目的:探讨妊娠期糖尿病(GDM)对新生子代大鼠膈肌功能和氧化应激水平的影响,阐明其可能作用机制.方法:44只怀孕的8周龄SD雌性大鼠随机分为正常对照组和GDM模型组.妊娠第1天,GDM组大鼠单次腹腔注射35 mg·kg-1链脲佐菌素(STZ),建立GDM大鼠模型(建模成功18只);正常对照组大鼠单次腹腔注射相同体积的柠檬酸-柠檬酸钠缓冲液.分娩后,体外检测2组新生子代大鼠的膈肌收缩力,免疫荧光法检测子代大鼠膈肌纤维横截面积,常规HE染色观察子代大鼠膈肌病理形态表现,透射电镜下观察子代大鼠膈肌超微结构,采用试剂盒检测子代大鼠膈肌组织中丙二醛(MDA)和羰基化蛋白水平及超氧化物歧化酶(SOD)和过氧化氢酶(CAT)活性.结果:体外膈肌收缩力检测,与正常对照组比较,GDM组子代大鼠膈肌最大紧张收缩力、最大强直收缩力和不同刺激频率下的膈肌收缩力均明显降低(P<0.05),膈肌疲劳指数明显升高(P<0.05).免疫荧光法检测,与正常对照组比较,GDM组子代大鼠膈肌组织中Ⅰ型和Ⅱ型膈肌纤维横截面积均明显缩小(P<0.05).HE染色,2组子代大鼠膈肌纤维结构完整,排列整齐、致密,膈肌细胞无明显肿胀,细胞核染色清晰.透射电镜下观察,正常对照组子代大鼠膈肌纤维排列整齐,明暗带及"Z"线规整且清晰可见,线粒体结构完整,嵴成隔板状,清晰可见;GDM组子代大鼠膈肌纤维明暗带及"Z"线无规则排列或消失,线粒体数量减少,更多线粒体出现凋亡呈空泡化.与正常对照组比较,GDM组子代大鼠膈肌组织中MDA和羰基化蛋白水平均明显升高(P<0.05),SOD和CAT活性明显降低(P<0.05).结论:GDM可引起子代大鼠膈肌收缩力降低、纤维横截面积减小和超微结构改变,而氧化应激水平的升高是影响其膈肌功能的原因之一.

目的：探讨实时三维超声心动图（RT-3DE）对难治性右心衰竭（RHF）患者右心室收缩功能的评估作用。方法选取难治性 RHF 患者30例（病例组）及健康志愿者30例（对照组），采用彩色多普勒超声诊断仪常规测量两组右心房左右径（RA-D1）、右心房上下径（RA-D2）、右室基底部左右径（RV-D）、右室游离壁厚度（RV-FW）、Tei指数，应用 RT-3DE 测量右室舒张末期容积（RVEDV）、右室收缩末期容积（RVESV）、右室每搏输出量（RVSV）、右室射血分数（RVEF），并比较两组以上检测指标的差异。结果两组 RA-D1、RA-D2、RV-D、Tei 指数、RVEDV、RVESV、RVSV、RVEF 比较差异均有统计学意义（P 均＜0．01），RVEF 与 Tei 指数高度相关（r ＝－0．733，P ＜0．01）。结论 RT-3DE 定量测量 RHF 患者右心室容积及 RVEF 等指标可准确评估其右心室收缩功能。

Objective To evaluate the aortomitral angle(AMA)changes in primary hypertension patients with left ventricular normal configuration (LVN) by echocardiography,and explore the correlation with left ventricular systolic function.Methods LVN group included 54 patients,control group included 79 healthy subjects.All subjects were examined by conventional echocardiography,the 2-dimensional gray-scale dynamic images of 5 consecutive cardiac cycles were collected by routine echocardiography;from parasternal left ventricular long axis,the related AMA at the starting isovolumic contraction time (S-IVCT),S-wave peak(SP),starting isovolumic relaxation time(S-IVRT),and starting-end diastole(SD) were measured respectively based on the tissue Doppler imaging,calculating the angle difference(⊿θ) as well as the rate of the angle change.The global systolic longitudinal strain(GLS) and circumferential strain (GCS) of left ventricle were measured by 2-dimensional speckle tracking and quantitative analysis software.Left ventricular ejection fraction (LVEF) was measured by Simpson′s biplane method.Results Compared with control group,the ⊿θ and AMA of each phases in cardiac cycles of LVN group were increased (P<0.05);Compared with control group,the GCS of the left ventricular was increased in LVN group (P<0.05).There was a correlation between AMA of the S-IVCT and that of GLS or GCS,and the LVEF of the left ventricular in the control group (r=-0.18,P=0.04;r=-0.17,P=0.04;r=-0.19,P=0.03).Conclusions AMA angle in patients with LVN is significantly greater than the normal population value,which may be to maintain effective left ventricular systolic function and could be used as an quantitative indicator to assess the left ventricular remodeling in patients with LVN.