Objective To investigate the characteristics of coronary artery angiography and myocardial enzyme among the cases with acute myocardial infarction but normal electrocardiogram,and reduce the missed diagnosis of acute myocardial infarction.Methods 574 cases with diagnosis of acute myocardial infarction from March 2005 to March 2011 participated in the study,and were divided into the groups of normal electrocardiogram and electrocardiographic ST segment elevation.The characteristics of coronary artery angiography and myocardial enzyme were compared between the two groups.Results There were 81 cases with normal electrocardiogram and 493 cases with ST segment elevation.Between the two groups,vascular lesion on left main coronary artery(LM) and right coronary artery(RCA) had significant difference in coronary artery angiography(P<0.05),and troponin(cTnI) and creatine kinase(CK) had signficant difference in the tests of myocardial enzyme(P<0.01).Conclusion The cases with normal electrocardiogram had more multivessel disease,less infarction on the left main coronary artery in the tests of coronary artery angiography,and higher value in the tests of myocardial enzyme than the cases with ST segment elevation.

Objective To investigate the electrocardiogram(ECG) features of rhesus monkeys in consciousness.Methods Sixty healthy rhesus monkeys,2～3 years old,2～3.5 kg,and 30 each gender,were selected.ECG changes of the lead I,Ⅱ,Ⅲ,aVR,aVL,aVF in resting conscious monkeys were examined,and the average heart rate,mean electrical axis,P wave,QRS complex,amplitude of T wave,PR interval,QT interval and so on,were calculated.Results and Conclusions Sinus rhythm was found in all the 60 rhesus monkeys.In most of the rhesus monkeys,the P wave was upright in Ⅱlead,S wave was absent in Ⅱ、Ⅲ、aVF leads,and there was no Q wave in aVR lead.The average voltage of R wave in female rhesus monkeys was significantly higher than that of the males(P0.005).In rhesus monkeys,the P wave is sharp,the QRS is diversified,the QT interval K value is 0.298±0.030,the ST segment locates at the isoelectric line,and the T wave is smooth in six leads and upright in the Ⅱ lead.In conclusion,we established the basic ECG data of rhesus monkeys.

对11例结核性脑膜炎患儿在侧脑室引流术前及术后进行监测及护理。术前宜做好患儿家长的心理护理,以取得家长的理解与配合,术后宜监测颅内压,保持引流管通畅,仔细观察并记录引流液的量及颜色,严格无菌操作,注意消毒隔离,以减少颅内感染,提高治愈率。

Objective To investigate the alterations of cardiac structure and function in acromegalic patients by using echocardiography.Methods Sixty patients,diagnosed as acromegaly,were selected as research subjects.Thirty-four sex and age matched normal individuals were used as control.Patients and control groups underwent echocardiography.Besides,among the sixty patients,seventeen patients suffered from diabetes mellitus and impaired glucose tolerance,and were denoted as subgroup cases.The results of both were analysed.Results 1)Left ventricular mass(LVM) and LVM index(LVMi) were higher in patients with acromegaly than in control subjects,reaching values of left ventricular hypertrophy(46.7%).The patient group also showed apparent cardiac chambers enlargement.Through the multiple stepwise regression analysis,the duration of the disease and serum GH level were the main influencing factors of acromegalic cardiomyopathy.2) Ejection fraction(EF) and fractional shortening(FS),were decreased,compared to control group,they still remained in normal range.3) Isovolumic relaxation time(IRT)and E wave descending time(MDT),were delayed apparently compared to control group,indicating the damage of cardiac relaxation.4)Subgroup analysis in acromegalic: The comparison between patients with diabetes mellitus and impaired glucose tolerance(DM/IGT) and patients without DM/IGT showed that there was no significant difference in terms of the parameters in the two groups,in spite of an mild increase of IVST in the former group.ConclusionThe echocardiographic alterations of cardiac structure mainly were LV hypertrophy and the increase of the LVM,the enlargement of the cardiac cambers.Changes of cardiac function mainly were the impairment of diastolic function.However,the systolic function still remained in normal range for a long time.

To investigate the effects of bisoprolol on heart function in old myocardial infarction(OMI), 35 patients with OMI received bisoprolol 2.5 mg per day for two months. Doppler echocardiographic measurements of left ventricular structure, transmitral flow velocity pattern, blood pressure and heart rate were monitored before and after 1 and 2 months therapy. Bisoprolol led to reduction in blood pressure and heart rate 〔(20.08/10.64±3.33/2.26） vs （19.42/10.37±2.79/1.86） kPa P＜0.01, （70.66±12.86） vs （64.31±9.84） bits/min P＜0.01〕, and E/A increased significantly 〔(0.85±0.18） vs （1.14±0.35） P＜0.01〕. No significant affection was found on left ventracular systolic function. Bisoprolol reduces blood pressure and heart rate, improves diastolic function, hence it would be valuable in treatment of OMI.

目的利用M型超声测定二尖瓣环运动(MAM)评价左室舒张功能。方法陈旧性心梗(OMI)及正常人各35例，记录二尖瓣环舒张早期和晚期M型运动曲线的下降幅度(EM、AM)和斜率(SM、SA)及二尖瓣口血流频谱。结果 OMI组的EM明显降低(5.61±1.32 vs 8.82±1.75，P<0.001)，SE下降(43.12±14.10 vs 73.92±21.44，P<0.001)，EM/AM低(1.06±0.358 vs 1.67±0.44,P<0.001)，EM及EM/AM与多普勒血流参数E/A具有相关(r=0.679，P<0.001，r=0.638，P<0.001)，以EM<6.93为标准判断有无舒张功能不全的敏感性和特异性分别为97.14%和91.43%。结论 MAM方法适用于无创评估OMI患者的左室舒张功能。