Experimental Results Using Nafamostat Mesilate as Anticoagulant During Extracorporeal Lung Assist for 24 Hours in Dogs

Abstract: We report on the experimental application of nafamostat mesilate (NM, 6-amidino-2-naphthyl p -guanidinobenzoate dimethanesulfonate, FUT®), a new anticoagulant, to extracorporeal lung assist (ECLA) with an artificial membrane lung. Venovenous ECLA, from the jugular vein to the femoral vein, was performed with a hollow-fiber membrane lung at a blood flow rate of approximate 82 ml kg^-1 min^-1 for 24 h in 7 dogs under anesthesia and hypoventilation. Heparin (10 U ml^-1 in a priming lactated Ringer solution of 140 ml, and 200 U kg^-1) was administered before blood access cannulation. After start of ECLA, however, no heparin was used, and nafamostat mesilate was continuously infused into the drainage line of the bypass circuit to control activated coagulation time (ACT) at about 150 to 200s. To maintain the prolonged ACT, 8:0 ± 1.7 mg kg^-1 h^-1 of NM was required. Arterial blood pressure and pulse rate decreased significantly. Though fibrin monomer test revealed hypercoagulability after 6 h of ECLA, platelet counts did not significantly decrease. Total blood loss remained less than 40 g. The artificial membrane lung sustained a good gas exchange and low flow resistance throughout ECLA. Macroscopic examination revealed small spotty thrombi in the artificial lung but no major pathologic changes of the visceral organs in the all dogs at autopsy. High-dose NM administration could control blood coagulation and decrease blood loss during ECLA for 24 h without deterioration of the artificial lung and systemic complication other than mild hypotension and bradycardia.     

Therapeutic Apheresis of Immune Diseases in Nephrology Department

Objective. The clinical efficacy of therapeutic apheresis is still controversial. We undertook a retrospective review of apheresis treatment to ascertain its safety and efficacy. Methods. We reviewed 31 patients (13 male, 18 female). Plasmapheresis was performed on 7 patients with hematologic disorders, 5 patients with neurologic disorders, 6 patients with systemic diseases, and 3 patients with Lyell syndrome. Immunoadsorption onto protein A sepharose was evaluated as rescue therapy in 7 patients. Low‐density lipoprotein (LDL) apheresis was performed on 3 patients. Results. There were five mortalities due to serious complications of their primary disease. Most complications were mild such as hypotension and hypocalcemia. Two patients who received LDL apheresis had severe anaphylactic reactions. Apheresis was effective in the remaining 24 patients. Conclusions. The therapeutic apheresis consists of a continuously improving therapeutic method for diseases with high mortality and morbidity, especially in cases with poor outcome by using current medications.     

Development of Immunosorbents for apoB-Containing Lipoproteins Apheresis

Abstract: Three types of sorbents were developed for the specific removal of atherogenic apoB-containing low-density lipoprotein (LDL) and lipoprotein LDL(a) (Lp[a])from human plasma. Two sorbents contained monospecific sheep polyclonal or mouse monoclonal antibodies against human apoprotein B-100. The third one was intended for specific removal of Lp(a) and contains sheep antibodies against human Lp(a). Thirty patients were treated for up to 9 years by LDL apheresis with anti-LDL immunosorbents. A pilot study of Lp(a) apheresis with 3 patients was conducted during 3 years. The results showed that extracorporeal immunosorption is safe and effective for lowering LDL and Lp(a). These procedures may be used both for metabolic investigations and for studies on possible regression of atherosclerosis.     

Investigation of Plasma Protein Adsorption on Functionalized Nanoparticles for Application in Apheresis

Particles with specific ligands for the adsorption of plasma proteins can be used in therapeutic or preparative apheresis. The development of these particles may benefit from an improved knowledge of the relationship between protein adsorption and the structure of ligands. Nanoparticles were functionalized with aliphatic diamines of increasing chain length; with the amino acids lysine, tryptophan, histidine, and their corresponding amines; and with tryptophan and histidine spaced with diamines of different length. Suitable protocols were developed for the washing of particles and the subsequent desorption of proteins adsorbed from human plasma. The adsorption pattern, as well as the quantification of the overall adsorption of proteins on these modified particles, was investigated with gel electrophoresis. This was followed by immuno-blotting which yielded specific assessments of bound human serum albumin and fibrinogen. The comparison of protein adsorption with surface charge density and measured hydrophobicities yielded no simple correlations although in general more hydrophobic ligands bound higher quantities of protein. The detection of human serum albumin yielded similar results because it was observed for overall protein adsorption while the adsorption of fibrinogen expressed a different pattern. In this case, particular nanoparticles functionalized with aliphatic diamines bound significantly higher amounts of fibrinogen than all other ligands.     

胃腺癌分化程度与低密度脂蛋白受体关系的初步研究

目的:分析胃腺癌组织的低密度脂蛋白受体(LDLR)活性,研究其与癌组织分化程度的关系.方法:以125I-LDL为配体,采用受体放射性配体结合分析法测定胃腺癌及其周边组织LDLR活性.结果:胃腺癌组织与其周边正常组织LDLR活性差异明显(P＜0.01),但LDLR的亲合性和特异性无明显改变;分化好与分化差的腺癌组织的LDLR活性差异显著(P＜0.01).结论:胃腺癌组织LDLR活性明显增高,组织分化越低,LDLR活性越高.     

Effect of low-dose citrate anticoagulation on the clinical safety and efficacy of direct adsorption of lipoproteins (DALI apheresis) in hypercholesterolemic patients: a prospective controlled clinical trial

Direct adsorption of lipoproteins (DALI) is the first lipid apheresis system compatible with whole blood with the advantage of a very simple procedure. A mixture of heparin plus citrate (ACD-A) is used for the anticoagulation regimen (AR). A clinical, prospective, controlled crossover study was performed to test the safety and efficacy of low-dose citrate (LDC) anticoagulation in DALI. Five chronic DALI patients suffering from coronary heart disease and hypercholesterolemia underwent 3 DALI sessions each using the LDC anticoagulation regimen (60 IU heparin/kg body weight as initial bolus; 1:40 ACD-A: blood as perfusion). This was compared to 3 sessions per patient with the standard AR (bolus of 20 IU heparin/kg, 1:20 ACD-A as perfusion). Patient blood volumes (1.6; average of 7,040 ml) were treated with 750 ml adsorber gel per session at a blood flow rate of 60 ml/min. Mean LDL and Lp(a) reductions exceeded 60% with both AR. No clinical side effects were observed. Both AR controlled the coagulation well as evidenced by a sufficient prolongation of the partial prothrombin time (PTT) and activated clotting time as well as low thrombin-antithrombin (TAT) formation. Biocompatibility parameters exhibited favorable results (low activation of complement and cells, and only slight formation of C3a, C5a, beta-thromboglobulin, elastase, and TNF-alpha). The asymptomatic bradykinin generation was comparable in both study arms. LDC optimized the ionized calcium levels and pH in the efferent blood postadsorber. LDC anticoagulation was safe and effective, and may further improve the tolerance of DALI apheresis in hypercholesterolemic patients.     

Loss of Anticoagulant Effect of Heparin During Circulation of Human Blood In Vitro

Device-induced thrombogenesis was studied in an in vitro model using human blood circulated through an artificial ventricle. A new constant pressure filtration technique was used to detect circulating microemboli, the activated partial thromboplastin time (APTT) test was used to monitor the blood for the presence of anticoagulant activity of heparin, and hemolysis was quantified by measuring the plasma free hemoglobin level. Circulation of blood through a 20-ml stroke volume pneumatically driven ventricle for 6-9 h resulted in a significant reduction of APTT, indicating the loss of the anticoagulant effect of heparin. Microemboli concentration was minimal until the APTT decreased below 125 s, at which time the microemboli concentration increased rapidly. This was presumed to be due to the formation of thrombi following a decrease in heparin activity. A significant increase in hemolysis was also noted when blood was pumped. None of these changes was noted in the nonpumped control blood. Spontaneous loss of heparin activity in blood circulated by a pneumatically driven pump may have clinical implications and may help understanding of the problems associated with device-induced thrombogenesis.     

The effects of isolated lipoproteins and triglyceride, combined oxidized low density lipoprotein (LDL) plus triglyceride, and combined oxidized LDL plus high density lipoprotein on the contractile and relaxation response of rabbit cavernous smooth muscle

The aim of this study was to investigate the effects of isolated lipoproteins and triglyceride (TG), and the effects of combined oxidized low density lipoprotein (LDL) plus TG and the combined oxidized LDL plus high density lipoprotein (HDL) on the contractility and relaxation response of rabbit cavernous smooth muscle. Cavernous muscle strips from New Zealand White rabbits were studied in organ chambers for isometric tension measurement. The strips were exposed to HDL, LDL, oxidized LDL, TG, combined oxidized LDL plus TG and combined oxidized LDL plus HDL for 30 min. Both HDL and LDL did not affect contraction and relaxation responses of the cavernous muscles. The oxidized LDL did not affect norepinephrine (NE)-induced contractility of the strips, but significantly ( p < 0.05) decreased the relaxation response to endothelium-dependent agonist, acetylcholine (Ach). Non-specific NO synthase inhibitor (L-NAME) completely inhibited the relaxation response to Ach, and L-arginine partially improved the diminished relaxation. TG did not significantly change the relaxation responses to Ach, but decreased the contractility of cavernous muscle to NE. Neither the combined oxidized LDL plus TG nor oxidized LDL plus HDL had significant synergistic or detoxication effects on the contractility and relaxation responses. In conclusion, oxidized LDL may have acute toxic effects on the endothelium-dependent, NO-mediated relaxation, but not on the contractility, of rabbit cavernous smooth muscle. TG may decrease contractility of the cavernous muscle. There may be neither synergistic nor detoxication effects on the contractility and relaxation response when TG or HDL is added to the oxidized LDL.     

针麻复合靶控输注对腹腔镜宫外孕手术病人术中心脏泵功能的影响

目的采用无创方法对患者血流动力学进行监测,探讨腹腔镜宫外孕手术中针麻复合靶控输注(target-controlled infusion,TCI)对心脏泵功能的影响。方法选择20例行腹腔镜宫外孕手术的患者作为研究对象,随机分为两组,每组10例。对照组行单纯TCI;观察组行TCI联合针刺合谷、内关。在维持相同麻醉深度的条件下,通过无创血流动力学监测患者麻醉前、诱导后插管前、插管时、气腹时、气腹毕以及苏醒时、拔管时的血流动力学指标,包括心率(HR)、平均动脉压(MAP)、每搏输出量(SV)、心输出量(CO)、体循环血管阻力(SVR)、胸腔液体量(TFC)。记录患者术中所用异丙酚和瑞芬太尼的用量。结果 1组内比较:对照组与基础值相比,插管前的HR、MAP、CO、SVR明显降低;插管时的MAP明显升高;气腹时HR、MAP、SVR明显升高;气腹毕的HR、CO明显降低;苏醒时HR、MAP、CO明显升高;拔管时的HR、MAP、CO明显升高。观察组与基础值相比,插管前的HR、MAP明显降低;气腹毕的HR明显降低。2组间比较:观察组在插管前的HR、SVR高于对照组,气腹时的HR、MAP低于对照组,苏醒及拔管时的HR、MAP、CO低于对照组。3观察组异丙酚和瑞芬太尼的用量小于对照组。结论在控制麻醉深度相同的条件下,针麻复合TCI能明显减轻术中血流动力学的波动,使血流动力学趋于稳定,并且能减少麻醉药物的用量。     

Lipid Abnormalities and Oxidized LDL in Chronic Kidney Disease Patients on Hemodialysis and Peritoneal Dialysis

Dyslipoproteinemia and oxidative modification of low-density lipoprotein (oxLDL) contribute to the development of oxidative stress and atherosclerosis in chronic kidney disease (CKD). On the contrary, high-density lipoprotein cholesterol (HDL-C), especially HDL3-C subtype, has protective effect against oxidative damage. There is limited evidence referring HDL-C subclass levels in patients on dialysis. This study was designed to compare lipid abnormalities and oxLDL levels in hemodialysis (HD) and peritoneal dialysis (PD) patients. Serum lipids, HDL subclasses, and oxLDL were measured in 55 patients with CKD-stage 5 (31 patients on HD and 24 patients on PD) and in 21 normal controls (NC). The results showed that in dialysis patients, triglycerides were higher than in controls (p < 0.0001) and HDL-C was significantly lower (p < 0.0001). The HDL2-C subclass concentration did not differ significantly between patients and controls, while HDL3-C was lower in patients (11 ± 0.5 mg/dL) than in NC (23 ± 1, p < 0.0001). oxLDL levels were markedly increased in patients (1.92 ± 0.29 mg/L) compared to NC (0.22 ± 0.05, p < 0.0001). Patients on PD had higher levels of cholesterol (p < 0.001) and apolipoprotein B (p < 0.05) than patients on HD. However, HDL-C, HDL-C subclasses, and oxLDL concentrations did not differ significantly between PD and HD patients. It is concluded that patients with CKD have a nearly 10-fold elevation of oxLDL compared with NC. Patients on PD have differences in the lipid profile compared with patients on HD; however, both modalities seem to possess similar potential to atherosclerosis development.     

白细胞介素1β对人肾小球系膜细胞LOX-1和ABCA1表达的影响

目的 研究白细胞介素1β（IL-1β）对人肾小球系膜细胞株（HMCL）植物血凝素样氧化低密度脂蛋白受体1（LOX-1）以及腺苷三磷酸结合盒转运体A1（ABCA1）表达的影响，及其与细胞胆固醇稳态的关系。 方法 实时定量PCR和Western印迹法检测IL-1β对人肾小球系膜细胞LOX-1、ABCA1表达的影响。 结果 人肾小球系膜细胞表达LOX-1 mRNA和蛋白。IL-1β促进人肾小球系膜细胞LOX-1 mRNA和蛋白表达，5 μg/L IL-1β刺激细胞0~24 h，LOX-1 mRNA表达于6 h达高峰，为对照的6.87倍；LOX-1蛋白24 h达高峰，为对照的1.88倍。IL-1β降低脂质负荷的人肾小球系膜细胞 ABCA1 mRNA和蛋白表达。5 μg/L IL-1β刺激细胞0~48 h，48 h时ABCA1 mRNA和蛋白下降最明显，分别为对照的19.0％和50.62％。 结论 IL-1β促进人肾小球系膜细胞LOX-1表达，抑制ABCA1的表达，导致细胞内胆固醇的失衡，促使其变成泡沫细胞，可能加重肾小球硬化和肾病的进展。     

血小板中cAMP与cGMP及血清LDL-ch对犬下腔静脉移植物内膜增生的影响

为探讨静脉系移植物通畅率的影响因素，对自体静脉碎片种植Ｄａｃｒｏｎ后植入下腔静脉（ＩＶＣ）的１３只犬及全血预凝Ｄａｃｒｏｎ后植入ＩＶＣ作对照的８只犬血清脂蛋白胆固醇、血小板环－磷酸腺苷（ｃＡＭＰ）、环－磷酸鸟苷（ｃＧＭＰ）及移植物内膜厚度进行了测定。结果：种植组通畅率（６１．５％）高于对照组（２５．０％），Ｄａｃｒｏｎ腔面术后２周完全内皮化；对照阻塞组与种植阻塞组血小板ｃＡＭＰ低于对照通畅组与种植通畅组，血清低密度脂蛋白胆固醇（ＬＤＬ－ｃｈ）高于对照通畅组与种植通畅组，前二组内膜厚度大于后二组。结果提示：内皮层不完整所致腔面前列环素及血小板ｃＡＭＰ减少，可能是静脉系移植物内膜增生的主要原因，高ＬＤＬ－ｃｈ血症可能对其有促进作用；人工血管内皮化，抗血小板与降血脂处理对预防内膜增生及提高通畅率可能有帮助。     

Effect of heparin on bone formation in cultured fetal rat calvaria

Summary To assess the effects of heparin on bone formation we measured [³H]proline incorporation into collagenase-digestible (CDP) and noncollagen protein (NCP), [³H]thymidine (TdR) incorporation into DNA, and DNA content in 21-day-old fetal rat calvaria cultured in BGJ medium with bovine serum albumin for 24–96 hours. Heparin at 5–125 μg/ml decreased TdR incorporation by 26–51% at 24 and 96 hours. At 96 hours, heparin 5, 25, and 125 μg/ml decreased [³H]proline incorporation into CDP by 41, 48, and 32%, respectively, with no significant change in NCP. To evaluate the possible role of PGE₂ in these inhibitory responses, media PGE₂ concentration was measured and the effects of heparin on CDP labeling and DNA synthesis were tested in the presence of indomethacin, piroxicam, and flurbiprofen to inhibit endogenous prostaglandin E₂ (PGE₂) production and in the presence of a high concentration (10⁻⁷ M) of exogenous PGE₂. Heparin did not alter PGE₂ production at 24 hours but at 48 hours there was a significant reduction. At 96 hours, indomethacin (10⁻⁶ M) inhibited [³H]proline incorporation into CDP by 38% but had no effect on the labeling of NCP. Heparin had no further significant inhibitory effect in the presence of indomethacin. Piroxicam and flurbiprofen did not alter DNA content and had a smaller inhibitory effect than indomethacin on the labeling of CDP. Moreover, addition of heparin produced a further inhibition of CDP and DNA content and finally, heparin decreased CDP labeling by 71% in the presence of PGE₂. We conclude that heparin has direct inhibitory effects on DNA and collagen synthesis, which could play a role in heparin-induced osteoporosis. The mechanism by which heparin decreases collagen and DNA synthesis appears to be largely unrelated to its effect to decrease PGE₂ production.     

缓激肽促进人肺腺癌细胞株A549的侵袭及其机制

目的 观察缓激肽(BK)对人肺癌细胞株A549迁移、侵袭能力的影响.方法 应用划痕愈合实验和Transwell实验检测BK对40例人肺癌细胞株A549的划痕愈合和运动侵袭能力.通过Western blot分析刺激和抑制缓激肽各20例后基质金属蛋白酶(MMP)-2、MMP-9和E-钙黏素(E-Cadherin)的变化并研究其机制.结果 划痕实验后分别测量愈合距离,结果 示BK组24h和48h后迁移细胞数分别为69.2±3.3、94.1±2.9,而阻断其受体或者ERK1/2通路则迁移细胞数分别为51.2±2.1、73.2±2.7和47.5±3.4、77.6±3.8.Transwell实验检测BK对A549侵袭能力的影响结果 显示BK可以明显促进A549的侵袭能力.阻断BK受体或ERK1/2通路则可以抑制其侵袭能力.结论 缓激肽促进人肺腺癌细胞株A549的迁移和侵袭能力.

Abstract：

Objective To investigate the effect of bradykinin (BK) on human lung cancer cell line A549 migration,invasion ability. Methods Scratch Healing and Transwell assay of bradykinin were used to detect scratch healing and movement on A549 human lung cancer cells. Analysis the changes of matrix metalloproteinase (MMP)-2, MMP-9 and E-Cadherin after stimulate and suppress 20 cases respectively in the aim to describe the mechanism by Western blotting. Results In the former, BK group promote cell migration significantly,migrated cell was 69.2±3.3, 94.1±2.9 respectively after 24 h and 48 h,blocking its receptor or ERK1/2 pathway inhibit migration,migrated cell was 51.2±2.1, 73.2±2.7 and 47.5±3.4,77.6±3.8 after 24 h and 48 h. In the latter,Transwell assay of A549 BK showed invasion of A549 BK can significantly promote the invasion ability of A549 to penetrate the basement membrane of the cell. And blocking BK receptor or ERK1/2 pathway can inhibit the invasion. Conclusion Bradykinin promote human lung adenocarcinoma cell line A549 migration and invasion.     

肾移植患者低密度脂蛋白受体TaqⅠ位点基因多态性及血脂水平检测

目的 探讨肾移植患者脂代谢紊乱的一般特征及低密度指蛋白受体（LDLR）TaqⅠ基因多态性对血脂水平的影响。方法 选择105例肾移植患者为病例组，60例血脂正常的健康人作为对照。检测空腹血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDLC）、高密度脂蛋白胆固醇（DLC）、载脂蛋白及脂蛋白（a）[Lp(a)]水平。采用聚合酶链反应－限制性长度片段多态性方法检测LDLR TaqⅠ基因多态性。结果 病例组于移植后3个月血脂水平即显著增高，于移植后6个月及1年时进一步升高；移植前血清TC、TG高于正常者仅占2.9%和7.6%，移植后3个月增高至28.6%和46.7%（P＜0.01）。移植后6个月升高至40.0%和59.0%，1年时升高至42.9%和62.9%，较3个月时显著升高（P＜0.05）。以TaqⅠ＋／－型人数最多，TaqⅠ＋／＋型最少；对照组Taq基因型分布与病例组的差异无显著性（P＞0.05）；不同基因型的受者血脂水平有所不同，多数指标依TaqⅠ－／－、TaqⅠ /-和TaqⅠ / 顺序递减；对照组因LDLR TaqⅠ基因型的不同，血清TC、LDLC水平的差异具有显著性，病例组除TC和LDLC外，TG、HDLC和Lp(a)的差异也有显著性。结论 肾移植术后易发生脂代谢紊乱，等位基因LDLR TaqⅠ是代谢紊乱发生的危险因子。     

右美托咪定对后腹腔镜手术患者术中血流动力学的影响

目的探讨右美托咪定对行后腹腔镜手术患者术中血流动力学的影响。方法选择择期后腹腔镜手术40例（ASAⅠ~Ⅱ级）,抽签法分成实验组和对照组。实验组患者给予0.5μg.kg-1右美托咪定泵注10 min,对照组患者给予相同剂量生理盐水,随后行常规诱导插管。术中实验组继续泵注右美托咪定0.4μg.kg-1.h-1,对照组给予同等剂量的生理盐水,记录诱导前（T0）、改变体位后1 min（T1）,切皮后（T2）,气腹后即刻（T3）,气腹后30 min（T4）,气腹后60 min（T5）以及气腹结束时（T6）患者BIS、HR、SBP、DBP、MAP以及血流动力学指标,计算相应时点的全身血管阻力（systemic vascular resistance,SVR）;记录术中每小时的丙泊酚用量及血管活性药物的使用情况。结果 2组间各观察时点血流动力学指标比较除T4时点HR有统计学差异（但无临床意义）外,均无明显差异（P〉0.05）。组内不同时点比较：与T1相比,术中各时间点2组患者HR变化不大（P〉0.05）;与T1相比,对照组T2时点MAP上升并持续到T4（P〈0.05）,而实验组患者仅在T3时点短暂上升。2组患者在气腹后中心静脉压均显著上升并持续到手术结束（P〈0.05）。与T1相比,对照组患者在T3时点心排血量（CO）、心脏排血指数（CI）、每搏量（SV）、每搏指数（SVI）均显著升高（P〈0.05）,且持续到T4,此后由于机体的代偿作用以及手术操作趋于平稳;实验组在气腹过程中CO、CI、SV、SVI等血流动力学指标变化没有显著差异（P〉0.05）。手术过程中对照组患者丙泊酚用量（10.7±3.4）mg/kg,显著多于实验组患者丙泊酚用量（6.8±2.6）mg/kg（t=4.075,P=0.000）。结论右美托咪定诱导及维持用药可以抑制气腹开始后的心血管反应,降低术中丙泊酚的用量。     

Prediction of Anticoagulation During Hemodialysis by Population Kinetics and an Artificial Neural Network

All systems currently used for routine hemodialysis require heparin administration to prevent blood clotting in the extracorporeal circuit. We tested the hypothesis that population-based statistical techniques can be used to predict heparin concentrations during routine hemodialysis. Two predictive models were developed, one based on nonlinear mixed effects modeling (NONMEM) and the other on a multilayer perceptron neural network. Serial clotting time data were obtained from forty-nine patients and used to develop the models. The models were used to predict the clotting times of 70 patients in a prospective test. We determined that the neural network provided greater precision, had fewer outliers in its predictions, and did not have the model misspecification in bolus administration that the NONMEM predictions demonstrated. A final NONMEM model was developed using all data from 119 patients to identify important covariates for predicting the heparin pharmacodynamic parameters, volume of distribution, and clearance. Both the volume of distribution and clearance increased following the initiation of dialysis and as the patient's baseline clotting time increased. The volume of distribution also increased as the patient's weight increased but was decreased by smoking and diabetes. Population-based statistical techniques may provide a useful alternative to existing methods for prescribing heparin.     

按摩治疗的生物力学效应及血液动力学改变

本文根据五年的临床观察经验，从生物力学，肢体血流图，微循环三方面重着研究了随机振动手法治疗腰椎间盘突出症的机理，临床治疗１００例观察结果表明：通过镇痛松解手法后，再着重使用随机振动手法，有效率达９５％。根据生物力学原理可知：在突出的腰椎间盘及相邻的两椎体行随机振动手法，不仅使腰椎及椎间盘突在垂直方向产生位移和加速度，而且使锥体前部和后部不断地交替产生的应力和压应力，迫使腰椎间隙前后部呈开合状态，由     

标准通道PCNL对肾脏血流动力学的影响

目的：探讨标准通道经皮肾镜碎石清石术（PCNI。）对肾内血流动力学影响。方法：应用彩色多普勒血流显像测量100例采用标准通道经皮肾镜碎石清石术患者术前、术后即时、术后1周、术后3个月肾脏主动脉、段间动脉、叶间动脉收缩期峰值流速（Vmax）及收缩期峰值（s）与舒张期末流速（D）的比值（S／D）和阻力指数（resistantin—dex,RI）。结果：术后即时的。肾主动脉、段间动脉、叶问动脉的Vmax、S／D、RI值与术前比较,均P〈0．05,差异有统计学意义;但术后1周的。肾主动脉、段问动脉、叶间动脉的Vmax、S／D、RI值与术前比较,均P〈O．05;并且术后3个月的。肾主动脉、段间动脉、叶间动脉的RI值与术前比较,均P％0．05。结论：标准通道经皮肾镜碎石清石术对肾脏血流灌注有短暂影响,但术后1周左右可以恢复,术后3个月肾脏血流灌注有所改善。