基于老年综合评估结果指导治疗对老年冠心病患者心功能、脂代谢和生活质量的影响

摘要 目的：探讨基于老年综合评估结果指导（CGA）治疗对老年冠心病患者心功能、脂代谢和生活质量的影响。方法：本次研究将2020年6月-2022年1月在江苏省人民医院心血管内科接受治疗的106例老年冠心病患者,采用随机数字法将其随机分为对照组（常规药物治疗,53例）与研究组（对照组的基础上结合CGA治疗,53例）。对比两组疗效、心功能、脂代谢和生活质量相关情况。结果：研究组的临床总有效率为94.34%,明显高于对照组的79.25%（P<0.05）。研究组治疗3个月后左心室舒张期末内径（LVEDD）、左心室收缩期末内径（LVESD）低于对照组,左心室射血分数（LVEF）高于对照组（P<0.05）。研究组治疗3个月后高密度脂蛋白胆固醇（HDL-C）高于对照组,甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）低于对照组（P<0.05）。研究组治疗3个月后病情、体力、医疗状况、一般生活、社会心理状况、工作状况各维度评分高于对照组（P<0.05）。研究组的住院期间心脏不良事件总发生率低于对照组（P<0.05）。结论：基于CGA治疗老年冠心病,可有效改善心功能、脂代谢,降低住院期间不良事件发生率,提高患者的生活质量。     

Functional analogs for the reduction of certain nitrogenase substrates. Are multiple sites within the Fe/Mo/S active center involved in the 6e– reduction of N2?

 Reactivity studies of clusters that contain the MFe₃S₄ cores (M = Mo, V) with catecholate, multicarboxylate (or DMF) ligands coordinated to the Mo (or V) atoms, and Cl ligands coordinated to the Fe atoms have been carried out. These studies show the M/Fe/S single cubane clusters to be effective catalysts in the reduction of nitrogenase substrates such as hydrazine, acetylene and protons to give ammonia, ethylene and dihydrogen respectively. The same molecules do not activate or catalyze the reduction of dinitrogen. The results indicate that the observed catalyses are occurring at the Mo (V) sites by a process that, in the case of hydrazine, involves substrate protonation prior to reduction. The facile catalytic reduction of hydrazine by clusters that contain coordinatively saturated polycarboxylate-bound Mo atoms is rationalized in terms of a possible protonation/proton delivery function of the coordinated polycarboxylate ligands. The reactivity characteristics of the M/Fe/S clusters (structurally quite similar to the nitrogenase cofactor) have led to the suggestion that the Mo (V) atoms may be involved in the reduction of hydrazine in the later stages of dinitrogen reduction. Received and accepted: 21 August 1996     

心肌电兴奋传导速度对心律失常影响的仿真研究

心电场是由心肌的电活动产生的。心肌细胞的电特性及心肌细胞间的传导关系决定了体表电位的分布及心电图的变化。心肌电兴奋传导速度则是影响心肌间兴奋传导关系的重要参数之一。由于很难通过实验方法来人为改变电兴奋传导速度,因而临床上有关该参数对心律影响的定量知识相当缺乏。本文采用真实三雏躯干模型及心脏模型,对心肌电兴奋传导速度与心律变化的关系进行定量仿真研究。结果表明,兴奋传导速度决定了整个心电图的变化,而局部普通心肌的传导速度在相当范围内变化似乎对心电图影响不明显,但传导速度超过一定范围后可能产生突变。     

Further characterization of nociception-related and arterial pressure-related neuronal responses in the nucleus reticularis gigantocellularis of the rat

The present study was undertaken to further characterize the nucleus reticularis gigantocellularis (NRGC) of the medulla oblongata in the central processing of nociceptive and cardiovascular signals, and its modulation by metenkephalin. In Sprague-Dawley rats anesthetized with pentobarbital sodium, we found that all 125 spontaneously active NRGC neurons that responded to noxious stimuli (tail clamp) also exhibited arterial pressure-relatedness. Forty neurons additionally manifested cardiac periodicity that persisted even during nociceptive responses. While maintaining their cardiovascular responsive characteristics, the nociception-related NRGC neuronal activity was blocked, naloxone-reversibly (0.5 mg/kg, i.v.), by morphine (5 mg/kg, i.v.). Microiontophoretically applied met-enkephalin suppressed the responsiveness of NRGC neurons to individually delivered tail clamp or transient hypertension induced by phenylephrine (5 µg/kg, i.v.). Interestingly, in NRGC neurons that manifested both nociception and arterial pressure relatedness, the preferential reduction in the response to noxious stimuli upon simultaneous elevation in systemic arterial pressure was reversed to one that favored nociception in the presence of met-enkephalin. All actions of met-enkephalin were discernibly blocked by the opioid receptor antagonist, naloxone. Our results suggest that individual NRGC neurons may participate in the processing of both nociceptive and cardiovascular information, or in the coordination of the necessary circulatory supports during nociception. In addition, neuropeptides such as met-enkephalin may exert differential modulation on neuronal responsiveness according to the prevailing physiologic status of the animal. They also showed that NRGC may be a central integrator for pain and cardiovascular-related functions.     

X-ray structure of recombinant horse L-chain apoferritin at 2.0 Å resolution: implications for stability and function

The X-ray structure of recombinant horse L-chain (rL) apoferritin, solved at 2.0?Å resolution with a final R factor of 17.9%, gives evidence that the residue at position 93 in the sequence is a proline and not a leucine, as found in earlier sequencing studies. The structure is isomorphous with other apoferritin structures, and we thus draw particular attention to those structural features which can be related to the stability and function of the protein. Analysis of hydrogen bonding and salt bridge interactions shows that dimers and tetramers are the most stable molecular entities within the protein shell: a result confirming earlier biophysical experiments. The stability of horse rL apoferritin to both dissociation into subunits at acidic pH values and to complete unfolding in guanidine chloride solutions is compared with that of other apoferritins. This emphasizes the role played by the salt bridge in the stability of this protein family. The horse rL apoferritin is significantly more resistant to denaturation than horse spleen ferritin, which in turn is more resistant than any human rH apoferritins, even those for which a salt bridge is restored. Finally, this structure determination not only establishes that a preformed pocket exists in L-chain apoferritin, at a site known to be able to bind porphyrin, but also underlines the particular function of a cluster of glutamic acids (E53, E56, E57 and E60) located at the entrance of this porphyrin-binding pocket.     

On the origin of Z-band material and myofilaments in myoblasts from the human atrial wall

Summary The origin of cardiac myofibrils in cells from the atrial wall in human embryos was studied. Z-band substance appears throughout the cytoplasm as irregular electron dense patches in a network of thin filaments. The thin and thick filaments are synthesized as separate units in the sarcoplasm and are later aggregated into myofibrils. Complexes of Z substance and thin filaments occur numerously at different stages of myofibrillar organisation. Thick filaments are formed in close proximity to free ribosomes and are later incorporated in an hexagonal pattern into the Z-band/thin filament complex.This work was supported by grants from The Norwegian Council on Cardiovascular Disease and from The Norwegian Research Council for Science and the Humanities     

Ultrastructure of myocardial widened Z bands and endocardial cells in two teleostean species

Summary Widened myocardial Z bands and endocardial cells are described in two teleostean species Cichlasoma meeki and Corydoras aeneus. Widened Z bands containing mainly amorphous and electron-dense material were seen in a number of myocardial cells. Further, similar material may occur in large amounts beneath the sarcolemma and at intercellular junctions. Occasionally, we observed continuity between the latter material and that in expanded Z bands.In C. meeki the ventricular endocardial layer consists of two structurally different cell types, whereas in C. aeneus only one cell type was seen. The functional aspects of widened Z bands are discussed.     

The structure and distribution of satellite cells of cardiac muscles in decapod crustaceans

Summary The structure and distribution of satellite cells of cardiac muscles were examined in twenty-one species of animals chosen from each tribe within the order Decapoda (Arthropoda, Crustacea). The satellite cells were found in all animals observed. Most of them are morphologically identical with those described in different striated muscles of other species, but some cells have unusual features. The decapod satellite cell occasionally lies right over the region corresponding to the intercalated disc between the apposed cardiac muscle cells. The cell sends cytoplasmic processes into the adjacent muscle cells, enabling the plasma membrane to make close contact with the cleft opening of the intercalated disc, and with the myofibril at the level of the Z-line. Another characteristic feature is the presence of paired cells. Such cells are clearly separated from each other over most of the contact area by the respective plasma membranes, which are smooth in appearance and devoid of specialized regions. The significance of the presence of satellite cells in decapod cardiac muscle and its possible role are discussed and compared with those described for other species.     

Differential sensitivity of cardiac K(ATP) + channels to guanine nucleotides — evidence for a heterogeneous channel population

In cell-free patches from cultured neonatal rat cardiocytes, the cytosolic presence of GTP--S (100 µmol/l) or GDP-\-S (100 µmol/1) activated K_(ATP) ⁺ channels. GTP--S required cytosolic Mg⁺⁺, suggesting that an activated G-protein causes the increase in open probability. The great variations of the channel response to GTP--S and GDP-\-S indicates that cardiac K_(ATP) ⁺ channels represent a heterogeneous family. Correspondence to: M. Kohlhardt