicular Tachycardia . Introduction: Fascicular tachycardia (FT) is an uncommon cause of monomorphic sustained ventricular tachycardia (VT). We describe 6 cases of FT with multiform QRS morphologies. Methods and Results : Six of 823 consecutive VT cases were retrospectively analyzed and found attributable to FT with multiform QRS patterns, with 3 cases exhibiting narrow QRS VT as well. All underwent electrophysiology study including fascicular potential mapping, entrainment pacing, and electroanatomic mapping. The first 3 cases describe similar multiform VT patterns with successful ablation in the upper mid septum. Initially, a right bundle branch block (RBBB) VT with superior axis was induced. Radiofrequency catheter ablation (RFCA) targeting the left posterior fascicle (LPF) resulted in a second VT with RBBB inferior axis. RFCA in the upper septum just apical to the LBB potential abolished VT in all cases. Cases 4 and 5 showed RBBB VT with alternating fascicular block compatible with upper septal dependent VT, resulting in bundle branch reentrant VT (BBRT) after ablation of LPF and left anterior fascicle (LAF). Finally, Cases 5 and 6 demonstrated spontaneous shift in QRS morphology during VT, implicating participation of a third fascicle. In Case 6, successful ablation was achieved over the proximal LAF, likely representing insertion of the auxiliary fascicle near the proximal LAF. Conclusions : Multiform FTs show a reentrant mechanism using multiple fascicular branches. We hypothesize that retrograde conduction over the septal fascicle produces alternate fascicular patterns as well as narrow VT forms. Ablation of the respective fascicle was successful in abolishing FT but does not preclude development of BBRT unless septal fascicle is targeted and ablated. (J Cardiovasc Electrophysiol, Vol. 24, pp. 297‐304, March 2013)     

Characteristic abnormal findings of ambulatory blood pressure indicative of hypertensive target organ complications

To study the correlation between ambulatory blood pressure andtarget organ complications of hypertension, ambulatory bloodpressure monitoring was performed on 290 patients with mildto moderate essential hypertension before treatment. Their targetorgan complications of hypertension were assessed by ECG, chestX-ray, urinalysis and an eye-fundus examination. An average ambulatory diastolic blood pressure value greaterthan the casual diastolic blood pressure was found in 35% ofsubjects with ECG evidence of left ventricular hypertrophy (LVH)and 5. 2% of subjects without (P<0.0001); in 36. 5% of patientswith chest roentgenographic evidence of LVH and 8.4% of patientswithout (P< 0.0001); in 38. 5% of patients with proteinuriaand 11% of patients without (P< 0. 0001); and in 27. 1% ofsubjects with retinopathy and 10. 7% of subjects without (P<0.01).A similar result was observed for the systolic blood pressure.A reversed circadian pattern of ambulatory diastolic blood pressurewas observed in 32. 5% of patients with ECG evidence of LVHand 12. 9% without (P< 0. 0001); in 28. 8% of patients withchest roentgenographic evidence of LVH and 16% without (P<0.05); in 26. 9% of subjects with proteinuria and 17. 4% without(P<0. 05); in 37. 5% of patients with retinopathy and 14.5% without (P<0.0001). A similar result was also demonstratedfor ambulatory systolic blood pressure. There was a close relationshipbetween the blood pressure load and hypertensive target organcomplications in terms of LVH and proteinuria, and between significantnocturnal reduction of ambulatory systolic blood pressure andLVH. The ambulatory blood pressure average also seemed to beara good relationship to LVH. In this study, 24 h ambulatory blood pressure monitoring revealeda close relationship between hypertensive target organ damage(ECG and chest roentgenographic evidence of L VH, proteinuriaand retinopathy) and the parameters of such measurements interms of blood pressure pattern (reversed circadian pattern),comparisons between casual blood pressure and ambulatory bloodpressure in addition to pressure load, and blood pressure average.     

HUMAN β-ENDORPHIN: SYNTHESIS AND BIOLOGICAL ACTIVITY OF ANALOGS WITH SUBSTITUTIONS IN POSITIONS 2, 9, 18, 27 AND 31

Four analogs of the opioid peptide human β-endorphin (β_h-EP) have been synthesized: [d -Lys⁹,Phe²⁷,Gly³¹]-β_h-EP, [d -Phe¹⁸,Phe²⁷,Gly³¹)-β_h-EP, [d -Thr²,d -Lys⁹,Phe²⁷,Gly³¹]-β_h-EP, and [d -Thr²,d -Phe¹⁸,Phe²⁷,Gly³¹]-β_h-EP. All are practically indistinguishable from β_h-EP in the guinea pig ileum assay. All show diminished analgesic potency in the mouse tail-flick assay.