老年人肺心病血清T_3、T_4测定的研究

为探索老年人慢性肺心病的甲状腺功能状态,本文报告了52例老年慢性肺心病急性发作期血清T_3、T_4的变化。结果表明:肺心病老年组T_3、T_4显著低于健康组,与非老年组比较T_3降低有显著意义,恢复期较急性期T_3有明显回升,说明老年肺心病急性期T_3、T_4降低系机体的选择性适应,属于“甲状腺功能正常病态综合症”(ESS)。提示T_3不仅能协助判断病情的严重程度,并有判断预后的价值。     

慢性充血性心力衰竭非药物治疗进展

慢性充血性心力衰竭(chronic congestive heart failure)是大多数器质性心脏疾病进展的最终结局,也是最主要的死亡原因.     

115例充血性心力衰竭合并定性心律失常的治疗

充血性心力衰竭时极易合并定性心律失常,室性心律失常与这类病人的猝死有直接关系。对此类病人是否使用抗心律失常药?用抗心律失常药的指征是什么?多年来临床上存在着争议。本文回顾性分析115例住院病人的资料,结果表明:使用心律失常药组住院期间猝死率明显低于未用心律失常药(P<0.05)。作者以这对充血性心力衰竭合并室性心律失常的病人应综合判断,合理使用抗心律失常药。     

二氢吡啶对尼罗罗非鱼生长作用及血清T3、T4水平的影响

二氢吡啶以三个不同水平(0、50、100mg/kg)添加饲喂雄性尼罗罗非鱼33d,探讨二氢吡啶的适宜添加水平及其对血清T3、T4水平的影响.结果表明,添加二氢吡啶(50、100ng/kg)可使日增重分别提高11.9%(p=0.063)、6.8%,体重特定生长率提高12.6%(p＜0.05)、8.7%,饵料系数分别较对照组降低9.0%、6.9%,但对试验鱼平均存活率及背侧肌组成无影响;试验末,50mg/kg组血清T3水平极显著高于对照组(2.449±1.119,1.757±0.555 p＜0.01),T4均处于不可测水平.     

慢性心力衰竭合并低渗性脑病误诊39例分析

目的 了解慢性心力衰竭合并低渗性脑病患者的临床特点.方法 对39例慢性心力衰竭合并低渗性脑病患者临床资料进行回顾性分析.结果 39例中,误诊为神经精神疾患26例(66.7%);31例经2～5 d治疗低钠血症逐渐纠正,意识状态渐恢复好转,8例死亡.结论 慢性心力衰竭合并低渗性脑病易导致误诊,积极治疗原发病的同时要及时纠正电解质紊乱.     

美托洛尔治疗老年人充血性心力衰竭的前瞻性临床研究

目的:探讨β-肾上腺素能受体阻滞剂美托洛尔在老年人充血性心力衰竭(CHF)中的应用。方法:本研究为前瞻性、多中心、单盲、随机对照试验,入选老年CHF患者152例,随机分为美托洛尔组(B组)和对照组(C组),均予标准抗心衰治疗,B组联用美托洛尔,C组联用与美托洛尔外观相同的淀粉安慰剂,观察治疗前和治疗后6周、12周、24周时的临床指征变化,评价其临床有效性和安全性。结果:与C组比较,B组无创心排量指针于12周时已显著改善(P<0.05),24周时更显著(P<0.01);临床心功能分级于24周时也显著改善(P<0.05)。结论:长期应用美托洛尔可明显改善老年人充血性心力衰竭患者的心脏功能,提高患者的生活质量和生存率。     

三碘甲腺原氨酸(T3)采用放射免疫分析法测定过程中四种数学拟合曲线的比较

三碘甲腺原氨酸(T3)是由人体甲状腺分泌物之一,能够部分反应甲状腺的功能。测定其在血清中含量,对甲状腺功能检查有重要的意义,通常在甲状腺机能亢进的诊断上作     

基于褐藻酸钠改性纳米金静电排斥作用的新型电化学免疫传感器的研制

通过胱胺将负电性的褐藻酸钠(AS)共价结合到纳米金表面形成聚合体，并以此来标记三碘甲状腺氨酸(T3)．T3抗体固定在金电极上构成检测T3的电化学免疫传感器．通过免疫反应，标记T3和待检测的T3结合到金电极表面，使电极表面微环境发生显著改变，用Fe(CN)6^4 为电化学探针，用循环伏安法获取电极表面微环境改变的电化学信息来检测T3、其检测的线性范围为100—10000pg／mL，检测限为45pg/mL.     

依那普利对充血性心力衰竭患者胰岛素抵抗的影响

目的观察慢性充血性心力衰竭（CHF）患者的血胰岛素和糖代谢变化,并探讨依那普利对CHF患者胰岛素敏感性的影响。方法CHF患者69例,依那普利（n=37）（第一周10mg,1次／d,后三周20mg,1次／d）和地高辛（n=32）（第一周0．25mg,1次／d,后三周0．125mg,1次／d）,治疗前和治疗4周后检测空腹血糖（FPG）、空腹血清胰岛素（FINS）和空腹血清C肽（CP）水平,并计算出FPG／FINS比值、胰岛素敏感性指数IAI值[IAI=－ln（FPG×FINS）]作为机体胰岛素敏感性评价指标,分别比较两组患者治疗前后的胰岛素敏感性变化。结果治疗4周后,依那普利组CHF患者的胰岛素敏感性显著增加,而地高辛组患者胰岛素敏感性无显著变化。结论依那普利有改善CHF患者IR的作用。     

螺内酯对老年人重度心力衰竭的疗效观察

目的 :探讨小剂量醛固酮拮抗剂螺内酯治疗老年人重度慢性充血性心力衰竭 (CHF)疗效和安全性。方法 :采用多中心、随机、单盲、安慰剂对照、平行组试验。入选老年重度CHF患者 15 2例 ,随机分为螺内酯组 (A组 )和对照组 (B组 ) ,均予标准三联抗心衰治疗 ,A组联用螺内酯 (2 0～ 4 0mg/d) ,B组联用与螺内酯外观相同的淀粉安慰剂。治疗前和治疗后 2周、4周、8周分别进行心功能 (NYHA)分级评估 ,心电图、超声心动图、血常规、生化等检查 ,并进行对照。结果 :治疗 8周后A、B两组心功能分级、无创心排量指标均显著改善 (P <0 .0 5 ) ;与B组比较 ,A组改善更显著 (P <0 .0 5 )。无肝、肾功能损害及血脂、血糖升高 ,未见高血钾症 ,毒副作用少。结论 :应用螺内酯治疗老年人重度CHF疗效肯定、可靠、安全性好、值得推广。     

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.     

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.     

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。     

Metabolic remodeling in chronic heart failure

Although the management of chronic heart failure (CHF) has made enormous progress over the past decades, CHF is still a tremendous medical and societal burden. Metabolic remodeling might play a crucial role in the pathophysiology of CHF. The characteristics and mechanisms of metabolic remodeling remained unclear, and the main hypothesis might include the changes in the availability of metabolic substrate and the decline of metabolic capability. In the early phases of the disease, metabolism shifts toward carbohydrate utilization from fatty acids (FAs) oxidation. Along with the progress of the disease, the increasing level of the hyperadrenergic state and insulin resistance cause the changes that shift back to a greater FA uptake and oxidation. In addition, a growing body of experimental and clinical evidence suggests that the improvement in the metabolic capability is likely to be more significant than the selection of the substrate.     

基于奇异值分解熵的心率变异性分析

Assessing the dynamics of heart rate fluctuations can provide valuable information about heart status. In this study, regularity of heart rate variability （HRV） of heart failure patients and healthy persons using the concept of singular value decomposition entropy （SvdEn） is analyzed. SvdEn is calculated from the time series using normalized singular values. The advantage of this method is its simplicity and fast computation. It enables analysis of very short and non-stationary data sets. The results show that SvdEn of patients with congestive heart failure （CHF） shows a low value （SvdEn： 0.056±0.006, p 〈 0.01） which can be completely separated from healthy subjects. In addition, differences of SvdEn values between day and night are found for the healthy groups. SvdEn decreases with age. The lower the SvdEn values, the higher the risk of heart disease. Moreover, SvdEn is associated with the energy of heart rhythm. The results show that using SvdEn for discriminating HRV in different physiological states for clinical applications is feasible and simple.     

表扬与儿童失败后反应的关系

有关表扬的研究非常丰富，但对于表扬是否必然对儿童有积极影响这一问题，已有的研究结论并不一致．本文通过大量文献研究发现表扬与儿童失败后反应的关系：（1）个人表扬将儿童取得的好成绩归因于个人特质，过程表扬则将儿童取得的好成绩归因于解决问题的过程；（2）个人表扬更可能使儿童失败后表现出无助反应，而过程表扬更可能使儿童失败后表现出掌握取向反应．     

Brain natriuretic peptide and optimal management of heart failure

BRAIN NATRIURETIC PEPTIDE Several studies demonstrated that the heart is an endocrine organ (Henry and Pearce, 1956; Kisch, 1956; de Bold, 1985; de Bold et al., 1981; 1996; 2001). Atrial natriuretic peptide (ANP) was the first cardiac hormone identified in 1984 (Kangawa et al., 1984; de Bold et al., 1981). Later on, a new com- pound from pig brain was found, which had similar natriuretic and diuretic effects as ANP (Sudoh et al., 1988). This peptide was named brain (B-type) natr…     

Brain natriuretic peptide and optimal management of heart failure

Aside from the important role of brain natriuretic peptide (BNP) in diagnosis, and differential diagnosis of heart failure, this biological peptide has proved to be an independent surrogate marker of rehospitalization and death of the fatal disease. Several randomized clinical trials demonstrated that drugs such as beta blocker, angiotensin converting enzyme inhibitor, spironolactone and amiodarone have beneficial effects in decreasing circulating BNP level during the management of chronic heart failure. The optimization of clinical decision-making appeals for a representative surrogate marker for heart failure prognosis. The serial point-of-care assessments of BNP concentration provide a therapeutic goal of clinical multi-therapy and an objective guidance for optimal treatment of heart failure. Nevertheless new questions and problems in this area remain to be clarified. On the basis of current research advances, this article gives an overview of BNP peptide and its property and role in the management of heart failure.     

Similarities and differences between nonorganic failure to thrive and deprivation dwarfism

Although the terms, nonorganic failure to thrive and deprivation dwarfism, are sometimes used interchangeably, and while the family pathology is similar in both conditions, the clinical features differ. The majority of children with nonorganic failure to thrive are under 2 years and often 18 months of age. Weight loss is the most marked feature and they are often withdrawn and apathetic. In contrast, the documented ages of children with deprivation dwarfism range from 2 to 15 years although the history may reveal earlier feeding and behavior problems. Short stature is the most striking feature, their weight often being in proportion to their height. They may steal and hoard food and have bizarre eating habits. In some cases reversible hypopituitarism has been documented. It is suggested that deprivation dwarfism constitutes a subgroup within the nonorganic failure to thrive syndrome. Management in both conditions is similar. It should emphasize a practical, supportive approach and be on a long-term basis.     

Research on the methods of detecting and removing slide valve failure

Various ways for detecting slide valve failure are discussed in the paper. Specifically, a new method for detecting slide valve sticking state is first presented. The method does not depend on any special sensor and is only based on the detection of oscillation current wave within a valve coil. Results of theoretical analysis and experimental research are given for comparison. In order to remove a slide valve sticking online, a concept and method of “electrical hammer” is introduced. At last, an application example of the methods is discussed. In fact, it is an electro-hydraulic turbine system with failure diagnosis, fault-tolerant and trouble removal functions. Project (59775003) supported by NSFC