丁胺卡那封管治疗双腔股静脉管感染疗效观察

目的观察丁胺卡那封管治疗双腔静脉管感染的疗效。方法将双腔股静脉管感染的患者随机分为两组,一组采用单纯丁胺卡那封管治疗感染,另一组采用丁胺卡那封管联合静脉抗生素治疗感染;比较两种方法对导管相关感染(catheter-related infection,CRI)的疗效。结果单纯用丁胺卡那封管治疗双腔股静脉管感染疗效可靠,与加上全身静脉用药治疗差异无统计学意义。结论单纯用丁胺卡那封管是临床上治疗双腔股静脉管感染理想的治疗方案。     

Endovascular stenting for nutcracker syndrome

Nutcracker syndrome (NCS) is a rare pathology manifested by pain or hematuria in males and females alike. It can be easily overlooked, and should be considered in young men or women with symptoms of extended duration. We present a case of a 54-year-old female with chronic lower abdominal pain radiating to the left thigh of 4 years in duration. Computed tomography (CT) eventually revealed engorged left renal, gonadal, and uterine veins due to compression between the superior mesenteric artery (SMA) and the abdominal aorta, consistent with NCS. After a successful endovascular stenting and a 6-month period of antiplatelet and anticoagulant therapy, the patient returned to stable health. NCS, while rare, should be suspected in patients of both sexes with persistent pain or hematuria.     

Venous Reactivity in Canine Renovascular Hypertension

The responsiveness of arterial smooth muscle to vasoactive stimuli is enhanced hypertension. It is however, unclear whether this increased reactivity is a generalised property of vascular smooth muscle, involving veins as well. We examined the responses of rings of cephalic veinin vitro taken from 11 dogs with chronic renovascular hypertension and 10 normal dogs. Mean blood pressure was 129 ± 3 mmHg in the hypertensive dogs, 26% above control. Veins from hypertensive dogs had steeper passive circumference-tension relationships than veins from normal dogs, indicating reduced compliance. Sensitivity (defined as location of EC₅₀) to potassium depolarisation was unchanged, but maximal contractile force (Fmax) developed was 35% greater in hypertension when compared with normotensive dogs. With noradrenaline and the selective alpha₁-adrenoceptor agonist methoxamine, there was no difference between normotensive and hypertensive dogs in either location of the EC₅₀ or in the Fmax. With the selective alphaz-adrenoceptor agonist UK 14304, there was a tenfold decrease in sensitivity in hypertension when compared with normotensive dogs, but no change in Fmax. There was, however a tenfold increase in sensitivity to serotonin in hypertension when compared to normotensive dogs, and a 22% increase in Fmax. Contractile responses to transmural sympathetic nerve stimulation were similar in the two groups. As desipramine caused equal increases in responses to neural stimulation, there was no demonstrable abnormality of neuronal uptake in hypertension. Morphometric examination showed no change in media thickness, media thickness/radius ratios or media cross sectional area in hypertension. Therefore, veins from dogs with chronic renovascular hypertension are stiffer but not hypertrophied, and exhibit some specific differences in contractile responses to vasoconstrictor agents when compared with veins from normotensive dogs.     

When To Hospitalize The Emphysema Patient

With emphysema now ranking second among causes of disability in men past 40, Dr. Haas believes that careful reappraisal of the criteria for hospitalization in this disease is indicated. Critical to this reappraisal, he maintains, is recognition that many patients now “written oil'” as hopeless cripples may be returned to “the dignity of economic and social independence.”     

Echocardiography

Echocardiography occupies a unique place as an investigative tool in cardiology. This introduction to the technique reviews the basic principles and outlines the diagnosis of common cardiac lesions. Being entirely noninvasive, echocardiography can be repeated to ascertain the severity and observe the progression of cardiac lesions.     

Changes in platelet volume,morphology and RNA content in subjects treated with haemodialysis

During haemodialysis treatment, blood flows from the body to the extracorporeal circuit and vice versa. In this study, pathophysiological defects in platelets indicated by alterations in RNA content and aberrations in platelet volume and morphology are detected before and during haemodialysis treatment. In subjects receiving haemodialysis treatment, qualitative interpretation of platelet characteristics with application of light microscopic evaluation reveals only 19±11?% of platelets with appropriate staining density of the granule‐containing cytoplasm. On the contrary, a reference group of apparently healthy subjects shows 70±12?% platelets with appropriate staining density of the granule‐containing cytoplasm. During haemodialysis treatment, mean values for platelet volume, platelet distribution width and platelet large cell ratio demonstrate a tendency to decrease by 10?%, 11?% and 6?%, respectively, from the mean initial value to the value at t = 150?min. Reduction of the platelet volume parameters just mentioned is hypothesized to be due to platelet degranulation as a result of platelet activation.     

视网膜静脉阻塞和Eales病患者玻璃体内皮生长因子含量测定

目的：了解血管内皮生长因子(vascular endothelial growth factor，VEGF)在视网膜血管增殖性疾病患者玻璃体中的含量。 方法：采用酶联免疫吸附实验(enzyme linked immunosorbent assay，ELISA)测定伴有新生血管的视网膜静脉阻塞(retinal vein occlusion，RVO)和视网膜静脉周围炎(Eales病)患者玻璃体VEGF含量。 结果：RVO患者(7例)和Eales病患者(7例)玻璃体VEGF含量分别为(4.67士3.38)ng/ml和(1.79土0.44)ng/ml，是正常人(0.35土0.15)ng/ml的13倍和5倍(P<0.01)。 结论；RVO和Eales病患者玻璃体VEGF水平明显升高，提示VEGF可能参与其眼内新生血管增殖机制。 （中华眼底病杂志，1997，13：171-173）     

两种顺行置管方式溶栓治疗急性髂股静脉血栓的对照研究

目的探讨经大隐静脉穿刺入路置管溶栓治疗急性髂股静脉血栓的应用价值。方法46例经造影明确诊断的急性髂股静脉血栓患者,随机分为2组,经患肢大隐静脉入路置管溶栓的为A组(21例),经患肢腘静脉入路置管溶栓的为B组(25例)。对两组患者总体治疗效果、静脉通畅度、患肢消肿率、穿刺置管消耗时间及治疗期间并发症发生率等进行观察比较。结果总体有效率A组95.2%;B组96.0%;消肿率A组(86.6±20.0)%,B组(85.7±14.6)%;静脉通畅度A组(57.9±19.4)%,B组(57.7±19.3)%。两组之间疗效差异无统计学意义(P>0.05)。A组穿刺消耗时间少于B组(P<0.05),大隐静脉穿刺难度低于腘静脉。大隐静脉置管的并发症发生率低于腘静脉置管(P<0.05)。结论经大隐静脉穿刺置管溶栓治疗急性髂股静脉血栓形成是简单易行、有效的方法。     

下肢静脉曲张的微创治疗

微创治疗是下肢静脉曲张治疗的发展方向,随着新方法和新器械的不断出现和改进,包括透光直视旋切术、静脉腔内激光闭合术、静脉腔内射频闭合术、腔镜深筋膜下交通静脉结扎术、静脉内血管硬化术、经皮静脉瓣膜植入术等,具有创伤小、手术时间短、恢复快、疗效确切等优点,将为下肢静脉曲张患者提供了多种选择。本文回顾了目前治疗下肢静脉曲张的概况,就微创治疗下肢静脉曲张的方法、器械以及初步研究成果和最新进展等进行综述。     

不同途径移植脂肪间充质干细胞在肝内定居数量的比较

目的：探讨大鼠脂肪间充质干细胞（adipose tissue-derived mesenchymal stemcells，ADMSCs），在同种异体不同途径移植后的肝内定居情况。方法：用5-溴脱氧尿嘧啶核苷（BrdU）标记从大鼠脂肪中分离并培养至的第三代脂肪间充质干细胞，分别从尾静脉和门静脉注入同种异体、由CCl4造成肝损伤的大鼠体内。移植2w后分别取肝组织，通过激光共聚焦显微镜观察两种移植途径对大鼠脂肪间充质干细胞在肝内定居的影响。结果：在两组大鼠的中央静脉及肝汇管区均可见BrdU标记的细胞；BrdU标记阳性的细胞在门静脉移植组600倍镜下每张切片平均为127．5个，在尾静脉移植组平均120．7个（P〉0．05）。结论：脂肪间充质干细胞在肝脏定居的细胞数量与移植途径无关。