Loss of consciousness and convulsion induced by a ventricular tachycardia mimicking epilepsy in a patient with noncompaction cardiomyopathy: a case report

Convulsions and loss of consciousness can be caused by, among other things, arrhythmias, conduction disorders or epilepsy. In clinical practice it can be difficult to distinguish between these causes of syncope, even for well-trained specialists. Patients with cardiac syncope have a substantial risk of subsequent sudden death. We present a patient with previously unknown noncompaction cardiomyopathy in whom syncope induced by ventricular tachycardia was misinterpreted as epilepsy. We present this case report in order to underline the necessity for cardiological assessment in patients with assumed mild epilepsy or syncope of unknown origin.     

Unroofed coronary sinus newly diagnosed in adult patients after corrected congenital heart disease

Patients with congenital heart disease corrected in early childhood may later in life present with cardiac symptoms caused by other associated congenital anomalies that were initially not diagnosed. Nowadays, several noninvasive imaging modalities are available for the visualisation of cardiac anatomy in great detail. We describe two patients with an unroofed coronary sinus, a rare congenital anomaly which could be diagnosed using a combination of modalities including echocardiography, cardiac CT and cardiac MRI.     

CRT_D介导室性心动过速的研究进展

心室再同步心脏转复除颤器(CRT_D)可有效改善心力衰竭(CHF)患者的运动耐量和生活质量,预防猝死,提高生存率,但CRT_D植入后由于心室激动顺序的改变,使QT间期延长、跨室壁复极离散度(TDR)增加,潜在致室性心律失常风险;且CHF患者通常存在心肌解剖改变,传导的不均一性,也为折返性心动过速的发生提供了维持的机制;而多次电击也可导致肌钙蛋白升高,引起心肌损伤,局部心肌复极离散度增加(DRVR)和QT间期延长,以及电除颤后心肌纤维化和急性细胞损伤,反复室速、室颤也会引起进行性左心功能不全、心肌细胞凋亡、恶化心律失常基质和增加心律失常易感性。CRT_D潜在致室性心律失常作用逐渐引起人们的重视,本文就近年来CRT_D致室性心律失常的电生理机制与临床防治对策等做一综述。     

超声心动图对高血压心室肥厚患者左心功能的评价及意义

目的:本研究利用超声心动图检测高血压心室肥厚患者左心房结构,探讨当左心结构发生变化时心脏功能所受到的影响,为高血压及其并发症的临床诊断提供检测及诊断参考。方法:选取2011年5月-2013年1月在我院接受检查的高血压心室肥厚患者76例作为观察组,另选取同期经体检的健康人群60例为健康对照组,利用超声心动图观察左心功能和结构,比较两组研究对象的左心房内径(LAD)、心肌质量(LVMM)、舒张末容积(LVEDV)、收缩末容积(LVESV)、左心室射血分数(LVEF)及二尖瓣口舒张末期流速比值(E/A)。结果:两组间心室收缩功能无显著性差异(P0.05);高血压组LAD高于对照组,LVEF及E/A低于对照组,差异具有统计学意义(P0.05);高血压Ⅰ期、Ⅱ期、Ⅲ期患者间比较,左房内径随血压的升高逐渐递增,而左心室射血分数和二尖瓣口舒张期流速比值则逐渐递减,差异具有统计学意义(P0.05)。结论:超声心动图可以直观的显示高血压心室肥厚患者左心功能及血流动力学的变化,对临床诊断具有积极的意义。     

自体软骨细胞移植技术治疗膝关节软骨缺损的研究进展

膝关节软骨缺损发病率高,且自身修复能力有限。治疗膝关节软骨缺损的传统方法包括钻孔术、微骨折术、自体骨软骨移植术。然而,钻孔术和微骨折术治疗后缺损区生成的是纤维软骨,而不是正常的透明软骨,两者在力学强度、硬度、耐磨损性等多方面存在很大差距。自体骨软骨移植术可生成正常的透明软骨,但存在供体有限、不适合进行大面积软骨缺损治疗等多方面缺点在临床方面应用受限。近年来,自体软骨细胞移植技术发展迅速,越来越多的病人接受此治疗方法并获得良好效果,引起人们广泛关注。本文根据近年来国内外的各项相关研究成果进行总结,阐述膝关节软骨缺损的各种治疗方法,着重介绍自体软骨细胞移植技术。第三代自体软骨细胞移植技术生成的软骨以透明软骨为主,符合关节生物力学要求,且避免了第一代、第二代自体软骨细胞移植的术后并发症,成为治疗膝关节大面积软骨缺损安全有效的治疗方法。另外,本文就软骨细胞支架材料的发展、移植物术后的转归等问题提出进一步设想。     

Thirteen Years Experience with Selective Screening for Disorders in Purine and Pyrimidine Metabolism

Purine and pyrimidine disorders represent a heterogeneous group with variable clinical symptoms and low prevalence rate. In the last thirteen years, we have studied urine/plasma specimens from about 1600 patients and we have identified 35 patients: eight patients with adenylosuccinate lyase deficiency, eight patients with hypoxanthine-guanine phosphoribosyltransferase deficiency, one patient with purine nucleoside phosphorylase deficiency, ten patients with xanthine dehydrogenase deficiency, six patients with molybdenum cofactor deficiency and two patients with dihydropyrimidine dehydrogenase deficiency.

Despite low incidence of these diseases, our findings highlight the importance of including the purine and pyrimidine analysis in the selective screening for inborn errors of metabolism in specialized laboratories, where amino acid and organic acid disorders are simultaneously investigated.     

芭蕉科花蜜腺形态比较: 兼论其与传粉者的关系

对狭义芭蕉科3个属的代表性种芭蕉(Musa basjoo)、象腿蕉(Ensete glaucum)和地涌金莲(Musella lasiocarpa)的花蜜腺形态进行了比较研究。结果表明它们的蜜腺属于隔膜蜜腺。雌花的蜜腺着生于子房的上部, 胚珠的上方; 雄花蜜腺占据了整个败育子房的位置。蜜腺结构由许多腔道组成, 这些腔道在横切面上呈现出复杂的发散式迷宫状结构。这3种植物花蜜腺的栅栏状表皮细胞、维管束和蜜腺开口方式相似, 而从纵切面和横切面上观察其结构存在一些差异。PAS反应显示象腿蕉泌蜜组织中淀粉粒含量高于其他两个种; 芭蕉和象腿蕉的蜜腺腔里有许多纤维状物质存在。3种植物的传粉综合征多样化, 花序和花的特征(如花序下垂或直立、苞片的颜色、泌蜜量和泌蜜时间等)和传粉样式之间有密切关系。它们的蜜腺结构和传粉者行为之间没有明显的相关性, 但是胶质或水质的花蜜对传粉者的取食方式有一定影响。     

Floral ontogeny and anatomy inKoelreuteria with special emphasis on monosymmetry and septal cavities

The floral ontogeny and anatomy ofKoelreuteria paniculata have been investigated to understand the developmental basis for the occurring monosymmetry and the origin of the septal cavities. Petals arise sequentially and one petal is missing between sepals 3 and 5, or rarely between sepals 2 and 5. The eight stamens arise sequentially before petal initiation is completed. The last formed petal and one stamen arise on a common primordium. Two stamen positions are empty (opposite the petal between the sepals 2 and 5, and the petal between sepal 1 and 3); consequently two antesepalous stamens have become displaced. The derivation of octandry from a diplostemonous ancestry, and reduction of the petal are discussed. The triangular gynoecium has a strong impact in obliquely reorganizing the symmetry of the flower, loss of organs, and shifts of stamens. The so-called septal slits occurring within the style are a deepreaching non-nectariferous extension of the stigma. Alternating locular furrows are present which could play a role as pollen transmitting tissue and in the loculicid dehiscence of the capsule.     

还原叶酸载体基因（RFC1）与神经管和颅面畸形病因学关系的研究进展

神经管畸形和颅面畸形是最常见的出生缺陷,由遗传和环境因素共同作用所致,大规模的人群流行病学研究已证实,叶酸能降低发生这类畸形的危险。叶酸缺乏是神经管和颅面畸形发生的主要环境因素,但其机制尚不清楚,通过对与叶酸代谢有关的还原叶酸载体（reduced folate carrier,RFC）的生化特点、生理功能、还原叶酸载体基因（RFC1）结构功能、调控、表达及其与叶酸水平和神经管颅面畸形的关系等研究进展进行综述,从而为神经管和颅面畸形的病因学研究提出可能的候选基因。 Abstract: Neural tube and craniofacial defects are common birth defects which are ascribed to the combination of genetic and environmental factors. The population epidemiological studies suggested that periconceptional use of multivitamins containing folic acid can reduce a woman’s risk of having a child with neural tube and craniofacial defects. It’s a major environmental factor that periconceptinal women with deficiency of folic acid may increase their risk for delivering babies with neural tube and craniofacial defects, but the mechanism by which folic acid facilitated this risk rediction is unknown. This paper reviews folate transport carrier, Reduced Folate Carrier(RFC)’s characteristics in biological chemistry, physiological function, the folate transport mechanism, structure, function, regulation and expression of reduced folate carrier gene(RFC1), and the relationship between RFC1 with plasm or erythrocyte folate level and neural tube defects, et al. It is suggested a etiologic hypothesis in investigation of candidate gene encoding specific folat-related pathways of neural tube and craniofacial defects.