Combined use of transmyocardial laser revascularization and endothelial progenitor cells enhances neovascularization and regional contractility in a canine model of ischemic hearts

The purpose of this study was to determine the combined effect of transmyocardial laser re- vascularization （TMLR） and the implantation of endothelial progenitor cells （EPCs） on cardiac function of ischemic hearts in canines. The left anterior descending artery （LAD） was occluded to establish the canine model of acute myocardial infarct （AMI）. Four weeks later, the animals were randomly divided into four groups： TMLR group, in which transmyocardial laser-induced channels were established at the ischemic region; EPCs＋TMLR group, in which EPCs were locally transplanted into laser-induced chan- nels at the ischemic region; EPCs group, in which the EPCs were injected into the ischemic region; con- trol group, in which the AMI animals received neither TMLR nor EPCs. The peripheral blood （50 mL） was sampled in all groups. Mononuclear cells from the peripheral blood were separated and cultured to obtain spindle-shaped attaching （AT） cells in vitro. AT cells were labeled with 1, 1 ＇-dioctadecyl-1 to 3,3, 3＇,3＇-tetramethyl-indocarbocyanine perchlorate （DiI） before injecting into the laser-induced channels or ischemic region. Four weeks after the first operation, TMLR was performed in the TMLR group and EPCs＋TMLR group, and at the same time, the EPCs originating from the AT cells were mixed with cal- cium alginate （CA）. Then the EPCs-CA composites were implanted into myocardial channels induced by laser in the EPCs＋TMLR group, and into the myocardial infarct area in the EPCs group. All dogs underwent echocardiography at second month after LAD occlusion. Finally the samples of myocardium around the LAD were subjected to histochemical and immunohistologic examinations. The results showed there was no significant difference in the diameter of left atrium and ventricle before treatment among all groups （P〉0.05）. Eight weeks after modeling, the regional contractility in the LAD territory in the EPCs＋TMLR group was increased as compared with control group and TMLR group, but there was no significant difference between control group and TMLR group. Neoangiogenesis was observed in the EPCs＋TMLR group, and the fibrosis was seen in the TMLR group. There was no significant dif- ference in neoangiogenesis around the channels induced by laser among EPCs＋TMLR, EPCs and TMLR groups. It was concluded that TMLR combined with EPCs could improve the regional and global cardiac function in AMI, and augment neovascularizaiton in channels of ischemic myocardium induced by laser.     

无肠道准备的结肠手术的应对措施

结肠因解剖及生理上的特点在施术时常需要3d~5d肠道准备,以防发生吻合口瘘。但在没有胃肠道准备时间的急诊手术中如何避免吻合口瘘的发生是临床工作中常需要应对的问题。以往的作法是分两期完成手术,但患者遭受的痛苦多,经济负担重。近年来为达一期手术的目地纷纷采用术中肠道灌洗的方法,取得较为理想的效果。我院自1987年以来开展该类手术107例,根据病情不同分别采用术中肠道灌洗,ZT蛋白胶加固、置管引流、分期手术的办法,也都取得良好的术后效果。未出现严重并发症,也未发生吻合口瘘。     

十二指肠溃疡穿孔手术中外引流的应用

十二指肠溃疡穿孔是外科临床最为常见的急腹症之一,在该类病人施术时常遇见的情况是溃疡瘢痕大、组织水肿、肥厚、穿孔病灶位置低,难以将溃疡病灶完全切除,也势必遭遇十二指肠残端关闭困难,术后十二指肠瘘也难以避免。我科自2002-2006年以来共施十二指肠溃疡穿孔手术134例,其中十二指肠前壁穿孔不能完全切除溃疡病灶者104例,全部采用十二指肠置管外引流之方法,结果全部病人术后顺利康复,未发生十二指肠瘘。1临床资料本组病人104例,其中男97例,女7例,年龄13~76岁,平均38·6岁。平均住院21·4天,本组病人术后全部痊愈出院,无并发症。本组病人…     

32例晚期胃癌的治疗体会

我院自1997年～2001年对32例Ⅲb期、Ⅳ期胃癌进行综合治疗,现将治疗体会报道如下。1临床资料1.1一般资料:本组32例,男21例,女11例,年龄33～67岁。平均51岁,术前经胃肠钡餐、胃镜及病理检查,参照新的TNM分期方法犤1犦,32例均属晚期胃癌,Ⅲb期20例,Ⅳ期12例。1.2综合治疗方法:采用姑息或改道手术,术前、术后化疗,以及辅以免疫治疗的综合治疗模式。手术方式:行胃癌原发灶姑息切除22例;改道手术8例,仅取材病理2例。化疗方式:30例术前给予5-FU750mg全身化疗3～5天。同时对水及电解质紊乱、低蛋白血症者给予纠正。血常规及肝、肾功能正常者可手…     

CT 血管造影诊断急性脑血管病的应用价值

〔摘 要〕 目的：探讨 CT 血管造影诊断急性脑血管病在神经内科中的应用价值。 方法：选取灵宝市第一人民医院神经 内科于 2016 年 2 月至 2019 年 2 月期间收治的急性脑血管病患者 62 例作为研究对象，均行 CT 常规平扫及 CT 血管造影诊断， 评价 CT 血管造影诊断价值。 结果：CT 血管造影诊断急性脑血管准确率为 95.16 %，其中脑梗死 96.15 %、短暂性脑缺血发 作 100.00 %、血栓性脑梗死 94.44 %、蛛网膜下腔出血 87.50 %，均显著高于 CT 平扫的 61.54 %、50.00 %、55.56 %、37.50 %， 差异具有统计学意义（P ＜ 0.05）；CT 血管造影诊断共发现颅内肿瘤 16 例，颈内动脉狭窄 32 例，椎动脉狭窄 4 例，血管 狭窄 25 例。 结论：在神经内科进行脑血管疾病诊断中采用 CT 血管造影价值较高，其可有效检出血管狭窄、肿瘤等。     

螺旋CT三维重建与X线在髋关节骨折诊断及治疗中的应用

目的探讨螺旋CT三维重建与X线在髋关节骨折诊断及治疗中的应用价值。方法髋关节骨折患者98例,均接受X线平片与螺旋CT三维重建检查,分析比较检测结果,并进行检出率比较。结果 X线对髋关节骨折检出率为95.65%,显著低于螺旋CT三维重建髋关节骨折检出率100.0%,P0.05; X线检出股骨头及胫骨骨折漏诊4例,粗隆间骨折漏诊2例,髋臼骨折漏诊2例,漏诊率为4.35%。结论在髋关节骨折诊断中采用螺旋CT三维重建可充分检出各骨折类型,避免出现漏诊,且提供清晰详细且全面的骨折损伤细节,为治疗提供可靠的依据,值得推广应用。     

介绍一种治疗扳机指的新方法

作者自1976年以来,用自己创制的钩拨器,先后为军内、外近千例扳机指患者进行了治疗,效果显著。1985年曾获军内科技成果奖。由于此法经济适用,现予介绍。     

钩封术与锥孔术治疗跟痛症90例报告

作者自1980年2月至1991年10月,分别用钩封术及锥孔术治疗足跟痛90例(119足),经半年随访,效果满意。此法不需手术切开,创伤小,简便易行,疗效好,患者乐意接受,可在各级医疗单位推广。