静脉滴注硝酸甘油介入99mTc-MIBI心肌显像对存活心肌的评价

目的 :评价静脉滴注硝酸甘油 (NTG)介入 99m Tc-甲氧基异丁基异腈 (MIBI)心肌断层显像在心肌存活的估测价值。方法:对 44例心肌梗死患者先行常规静息态 99m Tc- MIBI心肌断层显像 ,2 4～ 48h后静脉滴注 NTG再行静息态心肌断层显像。 结果:静息态心肌断层显像检出异常灌注节段 2 2 9个。 NTG介入后有 5 9个节段恢复正常 ,44个节段明显改善 ,12 6个节段部分改善 ,NTG介入后的缺血 /正常 (I/ N )比值为 0 .70 9± 0 .136 ,明显较静息时的 (0 .6 49± 0 .12 4)增大。 结论:静脉滴注 NTG对提高静态 99m Tc- MIBI心肌断层显像估测心肌存活有一定的临床价值 ,这对冠心病血运重建术对象选择以及心肌梗塞患者的预后评价有重要作用。     

~(99)Tc~m-MIBI心肌断层显像前硝酸甘油评估存活心肌

目的　探讨含服硝酸甘油在介入99Tcm MIBI心肌断层显像在判断心肌存活中的价值。方法　 12例心肌梗塞患者先行静息99Tcm MIBI心肌断层显像 ,4 8h后在静脉注射99Tcm MIBI前 5min舌下含服硝酸甘油 0 .5mg ,然后再行静息心肌断层显像 ,观察灌注情况。 结果　 12例心肌梗塞患者静息心肌断层显像有 6 8个节段放射性分布异常 ,含服硝酸甘油介入后 2 6个节段灌注改善 ;4 2个节段无变化或有异常加重。结论　含服硝酸甘油在介入99Tcm MIBII心肌断层显像对判断心肌存活有一定的临床价值 ,且方法简便易行 ,安全可靠。     

多巴酚丁胺、硝酸酯负荷试验18F-FDG双核素心肌代谢显像评价存活心肌的临床意义

目的:探讨多巴酚丁胺、硝酸酯负荷试验18F-FDG核素心肌显像在评价存活心肌中的价值.方法:选择40例陈旧性心肌梗死患者作为研究对象,经多巴酚丁胺、硝酸酯负荷试验后行99mTc-MIBI和18F-FDG心肌双核素心肌显像,并与PET心肌代谢显像对比,评价多巴酚丁胺、硝酸酯负荷试验18F-FDG心肌显像存活心肌检出率和与PET心肌代谢显像的符合率.结果:99mTc-MIBI心肌灌注显像示216个节段灌注减低.多巴酚丁胺、硝酸酯负荷试验18FDG-SPECT显像显示216个节段中有121个节段(56%)灌注(代谢)不匹配,提示心肌存活;95个节段(44%)灌注(代谢)匹配,以心肌坏死为主.而18FDG-PET心肌代谢显像显示216个节段中有128个节段(59%)灌注(代谢)不匹配,提示心肌存活;88个节段(41%)灌注(代谢)匹配,以心肌坏死为主.两组比较,18FDG-SPECT显像与18FDG-PET心肌代谢显像存活心肌的检出率差异无统计学意义(χ2=0.875 3P≥0.05);216个灌注减低心肌节段中,18FDG-SPECT与18FDG-PET得分符合率93%.18FDG-SPECT显像存活心肌检出与PET显像符合率93.7%,无存活心肌检出率与PET显像符合率为80%,两者具有较好一致性.结论:多巴酚丁胺、硝酸酯负荷试验18F-FDG SPEC DISA显像对存活心肌的检出率与FDG-PET显像无明显差别,两者具有很高的符合率.     

LDDE和含服硝酸甘油 99m / Tc～MIBI心肌灌注显像对血管重建术后存活心肌的评估

目的 :采用低剂量多巴酚丁胺超声心动图 (LDDE)和含服硝酸甘油 (NTG)介入99mTc MIBI心肌灌注显像评价血管重建术前后的心肌存活性 ,并进行对比分析。方法 :将 37例心肌梗塞患者分为 3组 ,于血管重建术前分别行LDDE和 /或NTG介入99mTc MIBI心肌灌注显像 ,术后 1个月行基础超声心动图或静息99mTc MIBI心肌显像。结果 :Ⅰ组 ,NTG介入99mTc MIBI心肌灌注显像对术后心肌灌注改善的阳性预测值为 86 1 % ,阴性预测值为 79 2 % ,准确率为 82 6% ;Ⅱ组 ,LDDE对术后室壁运动改善的阳性预测值为 82 5% ,阴性预测值为 81 1 % ,准确率为 81 6% ;Ⅲ组 ,2种方法对低动力心肌节段功能恢复的预测无显著差异 (P >0 0 5) ;而对无动力心肌节段差异显著 (P <0 0 5) ;LDDE和NTG介入99mTc MIBI心肌灌注显像对整个运动障碍节段功能恢复预测的敏感性分别为 70 2 %和84 9% ,特异性分别为 87 2 %和 68 2 %。结论 :LDDE和NTG介入99mTc MIBI心肌灌注显像均是临床检测心肌存活安全、有价值的方法 ,如以术后室壁运动改善作为存活心肌的标准 ,则LDDE有较高的特异度。     

二硝酸异山梨醇酯介入~(99m)Tc-MIBI再注射心肌断层显像评估存活心肌

目的 :观察 Isoket介入99m Tc- MIBI再注射显像能否提高心肌存活力。方法 :2 8例病人首先静脉注入 99m Tc- MIBI进行静息心肌断层显像 ,2 4 h后全部病人给予 Isoket2 0 mg+生理盐水2 0 0 ml滴注 ,静点结束后静脉注入 99m Tc- MIBI再次进行心肌显像。结果 :静息 99m Tc- MIBI显像的平均得分为 1 5.1± 3.8,Isoket介入 99m Tc- MIBI再注射显像的平均得分为 1 0 .8± 1 .6,两者比较差异显著 (P<0 .0 1 )。结论 :Isoket介入 99m Tc- MIBI再注射显像与静息 99m Tc- MIBI显像比较可明显提高对存活心肌检测的灵敏度。     

硝酸甘油介入99mTc-MIBI心肌灌注显像检测存活心肌

目的应用硝酸甘油(NTG)介入^99mTc-甲氧基异丁基异腈(MIBI)SPECT心肌显像评价心肌梗死患心肌细胞存活的情况。方法20例心肌梗死患分别行^99mTc-MIBI静息和NTG介入心肌显像，并进行对比分析。结果20例患共有75个心肌灌注异常节段，其中32个节段在NTG后心肌血流灌注改善，呈现可逆性缺损，占42.67％。结论NTG介入^99mTc—MIBISPECT心肌显像可明显提高心肌梗死患存活心肌细胞的检出率。     

^99mTc—MIBI和^18F—FDG双核素心肌显像检测存活心肌

目的　本研究旨在比较99mTc MIBI/ 18F FDG双核素同步心肌显像 (DISA)和小剂量多巴酚丁胺负荷超声心动图 (LDDE)检测存活心肌的一致性。方法　选择陈旧性心梗患者 3 0例 ,均行DISA(GIK溶液介入 )和LDDE(Dob5 μg/kg·min-1)检查 ,在心超和DISA图像上将左室壁分为相应的 16个节段 ,比较其血流灌注、代谢匹配情况及与收缩储备的关系。结果　 3 0个患者总共 480个节段 ,分析静息时室壁运动异常的 171个节段。DISA和LDDE检出存活心肌的节段数分别为 88个和 81个 ,共同检出存活或坏死心肌节段 148个 ( 86.5 % ) ,两者对存活心肌检出无差别 (x2 =1.5 7,P >0 .10 )。结论　DISA与LDDE对存活心肌检出没有差别 ,因而可能是一种有前途的检测存活心肌的方法     

硝酸甘油介入~(99m)Tc-MIBI心肌灌注显像检测存活心肌

目的　应用硝酸甘油 (NTG)介入99mTc -甲氧基异丁基异腈 (MIBl)SPECT心肌显像评价心肌梗死患者心肌细胞存活的情况。　方法　 2 0例心肌梗死患者分别行99mTc -MIBI静息和NTG介入心肌显像 ,并进行对比分析。　结果　 2 0例患者共有 75个心肌灌注异常节段 ,其中 3 2个节段在NTG后心肌血流灌注改善 ,呈现可逆性缺损 ,占 42 .67%。结论　NTG介入99mTc -MIBISPECT心肌显像可明显提高心肌梗死患者存活心肌细胞的检出率。     

硝酸甘油介入99mTc-MIBI SPECT心肌灌注显像评价存活心肌

目的探讨含服硝酸甘油(NTG)介入99mTc甲氧基异丁基异晴(99mTc-MIBI)单光子发射计算机断层(SPECT)心肌灌注显像在检测存活心肌中的价值。方法18例心肌梗死患者分别行99mTc-MIBI静息显像和24h后再次静脉注射99mTc-MI-BI,在注射前5min,患者给与硝酸甘油1.0mg舌下舍服,再次行静息心肌断层显像,并进行对比分析。结果18例患者共有97个心肌灌注异常节段,其中44个心肌节段在NTG后心肌血流灌注改善,呈现可逆性缺损,占45.36%;53个节段无变化。结论NTG介入99mTc-MIBISPECT心肌灌注显像可明显提高心肌梗死患者存活心肌细胞的检出率,可以真实地评价心肌梗死的面积和部位,并且操作安全、无创、方便。     

冠心病患者核素心肌灌注断层显像对PTCA术疗效评价

目的应用^99mTc-甲氧异晴（MIBI）心肌灌注断层显像判断经皮冠状动脉腔内成形术（PTCA）及支架置入术的疗效。方法54例冠心病患者在PTCA/支架术前、术后分别行运动＋静息或静息＋硝酸甘油介入心肌灌注断层显像检查。结果PTCA/支架置入术后,患者的缺血心肌节段及不可逆灌注缺损节段减少,即术前分别为2.64±0.43及3.64±0.47,术后分别为1.54±0.29及2.34±0.40。结论成功的PTCA/支架置入术治疗能明显改善冠心病心肌缺血。核素心肌灌注断层显像对PTCA术的疗效评价准确可靠,为一种有价值的无创性方法。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.