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1.
患儿,男,8岁。3岁发现心脏杂音,平素易感冒发热。胸廓无畸形,心尖搏动位于右侧第5肋间右锁骨中线外侧1cm,心率110次/分,律整,胸骨右缘3、4肋间闻及3/6级粗糙收缩期杂音。心电图示右位心,右心室肥厚。X线胸片见两肺血稍多,心影扩大,心尖向右下延伸,C/T∶0.53。超声心动图示心脏位于右侧胸腔完全性大动脉转位,两处室间隔缺损。腹部超声见肝脏、脾脏转位。手术在全麻低温体外循环下进行。暴露心脏后见右位心,升主动脉在左前方,主肺动脉在右后方,房室关系一致,肺动脉根部可扪到细震颤,冠状动脉单开口。…  相似文献   
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表达谱基因芯片筛选体外循环前后心肌细胞因子的变化   总被引:1,自引:0,他引:1  
Objestive Systemic inflarmmation may be triggered by injury, hypothermia, ischemia-reperfusion and the contact of the blood with foreign body during cardiopulmonary bypass (CPB). To determine the application values of gene chip technique in the clinical practice and the study of cardiovascular stagery, as well as to provide clues to the study of inflammatory responess during CPB, microarry for gene expression profiles was used to identify the differences in the gene expression of myocardium between pre-and post- CPB. Methods Six adult patients who underwent CPB from March to May in 2003 were involved. Samples of right atrium were col- lected before and at immediate end of CPB. BD AtlasTM cDNA Expression Arrays was used to identify the differences in the gene ex- pression of cytokines. The results were compared with that of semi-quantative RT-PCR. Resellts The mean age of 6 patients (5 males and 1 female) was (32.67± 11.72) years. The baseline heart function was gradeⅡin 3 cases and grade Ⅲ in 3 other cases. The baseline left ventricular ejection fraction(LVEF)was (58.17±7.91)%. The mere duration was (91.67±43.88) minutes for CPB and was (58.67±43.46) minutes for aorta blocking. The minimum nasopharynx/rectal temperture was (29.37±1.90)℃/ (32.15±1.52)℃. Gene expression profiles of cytokines in the myocardium pre- and post-CPB were analysed successfully. The ex- pression of IL-6, IFN-γ,Wnt5a, TNFRSF1B, a member of tumor necrosis factor receptor superfamily, PIGF and MFNG in the myo- cardium were unpregulated after CPB. Conclusion Microarray technique is applicable in the study of cytokines changes dying CPB. cDNA microarray identified pleliminarily the differences in the gene expression between pre- and post-CPB. These genes may be in- valved in inflammation and other psthophysiological responses incuced by CPB. The myocardiym is probably one of the major sources of cytokines during CPB. Further study may be helpful in understanding the llngthe development of inflammation during CPB, and eventually, reducing the post-operative complications.  相似文献   
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病人 男,35岁。发作性心前区闷痛1年,加重2个月。激动、饱餐、快步走可诱发心绞痛,休息后缓解,无静息下心绞痛发作。在外院按冠心病不稳定型心绞痛药物治疗,效果差。无高血压、糖尿病、高脂血症史,有10年吸烟史。查体无异常。心电图示窦性心律,T波V1~6、aVl倒置,ST段V5~6压低;运动心电图示下壁、侧壁阳性,运动中因心绞痛发作及缺血型ST-T改变而终止。心脏超声示正常。冠状动脉(冠脉)造影示前降支(LAD)中段有2处收缩期重度狭窄,舒张期完全恢复正常。静脉给硝酸甘油对其无影响。1999年1月在…  相似文献   
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高功率CO2激光心肌打孔机的研制及临床应用   总被引:1,自引:0,他引:1  
目的:研制用于激光心肌打孔血运重建术(TMLR)的高功率CO2激光治疗仪,并对其生物学效应及临床应用效果进行评价。方法:采用激光合成方法研制产生大功率CO2激光的心脏打孔机,分别在有机玻璃块,犬离体心脏和活体心肌缺血模型上进行激光心肌打孔实验,以检验合成光束的生物物理特性,选择安全有效的激光心肌打孔参数。在此基础上,使用该仪器为65例冠心病病人行TMLR手术并观察效果。结果:在有机玻璃和离体猪心打孔显示孔道孔径,深度可以满足TMLR的使用要求,使用该仪器在犬缺血心肌打孔形成透壁孔道,1周年镜下可见孔道通畅,65例接受TMLR手术患者,3例分别于术后第3天、第4天及第8天因呼吸衰竭、心力衰竭及心律失常死亡,其余病人均顺利院,随访6-30个月,50例患者心绞痛明显减轻,其中37例较术前减少2级,15例减少1级,7例变化不明显,失访5例,26例术后行心肌放射性核素断层扫描,有21例心肌的孔区域的血流灌注比前术前明显增加。结论:合成高功率CO2心脏激光打孔机治疗仪在TMLR的动物实验及临床应用中安全有效。  相似文献   
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体外循环前后不同组织细胞因子的差异表达   总被引:1,自引:0,他引:1  
目的应用基因芯片技术探讨外周血单个核细胞(PBMC)及心房组织细胞因子的差异表达基因,探讨不同组织对体外循环(CPB)的反应。方法CPB开始、CPB结束即刻抽取患者动脉血,密度梯度离心法分离PBMC; 取CPB开始及CPB结束即刻的右房组织。用BD Atlas^TM cDNA Expression Arrays表达谱基因芯片对比CPB前及CPB后二者间细胞因子的差异表达。结果CPB前PBMC及心房间细胞因子基因表达差异明显者有IL-6、IL-13、Wnt5a、促肾上腺皮质激素释放激素Ⅰ型受体、卵泡刺激素受体和盘状结构域受体2。CPB后二者的基因表达谱均发生变化,差异明显者变为IL-6、IL-13、α-干扰素诱导蛋白(IFI616)、钙结合蛋白S100A9(钙颗粒素B)、胎盘生长因子和Wnt5a。结论CPB前PBMC与心房组织的细胞因子基因表达谱不同,CPB刺激后基因表达谱发生变化,但变化不一致,使差异表达基因发生变化。  相似文献   
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1970年,Grinnan报告25条犬异体心肺移植,13条因技术问题如出血、气管支气管树血液和分泌物的潴留或急性肺水肿而于24小时内死亡,11条生存24~72小时,最长的1条生存10天,证明技术上是可行的,但因犬不能耐受肺去神经,终因呼吸衰竭导致死亡。1972年Castaneda用狒狒行自体心肺移植,23条狒狒中21条恢复自主呼吸,3条生存8个月以上,并显示了正常的呼吸功能。实验证明了灵长类动物有耐受心肺完全去神经的能力。Stanford大学医院于1980年在恒  相似文献   
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目的 观察激光心肌血运重建联合血管内皮生长因子基因(VEGF165cDNA)治疗急性缺血心肌后心肌血管密度的变化。方法 健康杂种犬48只,随机分为对照,激光打孔,激光打孔 VEGF165cDNA和激光打孔 空质粒4组,每组12只,所有犬均结扎冠状动脉,造成急性心肌缺血后,立即按预定组别行CO2激光心肌打孔及心肌基因转染,并于6周后处死动物,取心肌实验区标本,光镜下观察血管密度,数据采用SPSS统计软件处理。结果 激光打孔 VEGF165cDNA组心外膜,心内膜和心肌中层血管密度显著高于激光心肌打孔组。结论 激光打孔联合VEGF基因治疗后,缺血心肌血管生成显著增加。  相似文献   
10.
Objestive Systemic inflarmmation may be triggered by injury, hypothermia, ischemia-reperfusion and the contact of the blood with foreign body during cardiopulmonary bypass (CPB). To determine the application values of gene chip technique in the clinical practice and the study of cardiovascular stagery, as well as to provide clues to the study of inflammatory responess during CPB, microarry for gene expression profiles was used to identify the differences in the gene expression of myocardium between pre-and post- CPB. Methods Six adult patients who underwent CPB from March to May in 2003 were involved. Samples of right atrium were col- lected before and at immediate end of CPB. BD AtlasTM cDNA Expression Arrays was used to identify the differences in the gene ex- pression of cytokines. The results were compared with that of semi-quantative RT-PCR. Resellts The mean age of 6 patients (5 males and 1 female) was (32.67± 11.72) years. The baseline heart function was gradeⅡin 3 cases and grade Ⅲ in 3 other cases. The baseline left ventricular ejection fraction(LVEF)was (58.17±7.91)%. The mere duration was (91.67±43.88) minutes for CPB and was (58.67±43.46) minutes for aorta blocking. The minimum nasopharynx/rectal temperture was (29.37±1.90)℃/ (32.15±1.52)℃. Gene expression profiles of cytokines in the myocardium pre- and post-CPB were analysed successfully. The ex- pression of IL-6, IFN-γ,Wnt5a, TNFRSF1B, a member of tumor necrosis factor receptor superfamily, PIGF and MFNG in the myo- cardium were unpregulated after CPB. Conclusion Microarray technique is applicable in the study of cytokines changes dying CPB. cDNA microarray identified pleliminarily the differences in the gene expression between pre- and post-CPB. These genes may be in- valved in inflammation and other psthophysiological responses incuced by CPB. The myocardiym is probably one of the major sources of cytokines during CPB. Further study may be helpful in understanding the llngthe development of inflammation during CPB, and eventually, reducing the post-operative complications.  相似文献   
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