新型数字显示式颈总动脉压迫器

本文介绍了新近研制的数显便携式颈总劝脉压迫器的工作原理、电路设计和调试结果，该仪器增强了患侧动脉切术前施行压迫锻炼改善脑侧支循环的效果并为临床实时监测提供客观数据指标。     

Beta-adrenergic drugs do not affect phrenic nerve afterdischarge

Summary In anesthetized cats, a carotid sinus nerve was stimulated electrically. After this stimulation the time course of the afterdischarge in the phrenic nerve activity was studied in the control situation, during infusion of isoprenalin and after administration of metoprolol. The time courses were identical in all situations.It is concluded that in spite of the fact that the beta-adrenergic drugs change the steady state phrenic nerve activity, the afterdischarge is unchanged and therefore probably mediated by a separate mechanism. A comparison is made with analogous findings in patients with a hyperventilation syndrome.     

香丹注射液治疗心肌缺血血瘀证32例

目的：观察香丹注射液治疗心肌缺血（血瘀证）的临床疗效。方法：68例心电图提示心肌缺血且中医辨证属血瘀证患者随机分为西药对照组（简称对照组）30例和香丹注射液治疗组（简称治疗组）38例,对照组予消心痛5－10g,每日3次,或鲁南欣康10－20mg,每日2次;治疗组在对照组治疗基础上,用香丹注射液20ml加入50g/L葡萄糖溶液200ml中静滴,疗程均为14d。结果：治疗组总有效率达94．74％,对照组为76．67％,两组比较差异显著（P＜0．05）;治疗组胸闷,心绞痛,舌紫暗等症状,体征消减率均高于对照组（P＜0．05或P＜0．01）;心电图及血液流变性各项指标的改善均较对照组明显（P＜0．05或P＜0．01）。结论：香丹注射液对血瘀证的多种心脏病所致心肌缺血有较好疗效。     

COMBINED INTRAOPERATIVE ILIAC ARTERY STENTS AND FEMORO-POPLITEAL BYPASS FOR MULTILEVEL ATHEROSCLEROTIC OCCLUSIVE DISEASE

Objective. To review our preliminary experience and evaluate our early results of a combined intraopemtive iliac angioplasty and stenting with infrainguinal revascularization in multilevel atherosclerotic occlusive disease. Methods. From July 1999 to April 2000, intraoperative iliac angiOplasty and stenting combined with simultaneous femoro-pepliteal bypass were pedormed on 12 lower extremities of 10 patients suffering from multilevel athemsclemtic occlusive disease. There were 8 men and 2 women, average 72 years. The indicationsf or procedures included disabling claudication in 3 and rest pain in 7 patients. Results. Eleven iliac angioplasty and stem procedures combined with simultaneous 9 femoro-popliteal by-pass and 3 femoro-femoral-popliteal bypass were performed in 12 limbs of 10 patients. Angioplasty and stem placement was technically successful in all patients. One contralateral femoral-popliteal bypass was failure after femoro-femoral-popliteal bypass. There were no additional instances of procedural or postoperative morbidity or mortality. Mean follow-up was 5 months (range 1 -10 months). During the follow-up period, one femoro-infrapoplitealgraft became occluded after 7 months and above-knee amputation was required. The cumulative primary patencyrate of stented iliac arteries, femoro-femoral bypass grafts and femoro-popliteal bypass grafts were 100% (11/11), 100% (3/3) and 90. 9% (10/11) in the follow-up period, respectivdy. The amputation rate was 8. 3%(1/12). Conclusions. Intraoperative iliac artery PTA and stent placement can be safely and effectively pedormed simultaneously with infrainguinal revascularization for multilevel atherosclerotic occlusive disease by skilled vascular surgeon, using a portable C ann fluoroscopy in the operating room. Furthermore, iliac artery PTA and stenting was valuable adjunct to distal bypass either to improve inflow and outflow, or to reduce the extent of traditionalsurgical intervention, and also, any angioplasty and stenting-related complications can be immediately corrected as well.     

四道生理记录仪在心脏收缩时间间期测定中的应用

目的：探讨心脏收缩时间间期测定方法,为评价心室收缩功能提供客观指标。方法：用四道生理记录仪通过颈动脉搏动图法测定２０例正常人心脏收缩时间间期的四项指标ＬＶＥＴ、Ｑ－Ｓ２、ＰＥＰ、ＰＥＰ／ＬＶＥＴ。结果：ＬＶＥＴ＝０．２８４ｓ,Ｑ－Ｓ２＝０．３７３ｓ,Ｑ－Ｓ２＝０．３７３ｓ,ＰＥＰ＝０．０９１ｓ,ＰＥＰ／ＬＶＥＴ＝０．３２。结论：利用四道生理记录仪测定收缩时间间期方法简便,结果可靠。     

颈部肿块和瘢痕病变致颈动脉窦过敏综合征(附2例报告)

报告１例鼻咽癌颈淋巴结转移致颈动脉窦过敏综合征和１例全喉切除加颈淋巴结清扫术术后瘢痕形成出现颈动脉窦过敏综合征。对耳鼻咽喉科相关疾病引起的颈部肿块和瘢痕病变压迫颈动脉窦所致颈动脉窦过敏综合征的致病原因、临床表现及诊断、治疗原则进行了讨论。此类患者在临床上少见,易误诊,应引起重视。     

脑梗死患者颈动脉彩色多普勒超声研究

目的 探讨颈动脉粥样硬化及其危险因素与不同类型的脑梗死间的关系。方法：根据头颅ＣＴ或ＭＲＩ结果将１８８例脑梗死患者分成四个亚组：皮层梗死组（ＣＩ）,皮层下梗死组（ＳＣＩ）,椎－基底动脉支配区梗死组（ＶＢＡＩ）及心源性脑栓塞组（ＣＥＩ）,用彩色多勒超声（彩超）对各型脑梗死患者颅外颈动脉粥样硬化严重程度进行评估,并对可能危险因素进行探讨。结果 ３０％的ＣＩ组患者,１０％ＣＥＩ患者,６．９％ＶＢＡＩ患者     

Modulatory effect of nitric oxide on acetylcholine-induced activation of cat petrosal ganglion neurons in vitro

The inhibitory effect of nitric oxide (NO) on carotid chemosensory responses to hypoxia has been attributed in part to an antidromic inhibition of chemoreceptor cells activity. However, NO may also modulate the activity of the primary sensory neurons because NO is produced in the soma of these neurons located in the petrosal ganglion. Since a population of petrosal neurons is selectively activated by acetylcholine (ACh), we studied the effects of NO-donor, sodium nitroprusside (SNP), and the NO-synthase inhibitor, Nomega-nitro-l-arginine methyl ester (l-NAME), on the responses evoked in the carotid sinus nerve (CSN) by ACh applied to the petrosal ganglion in vitro. ACh (1 microgram-1 mg) increased the frequency of action potentials recorded from the CSN in a dose-dependent manner. SNP (10-50 microM) reduced the sensibility and amplitude of the CSN response to ACh, although the maximal response appears less affected. The withdrawal of SNP from the superfusion medium increased the sensibility of the responses to ACh. l-NAME (1-2 mM) slightly increased the sensibility of the ACh-induced responses, effect that persisted after l-NAME withdrawal. These results suggest that NO may play a role as modulator in this autonomic primary sensory ganglion.     

Microembolization from a carotid mural thrombus detected by transcranial Doppler

Over the last few years, many authors have described the possibility of using transcranial Doppler to demonstrate the passage of microemboli in the cerebral arteries. We report the case of a 44-year-old woman with thrombotic diathesis and thrombocytosis who was admitted twice within a short period of time (one and a half months) to a neurological department because of multiple cerebral infarctions. On the occasion of the second admission, a colour-Doppler examination of the epiaortic vessels, which had previously been negative, showed a carotid lesion due to a mural thrombus and, on the same side as the carotid lesion, transcranial Doppler detected short-duration, high-intensity signals in the middle and anterior cerebral arteries, an expression of the passage of microemboli.As already described by other authors in similar clinical situations, our case confirms that transcranial Doppler can identify the passage of microemboli in the circle of Willis.

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Sommario Negli ultimi anni è stata descritta da molti autori la possibilità di dimostrare mediante Doppler transcranico il passaggio di microemboli nelle arterie cerebrali. Riportiamo il caso di una donna di 44 anni con diatesi trombotica e trombocitosi ricoverata per due volte, a breve distanza di tempo (un mese e mezzo), in ambiente neurologico per infarti cerebrali multipli. In occasione del secondo ricovero l'esame Color-Doppler dei vasi epiaortici, che era risultato negativo in precedenza, ha evidenziato una lesione carotidea riferibile a un trombo murale e al Doppler transcranico sono stati rilevati, omolateralmente alla lesione carotidea, segnali di breve durata ed alta intensità nelle arterie cerebrali media e anteriore, espressione di passaggio di microemboli.Come già descritto da alcuni autori in situazioni cliniche simili, il nostro caso conferma la possibilità di individuare, mediante Doppler transcranico, il passaggio di microemboli nel circolo cerebrale.