聚乙烯醇和明胶海绵联合栓塞治疗急性大咯血

目的 探讨聚乙烯醇(PVA)和明胶海绵(GS)联合栓塞支气管动脉治疗急性大咯血临床疗效。方法 采用Seldinger法，对内科治疗无效的47例患者，在电镜引导下经支气管动脉进行栓塞，GS组21例，PVA GS组26例，并随访2年。结果 随访1个月GS组有效率(19／21)90．5％，PVA GS组有效率(23／26)88．5％；随访6个月GS组有效率(12／21)57．1％，PVA GS组有效率(20／26)76．9％；随访2年GS组有效率(5／21)23．8％，PVA GS组有效率(17／26)65．4％。结论：PVA GS联合栓塞支气管动脉治疗急性大咯血疗效好，复发率低。     

应用海藻酸钠微球支气管动脉栓塞治疗大咯血的临床研究

目的 观察不同栓塞剂与栓塞效果及并发症的关系，探讨海藻酸钠微球（KMG）支气管动脉栓塞治疗大咯血的临床意义。方法 112例大咯血患者，行选择性或超选择性支气管动脉栓塞，单纯明胶海绵栓塞69例，含KMG微球栓塞26例，明胶海绵及金属弹簧圈双重栓塞17例。随访1-12个月，再次栓塞为复发病例。结果 即刻止血107例（95．5％），1年内复发16例。明胶海绵组复发率15．0％；含KMG组复发率7．7％；弹簧栓子组复发率17．6％；总复发率为14．3％；3组间复发率差异无显著性（P〉0．05），但并发症差异有显著性（P〈0．05）。结论 合理的选用栓塞物质可明显降低咯血患者的复发率及并发症的发生率，KMG微球支气管动脉栓塞治疗大咯血安全、高效，能有效地减少复发率和并发症的发生。     

选择性支气管动脉栓塞治疗大咯血的临床应用

目的 探讨选择性支气管动脉栓塞（SBAE）治疗大咯血的疗效。方法 采用股动脉穿刺放入导管,对42例大咯血或长期反复咯血患者行DSA确定出血血管,然后对病变血管进行栓塞。共栓塞病变血管55支。结果 栓塞治疗24h内,42例中的40例（95．24％）被成功止血。随访6～72个月,仪3例肺癌与2例肺结核患者偶有痰中带血。所有病例未发生严重的栓塞相关并发症。结论S BAE治疗大咯血是一种高效、安全、操作简便的治疗方法,值得进一步推广。     

选择性支气管动脉栓塞术治疗大咯血失败原因分析

目的探讨选择性支气管动脉栓塞术（SBAE）治疗大咯血失败的原因。方法对12例经内科药物治疗无效的大咯血患者,行选择性支气管动脉栓塞术。结果 12例大咯血患者中治愈8例,治愈率为66.7%,有效2例,总有效率为83.3%,无效2例,无效率为16.7%。结论充分认识并避免可能导致选择性支气管动脉栓塞术治疗大咯血失败的原因,才可以提高其疗效。     

肺结核大咯血的介入治疗

目的探讨肺结核大咯血的介入诊断与治疗。方法对213例肺结核大咯血患者行支气管动脉造影（BAG）＋支气管动脉栓塞术（BAE）治疗。结果行支气管动脉栓塞术（BAE）后，经1周、1个月、3个月的疗效观察，大咯血止血成功率分别可达99．5％、95．5％、94．4％，随访6个月成功率达93．4％。结论对肺结核大咯血的病理基础，栓塞材料及方法选择、介入止血无效的原因进行了讨论，认为经由内科治疗无效又无外科手术条件的肺结核大咯血病人，介入治疗是一种有效手段。     

介入治疗大咯血的支气管造影与栓塞

目的讨论介入治疗的支气管造影与栓塞对不同的肺部疾病所引起的大咯血的应用价值。方法所有59例病人均采用SELDINGER技术经股动脉穿刺插管行数字减影血管造影（DSA），明确病变部位或出血动脉后，采用永久性栓塞剂灭菌真丝线段或／和金属钢圈，经支气管动脉或／和肋间动脉行拴塞术。结果59例病人有31例咯血立即停止，即时止血率达52．5％，21例咯血在1周内渐止，4例病人咯血次数及咯血量均有不同程度的减少，介入治疗近期有效率达88．14％（52／59）。在1～4年的随访中，良恶性病变3个月内复发率分别为6．45％（2／31）、42．86％（12／28），1年内复发率分别为78．57％（22／28），9．68％（3／31）。结论介入治疗对肺部大咯血近期疗效确切，但远期疗效与疾病的性质，血供情况，病灶大小及栓塞剂的选用密切相关。     

选择性支气管动脉栓塞术治疗心脏术后急性大咯血17例

心脏术后大咯血不常见,一旦发生,常常起病急,病情凶险,死亡率高达60%以上[1]。抢救性止血最为重要,我科采用选择性支气管动脉栓塞术(selective bronch ial artery emboli-zation,SBAE)治疗心脏术后急性大咯血17例,取得了满意的疗效,结果如下。1对象和方法1.1对象2003年1月~2005     

大咯血的介入治疗及复发的影响因素分析

目的观察大咯血不同介入治疗效果及复发的影响因素。方法本次实验选取2013年3月~2016年3月我院收治的大咯血患者104例作为研究对象,按照供血方式分为两组,按照栓塞方法分为三组。分析比较不同组别大咯血患者的治疗有效率、复发率、栓塞成功率等情况。结果大咯血患者多支动脉供血的复发率明显大于单支动脉供血,差异有统计学意义(P0.05)。结论在大咯血的治疗过程中单纯应用明胶海绵栓塞和多支动脉供血更容易导致介入栓塞治疗后复发且时间较短。在治疗过程中应尽量避免应用这种组合的治疗方式。单只动脉供血且选用PVA颗粒联合明胶海绵栓塞能够更好的保证治疗有效率,减少复发率,值得临床进一步推广使用。     

支气管动脉栓塞术后肺结核再咯血的综合治疗

目的探讨肺结核大咯血行支气管动脉栓塞术（BAE）后再次出现咯血的综合治疗方法。方法总结1997年8月至2006年2月间289例肺结核大咯血行BAE治疗失败后再次出现咯血的42例患者。根据咯血量的多少，采用不同的治疗措旌．20例小量咯血应用云南白药和止血芳酸治疗，22例中至大量咯血患者联合应用蛇毒血凝素和人工冬眠治疗。结果20例小量咯血经云南白药和止血芳酸治疗后，有效止血率95．0％，22例中至大量咯血联合应用蛇毒血凝素和人工冬眠治疗，有效止血率为86．4％。结论肺结核大咯血行BAE后再次出现小量咯血可以采取常规治疗，中至大量咯血联合应用蛇毒血凝素和人工冬眠不失为有效的治疗手段。     

支气管动脉栓塞术治疗肺结核咯血的中远期疗效评价

目的探讨支气管动脉栓塞术治疗肺结核咯血的中远期疗效。方法对1124例肺结核咯血病人行支气管动脉栓塞术。术后全部进行了随访,时间18～96个月,平均60±8个月,分析其临床特点及治疗效果。结果1124例全部达到即刻临床止血,即刻止血100％;2例（0．18％）术后出现脊髓损伤;中远期复发57例,复发率5．1％。结论支气管动脉栓塞术创伤小、痊愈快、并发症少,应视为治疗肺结核咯血的重要方法。     

Erythropoiesis Inhibiting Factor(s) (EIF)

The specificity and toxicity of the urinary erythropoiesis inhibiting factor (EIF) has been tested both in vivo and in vitro. When EIF was given to ESF stimulated erythropoietically suppressed polycythaemic mice and to mice at maximal endogenous erythropoietic stimulation, a reduction of the erythroid bone marrow cells, the erythropoietic ³H-TdR L.I. and the total number of bone marrow cells were observed. No effect was seen on the myelopoietic bone marrow cells. An unspecific toxic effect was unlikely, since addition of EIF did not alter the proliferation of lymphoblastic cells nor change the glucose utilization of bone marrow cells in vitro. Neither did the amount of dead bone marrow cells increase after being incubated with EIF for 72 h. The results indicate that the urinary EIF is a non-toxic, cell specific inhibitor on erythropoiesis.     

脂蛋白（a）和载脂蛋白（a）多态性与女性冠心病的相关性研究

冠心病（ＣＨＤ）在病因、发病年龄等诸多方面存在性别差异。载脂蛋白（ａ）［ａｐｏ（ａ）］多态性与脂蛋白（ａ）［Ｌｐ（ａ）］血浆水平对女性ＣＨＤ影响的资料甚少。我们通过检测３５例女性ＣＨＤ患者和４５例女性正常对照者的ａｐｏ（ａ）多态表型及Ｌｐ（ａ）水平，并与相应的男性组对比分析，发现含有等位基因Ｓ１、Ｓ２、Ｂ的ａｐｏ（ａ）低分子量表型的ＣＨＤ患者，女性占３７．１４％，显著高于对照组，而男性仅占２５．７１％，与对照组比较差异无显著性。在女性中低分子量表型发生ＣＨＤ危险度为对照组的４．７倍，在男性中仅为１．４倍。提示：低分子量表型对女性ＣＨＤ的影响大于男性。Ｌｐ（ａ）水平在两性ＣＨＤ组均明显高于对照组，而两性之间则差异无显著性。     

Compound heterozygosity of Hb D(Iran) (beta(22) Glu-->Gln) and beta(0)-thalassemia (619 bp-deletion) in India

The present report describes the hematologic and molecular study of the second case of Hb D(Iran) associated with beta(0)-thalassemia (619 bp-deletion) found in India and the first case in which the mutations have been identified at molecular level. The patient showed hypochromic, microcytic red cell picture with reduced red cell indices. The characterization of the hemoglobinopathy was made by electrophoretic and chromatographic techniques and confirmed by sequencing of the beta-globin gene. Both the propositus and her father were found to be carriers of the gene for beta(0)-thalassemia owing to the 619 bp-deletion mutation as seen by the polymerase chain reaction (PCR). Single base substitution GAA > CAA (indicative of Hb D(Iran)) in the heterozygous form was seen in the propositus as well as the mother by sequencing.     

Fibrodysplasia (myositis) ossificans progressiva (FOP)

Clinical Rheumatology -     

Platelet HDL(3) binding sites are not related to integrin alpha(IIb)beta(3) (GPIIb-IIIa)

Early studies considered that fibrinogen receptor (glycoprotein [GP] IIb-IIIa or platelet integrin alpha(IIb)beta(3)) is the binding site for low-density lipoprotein (LDL) and high-density lipoprotein type 3 (HDL(3)). Recent data, however, do not support the hypothesis that the binding of LDL to human intact resting platelets is related to integrin alpha(IIb)beta(3). In this study we present evidence that platelet integrin alpha(IIb)beta(3) is also not involved in the interaction of HDL(3) and human intact resting platelets. Firstly, specific ligands for platelet integrin alpha(IIb)beta(3), such as fibrinogen, vitronectin, von Willebrand factor and fibronectin, were unable to inhibit the binding of HDL(3) to intact resting platelets. Secondly, the HDL(3) binding characteristics (K(d) and B(max) values), the activation of protein kinase C (PKC) and the inhibition of thrombin-induced inositoltriphosphate (IP(3)) formation and calcium (Ca(2+)) mobilization mediated by HDL(3) particles were similar in platelets from control subjects and patients with type I and type II Glanzmann's thrombasthenia, which are characterized by total and partial lack of GPIIb-IIIa and fibrinogen, respectively. In contrast, nitrosylation of tyrosine residues of HDL(3) by tetranitromethane fully abolished both the ability of particles to interact with its specific binding sites and the functional effects. Thirdly, polyclonal antibodies against the GPIIb-IIIa complex (edu-3 and 5B12), human antiserums against platelet alloantigens (anti-Bak(a/B) and anti-PL(A1/2)), anti-integrin subunits (anti-alpha(V) and anti-beta(3)), and a wide panel of monoclonal antibodies (mAbs) against well-known epitopes of GPIIb (M3, M4, M5, M6, M8 and M95-2b) and GPIIIa (P23-7, P33, P37, P40, and P97) did not affect the binding of HDL(3) particles to human intact resting platelets. Overall results show that neither the GPIIb-IIIa complex nor GPIIb or GPIIIa individually are the membrane binding proteins for HDL(3)on intact resting platelets.