彩色多普勒超声心动图对缺血性心肌病与扩张型心肌病的鉴别诊断

为了研究彩色多普勒超声心动图对缺血性心肌病与扩张型心肌病的鉴别诊断价值.对经临床确诊的扩张型心肌病(DCM)85例,缺血性心肌病(ICM)130例的彩色多普勒超声心动图(CDUCG)资料进行对比分析.结果表明:1)两组都有左房室内径增大.DCM组心脏多个房室腔扩大呈球形结构,室壁变薄及弥漫性运动减低,ICM组室壁运动减低多为节段性,常伴有室间隔及左室后壁增厚.2)DCM组左室流出道增宽的病人较ICM组明显多.3)DCM组多瓣膜返流发病率高且程度较重,ICM组多为单瓣膜返流且程度较轻.4)DCM组收缩功能降低明显,舒张功能可正常,二尖瓣E/A>1,ICM组大多数表现为左室舒张功能障碍.可见上述超声心动图特征对ICM和DCM的鉴别诊断有重要价值.     

超声心动图诊断扩张型心肌病的体会

本文对近五年来经超声心动图诊断扩张型心肌病56例。将其各项测量结果进行统计及分析。发现扩张型心肌病超场所主动图上具有下列特征必变。 1 左心型:①左房室扩大,以左室为著,左室呈球形扩大。②主动脉以下室同隔呈新月形向右室凸出,左室后壁呈弓形后移。③室间隔与左室后壁呈普遍性搏动减弱。④室间隔收缩期增厚率普遍低于30％。⑤左室流     

二维彩色多普勒超声在急性心肌梗塞早期诊断中的应用价值

目的 探讨急性心肌梗塞患者早期室壁形态和运动的改变以及心电图和临床之间的关系.方法 急性心肌梗塞患者于症状发作后1-14天进行首次二维彩色多普勒超声检查,3个月内复查2-3次.出院后隔3-4个月复查一次.重点观察左室形态和大小、室壁厚度及运动协调性、室壁运动幅度及室壁增厚率、室壁膨出及心包渗出情况.结果 23例中,与心电图相对应部位的室壁异常21例(91.3%),室壁膨出3例(13.04%).心尖室壁瘤形成2例(8.69%).室壁膨出检出时间为2-14天,随访3例室壁膨出患者中2例形成室壁瘤,1例于发病2个月后室壁膨出消失.形成室壁瘤者梗塞面积大,心电图上坏死性Q波在3个或3个以上导联,且振幅深,多呈QR形或QS形,心功能多在Ⅲ-Ⅳ级,有严重心律失常或传导阻滞.结论 二维彩色多普勒超声心动图可快速检出节段性室壁运动异常,可鉴别心肌缺血、早期急性心肌梗塞和非缺血性胸痛,对临床上突发性杂音性质进行准确鉴别诊断,对急性心肌梗塞并乳头肌功能不全或穿孔有决定性诊断价值.     

姜黄素对糖尿病心肌病大鼠心脏的保护作用及机制研究

探讨姜黄素对糖尿病心肌病（DCM）大鼠心肌组织损伤的保护作用及其可能的机制。方法：50只SPF级健康雄性SD大鼠随机选取10只作为空白对照组,其余复制糖尿病心肌病模型。将造模成功的大鼠随机分为模型组、姜黄素低剂量组、姜黄素高剂量组。连续给药4周后,给大鼠做超声心电图、HE和Masson染色检测心肌纤维化程度;生化检测血脂血糖;Westem blot检测心肌组织中PPARα、PPARβ、PPARγ和CYP2J2蛋白表达。结果：与空白对照组相比,模型组大鼠血糖血脂指标明显升高,心脏收缩功能降低,HE染色显示心肌细胞肥大,Masson染色显示心肌胶原纤维明显增多,PPARα、PPARβ、PPARγ和CYP2J2蛋白表达减少（P<0.05）。与模型组比较,姜黄素可明显改善DCM大鼠血糖血脂水平,使心脏收缩功能显著提高,心肌细胞形态恢复,胶原纤维沉积减少,PPARα、PPARβ、PPARγ和CYP2J2蛋白明显升高（P<0.05）。结论：姜黄素可以改善糖尿病心肌病大鼠心肌损伤,其分子机制可能与其激活心肌CYP2J2/PPARs信号通路有关。     

尿毒症性心脏病的异常超声心动图表现

本文总结511例尿毒症性心脏病的超声心动图资料,发现各房室腔扩大发生率:LA:90.2%,LV:74.5%;IVS:62.7%;LVPW:62.7% RV:43.1%;AO:31.4%。心包积液发生率51%,多为少至中等量积波.二尖瓣返流发生率36.3%,均为轻至中度返流;主动脉瓣返流发生率7.8%,均为轻度返流.典型二尖瓣环钙化4例,占7.8%.此外,LA,LVDd、IVS 及 LVPW 总均值超正常高限;LVEF、FS%值偏低。建议应用尿毒症性心脏病术语,肯定超声心动图检查有重要临床价值.     

实时三维超声心动图评价冠脉介入术后左室收缩功能变化

应用实时三维超声心动图评价冠心病患者经皮冠状动脉介入术(PCI)后左室收缩功能的变化。研究对象分为两组,正常组14例为冠脉造影无异常发现者,冠心病组49例行冠脉内支架治疗。所有患者均于术前及术后14天行实时三维超声检查,测得左室收缩末容积(LVESV)、左室舒张末容积(LVEDV)及左室射血分数(LVEF)。结果,正常组术前与术后LVESV、LVEDV及LVEF差异无统计学意义;冠心病组术后LVESV、LVEDV显著小于术前(P<0.001),LVEF显著高于术前(P<0.001)。结果表明,实时三维超声心动图能准确评价左室收缩功能,冠心病患者PCI后左室收缩功能明显改善。     

妊娠高血压综合征患者应用组织追踪法对左室收缩功能的评价

目的：探讨应用组织追踪法（TT）测定左室壁收缩期位移,以此评价妊娠高血压综合征左室收缩功能.方法：获取标准心尖位左室长轴切面、两腔切面及四腔切面,应用TT技术对20例妊娠高血压病子痫前期孕妇和21例正常对照妊娠妇女心脏不同节段的位移曲线,测量左室射血分数（EF）、左室心肌重量指数（LVMI）、二尖瓣口血流舒张早期峰值流速（E）、舒张晚期峰值流速（A）、E/A比值、肺静脉心房收缩期反向血流充盈峰（AR）,肱动脉收缩压及舒张压,对所获指标进行定量分析.结果：妊娠高血压综合征组左室前壁、前间隔、后间隔各位点的收缩期位移低于对照组（P〈0.01）;左室侧壁、下壁、后壁各位点收缩期位移在两组之间比较,差异无统计学意义（P〉0.05）.结论：组织追踪法可无创、敏感、客观地评价妊娠高血压综合征左室收缩功能.     

AQi和CK检测高血压病左室功能

本文采用AQi和CK对36例高心病患者的左室功能与正常人对照分析。左室收缩功能两组无显著差异,但病例组舒张晚期与早期充盈量之比(0.91±0.45)显著高于正常组值(0.50±0.25,P<0.05),与二尖瓣血流频谱A/E呈显著正相关。CK显示高血压时室壁彩色位移增加。本文提示AQi和CK是评估正常人、高心病患者左室功能一项有用的新方法。     

运动通过Akt/GSK-3β信号通路改善大鼠糖尿病心肌病

背景:运动预防糖尿病心肌病(DCM)的机制还不明确.目的:探讨运动对糖尿病大鼠心功能障碍、纤维化、炎症和相关信号通路的影响.方法:腹膜内注射链脲霉素建立大鼠糖尿病模型.大鼠随机分为3组(n=16):健康坐式对照组(SC);坐式糖尿病对照组(SD)和运动+糖尿病组(ED).运动组大鼠在跑台上进行每天1小时运动,速度为27 m/min,坡度为6°,每周5天,共12周.测定糖化血红蛋白、肌酸激酶同工酶、血浆脑钠素、心肌胶原含量分数和左室质量指数.结果:与SC组比较,SD组大鼠BNP、CK-MB、TGF-β1和CTGF mRNA和蛋白表达、LVWI和CVF显著增加(P<0.05),同时Akt和GSK-β3磷酸化降低(P<0.05).结论:结果表明运动对DCM治疗的机制可能是通过Akt/GSK-3β信号通路.     

太极拳运动对中老年人心脏舒张功能的影响

目的探讨太极拳运动对中老年人心脏收缩功能、心脏舒张功能、顺应性等方面的影响.方法采用多普勒超声心动图对参加二十四式简化太极拳锻炼3个月的33名中老年知识分子进行心脏收缩、舒张功能、顺应性等指标的测试分析.结果太极拳锻炼前后安静状态下心率(HR)、左室舒张早、晚期二尖瓣血流峰值流速E、A峰及E/A比值、左室射血分数(LVEF)、左室短径缩短率(%△D)、每搏输出量(SV)差异均有显著性(p<0.05),以反映左室顺应性的指标E/A改善为明显(0.98±0.18 vs 1.21±0.17 p<0.01).结论太极拳锻炼对中老年人心脏功能,尤其是对左室舒张功能、心脏顺应性有良好影响.     

Advances in monoclonal antibody application in myocarditis

Monoclonal antibodies have become a part of daily preparation technologies in many laboratories. Attempts have been made to apply monoclonal antibodies to open a new train of thought for clinical treatments of autoimmune diseases, inflammatory diseases, cancer, and other immune-associated diseases. This paper is a prospective review to anticipate that monoclonal antibody application in the treatment of myocarditis, an inflammatory disease of the heart, could be a novel approach in the future. In order to better understand the current state of the art in monoclonal antibody techniques and advance applications in myocarditis, we, through a significant amount of literature research both domestic and abroad, developed a systematic elaboration of monoclonal antibodies, pathogenesis of myocarditis, and application of monoclonal antibodies in myocarditis. This paper presents review of the literature of some therapeutic aspects of monoclonal antibodies in myocarditis and dilated cardiomyopathy to demonstrate the advance of monoclonal antibody application in myocarditis and a strong anticipation that monoclonal antibody application may supply an effective therapeutic approach to relieve the severity of myocarditis in the future. Under conventional therapy, myocarditis is typically associated with congestive heart failure as a progressive outcome, indicating the need for alternative therapeutic strategies to improve long-term results. Reviewing some therapeutic aspects of monoclonal antibodies in myocarditis, we recently found that monoclonal antibodies with high purity and strong specificity can accurately act on target and achieve definite progress in the treatment of viral myocarditis in rat model and may meet the need above. However, several issues remain. The technology on how to make a higher homologous and weak immunogenic humanized or human source antibody and the treatment mechanism of monoclonal antibodies may provide solutions for these open issues. If we are to further stimulate progress in the area of clinical decision support, we must continue to develop and refine our understanding and use of monoclonal antibodies in myocarditis.     

Surgical outcomes and strategy of hypertrophic obstructive cardiomyopathy

Objective： To evaluate the surgical clinical results of hypertrophic obstructive cardiomyopathy. Methods： We retrospectively collected data on 24 patients who underwent surgical management in the past ten years in two hospitals in China and Madras Medical Mission in India. Myomectomy was carried out on all patients. Among them 3 patients underwent mitral valve replacement; 2 patients underwent mitral valve repair （anterior mitral leaflet plication）; 2 patients underwent aortic valve replacement; 1 patient underwent aortic valve repair; 2 patients underwent aortic root replacement; 1 patient underwent Bentall＇s procedure and 1 patient underwent coronary artery bypass grafting because of a breached muscle bridge, Results： One patient died of post-operative heart failure. The mean follow-up time was 4.3 years, There was significant improvement in the symptomatic status. Sixteen patients were asymptomatic with good effort tolerance and only four patients had New York heart association （NYHA） Classes Ⅰ-Ⅱ due to associated valvular lesions, Conclusion： Our experience proved that symptomatic hypertrophic obstructive cardiomyopathy or non-symptomatic hypertrophic obstructive cardiomyopathy with combined heart disease is indication for surgery as surgical intervention could get better clinical results in this kind of patients compared with other non-surgical method because it beneficially reduces the systolic anterior motion （SAM） of the mitral valve leaflet, which could not be avoided by other non-surgical treatment.     

家族性肥厚型心肌病相关cTnI基因突变检测芯片的应用

基于基因芯片技术对心肌钙蛋白(cTnI)基因上的突变进行了分析.针对外显子上的突变特征设计了特异性探针,制备了可以同时检测cTnI基因上第3,5,7,8外显子突变的低密度基因芯片.对每一个外显子,设计了2条5'端标记荧光的寡核苷酸链,一条模拟野生型序列,另一条模拟突变型序列,将二者混合起来模拟杂合子序列.经过实验条件的优化,制作的芯片可以灵敏、特异地检测cTnI基因外显子上的突变.结果表明,该芯片检测突变正配错配区别明显,荧光强度比值符合理论估计(正中碱基错配的信号强度是完全正配信号强度的50%左右).经进一步对芯片优化后,该芯片有望在家族性肥厚型心肌病的研究和诊断中得到应用.     

人参皂苷Rg1对糖尿病大鼠心肌氧化应激及细胞凋亡的影响（英文）

目的:探讨人参皂苷Rg1对高血糖所致心肌损害的保护作用及其机制。创新点:使用糖尿病大鼠为实验对象,探讨三种浓度的人参皂苷Rg1对糖尿病心肌损伤的保护作用及其机制,检测其是否具有浓度依赖性。方法:将60只Wistar大鼠随机分组,其中空白对照组10只,另50只给予高脂高糖饲养,4周后腹腔注射40 mg/kg链脲佐菌素(STZ)。成功制备糖尿病大鼠模型40只,再随机分为糖尿病模型组,糖尿病大鼠+低剂量人参皂苷Rg1(10 mg/(kg·d)),糖尿病大鼠+中剂量人参皂苷Rg1(15 mg/(kg·d)),糖尿病大鼠+高剂量人参皂苷Rg1(20 mg/(kg·d))。12周后处死大鼠,取血测定空腹血糖、总胆固醇(TC)、甘油三酯(TG)、心肌酶及氧化应激水平,留取心肌组织使用透射电镜观察心肌细胞超微结构改变,应用TUNEL法检测心肌细胞凋亡,免疫组化检测细胞凋亡相关蛋白半胱氨酸天冬氨酸蛋白酶3(CASP3)和Bcl-x L的表达。结论:人参皂苷Rg1对糖尿病大鼠糖脂代谢无明显影响,人参皂苷Rg1可降低糖尿病大鼠血清肌钙蛋白(c Tn I)和肌酸激酶同工酶(CK-MB)水平,改善心肌细胞超微结构,减少心肌细胞凋亡,降低大鼠血清和心肌组织中丙二醛(MDA)含量,提高超氧化物歧化酶(SOD)、过氧化氢酶(CAT)和谷胱甘肽过氧化物酶(GSH)水平,降低凋亡蛋白CASP3的表达,同时提高Bcl-x L蛋白表达。总之,人参皂苷Rg1能显著保护糖尿病大鼠心肌损伤,其机制可能与其抗氧化及抗细胞凋亡作用有关。     

卡思卡特城堡

It is worthy of noting that, whilst Crookston Castle witnessed the earlier and happier portion of Mary's variegated life,     

不同的吃喝玩乐

一、吃和喝吃苹果 eat an apple, 吃药 take medicine,吃糖 have some sweets,吃饭 have one's meals,吃馆子 dine out,吃惊 be surprised/     

漏洞百出的教育

Many college freshmen arrive woefully unprepared to do college work, and as disadvantaged populations continue to grow, the share of the American work force that has made it through college is expected to plummet. Many experts blame that educational failure not just on high schools but also on colleges. School & College, a special report by The Chronicle, looks at efforts to fix the system. What reforms would better prepare students for college? What should schools and colleges be doing differently? How should state and federal officials help?     

Western and Eastern culture differences in commercial field

The communication of people partially is the communication of cultures. Culture has a direct effect on international commercial activities in all aspects. Different conceptions about time, space, equality, law and the like, lead people to deal with things in different ways. So to know cultures of the counterpart is to facil-itate our enterprises so as to have a smooth and successful communication in commercial activity.     

只要努力,不要后悔

There are numbers of crossroads on our long and unpredictable life journey where we totally have no idea about which direction to choose. No matter what our decision is, we should not turn back, but face the music and go ahead instead. I am this kind of girl who always does try without regretting, one example is how I dealt with my love.