Later competence and adaptation in infants who survive severe heart defects

A model of risk potential for developmental outcome was created based on cardiac, medical, surgical, and family-stress factors in 31 children with transposition of the great arteries who had undergone reparative open heart surgery utilizing cardiopulmonary bypass during infancy. Impact of these potential risk factors was assessed by 4 current neurologic measures (neurologic anatomic abnormalities, functional impairment, electroencephalograph [EEG], and Pattern Visual Evoked Potential [PVEP]) and 4 psychologic measures (IQ, achievement, perceptual-motor function, and behavior). Results indicated that adverse developmental outcome was significantly associated with the following medical risk variables: failure of palliative surgery to alleviate hypoxia, prolonged hypoxia, growth failure, congestive heart failure, absence of ameliorating shunting heart defects, stroke, and CNS infection; and two psychosocial moderator variables: socioeconomic status and current life stress. Analysis of a "cumulative risk score" indicated significantly higher risk scores in children with abnormal EEGs, PVEPs, and neurologic examinations. The cumulative risk score highly correlated with composite neurologic outcome (r = .62), IQ (r = -.66), achievement (r = -.60), and perceptual-motor function (r = -.48). While overall outcome was favorable for children with TGA who experienced a single risk event, outcome was compromised if multiple risk factors occurred.     

苦参碱对急性心衰猫心功能和血流动力学的影响

目的：研究苦参碱对急性心衰猫心功能和血流动力学的影响方法：以成巴比妥钠造成猫急性心衰模型,iv甘参碱20、40mg/kg,用多道生理记录仪和电磁流量计测定猫的心脏血流动力学参数．结果：苦参碱低、高剂量组均可使LVSP、±dp／dtmax、CO、CI、SI、LVWI显著增加,LVEDP、MAP、TPVR、HR显著下降;高剂量组作用强于低剂量组,给药后15min作用达峰值．结论：苦参碱对戊巴比妥钠诱发的心衰猫具有明显的正性肌力作用,负性频率作用,且能增强心脏舒缩功能,降低外周血管阻力,减轻心脏负荷．说明苦参碱有抗心衰作用．     

Science Letters： Brain natriuretic peptide： A potential indicator of cardiomyogenesis after autologous mesenchymal stem cell transplantation？

We observed in a pilot study that there was a transient elevation of brain natriuretic peptide （BNP） level shortly after the transplantation in the patient with ischemic heart failure, which is unexplainable by the simultaneous increase of the cardiac output and six-minute walk distance. Similar findings were observed in the phase I trial. We postulated on the basis of the finding of Fukuda in vitro that this transient elevation of BNP level against the improvement of cardiac function and exercise capacity might indicate cardiomyogenesis in patients after mesenchymal stem cell transplantation. Further study is warranted to verify the hypothesis.     

Electrocardiogram (ECG) patterns of left anterior fascicular block and conduction impairment in ventricular myocardium: a whole-heart model-based simulation study

Left anterior fascicular block (LAFB) is a heart disease identifiable from an abnormal electrocardiogram (ECG). It has been reported that LAFB is associated with an increased risk of heart failure. Non-specific intraventricular conduction delay due to the lesions of the conduction bundles and slow cell to cell conduction has also been considered as another cause of heart failure. Since the location and mechanism of conduction delay have notable variability between individual patients, we hypothesized that the impaired conduction in the ventricular myocardium may lead to abnormal ECGs similar to LAFB ECG patterns. To test this hypothesis, based on a computer model with a three dimensional whole-heart anatomical structure, we simulated the cardiac exciting sequence map and 12-lead ECG caused by the block in the left anterior fascicle and by the slowed conduction velocity in the ventricular myocardium. The simulation results showed that the typical LAFB ECG patterns can also be observed from cases with slowed conduction velocity in the ventricular myocardium. The main differences were the duration of QRS and wave amplitude. In conclusion, our simulations provide a promising starting point to further investigate the underlying mechanism of heart failure with LAFB, which would provide a potential reference for LAFB diagnosis. the angulation of impaction having little effect on facture risk.     

Review:Cell therapy in congestive heart failure

Congestive heart failure (CHF) has emerged as a major worldwide epidemic and its main causes seem to be the aging of the population and the survival of patients with post-myocardial infarction. Cardiomyocyte dropout (necrosis and apoptosis) plays a critical role in the progress of CHF; thus treatment of CHF by exogenous cell implantation will be a promising medical approach. In the acute phase of cardiac damage cardiac stem cells (CSCs) within the heart divide symmetrically and/or asym-metrically in response to the change of heart homeostasis, and at the same time homing of bone marrow stem cells (BMCs) to injured area is thought to occur, which not only reconstitutes CSC population to normal levels but also repairs the heart by dif-ferentiation into cardiac tissue. So far, basic studies by using potential sources such as BMCs and CSCs to treat animal CHF have shown improved ventricular remodelling and heart function. Recently, however, a few of randomized, double-blind, pla-cebo-controlled clinical trials demonstrated mixed results in heart failure with BMC therapy during acute myocardial infarction.     

老年人原位心脏移植1例报告

总结为1例62岁的终末期缺血性心肌病患者施行同种原位心脏移植手术的初步经验及体会。应用人源化单克隆抗体赛尼哌加环磷酰胺免疫诱导方案。维持治疗应用“环孢霉素A+强的松+骁悉”新三联疗法。移植手术后无并发症发生,心功能良好。结果表明,心脏移植是治疗终末期心脏病的有效方法。低肺血管阻力受体的选择,合理的免疫抑制治疗方案的应用,供心的保护及围手术期对肝肾功能的保护是心脏移植成功的关键。     

Cell therapy in congestive heart failure

Congestive heart failure （CHF） has emerged as a major worldwide epidemic and its main causes seem to be the aging of the population and the survival of patients with post-myocardial infarction. Cardiomyocyte dropout （necrosis and apoptosis） plays a critical role in the progress of CHF; thus treatment of CHF by exogenous cell implantation will be a promising medical approach. In the acute phase of cardiac damage cardiac stem cells （CSCs） within the heart divide symmetrically and/or asymmetrically in response to the change of heart homeostasis, and at the same time homing of bone marrow stem cells （BMCs） to injured area is thought to occur, which not only reconstitutes CSC population to normal levels but also repairs the heart by differentiation into cardiac tissue. So far, basic studies by using potential sources such as BMCs and CSCs to treat animat CHF have shown improved ventricular remodelling and heart function. Recently, however, a few of randomized, double-blind, placebo-controlled clinical trials demonstrated mixed results in heart failure with BMC therapy during acute myocardial infarction.     

Development and current clinical application of ventricular assist devices in China

Heart failure has become one of the biggest threats to human health. Transplantation remains the most effective therapy for heart failure, but because of the shortage of donors, it cannot meet the demand. Ventricular assist devices (VADs) were developed to treat heart failure, and have now been clinically applied worldwide. As the country with the largest population, China is also facing the threat of heart failure. However, the development of VADs in China is very slow and is seldom discussed. This paper first talks about the background for VAD development in China. Then several home-developed VADs in China are introduced. The current clinical application status of VADs in China is also presented. Finally the challenge and opportunity for VAD development in China are discussed.     

The relation between neonatal heart period patterns and developmental outcome

Developmental psychophysiologists have long been interested in a means for evaluating infants at risk for cognitive disabilities. The current research addressed the utility of a noninvasive measure of cardiac vagal tone in predicting developmental outcome. At 40 weeks conceptional age, 3 min of resting EKG were recorded from 80 infants. Four groups of infants were evaluated: prematures who had no medical complications in the postnatal period; prematures who experienced respiratory distress syndrome during the postnatal period; term infants who experienced birth asphyxia during labor and/or postdelivery; and healthy term infants. The mental scale of the Bayley Scales of Mental Development was administered at 8 and 12 months conceptional age. Heart period data were analyzed to derive mean heart period, heart period variability, and estimates of vagal tone for each subject. Analyses of the relationship between the heart period variables and 8- and 12-month outcome (i.e., Bayley Scales) indicated that infants with high vagal tone at 40 weeks conceptional age always had positive developmental outcome at both eight and 12 months of age. Infants with low vagal tone had varied outcomes. Measures of medical complications and other measures of heart period variability were not related to developmental outcome. The results suggest that measurement of cardiac vagal tone may provide an important means for assessing risk in birth stressed populations.     

心衰康煎液对阿霉素心衰模型大鼠心肌的影响

目的观察中药复方制剂"心衰康煎液"对心衰大鼠心脏血流动力学的影响及心肌细胞的病理学改变.方法利用pclab实验记录分析系统观察和分析各实验组大鼠左心室内压、对大鼠心肌切片H.E染色镜下观察.结果心衰康使心衰得到明显改善,心肌细胞无明显变性、坏死.结论中药复方"心衰康煎液"对心衰大鼠的心肌病变有明显改善,从而产生良好的抗心衰作用.结论     

Early association of electrocardiogram alteration with infarct size and cardiac function after myocardial infarction

Objective: Myocardial infarction (MI) is the main cause of heart failure, but the relationship between the extent of MI and cardiac function has not been clearly determined. The present study was undertaken to investigate early changes in the electrocardiogram associated with infarct size and cardiac function after MI. Methods: MI was induced by ligating the left anterior descending coronary artery in rats. Electrocardiograms, echocardiographs and hemodynamic parameters were assessed and myocardial infarct size was measured from mid-transverse sections stained with Masson's trichrome. Results: The sum of pathological Q wave amplitudes was strongly correlated with myocardial infarct size (r = 0.920, P < 0.0001), left ventricular ejection fraction (r = (0.868, P < 0.0001) and left ventricular end diastolic pressure (r = 0.835, P < 0.0004). Furthermore, there was close relationship between MI size and cardiac function as assessed by left ventricular ejection fraction (r = (0.913, P < 0.0001) and left ventricular end diastolic pressure (r = 0.893, P < 0.0001). Conclusion: The sum of pathological Q wave amplitudes after MI can be used to estimate the extent of MI as well as cardiac function.     

心衰康煎液对实验心衰大鼠左心室内压的影响

目的 :观察中药复方心衰康煎液抗心衰的作用。方法 :取 4 0只成年Wistar大鼠 ,利用腹腔注射盐酸阿霉素的方法 ,连续 6周 ,复制心衰大鼠模型 ,再用心衰康煎液连续治疗 2 8d。利用北京微信达设计制造的Pclab实验记录分析系统观察和分析各组大鼠左心室内压、心电图 ,并观察心肌细胞的病理变化。结果 :心衰康煎液大、小剂量组和模型对照组比较左心室收缩内压显著性升高 (P <0 .0 1) ,病理学观察可见大、小剂量组心肌细胞的变性坏死均有明显减轻。结论 :心衰康煎液可减轻阿霉素对心肌的毒性作用 ,可明显改善心衰大鼠的心功能 ,表明该方有良好的抗心衰作用。     

运动训练致心肌损伤的机制探讨

不同强度的运动对心脏有着不同的影响,适度运动可提高心脏机能,而过度训练或力竭性运动则会损害其正常机能,使心脏出现病理性改变．文中分析了运动训练与心肌损伤的研究现状,指出运动性心肌损伤的发生机制,旨在为预防心肌损伤,研究心肌保护方法提供理论依据．     

LONG-TERM INHIBITION OF Na~ /H~ EXCHANGE ATTENUATES CARDIAC REMODELING AFTER MYOCARDIAL INFARCTION IN RATS

ＩＮＴＲＯＤＵＣＴＩＯＮＴｈｅＮａ /Ｈ ｅｘｃｈａｎｇｅｒ (ＮＨＥ)ｉｓａｐＨ ｒｅｇｕｌａｔｏｒｙｐｒｏｔｅｉｎｐｒｅｓｅｎｔｉｎｔｈｅｐｌａｓｍａｍｅｍ ｂｒａｎｃｅｏｆｃａｒｄｉｏｍｙｏｃｙｔｅｓａｎｄｏｔｈｅｒｃｅｌｌｔｙｐｅｓ.ＡｌｔｈｏｕｇｈｓｅｖｅｒａｌｉｓｏｆｏｒｍｓｏｆＮＨＥｈａｖｅｂｅｅｎｄｅ ｃｒｉｂｅｄ,ｔｈｅｐｒｅｄｏｍｉｎａｎｔｉｓｏｆｏｒｍｉｎｔｈｅｈｅａｒｔｉｓｔｈｅｕｂｉｑｕｉｔｏｕｓＮＨＥ 1 ,ｗｈｉｃｈｕｎｄｅｒｃｅｎｔａｉｎｐｈｙｓｉｏｌｏｇｉｃａｌｃｏｎｄｉｔｉ…     

后适应在接受直接PCI治疗的急性ST段抬高性心肌梗死患者中的临床疗效:基于随机对照试验的meta分析(英文)

目的:探讨后适应对接受直接经皮冠状动脉介入(PCI)治疗的急性ST段抬高性心肌梗死(STEMI)患者心血管不良事件的影响。创新点:进一步明确后适应处理对STEMI患者临床预后的影响。方法:对符合入选标准的随机对照临床试验进行meta分析。结论:缺血后适应显著降低ST段抬高性心肌梗死患者心衰风险。     

重组人脑利钠肽治疗急性心力衰竭的疗效观察

目的：探讨在监测血清脑钠肽水平下,短期使用注射用重组人脑利钠肽治疗急性心力衰竭或慢性心力衰竭急性发作的临床效果。方法：48例急性心力衰竭患者根据是否使用注射用重组人脑利钠肽分为常规组和注射用重组人脑利钠肽组,对比两组治疗的临床效果和超声心动图情况,并监测BNP水平。结果：治疗7d后,注射用重组人脑利钠肽组临床有效率明显好于常规组（81．7％vs61．6％,P〈0．05）,左室射血分数明显高于常规组（51±6）％vs（46±5）％,（P〈0．01）,且血清脑钠肽水平明显降低（498±209）pg／mL vs（642±318）pg／mL,（P〈0．01）,血清脑钠肽下降水平和左室射血分数提高水平差异有统计学意义（P〈0．05）,有效者治疗后左室射血分数提高及血清脑钠肽下降均强于无效者（P〈0．01）。结论：在血清脑钠肽指导下短期应用注射用重组人脑利钠肽有助于改善急性心力衰竭患者的临床症状和心功能。     

从语言学视角考释古人对思维器官的认定

古人对思维器官的认定经历了一个较长的时期。最初,＂心＂被认为是人体的思维器官,与人的心理活动相关的词多以＂心＂为形符。许慎认为＂思＂字＂从心,囟声＂,段玉裁将其划入会意字,＂从心,从囟＂。徐灏笺云：＂人之精髓在脑,脑主记忆,故思从囟。＂可知,随着对人体功能认识的逐渐深入,＂脑＂的思维功能被发现,人们对思维器官的认定完成了发展的蜕变。     

普通居民心血管功能与健身效果的测试与观察

在北京、上海和深圳3个城市,按年龄段和性别随机测试了2430人,测试内容主要为心血管功能各项指标和体脂等多项指标,总趋势随年龄的增长而逐渐增高的指标有:心率、血压、总周阻力、血液粘度及微循环平均滞留时间,总趋势随年龄的增长而逐渐下降的有:每搏量、心搏指数、心输出量。根据每个受试者测试结果推荐健身计划,随机对196名受试者在实施健身计划6个月后再检测心血管功能和体脂等各项指标并进行前后对比,其心血管功能指标大都出现了有益的变化。     

甲状腺功能变化对血流动力学指标的影响

本文对甲状腺功能异常者用心阻抗血流图测得其心功能20项指标,引入多元分析法评价血流动力学状况。甲亢者除了呈现高输出低阻力心功能改变以外,其舒张功能也有不同程度降低。     

果蝇EF-1α蛋白的原核表达及多克隆抗体制备

为进一步研究延长因子-1（elongationfactor-1α,E-1α）在调控心脏发育和果蝇心脏功能中发挥的作用,制备延长因子-1的抗体．利用生物信息学选择果蝇EF-1α基因抗原亲水区,并设计出特异性引物,PCR扩增出的片段克隆到原核表达pET-28a载体中,转入E．coli中后通过IPTG诱导融合蛋白表达,将His—EF-1α融合蛋白免疫新西兰大白兔制备多克隆抗体,再用WesternBlot检测抗体的效价和特异性．研究结果表明,获得了EF-1α原核表达重组融合蛋白以及高效价的、特异性兔抗EF-1α多克隆抗体．EF-1α多克隆抗体的效价可以达到1比1500,并且有很强的特异性,为后续研究EF-1α基因在心脏发育和心脏功能中的作用奠定了基础．