老年慢性肺心病伴发急性心肌梗死的分析

目的探讨老年慢性肺心病伴发急性心肌梗死(AMI)的临床特点.方法对66例老年慢性肺心病伴发AMI的病人(A组)进行分析,并与老年单纯冠心病AMI152例(B组)作比较.结果A组疼痛发生率(45.4%)显著低于B组(83.9%)(p＜0.01),A组急性左心衰、心源性休克发生率显著高于B组,分别为53.1%与25.0%,48.4%与21.7%(p＜0.05),A组病死率(42.4%)显著高于B组(15.7%),肺心病对其伴发AMI的发生部位无影响.结论对老年肺心病患者突然发生的急性左心衰和/或心源性休克应高度警惕伴发AMI的可能.     

急性出血性结膜炎的治疗和预防探讨

目的:探讨αlb基因工程干扰素治疗和预防流行性出血性结膜炎的疗效。方法:选同期门诊AHC双眼发病患者48例,单眼发病患者32例,均随机分成治疗组和对照组,以干扰素滴眼液和无环鸟苷滴眼液做治疗和预防对照,均双眼点药,健眼做预防用药。结果:双眼发病患者干扰素治疗组治愈时间平均5.33d,无环鸟苷对照组8.27d,经秩和检验有显著差异(P<0.05);单眼发病患者中,健眼干扰素组6例发病,无环鸟苷组13例发病,经统计学处理有显著差异(P=0.035)。结论:αlb基因工程干扰素滴眼液治疗AHC疗效显著,且时间短,见效快,并对健眼有明显的预防发病作用。     

知母抗真菌有效成分的遗传致畸实验研究

采用小鼠急性毒性实验、小鼠股骨骨髓微核实验和精子畸变试验进行观察,对知母有效成分进行遗传毒理性实验.结果表明:在本实验条件下,知母抗真菌有效成分不存在急性毒性和遗传致畸性.     

谈急性心肌梗塞病人预防便秘的护理

目的:探讨有效预防急性心肌梗塞病人因便秘及用力排便憋气而诱发心律失常、心力衰竭、休克和猝死等并发症发生的护理体会.方法:采用系统护理与常规护理相比较,对218例急性心肌梗塞病人入院后头两周的临床观察与统计,说明系统护理在抢救过程中预防便秘的临床意义.结果:采用系统护理能有效地预防便秘,使并发症的发生率明显降低.其效果优于常规护理(P<0.01和P<0.05).结论:在对急性心肌梗塞病人的临床护理中,应用系统护理能有效地预防便秘,减少并发症的发生,提高病人的救治成功率.     

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.     

An Alternative Approach for Expressing [Vdot]O2 Max Changes When Comparing Training Programs

The purpose of this study was to examine African American toddlers' cortisol response to acute physical play activity within a full-time subsidized day care environment. Saliva samples were taken from participants (N = 22, ages 26–45.5 months) before and after physical play and control play conditions at the same time of day. ActiheartTM monitors were used to estimate the intensity of the play conditions. Although heart rate and other indicators were significantly higher during physical play, no change in cortisol levels was seen pre- to postphysical play. Further research is needed to better understand the cortisol response observed.     

急性乙醇中毒大鼠中枢氨基酸类递质及行为学改变的研究

目的 观察急性乙醇中毒对大鼠海马、小脑氨基酸类神经递质及行为学改变的影响,以探讨急性乙醇中毒对中枢神经系统损害的机制。方法雄性Wistar大鼠48只,随机分为对照组,饮酒后0．5h组,饮酒后1．0h组,饮酒后1．5h组,饮酒后2．0h组,饮酒后4．0h组;实验组60％（v／v）白酒1次灌胃（灌胃体积10ml／kg）,对照组用等量生理盐水灌胃。采用高效液相色谱法和Moms水迷宫法分别检测大鼠小脑和海马中谷氨酸（glutamic acid,Glu）和γ-氨基丁酸（gamma aminobutyric acid,GABA）含量的变化以及逃逸潜伏期（escape latency,EL）的变化。结果实验组大鼠小脑和海马中Glu和GABA含量明显下降（P〈0．01）,小脑中Glu和GABA比值在0．5h和2,0h组明显升高（P〈0．01）．实验组大鼠在饮酒后逃逸潜伏期（EL）值明显延长（P〈0．01）,2．0h组和4．0h组的EL值较其他实验组明显缩短（P〈0．01）。结论急性乙醇中毒引起行为学改变可能与小脑和海马氨基酸类神经递质改变有关。     

Diagnosis of acute myocardial infarction: CK-MB versus cTn-T in Indian patients

The comparative diagnostic efficacy of two cardiac markers: CK-MB and cTn-T, has scarcely been investigated in Indian patients of acute myocardial infarction. The present study was conducted for the same objective. The present study comprised of 59 patients. Males were 44 (75%) and females were 15 (25 %). The age of patients ranged from 32–84 years with mean age of 62.8 yrs. The mean age of males and females were 60 and 63 yrs respectively. All patients presented with history of chest pain with a 12 leads ECG proven MI (ST Elevation, discordant T-waves). CK-MB was estimated in peripheral blood samples at 0,24,48 and 72 hours by an autoanalyzer. Following 12 hours of admission bed side Troponin-T test was done employing cTn-T marker kit. Initially (0 hr), in 50% patients CK-MB was elevated. By end of 24 hours all the patients were CKMB positive and peak level was attained at 24 hrs. Then it tended to decline over next 48 hrs. There were no false positive or negative results. The cTn-T test was positive only in 22 % of ECG positive infarctions. However, the cTn-T positive cases were always accompanied by a higher CK-MB levels. A significantly lower cTn-T positive cases in Indian patients can only be attributed to some difference in amino acid sequence of Indian cTn-T and occidental cTn-T. A larger study from other Indian cardiac centers can either substantiate or contradict our results.     

MTHFR (Ala 222 Val) polymorphism and AMI in patients with type II diabetes mellitus

The prevalent Ala222Val single nucleotide polymorphism of the MTHFR gene has been shown to be associated with type II diabetes. The objective of the present study was to find out whether there is genetic predisposition for development of acute myocardial infarction in type II diabetes mellitus among South Indian Tamil population. PCR-based restriction enzyme analysis was performed in DNA isolated from 120 acute myocardial infarction patients with diabetes mellitus and 100 non diabetic healthy individuals with no documented cardiovascular diseases. The results indicate that the MTHFR 677TT genotype is absent in both case and controls. The MTHFR 677CT genotype was observed among 32 (26.7 %) cases and 20 (20%) controls and the MTHFR 677CC genotype among 88 (73.3%) cases and 80 (80%) controls. The allelic frequencies were in accordance to Hardy Weinberg equilibrium. There was no statistical difference in genotype distribution between cases and controls. In conclusion, we suggest that the analysis of MTHFR genotyping for C677T polymorphism alone need not be considered to find out whether there is genetic predisposition for development of acute myocardial infarction in type II diabetes mellitus among South Indian Tamil population.     

Biochemical Basis of Heterogeneity in Acute Presentations of Propionic Acidemia

Propionic acidemia (PA), an uncommon organic acidemia has varied clinical and metabolic presentation causing difficulty and delay in the diagnosis. We report a case of PA in an infant who presented with failure to thrive, acute encephalopathy due to severe hyperammonemia without acidosis and fungal sepsis. The biochemical basis of severe hyperammonemia is discussed.