MRCP诊断梗阻性黄疸的价值评价

目的：探讨共振胆胰管成像（MRCP）在梗阻性黄疸定位、定性诊断中的应用价值。方法：采用重T2加权TSE序列采集、MIP法三重建,并与US、CT、ERCP／PTC及手术和病理相对照。结果：MRCP定位诊断准确率达100％,优于US（P＜0．05）,与CT、ERCP／TPC无显著差异;MRCP结合常规MRI定性诊断准确率达89．7％,优于US（P＜0．025）,与CT、ERCP／PIC无显著差异。结论：MRCP安全、简便、无创伤,在梗阻性黄疸的定位、定性诊断上具有很高的敏感性、准确性,是诊断性ERCP／PTC的有效替代方法。     

电针对不稳定膀胱影响的穴位特异性研究

目的：研究不同穴位电针治疗不稳定膀胱的尿动力学改变及其特异性。方法：将60只大鼠随机分为肾俞组、会阳组、肾俞加会阳组、药物组、模型组、假手术组，并给予相应处理；治疗12h后观察各组逼尿肌压力、膀胱顺应性、膀胱容量的变化。结果：各治疗方法均可改善USB大鼠的尿动力学状态；各治疗组尿动力改善情况较模型组显著（P〈0．05），且各穴位组尿动力改善与药物组相似；会阳组、肾俞加会阳组对不稳定膀胱大鼠尿动力学改善优于药物组、肾俞组（P〈0.05）；会阳组与肾俞加会阳组之间无明显差异。结论：会阳穴、会阳加肾俞穴可特异性地改善USB尿动力状态，抑制逼尿肌不稳定收缩，增加膀胱容量和膀胱顺应性。     

卵母细胞衰老的分子病因学研究进展

卵母细胞衰老是女性自然衰老的开始,在分子层面了解导致卵母细胞衰老的原因和机制,对于抑制与年龄相关的疾病和促进女性健康长寿至关重要。本文对卵母细胞衰老的分子病因机制,从基因组的完整性和稳定性、线粒体功能障碍、端粒缩短、DNA损伤修复、表观遗传学改变、以及神经内分泌级联反应等几个方面展开详细综述。     

Short and long-term outcomes of two drug eluting stents in bifurcation lesions

Background Because no large prospective studies are available, this study evaluated the clinical outcomes of two drug eluting stents in bifurcation lesions. Methods Lesions with diameter of side branch ≥2.5 mm were selected. From October 2003 to June 2005, 112 patients with 113 bifurcation lesions were treated by two drug eluting stents （DESs）, technique. The location of bifurcation lesions were left anterior descending coronary artery/diagonal in 62 patients, left main distal bifurcation in 32, left circumflex coronary artery/obtute marginal branch in 18 and right coronary artery distal bifurcation in 1. Procedures for bifurcation lesions were crush or modified crush technique in 64, ＂T＂ stenting technique in 27, modified ＂Y＂ stenting, kiss stenting, ＂V＂ stenting as well as culotte stenting technique in 11, 5, 3 and 3, respectively. Among 226 lesions, 91 Cypher or Cypher select stents, 74 TAXUS and 67 Firebird were used. Final kiss balloon dilation was performed in 60 （93.7%） with crush technique after stenting. Results Success rate of percutaneous coronary intervention for the bifurcation lesions was 100%. One patient, who developed inhospital acute myocardial infarction due to subacute thrombosis, was successfully treated by a second intervention. Major adverse cardiac events rate in-hospital was 0.89% （1/112） and during followup was 7.14% （8/112）, No death occurred during the followup of all patients. Angiographic followup was effected for 46 patients, restenosis for eight, coronary artery bypass grafting for 1 and a repeat intervention for 5. Restenosis involving TAXUS, Cypher and Firebird was 5 （5/18, 27.8%）, 2 （2/17, 11.8%） and 1 （1/11, 9.1%）, respectively （P〉0.05）. Total restenotic rate was 17.4% （8/46）. Conclusions When ostium of side branch has severe stenosis and 〉12.5 mm in diameter, two-stent strategy in this bifurcation lesion is safe and effective, and the outcomes are satisfactory. Restenotic rates were not different between TAXUS, Cypher and Firebird DESs.     

Comparison of immediate and followup results between transradial and transfemoral approach for percutaneous coronary intervention in true bifurcational lesions

Background  A comparison of efficacy and safety between transradial and transfemoral approach for percutaneous coronary intervention (PCI) in bifurcations has not been done. This study evaluated feasibility of transradial PCI (TRI) and compared the immediate and followup results with transfemoral PCI (TFI) in bifurcations.
Methods  One hundred and thirty-four consecutive patients with bifurcations were treated with PCI in our hospital from April 2004 to October 2005. Of these, there were 60 patients (88 lesions) in TRI group and 74 patients (101 lesions) in TFI group. Bifurcations type was classified according to the Institut Cardiovasculaire Paris Sud Classification.
Results  TRI group had smaller stent diameter ((3.06±0.37) mm vs (3.18±0.35) mm, P=0.023) and postprocedural in-stent minimum lumen diameter ((2.62±0.37) mm vs (2.74±0.41) mm, P=0.029) than TFI, but there were not significant differences in in-stent subacute thrombosis rate (0% vs 1.0%, P=0.349),  target lesion revascularization (TLR) (0% vs 1.0%, P=0.349) following procedure and thrombosis (2.3% vs 1.0%, P=0.482), in-stent restenosis (12.5% vs  10.9%, P=0.731), in-segment restenosis (17.0% vs 14.9%, P=0.681), TLR (10.2% vs 13.9%, P=0.446) and TLR-free cumulative survival rate (89.8% vs 86.1%, P=0.787) at seven months followup. No death was reported in the two groups.
Conclusion  Transradial intervention is feasible and appears to be as effective and safe as transfemoral PCI in treatment of true bifurcational lesions.

     

Incidence of thrombosis after implantation of drug-eluting stents in patients with coronary artery disease

Background Randomized clinical trials have demonstrated equivalent safety to bare-metal stents after drug-eluting stents （DES） implantation. However, the DES thrombosis in randomized trials could not be comparable to those observed in clinical practice, frequently including off-label indications. This study sought to assess the incidence of DES thrombosis after implantation of DES in patients with real world coronary artery disease （CAD） in China.
Methods From December 2001 to April 2007, 8190 consecutive patients received the treatment with DES, 5412 patients completed one year follow-up： 2210 with sirolimus-eluting stent Cypher, 1238 with paclitaxel-eluting stent Taxus and 1964 with Chinese sirolimus-eluting stent Firebird, After two years of follow-up, there were 2176 patients （1245 Cypher, 558 Taxus and 373 Firebird）. All patients were treated with aspirin and clopidogrel over at least 9 months.
Results Among 8190 patients, 17 patients had acute stent thrombosis （0.24%）： 7 in the Cypher group, 4 Taxus and 6 Firebird; 23 patients had subacute stent thrombosis： 8 Cypher, 6 Taxus and 9 Firebird. The incidence of acute and subacute thrombosis was 0.49%： 0.50% Cypher, 0.63% Taxus and 0.41% Firebird. The incidence of late thrombosis at one year followup was 0.63%： 0.63% Cypher, 0.88% Taxus and 0.46% Firebird; at two year follow-up the incidence was 0.74%： 0.72% Cypher, 0.90% Taxus and 0.54% Firebird. There was no significant difference among three groups at 1 year and 2 years follow-up.
Conclusion The first generation DES in the treatment of complex lesions are safe and effective if patients are aggressively treated with dual antiplatelet agents.     

Lack of sexual knowledge blamed for HIV/AIDS among Latin American youths

Lack of sexual knowledge is the main culprit for HIV/AIDS among Latin American youths, said Chilean expert Raquel Child, who also blamed the authorities for not doing enough to help youngsters deal with the deadly disease.     

Effects of Nω-nitro-L-arginine methyl ester and aminoguanidine on lipopolysaccharide-induced airway hyperresponsiveness in guinea pigs

Background The down-regulation of constitutive nitric oxide synthase （cNOS） and up-regulation of inducible nitric oxide synthase （iNOS） are associated with the allergen-provocated airway hyperresponsiveness （AHR）. This study aimed to determine whether their alteration also plays an important role in the AHR induced by lipopolysaccharide （LPS）. Methods Hartley male guinea pigs, weighing between 250 g and 350 g, were injected with LPS at a dose of 1 mg/kg every 24 hours for three days. A non-selective NOS inhibitor, N~-nitro-L-arginine methyl ester （L-NAME）, or a selective inducible NOS inhibitor, aminoguanidine （AG）, were used thirty minutes before each injection of LPS. Airway reactions, nitric oxide （NO） production and inflammatory changes were detected 24 hours after the last dose of LPS. Results AG significantly decreased the NO production in the bronchoalveolar lavage fluid （BALF） and sharply reduced the intensity of bronchoconstdction to histamine challenge. L-NAME also significantly decreased the NO production in the BALF, but had no effect on airway reactions or, perhaps, a tendency to enhance the intensity of AHR. Conclusions The data suggest that inducible NOS contributes to the AHR induced by repetitive intraperitoneal LPS, and constitutive NOS was also involved.     

彩色多普勒超声诊断下肢深静脉血栓的价值

目的探讨彩色多普勒超声诊断下肢深静脉血栓的价值。方法对32例下肢深静脉血栓形成患者进行检查,观察血栓形成的部位、大小、栓塞程度。结果32例(35条患肢)下肢深静脉血栓形成,其中单发于左下肢20例,单发于右下肢9例,双下肢同时患病3例。彩色多普勒超声诊断正确31例(96.9%),1例漏诊(3.1%)。结论彩色多普勒超声对下肢深静脉血栓的诊断具有重要价值,应作为无创性检查的首选方法。     

乌司他丁对婴儿体外循环中细胞粘附分子变化的影响

目的:探讨婴儿体外循环中细胞粘附分子的变化及乌司他丁对其的影响。方法:60例1岁以下先心病患儿随机分为乌司他丁组(U组,UTI20000U/kg,溶解于20ml生理盐水中)和对照组(C组,20ml等量生理盐水)。分别在体外循环不同时点采集血样,检测血管内皮细胞粘附分子-1(ICAM-1)和中性粒细胞整合素β-2亚族中的CD11b/CD18的蛋白表达量并观察其变化;检测血气值并计算呼吸指数(RI)。结果:体外循环后两组ICAM-1和CD11b/CD18的表达量均显著增加,RI上升,但乌司他丁组各相应值明显低于对照组(P<0.05)。结论:婴儿体外循环中,ICAM-1、CD11b/CD18和RI值均有明显升高,乌司他丁可减缓此变化过程。