美托洛尔舌下含服治疗老年急症高血压(24例临床报告)

本文旨在评估舌下含服美托洛尔对老年高血压急症的降压效果。方法：２４例老年急症高血压患者,于舌下含服美托洛尔５０ｍｇ前及含服后５、１０、３０、６０及１２０分钟,动态监测血压及心率,并比较用药前及用药后各时间段降压效果。结果：（１）治疗前、治疗后５、１０分钟,均有非常显著差异（Ｐ＜００１,Ｐ＜００５）,１０分钟血压降至安全水平,３０分钟完全降至正常,且降压效应持续至２小时。（２）无明显副作用。结论：舌下含服美托洛尔对老年急症高血压患者,是一种速效,稳效,无明显副作用,且方法简便的急症降压方法。     

内皮素-1前体基因反义寡核苷酸对正常和高血压大鼠血流动力学的影响

我们筛选出针对内皮素－１（ＥＴ－１）前体基因反义硫代寡核苷酸片断（ＥＴＡＳＯＤＮ）,已证明ＥＴＡＳＯＤＮ能显著抑制培养内皮细胞ＥＴ－１的生成,本应用该片断,对下沉和腹主动脉狭窄－高盐摄入型高血压大鼠侧脑室进行注射,记录注射前后血流动力学指标、注射后侧脑室周围组织中ＥＴ－１的含量及分布,ＥＴＡＳＯＤＮ对正常和高血压大鼠的影响,发现高血压大鼠脑干ＥＴ－１含量明显高于正常大鼠;ＥＴＡＳＯＤＮ能降低高血压     

超声心动图结合血清miR-122对原发性高血压所致左心室功能改变的评估价值

摘要 目的：探讨超声心动图结合血清微小RNA-122（miR-122）对原发性高血压（EH）所致左心室功能改变的评估价值。方法：选择2020年01月-2022年06月本院收治的58例EH患者作为研究组,另选择同期62例体检健康者作为对照组。所有研究对象均行超声心动图检查、血清miR-122检测,比较两组间超声心动图定量参数、血清miR-122水平差异,分析血清miR-122与左心室功能指标的相关性。通过绘制受试者工作特征曲线（ROC）并计算曲线下面积（AUC）分析超声心动图定量参数、血清miR-122单独诊断EH所致左心室功能改变的最佳诊断阈值以及相应敏感度、特异度;联合诊断采用多因素Logistic回归分析并绘制ROC曲线评估其诊断效能。结果：研究组患者左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、室间隔舒张末期厚度（IVSD）、左心室后壁舒张末期厚度（LVPWD）、E与室间隔和侧壁处二尖瓣环舒张早期运动速度e''室间隔和e''侧壁均值的比值（E/e''）、左心室舒张末期容积（EDV）和左心室收缩末期容积（ESV）、血清miR-122水平显著高于对照组（P<0.05）,二尖瓣口舒张早期血流速度E与舒张晚期血流速度A比值（E/A）显著低于对照组（P<0.05）,而两组间左心室射血分数（EF）差异不具有统计学意义（P＞0.05）。血清miR-122水平与LVEDD、LVESD、EDV、ESV呈正相关(P<0.05）,与其他超声心动图定量参数IVSD、LVPWD、EF、E/A、E/e''无显著相关性（P＜0.05）。与单独诊断相比较,超声心动图定量参数结合血清miR-122诊断EH所致左心室功能改变的AUC、约登指数、敏感度、特异度最高。结论：超声心动图结合血清miR-122能够准确评估EH所致左心室功能改变情况,有助于指导临床治疗方案的选择。     

转化生长因子β基因在某些心血管疾病中的表达

本文应用Ｎｏｒｔｈｅｒｎｂｌｏｔ杂交技术,观察了转化生长因子β基因在家兔动脉粥样硬化斑块、自发性高血压大鼠心肌组织和血管平滑肌细胞中的表达。结果表明,转化生长因子β基因在上述组织和细胞中的表达均明显增加,血管紧张素Ⅱ可以促进血管平滑肌细胞中转化生长因子β基因的表达,揭示转化生长因子β可能在心血管疾病发病过程中起作用。     

Stress management techniques: Are they all equivalent,or do they have specific effects?

This article evaluates the hypothesis that various stress management techniques have specific effects. Studies comparing various techniques are reviewed, as well as previous literature reviews evaluating the effects of individual techniques. There is evidence that cognitively oriented methods have specific cognitive effects, that specific autonomic effects result from autonomically oriented methods, and that specific muscular effects are produced by muscularly oriented methods. Muscle relaxation and/or EMG biofeedback have greater muscular effects and smaller autonomic effects than finger temperature biofeedback and/or autogenic training. EMG biofeedback produces greater effects on particular muscular groups than progressive relaxation, and thermal biofeedback has greater finger temperature effects than autogenic training. Disorders with a predominant muscular component (e.g., tension headaches) are treated more effectively by muscularly oriented methods, while disorders in which autonomic dysfunction predominates (e.g., hypertension, migraine headaches) are more effectively treated by techniques with a strong autonomic component. Anxiety and phobias tend to be most effectively treated by methods with both strong cognitive and behavioral components.This work was supported by grants Nos. HL-34336 and HL-44097 from the Heart, Lung, and Blood Institute of the National Institutes of Health. Material in this article has been condensed and updated from three chapters in Lehrer, P. M., and Woolfolk, R. L. (1993).Principles and practice of stress management, Vol. 2, New York: Guilford Press.     

大鼠自发性高血压与HSP70基因关系的研究

本实验采用热休克蛋白７０核酸分子杂交方法,检测了自发性高血压大鼠和正常血压大鼠离体培养的主动脉平滑肌细胞受热刺激后ＨＳＰ７０ｍＲＮＡ水平的变化以及整体动物肝组织ＨＳＰ７０ｍＲＮＡ的水平,并对肝组织基因组ＤＮＡ进行了限制性酶切片段长度多态性分析。结果表明：３７℃培养的ＳＨＲ ＡＳＭＣ及整体ＳＨＲ肝组织ＨＳＰ７０ ｍＲＮＡ的基础表达水平均低于ＷＫＹ鼠,ＳＨＲ ＡＳＭＣ受热刺激（４２℃ １５ｍｉｎ）后２     

兔肾性高血压时的动脉压力感受器反射

14只雄性家兔在双肾缩扎术后12周,经氨基甲酸乙酯静脉麻醉,分别在缓冲神经完整、切断两侧减压神经或切断两侧窦神经后静注新福林或硝普钠升降血压以改变动脉压力感受器活动,观察其心率、后肢血管阻力和肾交感神经活动的反射性变化,并与正常血压兔的反射效应相比较。主要结果如下:(1) 动物双肾动脉缩扎后12周,平均动脉血压(131±9mmHg)较正常动物血压(95±10mmHg)有显著升高(P<0.001);(2) 缓冲神经完整时,新福林和硝普钠升降血压诱发的心率反射性变化与正常血压动物相比显著减弱(P<0.001),而后肢血管阻力和肾交感神经活动的反射性调节无明显改变,表明肾性高血压动物的心率反射性调节与外周循环的反射性调节机能不相平行;而由股动脉内直接注射新福林或硝普钠时,股动脉灌流压的增减幅度与正常血压动物相比并无明显差异;(3) 切断两侧减压神经或切断两侧窦神经后,在正常动物仅使反射性心率调节作用减弱,而后肢血管阻力和肾交感神经活动的反射性调节无明显改变;但在高血压动物,除心率的反射性调节进一步减弱外,新福林和硝普钠升降血压时后肢血管阻力和肾交感神经活动的反射性调节效应也显著地减弱(P<0.001),提示肾性高血压时动脉压力感受器反射的潜在调节能力降低。由此似表明,肾性高血压时动脉压力感受器反射     

Hand temperature norms for headache,hypertension, and irritable bowel syndrome

Hand temperature norms are presented for 221 headache patients (migraine, mixed, and tension), 105 hypertensives, 45 irritable bowel syndrome patients, and 56 normal controls under conditions of resting baseline, self-relaxation, volitional handwarming, mental arithmetic, and cold pressor. The two vascular headache groups (migraine and mixed) had significantly lower hand temperatures across conditions.This research was supported in part by grants from NINCDS (NS-15235 and NS-23440), from NHLBI (HL-27622 and HL-31189), and from NIDDK (DK-38614).     

心脏磁共振成像诊断原发性醛固酮增多症患者左室重构价值研究

摘要 目的：探讨心脏磁共振成像（CMRI）诊断原发性醛固酮增多症（PA）患者左室重构的价值。方法：选取2017年10月-2022年12月在辽宁省金秋医院诊断为PA的患者82例作为研究组，另选取同时期内在我院就诊的原发性高血压（EH）患者82例作为对照组。对比研究组和对照组临床资料、CMRI参数、生化及激素指标水平。根据研究组患者有无左室重构分为PA且有左室重构亚组（PA1组，n=38）和PA但无左室重构亚组（PA2组，n=44），对比PA1组和PA2组患者CMRI参数。采用多因素Logistic回归分析 PA患者左室重构的因素，建立回归方程及ROC曲线评价CMRI对PA患者左室重构的诊断效能。结果：研究组患者血清K、肾素活性低于对照组，醛固酮显著高于对照组（P＜0.05）。研究组患者EDVi、ESVi、Massi、初始T1 mapping值和ECV均高于对照组，增强后T1 mapping值低于对照组（P＜0.05）。多因素Logistic回归分析结果显示，ESVi、Massi、增强后T1 mapping值、ECV均与PA患者左室重构密切关联（P＜0.05）。ROC分析结果显示，ESVi、Massi、增强后T1 mapping值、ECV各指标及其联合诊断PA患者左室重构时的AUC分别为0.623、0.677、0.736、0.675、0.779，说明联合诊断效能较高。结论：CMRI可定量评估PA患者的左室重构情况，其诊断效能较高，可为临床治疗、监测进展等提供参考依据。     

Genotoxic studies in hypertensive and normotensive rats treated with amiodarone

Amiodarone, a benzofuran derivative, is a very effective antiarrhythmic medication, but has potential to cause side effects. Although its cytotoxicity potential is very well-known, there are few reports about its genotoxicity effects. Since amiodarone has not been investigated in genotoxicity studies, and the spontaneously hypertensive rat (SHR) is a well-characterized model for hypertension, the aim of the present study was to perform cytogenetic analysis on chromosome aberrations in bone marrow cells of SHRs and normotensive Wistar-Kyoto rats (WKYs) that received oral amiodarone treatment for 4 weeks. Amiodarone activity was also monitored using electrocardiograms. The presence of bradycardia in amiodarone-treated rats confirmed that this drug was really active. Metaphase analysis on bone marrow cells showed that there were significant differences in total chromosomal damage and percentage abnormal metaphase between WKY and SHR negative controls. In the SHR negative control, the frequencies of basal chromosomal aberrations and abnormal metaphases were significantly higher (p < 0.05). There were high numbers of chromosomal aberrations in all amiodarone-treated groups, compared with negative controls. In amiodarone-treated groups, the most frequent chromosomal aberration was chromatid breaks. More chromosomal aberrations were found in WKYs that received amiodarone, with a statistically significant difference in comparison with negative controls (p < 0.05). However, in SHR rats there was no significant difference between the amiodarone and negative groups regarding chromosomal damage induction. These results showed that treatment with amiodarone was genotoxic in WKYs, but not in SHRs. Further studies are needed to confirm whether amiodarone is genotoxic or efficient and harmless, among humans undergoing therapy.