目的:观察胰激肽原酶对血管损伤后兔血管形态及MMP-2、TIMP-2、P53蛋白表达的影响.方法:18只西新兰兔随机分为假手术组、模型组及胰激肽原酶组,每组6只.通过球囊损伤制备兔腹主动脉损伤模型,并进行3周的胰激肽原酶治疗,之后观察血管形态及检测MMP-2、TIMP-2、P53蛋白表达的变化.结果:与假手术组相比,模型组内膜增生明显(P<0.05);与模型组相比,胰激肽原酶组内膜增生有改善(P<0.05).模型组MMP-2、TIMP-2表达均较假手术组升高,胰激肽原酶组MMP-2表达较模型组下降,差异均有统计学意义(P<0.05);胰激肽原酶组TIMP-2表达与模型组比较,差异无统计学意义(P>0.05);模型组P53表达较假手术组下降,胰激肽原酶组P53表达较模型组升高,差异均有统计学意义(P<0.05).结论:胰激肽原酶具有抑制血管损伤后内膜增生,与促进P53蛋白表达及抑制MMP-2表达相关.

Objective:To observe the clinical efficacy of ordinary-days moxibustion and midsummer moxibustion on bronchial asthma with Yang deficiency constitution,as well as their consequent effect on patients' constitution.Methods:A total of 63 patients who had bronchial asthma of Yang deficiency constitution were enrolled and divided into ordinary-days moxibustion group (32) and midsummer moxibustion group (31).Patients were treated respectively on midsummer days and ordinary days,with same moxibustion plaster and at same acupoints.The asthma syndrome score,asthma control test score (ACT) and Yang deficiency transformation score were compared between the two groups.Results:Effectiveness of both the two groups was satisfying,but no significant difference was showed.The asthma syndrome score and ACT of both the groups indicated significant difference before and after the treatment (P ＜ 0.05),but no significant difference was revealed (P ＞ 0.05).Improvements were achieved in both the groups after the treatment for the scores of Yang deficiency transformation (P ＜ 0.05),but better curative result was made in the midsummer group (P ＜ 0.05).Conclusion:Similar curative effect was obtained in both ordinary-days moxibustion and midsummer moxibustion for bronchial asthma with Yang deficiency constitution.Midsummer moxibustion has more significantly efficacy in term of Yang deficiency constitution transformation.

【Objective】To investigate the effect of trimetazidine on left atrial volume index(LAVI) in patients with chronic heart failure(CHF).【Methods】65 CHF Patients were randomized into trimetazidine group(n=33) and control group(n=32).The control group received conventional therapy,and the trimetazidine group received trimetazidine 20mg tid in addition to conventional therapy,with a follow up of 6 months.Echocardiographic examinations were performed before and 6 months after the study,and LAVIs were measured.【Resluts】Before and 6 months after the study,LAVIs were 43±11.6 mL/m2 vs 34±12.8 mL/ m2 in the trimetazidine group(P<0.05),and 42±10.9 mL/m2 vs 40±8.8mL/m2 in the control group(P>0.05),respectively.【Conclusion】In CHF Patients,addition of trimetazidine to conventional therapy improved LAVI.

【Objective】To explore the impact of psychological intervention on depression in patients with chronic congestive heart failure(CHF) associated with depression and heart function.【Methods】Chronic congestive heart failure with depression were randomLy divided into psychological intervention group(45 cases) and control group(45 cases).The control group was given conventional cardiovascular medications,the intervention group received a comprehensive psychological intervention on the basis of conventional cardiovascular medications,in severe cases of depression taking the amount of antidepressant drugs.All patients were followed up for 3 months.【Resluts】(1)Compared between two groups 3 months after treatment,depression of the treatment group than the control group significantly reduced(P0.01);(2)The NYHA functional grade significantly improved(P 0.05),LVEF significantly increased in treatment group(P 0.05).【Conclusion】With depression in patients with chronic congestive heart failure(CHF),psychological intervention can reduce depression and further improve heart function.

Objective To investigate the effect of one-hour postload plasma glucose concentration(1h PG) during oral glucose tolerance test(OGTT) on P wave dispersion(PWD).Methods With a cutoff point of 8.6 mmol/L for the 1h PG,60 subjects with normal glucose tolerance(NGT) were divided into two groups,NGT<8.6 mmol/L(n=45) and NGT≥8.6 mmol/L(n=45).PWD,blood lipid were measured,and echocardiography were performed in the two groups,data of both groups were compared to each other.Results PWD increased in the group of NGT≥8.6 mmol/L,compared to the group of NGT<8.6 mmol/L(42 ±12 vs.34±11,P<0.05).Conclusion PWD increased in NGT subjects with 1 h PG≥8.6 mmol/L and may be the predictor of AF.

目的:对测定视黄醇结合蛋白(RBP)的胶乳增强透射比浊法进行方法学评价,以便为临床实验室引进该检测方法提供依据.方法:采用胶乳增强透射比浊法测定RBP,根据NCCLS评价方案和相关文件的要求,对该方法的精密度、准确度、线性范围和干扰因素进行评价.结果:正常值和高值的批内CV%为4.4%和5.6%,批间CV%为4.8%和6.1%a,日间CV%为5.9%和7.2%,总CV%为7.5%和9.3%;平均回收率为 104.8%; RBP浓度在130mg/L范围内线性良好;血红蛋白浓度小于或等于5g/L、胆红素浓度小于或等于442umol/L和兰酰甘油小于或等于1Ommol/L时对RBP测定均无显著性干扰(P>0.05).结论:胶乳增强透射比浊法有较高的精密度和准确度,较宽的线性范围和较强的抗干扰性能,加上自动化程度高,检测速度快,所以具备全自动生化分析仪的临床实验室值得引进该检测方法用于常规测定.

Objective: To investigate the effect of Pravastatin on maintenance of sinus rhythm and improving cardiac function in patients with normal blood lipid level complicated with chronic heart failure and paroxysmal atrial fibrillation.Methods: A total of 68 patients with normal blood lipid level complicated with chronic heart failure and paroxysmal atrial fibrillation were divided into treatment group(35 cases) and control group(33 cases).Aminodarone was used in the control group,based on the control group,Pravastatin(20 mg/d) was given in the treatment group.All patients were followed up for 6 months.Results: Compared between the two groups 6 months after treatment,the NYHA functional grade significantly improved(P0.05),LVEF significantly increased in the treatment group(P0.05).The recurrence rate of paroxysmal atrial fibrillatio in the treatment group decreased significantly compared with that in the control group(P0.05).Conclusion: Long-term administration of Pravastatin can inhibit the in flammatory reaction,improve cardiac function and reduce the relapse rate of paroxysmal atrial fibrillation in patients with normal blood lipid level complicated with chronic heart failure and paroxysmal atrial fibrillation.

Objective To study the influenc of metoprolol succinate sustained-release tablets therapy on ventricular rate and heart function of patients with chronic atrial fibrillation(CHF)and chronic heart failure(HF).Methods A total of 69 patients with chronic atrial fibrillation and chronic heart failure were randomly divided into treatment group(35 cases)and control group(34 cases).The general therapy included digoxin,diuretics,angiotensin-converting enzyme inhibitors(ACEI)or angiotensin-Ⅱ-receptor antagonists(ARB)and anticoagulants for a 6-momth follow-up period.The patients of treatment group was treated with metoprolol succinate sustained-release tablets above the base of the general therapy.The ventricular rate at rest and the ventricular rate after 6-minute walk,left ventricular end diastolic dimension(LVEDD),left ventricular end systolic dimension(LVESD),left ventricular ejection fraction(LVEF)and the distance of 6-minute walk were examined before and 6 months after therapy.After 6 months,to compare the changes of clinical manifestations.Results ①The ventricular rate at rest decreased significantly in both two groups(P＜0.01),the ventricular rate after 6-minute walk decreased significantly in treatment group 6 month after treatment(P＜0.01),but there was no significant difference betwen before and after treatment in control group on the ventricular rate after 6-minute walk(P＞0.05),and the ventricular rate after 6-minute walk was decreased more in tretment group than that in control group(P＜0.01).②The LVEF,LVEDD,LVESD and the distance of 6-minute walk in both groups had significant improvement as compared with before treatment(P＜0.01～0.05),with the treatment group showing a better improvement than in control group(P＜0.05).③The total responsive rate in the treatment group(93.8%)was significantly higher than in control group(77.4%)(P＜0.05).Conclusion Based on the medication of digitalis,diuretics and ACEI or ARB,metoprolol succinate sustained-release tablets therapy can effectively control ventricular rate,significantly improve heart function and also reverse left ventricular in patients with chronic atrial fibrillation and chronic heart failure.

Objective To evaluate the effect of bisoprolol on BODE index in patients with coronary heart disease and concomitant chronic obstructive pulmonary disease(COPD).Methods Oral bisoprolol,with the initial dose of 1.25 mg/d,increased gradually to 5 mg/d,was administered to 42 cases of coronary heart disease patients complicated with stable mild to moderate COPD.Before the administration of bisoprolol and 60 days after,four relevant variables of BODE index,including FEV1% of predicted(FEV1% pred),the distance walked in 6 minutes(6MWD),score on the the MMRC dyspnea scale(MMRC)and Body mass index (BMI),were measured,and BODE index were constructed with the four variables above.Results Before and after the administration of bisoprolol,the results were:FEV1% pred(68.05±7.32 vs.67.38 ±7.13);6MWD(322.83±65.72 vs.320.43±62.34);MMRC(2.13±0.57 vs.2.18±0.65);BMI(20.58±3.52vs.20.26±3.07);BODE index(3.51±1.97 vs. 3.54±2.01).(all P>0.05).Conclusion Bisoprolol had no significant effect on BODE index in patients with coronary heart disease and concomitant stable mild to moderate COPD.

Objective To investigate the effect of Lidocaine on heart rate variability in epidural block anesthesia,and judge the relationship between the functional status of autonomic nerve and epidural block anesthesia.Methods By Fourier analysis transfer principle and heart rate variability power spectrum analysis(HRV-PSA),the power spectrum was analyzed in 60 minutes before and after Lidocaine being injected into epidural space to investigate the sympathetic activity.Results 3 minutes after Lidocaine being injected into epidural space,parts of sympathetic nerve was restrained,twelve minutes after epidural block,the plane was fixed basically.Conclusions Heart rate variability can reflect the effect of epidural block,and be used as a reference index of judging epidural anesthesia effect.

Objective:To investigate the effect of candesartan cilexetil in preventing recurrence of essential hypertension complicated with atrial fibrillation(AF) .Methods:78 patients with essential hypertension complicated with AF who were recovered the sinus rhythm through electrotherapy or medicines were randomly divided into observation group and control group.Aminodarone were used in all patients to keep the sinus rhythm.Candesartan cilexetil 4～8 mg/d was added in observation group,and Norvasc 5～10 mg/d was added in control group.The follow-up lasted one year.The recurrent rates of AF in two groups were observed during one year,the inner diameter of left atrium was measured by echocardiogram and the blood pressure was observed in two groups before and after treatment.Results:The recurrent rate of AF in observation group decreased significantly compared with that in control group(P0.05) .After treatment the inner diameter of left atrium in observation group decreased significantly compared with that before treatment(P0.05) .The inner diameter of left atrium after treatment showed significant difference between the two groups(P0.05) .After treatment there was no significant difference in the blood pressure between the two groups(P0.05) .Conclusions:Long term treatment of candesartan cilexetil may reverse the enlargement of left atrium of patients with essential hypertension complicated with AF,and reduce the onsets of AF.

近年来双水平正压无创通气(BiPAP)在临床上的应用日渐广泛,尤其在急性左心衰竭治疗中应用较多.我院从2005年7月采用BiPAP治疗急性左心衰竭16例,收到了较好的效果,报告如下.

目的 观察福辛普利、螺内酯与常规抗心力衰竭药物联用治疗充血性心力衰竭的疗效.方法 将86例心力衰竭患者随机分为治疗组43例(福辛普利、螺内酯加常规抗心力衰竭药物)和对照组43例(福辛普利加常规抗心力衰竭药物),疗程8周.观察治疗前后临床心功能、心率、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)和左室收缩末期内径(LVESD)、血生化指标等变化.结果 两组患者临床心功能均有改善、治疗组心力衰竭纠正的有效率显著高于对照组(P＜0.05);治疗组治疗后心率的改善亦优于对照组(P＜0.05);治疗后两组的左室射血分数(LVEF)均有增加,左室舒张末内径(LVEDD)和左室收缩末期内径(LVESD)均有减少;治疗后两组LVEF比较(P＜0.05)、两组LVEDD比较P＜0.01、两组LVESD比较P＜0.01.结论 福辛普利联合螺内酯治疗慢性充血性心力衰竭明显改善心功能、改善左室重塑,治疗有效。

目的:观察葛根素注射液治疗慢性充血性心力衰竭(CHF)临床疗效。方法:将CHF患者82例随机分为常规治疗组、常规治疗+葛根素组(简称葛根素组),均以洋地黄类、利尿剂、硝酸酯类、血管紧张素转换酶抑制剂(ACEI)等药物治疗作为常规治疗,葛根素组加葛根素注射液静滴,疗程14日。观察治疗前后临床心功能、心率、左室射血分数(LVEF)等的变化。结果:两组患者临床心功能均有改善,葛根素组心力衰竭纠正的有效率显著高于对照组(P<0.05);葛根素组治疗后左室射血分数(LVEF)的提高及心率的改善亦优于对照组(P<0.01)。结论:葛根素能有效改善慢性充血性心力衰竭的心功能、提高左室射血分数。

目的观察通心络胶囊对冠心病心绞痛患者内皮功能及血镁的影响.方法 74例冠心病心绞痛患者随机分为两组,治疗组 38例给予通心络胶囊,对照组 36例给予复方丹参滴丸.疗程 4周.观察治疗前后血清内皮素 (ET)、血清一氧化氮 (NO)及血镁的变化.结果治疗组 ET水平降低, NO含量增加,血镁升高.结论通心络胶囊治疗冠心病心绞痛的作用机理可能系通过抑制 ET、增加 NO及对血镁的影响而介导的.

我们自1993年以来,对31例自发性气胸患者采用静脉鞘管引导一次性塑料管作胸腔闭式引流,效果良好.