Percutaneous transcatheter occlusion of coronary artery fistulas using detachable balloons

Three pediatric patients underwent successful transcatheter coronary artery fistula occlusion using the Debrun system. This latex balloon system offers several advantages over other occlusion systems. First, the balloon delivery and release is controlled. Second, “test occlusions” can be performed that allow simultaneous balloon inflation, coronary cineangiography, and electrocardiographic monitoring. Third, because the balloons are flow-directed, they are easily positioned in properly chosen locations. Finally, the balloons can be constructed to suit the size of the fistula. In this study, two patients received only one balloon; in the other patient two balloons were placed in the same fistula. All fistulas drained into either the right atrium or ventricle and were successfully occluded. After a follow-up period of up to 3 years, no local or systemic reactions to the balloons were recognized. We conclude that detachable balloon occlusion of coronary artery fistulas is a safe, effective alternative to surgical ligation in selected pediatric patients.     

Continuous recording of middle cerebral artery blood velocity in clinical neurosurgery

Summary Intracranial pressure, arterial blood pressure, and middle cerebral artery blood velocity were monitored for periods from 1 to 10 days in 30 neurosurgical intensive care patients. The recordings revealed rapid changes in the cerebral perfusion and gave insight into individual cerebral haemodynamic states.Twenty patients consistently showed CO₂ reactivity within normal limits, between 2.5 and 5% per mm Hg (19–38% per kPa). Severely impaired CO₂ reactivity, considerably below 1% per mm Hg (7.5% per kPa) was observed in four patients. Three of these patients died, while the fourth patient survived in a persistent vegetative state.Seven patients demonstrated pressure-passive blood velocity changes throughout the observed CPP range. The four patients with severely impaired CO₂ reactivity all belonged to this group. The recordings from three of the remaining 23 patients showed signs of MCA blood velocity autoregulation with a lower regulatory limit of about 40–45 mm Hg. This observation is in keeping with findings from electromagnetic flowmetry on brain arteries in the neurosurgical operating field, and supports blood velocity measurements as a relevant index of brain perfusion in clinical neurosurgery and neuro-intensive care settings.     

锌铜镉铁与高血压病

用原子吸收光谙仪，测定２６例高血压病人血清和红细胞内锌、铜、镉、铁含量，并以３０名健康中年人作对照。结果发现：高血压病人红细胞内锌含量增加，血清铜、铁含量降低，血清及红细胞内镉元素均降低。各元素水平与血压读数间未发现相关性。     

中西医结合治疗肺心病心律失常40例疗效观察

为提高肺心病心律失常的临床疗效,采用中药清肺化痰活血剂配合抗菌素及氧疗法对40例肺心病并发心律失常患者进行了治疗观察,同时与单纯使用抗菌素及氧疗法治疗的40例患者进行对照。临床以心电图改善情况为观察指标,结果两组有效率分别为87.5％和67.5％。Ridit分析结果表明,治疗组疗效明显优于对照组,经显著性检验,两组差异显著(P<0.05)。     

瘤体内DNA倍体异质性与食管鳞状细胞癌病理特性的关系

目的探讨食管鳞状细胞癌瘤体内ＤＮＡ倍体异质性及其与肿瘤病理学特性的关系。方法采用多点取材方法，应用流式细胞术对８０例中晚期食管鳞癌标本的ＤＮＡ倍体类型进行分析。如果一个标本中的３个样品中的倍体类型不一致，即判定为倍体异质性肿瘤（ＰＨＴ），其余为非倍体异质性肿瘤（Ｎ－ＰＨＴ）。然后用统计学方法分析ＤＮＡ倍体异质性与肿瘤病理学特性的关系。结果８０例中，共检出异倍体肿瘤７１例（８８．８％），ＤＮＡ指数范围为０．７７～１．７４。倍体异质性肿瘤的检出率为４７．５％（３８／８０）。倍体异质性与肿瘤的侵润程度，淋巴结转移及患者预后有关（Ｐ＜０．０５～０．０２５），而与组织分级和瘤体大小无关（Ｐ＞０．０５）。结论ＤＮＡ倍体异质性是一种重要的肿瘤生物学现象。深入研究它将对判断肿瘤的病理特性、患者预后及协助组织学分级具有重要的价值。     

Diagnosis and therapy for primary hepatic carcinoma: Transcatheter inferior phrenic arteriography and chemoembolization

Summary Transcatheter inferior phrenic arterial (IPA) and hepatic arteriography was performed on 38 patients with advanced primary hepatic carcinoma (PHC) with blood supplied by IPA and hepatic artery. 18 patients received single treatment with hepatic arterial infusion (HAI) or embolization (HAE) 20 received double treatment with IPA and hepatic arterial infusion or embolization. The results show that the double treatment is superior to the single one. The angiographic features and mechanism of parasitization of inferior phrenic arterial supply to PHC were also discussed.     

脐血来源的间充质干细胞生物学特性与向成骨细胞分化能力的研究

目的研究人脐血来源的间充质干细胞（UCBMSC）的免疫表型、生物学特性及其向成骨细胞分化的能力。方法分离脐血单个核细胞，以干细胞培养液培养间充质干细胞（MSC），观察其体外生长特性；用流式细胞术进行免疫表型测定和细胞周期分析；以含地塞米松、β-磷酸甘油和维生素C的诱导液定向诱导向成骨细胞分化；以碱性磷酸酶染色、矿化结节染色、骨桥蛋白mRNA的表达以及I型胶原表达鉴定MSC向成骨细胞分化的潜能。结果从脐血中可以培养出MSC，为成纤维细胞样的贴壁细胞。免疫表型分析显示CD45、CD34、CD11a、CD14、HLA．DR阳性细胞占1％～3％；CD166、CD44、CD106、CD29、CD105、CD49e、CD90、CD73表达率达91％～98％。细胞周期分析显示95％以上的细胞处于G0／G1期。定向成骨细胞诱导后，可以检测到碱性磷酸酶、I型胶原的表达，矿化结节的形成和骨桥蛋白mRNA的表达。结论UCBMSC是基质细胞的祖细胞，在合适的条件下可被诱导向成骨细胞分化，因此有可能作为有潜力的骨组织工程的种子细胞来源。     

隐动脉筋膜蒂的交腿皮瓣修复小腿严重软组织缺损

目的探讨一种小腿严重软组织缺损的修复方法。方法以健侧隐动脉为蒂的顺行或逆行交腿皮瓣修复患侧小腿软组织缺损。结果本组8例均有效地覆盖受区创面,随访三个月,皮瓣全部成活。结论该皮瓣不牺牲小腿的重要血管,质地与受区相似,方法简单易行,血运可靠,血管蒂长,是修复小腿严重软组织缺损的较好方法。     

硫酸镁治疗新生儿重症肺炎的临床研究及对血气血镁的影响

目的　为探讨硫酸镁治疗新生儿重症肺炎的临床效果及对血气血镁的影响。方法　采用 96例新生儿重症肺炎患儿随机分成治疗组 4 8例 ,对照组 4 8例 ,治疗组加用硫酸镁 30～ 5 0mg/(kg·d)加入 5 %葡萄糖 2 0ml静滴 ,持续 1h ,疗程3～ 8d ,同时监测血气血镁。结果　治疗组总有效率 79.2 % ,对照组总有效率 5 0 .0 % (P <0 .0 1) ,硫酸镁在改善症状 ,消除肺部体征及缩短住院时间和提高治愈率等方面优于对照组 ,治疗组病死率下降 ,同时血气恢复正常优于对照组 ,血镁含量治疗前后无变化。结论　硫酸镁治疗新生儿重症肺炎疗效显著 ,未发现明显副作用。     

妊娠期低水平铅暴露对新生儿钙磷代谢及造血系统的影响

目的 :研究妊娠期低水平铅暴露对新生儿钙磷代谢及造血系统的影响。 方法 :分别测定 79例汉族及5 9例维吾尔族 (维族 )母亲及新生儿脐血铅、钙、磷、碱性磷酸酶、血红蛋白、红细胞游离原卟啉的含量 ,分析脐血铅对新生儿钙、磷、碱性磷酸酶及血红蛋白、红细胞游离原卟啉的影响。 结果 :(1)汉族产妇血铅 6 3 87μg/L ,新生儿脐血铅 4 7.71μg/L ,维族产妇血铅 87 92 μg/L ,新生儿脐血铅 6 1.5 7μg/L ,维族产妇及新生儿脐血铅均高于汉族产妇及新生儿脐血铅含量 (P <0 .0 5 ～ 0 .0 1) 。 (2 )以脐血铅 10 0 μg/L为界将新生儿分为高铅组和低铅组 ,两组血钙相比差异有统计学意义 (P <0 .0 1) ,而两组血红蛋白及红细胞游离原卟啉相比差异均无统计学意义 (P >0 .0 5 )。 结论 :妊娠期低水平铅暴露可致新生儿血钙下降 ,但对新生儿血红蛋白及红细胞游离原卟啉则无影响