一种计算心肌梗塞面积的数学模型

本讨论了用数学建模的方法计算心肌梗塞面积，是数学应用于医学的又一成功的实例。该方法是：在急性心肌梗塞初期，由电体表面电位分布状态得出心脏的局部电现象，建立数学模型，编写计算机程序实现梗塞面积的计算。     

高血压和心肌梗塞患者血液中微量元素动态变化的研究

研究了高血压患者服用西药治疗前后微量元素浓度的变化和心肌梗塞患者在发病后六天内血液中微量元素浓度动态变化的规律。结果对临床诊断有一定参考价值。     

经食道心脏超声和经胸壁心脏超声检查对心源性栓塞性脑梗死的诊断效能

为分析经食道心脏超声(transesophageal echocardiography,TEE)和经胸壁心脏超声(transthoracic echocardiography,TTE)对心源性栓塞性脑梗死(cardio-embolic cerebral infarction,CECI)的诊断效能,本研究选取我院2018年5月~2019年12月收治的CECI患者65例,对患者分别实施TEE和TTE检查,比较不同检查方法对心脏疾病栓塞源的检出情况和不同检查方法的敏感性、特异性。结果显示,TEE对房间隔缺损、主动脉斑块、卵圆孔未闭、二尖瓣脱垂、二尖瓣增厚、房间隔瘤的检出率高于TTE(P<0.05);TEE联合TTE诊断CECI的敏感性和特异性均高于单独检查(P<0.05)。据此可知,TEE诊断CECI具有较高的检出率,而TTE存在漏检情况,TEE联合TTE有助于提高CECI的诊断准确率。     

The significance of plasma catecholamine levels in the pathogenesis of arteriosclerosis

Summary Experiments, with animals and with cultured vascular wall cells as well as clinical observations on patients suffering from pheochromocytoma, favour the hypothesis that catecholamines could play an important role in the pathogenesis of arteriosclerosis. As the catecholamines, adrenaline and/or noradrenaline, promote metabolic dysfunctions in vascular wall cells, which are important in the pathogenesis of arteriosclerosis, these compounds may well be acting as chemical mediators during atherogenesis. Therefore investigations on plasma catecholamine levels in patients, exposed to atherogenic risk factors, with different stages of arteriosclerosis, and in patients suffering from thrombotic complications of an arteriosclerotic vascular disease, may lead to an answer for the question of whether or not plasma catecholamine levels are of clinical importance in the pathogenesis of arteriosclerosis in man.In individuals subjected to the atherogenic risk factors, smoking, essential hypertension, and mental stress, plasma catecholamine levels were statistically significantly elevated. In patients suffering from diabetes mellitus plasma adrenaline and noradrenaline concentrations however were similar to those of healthy controls. In dialysis patients, who often develop arteriosclerosis which progresses with great rapidity, plasma adrenaline and noradrenaline concentration showed a positive correlation with different stages of arteriosclerosis; i.e. plasma catecholamine concentration increases with the severity of this disease. Arteriosclerotic vascular diseases sometimes give rise to thrombotic complications, the most prominent ones being myocardial infarction and stroke. Compared with healthy controls, even one year after infarction, 70% of the patients who had had a myocardial infarction and 50% of the stroke patients had significantly elevated plasma adrenaline and/or noradrenaline levels. Further investigations on patients suffering from coronary heart disease showed that elevated plasma catecholamine concentration is more probably related to the pathogenesis of the vascular disease than to the incurrence of myocardial infarction.From these data we conclude that catecholamines are substances that can act as chemical mediators during the pathogenesis of arteriosclerosis in man and thus may contribute to the development and subsequent complications of this important vascular disease.     

Direct detection of myoglobin in whole blood using a disposable amperometric immunosensor

An amperometric immunosensor for the rapid detection of myoglobin in whole blood was developed. Due to its rapid kinetics, myoglobin is a useful biochemical marker for the early assessment of acute myocardial infarction (AMI). A one-step indirect sandwich assay was employed using a polyclonal goat anti-human cardiac myoglobin antibody with monoclonal mouse anti-myoglobin and goat anti-mouse IgG conjugated to alkaline phosphatase (AP), as the detecting antibodies. The final sensor required 30 min for incubation. The standard curve was linear between 85 and 925 ng/ml. The intra- and inter-assay coefficients of variation were below 8%. No cross-reactivity of the antibodies was found with other cardiac proteins. The overall performance of the sensor, rapid analysis time, wide working range, good precision and specificity demonstrate its potential usefulness for early assessment of AMI.     

The potential of mass spectrometry to study iron-containing proteins used in clinical diagnosis

Many proteins contain iron as metal ion either within their own structures or bound to their active sites. These iron-containing proteins are involved in numerous biological processes and some of them serve as biomarkers of clinical pathologies, not only related to iron homeostasis but also to other physiological disorders. Thus, a variety of analytical strategies have been developed over the last years in order to conduct studies on Fe-containing proteins. Among them, mass spectrometric (MS) methods still remain as preferred tools since they provide the capabilities of structure elucidation together with quantitative possibilities. Therefore, in this work we have tried to summarize the most recent applications of elemental and molecular mass spectrometric-based methods for the characterization (mostly qualitative but quantitative in some cases) of the high abundant Fe-containing proteins used for clinical diagnosis.     

急性心肌梗塞患者头发锌、铜及血清钾、钙、镁含量的变化

对２５例刀性心肌梗塞患者的头发锌、铜及血清钾、钙、镁含量进行了测量分析,结果显示患者中高发锌者占２０％,低发锌者占１２％;８８％患者的发铜含量减少;约１／４患者的血钾浓度轻度升高,１／３患者血钙增多,而血镁降低者较多,占７６％。     

Possible mechanism for nitric oxide and oxidative stress induced pathophysiological variance in acute myocardial infarction development: A study by a flow injection-chemiluminescence method

The acute myocardial infarction (AMI) model was established through rabbits, and this kind of model was used to investigate the possible mechanism for the AMI mediated damage, induced by NO release and oxidative stress. The biomedical parameters nitric oxide (NO), total antioxidant capacity (TAC) variation in vivo and the enzymatic activity of nitric oxide synthase (NOS) and superoxide dismutase (SOD), which are considered as the major markers for pathophysiological variation, were detected. The results obtained gave evidence that AMI can lead to the NO excess release and compensation by excess cellular respiration, and both of them can result in oxidative stress and further generation of reactive oxygen species (ROS). The latter can bring a series of damages to the organism, including decrease of the TAC value, and NOS and SOD activity.     

Myocardial proton spin-lattice relaxation times in vitro: Effect of elapsed time after excision

An assumption made in using excised tissue for in vitro nuclear magnetic resonance (NMR) studies is that variables of interest, such as spin-lattice (T₁) relaxation times, remain stable for periods of time after excision sufficient to perform NMR spectroscopy. In this study, we evaluated the changes in T₁ of rat myocardium, measured at two NMR field strengths, at serial time intervals up to 72 hours postmortem. Left ventricular myocardium from six male Sprague-Dawley rats was excised and stored at room temperature in sealed NMR sample tubes. Spin-lattice relaxation times were determined with a modified inversion-recovery pulse sequence immediately postmortem and at intervals up to 72 hours post-excision; NMR studies were performed using 90 MHz and 360 MHz spectrometers. A gradual decrease in T₁ was noted with increasing time post-excision; T₁ was not significantly shorter than baseline until 72 hours postmortem at either field strength. The rate of change of T₁ was similar at the two field strengths. At any given time post-excision, T₁ was significantly higher (p < 0.001) at 360 MHz than at 90 MHz. We conclude that, with proper tissue handling and storage techniques, rat myocardial T₁ is stable postmortem sufficiently long to permit meaningful NMR studies of excised tissue.     

心脏外科手术后脑梗死患者的影像学特点及相关因素分析

本文对心脏外科手术后脑梗死患者的影像学特点及发生脑梗死的相关因素进行探讨。选取本院心脏外科手术患者286例作为研究对象,术后34例发生脑梗死,按照手术方式的不同将脑梗死患者分为体外循环组(11例)和非体外循环组(23例),比较两组术后脑梗死的影像学特点,并对心脏外科手术后脑梗死的影响因素进行分析。研究发现,两组穿支梗死、分水岭梗死、多发梗死、陈旧梗死的发生率比较,差异无统计学意义(P>0.05);体外循环组皮层梗死的发生率明显低于非体外循环组,体外循环组大面积梗死、双侧梗死的发生率明显高于非体外循环组,差异有统计学意义(P<0.05)。经单因素分析,性别、空腹血糖、TC、TG、LDL-C、Hcy、吸烟、饮酒不是心脏外科手术后脑梗死的影响因素(P>0.05),年龄、文化程度、高血压病史、糖尿病为心脏外科手术后脑梗死的影响因素(P<0.05),经多因素二元Logistic回归分析,年龄高、文化程度低、高血压病史≥10、有糖尿病,是心脏外科手术后脑梗死的独立影响因素(P<0.05)。结果显示,体外循环手术常为大面积梗死、双侧梗死,症状较重,而非体外循环手术常为皮层梗死,且两者分水岭梗死较多,均与栓塞和低灌注有关。心脏外科手术后脑梗死与年龄高、文化程度低、高血压病史≥10、有糖尿病密切相关,早期给予针对性预防干预可能降低脑梗死的发生。