平板运动试验对大学生室性早搏的评价

应用美国MAX运动平板试验系统,观察了16名大学生不明原因室早患者与16名健康对照者运动平板试验过程中心率、早搏、心电图Q—T间期、Q—T离散度的变化。结果是室早组次极量运动时室早明显减少或消失14例,良性早搏占87．5％,对照组中1名运动过程中出现偶发室早。与对照组相比,两组运动前后心率、心电图Q—Td、Q～Tcd差异均无统计学意义（P〉0．05）。运动平板试验能够作为评价青年人不明原因室早的依据,有益于指导临床治疗。     

参麦注射液对大鼠急性心肌梗死后心功能的影响

目的:探讨参麦注射液对大鼠急性心肌梗死后心功能的影响。方法:结扎大鼠左冠状动脉前降支(LAD)建立AMI模型,分组:①MI 1周组;②SM 1周组;③MI 2周组;④SM 2周组(MI心梗模型组,SM参麦注射液治疗组)。另设1周、2周假手术(Sham)组。记录心率(HR)及心功能参数:平均动脉压(MAP),左室收缩压(LVSP)、左室舒张末压(LVEDP)、左室内压最大上升速率( dp/dtmax)和下降速率(-dp/dtmax)。结果:在心梗后1周、2周时,模型组LVSP、±dp/dtmax均明显降低,而LVEDP则明显增加(P<0.01);参麦注射液治疗组LVSP、±dp/dtmax显著回升、LVEDP下降,与对应时间点MI组比较均具有显著性差异(P<0.05,0.01)。结论:参麦注射液能显著改善大鼠急性心肌梗死后的心功能。     

The effects of sotalol on ventricular repolarization during exercise

Objective: Although after pacing animal and human studies have demonstrated a rate-dependent effect of sotalol on ventricular repolarization, there is little information on the effects of sotalol on ventricular repolarization during exercise. This study attempted to show the effects of sotalol on ventricular repolarization during physiological exercise. Methods: Thirty-one healthy volunteers (18 males, 13 females) were enrolled in the study. Each performed a maximal treadmill exercise test according to the Bruce protocol after random treatment with sotalol, propranolol and placebo. Results: Sotalol significantly prolonged QTc(corrected QT) and JTc (corrected JT) intervals at rest compared with propranolol (QTc 324.86 ms vs 305.21 ms, P＜0.001; JTc245.04 ms vs 224.17 ms, P＜0.001) and placebo (QTc 324.86 ms vs 314.06 ms, P＜0.01; JTc 245.04 ms vs. 232.69 ms, P＜0.001).The JTc percent reduction increased progressively with each stage of exercise and correlated positively with exercise heart rate(r=0.148, P＜0.01). The JTc percent reduction correlation with exercise heart rate did not exist with either propranolol or placebo.Conclusions: These results imply that with sotalol ventricular repolarization is progressively shortened after exercise. Thus the specific class Ⅲ antiarrhythmic activity of sotalol, present as delay of ventricular repolarization, may be attenuated during exercise.Such findings may imply the need to consider other antiarrythmic therapy during periods of stress-induced tachycardia.     

乙酰胆碱对豚鼠左心室流出道自律细胞电活动的影响

目的：采用乙酰胆碱（ACh）和阿托品对豚鼠左心室流出道慢反应自律细胞电活动的影响来间接反映迷走神经对左心室流出道自律细胞的支配和胆碱能受体的分布。方法：采用标准玻璃微电极细胞内记录技术，观测了胆碱能受体激动剂（ACh）对离体豚鼠左心室流出道组织自发慢反应电位的影响及阿托品对ACh效应的拮抗。观测指标有：最大舒张电位（MDP）、动作电位幅度（APA）、0相最大除极速度（Vmax）、4相自动除极速度（VDD）、复极50％（APD50）和90％（APD90）时间以及自发放电频率（RPF）；结果：10μmol／LACh可使RPF和VDD减慢（P〈O．05）．APA显著减小（P〈0．001），APD50缩短（P〈0．05）；ACh对APD50的缩短效应可被10μmol／L阿托品拮抗（P〈0．05）。结论：左心室流出道自律细胞可能也受心迷走神经支配，其细胞膜上可能也存在M—R。     

电复律治疗室性心动过速21例临床疗效分析

目的：本文对2l例采用急诊电复律治疗的室性心动过速进行分析，观察其有效性、安全性和临床实用性。方法：病例选择年龄≤45岁；以往无窦房结功能不良记录；室性心动过速伴有血流动力学障碍或药物不能终止。选择同步复律50-100J。非同步复律100-200J。结果：21例中复律成动18例，成功率85．7％。21例均未出现电复律所致的并发症。结论：急诊电复律治疗室性心动过速具有快速复律、安全可靠、操作简便、复律成功率高、副作用和并发症少等优点。     

hs-CRP and oxidative stress in young CAD patients: A pilot study

Premature coronary artery disease (CAD) is common in India. We, therefore, studied oxidative stress, dyslipidemia, and high sensitivity-C reactive protein (hs-CRP) levels in young CAD patients. Present study consisted of male CAD patients below 40 years and age and sex matched healthy controls (n=30 each). Fasting blood samples were analyzed for serum lipid profile, malondialdehyde, antioxidant enzymes and hs-CRP levels. Dyslipidemia was observed in 90% of the young CAD patients, of which 72.2% showed increased serum triglycerides and decreased HDL-cholesterol. LDL-cholesterol levels were high in 77.8%. Serum malondialdehyde and hs-CRP levels were increased significantly (p<0.0001) as compared to controls. hs-CRP levels were in high risk range in all the young patients. However, glutathione peroxidase activity was reduced significantly (p<0.05). Our data suggests that elevated hs-CRP levels along with dyslipidemia and oxidative stress adds to the predictive value of premature CAD in young Indians.     

论海子的创作心理

海子是当代诗坛上重要的抒情诗人与史诗诗人，是80年代后期新诗潮的重要代表人物。本文从创作心理角度分析海子诗歌创作的特点，指出早熟与早慧的内在分裂构成其创作心理的基本面貌，并导致了他最终以极端的方式结束自己的生命。     

Concurrent pulmonary thrombosis with systemic embolism: a case report

Based on different mechanisms of blood coagulation, coexistence of venous thromboembolism and arterial thrombosis in a single individual is extremely rare in clinical practice. Both antiplatelet and anticoagulation therapy should be adopted for patients with arteriovenous embolism. Balancing the risk of ischemia and hemorrhage is especially challenging in these patients in order to achieve an optimal clinical benefit. We report on a 55-year-old female with acute pulmonary embolism (PE), subsequently diagnosed as having acute myocardial infarction (AMI) and a cerebral infarction. Examinations had been carried out, excluding potential arteriovenous shunts, cancer, antiphospholipid syndrome and other common hypercoagulable states. A combination of an anticoagulant drug (rivaroxaban, an Xa inhibitor) and an antiplatelet agent (clopidogrel, an ADP receptor inhibitor) was prescribed with a β-blocker and atorvastatin. The embolus was gradually shrunk during the next 10 months, and then it turned back into expanding. During the 16 months’ follow-up, an aneurysm of left ventricular apex was found through an echocardiogram and an angiotensin-converting enzyme inhibitor was administered. We conclude that combined anticoagulation and antiplatelet therapy significantly relieved the symptoms and improved the prognosis in patients suffering from arteriovenous embolism without any major clinical bleeding events.     

举重、摔跤运动员心室及肺动脉内径的测定与分析

为了进一步探讨以无氧供能为主的举重、摔跤运动对心血管系统的影响，实验测定分析了１０名举重运动员、１０名摔跤运动员和１０名无训练者安静时左右心室舒张末内径及肺动脉内径。结果发现举重运动员的ＬＶＩＤｄ、ＲＶＩＤｄ和肺动脉内径与对照组比较，指数值增大并有显著性意义；摔跤运动员仅ＬＶＩＤｄ较举重组和对照组有统计学意义，表明举重运动的缺氧程度比摔跤运动高，体现了专项特点。