TIA患者血清IL-6、IL-18水平与颈动脉内中膜厚度的关系

目的 通过分析颈动脉内中膜厚度(IMT)与血清细胞因子白介素-6(IL-6)、白介素-18(IL-18)水平的关系,探讨IMT增厚的发生机制.方法 选择66例短暂性脑缺血发作(TIA)患者(TIA组)作为研究对象,另选择40名健康者作为正常对照组.分别测量其颈动脉IMT值,并分为IMT＜1.0mm亚组和IMT≥1.0mm亚组.利用液相平衡竞争放射免疫分析法(RIA)和酶联免疫吸附法(ELISA)分别测定了2组的血清IL-6和IL-18水平,并对IMT与IL-6,IL-18的关系进行分析.结果 TIA组所有IMT≥1.0mm患者血清IL-6、IL-18含量均比正常对照组升高,差异有统计学意义(P＜0.05,P＜0.01); TIA组IMT≥1.0mm亚组患者血清IL-6、IL-18含量比IMT＜1.0 mm亚组患者升高,差异有统计学意义(P＜0.05).经Pearson相关分析,TIA组IMT≥1.0mm亚组患者IMT与血清IL-18含量呈明显正相关(r=0.551,P＜0.01);TIA组、脑梗塞组IMT≥1.0mm亚组患者IMT与血清IL-6含量无相关性(r=0.303,P=0.058).结论 TIA组IMT增厚的患者血清IL-6、IL-18的水平是升高的.IMT的增厚与血清IL-18含量呈明显正相关,与血清IL-6含量无相关性.IL-6、IL-18可能参与了AS的形成过程.     

彩色多普勒超声在腓肠内侧动脉穿支皮瓣术前评估中的应用

目的：探讨彩色多普勒血流显像在腓肠内侧动脉穿支血管检查中的应用。方法：以术中所见为标准,采用单盲的方法比较手持式声学多普勒及彩色多普勒血流显像对腓肠内侧动脉穿支数目、位置、血管直径检查及判断血管走行中的价值。结果：本研究移植8例皮瓣,共计24支穿支动脉,彩色多普勒血流显像与声学多普勒超声分别确诊22支及17支,误诊为2支和6支,漏诊为2支和7支,二者有显著统计学差异（P＜0.05）。彩色多普勒血流显像测量血管直径与术中测量无统计学差异（P＞0.05）。穿支血管主干分叉点16处,彩色多普勒血流显像与术中所见一致,二者吻合率为100%。8例皮瓣存活良好,术后未出现明显并发症。结论：彩色多普勒血流显像对腓肠内侧动脉穿支血管检测和皮瓣设计方面具有重要价值,能够提高皮瓣移植的可靠性。     

兔烫伤后动脉壁脑啡肽含量的变化

目的：研究兔烫伤早期发生多器官功能衰竭时，动脉壁脑啡肽含量的变化及其意义。方法：兔乙醚吸入法全身麻醉后，以95℃水烫伤其背部及躯干两侧30s，造成30％体表面积Ⅲ度烫伤(Ⅲ度30％TBSA)。测定烫伤48h后的平均动脉血压、中心静脉压、心输出量，计算总外周阻力、心指数；测定血中肌酸磷酸激酶、谷丙转氨酶、尿素、肌酐、血小板等反映心、肺、肝、肾功能的一系列指标。用放射免疫测定法测定动脉脑啡肽的含量。结果：烫伤后48h肠系膜动脉、肾动脉、肺动脉中亮氨酸脑啡肽的含量明显减少。血流动力学指标中平均动脉血压无明显变化，总外周阻力明显增高，心脏指数明显下降。心、肝、肾功能下降达到衰竭标准，肺功能下降，动物发生MOF。给烫伤动物应用钠洛酮以后，动物的心脏指数明显改善，血管总外周阻力下降。但是，多脏器功能衰竭的各项指标均未见改善。结论：烫伤后动脉壁内源性脑啡肽含量减少，可能是外周微血管痉挛收缩，全身总血管阻力增高，脏器功能损害的原因之一。     

男性高血压患者睾酮与动脉顺应性关系的研究

目的 探讨男性高血压患者睾酮与动脉顺应性的关系.方法 按照收缩压≥140 mm Hg(1 mm Hg=0.133 kPa)和(或)舒张压≥90 mm Hg诊断为高血压的标准,将277例受试者分为男性对照组、男性高血压组、女性对照组和女性高血压组.采用CVProfilor DO-2020动脉脉搏分析仪分别测定各组受试者大动脉顺应性(C1)、小动脉顺应性(C2),用酶促化学发光法检测血清睾酮浓度,用放免法检测血清胰岛索浓度.结果 (1)男女性高血压组C1、C2均显著低于相应对照组,血清睾酮浓度在男性高血压组低于男性对照组(P均<0.01),而在女性两组问比较差异无统计学意义.(2)睾酮在男性组与C1、C2正相关,与血压、甘油三酯、血糖、体质指数、胰岛素抵抗指数负相关.在女性组与体质指数负相关(P均<0.05).(3)多元逐步回归分析表明,年龄、睾酮足影响男性血压的主要因素,年龄、C2、体质指数是影响女性血压的主要因素.结论 动脉顺应性减退是高血压的预测指标;中年男性血清睾酮水平下降与动脉顺应性减退密切相关,是男性发生高血压的主要危险因素之一.     

舌动脉临床解剖学研究

目的 获得舌动脉的临床解剖学资料,为涉及舌动脉的临床应用提供解剖依据.方法 分别在头颈血管的64层螺旋CT血管成像(64-slices spiral computed tomography angiography,CTA)和成人头颈部标本上观察舌动脉的起源、形态、走行,测量舌动脉与颈动脉分叉、舌骨大角的关系,并对其结果进行对比分析.结果 舌动脉主要起源于颈外动脉(CTA组,74.4%;标本组,80%),其次起源于面动脉(CTA组,23.1%;标本组,20%);起源于甲状腺上动脉者少见,在CTA组占2.5%,在标本组中未发现舌动脉起源于甲状腺上动脉.舌动脉走行变异较大,在舌骨大角处较恒定,在CTA组舌动脉在舌骨大角上(2.32±1.29)mm、下(2.00±1.68)mm范围内,近似平行于舌骨大角水平向前入舌.在CTA组和标本组,舌动脉起始点到颈动脉分叉水平和舌骨大角尖端水平之间距离分别为(12.93±7.36)mm、(10.40±5.75)mm;(14.80±6.18)mm、(8.35±5.44)mm.结论 舌动脉在CTA上能清楚地显示,并能获得生理状态下的解剖学资料.     

N rf2基因多态性对脑动脉粥样硬化患者血清总抗氧化能力的影响

[目的]探讨N rf2不同基因型的脑动脉粥样硬化患者中血清总抗氧化能力水平。[方法]对本院神经内科住院患者208例根据是否存在动脉粥样硬化表现,分为对照组和脑动脉硬化病例组。采用基因芯片技术检测两组N rf2基因4个标签位点rs6726395、rs1806649、rs13005431、rs2886161的基因型频率分布,用ELISA法检测脑动脉粥样硬化患者的血清总抗氧化能力水平。[结果]病例组和对照组间,Nrf2基因4个标签位点中 rs6726395和 rs2886161基因型频数分布比较差异有显著性（ P ＜0．05）。在病例组中,携带rs6726395AA基因型的血清总抗氧化能力低于GG基因型,且差异有显著性（ P ＝0．003）。[结论]Nrf2基因rs6726395多态性位点可能与脑动脉粥样硬化的发生有关,且携带rs6726395 A A基因型者易发生脑动脉粥样硬化,可能与其血清总抗氧化能力下降有关。     

Traumatic Axillary Artery Dissection with Radial Artery Embolism

This report describes a case of pathologically proven traumatic arterial dissection, presenting as complete occlusion of the axillary artery with radial artery embolism. Occlusion of the axillary artery by traumatic dissection mimicked transection and radial artery embolism mimicked congenital absence of the radial artery on the initial angiogram, but these were correctly diagnosed with the following sonogram.     

Dual Frequency Method for Simultaneous Translation and Real-Time Imaging of Ultrasound Contrast Agents Within Large Blood Vessels

A dual frequency excitation method for simultaneous translation and selective real-time imaging of microbubbles is presented. The method can distinguish signals originating from free flowing and static microbubbles. This method is implemented on a programmable scanner with a broadband linear array. The programmable interface allows for dynamic variations in the acoustic parameters and aperture attributes, enabling application of this method to large blood vessels located at varying depths. The performance of the method was evaluated in vitro (vessel diameter 2mm) by quantifying the sensitivity of the method to various acoustic, microbubble, and fluid flow parameters. It was observed that the static microbubble response maximized at the approximate resonance frequency of the microbubble population (estimated from a coulter counter measurement), thus, signifying the need for dual frequency excitation. The static microbubble signal declined from 25 to 12 dB with increasing centerline flow velocities (2.65–15.9cm/s); indicating the applicable range of flow velocities. The maximum intensity of the static microbubbles signal scaled with variations in the microbubble concentration. The rate of increment of static microbubble signal was independent of microbubble concentration. It was deduced that the rate of increment of the static microbubble signal is primarily a function of the pulse frequency, whereas the maximum static microbubble signal intensity is dependent on three parameters: (a) the pulse frequency, (b) the flow velocity and (c) the microbubble concentration. The proposed dual frequency sequence may enable the application of radiation force for optimizing the effect of targeted imaging and modulating drug delivery in large blood vessels with high flow velocities. (E-mail: avp2b@virginia.edu)     

Quantitative Image Analysis Study of the Cerebral Vasodilatory Activity of Nicardipine in Spontaneously Hypertensive Rats

The effect of the Ca²⁺ channel blocker nicardipine on the circle of Willis and the different sized pial arteries was assessed in 20—week- old spontaneously hypertensive rats (SHR) using quantitative image analysis techniques. Normotensive Wistar Kyoto (WKY) rats were also used as a normotensive reference group. In SHR a significant increase of systolic blood pressure (SBP) is noticeable in comparison with WKY rats. The media-to-lumen ratio was increased in the circle of Willis arteries, large sized (diameter > than 150 μm), medium sized (diameter between 150 and 50 μm) and small sized (diameter < than 50 μm), pial artery branches. An increase in the thickness of the tunica media and a luminal narrowing was also seen in medium and small sized pial arteries of SHR in comparison with WKY rats. Treatment with an oral dose of 10 mg/Kg of nicardipine 3 h before the sacrifice significantly reduced SBP in SHR. The drug was without effect on circle of Willis and on large sized pial arteries. Moreover, treatment with nicardipine reduced the thickness of the tunica     

Atomic force microscopic measurement of the mechanical properties of intact endothelial cells in fresh arteries

Mechanical properties of living endothelial cells in the abdominal aortas and in the medial and lateral wall of aortic bifurcations obtained from rabbits were determined by means of an atomic force microscope (AFM), focusing on the locational differences. Force (F)-indentation (δ) curves of the cells were expressed by an exponential function: F=a(exp(bδ)−1), where a and b are constants. The parameters b and c(=ab) represent the rate of modulus change and initial modulus, respectively. The slope of F-δ curves a and the parameter c were higher in the medial wall than in the other sites, which is attributable to abundant stress fibres in endothelial cells in the medial wall. There were no differences in the parameter b among the three locations. These results indicate that endothelial cells are stiffer in the medial wall of aortic bifurcation than in the other regions.