颈动脉外翻内膜剥脱术治疗颈动脉硬化狭窄

目的观察颈动脉外翻内膜剥脱术治疗颈动脉狭窄的疗效。方法24例颈动脉硬化狭窄患者,其中18例有慢性或一过性脑缺血症状,6例无症状;术前均行彩色超声、数字减影动脉造影(DSA)或CT和MRA扫描检查,颈动脉狭窄程度65％～95％;在颈丛麻醉下行颈动脉外翻内膜剥脱术,手术要点是于颈动脉分叉处斜形切断颈内动脉,外翻颈内动脉剥除有粥样斑块的内膜,同时从颈总动脉切口剥除颈总动脉和颈外动脉增厚的内膜。结果全组无手术死亡,术后随访3～20个月,临床症状均有不同程度改善,一过性脑缺血症状消失,4例仍有轻度慢性脑缺血症状。术后行脑部多普勒超声检查,22例脑部供血有明显改善。结论颈动脉外翻内膜剥脱术是一种安全、有效和合理的手术方式。     

彩色多普勒超声在检测脑梗死患者颈动脉粥样硬化中的应用价值

目的：探讨分析彩色多普勒超声在检测脑梗死患者颈动脉粥样硬化中的应用价值。方法选择于2011年4月～2013年8月在我院接受治疗45例脑梗死患者设为观察组,45例不存在脑梗死的人群设为对照组,应用彩色多普勒超声检查两组人群是否存在颈动脉粥样硬化斑块、梗死侧和非梗死侧颈动脉内中膜厚度、斑块的部位、大小及其数目、动脉狭窄程度。结果观察组的颈动脉粥样硬化斑块存在率为84.44%,显著高于对照组的22.22%,两组比较差异显著（P＜0.05）,具有统计学意义;研究显示颈动脉主要出现在脑梗死一侧,斑块大小及其数量与脑梗死有明显的相关性,颈动脉内中膜厚度、狭窄程度无明显差异。结论颈动脉粥样硬化是引起脑梗死的危险因素之一,预防斑块的形成对避免脑梗死的发生有十分重要的意义;彩色多普勒超声能够及早检查斑块的存在,确定斑块的性质,具有较高的临床应用价值。     

颈动脉狭窄与失语症发病关系的临床研究

目的通过检测颅内外血管狭窄程度,探讨颈动脉狭窄与失语症发病的关系,推测失语症可能的发病机制,为临床选择实施治疗方案提供客观依据。方法对10例脑梗死失语症且经头颅CT或MRI证实为左侧半球病变的患者,均行北京医科大学第一附属医院汉语失语成套测验中的亚项利手评定和判断失语症类型,采用Frenchy构音障碍评定标准进行构音障碍评定。并对颅内外血管的血流速度进行分析。结果10例患者利手评定均为右利手,8例运动性失语,1例感觉性失语,1例混合性失语。Frenchy构音障碍评定均无构音障碍。超声检查8例患者左侧颈内动脉中-重度狭窄或闭塞．颅内动脉处于低灌注状态;1例左侧大脑中动脉重度狭窄;1例左侧颈内动脉窦部斑块形成。10例患者中5例行全脑数字减影血管造影（DSA）,结果与经颅多普勒、颈动脉超声检查结果一致。结论颈动脉系统中－重度狭窄或闭塞,使颅内动脉灌注压下降,狭窄远端血流速度减低,语青中枢的低血流灌注可能为失语症的发病机制。     

数字减影血管造影和高频超声诊断颈动脉粥样硬化的对比研究

目的:探讨数字减影血管造影和高频超声诊断颈动脉粥样硬化的优劣.方法:对100例临床怀疑颈动脉硬化的住院患者行数字减影血管造影和颈动脉超声检查,观察颈动脉管腔内径,颈动脉内中膜厚度,有无斑块及其性质、部位,有无狭窄并计算狭窄率.结果:颈动脉斑块发生部位以颈总动脉分叉处最多见.100例患者经高频超声检查有80例患者检出动脉硬化,75例患者检出动脉硬化斑块,其中轻度狭窄45例,中度狭窄26例,重度狭窄4例;100例患者经数字减影血管造影检查有70例患者检出动脉硬化斑块,其中轻度狭窄41例,中度狭窄25例,重度狭窄4例.结论:高频超声诊断颈动脉粥样硬化斑块检出率高于血管造影,联合应用两种技术对颈动脉粥样硬化的病因、诊断、临床治疗及术前评估与术后随访意义重大意义.     

颈动脉彩色多普勒超声检查对急性缺血性脑卒中患者的临床价值

目的 探讨颈动脉彩色多普勒超声检查对急性缺血性脑卒中患者的临床价值。方法 收集2020年2月至2022年10月于首都医科大学附属北京大兴教学医院就诊的90例急性缺血性脑卒中患者为卒中组,收集同时期于本院进行体检的90例体检者为对照组。比较两组研究对象的一般资料、颈动脉内膜中层增厚检出率、斑块检出率、狭窄程度、颈动脉内膜中层厚度。结果 卒中组患者体重指数、高血压、糖尿病、收缩压、血糖、甘油三酯均高于对照组患者,差异均有统计学意义（P﹤0.05）。卒中组患者内膜中层增厚、颈动脉斑块、中重度颈动脉狭窄检出率均明显高于对照组患者,差异均有统计学意义（P﹤0.01）。卒中组患者颈总动脉、颈内动脉及颈外动脉的内膜中层厚度均明显高于对照组患者,差异均有统计学意义（P﹤0.01）。结论 彩色多普勒超声检查颈动脉可判断患者缺血性脑卒中的发生风险,有利于临床上及时识别高危人群,从而积极进行干预,为临床治疗提供参考。     

糖尿病合并脑梗死患者颈动脉内膜形态改变临床分析

目的:探讨糖尿病并发急性脑梗死患者发病的危险因素.方法:本组共选取2008年1月至2009年12月在我院住院的脑梗死患者99例,根据是其否患有糖尿病,分成糖尿病合并脑梗死组(n=45)和非糖尿病合并脑梗死组(n=54),2组采用彩色多普勒超声检查颈总动脉和颈内动脉内膜形态及有无斑块,观察结果并进行比较.结果:糖尿病合并脑梗死组以2级狭窄(X2=3.68 P＜0.05)、3级狭窄多见(X2=5.33 P＜0.05),且颈动脉斑块发生率高(p＜0.05);非糖尿病组颈动脉狭窄及斑块发生率低,两组比较有统计学意义.结论:糖尿病患者采用彩色多普勒超声检查,有助于对颈总动脉、颈内动脉受损程度进行评估,对预防脑梗死的发生、发展有重要价值.     

颈动脉粥样硬化性狭窄的超声与血管造影比较研究

目的比较超声与数字减影血管造影（DSA）诊断颈动脉粥样硬化性狭窄的差异。方法对340例缺血性脑血管病患者行颈动脉超声及全脑DSA检查,其中短暂性脑缺血发作（TIA）患者105例,脑梗死患者235例;又根据年龄分为青年组（n=54）、中年组（n=137）和老年组（n=149）。结果超声与DSA检查均发现梗死组颈动脉狭窄高于TIA组（P〈0．05）;超声与DSA检查均发现老年组颈动脉狭窄高于中年组和青年组（P〈0．05）,中年组高于青年组（P〈0．05）;超声检查颈动脉颅外段动脉狭窄与DSA相比,狭窄、闭塞及总体符合率分别为89．39％、80．85％、87．15％。结论颈部血管超声联合应用DSA对颈动脉粥样硬化的病因、诊断、临床治疗及术前评估与术后随访意义重大。     

颈动脉体瘤的诊疗体会

目的探讨颈动脉体瘤(CBT)的有效诊治方案。方法回顾性分析2008年6月～2011年9月我院收治的6例CBT患者的临床资料。患者术前均联合行颈动脉CT血管造影、颈动脉数字减影血管造影和彩色多普勒超声检查明确诊断。经过2周以上Matas训练。结果 6例均接受手术并完整切除肿瘤,其中2例因肿物大,颈内动脉末端难以显露,需行下颌骨旁正中劈开术显露。无病例死亡,无严重手术并发症。随访0.5～5年无复发病例。结论充分的术前检查及准备、合理的手术方法能提高CBT手术的成功率。     

颈动脉体瘤的诊断和治疗(附26例报告)

我科１９８８年１１月至１９９７年１０月９年间共收治颈动脉体瘤患者２６例（２７个）,其中１１例在外院被误诊,入院后２６例均行Ｂ超检查,其中１８例行颈动脉造影检查。２６例中行低温（３０℃～３２℃）麻醉１７例,应用Ｓｈｕｎｔ９例（１０个）;２７个肿瘤均一期切除,其中行单纯瘤体剥除８例（９个）,瘤体连同颈外动脉一同切除３例;瘤体连同部分颈内动脉、颈外动脉及颈总动脉一并切除后行颈动脉搭桥重建术１１例,颈总动脉颈内动脉吻合２例,颈内动脉结扎术２例。结果除１例术后发生偏瘫外,其余效果均良好。笔者认为,仔细的体检,结合超声波和颈动脉造影检查是诊断颈动脉体瘤,防止误诊的重要方法;低温全身麻醉和术中颈总动脉颈内动脉分流是保护脑组织的重要措施     

颈动脉多普勒超声在颈动脉剥脱术前评估中的应用价值

目的 探讨颈动脉多普勒超声在颈动脉剥脱术（CEA）术前评估中的应用价值。方法 收集2017年1月至2022年5月首都医科大学附属北京友谊医院平谷医院收治的113例疑似颈动脉狭窄患者的临床资料,以CEA术中测量结果为金标准,分析术前彩色多普勒超声的诊断效能及其与金标准的一致性,比较手术前后CEA患者病变指标的变化情况。结果 符合CEA治疗患者的共82例,104处狭窄病灶。术前颈动脉彩色多普勒超声对符合CEA治疗患者的诊断结果与金标准具有高度一致性（Kappa=0.911）,诊断价值较高（AUC=0.873）。术前颈动脉彩色多普勒超声对狭窄程度的评估结果与金标准具有较高一致性（Kappa=0.850）。术前颈动脉彩色多普勒超声对斑块性质的诊断结果与金标准具有较高一致性（Kappa=0.882）,诊断价值较高（AUC=0.850）。术后狭窄处颈动脉内径明显高于术前,收缩期峰值流速（PSV）、舒张末期峰值流速（EDV）、颈内动脉（ICA）PSV与颈总动脉（CCA）PSV的比值（PSVICA/PSVCCA）均明显低于术前,差异均有统计学意义（P﹤0.01）。结论 颈动脉多普勒超声在CEA术前评估...     

Reversible changes in tumor growth and metastatic behavior induced by immune pressure

Prolonged exposure to host immunity was studied for its effect on several characteristics of a cloned 3-methylcholanthrene-induced fibrosarcoma. One million cells of a clone 10-O were injected subcutaneously into normal C3H/HeJ mice (clone 10-N) or tumor-immune mice (clone 10-I). After 10 passages in immune mice, 1 X 10(6) cells from 10-I tumor were transferred back into normal mice (clone 10-R). After 5 to 10 additional in vivo passages, clone 10-O, 10-N, 10-I, and 10-R tumors were transplanted into normal mice and observed for tumor growth rate, tumorigenicity, antigen specificity, metastatic potential, and plating efficiency. Clone 10-I after 10 passages in immunized mice grew significantly more slowly than did 10-O or 10-N clones, required more tumor cells to cause 50% tumor incidence in normal mice (tumorigenicity), and completely lost its capacity to metastasize spontaneously or experimentally. The plating efficiency in vitro of 10-I was also less than that of 10-O or 10-N. All these changes reversed after 5 to 10 passages of 10-I clone back into normal mice (10-R). Although immune pressure induced qualitative antigenic changes, as demonstrated by a tumor-rejection assay, and resulted in no cross-reactivity with control tumor clones (antigen specificity), the degree of immune response to its autologous clone in immune mice (immunogenicity) remained constant. These results suggest that several unrelated characteristics of this clone 10 can be phenotypically changed during the same period by immune pressure.     

Insulin secretion in vitro and insulin binding to isolated hepatocytes in congenic mice with different H-2 complexes

Congenic male mice with differences in the H-2 complex have been used to investigate insulin secretion in vitro, insulin binding to isolated hepatocytes, plasma glucose, and serum insulin. Plasma glucose and serum insulin did not show consistent differences in the B10.BR, B10.D2, B10.A, B10.G, B10.M, B10.S, C57/10SCSN, and C3H.OH strains. Isolated islets of Langerhans responded to stimulation with 400 mg/dl glucose with a 3-5-fold increase in insulin secretion rates (2P less than 0.01): B10.BR greater than B10.M greater than C57BL/10SCSN greater than B10.G greater than C3H.OH, B10.D2, B10.A, B10.S. The biphasic pattern of insulin secretion was less distinct in B10.M, B10.G, and C3H.OH mice. The high-affinity constants of insulin binding to isolated hepatocytes at 37 degrees C varied between 4.5 X 10(7) L X mol-1 and 4.5 X 10(8) L X mol-1 (2P less than 0.01): B10.A greater than B10.BR greater than C57BL/10SCSN, B10.S, B10.D2 greater than B10.M, B10.G. The glucose-stimulated insulin secretion from isolated islets of Langerhans and the binding of insulin to isolated hepatocytes correlate to the H-2 complex independently.     

Interleukin-10 fails to modulate low shear stress-induced neointimal hyperplasia.

INTRODUCTION: Overexpression of the anti-inflammatory cytokine interleukin-10 (IL-10) blocks atherosclerotic events in vivo, and IL-10 has been recently hailed as an "immunologic scalpel" for atherosclerosis. Alternatively, mice lacking IL-10 receiving atherogenic diets have increased occlusive lesions. It remains unclear whether such IL-10 modulation broadly applies to other forms of occlusive arterial remodeling. We hypothesized that lack of IL-10 would exacerbate, and exogenous or overexpression of IL-10 would abrogate low shear stress-induced neointimal hyperplasia (NIH). METHODS: Wild-type (WT) and IL-10-deficient (IL-10-/-) mice underwent unilateral common carotid artery (CCA) ligation. Low shear stress in the patent ligated artery results in remodeling and formation of neointima containing BrdU and SMC alpha-actin-positive cells. Additional groups of WT mice underwent CCA ligation and were treated daily with intraperitoneal saline or 1 microg of human IL-10. Chronic delivery gene therapy approaches were also utilized to define the role of IL-10 signaling. WT mice were treated adventitially with 1 x 10(10) adenovirus/green fluorescent protein (Ad/gfp) and an Ad/empty control to confirm the veracity of adventitial delivery. Then, Ad viral IL-10 (vIL-10), Ad/empty, and virus buffer alone were applied directly to the adventitia of the CAA immediately following ligation. In separate experiments, 1 x 10(10) Ad/empty or Ad/vIL-10 was injected intramuscularly. CCAs were perfusion fixed 28 days postligation, the time at which NIH is near maximum. RESULTS: IL-10-/- mice developed identical NIH areas compared to WT controls. Mice receiving IL-10 demonstrated NIH equivalent to saline controls. Mice receiving intramuscular or adventitial Ad/IL-10 developed high serum levels of IL-10 yet formed NIH areas similar to those of controls. Serum IL-10 levels were significantly higher (P = 0.04) with adventitial delivery. Mice treated adventitially with Ad/gfp showed reliable transfection of cells within the adventitia of CAA. No antibody to human IL-10 was found in the sera of intraperitoneal IL-10-treated mice, which failed to attenuate NIH. CONCLUSION: Under the conditions of this experiment, lack of IL-10 does not exacerbate low shear stress-induced NIH, nor does exogenous administration or overexpression of IL-10 attenuate it. Despite high serum levels of vIL-10 in mice treated with ad/vIL-10 adventitially, there appears to be no therapeutic effect despite the confirmed transfection of adventitial cells. Discrepancies between these findings and previous research may be related to IL-10 dosing, inflammation induced by the adenoviral vector, or disparities between the NIH models.     

Quality benchmark for trans-tibial prostheses in low-income countries

Based on four series of patients (N=141) participating in clinical field testing of prosthetic feet and all provided with trans-tibial prostheses in accordance with the polypropylene component and assembly system developed by the International Committee of the Red Cross (ICRC) a series of quality benchmarks was developed and tested against historical data. The patient compliance demands were set for walking >1 km at 90 +/- 10%, non-users at 5 +/- 5%, discomfort at 10 +/- 10%, pain at 10 +/- 10%, and patient satisfaction at 90 +/- 10%. The technical performance demands were set for good socket fit at 60 +/- 10%, misalignment at 15 +/- 10%, insufficient craftsmanship at 10 +/- 10%, and requirements for socket change at 10 +/- 10%.     

免疫抑制剂对嗜铬细胞瘤12细胞和L929细胞增殖的影响

目的 初步探讨多种免疫抑制剂对嗜铬细胞瘤12（pheochromocytoma 12，PC12）细胞和L929细胞增殖的影响。方法 对数生长期PC12细胞和L929细胞传代，取细胞株复苏后第3代细胞均以1×10^6／ml密度接种于培养板中，分别加入10、10、10^-7和10^8mol／L环孢菌素A（cyclosporin A，CsA），10^-6、10^-7、10^-8和10^-9mol／LFK506以及10^-3、10^-4、10^-6和10^-8mol／L甲基强地松龙，并设立空白对照组。于培养24、48和72h后，取各浓度药物作用的细胞，采用MTT法检测细胞增殖。结果 高浓度（10mol／L）甲基强地松龙和较低浓度（10^-8～10^-7mol／L）CsA，在给药后48h内对PCI2细胞增殖有明显促进作用，此后促增殖作用不明显；而各个浓度的FK506均无促进PCI2细胞增殖的作用。高浓度甲基强地松龙（10^-3mol／L）和CsA（10^-6～10mol／L）作用24h后，对L929细胞增殖有显著抑制作用，FK506仅在较高浓度（10^-6mol／L）有一过性（仅出现于给药后48h）促进L929细胞增殖的作用。结论 10^-3mol／L甲基强地松龙和10^-8～10^-7mol／LCsA能够在短时间内促进PC12细胞增殖，而10^-3mol／L甲基强地松龙和10^-6～10^-5mol／L CsA对L929细胞增殖有显著抑制作用。     

AcSDKP对正常人真皮成纤维细胞表达TGF-β1的影响

目的探讨N-乙酰基-丝氨酰-天冬氨酰-赖氨酰-脯氨酸（AcSDKP）对真皮成纤维细胞表达TGF—β1的影响。方法对人皮肤成纤维细胞原代培养及鉴定后,给予不同浓度AcSDKP（10^-7mol／L、10^-8mol／L、10^-9mol／L、10^-10mol／L、10^-11mol／L）干预,设立空白对照组。WST-8法检测人皮肤成纤维细胞增殖;RT-PCR技术检测人皮肤成纤维细胞TGF～β1 mRNA表达：酶联免疫法检测培养细胞上清液TGF-β1含量。结果与空白对照组相比,各浓度组对成纤维细胞的增殖都有抑制作用,其中10^-10mol／LAcSDKP抑制成纤维细胞增殖作用最强;10^-7mol／L、10^-8mol／L、10^-9mol／L、10^-10mol／LAcSDKP对TGF-β1 mRNA表达有显著的抑制作用,且各浓度组间的抑制作用无差异;10^-8mol／L、10^-9mol／L、10^-10mol／LAcSDKP可使培养上清液中的TGF—β1显著减少,各浓度组间差异无显著性。结论AcSDKP能够抑制人皮肤成纤维细胞增殖及TGF—β1的生成,有望成为病理性瘢痕防治的新方法。     

免疫抑制剂对培养大鼠巨噬细胞和雪旺细胞影响的研究

目的 初步探讨多种免疫抑制剂对培养的大鼠巨噬细胞和雪旺细胞数量的影响。方法 取新生大鼠腹腔巨噬细胞和坐骨神经雪旺细胞进行培养，细胞生长稳定、定量计数后，分别加入不同浓度的环孢素A（ciclosporin A，CsA）、FK506和甲基强地松龙（CsA浓度为10^-5、10^-6、10^-7和10^-8mol／L；FK506浓度为10^-4、10^-7、10^-8和10^-9mol／L；甲基强地松龙浓度为10^-3、10^-4、10^-6和10^-8mol／L），设立不加药物的空白对照组。于培养24、48和72h后，分别取各浓度药物作用的细胞，用MTT法检测细胞数量。结果 对于巨噬细胞，甲基强地松龙仅在10^-4mol／L对其有明显保护作用，而CsA和FK506则分别在10^-6、10^-7、10^-8mol／L和10^-7、10^-8、10^-9mol／L能够较好地保护巨噬细胞。对于雪旺细胞，10^-3mol／L甲基强地松龙对其生长有显著抑制作用，而10^-8mol／L作用72h，则表现为对雪旺细胞明显的保护作用。除了10^-5mol／L CsA作用72h会显著减少培养的雪旺细胞数量外，其他浓度的CsA和FK506对雪旺细胞的数量无显著影响。结论 高浓度的甲基强地松龙以及一定浓度的CsA和FK506能够保护培养的巨噬细胞，但高浓度的甲基强地松龙和CsA可抑制雪旺细胞的生长，长时间、低剂量的甲基强地松龙对雪旺细胞有明显的保护作用。     

Comparative studies on monoclonal antibody KM10 and anti-CEA monoclonal antibodies

The specificity of KM10 was evaluated in comparison with newly developed anti-CEA monoclonal antibodies (A10, B9, JA4, AH3). Both KM10 and all anti-CEA monoclonal antibodies reacted with CEA in ELISA system, and with adenocarcinoma of the stomach, colon, and pancreas in the immunohistochemical assay. B9, JA4, and AH3 were suggested to react with CEA related antigens, such as NCA and BGPI, whereas KM10 and A10 were suggested to recognize the distinctive part of CEA. The antigenic determinant of CEA reactive with KM10 and A10 was revealed to be protein moiety after enzyme treatment. The competitive binding inhibition assay, however, indicated that epitopes of KM10 and A10 were different each other. Enzyme immunoassay using both KM10 and A10 could detect CEA. These findings showed the possible use of both KM10 and A10 for clinical diagnosis and treatment by means of targeting for the distinctive part of CEA.     

Pancuronium,vecuronium, and d-tubocurarine inhibit and succinylcholine stimulates choline acetyltransferase activity

The effects of the nondepolarizing muscle relaxants (NDMR), pancuronium, vecuronium, and d-tubocurarine and a depolarizing muscle relaxant, succinylcholine, were studied on choline acetyltransferase (ChAT) activity. A radiochemical assay was used in the determination of ChAT activity using purified placental enzyme. Pancuronium at concentrations of 10(-7) M, 10(-6) M, 10(-5) M, 10(-4) M, and 10(-3) M inhibited ChAT activity by 3, 10, 15, 40 and 85 per cent, respectively; vecuronium at concentrations of 10(-6) M, 10(-5) M, 10(-4) M, and 10(-3) M inhibited ChAT activity by 5, 10, 26 and 57 per cent, respectively; d-tubocurarine at concentrations of 10(-6) M, 10(-5) M, 10(-4) M, and 10(-3) M inhibited ChAT activity by 0, 4, 12.5 and 29 per cent, respectively; whereas succinylcholine at concentrations of 10(-7) M, 10(-6) M, 10(-5) M, and 10(-4) M activated ChAT activity by 8, 10, 1, and 2 per cent, respectively. Even though our present data demonstrated a significant dose-dependent inhibitory effect on ChAT activity by pancuronium, vecuronium and d-tubocurarine, it is unlikely that this inhibitory effect will contribute to the mechanism of action of NDMR. Our data, however, may suggest an additional mechanism for the phenomena of tetanic and train-of-four fades that are seen following the administration of nondepolarizing muscle relaxants.