利用兔颈动脉旁路移植模型评价新型全生物化小口径移植血管

目的 建立兔双侧颈动脉旁路移植模型,以模拟冠状动脉旁路移植术,并在此模型上对经脱细胞联合肝素处理的犬颈动脉进行体内实验,以评价其作为小口径血管移植物的可行性.方法 犬10只,取双侧颈动脉,先经过去污剂-酶消化法脱除管壁细胞,脱细胞后的血管分为两组,肝素结合联合脱细胞组(A组)对脱细胞血管材料再进行肝素结合处理;仅脱细胞组(B组).测量两组血管的管径,并与同期手术患者的乳内动脉进行比较.兔20只作自身对照,左侧颈动脉移植A组血管,右侧移植B组血管,以建立双侧颈动脉旁路移植模型.实验同期测量20只兔双侧颈动脉的管径,并与20例冠心病患者的冠状动脉进行比较.移植后3周和3个月分别经过超声观察移植血管的通畅性及血流动力学.3个月后处死20只兔,取双侧移植血管,经HE染色及电镜观察血管重塑情况.结果 A组和B组的管径与患者乳内动脉比较差异无统计学意义(P＞0.05),兔颈动脉的管径与人的冠状动脉比较差异也无统计学意义(P＞0.05).犬颈动脉经过去污剂-酶消化法脱细胞处理后,细胞去除完全而且基质保存完整,肝素可以成功结合于管壁全层;术后超声发现,两组中均有部分血管内可见血栓形成,3周时A组的通畅率(95%)高于B组(40%)(P<0.05),3个月时 A组(90%)也高于B组(30%)(P<0.05);3个月后的HE染色、电镜显示两组中未形成血栓的血管可以发生较满意的血管重塑.结论 兔双侧颈动脉旁路移植模型建立简便,可以用于冠状动脉旁路移植术中对小口径血管移植材料的探索和评价;肝素结合联合脱细胞处理的犬颈动脉可能作为新型的全生物化小口径移植血管材料.     

迷走神经与房室结双径路研究进展

房室结折返性心动过速(atrioventricular nodal reentry tachycardia,AVNRT)是临床上常见的阵发性室上性心动过速的类型之一,其解剖基础为房室结双径路(dual atrioventricular nodal physiology,DAVNP)。近年来研究发现DAVNP的慢径路区域分布有丰富的迷走神经,影响DAVNP的临床表现及电生理性质。深入了解迷走神经与DAVNP的关系对临床诊断和治疗具有重要的意义。     

宿迁医改一小步成败难断

宿迁医改，成败难定论。     

17β-雌二醇对牛视网膜毛细血管内皮细胞eNOS mRNA及NO调控的实验研究

目的探讨17β-雌二醇(E2)在不同氧(O2)环境下对牛视网膜毛细血管内皮细胞(BRECs)一氧化氮合酶(eNOS)mRNA及NO的影响。方法在正常O2及缺O2环境下,采用不同生理浓度(10-12、10-10、10-8mol/L)的17β-E2及雌激素受体拮抗剂他莫昔芬处理培养的BRECs。采用RT-PCR检测eNOS mRNA,硝酸还原酶法测定NO。结果①低O2条件下BRECs的eNOS mRNA、NO表达较正常O2条件下明显增多(P<0.05)。②正常O2及低O2条件下,不同生理浓度17β-E2作用24 h后,17β-E2均呈浓度依赖性促进BRECs的eNOS mRNA、NO表达(P<0.05);10-8mol/L 17β-E2作用8、24 h,eNOS mRNA表达量呈时间依赖性增多(P<0.05)。结论生理浓度的17β-E2使BRECs的eNOS mRNA、NO表达呈浓度、时间依赖性增加。     

急诊科急性心肌梗死抢救护理流程模式的改进

Objective To increase the success rate of first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments.Methods A total of 50 patients with acute infarct of cardiac muscle were taken,for seeking for the most convenient,effective flow model for first-aid and nursing under current conditions,which has a smooth cooperation with doctors,and shortens the time of patients staying in hosptal.Results The 50 patients were primarily first-aided in emergency department,and shew a stable status of disease,and were sent to the complex ICU or the cardiacology department in the in-patient section with care.The success rate was 94%.Compared with 50 patients in the past,the success rate was increased by 10% (P＜0.05).The time for staying in hospital was reduced to 6 rain for a patient at a time in average,from the tradiational average time for a patient at a time of 15.5 rain.Conclusions This exploration in nursing model for first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments provides an improvement which can closely match with doctors,and increase the success rate of first aid.It clearly shortens the in-hospital time for patients.The model gives valuable time for the first-aid process which shows time is life,and increases the patients' satisfication degree.     

急诊科急性心肌梗死抢救护理流程模式的改进

Objective To increase the success rate of first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments.Methods A total of 50 patients with acute infarct of cardiac muscle were taken,for seeking for the most convenient,effective flow model for first-aid and nursing under current conditions,which has a smooth cooperation with doctors,and shortens the time of patients staying in hosptal.Results The 50 patients were primarily first-aided in emergency department,and shew a stable status of disease,and were sent to the complex ICU or the cardiacology department in the in-patient section with care.The success rate was 94%.Compared with 50 patients in the past,the success rate was increased by 10% (P＜0.05).The time for staying in hospital was reduced to 6 rain for a patient at a time in average,from the tradiational average time for a patient at a time of 15.5 rain.Conclusions This exploration in nursing model for first-aid and nursing of patients with acute infarct of cardiac muscle in emergency departments provides an improvement which can closely match with doctors,and increase the success rate of first aid.It clearly shortens the in-hospital time for patients.The model gives valuable time for the first-aid process which shows time is life,and increases the patients' satisfication degree.     

山东菏泽：仓促医改引发四大疑问

在菏泽这个经济并不发达的地级市，医疗体制改革行走得甚为迅猛，诸多问题纷纷暴露。     

3例肝移植手术病人的临床护理观察

对3例肝移植手术病人的术前后护理进行回顾分析总结,认为肝移植手术病人的护理关键:术前心理护理、周密的术前准备、术后严密监测生命体征及血液动力学的变化;维持液体的平衡,注意出血的观察,排斥反应的观察,做好保护性隔离;加强基础护理,是减少术后并发症,提高手术成功率,促进病人康复的关键。     

粪便和组织样本高通量测序前处理方法的评估

目的:优化和评估粪便和组织样本高通量测序前处理方法,提高高通量测序在宏病毒组研究中的灵敏度。方法:针对粪便样本,选取经粪便排毒的5种病毒阳性样本混合模拟样本,对不同材质的滤器、核酸酶不同处理时间、不同的提取核酸方法进行评价。针对组织样本,选取动物组织中检出的2种病毒阳性样本,对过滤、核酸酶处理和不同的核酸提取方法进行评...