Percutaneous balloon angioplasty of coarctation of the aorta in children: 12 -year follow-up results

Objective To evaluate the efficiency of percutaneous balloon angioplasty of coarctation o f the aorta in children and discuss its risk factors that can lead to poor long -term results.Methods From September 1987 to August 1999, 24 patients underwent 27 balloon angioplasty procedures for native or recurrent coarctation of the aorta at our institution . There were 19 patients with discrete (membranous) coarctation, 4 patients wit h long-segment and aortic arch hypoplasia, and 1 patient with postoperative recu rr ence. The balloon diameter was chosen not to exceed the diameter of the aorta p roximal to the stenotic site (11.06±2.80 mm vs 11.78±3.18 mm), with th e chosen diameter two to four times that of the stenotic segment (2.57±0.68 t imes). The patients have been followed up for half to twelve years (mean 6.2 ±2.8 years). Satisfactory result was defined as a reduction in the pressure g radient across the site of coarctation to ≤20 mm Hg. Results The systolic pressure gradient across the coarctation site decreased from 48. 17±14.68 mm Hg to 14.96±13.12 mm Hg (P<0.01) and the diameter of the coarctation site increased from 4.66±2.43 mm to 8.80±3.32 mm (P<0. 01). Immediate satisfactory results were obtained in 19 patients (79%). Of the 5 patients with unsatisfactory results, 4 had aortic arch hypoplasia and 1 had membranous coarctation. Of the 19 patients with satisfactory results, 18 patie nts had membranous coarctation and 1 patient had recurrent postoperative coarcta tion. No aneurysm and other complications had occurred in any patients at the follow-ups. Conclusion Percutaneous balloon angioplasty is an effective treatment alternative to surger y in most patients with recurrent postoperative or native membranous coarctation of the aorta. It should not be recommended for the coarctation of aortic arch hypoplasia.     

Percutaneous balloon aortic valvuloplasty in the treatment of congenital valvu lar aortic stenosis in children

Objective To assess the effect of the balloon valvuloplasty for congenital valvular aortic stenosis (AS) in children.Methods A total of 27 (mean age 6.09 years) children with AS accepted the treatment of percutaneous balloon aortic valvuloplasty (PBAV).The ratios of balloon/valve were 0.95±0.08 for 19 cases of typical AS and 1.00±0.11 for 8 cases of hyp oplastic AS.The patients were evaluated by the gradients across aotic valves i n pre- and post-PBAV and by echocardiogram during the follow-up period.Results Fifteen of 19 （78.9%）cases of typical AS had a better outcome and the gradien t of the remaining 4 cases (26.7%) had increased after follow-up (ΔP>50 mm Hg).Four of 8 (50.0%) cases of hypoplastic AS had satisfactory responses and the gradient of the remaining 3 cases (75.0%) rose.There was no moderate to s evere aortic insufficiency (AI). Conclusion The balloon aortic valvuloplasty provides safe and significant hemodynamic and c linical improvement in pediatric patients.The outcome of PBAV for typical AS is better than for hypoplastic AS.     

10年早产儿及新生儿结果分析

目的 探讨早产儿的发生因素和对母儿的影响及防治。方法 收集１９８９年１月至１９９８年１２月,１０年中我院住院分娩的全部早产病例８１６例,按产５年和后５年分为两组进行回顾性分析。结果 前组早产数为５３４例,早产发生率为３．２０％;后组早产数为２８２例,发生率为３．０５％,两组发生率对比无统计学差异（Ｐ〉０．０５）。其流行病学调查显示在职业、流动人口数和产前检查方面两组对比有极其显著性差异（Ｐ〈０．０     

大鼠原位肝移植及术后肝细胞超微结构观察

用５１只Ｗｉｓｔａｒ大鼠建立了新的大鼠原位肝移植手术模型,手术成功率为９２．１％,周存活率为８６．２７％。手术要点是术前供肝冷灌注;受体肝只建立门静脉血供,静脉吻合分别采用“双袖套”式吻合和“８”字外翻缝合;胆管重建采用单管支架总胆管对端吻合法。移植术后肝细胞超微结构动态观察表明：术后２周是控制免疫排斥反应的关键时期,术后８周实验鼠产生免疫耐受性,移植肝脏成活。     

烹调油烟对大鼠肺细胞的DNA损伤机制

目的：以大鼠肺Ⅱ型细胞为靶细胞,检测烹调油烟的细胞毒作用和对细胞ＤＮＡ的损伤。方法：烹调油烟颗粒提取物对大鼠肺Ⅱ型细胞染毒２４ｈ后,应用ＭＴＴ法、溴乙锭荧光法以及单细胞凝胶电泳技术检测烹调油烟对大鼠肺Ⅱ型细胞的细胞毒性和ＤＮＡ的损伤。结果：在受试剂量范围内,烹调油烟颗粒提取物具有细胞毒性,可致ＤＮＡ交联及断裂的作用随染毒剂量的增加而增强,并存在剂量－反应关系（ｒ细胞毒性＝－０．９４８,Ｐ＜０．０１;ｒ交联＝０．９７６,Ｐ＜０．０１;ｒ断裂＝０．９５７,Ｐ＜０．０１）。结论：烹调油烟颗粒提取物对大鼠肺Ⅱ型细胞具有细胞毒性作用和ＤＮＡ损伤作用,可使ＤＮＡ链间交联和ＤＮＡ单链断裂。     

小鼠骨髓巨噬细胞培养液的造血抑制活性研究

观察了小鼠骨髓型正常巨噬细胞株经６Ｇｙ＾６０Ｃｏ照射后细胞培养上对ＣＦＵ－Ｅ和ＣＦＵ－Ｇ同期怕影响,结果未照射和照射后Ａｎａ－１细胞培养３上清对ＣＦＵ－Ｅ和ＣＦＵ－ＧＭ的形成均垢抑制活性,但照射后抑制活性更强,上清经灭活后抑制活性减弱,结论;小鼠骨髓巨噬 培养上清对ＣＦＵ－＝Ｅ和ＣＦＵ－ＧＭ均的抑制活性,这种抑制活性可能是抑制因子和细胞毒共同作用的结果。     

氯霉素在神经外科开颅术后继发颅内感染的应用

目的：评价氯霉素在神经外科开颅术后继发颅内感染的治疗作用。方法：分析２３例颅内感染者２１例氯霉素治疗前用过其他类抗生素,因无效而改用氯霉素,另２例因过敏体质而直接使用氯霉素。结果：本组氯霉素治疗均有效。结论：治疗颅内感染,氯霉素可作为青霉素类和头孢菌素等抗生素治疗无效的替换药,有很好的临床效果。     

公路费用分摊方法的分析与评价

明确了公路费用分摊的概念,指出了它在道路使用者税费制定过程中的地位与作用;阐述了费用分摊的两大基本目标--效率与公平,并据此对国外公路费用分摊方法进行了分类,提出了公路费用分摊研究的基本框架;介绍了每种分摊方法的基本内容,并着重分析了它们的优缺点.     

铁路危险品货运站空气污染指标的探讨

铁路危险品货运站（危货站）空气污染物种类多,空气污染严重,为探讨对其监测和评价的综合性能指标和方法,采用空气耗氧量（ＡＯＤ）和ＳＯＳ致遗传毒性原位监测法（ＳＯＳ原位法）,分别对危货站空气污染进行了研究。结果表明,危货站中各点所测ＡＯＤ值与对照区ＡＯＤ值,在统计学上差异均有显著性（Ｐ〈０．０５）。ＳＯＳ原位法显示,随采样体积的增加,β－半乳糖苷酶的量也增加,采样体积与酶诱导率之间存在剂量－反应关系。     

重组组织纤溶酶原激活物预防蛛网膜下腔出血后迟发性脑血管痉挛的实验研究

目的实验研究重组组织纤溶酶原激活物预防蛛网膜下腔出血后迟发性脑血管痉挛(DVS).方法实验选取12只家犬,随机分成两组.采取"两次出血法"制成蛛网膜下腔出血(SAH)模型.SAH前先做基底动脉造影,然后行枕大池穿刺,抽出脑脊液4ml后注入等量自体动脉血.第一次"SAH"后48小时再次注入自体动脉血4ml.第二次注血后6小时治疗组6只动物经枕大池穿刺注入组织型纤维蛋白溶解酶原激活物(r-TPA)25mg;对照组注入生理盐水.7天后再次行基底动脉造影.结果动脉造影r-TPA治疗组基底动脉口径无明显变化(P＞0.05);解剖除1例基底动脉外膜上可见数点凝血外,其余动物颅底均无血块.对照组两次动脉造影基底动脉缩小极为明显(P＜0.01),有严重的血管痉挛.颅底充满血块,基底动脉被血块所包绕.结论r-TPA能充分地溶解未成熟的(SAH后48小时)蛛网膜下腔凝血块,从而有效的预防迟发性脑血管痉挛的出现.