内皮祖细胞移植治疗慢性深静脉血栓形成的实验研究

目的 研究内皮祖细胞(endothelial progenitor cells,EPCs)移植对慢性深静脉血栓的治疗作用. 方法 Ficoll法分离大鼠骨髓单个核细胞(bone marrow-derived mononuclear cells,BMMNCs),采用内皮祖细胞培养基(EGM-2MV)诱导分化为骨髓源性EPCs.建立大鼠慢性深静脉血栓模型,饲养至10 d,并分三组:A组(25只):单纯EPCs组,移植1 ml含有10~6 个EPCs细胞悬液;B组(25只):EGM-2MV培养基对照组,移植1 ml EGM-2MV培养基;C组(25只):空白对照组.移植后第14天取出血栓段下腔静脉及血栓,应用HE染色及vWF免疫组化染色观察血栓机化再通情况,高倍镜下计数血栓内毛细血管数目;Western blot检测血管内皮生长凶子(VEGF)、碱性成纤维细胞生长因子(bFGF)的蛋白表达变化;实验数据采用SPSS13.0软件进行分析.结果 体外成功培养了骨髓源性EPCs和构建了大鼠慢性深静脉血栓模型,EPCs移植后A组VEGF、bFGF的表达有明显的上调(P＜0.05).B组和C组之间差异无统计学意义(P＞0.05).移植后A组血栓再通毛细血管数目明显高于B、C组.免疫组化染色vWF确定再通管道为新牛血管,管道为内皮细胞组成.结论 EPCs为内皮细胞的前体细胞,移植到深静脉血栓中能够促进血管新生,加快血栓的机化和再通.     

非急性早期症状性椎动脉颅内段闭塞的血管内治疗策略

目的探讨药物治疗时间窗外的症状性椎动脉颅内段(ICVA)闭塞患者行血管内治疗的安全性和有效性。方法回顾性分析2014年1月至2019年12月间北京大学第一医院神经外科连续收治的9例接受血管内治疗的非急性早期症状性ICVA闭塞患者的临床资料。男性7例, 女性2例, 年龄63.4岁(范围:52～72岁)。术前患者改良Rankin量表评分4.3分(范围:4～5分), 美国国立卫生研究院卒中量表(NIHSS)评分12.3分(范围:8～18分)。其中2例患者行同期血管内治疗;7例患者行分期血管内治疗, 即一期应用微导丝通过闭塞病变并球囊成形, 使血流保持在脑血流灌注分级系统分级2b级及以上, 随后通过抗血小板药物及自身纤溶系统溶解病变部位附壁血栓;二期于残余重度狭窄部位行支架植入术。采用NIHSS评分及改良Rankin量表评分评价患者神经功能改善情况, 记录血管内治疗的并发症及血管再通情况。结果 2例同期血管内治疗患者虽经积极治疗后闭塞血管均再通, 但1例术中出现血栓移位, 1例出现拉栓后血管再次闭塞;分期治疗的7例患者中6例血管再通, 出院时NIHSS评分平均5.7分(范围:3～14分);术后...     

血管内再通治疗症状性颅内动脉非急性期闭塞的临床效果

目的探讨血管内再通治疗症状性颅内动脉非急性期闭塞病例的安全性和可行性。方法回顾性收集2017年1月至2019年10月于北京医院神经外科行血管内再通治疗的25例症状性颅内动脉狭窄的连续病例资料。男性20例, 女性5例, 年龄(60.5±11.0)岁(范围:41～73岁)。术前改良Rankin量表评分为2(2.5)分[M(QR)](范围:1～5分)。颅内动脉闭塞时间为40(54)d(范围:17～570 d)。分析患者血管内治疗情况、临床和影像学随访结果及并发症情况。结果 25例患者共接受27例次血管内再通治疗, 其中20例次获得成功, 技术成功率为74.1%;3例次(11.1%)出现手术相关并发症, 其中1例次为导丝穿破动脉导致出血, 1例次为动脉夹层出血, 1例次为穿支闭塞;永久性并发症发生率为3.7%(1/27)。25例患者全部进行了临床随访, 中位随访时间8个月(范围:1～33个月), 改良Rankin量表评分改善或稳定者23例(92%)。1例(4%)出院后2个月出现新发缺血症状, 1例(4%)因卧床相关并发症死亡。20例再通成功的患者获得影像学检查随访, 中位随访时间为4个月(范围...     

介入疗法在急性肢体动脉闭塞治疗中的应用价值

目的探讨介入疗法在急性肢体动脉闭塞治疗中的应用价值。方法回顾性总结28例急性肢体动脉闭塞介入治疗经验。采用经皮血管腔内成形术和动脉内溶栓术治疗上肢动脉闭塞5例、腹主动脉下段闭塞1例、下肢动脉闭塞22例。结果经术后4个月~9年临床观察,急性单段动脉闭塞血管再通率为100%(8/8例)、多段动脉闭塞血管再通率为80%(16/20例),总血管再通率为85.71%(24/28例)。结论介入疗法是治疗急性肢体动脉闭塞的一种有效方法,值得推广应用。     

WIFi分级用于预测糖尿病足合并周围血管病变病人下肢血管再通后伤口愈合效果研究

目的 探讨2014年美国血管外科协会颁布的WIFi分级用于预测糖尿病足合并周围血管病变病人下肢血管再通后的伤口愈合效果评价的临床意义。方法 2013年1月至2016年1月,上海交通大学附属第六人民医院对109例糖尿病足合并周围血管病变病人行下肢血管再通成功,根据伤口愈合结果分为伤口愈合组（n=64）和未愈合组（对照组,n=45）;分析两组临床资料和WIFi分级情况,并通过单因素、多因素和Logistic回归分析总结糖尿病足合并血管病变病人行下肢血管再通后伤口愈合的独立危险因素。结果 两组病人年龄、性别、踝肱指数（ABI）、血白蛋白、总胆固醇（TC）、饮酒史、吸烟史、糖化血红蛋白（HbA1c）、创面大小、发生溃疡时间、空腹血糖、糖尿病病程以及心脑血管合并疾病比例差异均无统计学意义（P＞0.05）,单因素分析提示WIFi分级中的创面分级（W）和缺血分级（I）在伤口愈合中具有预测意义（P<0.01）。多因素回归分析中创面等级和下肢缺血程度是延缓血管再通后伤口愈合时间的危险因素（P<0.01）。二元Logistic回归显示WIFi分级中的I分级是预测血管再通后影响伤口愈合的独立危险因素（P<0.01）。 结论 WIFi分级对糖尿病合并周围血管病变病人血管再通后预测伤口愈合情况具有较好的预测和评估价值。     

脑血管串联狭窄血管内治疗的临床效果

目的初步评价脑血管缺血性串联狭窄行血管内治疗的效果及安全性。方法回顾性分析2013年1月至2018年12月于北京大学第一医院神经外科收治的因2处脑血管狭窄行同期血管内治疗的35例症状性前循环、后循环串联狭窄患者的临床资料。男性27例,女性8例,年龄(65.6±9.4)岁(范围:47~81岁);前循环串联狭窄14例,后循环串联狭窄21例。记录患者术后临床症状、影像学检查结果及改良Rankin量表(mRS)评分等。结果35例患者共植入支架68枚,其中颅外植入49枚,颅内植入19枚,手术成功率100%;围手术期无死亡病例,1例出现术后脑出血(2.9%)。所有患者随访至术后18个月。术后3~12个月,1例(1/35,2.9%)患者出现支架内再狭窄,4例(4/35,11.4%)患者仍有头晕、肢体无力等症状,所有患者mRS评分≤2分,无新发卒中事件;术后12~18个月,新增3例支架内再狭窄患者,支架内再狭窄率为11.4%(4/35),32例患者mRS≤2分(32/35,91.4%)。结论症状性串联狭窄患者同期实施血管内治疗的可操作性强,近期效果良好。     

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下肢静脉疾病与先天性血管疾病在临床表现上有诸多相似之处 ,容易混淆。本文将着重介绍下肢静脉疾病 (单纯性大隐静脉曲张、深静脉血栓形成后综合征 )与先天性血管畸形 (先天性动静脉瘘、先天性静脉畸形骨肥大综合征 )的各自病因、病理特点及检查手段。1　病因学鉴别按血流动力学变化 ,可将下肢静脉疾病分为两大类型 :(1)血液倒流性病变 :均由瓣膜本身的病变引起。主要包括原发性深静脉瓣膜功能不全、单纯性大隐静脉曲张、深静脉血栓形成后完全再通型 (管道再通 ,但瓣膜已破坏 )、先天性深静脉无瓣症等。约占下肢静脉病的 70 %。 (2 )回流障…     

抗阻运动对小鼠深静脉血栓血管生成的影响

背景与目的：目前有证据支持急性深静脉血栓形成（DVT）患者在充分抗凝基础上早期活动,并不增加肺栓塞的风险,反而可以改善患者症状,但抗阻运动对DVT血管生成的影响鲜有研究。本研究旨在探讨抗阻运动能否促进DVT的血管生成,从而促进静脉血栓再通。方法：将72只成年雄性C57BL/6J小鼠通过狭窄下腔静脉方法构建DVT模型,并随机分为模型组和抗阻运动组,抗阻运动组小鼠通过尾部负重法进行抗阻运动干预,模型组小鼠不做任何干预。两组分别于造模后7、14、28 d处死部分小鼠取材,取材前通过超声观察静脉血栓情况。HE染色法观察小鼠静脉血栓及肺组织病理情况;计算血栓再通率;ELISA法检测各组小鼠血清中血管内皮生长因子（VEGF）的表达水平;免疫组化染色检测小鼠静脉血栓的血管内皮生长因子A (VEGF-A),血管内皮生长因子受体2 (VEGFR-2)和血小板内皮黏附分子（CD31）的表达情况,并计算CD31阳性血管数;qRT-PCR法检测含有血栓的静脉组织VEGF和VEGFR-2 mRNA表达情况。结果：超声发现两组小鼠术后血栓大小逐渐减小;与模型组比较,术后28 d抗阻运动组小鼠血栓大小和管腔直径明显...     

血管新生过程中CD105的表达变化及其作用

目的 建立基于人脐静脉内皮细胞(HUVEC)、纤维蛋白基质及微载体的体外三维新生血管模型,在此模型的基础上,研究CD105在血管新生过程中的表达变化及其作用.方法 分离、纯化并培养HUVEC;建立三维新生血管模型: 将HUVEC包被于微载体(Cytodex-3)上,然后将该包被有HUVEC的微载体包埋于纤维蛋白凝胶基质中,在培养体系中内皮细胞生长因子的作用下完成HUVEC的出芽、分支、连接成网等过程.通过逆转录-聚合酶链反应(RT-PCR)检测血管新生不同时期CD105的表达情况,并利用反义寡核苷酸技术干预CD105的表达,观察抑制CD105表达后HUVEC与血管新生过程的表形变化.结果 包埋于三维纤维蛋白基质中的HUVEC出现出芽、分支、连接成网等典型的血管新生过程;在此过程中,CD105的表达在出芽早期及出芽分支期明显增强,而在出芽前及成网后的相对稳定期则呈不表达或弱表达状态.利用反义寡核苷酸抑制CD105表达后,HUVEC的生长及新生血管模型中的出芽、分支过程均受到明显抑制.结论 CD105在血管新生的不同阶段表达水平不同,在出芽、分支期明显过表达;CD105参与了血管新生过程,抑制CD105的表达可以有效地抑制血管新生.     

门静脉高压症大鼠食管胃底侧枝循环形成机制研究

目的 观察缺氧诱导因子(HIF)-1α和血管内皮生长因子(VEGF)在门静脉高压症大鼠贲门及周围组织血管的表达,探讨其在门静脉高压症食管胃底侧枝循环形成机制中的作用.方法 对肝前型门静脉高压症模型组80只和假手术对照组20只的贲门及周围组织行HIF-1α和VEGF免疫组织化学染色,测定其表达并进行相关性分析.结果 肝前型门静脉高压大鼠模型术后30 d小网膜组织内出现小静脉血管内皮细胞的细胞质和细胞核内出现阳性反应的棕黄色颗粒,术后60 d食管胃底组织肌层及黏膜下层新生静脉血管内皮细胞的细胞质和细胞核内出现阳性反应的棕黄色颗粒.对照组呈阴性或弱阳性.差异有统计学意义(P《0.05).结论 HI-1α和VEGF过度表达可能在门静脉高压食管胃底侧枝循环形成中起重要作用.     

Effect of Edaravone on Favorable Outcome in Patients with Acute Cerebral Large Vessel Occlusion: Subanalysis of RESCUE-Japan Registry

The data of the nationwide prospective registry of acute cerebral large vessel occlusion (LVO; RESCUE-Japan Registry) were analyzed to know the effect of edaravone, a free radical scavenger, on clinical outcome at 90 days after onset. In this registry, patients with acute cerebral LVO admitted within 24 h after onset were prospectively registered. The effect of various factors including endovascular treatment (EVT), intravenous recombinant tissue plasminogen activator (IV rt-PA), and other medication including edaravone on favorable outcome (modified Rankin scale 0–1) was analyzed. Of the 1,454 registered patients, 1,442 patients (99.2%) had the information of edaravone were analyzed. In total, edaravone group had more patients with favorable outcome compared to non-edaravone group (22.9% vs. 13.8%, p = 0.0006). Edaravone increased favorable outcome in patients treated with IV rt-PA (29.4% vs. 11.1%, p = 0.0107), but not with EVT (21.2% vs. 13.9%, p = 0.309). Logistic regression analysis revealed that higher National Institutes of Health Stroke Scale (NIHSS) score on admission [odds ratio (OR) 0.875, 95% confidence interval (CI) 0.858–0.894] and advanced age (OR 0.963, 95%CI 0.952–0.975) were significantly related to unfavorable outcome. In contrast, IV rt-PA (OR 2.489, 95%CI 1.867–3.319), EVT (OR 1.375, 95%CI 1.013–1.865), and edaravone (OR 1.483, 95%CI 1.027–2.143) were significantly associated with favorable outcome. This analysis indicated that IV rt-PA, EVT, and edaravone were effective to obtain favorable outcome in patients with acute LVO. Combination IV rt-PA with edaravone was more effective.     

Endovascular Treatment of Acute Stroke with Major Vessel Occlusion before Approval of Mechanical Thrombectomy Devices in Japan: Japanese Registry of Neuroendovascular Therapy (JR-NET) and JR-NET 2

The aim of this study was to clarify the general status and historical transition of endovascular therapy (EVT) of acute stroke with major vessel occlusion before approval of mechanical thrombectomy devices in Japan from January 2005 to December 2009. We extracted 1,409 acute ischemic stroke patients receiving EVT (513 women, 69.8 ± 11.8 years) from two nationwide registry studies, the Japanese Registry of Neuroendovascular Therapy (JR-NET) and JR-NET 2. The median baseline National Institutes of Health Stroke Scale (NIHSS) score was 18, and 81.3% of the patients received EVT within 6 hours after symptom onset. The culprit occluded arteries were the internal carotid artery (ICA) in 21.2%, middle cerebral artery (MCA) in 53.0%, and basilar artery (BA) in 20.6%. Intravenous thrombolysis was administered to 6.7% of the patients, and EVT mainly consisted of intra-arterial thrombolysis and percutaneous balloon angioplasty/balloon clot disruption. The final recanalization rate was 82.5%, and the clinical outcome was favorable in 35.8% and fatal in 11.6% at 30 days after onset or at discharge. There was no significant change in neurological severity at baseline throughout the study period, but the onset-to-treatment time became longer and the proportion of ICA or BA occlusion increased annually. Although the final recanalization rate was similar throughout the study period, the incidence of a favorable outcome tended to decreased annually from 41.0% to 29.0%. These results could be considered as baseline data that can be used to validate the beneficial effects of novel EVT devices in Japan.     

Local intraarterial fibrinolytic therapy for embolic stroke associated with vascular anomalies--two case reports

Two cases of embolic stroke associated with vascular anomalies were treated by intraarterial fibrinolytic therapy. A 78-year-old male had embolic stroke associated with fenestration of the middle cerebral artery (MCA). The embolus lodged in the terminal portion of the right internal carotid artery (ICA) and in the M2 portion of the right MCA. The fenestration was not detected before local fibrinolytic therapy, but was identified by postinterventional angiography. An 82-year-old female had a left-sided persistent primitive trigeminal artery (PPTA), and the embolus lodged in the terminal portion of the left ICA. Left internal carotid angiography also showed rich collateral circulation via the abundant leptomeningeal anastomosis. The PPTA involved the left ICA, so the anomalous anatomy had to be considered in performing local thrombolysis. However, the rich collateral circulation allowed recanalization of the occluded ICA without inducing bleeding. Dissolution of persistently adherent emboli must be performed with great care because of the possibility of such rare vascular anomalies.     

动脉内机械取栓治疗急性后循环缺血性脑卒中临床效果及预后影响因素

目的探讨机械取栓治疗急性后循环缺血性脑卒中患者的临床效果及预后影响因素。方法对15例急性后循环缺血性脑卒中患者行动脉内机械取栓治疗,统计血管成功再通率,并观察术后24 h内脑出血、脑梗死等不良反应发生情况。术后3个月随访,以改良Rankin量表(mRS)评估患者预后;对比预后良好(mRS评分0～2分)与不良(mRS评分3～6分)患者间基线资料及治疗相关指标的差异。结果对15例患者均成功开通闭塞血管,血管成功再通率100%(15/15)。术后24 h内1例发生脑出血,5例发生大面积脑梗死。术后3个月9例患者预后良好,5例预后不良,1例死亡。与预后不良患者比较,预后良好患者发病至入院时间更短(t=-2.435,P=0.030),入院时后循环Alberta卒中项目早期CT评分(pc-ASPECTS)更高(t=5.925,P0.001),术前美国国立卫生研究院卒中量表(NIHSS)评分更低(t=3.053,P=0.009)。结论动脉内机械取栓治疗急性后循环缺血性脑卒中效果好且安全性高;发病至入院时间、术前NIHSS评分及pc-ASPECTS是影响患者预后的因素。     

A case of distal posterior cerebral artery aneurysm associated with occlusion of the internal carotid artery

Hemodynamic stress is considered one of the most important factors in the growth of cerebral aneurysms. The authors report a rare case of cerebral aneurysm located at the distal posterior cerebral artery (PCA) in which collateral circulation developed due to occlusion of the internal carotid artery (ICA). A 73-year-old male was admitted to our hospital with a sudden headache and nausea. Computerized tomography (CT) revealed an intracerebral hematoma in the right parieto-occipital lobe and the acute subdural hematoma in both the cerebral interhemispheric fissure and the convexity. Moreover, angiography revealed a saccular aneurysm at the P4 portion of the PCA. The right ICA was occluded at the cervical portion and collateral circulation which had developed in the PCA was extended to the region of the right middle cerebral artery. The aneurysm was clipped 15 days after admission without new neurological complications. This case demonstrates that increased hemodynamic stress plays a role in the growth and rupture of cerebral aneurysm.     

钆塞酸二钠增强MRI影像组学对肝血管瘤腹腔镜肝切除术后疗效的预测价值

目的 探讨钆塞酸二钠（Gd-EOB-DTPA）增强MRI影像组学对肝血管瘤腹腔镜肝切除术疗效的预测价值。方法 选取2018年2月至2020年10月行腹腔镜肝切除术治疗的肝血管瘤患者131例作为研究对象。采用计算机产生随机数法将131例肝血管瘤患者以7:3的比例分为训练集（92例）和验证集（39例）,分别用于构建和验证预测模型效能。根据术后是否出现并发症将训练集患者分为预后不良组和预后良好组,比较两组患者的临床特征资料。使用最小绝对收缩和选择算子（the least absolute shrinkage and selection operator,LASSO）回归5折交叉验证方法筛选训练集临床和影像组学特征,得到最优特征子集。使用机器学习算法构建预测模型,并使用受试者工作特征（receiver operating characteristics,ROC）曲线评价各模型对肝血管瘤术后疗效的预测价值。结果 训练集中预后良好64例,预后不良28例,两组在慢性疾病、肝血管瘤最大径、血管瘤数、血管瘤供血动脉支数、肝切除大小、术中出血量方面差异均有统计学意义（P<0.05）。依据LASSO回归中的最佳λ取值筛选出14个非零系数特征构成的最优特征子集,其中包括12个组学特征和2个临床特征。利用训练集筛选出的最优特征子集构建Logistic回归、CatBoost、XGBoost和LightGBM模型的AUC分别为0.820、0.722、0.784、0.693。验证集构建的Logistic回归、CatBoost、XGBoost和LightGBM模型的ROC曲线下面积（AUC）分别为0.814、0.706、0.785、0.684。4种机器学习模型的预测效果良好,其中Logistic回归的预测效果优于其他3种。结论 血管瘤最大径和血管瘤数目,结合Gd-EOB-DTPA增强MRI影像组学,以此构建的机器学习模型可用于预测肝血管瘤腹腔镜肝切除术后疗效,其中Logistic回归算法构建的模型更加精准。     

Endovascular interventions for patients with serious symptoms caused by embolic carotid T occlusion

The efficacy of endovascular interventions based on magnetic resonance (MR) imaging for acute ischemic stroke caused by embolic carotid T occlusion was assessed. Endovascular intervention was performed in 10 of 751 consecutive acute ischemic stroke patients admitted to our institution between April 2001 and July 2003. Indications were: presentation within 6 hours of onset of cardioembolic stroke; National Institute of Health Stroke Scale (NIHSS) score ≥ 10 on admission; absence of extensive signal hyperintensity on diffusion-weighted imaging; and carotid T occlusion on angiography. Localized intra-arterial thrombolysis using urokinase and/or mechanical clot disruption using micro-balloon catheter were performed. Radiographic findings, ΔNIHSS defined as NIHSS on day 7 - NIHSS on admission, 3-month modified Rankin scale (mRS), 3-month mortality, and symptomatic intracranial hemorrhage (ICH) were evaluated. Partial recanalization was achieved in 5 of 10 patients, but no recanalization was obtained in 5 patients. No significant differences in 3-month mRS (0-2) or symptomatic ICH were identified between these groups. However, the partial recanalization group showed significantly better clinical outcomes (median 3-month mRS 3 vs. 6, p = 0.009) and lower mortality rate at 90 days (0% vs. 80%, p = 0.047) with significantly greater ΔNIHSS (-8 vs. +6, p = 0.009). Endovascular intervention based on MR imaging resulting in partial recanalization may reduce poor outcomes and mortality in patients with embolic carotid T occlusion. Improvement of the outcomes of such patients requires more efficient methods such as clot retrieval therapy.     

Can diffusion- and perfusion-weighted magnetic resonance imaging evaluate the efficacy of acute thrombolysis in patients with internal carotid artery or middle cerebral artery occlusion?

OBJECTIVE: The value of combined diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) for detecting ischemic lesions of patients with acute ischemic injury was analyzed. Combined pre- and posttreatment DWI and PWI studies were used to assess the efficacy of intra-arterial thrombolysis. METHODS: Intra-arterial thrombolysis was performed within 6 hours of onset in 10 patients who presented with acute middle cerebral artery or internal carotid artery occlusion. DWI and PWI obtained before and after treatment were studied. The final T2-weighted magnetic resonance scans were obtained 1 month after onset. Thrombolysis resulted in recanalization in seven patients. The mismatch ratio percentage ([initial PWI-initial DWI/initial PWI] x 100) and the rescued ratio percentage ([initial PWI-final T2/initial PWI] x 100) were calculated. The National Institutes of Health Stroke Scale (NIHSS) was used for neurological assessment of stroke severity at admission and at 1 month after onset. RESULTS: In all patients, the mismatch ratio was greater than 60% (mean +/- standard deviation, 81.7 +/- 16.7%) and was significantly correlated with initial NIHSS score (-0.74; P = 0.03), and the rescued ratio was significantly correlated with the NIHSS score 1 month after the insult (r = -0.83; P = 0.01). In patients who exhibited recanalization of the occluded artery (n = 7), the mean rescued ratio was 89.6 +/- 12.8% (range, 63-100%). In addition, the lesion volume on posttreatment DWI scans and final T2-weighted magnetic resonance images was not enlarged; on posttreatment PWI scans, it was significantly decreased. The NHISS score at 1 month after the insult (2.3 +/- 2.1) was markedly improved as compared with the initial NHISS score (10.7 +/- 3.9). CONCLUSION: In a small number of patients who presented with internal carotid artery or middle cerebral artery occlusion, the DWI/PWI mismatch ratio correlated with the initial neurological severity. The rescued ratio may be an objective indicator of the efficacy of treatment.     

胰腺残端捆绑结扎对胰腺远端切除术后胰瘘的影响

目的:探讨胰腺残端捆绑结扎对胰腺远端切除术后胰瘘的影响。方法:采用回顾性病例对照研究方法。收集2011年1月至2018年8月内蒙古医科大学附属医院收治的60例胰体尾部病变行胰腺远端切除术病人的临床资料;男24例,女36例;中位年龄为45岁,年龄范围为19~68岁。60例病人中,36例离断胰腺仅采用直线切割闭合器,设为未...     

Hyperbaric oxygen combined with intravenous edaravone for treatment of acute embolic stroke: a pilot clinical trial

The efficacy of hyperbaric oxygen (HBO) therapy combined with intravenous edaravone (free radical scavenger) administration was prospectively investigated in patients with acute embolic stroke involving the anterior cerebral circulation. Patients with acute embolic stroke in the anterior cerebral circulation admitted within 48 hours of onset from August 2001 to March 2002 with National Institutes of Health Stroke Scale (NIHSS) scores on admission of 5 or more were assigned randomly to HBO and control groups. The HBO group underwent HBO therapy combined with intravenous edaravone administration for 7 days, whereas the control group received only conventional treatment. The primary endpoint was the modified Rankin Scale score at 90 days (favorable outcome, score 0 or 1). The secondary endpoint was the NIHSS score at 7 days. Analysis was carried out by intention to treat. Six of the 19 patients in the HBO group, but only one of the 19 patients in the control group, had favorable outcomes at 90 days (p < 0.05), although NIHSS score at 7 days did not differ significantly between the two groups. HBO therapy combined with intravenous edaravone administration appears to be effective for the treatment of patients with acute embolic stroke in the anterior cerebral circulation.