高效液相色谱法测定四川粉葛中葛根素的含量

目的：采用HPLC法测定四川粉葛中葛根素的含量。方法：色谱柱为依利特C18柱（4．6min&;#215;150mm,5μm）,流动相为甲醇-水（25：75）,流速为0．8ml／min,检测波长为250nm,柱温为25℃。结果：葛根素在0．0880～0．7040μg范围内峰面积与进样量呈良好的线性关系,回归方程为A=336．35X-1．7716,r=1．0000,其平均同收率为100．01％,RSD为0．14％（n=6）。结论：该方法简便易行,结果准确,可用于四川粉葛药材的质量控制。     

Three cases of dural arteriovenous fistula of the anterior condylar vein within the hypoglossal canal

Dural arteriovenous fistulas (DAVFs) of the anterior condylar vein are an uncommon but important subset of fistulas occurring at the skull base that can be confused with DAVFs of the marginal sinus on angiography. MR angiography source images can document the intraosseous extent and the relationship to the hypoglossal canal of this type of fistula, which can have significant clinical implications. We present the imaging features of angiography, CT, and MR angiography of three cases of DAVFs localized to the anterior condylar vein and within the hypoglossal canal, which were confirmed by source images from MR angiography. Transvenous coil embolization was curative in two of three cases and would seem to be the treatment of choice when venous access is available.     

中心静脉导管胸腔留置治疗胸腔积液

目的评价中心静脉导管留置治疗胸腔积液的疗效。方法257例胸腔积液患者分为两组，治疗组207例，应用胸腔留置中心静脉导管治疗；对照组50例，常规胸穿抽液治疗，观察并比较不同治疗方法的疗效、并发症等指标。结果两组对比多项指标差异有显著性（P〈0．05）。结论采用中心静脉导管治疗胸腔积液可减少胸穿次数、降低反应，提高治愈率。     

Prolonged Atrium Electromechanical Interval Is Associated with Stroke in Patients with Atrial Fibrillation After Catheter Ablation

Electromechanical Interval and Strokes After Ablations of AF . Introduction: Atrial fibrillation (AF) is associated with increased risk of embolic stroke. Catheter ablation of AF provides an effective therapy for patients with symptomatic and drug‐refractory AF. The aim of this study was to evaluate whether the atrial electromechanical interval is useful in identifying patients at risk of stroke after successful catheter ablation. Methods and Results: A total of 279 AF patients who received catheter ablation and showed no evidence of recurrences were enrolled. Electromechanical interval (PA–PDI) was determined as the time interval from the initiation of P wave deflection to the peak of mitral inflow A wave on pulse wave Doppler imaging. The PA–PDI interval was measured for each patient after the 3‐month blanking period of catheter ablation. The clinical endpoint was the occurrence of ischemic stroke. During the follow‐up of 46.5 ± 17.2 months, 6 patients suffered from ischemic strokes. Patients with strokes had higher CHA₂DS₂–VASc scores and longer PA–PDI intervals (138.7 ± 12.4 ms vs 161.2 ± 7.7 ms, P value < 0.001) compared to those without strokes. At a cutoff point of 150 ms identified by ROC curve, the positive and negative predictive values of the PA–PDI interval to predict stroke were 86.7% and 100%, respectively. The PA–PDI interval improved the predictive performance of the CHA₂DS₂–VASc score, and the area under the ROC curve increased from 0.75 to 0.85. Conclusions: Our results suggest that the PA–PDI interval is a useful tool to identify patients with high risk of stroke after successful catheter ablation of AF. (J Cardiovasc Electrophysiol, Vol. 24, pp. 375‐380, April 2013)     

The Novel Electrophysiology of Complex Fractionated Atrial Electrograms: Insight from Noncontact Unipolar Electrograms

Unipolar Characteristics of CFAEs. Background: The noncontact mapping (NCM) system possesses the merit of global endocardial recording for unipolar and activation mapping. Objective: We aimed to evaluate the unipolar electrogram characteristics and activation pattern over the bipolar complex fractionated atrial electrogram (CFAE) sites during atrial fibrillation (AF). Methods: Twenty patients (age 55 ± 11 years old, 15 males) who underwent NCM and ablation of AF (paroxysmal/persistent = 13/7) were included. Both contact bipolar (32–300 Hz) and NCM virtual unipolar electrograms (0.5–300 Hz) were simultaneously recorded along with the activation pattern (total 223 sites, 11 ± 4 sites/patient). A CFAE was defined as a mean bipolar cycle length of ≤ 120 ms with an intervening isoelectric interval of more than 50 ms (Group 1A, n = 63, rapid repetitive CFAEs) or continuous fractionated activity (Group 1B, n = 59, continuous fractionated CFAEs), measured over a 7.2‐second duration. Group 2 consisted of those with a bipolar cycle length of more than 120 ms (n = 101). Results: The Group 1A CFAE sites exhibited a shorter unipolar electrogram cycle length (129 ± 11 vs 164 ± 20 ms, P < 0.001), and higher percentage of an S‐wave predominant pattern (QS or rS wave, 63 ± 13% vs 35 ± 13%, P < 0.001) than the Group 2 non‐CFAE sites. There was a linear correlation between the bipolar and unipolar cycle lengths (P < 0.001, R = 0.87). Most of the Group 1A CFAEs were located over arrhythmogenic pulmonary vein ostia or nonpulmonary vein ectopy with repetitive activations from those ectopies (62%) or the pivot points of the turning wavefronts (21%), whereas the Group 1B CFAEs exhibited a passive activation (44%) or slow conduction (31%). Conclusions: The bipolar repetitive and continuous fractionated CFAEs represented different activation patterns. The former was associated with an S wave predominant unipolar morphology which may represent an important focus for maintaining AF. (J Cardiovasc Electrophysiol, Vol. 21, pp. 640‐648, June 2010)     

Gender Differences in the Clinical Characteristics and Atrioventricular Nodal Conduction Properties in Patients With Atrioventricular Nodal Reentrant Tachycardia

Gender Differences in Patients With AVNRT. Introduction: The detailed electrophysiological characteristics of the gender differences associated with atrioventricular nodal reentrant tachycardia (AVNRT) have not been clarified. This study investigated the gender‐related electrophysiological differences in a large series of patients undergoing radiofrequency catheter ablation. Methods and Results: A total of 2,088 consecutive AVNRT patients (men/women 869/1,219) who underwent catheter ablation were enrolled in this study. We evaluated the gender differences in their electrophysiological characteristics. Women had a significantly younger age of onset, higher incidence of multiple jumps, shorter AH interval, atrial effective refractory period (ERP), anterograde fast pathway ERP, anterograde slow pathway ERP, and retrograde slow pathway ERP, and longer ventricular ERP than men. The incidence of baseline ventriculoatrial dissociation was lower in women than in men. Women needed less isoproterenol/atropine to induce AVNRT. No gender differences in the radiation exposure time, procedure time, complication rate, acute success rate, or second procedure rate were noted. Both typical and atypical AVNRT were more predominant in women. In the patients with atypical AVNRT, there was no significant gender difference in incidence of baseline ventriculoatrial dissociation; however, the retrograde slow pathway ERP was significantly shorter in women than in men. Women of premenopausal age (≤50 years old) had a significantly higher incidence of anterograde multiple jumps and a retrograde jump phenomenon, and a shorter anterograde slow pathway ERP and retrograde slow pathway ERP than those of women over 50 years old. Conclusion: Gender differences in the anterograde and retrograde AV nodal electrophysiology were noted in the patients with AVNRT. (J Cardiovasc Electrophysiol, Vol. 21, pp. 1114‐1119)     

α-珠蛋白生成障碍性贫血干预效果分析

目的探讨α-珠蛋白生成障碍性贫血产前诊断在降低出生缺陷中的效果。方法选择2003年1月至2012年7月进行α-珠蛋白生成障碍性贫血产前诊断的妊娠1 037例,采用聚合酶链反应结合琼脂糖凝胶电泳和反向点杂交技术对脐带血和原位培养后的羊水或绒毛组织检测α珠蛋白基因,同时对合并β-珠蛋白生成障碍贫血者进行β-珠蛋白基因检测。结果 1 037例妊娠中α-珠蛋白生成障碍性贫血检出率为79.27%,其中血红蛋白H（Hb Bart′s）胎儿水肿综合征292例,HbH病45例;同时检出中间型、重型β-珠蛋白生成障碍贫血5例,β-珠蛋白生成障碍贫血杂合子28例,包括α复合β-珠蛋白生成障碍贫血26例,终止妊娠339例。结论α-珠蛋白生成障碍性贫血产前干预是防止该类患儿出生的有效措施,同时应加强复合型珠蛋白生成障碍贫血的干预。     

自闭症患儿父母心理状况调查及健康教育意义分析

目的分析自闭症儿童父母的心理状况,实施及时有效的健康教育。方法采用症状自评量表（SCL-90）、抑郁自评量表（SDS）、焦虑自评量表（SAS ）对89例自闭症儿童父母进行测评。并对这些父母实施有效的健康教育,对健康教育前的测评结果分别同国内常模、健康教育后比较。结果在健康教育实施前,自闭症儿童父母SCL-90、SAS、SDS得分均高于全国常模,差异有统计学意义（P＜0．01）;健康教育前后得分比较差异有统计学意义（P＜0．01）。结论自闭症儿童父母普遍存在心理问题,及时开展健康教育能改善其心理状况。     

PCI-32765和Bortezomib对B细胞肿瘤细胞系细胞增殖、凋亡的影响及其机制的研究

本研究旨在探讨Btk抑制剂PCI-32765和蛋白酶体抑制剂bortezomib对Raji、Ramos细胞的增殖、凋亡的影响及其作用机制.PCI-32765和bortezomib单药及联合用药处理Raji和Ramos细胞后,分别运用CCK-8法及流式细胞术检测细胞的增殖与凋亡,Western blot法检测Btk、NFκB、c-IAP1、Bcl-xL、caspase-3等蛋白的表达.结果表明：①PCI-32765（0.5、1.0、2.0、3.0、4.0、5.0、6.0μmol/L）和bortezomib（10、20、30、40、50、60、80 nmol/L）处理Raji和Ramos细胞48 h,均可抑制细胞增殖,抑制率呈剂量依赖性,且两药具有协同作用;②PCI-32765（2.0μmol/L）、bortezomib（20 nmol/L）单药及联合用药处理Raji和Ramos细胞不同时间（8、12、24、36、48、72 h）,均可抑制细胞存活率,抑制率呈时间依赖性,且两药具有协同作用;③PCI-32765（2μmol/L）和bortezomib（20 nmol/L）单药及联合用药处理Raji和Ramos细胞48 h,可明显促进Raji及Ramos细胞的凋亡.Raji细胞实验结果,空白对照组、PCI-32765和bonezomib单药组、联合用药组的细胞凋亡率分别为10.34±0.53％、24.26±0.91％、43.66±1.08％与74.06±0.72％,各组间有统计学差异（P＜0.05）;Ramos细胞实验结果,空白对照组、PCI-32765和bortezomib单药组、联合用药组的细胞凋亡率分别为15.16±1.49％、71.36±0.82％、75.32±2.36％与84.30±0.91％,各组间有统计学差异（P＜0.05）;④PCI-32765和bonezomib单药处理Raji、Ramos细胞后,细胞内Btk、NFκB、Bcl-xl及c-.IAP1的表达水平较对照组降低,Caspase-3的表达水平升高,两药联用后,作用增强.结论：PCI-32765和bonezomib可以协同抑制Raji与Ramos细胞的增殖,促进其凋亡,其机制可能与抑制Btk、NFκB的活性,下调Bcl-xl及c-IAP1等抗凋亡蛋白,同时上调Caspase-3等凋亡蛋白的表达而发挥作用.