先心病并重度肺高压测定肺嵌压的临床意义(附37例报告)

左向右分流的先天性心脏病常合并肺高压,术前评估肺高压的程度和性质,具有极重要的临床意义,肺高压的程度容易测定,但其性质却难以肯定.我科自1986年3月至1992年12月共作小儿经皮穿刺心导管380例,其中对37例左向右分流的先心病并重度肺高压,在作心导管的同时测定肺毛细血管嵌压(PWP),与肺循环血流量(QP)/体循环血流量(QS)对照,结合手术疗效观察,初步认为PWP在鉴别肺高压的性质,是一项较为可靠可行的参数,如PWP≥1.33kPa(10mmHg),常提示动力性肺高压,如PWP<1.33kPa,常提示器质性肺高压.     

PDE评价硝苯吡啶对先心病肺体循环血流量的影响

应用脉冲多普勒超声心动图(FDE),评价硝苯吡啶对30例单纯左向右分流型先天性心脏病患儿的左心搏血量(Vs)、右心搏血量(Vp),体循环血流量(Qs)、肺循环血流量(Qp)及肺,体循环血流比值(Qp/Qs)的影响。结果发现,用药后中到大量分流组的Vs、Qs增加和Qp/Qs比值减小,经统计学处理,均有非常显著性意义(P<0.001);小分流组的Vs、Qs和Qp/Qs的变化均无显著性意义。研究表明,PDE容积血流测定技术是评价儿科临床心血管药物疗效的可靠手段;硝苯吡啶可增加中到大量左向右分流型先心病的Vs和Qs,减少左向右分流,改善心功能。     

彩色多普勒血流显象对54例先心间隔缺损的定量诊断价值研究

彩色多普勒血流显象(Color Doppler Flow Imaging,CDFI)是80年代新兴的第三代多普勒超声技术,近年来正在国内逐渐普及,有关CDFI在先天性心脏病中的诊断研究屡有报道,对分流性先心病的定量诊断研究也在逐步开展中,目前认为多普勒超声心动图对常见分流性先心病室间隔缺损(VSD)的定量诊断价值较高,而对房间隔缺损(ASD)的定量诊断与手术结果相关性较差。本文目的拟采用彩色分流束起始宽度与手术结果对照。对先心病室间隔缺损(VSD)和房间隔缺损(ASD)的定量诊断价值进一步积累资料;对VSD和ASD的湍流频谱最大流速进行比较并以多普勒血流量测定左向右分流分数,分析分流分数与缺损直径的相关性,以期探讨由分流分数预测缺损大小的可能性。     

经胸与经食道超声心动图在导管介入与经胸小切口封堵术中的比较

目的探讨经胸超声心动图(TTE)引导心导管介入法和经食道超声心动图(TEE)引导经胸小切口法在房、室间隔缺损封堵术中的应用效果。方法心内、心外科分别收治的先天性心脏病房间隔缺损(ASD)、室间隔缺损(VSD)患者共51例,采用经胸超声心动图引导心导管介入封堵术与经食道超声心动图引导经胸小切口封堵术治疗。按照封堵术式与超声路径的不同分为TTE组38例和TEE组13例。结果 TTE引导心导管法封堵成功ASD13例、VSD20例。封堵失败ASD3例、VSD2例;TEE引导经胸小切口法封堵成功ASD5例,VSD8例。结论 TTE与TEE在先心病房、室间隔缺损封堵术中均可采用,各有所长,互为补充。     

小儿单纯室缺左房内径与主动脉内径比和左向右分流量关系的探讨

对27例单纯室缺（VSD）患儿手术中所见缺口检测，直径≤1.0cm为A组，计14例，直径>1.0cm为B组，计13例，A组LAD（左房内径）/AOD（主动脉内径）的均值为1.13±0.18;B组LAD/AOD的均值为1.46±0.23，表明VSD大小与LAD/AOD有一定关系。右心导管检查14例，按Fick法计算出肺循环流量和体循环流量的比（QP/QS）与LAD/AOD对照观察，二亦存在一定关系，r=0.62(P<0.05)。结论：患儿左向右分流量的多少和VSD的大小与LAD/AOD呈正相关系。     

心脏超声、核磁共振和心血管造影技术在婴儿左向右分流先天性心脏病诊断中的应用价值

目的:探讨心脏超声、核磁共振(MRI)和心血管造影在婴儿左向右分流先天性心脏病(先心病)诊断中的应用价值.方法:88例年龄小于1岁的婴儿均行心脏超声及MRI检查,并作增强磁共振血管造影(CE-MRA);88例中12例作心血管造影检查,其中4例合并主动脉缩窄(COA)者同时作经皮球囊COA成形术.结果:心脏超声显示单纯室间隔缺损(VSD)66例,单纯房间隔缺损(ASD)2例,单纯动脉导管未闭(PDA)3例,VSD合并ASD 11例,VSD合并PDA 2例,ASD合并PDA 1例,VSD合并ASD、PDA 3例.MRI检查出超声心动图漏诊伴有主动脉弓病变18例(占20.5%).12例心血管造影均有不同程度的主动脉缩窄,且介入治疗者获得成功.结论:超声心动图能对左向右分流先心病心内结构异常作出准确诊断,而MRI可排除心外大血管畸形;心血管造影则在超声心动图和MRI不能提供准确主动脉弓病变或需介入治疗时应用.     

婴幼儿室间隔缺损合并动脉导管未闭伴随肺动高压的处理

作者在1959～78年,迂到41例婴幼儿动脉导管未闭(PDA)合并室间隔缺损(VSD)。女性34例,男性9例。年龄从1个月～11岁(平均19.7个月)。右心导管通过来闭导管者39例,并得以下资料: 肺动脉收缩压、体循环收缩压比率(Pp:Ps)、肺体循环血流量比率(Qp:Qs)、肺血管阻力(PVR)以及肺体循环阻力比率(Rp:Rs)。     

超声心动图在先天性心脏病封堵术中的应用

目的评价超声心动图在先天性心脏病(先心病)房间隔缺损(ASD)、动脉导管未闭(PDA)及室间隔缺损(VSD)封堵术中的应用价值。方法11例继发孔型ASD、12例管型PDA和4例膜周型VSD,均选用Amplatzer封堵器进行治疗,超声心动图在术前、术中及术后进行诊断、监测、评价疗效和随访。结果27例患者在超声心动图指导下即刻成功封堵,1例ASD封堵失败。封堵成功者术后立即观察分流消失,术后复查无残余分流,无血栓形成,各瓣膜口无返流及心腔大小的变化。结论超声心动图在先心病介入封堵治疗的术前病例选择、术中监测引导以及术后随访中有着重要的作用。     

多普勒超声检测房、室间隔缺损患者的肺、体循环血流量及分流量

运用多普勒超声(DE)技术检测13例房间隔缺损(ASD)和27例室间隔缺损(VSD)患者的肺循环血流量(Qp)、体循环血流量(Qs)及 Qp/Qs 比值和左向右分流量,并将数据与心导管 Fick 法作比较。结果显示,DE 检测的 Qp、Qs 及 Qp/Qs 比值均与 Fick 法结果呈高度正相关性,相关系数 r 分别为0.95、0.91和0.94(P 均<0.001)。DE 测定的 Qp 与 Fick 法测值无显著的统计学差异(P>0.5),Qs 则较 Fick 法者略高(0.010.5,>0.1,)并呈良好正相关性(r 分别为0.96、0.93,P<0.001)。作者认为,用 DE 检测 ASD 或 VSD 的 Qp、Qs 及 Qp/Qs 比值,以及由之计算的心内左向右分流量,方法可行,结果可靠;用 DE 直接测跨缺损处分流量,方法简便,初步结果可信,值得进一步研讨。     

复合型左向右分流先心病临床特征及治疗探讨（附56例报告）

临床资料一、对象 1984年4月至1990年10月经有创性检查和手术证实的2～3个水平左年龄1～14岁。男占52％,无明显性别差异。初次发现心杂音而疑及先心病者36例(64.3％)。活动耐力降低44例(78.4％),1次以上肺炎史28例(50％),5次以上6例。暂时青紫史26例(46.4％),心衰史11例,反向右分流先心病共56例。室间隔缺损伴动脉导管未闭(VSD+PDA)25例,房间隔缺损(ASD)伴PDA 9例,VSD+ASD 18例,VSD伴PDA伴ASD 4例。心血管体征见附表。     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.     

Development Is A High Level Inheritance for China Time-honored Brand Products

<正>As culture is the soul of a nation,the three books,"History of Chinese Philosophy,""History of Chinese Culture"and"History of Chinese Science and Technology"have demonstrated the superiority of our great Chinese culture,and its significant impact in the field of international culture.Both core value and practical value of the Chinese culture are very clear,reflected in the views of universe,nature,life,health,disease,and therapy and related considerations,concepts,and technical methods.