PARTNER~(TM)药物洗脱支架的临床应用

目的:评价PARTNERTM药物洗脱支架的临床疗效及安全性。方法:选择2006年1～12月111例冠心病患者,所有患者行经皮冠状动脉介入治疗置入PARTNERTM药物洗脱支架,术后对患者进行随访,观察有无胸痛复发、心电图改变及重要心血管不良事件的发生。结果:111例患者共180处病变置入196枚PARTNERTM药物洗脱支架,手术成功率100%,胸痛缓解无复发,术后无重要心血管不良事件发生。结论:PCI术中应用国产PARTNERTM雷帕霉素药物洗脱支架近期疗效满意,应用安全方便。     

国产药物洗脱支架在冠心病中的临床应用

目的评价国产药物洗脱支架(Firebird)临床应用的安全性和有效性。方法对110例冠心病患者置入Firebird支架治疗,术后对患者进行随访,观察有无胸痛复发、心电图异常改变、重要心脏不良事件发生等。结果110例患者共置入Firebird支架146枚,手术即刻成功率100%。对患者至少随访3个月,平均8个月,无重要心脏不良事件发生,38例患者6个月后复查造影2例出现再狭窄,再狭窄率5.2%。结论Firebird支架置入即刻成功率高,能有效预防PCI术后再狭窄,治疗冠心病安全、有效。     

可降解涂层与永久涂层药物洗脱支架治疗冠状动脉粥样硬化性心脏病合并糖尿病患者的近期疗效

目的比较可降解涂层药物洗脱支架与永久涂层药物洗脱支架在冠状动脉粥样硬化性心脏病（简称冠心病）合并糖尿病患者中的应用疗效。方法回顾性分析240例择期行经皮冠状动脉介入术（PCI）置入药物洗脱支架治疗冠。0病合并糖尿病患者。其中112例患者置入可降解涂层药物洗脱支架（观察组）,128例患者置入永久涂层药物洗脱支架（对照组）,术后进行随访,观察患者的疗效及临床主要不良心脏事件的发生情况。结果平均随访时间（360±65）d。观察组与对照组在总死亡、靶病变重建、靶血管重建、支架内血栓形成及主要不良心脏事件等方面比较差异均无统计学意义（P〉0．05）。结论可降解涂层药物洗脱支架用于冠心病合并糖尿病患者PCI后近期疗效与永久涂层药物洗脱支架相当,其远期效果有待进一步研究。     

国产雷帕霉素药物洗脱支架在急诊介入治疗急性心肌梗死近远期疗效观察

目的评价急性心肌梗死（AMI）患者接受国产雷帕霉素药物洗脱支架（Partner支架）的近远期安全性及有效性。方法2006年6月至2008年1月急性心肌梗死患者82例，所有患者均于发病12h内行急诊经皮冠状动脉介入治疗（PCI）。术后对患者进行随访，观察有无胸痛复发，心电图异常改变，重要心脏不良事件等。结果82例患者共置入Partner支架108枚。82例患者随访3～6个月，2例患者类似胸痛发作，复查了冠脉造影，1例支架及节段内再狭窄。无1例死亡。结论国产药物洗脱支架治疗急性心肌梗死患者近期疗效安全有效。     

药物洗脱支架治疗冠状动脉支架内再狭窄的临床观察

目的观察药物洗脱支架治疗冠脉支架内再狭窄的临床疗效。方法对入选的患者行药物洗脱支架治疗,术后观察心脏不良反应事件的发生情况。结果 44例患者中发生不良反应事件22例,其中胸痛复发19例,TVR7例,ISR处原支架的类型是影响术后疗效的重要因素,本研究认为DES术后ISR的疗效好于BMS术后ISR（P=0.002）。而患者的年龄、性别、病变血管的直径和病变部位、病变的严重程度以及DES涂层材料的不同与治疗效果无明显的相关性。结论药物洗脱支架是治疗冠状动脉支架内再狭窄的有效手段。     

药物洗脱支架治疗冠状动脉支架内再狭窄的临床观察

目的观察药物洗脱支架治疗冠脉支架内再狭窄的临床疗效。方法对入选的患者行药物洗脱支架治疗,术后观察心脏不良反应事件的发生情况。结果 44例患者中发生不良反应事件22例,其中胸痛复发19例,TVR7例,ISR处原支架的类型是影响术后疗效的重要因素,本研究认为DES术后ISR的疗效好于BMS术后ISR(P=0.002)。而患者的年龄、性别、病变血管的直径和病变部位、病变的严重程度以及DES涂层材料的不同与治疗效果无明显的相关性。结论药物洗脱支架是治疗冠状动脉支架内再狭窄的有效手段。     

Firebird药物洗脱支架在冠心病介入治疗中应用的临床观察

目的：研究国产雷帕霉素药物洗脱支架（Firebird）在冠心病介入治疗中应用的安全性及疗效。方法：26例冠心病患者接受Firebird支架置入术，观察支架置入术即刻及近期结果。结果：26例患者置入支架56枚，手术即刻成功率100％。严重心脏不良事件（MACE）1例（发生率3．8％）；其余25例患者术后随访1—12月，无再发心绞痛和MACE。结论：Firebird药物洗脱支架用于冠心病介入治疗即刻手术成功率高，安全有效。     

雷帕霉素药物洗脱支架治疗急性ST段抬高性心肌梗死早期疗效观察

目的探讨雷帕霉素药物洗脱支架（Cypher^TM）在急性ST段抬高性心肌梗死（STEMI）经皮冠状动脉介入治疗（PCI）中的早期疗效。方法选择2004年1月至2005年6月的STEMI患者100例,随机分为两组：药物支架组50例和普通支架组50例,所有患者均于发病12 h内行急诊PCI治疗,一组置入Cypher^TM,另一组置入普通支架。比较两组支架置入情况及早期临床事件发生率。结果100例患者急诊PCI治疗均获得成功。药物支架组95支梗死相关血管（IRA）的99处病变置入98枚药物洗脱支架,普通支架组77支IRA的81处病变置入83枚普通支架。药物支架组1例介入治疗后第3天猝死。药物支架组和普通支架组相比较,手术成功率及PCI后造影结果和临床结果比较差异均无统计学意义。随后对99例病人进行了1-6个月随访,药物支架组有较低的再狭窄率和较少的心血管事件发生率（6.0%、16.0%和8.0%、14.0%,P〈0.01）。结论STEMI患者在PCI中应用Cypher^TM支架早期临床效果优于普通支架。     

涂层可降解与不可降解药物洗脱支架在冠状动脉疾病治疗中的对比研究

目的：比较涂层可降解药物洗脱支架（Excel）与涂层不可降解药物洗脱支架（Partner）在冠状动脉疾病治疗中的近期疗效及安全性。方法：将1315例接受药物洗脱支架治疗的冠心病患者纳入此回顾性对照研究,其中Excel组498例,Partner组817例．观察术后1年内两组患者主要不良心脏事件（MACE）及支架内血栓事件发生情况。结果：两组患者在基线资料、冠脉病变特征等方面均无统计学差异（P〉0．05）;两组患者平均置入支架直径[（2．97±0．39）mm vs（3．03±0．46）mm]及置入支架长度[（25．37±7．39）mm vs（24．57±7．11）mm]比较,差异均有统计学意义（P〈0．05）。尽管Excel组患者平均置入支架直径较小且支架长度偏长,但随访结果显示两组患者1年内主要不良心脏事件及支架内血栓事件发生情况差异均无统计学意义（2．41％vs2．69％,P〉0．05;0．60％vs0．86％,P〉0．05）。结论：涂层可降解与不可降解药物洗脱支架在冠状动脉疾病治疗中的近期疗效及安全性相似。     

药物洗脱支架治疗后冠状动脉再狭窄的分析与研究

目的分析研究药物洗脱支架治疗后冠状动脉再狭窄的情况。方法选择我院2015年3月至2017年3月间进行药物洗脱支架治疗的患者184例,根据冠状动脉造影的结果分为狭窄组和未狭窄组,每组患者92例,对两组患者进行回顾性分析,了解再狭窄发生影响因素。结果狭窄组患者的心血管不良事件发生率、心肌梗死的发生率、复发胸痛的情况明显高于未狭窄组,P0.05,其差异具有统计学意义。狭窄组患者存在糖尿病患者和高血脂患者明显多于未狭窄组,P0.05,其差异具有统计学意义。结论在术后心血管不良事件发生率高、本身存在糖尿病、高血脂疾病的患者更容易发生冠状动脉再狭窄。     

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.     

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.     

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     

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.     

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…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.