老年高血压颈动脉硬化尿微量白蛋白与中医证型关系的研究

为研究老年高血压颈动脉硬化尿微量白蛋白与血瘀、痰瘀互结的关系,将60例高血压颈动脉硬化患者分为血瘀组、痰瘀组,用超声波检测颈动脉中层内膜厚度(IMT),并用放射免疫法测定尿β2微球蛋白(β2-MG)、尿微量白蛋白(Alb)、尿转铁蛋白(TRU),分析老年高血压颈动脉硬化及尿微量白蛋白与血瘀、痰瘀的关系,结果痰瘀组尿β2微球蛋白、尿微球蛋白、尿转铁蛋白升高显著,说明老年高血压颈动脉硬化与尿微量白蛋白变化有密切关系,高血压肾病早期改变以痰瘀互结为主。     

主动脉弓粥样硬化和缺血性脑卒中的关系

主动脉弓粥样斑块与缺血性脑卒中密切相关,主动脉粥样硬化是缺血性脑血管病的重要栓塞源。,经食道超声技术是检测活体胸主动脉脉粥样硬化病变的重要方法。     

INTRACRANIAL ARTERIAL OCCLUSIVE LESION IN PATIENTS WITH GRAVES DISEASE

MHYAoitwhSTe GvHerarEv,Ne oIs Anldy igs9reaavpsieast i(eoGnrtDs m)wy iiosthp na iotnhtty ruanc acrsaosnmoicamilao tanerd.-ery occlusive lesions(IAOLs)associated with GD werereported in the previous literatures.1-6We presumed thatthere are some relationships between them,and at the sametime these vascular stenoses must be treated promptly,oth-erwise irreversible stroke will happen.So in current study,we investigated the clinical manifestations and the distribu-tion characteristics of IA…     

氟伐他汀对缺血性脑卒中患者的疗效观察及护理措施

Objective To explore the effect and nursing main points of fluvastatin on the patients with cerebral arterial thrombosis. Methods Eighty-five patients with cerebral arterial thrombosis were randomly divided into three groups. Group Ⅰ was the negative control group. Group Ⅱ was the conventional-dose therapy group and group Ⅲ was the high-dose therapy group. Each group was treated with related therapy and care. The blood lipids in all groups were tested before the treatment, 4 weeks, 12 weeks and 24 weeks after the treatment; the carotid intima-media thickness (IMT) were measured by the Germany SEQUOIAS-512-B ultra machine before the treatment and 24 weeks after the treatment; At the same time, the side effects of fluvastatin were recorded. Results The results of blood lipid tests showed that the LDL, TC and TG in two treated groups were significantly decreased compared to negative control group (P<0.05). After treated for 24 weeks, the carotid intima-media thickness (IMT) in two treated groups were significantly reduced (P<0.05); the side effects of fluvastatin were infrequent and there was no significant different among the three groups (P>0.05). Conclusion The effects of different doses of fluvastatin on cerebral arterial thrombosis were significantly different. With the dose of fluvastatin increased, the serum LDL-L and TC reduced more obvious and the inhibition on carotid atherosclerosis shows more obvious, and the side effects did not increased.     

内皮素对慢性低氧大鼠肺动脉平滑肌细胞膜钾通道活性的影响

目的观察内皮素(ET-1)对慢性低氧大鼠肺动脉平滑肌细胞(PASMCs)膜电压门控钾通道(K_V)活性的影响。方法将12只Wistar大鼠随机分为对照组和慢性低氧组，每组6只。用全细胞膜片钳记录方法研究ET-1对两组大鼠PASMCs膜电位(E_m)、膜电容(C_m)及电压门控钾电流(IK_V)的影响。结果ET-1可引起两组大鼠PASMCs去极化，且对两组大鼠IK_V均有明显的浓度依赖性抑制作用。在慢性低氧组，高浓度ET-1对IK_V的抑制作用强于对照组。结论低氧并未改变ET-1引起PASMCs去极化及浓度依赖性抑制IK_V的特性，且慢性低氧可能改变了PASMCs对ET-1的敏感性，内皮素和低氧对PASMCs IK_V的抑制作用有协同性。     

冠心病冠脉优势型与血管病变数目及严重程度的相关性分析

目的 探讨冠心病中冠脉优势型与血管病变数目及疾病严重程度的关系,为冠心病危重度预测及分级提供理论依据。方法 选取2010年7月～2014年4月西安交通大学第二附属医院确诊的冠心病患者1654例为研究对象,行单中心回顾性观察性研究。根据病变累及部位分为3组：单支血管病变组（n=465）、双支血管病变组（n=414）和三支血管病变组(n=775）。再根据冠脉优势型将所有患者分为两组：右冠优势型（n=1500）、非右冠优势型（左冠优势型和均衡型,n=154）（考虑后两者所占比例偏低,将其合并）。将年龄、性别、吸烟史、是否患高血压、糖尿病及高脂血症作为协变量,利用Logistic回归模型分析何种冠脉优势型是冠心病血管病变数目增加的可能危险因素;比较Gensini评分,探讨冠脉优势型和冠心病严重程度的关系。结果 右冠优势型患三支血管病变的可能性是非右冠优势型的1.681倍（OR=1.681;95% CI=1.096～2.579; P=0.017）;但右冠优势型患双支血管病变的可能性与非右优势型比较,差异无〖JP2〗统计学意义（OR=1.212; 95%CI=0.781～1.880;P=0.392）。右冠优势型Gensini评分明显高于非右冠优势型（42.3±〖JP〗33.6 vs36.3±29.8,P=0.033）。结论 右冠优势型可能是三支血管病变的独立危险因素,并且右冠优势型会导致较严重的血管病变程度。     

《TAVR围术期超声心动图检查专家共识》解读

经导管主动脉瓣置入术（TAVR）已成为有临床症状,但不能耐受外科手术治疗（SAVR）的重度主动脉瓣狭窄患者的替代治疗方案。针对即将在国内广泛开展的这项技术,国内心血管超声专家起草了《TAVR围术期超声心动图检查专家共识》,详细介绍了TAVR人工瓣膜及路径,TAVR术的主要适应证,TAVR术前超声评估,TAVR术中超声监测引导及术后即刻评估。为了让超声心动图及心血管临床医师更好地了解专家共识,本文对专家共识的要点进行了梳理与解读。     

经肝动脉化疗栓塞联合经皮射频消融术治疗原发性肝癌的疗效观察

【摘要】 目的 探讨经肝动脉化疗栓塞（TACE）联合经皮射频消融术（PRFA）与单独应用经皮射频消融术治疗原发性肝癌的临床疗效。方法 选择2012年3月～2014年3月在我院诊治的肝癌患者90例,随机分为观察组（50例）与对照组（40例）。观察组予以经肝动脉化疗栓塞联合经皮射频消融术,对照组应用经皮射频消融术治疗,观察两组疗效及预后情况。结果 术后1个月两组患者并发症如疼痛、肺部感染、出血、恶心呕吐等发生率差异无统计学意义（P＞0.05）;两组术后1个月时血清丙氨酸氨基转移酶（ALT）与门冬氨酸氨基转移酶（AST）水平均低于术前(P＜0.05),但观察组术后一个月血清ALT和AST值显著低于对照组(P＜0.05);观察组与对照组比较能明显提高近期有效率(P＜0.05)。结论 两种治疗方案均能有效治疗原发性肝癌,但经肝动脉化疗栓塞联合经皮射融术相对于单独应用经皮射频消融术,在原发性肝癌治疗中具有更高的缓解率,更有利于肝功能的恢复,可减少术后并发症。     

“Hepatocellular carcinoma: A life-threatening disease”

An estimated rise in liver cancer incidence will increase to 95374 new cases by 2020. Hepatocellular Carcinoma (HCC), the most common primary malignant tumour of the liver, is considered to be the third leading cause of all cancer-related deaths and fifth common cancer worldwide. The reported data shows that the rate of HCC incidence in male population is three to four times higher compared with the female population. In the United States, HCV-induced liver cancer is increasing very fast because of the lack of proper treatment option. There are various treatment strategies available for HCC like liver transplantation, resection, ablation, embolization and chemotherapy still the prognosis is destitute. If the patient is eligible, liver transplantation is the only therapeutic option that may give around 90% survival rate, but the scarcity of liver donor limits its broad applicability. A sudden address is necessary to develop specific drugs, personalized medicine, for HCC.     

Secondary Prevention of Cardiovascular Disease in Older Adults

Atherosclerotic cardiovascular disease is extremely common in older adults and the potential benefits of secondary prevention are perhaps greater in this population than in younger patients. While there is good evidence that secondary prevention efforts are justified in patients up to 80 years of age, limited data are available on secondary prevention in octogenarians and there is no evidence to guide treatment in patients ≥ 90 years of age. Further, the value of secondary prevention may be confounded by prevalent comorbidities, polypharmacy, and limited life expectancy. It is therefore essential that all management decisions be made in relation to individual preferences and goals of care, with understanding by patients that benefits as well as risks may increase with age. Furthermore, research is needed to refine markers to better delineate which older adults are most likely to benefit from preventive therapies.