建立减压病动物模型的研究

目的为深入研究减压病（DCS）提供复现不同种类动物DCS的基本实验方法,掌握不同种类动物DCS发病的共性并明确减压致病的靶器官。方法使11种动物在不同压力、暴露不同时间,以不同加、减压速率将动物减至常压后,心前区Doppler间断监测气泡音,观察动物发病过程,对一些动物进行球结膜显微和病理学检查。结果所用动物减压后心前区监测到Ⅳ级气泡音,75％～100％发生不同程度的DCS,DCS动物血管痉挛,功能障碍,血管内皮肿胀,出血。结论11种动物都能复现出DCS。不同种类动物DCS发病规律相同,血管是减压致病的靶器官。     

乙醇治疗急性减压病的实验研究

目的 探讨乙醇治疗急性减压病的病因学及其作用机制.方法 将实验兔32只复制成急性减压病(ADCS)模型,随机分为治疗组和对照组,每组16只.放人动物舱内在5 min内加压至0.6MPa,停留30 min,然后用10 min匀速减至常压(0.1 Mpa)出舱.出舱后每隔5 min定时测定Doppler气泡音.戊巴比妥纳20 mg/kg耳缘静脉麻醉后,手术暴露后腔静脉约10 cm作为观察段.治疗组ADCS模型兔在测定Doppler气泡音后,用25%乙醇溶液3 ml/kg,由耳缘静脉缓慢注射入血管内;对照组则由耳缘静脉缓慢注射10 ml生理盐水.然后经后腔静脉直接观察气泡消长情况,分次解剖,整体观察.结果 对照组16只兔,出舱后30 min相继死亡8只,其余在60～100 min时仍有Ⅰ～Ⅲ级Doppler气泡音,后腔静脉、皮下、肌肉、内脏器官及循环系统可见大量气泡,部分血管完全被气泡阻塞.治疗组无死亡,Doppler气泡音在30～60 min内消失.后腔静脉、皮下、肌肉、内脏器官的血管直径增加一倍以上,血流显著增快.血循环内无气泡或有极少量单个气泡.结论 乙醇疗法是一种快速有效、经济实用的消除急性减压病的新方法.     

加压治疗减压病机理的实验研究

目的探讨加压治疗减压病的机理。方法在兔减压病(decompression sickness,DCS)发病后和发展到严重DCS时,人随动物立即被加压到0．5MPa,在压力下Doppler连续监测心前区,间断显微球结膜血管,观察动物行为。结果加压的疗效、循环系统内气泡的消除与微血管功能恢复的速度、程度呈相应关系。血管功能严重障碍或衰竭的动物,在加压和减压过程中,因微血管功能进行性障碍,使病情恶化。结论压力只能消除DCS发病时血液中气体过饱和的膨胀力,使有代偿功能的痉挛血管解痉,恢复血液循环,逆转DCS的发病过程。压力不能使功能严重障碍、衰竭的血管恢复功能、不能修复损伤组织,也不能直接消除循环系统内的气泡。     

高血压病的球结膜微循环

球结膜微循环测定是临床应用的外周微循环检查方法之一，球结膜微血管是全身中最易直接看到并能对微循环的全部流程做深人观察的血管系统。通过测定高血压病人的球结膜微循环情况可了解其全身一般微循环的改变，为早期诊断高血压病提供客观的依据。     

循环系统内注入空气致病机理的探讨

为探讨循环系统内注入空气致病机理，向２２只狗大隐静脉注入不等量空气并在心前区用Ｄｏｐｐｌｅｒ监测心率，心律和气泡音。结果发现，维持心前区Ⅳ级气泡音的１７只狗，依次出现呼吸和心率加快，心律紊乱，心率缓慢，腹式呼吸加强，基中１２只狗继续缓慢注入空气至呼吸停止，任选１０只狗胸外按压，８只狗复苏后行为针异常，２只狗未能复活。另２只狗呼吸停止后立即尸检，可见右心房，室，腔静脉和肺血管中有大量气泡。提示：循环     

急性有机磷中毒后脑水肿MRI表现和病理改变的实验研究

目的建立有机磷农药皮下染毒急性猫中毒模型，观察急性有机磷中毒脑损害MR影像学表现的发生发展规律，比较影像学表现与脑组织病理改变的关系。方法将25只健康猫分为3组，对照组、染毒治疗组、染毒未治疗组。对照组(5只)：腹部皮下4点等量注射生理盐水0．3mE／ks。染毒治疗组(简称染毒组)(15只)：腹部皮下4点等量注射40％N-甲基氨基甲酰甲基硫代磷酸酯(氧化乐果)0．3ml／kg。染毒后2min肌内注射0．5mg／kg硫酸阿托品，然后视动物流涎、流泪情况酌情肌内注射阿托品。染毒未治疗组(5只)：腹部皮下4点等量注射40％氧化乐果0．3ml／kg。对染毒后3、6、24h脑MRI表现与相应时间点脑组织病理检查结果进行对照研究。结果氧化乐果皮下染毒制作猫急性中毒模型，染毒后6、24hMR图像出现脑水肿。HE染色光学显微镜(简称光镜)和透射电子显微镜(简称电镜)观察，3h开始即出现广泛水肿表现，同时存在细胞毒性水肿和血管源性水肿，三者形态学表现相一致。电镜观察显示血脑屏障出现形态学变化，延髓6、24h电镜切片中观察到神经元细胞质近三角形类晶体样物质。结论氧化乐果染毒急性脑水肿模型成功建立，中毒后脑水肿为混合性水肿，MRI出现异常表现稍晚于病理改变。     

口服酒精溶液对豚鼠高空减压气泡生成的影响

目的为建立高空减压病易感性的筛选指标提供实验依据，我们观察了豚鼠口服酒精后高空减压时体内气泡生成的变化。方法30只豚鼠随机分成3组，其中两组分别在口服50％酒精溶液4.0和8．0ml后10.min和20min减压至13000m高度。用超声多普勒装置检测豚鼠心前区气泡音。结果口服8．0ml酒精溶液后减压，气泡生成明显增加（P＜0．01），血浆表面张力明显降低（＜0．01）。结论减压前饮酒能明显促进动物高空减压气泡的生成。     

在动物内比较三维分子靶向超声成像和三维动态对比增强超声对结肠癌早期抗血管生成治疗疗效评估

正摘要目的在动物内比较用靶向临床分级的血管内皮生长因子受体2(VEGFR2)的微气泡进行三维分子靶向超声成像和用非靶向微气泡进行三维动态对比增强超声对人结     

高空减压气泡的多普勒超声检测

1968年，Spencer等以及Gillis等将多普勒(Doppler)超声血流测定技术加以改进，应用于高压一减压实验动物血管中气泡的检测以来，现已发展为广泛使用的无创性人体心前区气泡检测方法，成为潜水医学、航空航天医学中减压病的有效研究手段之一，并为该领域谱写了新篇章。我国海军医学研究所1975年首先开始应用Doppler超声技术于科研工作，也已获得一定成果。     

硝酸羟胺对兔皮肤及眼睛的刺激性观察

目的 观察硝酸羟胺对家兔皮肤及眼睛的刺激作用. 方法 健康家兔30只.采用硝酸羟胺直接涂抹皮肤,分为急性皮肤刺激(310 mg/kg)和慢性皮肤刺激(0.74 mg/kg、5.85 mg/kg和62 mg/kg 3个剂量组),分别观察涂抹部位皮肤反应.一定剂量硝酸羟胺滴入动物一侧眼睛,分为30 s后温水冲洗组和不冲洗组,观察动物角膜、虹膜和结膜损伤情况及球结膜水肿情况. 结果 皮肤直接涂抹后给药区域出现红斑、水肿,慢性刺激62 mg/kg剂量组全身症状较严重,第3次给药后80%动物死亡.眼内滴入硝酸羟胺后1h动物开始出现结膜充血、球结膜水肿,部分动物同时伴有角膜混浊、虹膜变暗及褶皱加深等表现. 结论 硝酸羟胺对家兔皮肤具有中等刺激性,并可通过皮肤引起全身中毒症状,反复较大剂量给药可致动物死亡;对家兔眼睛局部具有轻度刺激性.     

长跑运动对老年人球结膜微循环影响的初步探讨

本文对70名老年长跑队员进行球结膜微循环观察,井以77名非长跑运动健康老年人作对照。观察结果均采用田牛氏加权积分法计分评定。结果表明,老年长跑运动组的形态积分、流态积分、周围状态积分与总积分值均显著低于非长跑运动对照组。老年长跑运动组球结膜微循环主要指标的异常发生率明显少于非长跑运动对照组。长跑运动依跑龄时问长短,反映球结膜微循环的加权积分值不同,跑龄越长,加权积分值越低。提示:长跑运动对改善老年人微循环障碍有明显的效应,长期坚持长跑运动,对维持老年人全身微循环始终保持良好状态有重要作用。     

Self-expanding versus balloon-mounted stents for vessel recanalization following embolic occlusion in the canine model: technical feasibility study

BACKGROUND AND PURPOSE: Despite advances in mechanical thrombolysis for acute stroke, recanalization rates remain approximately 50%-60%. Technologic improvements allowed safe intracranial delivery of stents. To study the feasibility of stent-assisted recanalization for acute stroke, we deployed self-expanding or balloon-mounted stents in 2- to 3.5-mm canine vessels acutely occluded with clot emboli. METHODS: Six mongrel dogs were placed under general anesthesia. A guiding catheter was placed in the distal vertebral artery or an external carotid artery branch. A 7 x 3 mm (length x diameter) soft or hard clot was injected into the catheter and allowed to embolize distally; 20 vessels were successfully occluded. After systemic heparin anticoagulation, recanalization with a self-expanding stent was attempted in 11 vessels (5 occluded with soft clot; 6, with hard clot). Balloon-mounted stents were placed in an attempt to revascularize 9 vessels (4 occluded with soft clot; 5, with hard clot). Vessel recanalization was assessed as the primary end point. Side-branch occlusion and stent-induced vasospasm were also assessed. RESULTS: Thrombolysis in Myocardial Infarction/Thrombolysis in Cerebral Infarction flow for 11 vessels treated with self-expanding stents versus 9 treated with balloon-mounted stents was as follows: grade 3, 91% of vessels versus 78% of vessels; grade 2, 0% versus 11%; grade 1, 9% versus 0%; grade 0, 0% versus 11%. Lower rates of spasm and side-branch occlusion were noticed with self-expanding stents. Grade 2/3 flow was achieved in 18/20 vessels (90%). CONCLUSIONS: Excellent recanalization was demonstrated with both stents. Recanalization in self-expanding stents was achieved without pre- or post-balloon dilation. Stents may prove to be a useful adjunct for intra-arterial acute stroke treatment.     

国产乙烯-乙烯醇聚合物的动物实验研究

目的研究国产乙烯-乙烯醇(EVAL)聚合物栓塞动物模型的技术可行性及栓塞效果。方法家猪6头,体重25~30kg,雌雄不限,全麻下,超选择插管至咽升动脉/奇网(retemirable,RMB),在持续透视下,缓慢注入国产EVAL聚合物,对血管进行栓塞,直至满意为止。对猪进行随观,随观期限分别为1d、1周、4周、8周、12周、24周,随观内容包括DSA复查、大体标本及组织病理学观察。结果所有的动物均成功进行了栓塞,除1头家猪由于返流过度“挤管”外,其余的栓塞及拔管顺利,造影显示所有的栓塞血管均未显影。大体标本显示血管内可见黑色栓塞物铸型,自尾侧向头端弥散,质实,容易剥离。病理显示急性期血管壁不同程度的破坏,栓塞剂周围及血管外可见中性粒细胞及嗜酸性粒细胞浸润以及大量的红细胞;亚急性期及慢性期可见单核细胞浸润和不同程度的肉芽组织/纤维化。结论作为非黏附性液体栓塞材料,EVAL聚合物是一种具有栓塞可控性好,易判断栓塞的开始和终结点的较理想栓塞物。     

3D-FIESTA-C联合3D-TOF-MRA序列在面肌痉挛微血管压迫的诊断价值

目的 评价3D-FIESTA-C联合3D-TOF-MRA序列在诊断原发性面肌痉挛微血管压迫的应用价值.方法 回顾性分析经微血管减压术(MVD)的84例原发性面肌痉挛患者的影像学资料,所有患者均采用3D-FIESTA-C和3D-TOF-MRA序列扫描,以MVD手术结果为金标准,对比分析3D-FIESTA-C、3D-TOF...     

Ophthalmic Artery Embolization as Pretreatment of Orbital Exenteration for Conjunctival Squamous Cell Carcinoma

The aim of this study is to describe the effect of transarterial embolization from the ophthalmic artery as a pretreatment for orbital exenteration. A 75-year-old Chinese man with a 7-year history of gradual increase of the left eye swelling showed a massive conjunctival tumor growing outwardly from the interpalpebral fissure and had no light perception in the left eye. Magnetic resonance imaging showed orbital invasion of the tumor around the left eyeglobe. The initial surgery for the planned orbital exenteration was discontinued after skin incision around the orbital margin due to massive hemorrhage. The patient underwent transarterial embolization with gelatin sponge (Spongel) of the feeding arteries from the left ophthalmic artery and, the next day, had orbital exenteration with well-controllable bleeding and reconstruction with free vascularized anterolateral thigh cutaneous flap transfer. Pathologically, well-differentiated squamous cell carcinoma proliferated in exophytic, papillary, and nested fashions, arising from the bulbar conjunctiva. Tumor cells were also found in the conjunctival stroma around the vessels. The sclera at the equator had a perforated site with tumor cell invasion, but no intraocular invasion was found. Hematoxylin-positive gelatin sponges were found inside the orbital vessels and large choroidal vessels. In conclusion, transarterial embolization of feeding arteries arising from the ophthalmic artery is a useful pretreatment to control bleeding at orbital exenteration for malignancy.     

Coronary angiography and thallium-201 single photon emission computed tomography in single vessel coronary artery disease

Polar presentations of selective coronary angiography and myocardial 201T1 SPECT were compared in 49 patients with single vessel disease. Twenty-six lesions were located in LAD, 8 in LCX and 15 in RCA. Perfusion defects were found within the supply area of 44 stenotic and 20 non-stenotic arteries. 201T1 SPECT detected coronary disease in 45 patients (92%) and the obstructed artery in 44 (90%). Single vessel disease was correctly indicated in 28 patients (57%) where the perfusion defects did not extend significantly outside the area supplied by the stenotic artery. Extensive perfusion defects could be explained by 'collateral steal', myocardial disease, LV aneurysm or spasm in 9 patients (18%). The absence of perfusion defect related to the stenotic artery could be explained by a moderate degree of stenosis or well developed collateral vessels in 5 patients (10%). Proximal LAD lesions resulted in larger perfusion defects than distal.     

DSA在断指再植血管评价中的价值

目的 探讨DSA在评价断指再植血管及血流状况中的价值.方法 12例断指再植患者术后2～4 d行再植指体DSA检查,观察再植指体血管轮廓、吻合口形态、血液动力学改变、有无血管痉挛或血栓及侧支循环建立情况,根据造影结果 确定进一步的处理方案.结果 共27条吻合血管中,DSA全部显示清晰,其中9例23条吻合血管血流通畅,均存活,断指再植指体早期存活诊断符合率为100%(23/23).2例(右手中指和无名指各1例)吻合血管中断,考虑重度血管危象,即行手术探查发现血栓;1例(左手无名指和小指)吻合动脉痉挛变细,提示轻度血管危象,经保守治疗最终存活.DSA对4条吻合血管病变均检出.结论 DSA能够对再植指体血供重建和血液循环情况作出客观、准确的评价,在指导临床对再植指体的进一步处理及预测再植指体早期存活方面具有重要意义.     

Occlusion during iliac angioplasty: a salvageable complication

During transluminal dilation of the iliac artery, occlusion resulting from dissection occurred in four patients. In all four, the deteriorating clinical findings prompted surgical intervention. In three patients, Fogarty balloon catheters easily passed the occluded segments and specimens much the same as surgical endarterectomy specimens were retrieved. A clamp was used to retrieve the dissected portion of the vessel wall in the fourth patient. Three of four vessels have remained patent for 18 months, 18 months, and 6 months, respectively. One patient underwent bypass surgery 4 months after the occlusion episode for recurrent stenosis in a segment of vessel above the occluded segment, which had also been dilated during the same procedure. It is therefore possible in some cases to salvage vessels occluded during angioplasty, making it unnecessary to resort to aortofemoral or other type of bypass.