心内膜

Methods Re-operations were done in235cases with recurrent cardiac valve diseases from1985to2003.Aˉmong these patients,155cases had received closed mitral commissurotomy,12with mitral valvuloplasty,43with biologˉical prosthetic failure,6with mechanical prosthetic dysfuction,6with periprosthetic leakage,2with prosthetic valve enˉdocarditis,8with other valve disease after valve replacement,1with closed mitral commissurotomy and redo MVR,redo DVR,1with closed mitral commissurotomy and redo MVR,redo MVRand redo AVR.6cases received TVR and179with tricuspid valvuloplasty.

1985年1月～2003年9月，235例复发性心脏瓣膜病再次手术，其中二尖瓣闭式分离术后155例，二尖瓣直视成形术后12例，生物瓣衰43例，机械瓣功能障碍6例，瓣周漏6例，机械瓣心内膜炎2例，换瓣后其它瓣膜病8例，1例闭式分离术后MVR后瓣膜障碍再次DVR，1例闭式术后MVR后瓣衰再次MVR后再行AVR，1例MVR后AVR后TVR。

METHODS We used a dermatome to obtain thin endocardium,midcardium and epicardium transmural strips from left ventricular free wall of canine(weight 15-18 kg) and standard microelectrode techniques to record and measure the transmembrane action potential duration.

结果：①胺碘酮延长内、外膜层心肌细胞的动作电位时程，当基础周长为1 000 m s时，使用胺碘酮后心内膜层肌细胞的APD90由(254±38)m s延长为(274±37)m s(P.01)，外膜层肌细胞的APD90由(205±37)m s延长为(229±16)m s(P.01)；但其明显缩短中层肌细胞的APD，其APD90由(331±50)m s缩短为(290±62)m s(P.01)。

Objective To analyze the clinical features of patients with infective endocarditis for improving its diagnosis and treatment.

目的 分析感染性心内膜炎患者的临床特徵，以提高对其的诊疗水平。

With appropriate medical treatment approximately 90% of people with bacterial endocarditis recover.

与适当的医疗治疗，大约90 ％的人与细菌性心内膜炎收回。

Objective To evaluate the clinical features of infectious endocarditis in recent years.

目的 分析近年来感染性心内膜炎临床特点的变化。

ABSTRACT］ Objective To report our experience in the treatment of infective endocarditis.

目的 探讨感染性心内膜炎的治疗体会。

Objective To review the experience of surgical treatment of infective endocarditis.

目的 总结感染性心内膜炎的外科治疗经验。

Measurirg indxes included:(1) Electrocardiograh;(2) Hemodynamics: cardiac output, pump output, aortic pressire, pulmo nary artery pressure, left atrium pressure, right atrium pressure, left ventricular end systolic pressure, left ventricular end diastolic pressure, LV-dp/dt, right ventricul ar end systolic pressure, RV-dp/dt, systolic pressure time index, diastolic pressure time index, endocardial viability ratio;(3) Myocardial metabolism: coronory sinus blood flow, myocardial oxygen consumption, myocardial lactate extractiorn;(4) Ischemic myocardial area;(5) Ultrastructure of myocardium.

测量指标包括：①心电图；②血流动力学：心输出量、泵输出量、主动脉压、肺动脉压、左房压、右房压、左室收缩末压、左室舒张末压、左室压的一阶导数、右室收缩末压、右室压的一阶导数、收缩压力时间指标、舒张压力时间指标、心内膜下心肌供血比率；③心肌代谢；冠状窦血流量、心肌氧耗量、心肌乳酸摄取量；④心肌缺血面积检查及缺血心肌的超微结构观察。

Sinus bradycardia or sinus bradycardia with arrhythmia,sino-auricular block,sinus stopping beat with junctional abnormal beat occurred in15cases;Sinus bradycardia with ST-T changes occurred in10cases,ab-normal excitation（including ventricular,supraventricular premature beat with tachycardia）occurred in6cases the cardiac function of9cases were checked up:stroke volume,cardiac indexand ejection timewere normal or on the low side.

窦性心动过缓或窦性心动过缓伴不齐、窦房传导阻滞、窦性停搏伴交界性异搏共18例；窦性心动过缓伴ST-T改变11例；兴奋性异常（室性、室上性早搏伴心动过速）6例。9例心功能检查：心输出量、心脏指数、射血分数三项指标在正常偏低水平。3例心脏彩超三尖瓣赘生物，诊断为感染性细菌性心内膜炎。

Sinus bradycardia or sinus bradycardia with arrhythmia,sino-auricular block,sinus stopping beat with junctional abnormal beat occurred in15cases;Sinus bradycardia with ST-T changes occurred in10cases,ab-normal excitation（including ventricular,supraventricular premature beat with tachycardia）occurred in6cases the cardiac function of9cases were checked up:stroke volume,cardiac indexand ejection timewere normal or on the low side.The colour Doppler showed that excrescence in tricuspid valve of3cases and the diagnosis was infectivity bacterial endocarditis.

窦性心动过缓或窦性心动过缓伴不齐、窦房传导阻滞、窦性停搏伴交界性异搏共18例；窦性心动过缓伴ST-T改变11例；兴奋性异常（室性、室上性早搏伴心动过速）6例。9例心功能检查：心输出量、心脏指数、射血分数三项指标在正常偏低水平。3例心脏彩超三尖瓣赘生物，诊断为感染性细菌性心内膜炎。

We have no common name for a mime of Sophron or Xenarchus and a Socratic Conversation; and we should still be without one even if the imitation in the two instances were in trimeters or elegiacs or some other kind of verse--though it is the way with people to tack on 'poet' to the name of a metre, and talk of elegiac-poets and epic-poets, thinking that they call them poets not by reason of the imitative nature of their work, but indiscriminately by reason of the metre they write in.

索夫农 、森那库斯和苏格拉底式的对话采用的模仿没有一个公共的名称；三音步诗、挽歌体或其他类型的诗的模仿也没有——人们把&诗人&这一名词和格律名称结合到一起，称之为挽歌体诗人或者史诗诗人，他们被称为诗人，似乎只是因为遵守格律写作，而非他们作品的模仿本质。

The relationship between communicative competence and grammar teaching should be that of the ends and the means.

交际能力和语法的关系应该是目标与途径的关系。