经皮腔血管成形术联合血管内支架治疗下肢动脉硬化闭塞症的临床疗效研究

目的探讨经皮腔血管成形术联合血管内支架治疗下肢动脉硬化闭塞症的临床疗效。方法选取2017年2月至2018年10月来我院治疗的下肢动脉硬化闭塞症患者120例,随机将研究对象分为联合组和对照组,每组60例,对照组给予经皮腔血管成形术治疗,联合组在对照组基础上使用血管内支架治疗。比较两组足背动脉踝肱指数和胫后动脉踝肱指数。随访记录两组患者术后1、3、6个月的aBi。结果术后两组足背动脉踝肱指数和胫后动脉踝肱指数均明显升高(P0.05),较对照组,联合组上述指标升高水平更显著(P0.05)。联合组术后随访1、3、6个月的aBi明显高于术前(P0.05),对照组术后随访1、3、6个月的aBi较术前无显著差异(P 0.05),联合组术后随访1、3、6个月的aBi较对照组明显升高(P0.05)。结论经皮腔血管成形术联合血管内支架治疗下肢动脉硬化闭塞症的临床疗效显著,可有效改善下肢供血,有利于改善预后。     

电针夹脊穴治疗早期糖尿病性下肢动脉硬化闭塞症疗效观察

目的 观察电针夹脊穴治疗早期糖尿病性下肢动脉硬化闭塞症的临床疗效。方法 将60例患者随机分为对照组和治疗组,每组30例,对照组采用常规西药治疗,治疗组在此基础上增加电针夹脊穴治疗。结果 两组治疗后踝肱指数、临床症状（皮肤温度、皮肤疼痛、皮肤色泽）评分、足背动脉内径及血流速度峰值均高于治疗前（P＜0.05）,治疗后治疗组的跛行指数,皮肤温度、皮肤疼痛、皮肤色泽评分增加程度及踝肱指数、足背动脉内径及血流速度峰值升高程度均明显大于对照组（P＜0.05）;治疗组临床疗效显著优于对照组（P＜0.05）。结论 采用电针夹脊穴治疗早期糖尿病性下肢动脉硬化闭塞症可显著改善患者临床症状及踝肱指数,增加患者足背动脉内径及血流速度峰值,改善患者下肢血液循环。     

木丹颗粒治疗气虚血瘀型糖尿病并下肢动脉硬化闭塞症

目的 探讨木丹颗粒治疗气虚血瘀型糖尿病合并下肢动脉硬化闭塞症(ASO)疗效.方法 按照随机数表法将82例糖尿病合并下肢动脉硬化闭塞症患者分成对照组和观察组,各41例.对照组采用基础治疗法+贝前列素钠片治疗,观察组在对照组治疗基础上配合木丹颗粒治疗,2组均连续治疗4周.观察2组治疗后临床症状积分(患肢皮肤温度、患肢皮肤色泽、患肢疼痛)、踝肱指数、跛行距离、下肢动脉血流动力学指标(患肢股动脉、腘动脉、胫前动脉、足背动脉)变化,比较2组临床总有效率及治疗方案安全性.结果 观察组患肢皮肤温度、患肢皮肤色泽、患肢疼痛积分均低于对照组(P<0.05),观察组临床总有效率(90.24％,37/41)高于对照组(70.73％,29/41)(P<0.05),2组治疗过程中均未发生严重不良反应.结论 木丹颗粒联合贝前列素钠片治疗糖尿病合并下肢动脉硬化闭塞症,能明显缓解患者临床症状,提高踝肱指数和跛行距离,改善下肢动脉血流动力学,疗效确切,安全性佳.     

经皮球囊血管成形术治疗糖尿病致下肢动脉闭塞症的疗效评价

目的：比较糖尿病致下肢动脉硬化闭塞症患者传统内科治疗和经皮球囊血管成形术（PTA）治疗效果,探讨PTA对糖尿病致下肢动脉硬化闭塞症患者治疗价值。方法：40例糖尿病致下肢动脉硬化闭塞症患者,根据患者志愿20例行PTA（PTA组）,另20例给予传统内科治疗（对照组）,观察两组患者治疗前及治疗6个月后患肢疼痛、冷感、踝动脉收缩压、踝肱指数、血流峰值的变化,并且判断两组治疗6个月的疗效。结果：两组患者治疗前下肢及足部疼痛积分、冷感积分、踝动脉收缩压、踝肱指数、血流速度比较差异均无显著性 (P＞0.05);治疗6个月后,PTA组患者下肢及足部疼痛积分、冷感积分均低于治疗前及对照组治疗后(P<0.01),踝动脉收缩压、踝肱指数和下肢动脉血流速度均高于治疗前及对照组治疗后(P<0.01)。治疗6个月后PTA组特校率为85%（17/20）,对照组为0;PTA组有效率为95%（19/20）,对照组75%（15/20）。PTA组特效率和有效率均高于对照组 (P<0.01)。结论：PTA治疗糖尿病致下肢动脉闭塞症效果明显优于传统内科药物治疗,是一种安全有效的治疗方法。     

逐瘀化痰法治疗下肢动脉硬化闭塞症临床研究

目的:观察逐瘀化痰法治疗下肢动脉硬化闭塞症临床疗效及其对血脂水平和动脉硬化指标的影响。方法:将80例下肢动脉硬化闭塞症患者随机分为观察组(40例)、对照组(40例),对照组予常规降糖、降压、降脂、抗血小板、血管扩张治疗,观察组在对照组治疗基础上以逐瘀化痰方口服,两组治疗前后下肢彩超检测踝-肱指数(ABI)、趾-肱指数(TBI)及足背动脉血流量,检测血脂中总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、血清同型半胱氨酸(Hcy)含量并评价临床疗效。结果:观察组疗效优于对照组(P0.05);治疗后,观察组与对照组TG、TC、LDL-C及Hcy水平均降低(P0.05),观察组低于对照组(P0.05);HDL-C水平升高(P0.05),观察组高于对照组(P0.05);治疗后,观察组ABI、TBI指数及足背动脉血流量均高于治疗前(P0.05),观察组高于对照组(P0.05)。结论:逐瘀化痰法治疗下肢动脉硬化闭塞症可有效改善血脂水平及动脉硬化,值得临床推广使用。     

下肢动脉硬化闭塞症介入术后并发血栓形成的护理

目的探究下肢动脉硬化闭塞症介入术后并发血栓形成的护理措施。方法选取我院2014年1月至2017年1月下肢动脉硬化闭塞症患者62例,按入院顺序编号,采用随机数表法将患者分为观察组与对照组两组,每组31例,给予对照组患者常规护理干预,观察组在对照组治疗基础上给予围术期细节护理干预,比较两组术后并发症发生率,比较两组治疗前后血脂、血液流变学指标以及前后股浅动脉、胫后动脉、足背动脉内径和血流量水平变化情况。结果观察组术后并发症发生率为12.90%较对照组35.48%显著较低(P0.05);两组患者治疗后血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、全血粘度、纤维蛋白原水平较治疗前均显著降低(P0.05);治疗后观察组TC、LDL-C水平较对照组显著较低(P0.05);两组患者治疗后股浅动脉、胫后动脉、足背动脉内径及血流量较治疗前显著增加(P0.05);观察组治疗后股浅动脉、胫后动脉血流量较对照组显著较快(P0.05)。结论加强对下肢动脉硬化闭塞症患者术前术后的护理工作,是提高介入术手术成功率的关键,能有效预防并减少血栓形成等并发症的发生。     

脉血康胶囊治疗下肢动脉硬化闭塞症60例疗效观察

目的探讨脉血康胶囊对下肢动脉硬化闭塞症的疗效。方法 60例患者给予脉血康胶囊治疗后2个疗程末对自觉症状、疼痛程度、超声测足背动脉血流量和踝肱指数进行测评,观察治疗前后变化。结果自觉症状明显好转、疼痛程度减轻、足背动脉血流量增加、踝肱指数升高。结论脉血康胶囊治疗下肢动脉硬化闭塞症有较好效果。     

经皮腔内血管成形术联合血管内支架治疗老年下肢动脉硬化闭塞症疗效观察

目的:观察经皮腔内血管成形术(PTA)联合血管内支架治疗老年下肢动脉硬化闭塞症疗效。方法:选择86例老年下肢动脉硬化闭塞症患者,依据手术方案不同分为对照组和观察组各43例。对照组给予PTA治疗,观察组给予PTA联合血管内支架治疗,术后随访6个月。比较两组治疗前后踝肱指数(ABI)、跛行距离、日常生活能力及术后并发症发生率。结果:治疗后观察组ABI及跛行距离优于对照组,术后并发症发生率低于对照组,差异均有统计学意义(P<0.05);治疗后观察组BI指数明显高于对照组,差异有统计学意义(t=4.228,P=0.000)。结论:PTA联合血管内支架治疗老年下肢动脉硬化闭塞症疗效优于单纯PTA治疗疗效。     

益气活血法联合介入手术治疗下肢动脉硬化闭塞的疗效观察

目的探讨益气活血法联合介入手术治疗下肢动脉硬化闭塞致重症下肢动脉缺血的临床效果。方法选取重症下肢动脉缺血患者90例,利用随机数字表法分为对照组与观察组,各45例。两组患者均进行腔内介入手术治疗并成功进行血运重建。术后对照组实施常规治疗,观察组在常规治疗基础上,增加外用益气活血法治疗。治疗后6个月,对比两组患者的临床疗效、踝肱指数以及临床症状改善情况。结果治疗后6个月,观察组患者踝肱指数显著高于对照组,总有效率高于对照组(95.6%vs. 71.1%),治疗后间歇性跛行、静息性痛以及截肢(趾)发生率低于对照组(13.3%vs. 42.2%),差异均有统计学意义(P0.05)。结论采用益气活血法联合介入手术治疗下肢动脉硬化闭塞致重症下肢动脉缺血,可显著提高患者的临床疗效,改善临床症状,促进预后康复。     

针刺联合生理性缺血训练治疗糖尿病下肢动脉硬化闭塞症

目的:观察针刺联合生理性缺血训练治疗糖尿病下肢动脉硬化闭塞症的临床疗效.方法:将52例糖尿病下肢动脉硬化闭塞症患者按照就诊顺序随机分为观察组(26例)与对照组(26例).对照组给予针刺治疗,观察组给予针刺+生理性缺血训练.比较两组患者治疗前后的踝肱指数(ankle-brachial index,ABI),动脉硬化指数(...     

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.