改良的阴道紧缩术

目的:探讨更安全有效的阴道紧缩方法。方法:应用埋没导引缝合技术行保留粘膜的阴道两侧壁紧缩术22例,不切除阴道粘膜,经阴道两侧壁处女膜痕处切口,应用埋没导引缝合技术,紧缩阴道两侧肛提肌。结果:所有患者无并发症,部分患者随访半年到两年,效果良好。结论:该方法安全简单可靠,有推广应用价值。     

新一代基因组编辑技术在基因治疗及生物制药领域中的应用

近年来,随着锌指核酸酶、转录激活子样效应因子核酸酶和成簇可调控间隔短回文重复RNA引导核酸酶的出现,“基因组编辑”技术得到广泛应用。由于此类技术具有高效和可定制的特点,在基因治疗、细胞模型、糖基化工程、细胞工程等方面许多新策略、新方法不断涌现,产生了十分重要的影响。本文就近年来基因组编辑技术的发展及其在基因治疗和生物制药领域的应用进行综述。     

微化地奥司明片在糖尿病足溃疡愈合中的应用价值

目的探讨地奥司明片治疗糖尿病足患者中的临床效果。方法选择2008年8月~2009年8月收治的72例糖尿病足患者,按照Wagner分级,随机分配为2组,以治疗前后患足创面大小变化情况作为评价指标。结果地奥司明组治愈27例(75.0%),好转7例,(19.4%),无效2例(5.5%),治疗后创面大小变化与治疗前比较,差异有统计学意义(P<0.05)。对照组治愈14例(38.9%),好转13例(33.3%);无效9例(25.0%),治疗后创面大小变化与治疗前比较,差异无统计学意义(P>0.05)。结论地奥司明片能有效促进糖尿病足患者创面愈合时间,值得临床推广。     

高血压大鼠视网膜和肾脏微血管损害的实验研究

目的：探讨高血压大鼠视网膜和肾脏微血管损害及两者的关系。方法：手术切除大鼠一侧肾脏，部分结扎另一侧肾动脉，建立高血压动物模型，对照组模拟手术。活体检查大鼠眼底，检测肾功能，采用常规光镜组织化学染色、免疫组织化学染色、电镜和组织化学电镜等技术,观察大鼠术后2周、1个月、2个月、4个月4个不同时间点视网膜和肾脏微血管的改变。结果：①高血压大鼠眼底和肾功能从术后2个月起即有明显损害；②高血压大鼠视网膜毛细血管基底膜（retinal capillary basement membrane,RBM）和肾小球毛细血管基底膜（glomerular capillary basement membrane,GBM）从术后2个月起即普遍增厚；③高血压大鼠RBM和GBM的增厚伴有其构成成分Ⅳ型胶原和层粘连蛋白增多，并伴有RBM和GBM上负电荷位点数目的减少；④高血压大鼠视网膜毛细血管和肾小球毛细血管分别在术后2周和1个月时出现内皮细胞下水肿，与其底膜脱离的现象；⑤高血压大鼠病程4个月时视网膜毛细血管周细胞水肿变性，肾小球毛细血管上皮细胞病变较轻。结论：高血压大鼠视网膜和肾脏损害有共同的病理学基础：毛细血管内皮细胞下水肿，与基底膜脱离；基底膜增厚，伴有其上负电荷位点数目的减少。高血压大鼠视网膜和肾脏毛细血管的改变又有其独特性。     

自体髓核移植接触神经根后大鼠诱发电位及神经显微结构的观察

目的:探索髓核移植接触神经根后对大鼠诱发电位及神经显微结构的影响。方法:20只SD大鼠随机分成2组,A组、B组分别取大鼠自体皮下筋膜脂肪及尾部的髓核组织,无压迫下放置在L4~5神经根周围。分别在术前、术后即刻、术后3天检测大鼠术侧诱发电位。3天时处死大鼠,进行神经根的病理切片观察。结果:A组大鼠感觉及运动诱发电位手术前后没有明显变化,B组诱发电位潜伏期延长。神经显微结构观察,A组少量炎性细胞浸润,B组神经外膜水肿、大量炎性细胞侵润,髓鞘水肿。结论:髓核接触神经根后可引起神经周围急性炎症病理改变,并引起神经传导功能的下降。     

LED-蓝光对大鼠肝再生TNF-α、IL-6的影响

目的探讨LED-蓝光对大鼠肝大部切除肝再生后TNF-α、IL-6含量变化的影响。方法健康雄性Wistar大鼠24只,随机分为3组,假手术组、模型组及LED干预组。采用Higgins改良方法制备大鼠70%肝切除后肝再生的模型,在手术后的不同时间点,检测血清中TNF-α、IL-6的含量变化。结果各实验组动物在手术后1 d血清中TNF-α、IL-6的水平均有升高,模型组和LED干预组的TNF-α、IL-6水平均高于假手术组(P<0.05),且LED干预组的TNF-α、IL-6水平均显著高于模型组;在术后3 d假手术组血清TNF-α、IL-6水平即趋于正常,而模型组和LED干预组TNF-α、IL-6水平达高峰;在术后5 d和7 d,模型组和LED干预组血清中TNF-α、IL-6的水平开始下降,但LED干预组TNF-α、IL-6的水平仍高于模型组。结论LED-蓝光对肝切除后肝再生起明显的促进作用,其机制可能与增强TNF-α、IL-6的含量有关。     

螺旋CT血管造影在肝动脉系统成像中的应用

螺旋CT血管造影技术(MSCTA)是一种非侵入性血管成像技术,目前已广泛应用于颅内动脉、主动脉、冠状动脉、门静脉等疾病的诊断和治疗中。本文就肝脏血管系统CTA的技术及临床应用进行探讨。     

Pregnancy outcomes in women with type 1 diabetes in China during 2004 to 2014: A retrospective study (the CARNATION Study)

BackgroundWe aimed to report pregnancy outcomes of women with type 1 diabetes (T1D) in China, on which data were sparse.MethodsThis is a nationwide retrospective study conducted in 11 general medical centers in 8 cities across China. We investigated the clinical data of all women who attended these centers with a singleton pregnancy and whose pregnancy ended between 1 January 2004 and 31 December 2014. Pregnancies of women with pregestational T1D were ascertained and compared with those of women without T1D.ResultsFrom over 300 000 pregnancies over the 11‐year study period, we identified 265 singleton pregnancies of women with T1D. One maternal death was documented among 265 (0.37%) women with T1D and 83 among 318 486 (0.03%) women without T1D. Women with T1D suffered from higher rates of pregnancy loss (13.21% vs 2.92%, crude risk ratio [cRR] 5.08 [95% CI, 3.56‐7.26]) and preeclampsia (17.74% vs 4.20%, cRR 4.94 [95% CI, 3.60‐6.77]) compared with those without T1D. Infants of these women with T1D had elevated rates of neonatal death (5.65% vs 0.16%, cRR 37.36 [95% CI, 21.21‐65.82]) and congenital malformation(s) (8.26% vs 3.53%, cRR 2.46 [95% CI, 1.54‐3.93]) compared with those of women without T1D. No significant improvement in pregnancy outcomes in women with T1D was observed over the period 2004 to 2014.ConclusionsPregnancy outcomes were persistently poor in women with T1D during 2004 to 2014 in China. Pregnancy care needs to be improved to reduce adverse pregnancy outcomes among Chinese women with T1D.     

Underlying mechanisms of saphenous vein graft stenosis after coronary artery bypass caused by clipping of the side branches: an experimental study

BackgroundSaphenous veins are regular bypass conduits selected in non-left anterior descending artery (LAD) coronary artery bypass graft (CABG) surgery. Despite the technical errors, acute thrombosis, intimal hyperplasia and arteriosclerosis which could lead to saphenous vein graft (SVG) failure, the metal-clipping-related SVG failure is unique and rare. This study was conducted to investigate the clinical and underlying mechanisms of the metal-clipping-related SVG failure.MethodsWe collected 6 typical cases of the metal-clipping-related SVG failure in 41 patients who were diagnosed graft stenosis by coronary angiograph after CABG in the Department of Cardiology, Beijing Anzhen Hospital, from January 2020 to September 2021. Furthermore, we built an in vitro model to verify the identical intravascular ultrasound (IVUS) pattern of metal clip.ResultsThere were 6 in 41 cases of SVG stenosis caused by clipping of the side branches. We found that the stenosis of SVG caused by metal clipping mostly occurred at the corner and multipole clipping points. In this situation, great resistance could be felt when pushing the instruments through the stenosis and crystallized cholesterol was rarely caught by the distal protection device. We verified the similar IVUS pattern of metal clip at the side-branches of SVG in vitro.ConclusionsThe metal-clipping-related stenosis may lead to SVG failure. The stenosis of SVG caused by metal clipping mostly occurred at the corner and multipole clipping points. IVUS showed great modality for clarification.