早期类风湿性关节炎患者动脉内皮中膜厚度与内皮功能的相关研究

目的:探讨早期类风湿性关节炎(RA)患者动脉内皮中膜厚度(IMT)与内皮功能生物指标的关系。方法:对85名早期RA患者和60名健康受试者进行研究,超声检查颈动脉IMT,采集血液标本分析血脂、血沉(ESR)、C反应蛋白(CRP)、纤溶酶原激活物抑制剂-1(PAI-1)、组织型纤溶酶原激活物(tPA)、VonWillebrand因子(VWF)、可溶的细胞间黏附分子-1(slCAM-1)、可溶的血管细胞黏附分子-1(sVCAM)、sL选择素和单核细胞趋化蛋白-1(MCP-1)。结果:与对照组相比,RA患者IMT与一些传统的CVD危险因素、tPA、VWF和MCP-1相关(P<0.01),与sL选择素负相关(P<0.05)。结论:早期RA患者IMT与血管内皮活化的某些指标明显相关。     

睾丸鞘膜外入路切除附睾肿块效果观察

目的探讨睾丸鞘膜外入路切除术在附睾肿块中的手术效果。方法选择我院收治的患者46例,分为经睾丸鞘膜外入路附睾肿块切除术组(观察组)和经睾丸鞘膜入路附睾肿块切除术组(对照组),每组23例。比较观察组和对照组手术时间、术中出血量、术中情况、术后切口出血、引流、阴囊肿胀、住院时间等。结果两组患者手术时间、术中出血及术中副损伤情况比较差异无统计学意义(P>0.05),对照组术后切口出血、阴囊水肿发生率显著高于观察组(P<0.05)。结论睾丸鞘膜外入路附睾肿块切除术保留了睾丸鞘膜,操作简单,解剖层次清晰,术后阴囊无肿胀,恢复快,并不增加手术难度,对治疗附睾良性肿物有较好的临床应用价值。     

Arterial Compression during Overhead Throwing: A Risk for Arterial Injury?

Case studies reporting aneurysm formation in the axillary artery have been described in overhead throwing athletes, possibly due to repetitive arterial compression by the humeral head that has been transiently observed during sonographic diagnostic arm manoeuvres. Whether compression negatively alters arterial health has not been investigated and was the focus of this study. The throwing arm of elite overhead athletes was screened for inducible axillary artery compression. Compressors (COMP, n = 11, mean age: 20 (SD: 2) year, 7 male, 4 female) were age and sex matched with noncompressing (NONCOMP) athlete controls. Four indices of arterial health (flow mediated dilation [FMD], conduit artery vasodilatory capacity [CADC], glyceryl-trinitrate [GTN]-induced vasodilation and intima-media thickness [IMT]) were assessed with high-resolution ultrasound at the brachial and the axillary, artery. No significant between-group differences were observed at the brachial, or axillary, artery for FMD (brachial: COMP: mean (SD) 6.2 (3.1)%, NONCOMP: 6.1 (3.5)%, p = 0.967, axillary: COMP: 8.0 (5.5)%, NONCOMP: 9.0 (3.6)%, p = 0.602), CADC (brachial: COMP: 10.4 (3.4)%, NONCOMP: 10.4 (5.4)%, p = 0.999, axillary: COMP: 9.6 (4.2)%, NONCOMP: 8.5 (3.2)%, p = 0.492), GTN-induced vasodilation (brachial: COMP: 17.9 (5.1)%, NONCOMP:14.1 (7.2)%, p = 0.173, axillary: COMP: 9.5 (4.3)%, NONCOMP: 7.7 (3.1)%, p = 0.302) or IMT (brachial: p = 0.084, axillary: p = 0.581). These results suggest that transient arterial compression, observed during diagnostic arm manoeuvres in overhead throwing athletes, is not associated with abnormal indices of artery function or structure and that other mechanisms must be responsible for the published cases of aneurysm formation in elite athletes performing overhead throwing actions. (E-mail: c.stapleton@ljmu.ac.uk)     

老年男性2型糖尿病患者睾酮与颈动脉内膜中层厚度的相关性

目的探讨老年男性2型糖尿病患者睾酮水平与颈动脉内膜中层厚度的相关性。方法根据彩色多普勒超声测定的颈动脉内膜中层厚度,58例老年男性2型糖尿病患者分为2型糖尿病合并颈动脉粥样硬化组(T2DM-AS组)和2型糖尿病无颈动脉粥样硬化组(T2DM-NAS组),并测定血空腹血糖、血脂、糖化血红蛋白及血清睾酮水平。结果 T2DM-AS组和T2DM-NAS组的睾酮水平均低于对照组(P<0.05)。T2DM-AS组的IMT大于T2DM-NAS组和对照组(分别为P<0.05和P<0.01)。血清睾酮与IMT、年龄呈负相关,与TC呈正相关,多元逐步回归分析结果显示年龄、BMI和睾酮是IMT的独立危险因素。结论睾酮对于老年男性2型糖尿病患者颈动脉粥样硬化可能具有保护作用。     

~(192)Ir高线量率血管腔内照射对抑制兔血管平滑肌细胞增殖及新生内膜过度增生的研究

目的　研究192 Ir高线量率血管腔内照射对用切割球囊导管行经皮血管腔内成形术(PTA)后的日本白兔髂动脉平滑肌细胞增殖抑制的经时反应和效果。方法　 2 0只日本白兔经左侧颈总动脉放置切割球囊导管行髂动脉PTA术 ,随机于一侧髂动脉施行 12Gy剂量的血管腔内照射 ,非照射侧作为对照侧。实验动物于术后 1、2、3、4、8及 12周处死。根据新生内膜的形成情况 ,血管成形术后接受血管腔内照射的血管段按时间分为 3组 :即 1周组 5只、2～ 4周组 9只、8～ 12周组 6只。随后对标本进行了组织病理、形态学测量和免疫组织化学分析。结果　 1周时 ,与照射侧比较 ,对照侧血管段创口修复处可见明显的新生内膜增生 ,新生内膜中抗增殖细胞核抗原 (PCNA)阳性细胞率呈一峰值 ;2～ 4周期间 ,与对照侧比较 ,照射侧血管段新生内膜增生明显减弱 (P <0 .0 1) ,新生内膜中PCNA阳性细胞率较对照侧低 ,差异有显著性意义 (P <0 .0 1) ;8～ 12周 ,照射侧血管段增生的新生内膜较对照侧仍处较低水平 ,新生内膜中PCNA阳性细胞率约低于 1%。经抗平滑肌细胞α胶原免疫组织化学染色 ,证实新生内膜中主要为平滑肌细胞。结论　由照射所致的新生内膜增生过程的抑制作用从开始时即已启动。 12Gy的192 Ir高线量率照射能有效地抑制用切割球囊导管损     

颈动脉超声评分在冠心病危险评估中的应用价值

目的：评价颈动脉超声评分在冠心病危险评估中的应用价值。方法：通过对178例因不同病因在我院心内科住院行冠状动脉造影检查的患者,于造影前后1周内对上述患者行颈动脉血管彩色多普勒超声检查,根据造影结果分为冠心病单支病变组、多支病变组和正常组（对照组）,比较各组间所测得的颈动脉血管后壁内中膜厚度（IMT）及斑块发生率。结果：与正常组相比,冠心病单支病变组及多支病变组IMT值及斑块发生率均明显增高,差异有统计学意义（P〈0.05）,单支病组与多支病组间差异亦有统计学意义（P〈0.05）。结论：颈动脉粥样硬化与冠心病之间关系密切,较早行颈动脉超声的检查可以早期估计冠状动脉病变的危险程度。     

Is mobile testis a true pathological condition due to a gubernaculum abnormality?

The present study was conducted to clarify whether a gubernaculum abnormality exists in mobile testis or not. Testicular fixation was performed in 57 patients with mobile testis with a mean age of 3.6 years (range; 7 months–12 years). Twenty-six patients were bilateral and 31 patients were unilateral cases. Control gubernaculum findings were obtained from 12 patients with hydrocele testis with a mean age of 3.3 years (1.6–5 years). In 12 patients with hydrocele testis, the gubernaculum was found from the lower third of the testis to the scrotal base inside the tunica vaginalis (plica gubernaculi), while outside the tunica vaginalis pars infravaginalis gubernaculi further extended into the scrotal base. On the other hand, in 57 patients with mobile testis, the gubernaculum was easily identified only inside the tunica vaginalis without any recognizable gubernaculum outside the tunica vaginalis. In 31 unilateral patients, associated anomalies of the contralateral testis were found in 13 patients (42%); 11 cases with undescended testis and two cases with ectopic testis. These results suggest that mobile testis might therefore be a true pathological condition, which were highly associated with contralateral testicular morbidities.     

颈动脉内膜中膜厚度联合踝臂指数对冠心病预测价值的研究

目的研究颈动脉内膜中膜厚度（IMT）联合踝臂指数（ABI）对冠心病的预测价值。方法选择2008至2010年在日照市人民医院住院并行冠状动脉造影或介入治疗患者194例,术前对其进行颈动脉内膜中膜厚度以及踝臂指数测量,血液生化检查,病史采集,并根据ABI≤0．90为阳性,ABI〉0．90为阴性,IMTI〉0．9mm为阳性,IMT〈0．9mm为阴性,设定为两项指标均为阴性为A组,ABI阳性为B1组,阴性为B2组,IMT阳性为C1组,阴性为C2组,两项指标均为阳性者为D组,并根据冠状动脉造影结果得出各组冠心病发病率。结果A组中冠心病发病率为9．1％,B1组为64．8％,B2组为29．9％,C1组为70．8％,C2组为28．4％,D组为89．1％,从以上结果中我们可以看出,踝臂指数阳性能较好预测冠心病发生（B1：64．8％比B2：29．9％,P〈0．05）;颈动脉内膜中膜厚度对冠心病的预测也有重要意义（C1：70．8％比C2：28．4％,P〈0．05）,两项指标均为阳性对冠心病的预测价值要高于单一项指标（D：89．1％比B1：64．8％,C1：70．8％,P〈0．05）,且两项指标阴性对冠心病的排除价值也要高于单一项指标阴性者（A：9．1％比B2：29．9％,C2：28．4％,P〈0．01）。结论联合应用ABI、IMT两项指标对冠心病的预测具有重要的临床意义。