介入治疗开通无名动脉闭塞性病变1例

北京协和医院血管外科在数字减影血管造影(DSA)下利用脑保护伞为1例完全无名动脉(IA)闭塞患者成功实施了血管内支架植入术。患者因发作性黑曚1年、右上肢麻木6个月入院。既往有高脂血症病史1年,吸烟30年。结合磁共振血管成像(MRA)及CT血管成像(CTA)检查,该患者被诊断为无名动脉闭塞。经术前充分评估,采取右股动脉及右肱动脉双入路,在右颈内动脉(ICA)脑保护伞保护下,成功实施了无名动脉血管内支架植入术。本例诊疗过程提示介入治疗是开通无名动脉闭塞性病变的首选方法,成功率高,安全,有效。脑保护伞的正确选择与应用在预防脑梗死方面有较大意义。     

2-Methoxyestradiol inhibits the proliferation level in keloid fibroblasts through p38 in the MAPK/Erk signaling pathway

Background

The MAPK/Erk signaling pathway is a classic pathway in cell proliferation. Our former study showed that keloid tissue revealed a higher proliferation level than physiological scars and normal skin. As a natural metabolite of estradiol, 2-methoxyestradiol (2ME2) showed an inhibition proliferation effect on tumor cells.

Aim

In this study, the treatment effect of 2ME2 and its potential mechanisms are explored.

Methods

Six keloid patients and six non-keloid patients were randomly selected from the Department of Plastic Surgery at our hospital during June 2021 to December 2021. Six groups were established: normal skin fibroblasts (N); keloid fibroblasts (K); keloid fibroblasts treated with 2ME2 (K + 2ME2); keloid fibroblasts treated with dimethyl sulfoxide (DMSO) (K + DMSO); keloid fibroblasts treated with doramapimod (K + IN); keloid fibroblasts treated with doramapimod (p38 inhibitor) and 2ME2 (K + IN+2ME2). The fibroblast activity and key factor expression of the MAPK/Erk signaling pathway were measured.

Results

In the results, 2ME2 significantly inhibited keloid fibroblast activity and key factor expression (except STAT1).

Conclusion

The proliferation levels were reduced by both the p38 inhibitor and 2ME2, indicating 2ME2 may achieve an antiproliferation effect by targeting p38 in keloid fibroblasts.     

21例自发性及变异性心绞痛的中医证侯特点分析

通过对21例自发性、变异性心绞痛与147例劳力性心绞痛的对比分析,结果认为前者有三个中医证候特点:寒凝标实证型较多(42.86%:3.40%),阳虚本证较多(33.33%:6.12%),气虚本证较少(33.33%:72.11%);自发与变异两型心绞痛间证型无明显差异;寒凝型心绞痛的本证以阳虚与阴虚为多。文中对以上发生机理进行讨论,同时,还提出寒凝型心绞痛的辨证标准补充修改意见及该证型在临床上的重要意义。     

眶区眼轮匝肌蒂岛状皮瓣在眶周皮肤缺损修复中的应用

目的 探讨应用眶区眼轮匝肌蒂岛状皮瓣修复眶周皮肤全层缺损的方法与手术技巧。方法 根据缺损的部位、形态及面积,分别应用以上、下眶区眼轮匝肌内侧为蒂的岛状皮瓣修复眶周的皮肤缺损,供区直接缝合。结果 2003年7月至2009年10月,应用上述方法共修复24例,除l例术后皮瓣远端部分坏死,经换药愈合,2例皮瓣表皮坏死未行处理,自行愈合外,其余皮瓣均成活良好。随访6 ～ 24个月,所有皮瓣色泽、质地均良好,与周围组织无明显差别,供区瘢痕不明显,外形满意。结论选择以眼轮匝肌眶部内侧为蒂的岛状皮瓣一期修复眶周皮肤缺损,血供良好,供区隐蔽,术后效果满意。