CT-1-CP-induced Ventricular Electrical Remodeling in Mice

The chronic effects of carboxyl-terminal polypeptide of Cardiotrophin-1(CT-1-CP) on ventricular electrical remodeling were investigated. CT-1-CP, which contains 16 amino acids in sequence of the C-terminal of Cardiotrophin-1, was selected and synthesized, and then administered to Kunming mice(aged 5 weeks) by intraperitoneal injection(500 ng·g-1·day-1)(4 groups, n=10 and female: male=1:1 in each group) for 1, 2, 3 and 4 weeks, respectively. The control group(n=10, female:male=1:1) was injected by physiological saline for 4 weeks. The epicardial monophasic action potential(MAP) was recorded by using a contact-type MAP electrode placed vertically on the left ventricular(LV) epicardium surface, and the electrocardiogram(ECG) signal in lead Ⅱ was monitored synchronously. ECG intervals(RR, PR, QRS and QT) and the amplitude of MAP(Am), the maximum upstroke velocity(Vmax), as well as action potential durations(APDs) at different repolarization levels(APD30, APD50, APD70, and APD90) of MAP were determined and analyzed in detail. There were no significant differences in RR and P intervals between CT-1-CP-treated groups and control group, but the PR segment and the QRS complex were greater in the former than in the latter(F=2.681 and 5.462 respectively, P<0.05). Though QT interval and the corrected QT interval(QTc) were shorter in CT-1-CP-treated groups than in control group, the QT dispersion(QTd) of them was greater in the latter than in the former(F=3.090, P<0.05) and increased with the time. The ECG monitoring synchronously with the MAP showed that the compression of MAP electrode on the left ventricular epicardium induced performance similar to myocardium ischemia. As compared with those before chest-opening, the PR segment and QT intervals remained basically unchanged in control group, but prolonged significantly in all CT-1-CP-treated groups and the prolongation of QT intervals increased gradually along with the time of exposure to CT-1-CP. The QRS complex had no significant change in control group, one-week and three-week CT-1-CP-treated groups, but prolonged significantly in two-week and four-week CT-1-CP-treated groups. Interestingly, the QTd after chest-opening was significantly greater than that before chest-opening in control group(t=5.242, P<0.01), but decreased along with the time in CT-1-CP-treated groups. The mean MAP amplitude, Vmax and APD were greater in CT-1-CP-treated groups than those in control group, and became more obvious along with the time. The APD in four CT-1-CP-treat groups was prolonged mainly in middle to final repolarization phase. The difference among these groups became significant in middle phase(APD50)(F=6.076, P<0.01) and increased furthermore in late and final phases(APD70: F=10.054; APD90: F=18.691, P<0.01) along with the time of injection of CT-1-CP. The chronic action of CT-1-CP might induce the adapting alteration in cardiac conductivity and ventricular repolarization. The amplitude and the Vmax of the anterior LV epicardial MAP increased obviously, and the APD prolonged mainly in late and final phase of repolarization.     

食管和改良V1导联同步心电图对心动过速直观定性及定位的意义

目的评价食管和改良V     

食管和改良V_1导联同步心电图对心动过速直观定性及定位的意义

目的 :评价食管和改良 V1导联同步记录心电图对心动过速定性、定位的应用价值。方法 :应用美国 BRENTWOOD1 2导联同步记录心电图机 ,记录 63例心动过速发作时的标准导联和食管及改良 V1导联心电图 ( ECGe+ ECGvv1) ,并分析心动过速的性质和发病机制。结果 :诊断左侧旁路合并 35例 ,右侧旁路 2例均合并房室折返性心动过速 ( AVRT) ;房室结双径路并房室结折返性心动过速 ( AVNRT) 2 4例 ;房性心动过速 2∶ 1传导和室性心动过速 1∶ 1逆传各 1例。除后 2例患者因先天性心脏病行外科手术治疗外 ,余患者均经心内电生理检查和射频电消融治疗所证实。结论 :ECGe+ ECGvv1能分别反映左右心房激动顺序 ,在心动过速定性方面和异位节律点的定位方面具有简单、直接、准确、无并发症等优点和良好的应用价值。     

骨保护素不同层面对内皮细胞的影响

目的：观察骨保护素（OPG）作为始动因素对人内皮细胞的数量变化及内皮型一氧化氮合酶 （endothelial nitric oxide synthase,eNOS）和一氧化氮（NO）产生的影响。方法：常规培养永生化的人内皮细胞,以不同浓度（0、0.5、1.0、2.0、4.0、6.0、8.0、10.0及100.0 ng/ml,共9组）的OPG作用细胞48 h后,用细胞计数试剂盒 8（cell count kit,CCK 8）来检测细胞的数量及NO检测试剂盒检测NO的产量。用免疫细胞化学染色法检测eNOS蛋白表达的水平,实时定量PCR检测eNOS基因的定量表达。结果： 与对照组的细胞数（0.759±0.067）相比,8.0 ng/ml OPG组的细胞数为（1.091±0.200）,P〈0.05,10.0 ng/ml OPG组的细胞数为（1.103±0.152）及100.0 ng/ml OPG组的细胞数为（1.231±0.192）,均P〈0.01。8.0 ng/ml OPG组NO生成量为（102224±0612） μmol/L（P〈0.05）,10.0 ng/ml OPG组NO生成量为（117.183±0.552） μmol/L和1000 ng/ml OPG组NO生成量为（128.216±0.492） μmol/L（均P〈0.01）。同时eNOS蛋白及eNOS mRNA的表达量在6.0 ng/ml、8.0 ng/ml、10.0 ng/ml及100.0 ng/ml OPG组均显著地呈浓度依赖性增加（均P〈0.01）。结论：OPG具有促进内皮细胞增殖效应,可能在抗动脉粥样硬化过程中有一定意义,且与浓度梯度呈明显的正相关。     

144例陈旧性心肌梗塞患者Holter监测临床分析

１４４例陈旧性心肌梗塞患者Ｈｏｌｔｅｒ监测临床分析吴剑萍，饶利亚目前，对改善心肌梗塞（心梗）患者长期预后的重要性日益引起重视。据此，笔者总结１９８６年８月至１９９４年８月间１４４例陈旧性下壁、前壁心梗患者的连续２４小时动态心电图监测资料，对其中心律失...     

老年原发性高血压并靶器官损害的临床研究

目的 :研究老年原发性高血压 (EH)并靶器官损害的临床特点。方法 :观察了 2 6 1例老年EH与 2 0 8例非老年EH患者的 2 4h动态血压、2 4h动态心电图、心脏B超、头颅CT或MRI及血液生化检查。结果 :单纯收缩期高血压及血压昼夜节律消失在老年EH组多见 ,并且老年EH尤其是血压昼夜节律消失者较非老年EH并发靶器官损害多见。结论 :老年EH具有单纯收缩期高血压多见的临床特点 ,其临床特点与并发靶器官损害相关。因此 ,临床应重视单纯收缩期高血压的治疗 ,并且在降压治疗过程中注意血压节律的调整。     

调脂治疗对冠心病病人血脂和心肌缺血影响的研究

目的：探讨调脂治疗在冠心病二级预防中．能否通过纠正血脂异常而发挥抗心肌缺血的有益作用和改善临床症状。方法：选择22例冠心病合并高三酰甘油（TG)、低高密度脂蛋白-胆固醇(HDL-C)血症病人应用非诺贝特治疗一月后．观察其治疗前后血脂和部分病人缺血总负荷的变化以及临床症状是否改善．缺血总负荷的变化指24小时内动态心电图发作性ST段水平型或下斜性压低≥1mm相加的总时间。结果：经非诺贝特治疗一月后．血TG水平明显下降(分别为3.14±0.9kmmol/L和1．16±0.40mmol／L，P<0.01)。血胆固醇(TC)水平也明显下降(分别为6.06±0.52mmol／L和5.38±0.28mmol／L,P<0.05)；调脂治疗前后血HDC-C、HDL2-C和HDL3-C则分别为0.85±0.14、0．26±0.16、0．67±0.17mmol／L和1.15±0.28、0.39±0.15、0．75±0.18mmol／L，三项指标治疗前后均有显性差异(均P<0．05)。7例缺血总负荷的变化为：3例发作性ST段下移均有降低．4例呈固定性ST段下移则无明显改变。11例病人硝酸酯类制剂用量和胸痛发作减少。结论：调脂药非诺贝特能显降低冠心病病人血TG和TC水平．升高HDL水平．并可能对改善心肌缺血发挥有益作用。     

Expression Patterns of Sarcomeric α-Actin, α-Actinin and UCP2 in the Myocardium of Kunming Mice after Exposure to C-Terminal Polypeptide of Cardiotrophin-1

Cardiotrophin-1 （CT-1） activates a distinct form of cardiac muscle cell hypertrophy in which the sarcomeric units are assembled in series. The aim of the study was to determine the expres- sion pattern of sarcomeric contractile protein α-actin, specialized eytoskeletal protein α-actinin and mitochondrial uncoupling protein-2 （UCP2） in myocardial remodeling induced by chronic exposure to CT-1. Kunming mice were intraperitoneally injected with carboxy-terminal polypeptide （CP） of CT-1 （CT-1-CP, 500 μg·kg-1·day^-1） for 1, 2, 3 and 4 week （s）, respectively （4 groups obtained according to the injection time, n=10 each, with 5 males and 5 females in each group）, Those injected with physiological saline for 4 weeks served as controls （n=10, with 5 males and 5 females）. The heart tissues of mice were harvested at 1, 2, 3 or 4 week （s）. Immunohistochemistry （IHC） and Western blotting （WB） were used to detect the distribution and expression of sarcomeric α-actin, α-aetinin and mitoehondrial UCP2 in myocardial tissues. IHC showed that α-actin was mainly distributed around the nuclei of cardiomyo- cytes, α-actinin concentrated around the striae and UCP2 scattered rather evenly in the plasma. The ex- pression of α-actin was slightly greater than that of α-actinin and UCP2 in the control group （IHC： χ^2=6.125; WB： F=0.249, P〉0.05） and it gradually decreased after exposure to CT-1-CP. There was no significant difference in the expression of α-actin between the control group and the CT-1-CP-treated groups （χ^2=7.386, P〉0.05）. But Western blotting revealed significant difference in the expression of α-actin between the control group and the 4-week CT-1-CP-treated group （F=2.912; q=4.203, P〈0.05）. Moreover, it was found that the expression of α-actinin increased stepwise with the exposure time in CT-1-CP-treated groups and differed significantly between CT-1-CP-treated groups and the control group （ICH： χ^2=21.977; WB： F=50.388; P〈0.01）. The e     

海口市社区卫生服务体系发展状况调查及优势、潜力和困境探讨

目的 了解海口市社区卫生服务（CHS）体系发展状况,并探讨其优势、潜力和困境。方法 以海口市4个区的所有CHS中心和CHS站为调查对象,采用卫生部妇社司下发的《社区卫生服务站常规监测调查表》和《社区卫生服务中心常规监测调查表》,对2007-2010年海口市CHS机构的总体规模、卫生人力资源、财务收支及卫生服务提供情况等进行调查。抽取部分CHS机构的处方,采用卫生部妇社司下发的《社区卫生服务机构合理用药及处方费用常规监测调查表》,对2008-2010年CHS机构处方的用药个数、抗生素和激素使用情况及费用进行调查。随机拦截部分就诊CHS机构的社区居民,采用卫生部妇社司下发的《社区卫生服务利用者满意度调查表》,对2009-2010年社区居民的CHS知晓、利用及满意情况进行调查。结果 2010年建成并投入运行的CHS中心已有11家,完成规划数的55.0%（11/20）;CHS站74家,完成规划任务。到2010年底,全市CHS中心的平均固定资产额为300.51万元,CHS站为44.66万元。2010年底,CHS机构卫生技术人员总数已达到1 180人,医师403人,护士548人,医护比为1∶1.36。CHS站和CHS中心分别于2009年和2010年实现了收支基本持平,并略有盈余;在收入方面,业务收入是CHS机构收入的主要来源,占总收入的70%以上;在支出方面,业务支出和人力支出是CHS机构支出的主要部分,CHS中心药品支出占业务支出的60%以上,CHS站则高达78%以上,在人力支出方面,人员的工资支出占绝大部分。2010年,海口市CHS机构的门急诊总量为1 633 913人次,占当年全市所有各级医疗机构门急诊总量6 151 781人次的26.6%;2007年CHS机构的急诊量为36 041人次,到2010年达到257 282人次,为2007年的7.1倍;双向转诊始终表现为上转多于下转的不对等态势。2008-2010年,2/3的处方中使用了抗生素,而且使用二联抗生素和激素的处方数均占抽查总数的20%以上。2010年,全市CHS机构共登记管理高血压患者35 634人,糖尿病患者10 550人。满意度较高的是CHS机构医务人员的服务态度,其次为等候时间和医务人员的解释和交流,最低的是就诊机构的设施和设备。结论 以社会力量为主体的海口市CHS体系的优势在于资金筹措范围广,运作灵活,较短的时间内在机构的布局上实现了地域上的医疗服务可及性。其潜力首先在于成本控制相对容易,从而使药品价格下调有很大的空间;其次在高血压、糖尿病等慢性病管理方面,CHS机构逐渐积累起来的资料,为心脑血管疾病的人群防控奠定基础。目前所面临的发展困境主要是难以获得综合医院的技术支持及其私有制属性而引发的对其公益性的质疑。