冠心病患者心肌缺血的动态心电图变化

目的提高冠心病(CHD)患者无症状性心肌缺血(SMI)的检出率。方法对60例CHD患者应用12导联24小时动态心电图进行检测。按临床特征分为3组:A组:稳定型心绞痛伴有SMI患者;B组:不稳定型心绞痛伴SMI者;C组:急性心肌梗死后伴SMI发作者。结果60例CHD患者中,共检出心肌缺血612阵次,其中SMI542阵次,占88.56%;有症状心肌缺血70阵次,占11.44%。SMI发作高峰为6-12时,0-6时最低,白昼发作是夜间发作的2.37倍。临床情况越重,SMI缺血负荷值越大。结论CHD患者SMI比有症状性心肌缺血更常见,动态心电图提高了其检出率,对判断病情及指导治疗有重要的临床意义。     

动态心电图监测无症状性心肌缺血的临床评价

目的:评价动态心电图(DCG)监测冠心病(CHD)无症状性心肌缺血(SMI)的临床意义.方法:对60例CHD患者进行DCG监测,男42例,女18例,平均年龄59岁(38～85岁).结果:检出有缺血性ST-T改变者52例,其检出率为86.7%.检出缺血性ST-T改变186阵次,其中140阵次为SMI,占缺血性ST-T改变的75.3%;46阵次为有症状发作,占缺血性ST-T改变的24.7%.140阵次SMI中102阵次(72.9%)发生于上午6时～12时,仅38阵次(27.1%)发生于夜间0时至次日晨6时.检出各种心律失常44例.结论: DCG监测CHD患者SMI检出率高,SMI与CHD预后密切相关,应重视SMI的检出、治疗与预防.     

冠心病患者的动态心电图及昼夜变化规律分析

目的探讨冠心病(CHD)无症状心肌缺血(SMI)的心电图表现.方法采用动态心电图(DCG)对184例CHD者连续监测24 h,详细记录检测时间内昼夜变化规律的心电活动.结果 184例CHD者有心肌缺血138例(75%),发生缺血性ST段改变910阵次,SMI占656阵次(72.1%),有症状心肌缺血(SyMI)为254阵次(27.9%),上午6:00-12:00发作334阵次,占全天次数的50.9%,严重室性心律失常63例,占心律失常总例数的75%.结论 CHD中SMI发生率较高,有明显的昼夜规律,可诱发严重心律失常乃至心肌梗死,务必引起临床医生的高度重视.     

无症状性心肌缺血1200例动态心电图结果分析

目的分析冠心病无症状性心肌缺血的动态心电图（DCG）变化特点及机制。方法对我院2003年12月—2011年8月住院及门诊患者共1 200例的DCG表现进行分析。结果 7 953阵次缺血发作,其中5 999阵次（75.44%）为无症状性心肌缺血（SMI）,1 954阵次（24.56%）为有症状性心肌缺血。60岁以上患者发作4 367阵次,占SMI的72.87%.SMI与有症状性心肌缺血的ST段压低程度无显著性差异（P〉0.05）,但无症状较有症状性心肌缺血持续时间有显著性差异（P〈0.05）。06：00￣12：00 SMI的发作频率（43.46%）,明显多于0：00￣06：00（13.62%）;而有症状性心肌缺血以白天频率最高（45.18%）,夜间发作最低（9.0%）。62.1%的SMI具有快频率依赖性,9.2%的SMI具有慢频率依赖性。检出心律失常共673例,SMI与有症状性心肌缺血之间无显著性差异（P〉0.05）。结论 DCG是临床上检测无症状性心肌缺血重要方法之一,对评估SMI的预后有重要意义。     

冠心病无症状性心肌缺血的动态心电图探讨

目的:为探讨冠心病无症状性心肌缺血的动态心电图(DCG)的临床特点。方法:对582例冠心病患者进行DCG监测。结果:402例有3884阵次缺血发作,其中307例2930阵次(75.44%)为无症状性心肌缺血(SMI)其中60岁以上者发作2135阵次,占SMI的72.87%,无症状与有症状组心肌缺血的ST段压低程度差异无显著性,但无症状较有症状组心肌缺血持续时间长(P<0.05)。上午6:00~12:00SMI的发作频率最高(43.46%),明显多于夜间24:00~晨6:00的13.62%(P<0.01)。检出严重心律失常共327例,无症状与有症状组之间差异无显著性(P>005)。结论:SMI检出率远高于有症状心肌缺血,60岁以上者多见,容易引起患者忽视而得不到及时治疗,因此,更具有潜在危险,在诊治上应给予高度重视。     

分析探讨动态心电图检测冠心病无症状性心肌缺血

目的:探讨动态心电图(DCG)对监测心肌缺血,特别是无症状心肌缺血(SMI)的诊断价值。方法:分析我院近几年冠心病患者(有症状与无症状心肌缺血)的DCG和临床资料。结果:一组确诊冠心病129例,动态心电图检出SMI占71%,而一组心绞痛和心肌梗死后患者130例,动态心电图记录252次缺血发作,其中SMI占29%,此外还有一组117例,老年人心绞痛和心肌梗死后的统计中,SMI发作达90.6%。3组患者在心肌缺血发作时间及ST段下降临床方面差异无显著性,心肌缺血的发作及发作时伴发心律失常有明显的时间分布规律,均以6:00~9:00之间高峰;而无症状组恶性心律失常发生率明显高于有症状组。结论:DCG对SMI检出率高,有助于对冠心病的早期防治。     

冠心病无痛性心肌缺血动态心电图检测分析

目的 探讨冠心病患者无痛性心肌缺血和心律失常与Holter的相关性.方法 应用Holter监测126例冠心病患者心肌缺血发生阵次、每次缺血发作时间和ST段最大压低,以及昼夜缺血次数.结果 无痛性心肌缺血(SMI)86例,占68%;伴典型心绞痛12例,占9.5%;心肌缺血发作时,快频率依赖者84例,占67%.昼夜发作规律为6:00～12:00发生最高,检出694阵次占57.92%.结论 Holter对心肌缺血和心律失常就其种类、时间、数量与日常活动的关系,变化规律以及药物的疗效进行详细的观察,是监测心肌缺血和心律失常有效方法之一.     

动态心电图监测冠心病无症状心肌缺血结果分析

目的　探讨冠心病无症状性缺血的心电图表现。方法　对 70例冠心病患者用动态心电图进行 2 4h监测。 62例 ( 88 6% )有心肌缺血发作 ,总计发作 2 0 2阵次 ,其中 150阵次 ( 74 3% )为无症状心肌缺血发作 ,陈旧性心梗组与稳定型劳力性心绞痛组比较。结果　两组发生率无显著性 (P值 >0 5) ,无症状与有症状心肌缺血的ST段压低程度及持续时间的差异无显著性 (P值 >0 5)。结论　无症状心肌缺血发作有昼夜规律 ,严重心律失常发生率陈旧性心梗组比稳定型劳力性心绞痛组明显增高 (P <0 0 1)。     

Holter监测老年人无症状性心肌缺血及其临床意义

目的　探讨老年人无症状性心肌缺血 (asymptomaticmyocardialischemiaSMI)的临床特征。方法应用 2 4h动态心电图 (Holter)对 340例老年患者进行监测。结果　发现有缺血性ST段改变者 1 91例 ,占 5 6.2 %。其中无症状性心肌缺血 1 2 0例 ,占 62 .8%。老年前期组 1 0 0例 ,SMI检出率为 48.0 %。老年组检出率明显高于老年前期组 (P <0 .0 5 )。心律失常检出率老年组明显高于老年前期组 (P <0 .0 1 ) ,提示SMI患者容易合并心律失常。 2 4h内ST段改变程度轻、频率低、持续时间短的患者SMI检出率高。结论　SMI的检出率与 2 4h内ST段改变的程度、频率、持续总时间、有无心绞痛史及心肌梗塞史等有密切关系。对决定治疗、及时发现心肌缺血状态 ,减少心律失常和防止猝死、心肌梗塞等发生具有重要的临床意义。     

动态心电图对无痛性心肌缺血的诊断价值

目的:探讨动态心电图在无痛性心肌缺血(SMI)中的诊断价值。方法:对98例临床已确诊为心肌缺血的患者进行24h动态心电图监测,并对结果进行回顾性分析。结果:98例中,有缺血性ST-T改变87例,占总数的89%。87例中共检出465阵次缺血发作,其中384阵次(83%)为SMI发作,81阵(17%)为有症状发作,ST段压低0.1~0.4mV。结论:动态心电图明显提高了冠心病的检出率,是临床监测无痛性心肌缺血的重要手段,对无痛性心肌缺血的临床评估及预后评价有重要的临床意义。     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

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.     

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…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.