直接PTCA对急性心肌梗死的QT离散的影响

目的 观察直接PTCA对急性心肌梗死（AMI）患者QT离散度（QTd) 及QTc离散度（QTcd)的影响。方法 对30例AMI患者行直接PTCA，使病变血管血流达到TIMI血流3级，于PTCA术前、术后2h、48h作同步12导心电图并测量QTd及QTcd，然后与30例正常人对照。结果 AMI组与正常对照组间QTd及QTcd有极显著差异（P＜0.01)。有室性心律失常的AMI患者其QTd和QTcd高于无室性心律失常患者，但差异无显著性（P＞0.05)，PTCA术后其QTd和QTcd下降（P＜0.01)，室性心律失常好转。结论 成功的直接PTCA可降低AMI患者的QTd和QTcd，减少室性心律失常的发生，改善预后。     

直接PTCA和溶栓对急性心肌梗塞的QT离散度的不同影响

目的：观察直接PTCA和溶栓治疗对急性心肌梗塞（AMI）患者QT离散度（QTd）及QTc离散度（QTcd）的影响。方法：对50例AMI患者行直接PTCA，使病变血管血流达到TIMI血流3级，于PTCA术前、术后2小时、48小时作同步12导心电图并测量QTd及QTcd。并与50例AMI患者行溶栓治疗进行比较。同时与50例冠脉造影正常者对照。结果：AMI组与正常对照组间QTd及QTcd有极显著差异。有室性心律失常的AMI患者其QTd和QTcd明显高于无室性心律失常患者（P＜0．05），PTCA组经PTCA术后其QTd和QTcd下降（P值均＜0．01），室性心律失常好转。经静脉溶栓组其QTd和QTcd也下降，但两者下降的程度不同，经PTCA术组其QTd和QTcd下降的程度高于静脉溶栓组，两者差异显著。结论：成功的直接PTCA和静脉溶栓均可降低AMI患者的QTd和QTcd，以往减少室性心律失常的发生，改善预后。     

急性心肌梗死早期QT间期JT间期离散度与近期严重心律失常的关系

目的 :探讨AMI早期QT间期离散度、JT间期离散度与严重心律失常的关系。方法 :测定 46例AMI患者心梗发生后第 3d的QT间期离散度 (QTd)和JT间期离度 (JTd)。并与30例正常人的对照组比较。结果 :AMI组QTd、JTd、QTcd较对照组显著增大 (P <0 0 1 )。住院期间严重室性心律失常发生组 (1 8例 )的QTd、JTd、QTcd较无严重室性心律失常组 (2 8例 )明显增大 (P <0 0 1 ) ,且发生室颤的 9例患者QTd、JTd、QTcd比无室颤的明显增大 (P <0 0 1 )。结论 :早期测定AMI患者QTd、JTd、QTcd对患者近期严重室性心律失常的发生有预测意义     

急性心肌梗死患者QT离散度的临床意义

目的观察急性心肌梗死(AMI)患者QT间期离散度(QTd)的变化,探讨其与AMI患者室性心律失常的关系。方法对比观察89例AMI患者和42例正常对照者的QTd以及校正QTd(QTcd)变化,并对AMI组有室性心律失常与无室性心律失常的患者QTd及QTcd进行比较。结果 AMI组QTd及QTcd明显大于正常对照组,AMI患者有室性心律失常组QTd及QTcd显著高于无室性心律失常组。结论 AMI患者QTd及QTcd显著延长。AMI患者QTd及QTcd增大时发生室性心律失常的可能性增大,QT间期离散度可作为AMI患者病情预测的一项无创性指标。     

阿替洛尔对急性心肌梗死Q - T 及Q - Tc 离散度的影响

目的　观察阿替洛尔对急性心肌梗死 (AMI)患者QT离散度 (QTd)和QTc离散度 (QTcd)的影响。方法　 78例AMI分为对照组 32例 ,观察组加服阿替洛尔 46例 ,分别于入院d1、d3和治疗后第 1周、第 4周测定QTd、QTcd。结果　 78例AMId1、d3测定的QTd、QTcd明显增高 ,服阿替洛尔后 4周观察组自身比较及与对照组比较QTd、QTcd明显缩短 (P<0 .0 0 1 ) ,室性心律失常发生率和院内死亡率明显降低 (P <0 .0 1 )。结论　阿替洛尔可缩小AMI患者心肌复极化离散度 ,有利于AMI患者心肌电活动的一致性和稳定状态 ,AMI患者如无缓慢性心律失常及心功能不全 ,早期应用阿替洛尔有助于防治室性心律失常和心脏事件的发生。     

急性心肌梗死患者QT离散度的临床意义

目的观察急性心肌梗死（AMI）患者QT间期离散度（QTd）的变化,探讨其与AMI患者室性心律失常的关系。方法对比观察89例AMI患者和42例正常对照者的QTd以及校正QTd（QTcd）变化,并对AMI组有室性心律失常与无室性心律失常的患者QTd及QTcd进行比较。结果 AMI组QTd及QTcd明显大于正常对照组,AMI患者有室性心律失常组QTd及QTcd显著高于无室性心律失常组。结论 AMI患者QTd及QTcd显著延长。AMI患者QTd及QTcd增大时发生室性心律失常的可能性增大,QT间期离散度可作为AMI患者病情预测的一项无创性指标。     

经皮冠状动脉腔内成形及支架术对冠心病患者QT离散度的影响

目的 :探讨经皮冠状动脉腔内成形及支架术 (PTCA +Stent)对冠心病患者QT间期离散度 (QTd)的影响。方法 :对 42例成功进行PTCA +Stent的冠心病患者 ,进行术前、后 12导联同步心电图QTd及校正后QTd(QTcd)测定。结果 :术后QTd及QTcd均明显减少 (P <0 .0 1) ,单支病变与多支病变术前QTd及QTcd无明显差别 (P >0 .0 5 ) ,术后单支病变QTd及QTcd的降低程度显著大于多支病变 (P <0 .0 1)。 9例伴室性心律失常者术后该症状消失。结论 :冠心病患者QTd及QTcd在PTCA +Stent术后随着心肌缺血及心室复极不均一性的改善而降低 ,其降低程度可能与侧支循环建立开放有关。     

急性心肌梗死QT离散度与室性心律失常的关系

目的 :探讨急性心肌梗死时QT离散度与室性心律失常的关系。方法 :测量 72例急性心肌梗死QT离散度 (QTd) ,计算校正QT离散度 (QTcd)。分析QTd ,QTcd以及室性心律失常 (VA)之间的关系。结果 :急性心肌梗死合并室性心律失常组 (VA)组QTd和QTcd均显著高于无室性心律失常组 (NAV)组 ,P <0 .0 1;急性心肌梗死患者QTcd≥ 6 0ms者 ,其VA发生率显著高于QTcd <6 0ms者 ,P <0 .0 1。结论 :急性心肌梗死患者QTd或QTcd值越大 ,室性心律失常发生率越高     

急性心肌梗死患者QT离散度与预后关系的临床观察

探讨急性心肌梗死(AMI)患者QT离散度(QTd)和心率校正的QT离散度(QTcd)与室性心律失常和预后的关系。方法,测定了58例AMI患者的QTd及QTcd,其中存活组48例,住院死亡组10例。AMI组QTd及QTcd均显著大于对照组(P<0.01),AMI死亡组QTd及QTcd明显大于对照组(P<0.01),死亡组以室颤为主。AMI患者QTd、QTcd的延长对室性心律失常及预后的预测有重要参考价值。     

三种心电信息对急性心肌梗塞患者恶性室性心律失常事件发生的预测价值

目的 :探讨心室晚电位 (VLP)、QT离散度 (QTd)、校正QT离散度 (QTcd)对急性心肌梗塞 (AMI)患者恶性室性心律失常事件发生的预测价值。方法 :测定 6 4例AMI患者和 30例健康人的VLP、QTd、QTcd ,并对AMI患者随访 1年。结果 :AMI组VLP阳性率 (4 2 2 % )较对照组 (6 7% )明显增高 (P <0 0 1) ,QTd、QTcd分别为 74 2± 18 4ms和 81 3± 2 2 6ms较对照组 (2 8 4± 10 6ms和 34 8± 15 3ms)明显延长 (P <0 0 1)。 6 4例AMI患者随访 1年发生恶性室性心律失常事件 18例 ,其中VLP阳性率、QTd、QTcd分别为 88 9%、86 5± 2 7 4ms、93 6± 34 8ms和非事件组(2 3 9%、6 2 7± 2 4 3ms、6 9 4± 2 5 2ms)比较 ,差异有显著性 (P <0 0 1)。在预测AMI患者恶性室性心律失常事件发生的敏感性 ,特异性和有效性QTd分别为 6 6 5 %、85 4%、78% ,QTcd分别为 72 4%、71 3 %、71% ,VLP分别为42 6 %、92 8%、6 8%。结论 :VLP(+ )和QTd、QTcd明显延长与AMI患者发生恶性室性心律失常事件密切相关 ,并可作为AMI患者预后和恶性室性心律失常事件发生可靠的 ,非侵入性预测指标。其中以QTcd敏感性最高 ,VLP(+ )最具特异性。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.