喉罩全麻在颈动脉狭窄造影及介入治疗术中的应用

目的：观察喉罩全麻下行颈动脉狭窄的造影诊断及介入治疗术的临床效果。方法：择期DSA下颈动脉狭窄患者23例，年龄42-78岁，无明显肺部疾患及喉罩禁忌症患者，异丙酚（Pmpofol）泵入静脉全麻下插入喉罩完成手术，观察其不同时段的BP（MAP）、SpO2、HR、ECG（ST-Ⅱ）。结果：各时段的BP（MAP）、Sp02、HR、ECG（ST-Ⅱ）比较无显著性差异。结论：喉罩全麻在行颈动脉狭窄的造影诊断及介入治疗术的临床效果是肯定的。喉罩全麻颈动脉狭窄造影介入治疗     

足底深支或(和)第一跖背动脉逆行足背岛状皮瓣的临床应用

目的探索足部远端软组织缺损修复的较佳方法。方法采用足底深支或(和)第1跖背动脉逆行足背岛状皮瓣对6例足部远端软组织缺损创面进行修复。结果6例患者均一次性修复,软组织缺损最大面积8cm×6cm,术后随访1~4年,足部功能与外观均较满意。结论足底深支或(和)第1跖背动脉逆行足背岛状皮瓣血管解剖比较恒定,操作简单,是修复足远端软组织缺损的较好方法。     

大白鼠尾动脉吻合实验的方法与体会

报告了960次大白鼠尾动脉吻合实验,采用端端吻合法800次,即刻通畅率96.5％,套叠吻合法160次,即刻通畅率100％。作者认为利用大白鼠尾动脉作吻合训练,具有节省动物、可多次操作、无需无菌条件、操作简单易行等优点,并介绍了操作方法和注意点。     

兔内听动脉阻断与听觉改变的关系

目的 探讨实验性内听动脉阻断与术后听力改变的关系及术中听觉监控的方法。方法 实验兔乙状窦后进路暴露小脑桥脑角，下压小脑暴露内听道及第Ⅷ神经复合体，分辨出内听动脉，予阻断不同时间，分别行蜗神经直接复合动作电位(DCAP)和畸变产物耳声发射记录(DPOAE)。结果对照组DCAPN1波潜伏期值无明显改变。内耳血供阻断10s和30s组在压迫开始后3min，DCAPN1波潜伏期值均恢复为初始值。内耳血供阻断1min组在压迫开始后3h，DCAPN1波潜伏期值未恢复为初始值假手术组DPOAE幅值无明显改变，内耳血供阻断10s、30s对DPOAE幅值无影响，内耳血供阻断1min使得DPOAE幅值下降结论兔内耳血供阻断1min可能造成兔听觉不可逆损伤。DCAP、DPOAE能有效、持续地监控内耳血供阻断，是耳神经外科手术中实用的听觉监测手段。     

Melatonin‐evoked potentiation of the juvenile rat tail artery neurogenic reactivity depends on degree of the change in the reactivity

Aim: Dependence of the melatonin‐evoked potentiation of the rat tail artery neurogenic reactivity on degree of the change in the reactivity was studied. Method: Electrical field stimulation‐evoked contractile response of the juvenile rat tail artery segment under isometric conditions was recorded. 0.1 μm melatonin was administered after the change in the response produced both spontaneously and by acidification (pH 6.6) or alkalinization (pH 7.8) of the solution. Results: During the course of experiment, the contraction force continuously declined, being reduced by 12 ± 5, 24 ± 7 and 32 ± 6% at 20, 70, and 170 min after beginning of experiment, respectively. Melatonin applied at these time points increased the contraction by 20 ± 5, 41 ± 10, and 48 ± 8%, respectively, relative to control. This increase in potentiating effect of melatonin during the course of experiment was not because of sensitization of the segment to the hormone. Acidosis‐induced considerable decline in neurogenic contraction was counteracted by melatonin, while after alkalosis‐induced augmentation in the contraction the hormone was not effective. Melatonin increased the artery response to 0.1 μm noradrenaline. Conclusion: These data suggest that melatonin can restore an attenuated neurogenic reactivity of the juvenile rat tail artery. The effect is more pronounced with further decrease in reactivity and might be due to a change in sensitivity of the post‐junctional membrane to noradrenaline.     

子宫动脉栓塞治疗子宫肌瘤89例报告

目的 评价子宫动脉栓塞术治疗子宫肌瘤的近期疗效。方法 89例子宫肌瘤患者，采用Seldinger技术分别作左右子宫动脉主干插管检查和栓塞治疗，栓塞剂采用聚乙稀醇颗粒(PVA)或白芨混合颗粒。结果 72例(80．9％)完成随访，随访时间1～28个月。有94．1％(64／68)的患者月经复常；治疗后瘤体缩小25．2％～76．8％(M=41．3％)。除了术中术后疼痛(65例)和发热(16例)外，有2例因肌瘤坏死行子宫切除术，1例出现卵巢早衰。结论 子宫动脉栓塞术治疗子宫肌瘤的近期疗效满意，远期疗效尚待进一步观察。     

Thyroid Artery Erosion by Esophageal Cancer: Management with Interventional Radiology

Management of upper gastrointestinal bleeding because of erosion of vessels by esophageal cancer may be challenging. We present herein the angiographic images of a 49-year-old patient who was admitted with massive bleeding from a tumor-eroded inferior thyroid artery. Attempts to control the bleeding by means of flexible endoscopy and insertion of a Sengstaken–Blakemore tube had failed. The diagnosis was impressively demonstrated by multislice computed tomography with intravenous contrast in the arterial phase and multiplanar reconstructions (computed tomography angiography) and by digital subtraction angiography. The bleeding was successfully treated with superselective catheterization and coiling of the eroded vessel.     

人胎冠状动脉原位杂交c-myc和jun原癌基因表达

目的研究原癌基因c-myc和jun在人胎冠状动脉发育过程中的表达与平滑肌细胞增殖的关系.方法用原位杂交方法检测,胎龄分别为16周、22周(因治疗需要引产)的胎儿和意外死亡的足月胎儿冠状动脉前降支c-myc mRNA和jun mRNA的表达水平.杂交反应产物用图像分析仪(MIAS300)作定量分析.结果C-myc mRNA原位杂交反应产物与被测血管区域面积的百分比在16周、22周和足月胎儿分别是70、56和10;Jun mRNA的杂交信反应产物与被测血管区域面积的百分比在这三个时期分别是68、53和8.两个原癌基因在不同阶段的表达均具有显著性差异.结论本实验首次报道c-myc和jun在人胎冠状动脉发育过程中平滑肌的表达图型,c-myc和jun在胎儿冠状动脉平滑肌细胞增殖和内膜的形成过程中可能具有重要的调控作用.     

平板运动试验阴性患者最大ST/HR斜率对冠心病的诊断价值

目的探讨平板运动试验阴性患者最大ST/HR斜率对冠心病的诊断价值.方法选择122例平板运动试验阴性而临床有明显冠心病指征的患者进行冠状动脉造影,测定其最大ST/HR斜率.结果平板运动试验阴性患者最大ST/HR斜率诊断冠心病的敏感性为68.2%,特异性为80.8%,准确性为76.2%;运动峰值心率＜预计最大心率之85%组最大ST/HR斜率诊断冠心病的敏感性为92.8%,特异性为86.7%,准确性为89.7%,高于运动峰值心率≥预计最大心率之85%组.结论平板运动试验阴性患者最大ST/HR斜率对冠心病的临床诊断有较高的敏感性、特异性和准确性,尤其是对低运动水平的患者,对减少运动试验诊断的漏诊率具有重要意义.