国产Firebird支架治疗2型糖尿病合并冠心病患者的临床疗效观察

目的:观察国产Firebird支架在2型糖尿合并冠心病患者中的临床疗效.方法:纳入我院2005年3月至2006年12月行冠状动脉介入治疗(Percutaneous coronary intervention,PCI)的2型糖尿合并冠心病患者共90例,其中Firebird支架组47例,普通支架组43例,术前术后除常规使用阿司匹林和波立维外,同时给予严格的内科强化治疗,术后进行随访,观察2组的临床疗效.结果:冠状动脉造影显示2支以上血管病变占71.11%,一共植入Firebird支架74枚,普通支架55枚,所有患者均获得成功.平均随访(10.2±3.3)月,其中药物支架组复发心绞痛3例(6.4%),主要心脏不良事件2例(4.2%);普通支架组复发心绞痛13例(30.2%),主要心脏不良事件13例(30.2%).国产Firebird支架组心绞痛复发率以及主要心脏不良事件发生率均低于普通支架组,差异显著(6.4%比30.2%,P相似文献   

国产药物洗脱支架的疗效评价

目的 评价国产药物洗脱支架治疗冠状动脉病变的临床疗效.方法 对47例冠心病冠脉病变患者置入药物涂层长支架(63枚).随访2～12个月,记录病死率、靶血管重建率及主要心血管事件发生率.结果 对47例患者进行随访,病死率、靶血管重建率和主要心脏事件发生率分别为2.1%、2.1%和6.4%.结论 国产药物洗脱支架在进行冠状动脉支架置入治疗中是安全和有效的.     

垠艺支架与Firebird支架治疗冠心病合并糖尿病患者疗效比较

目的:探讨药物涂层支架在冠心病合并糖尿病患者介入治疗中的临床疗效。方法:并发糖尿病的冠心病患者90例常规冠状动脉造影,进行经皮冠状动脉介入治疗,其中44例植入国产雷帕霉素药物涂层支架(Firebird组),46例植入国产紫杉醇药物涂层支架(垠艺组),术前术后常规使用阿司匹林和氯吡格雷,术后进行随访。结果:冠状动脉造影显示2支以上血管病变占83.3%,Firebird组植入雷帕霉素药物涂层支架77枚,垠艺组植入垠艺支架82枚,所有患者均获得成功。平均随访6.2±1.3个月,其中Firebird组复发心绞痛3例,1例发生心肌梗死。垠艺组复发心绞痛3例,1例发生心肌梗死。Firebird组发生再狭窄2例,垠艺组发生再狭窄2例。两组无支架内血栓形成和死亡。结论:垠艺支架对冠心病并发糖尿病患者的近期疗效与Firebird支架相似。     

药物洗脱支架在冠心病超长病变择期经皮冠状动脉介入治疗中的应用

目的 评价药物洗脱支架应用于冠心病超长病变(≥50 mm)的安全性、有效性.方法 选取68例行经皮冠状动脉介入治疗(PCI)的冠心病超长病变患者置入Cypher支架、Firebird支架及Taxus支架,记录患者的治疗、在院期间和随访等情况.结果 68例患者PCI治疗均获成功,共置入Cypher支架84枚、Firebird支架42枚、Taxus支架69枚.1例合并糖尿病者术后出现支架内亚急性血栓,2例发生非Q波型心肌梗死,其他患者住院期间均无严重并发症发生.随访6～12个月,患者均未发生主要心脏不良事件,36例患者术后6～9个月行冠状动脉造影复查,其中3例发生支架内再狭窄并行外科搭桥术.结论 药物洗脱支架在冠心病超长病变PCI治疗中安全、有效,但需进一步评价.     

国产生物可降解涂层帕霉素洗脱支架的临床研究

目的观察国产生物可降解涂层雷帕霉素洗脱支架植入后的有效性和安全性.方法连续观察169例冠心病住院患者病情变化,常规进行冠状动脉造影及支架植入.主要观察术后(14.0±7.4)个月无主要不良心脏事件(MACE)生存率.术后急性、亚急性及晚期迟发支架血栓发生率,以及术后6-12个月冠脉造影随访.结果169例患者214支血管247处痛变共植入287枚支架.术后(14.0±7.4)个月无MACE生存率98.8%;可能的亚急性支架血栓发生率0.6%,晚期迟发支架血栓发生率0.6%.术后6-12个月冠状动脉造影随访的支架再狭窄为0.结论国产生物可降解涂层雷帕霉素药物支架用于冠状动脉病变的介入治疗是有效且安全的.     

冠脉内植入国产金属裸支架的临床观察

目的评价国产冠脉金属裸支架(乐普H-stent支架)临床应用的有效性和安全性。方法选择48例冠心病患者行冠脉内支架植入术,植入63枚国产乐普H-stent金属裸支架。结果48例患者术后随访6~24(16.6±7.8)个月,38例症状消失(79.2%),10例术后心绞痛复发(20.8%),再狭窄6例(12.5%),新生血管病变4例(8.3%),随访期间无死亡、急性心肌梗死病例发生。结论国产H-stent金属裸支架应用于冠脉介入治疗安全有效。     

Excel雷帕霉素药物洗脱支架临床应用安全性及疗效评价

目的:探讨国产Excel雷帕霉素药物洗脱支架对冠心病患者介入治疗的安全性和近中期疗效。方法:2006年7月~2009年6月共对240例冠心病患者进行介入治疗。术后随访6~24个月,观察有无心绞痛、心肌梗死、猝死及再次血管重建事件。结果:272处病变血管(de novo病变269处,再狭窄病变3处)共使用327枚Excel支架,成功置入支架325枚,2例患者支架置入失败(1例前降支近中段病变严重钙化扭曲,支架不能通过病变;1例回旋支中段病变成角大于90度,支架不能通过成角血管),置入支架成功率99%,5例分别于术后8~18个月出现心绞痛症状,复查造影发现2例发生支架内再狭窄,3例血管造影未见支架再狭窄。1例术后5个月出现疑似晚期支架血栓形成(发生心室颤动)。4例患者术后6个月左右发生上消化道出血,其中1例住院输血治疗。术后6~24个月内主要不良反应事件发生率4.58%。结论:Excel雷帕霉素药物洗脱支架治疗冠心病,具有良好的安全性和满意的近中期临床效果。     

药物洗脱支架介入治疗冠心病三支病变合并糖尿病患者的临床观察

目的:观察冠心病三支病变合并糖尿病患者置人药物洗脱支架的安全性及近、中期疗效.方法:2003年10月～2007年10月间57例经冠状动脉造影证实为冠心病三支病变合并糖尿病的患者置入药物洗脱支架.男38例、女19例,年龄41～79岁,平均62岁,其中稳定型心绞痛17例,不稳定型心绞痛40例.糖尿病史2～12年,其中胰岛素治疗26例,采用常规经皮冠脉介入治疗.结果:全部患者支架置入成功,临床症状明显好转或消失,57例患者共治疗193处病变,置入药物洗脱支架277枚.1例(1.8%)患者术后d4支架内亚急性血栓形成.41例(71.9%)患者术后6个月行冠脉造影,3例(7.3%)患者支架内再狭窄,选择外科搭桥治疗.随访12个月.无死亡、心肌梗死等严重心脏事件发生.结论:药物洗脱支架治疗冠心病三支病变合并糖尿病患者安全有效,近、中期效果好,远期疗效有待证实.     

国产生物可降解涂层雷帕霉素药物支架临床应用长期随访观察

目的：观察国产生物可降解涂层雷帕霉素洗脱支架治疗冠心病原发病变的长期有效性和安全性。方法：88例冠心病住院患者经单一国产生物可降解涂层雷帕霉素洗脱支架介入治疗,并予长期随访。主要研究终点为术后1年的主要不良心脏事件,次要研究终点为术后长期随访中的各种不良事件及平均14个月冠脉造影判定的支架内再狭窄发生率。结果：88例患者105处病变共植入131枚支架,术后1年内有3例患者复发心绞痛住院,复查造影2例证实为支架内再狭窄,1年主要心脏不良事件发生率为3.4%;术后平均随访22个月,其中2例患者非心源性死亡,2例心源性死亡,无美国学术研究联合会（ARC）定义的血栓事件发生;31例（35%）患者（45处病变）术后平均14个月接受冠脉造影复查,定量冠脉造影测量4处靶病变再狭窄,再狭窄率为8.8%。结论：国产生物可降解涂层雷帕霉素药物支架用于冠状动脉原发病变的介入治疗是有效且安全的。     

雷帕霉素洗脱支架直接介入治疗急性心肌梗死的疗效观察

目的:探讨国产雷帕霉素洗脱支架在急性心肌梗死(AMI)直接介入治疗中的有效性和安全性。方法:选择2005年8月至2008年1月就诊于我院心脏病科诊断AMI的患者共7l例,剔除严重左主干病变、多支弥漫性病变、经皮冠脉介入术(PCI)无法处理的患者。主要观察术后平均12～18个月的无主要不良心脏事件(MACE,包括心源性死亡、心肌梗死、靶血管再次介入治疗)生存率、术后急性、亚急性及晚发血栓的发生率。结果:71例患者90支血管的104处病变共植入113枚支架,1例患者急性支架内血栓形成,71例患者完成了随访。随访期间未发生支架内再狭窄。术后18个月无MACE生存率为100%,支架急性血栓发生率1.4%。结论:国产雷帕霉素洗脱支架对急性心肌梗死直接介入有良好的有效性和安全性。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.