脐门静脉造影的临床应用

为开展脐门静脉造影的介入放射学,弥补肝动脉化疗的不足,探讨肝脏内恶性肿瘤化疗的新途径。本文对8例男性肝脏左叶占位性病变患者作脐静脉穿刺造影测得肝圆韧带内脐静脉自肝门静脉左支囊都至腹壁脐切迹全长为19.4±4.3 cm。讨论了脐门静脉造影的优点及其临床意义。     

Techniques for high-resolution MR imaging of atherosclerotic plaque

Atherosclerotic cardiovascular disease is the most common cause of death in the United States. Investigation of atherosclerotic plaque morphology and composition is important because the findings may be useful in predicting prognosis or response to therapy. This study presents high-resolution magnetic resonance (MR) imaging techniques developed on a 1.5-T whole-body imager with a custom-built surface coil, for characterizing the composition and morphology of plaque removed at carotid endarterectomy. The initial comparison of MR imaging and histologic results showed good correlation. In conjunction with MR angiography, these techniques could be used in in vivo imaging to define the size, location, and contents of atherosclerotic plaque at the carotid bifurcation.     

年轻人冠状动脉壁平滑肌细胞的表型变化及其与巨噬细胞的关系——免疫组织化学研究

选用年轻人冠状动脉材料，免疫组织化学方法，观察了弥漫性内膜增厚、脂纹、动脉粥样硬化斑块中平滑肌细胞的免疫表型变化，并将这些变化同巨噬细胞进行了联系。结果表明，凡是有巨噬细胞浸润之处，不管何种病变，该处的平滑肌细胞便失去了相应抗体的反应性，但仍能被抗间叶细胞抗体所标记，提示平滑肌细胞已经发生表型转变。这一现象说明巨噬细胞在平滑肌细胞表型转变过程中起重要作用，有助于人们对动脉粥样硬化病变、冠脉成形术后再狭窄病变发生过程的认识。     

瑞芬太尼对人肠系膜小动脉平滑肌细胞L-型钙通道电流的影响

目的观察瑞芬太尼对人肠系膜小动脉平滑肌细胞(MASMCs)L-型钙通道电流的影响,探讨其扩张血管的机制。方法酶解法分离人肠系膜小动脉单个平滑肌细胞,采用全细胞膜片钳技术,以钡电流作为载流子,观察19.4nmol／L瑞芬太尼在不同钳制电压下以及不同浓度瑞芬太尼在最大激活电压下对MASMCs L-型钡电流(TBa-L)的影响。结果19．4 nmol／L瑞芬太尼可抑制TBa-L,使电流密度-电压曲线上移,最大激活电压及翻转电压均向膜的负电位方向移动(P<0．01)。瑞芬太尼浓度依赖性地抑制TBa-L,其半数最大抑制效应的浓度为(39±4)nmol／L。结论瑞芬太尼浓度依赖性地抑制人肠系膜小动脉平滑肌细胞L-型钙通道,从而产生扩张血管的作用。     

脐带夹对防止脐部感染和出血的临床与实验研究

目的应用国产脐带夹用于农村山区破伤风高发区，并经离体试验验证其可靠性。方法经湖南、江西、广西等省基层接生员临床应用、并与当地同期或前一年未用夹者进行对照；同时经离体脐带用脐带夹、气门芯或纱线结扎阻断血管后进行金黄色葡萄球菌和破伤风毒素通透试验以及测试承受气压程度试验。结果1年临床使用2296例中，无1例发生破伤风和败血症。可靠性试验结果证明，粗纱线结扎最差，气门芯虽优于前者，但不如脐带夹。结论该脐带夹由于夹持力持久有力，细菌、毒素难以通过、安全可靠，因此能降低新生儿“病从脐入”的发病率和死亡率，有利干优生优育的贯彻．这是一项花费少、收效大的简而易行的适宜技术，值得推广。     

Renal vein renin analysis: Limitations of its use in predicting benefit from percutaneous angioplasty

Two hundred forty-four consecutive patients (mean age 61 years), including 123 who had technically valid renal vein renin (RVR) analysis and 121 without RVR data, underwent technically successful percutaneous renal artery angioplasty (PTRA). They were retrospectively examined to evaluate the utility of RVR analysis in identifying renal hypertension (RVH), predicting benefit from PTRA, and determining if the lack of knowledge of renin levels significantly affected clinical outcome after PTRA. Abnormal RVR values were associated with clinical benefit after PTRA in 62 of 93 patients (67% sensitivity, 20% specificity, 72% positive predictive value). Clinical improvement following PTRA occurred in 31 of 37 patients with normal pre-PTRA RVR values (16% negative predictive value). RVR analysis correctly identified 86 of 117 patients with renovascular hypertension (74% sensitivity, 16% negative predictive value). Improved blood pressure (BP) control occurred in 72% with abnormal RVR analysis and 66% of the 121 patients without RVR data (p>0.1). We conclude that the very low negative predictive value significantly limited the use of RVR analysis in this elderly (mean age 60 years) patient population with a high incidence of mild renal functional impairment (mean serum creatinine 1.4 mg/dl) and bilateral renal artery stenosis (38%). The lack of pre-PTRA renin data did not significantly affect clinical outcome. If RVR data were relied upon as the exclusive selection criterion in patients of this type, many would be prevented from having the benefit of cure or improvement by PTRA.     

白兔局部动脉粥样硬化不稳定斑块对其余血管斑块形成的影响

目的 分析局部动脉粥样硬化不稳定斑块对其余动脉粥样硬化斑块形成的影响。方法 选取体质量年龄适合的新西兰白兔30只,按照随机数字表法将其随机分为3组（n=10）。实验组和对照组予以高脂饲料喂养,空白组予以普通饲料喂养。喂养4周后,对实验组采用颈动脉球囊损伤术进行动脉粥样硬化建模,12周后杀死兔子,取颈动脉、腹主动脉进行病理组织学检测,利用图像分析软件测量各部位平均内膜厚度、斑块面积与管腔面积之比,同时抽取兔子静脉血行血脂分析。结果 4周末、8周末、12周末时,实验组、对照组体质量较0周时明显升高（P<0.05）,空白组体质量较0周时无明显差异（P>0.05）,且空白组体质量明显低于实验组、对照组（P<0.05）,对照组间体质量比较无明显差异（P>0.05）;实验组平均内膜厚度明显大于对照组、空白组（P<0.05）,且实验组手术侧颈动脉平均内膜厚度、斑块面积与管腔面积明显大于对侧颈动脉、腹主动脉（P<0.05）;12周末时,实验组、对照组甘油三酯（TG）、总胆固醇（TC）、低密度胆固醇（LDL-C）、高密度胆固醇（HDL-C）、超敏C反应蛋白（CRP）水平明显高于空白组（P<0.05）,且对照组间TG、TC、LDL-C、HDL-C、CRP水平比较无明显差异（P>0.05）,实验组CRP水平明显高于对照组（P<0.05）。结论 局部动脉粥样硬化不稳定斑块可使机体CRP水平升高,进而促进其余动脉粥样硬化斑块的形成。     

Effects of calcitonin gene-related peptide on canine cerebral artery strips and the in-vivo vertebral blood flow in dogs

Summary The effects of calcitonin gene-related peptide (CGRP) on canine cerebral arteries and on vertebral blood flow were investigated in-vivo and in-vitro and the findings compared with the effects of vasoactive intestinal peptide (VIP) and substance P. Administration of CGRP into the vertebral artery caused a dose-dependent and long-lasting increase in blood flow. The in-vivo vasodilatory effects of substance P and VIP were short-lasting. CGRP (0.1 to 100 nmol/l) elicited a concentration-dependent relaxation of the isolated middle cerebral and basilar arteries when the tissues were precontracted by exposure to prostaglandin F₂ (PGF₂). This effect was not antagonized by propranolol, atropine, tetrodotoxin, (N-Ac-Tyr¹, D-Phe²)-growth hormone-releasing factor(1–29)-NH₂ or (D-Pro², D-Trp^7,9) substance P. CGRP also reduced concentration-dependently the contraction of cerebral arteries induced by KCl or 9,11-epithio-11,12-metano-thromboxane A₂ (STXA₂). Mechanical removal of the endothelium did not abolish the vasodilatory response to CGRP. In PGF₂-contracted canine cerebral arteries, VIP (0.1 to 100 nmol/l) was less potent a vasodilator than CGRP. At low concentrations (0.01 to 1 nmol/l) substance P elicited a rapid and short-lasting relaxation, and in the absence of endothelium this relaxation disappeared. These findings are clear evidence that CGRP modulates vascular tone.     

Dopamine inhibits prostaglandin F2α-induced depolarization of rabbit jejunal arteries via activation of DA1-receptors

Summary In rabbit jejunal arteries, the membrane potential of single smooth muscle cells decreased on the application of noradrenaline 3 mol/1. LY 171555 1 mol/1 did not change, whereas SKF 38393 10 mol/1 reversed the effect of noradrenaline. When prostaglandin F₂ (PGF₂) was used to evoke depolarization in the presence of prazosin 0.1 mol/1, rauwolscine 1 mol/1 and propranolol 1 mol/1, both SKF 38393 10 mol/1 and dopamine 10 mol/1 repolarized the membrane. SCH 23390 1 mol/1 antagonized the effects of SKF 38393 10 mol/1 and dopamine 10 mol/1. Thus, the change in membrane potential is mediated by a DA₁-recep-tor.     

AN ARTERIAL PERFORMANCE INDEX

INTRODUCTIONWhenpulsatingbloodflowsthroughtheartery,thearterialwallwilldilateandcontractperiodicallybecauseoftheelasticityofarterialwallandtheperipheralresistance'Thisensuresthecontinuityofbloodflowandthelocalbloodpressurenotchangingtoomuch.Ifthearterialwallispathologicallychanged,causingthechangeoftheelasticityofarterialwall,theperformanceofarterywillbeaffected'Atpresent,thecomplianceiswidelyusedtoevaluatethedistensibilityofarterialwass[1],butitcannotevaluatethetotalperformanceofartery'T…