A new method of measuring arterial dilation and its application

An instrument has been designed and constructed for thein-vivo measurement of instantaneous (phasic) diameter changes of arteries. The continuous record of this blood-vessel dimension, when recorded simultaneously with blood pressure, may be used to estimate the viscoelastic properties of the arterial wall.     

夹闭大鼠双侧颈总动脉对胃运动的影响

采用动脉夹夹闭大鼠双侧颈总动脉,胃内放置水囊记录胃运动的方法,观察了脑供血不足对胃运动的影响。结果表明:(1)夹闭30 min过程中,最初2 min内的胃运动指标(收缩频率、总收缩时程、总收缩幅度、胃运动指数)较夹闭前2 min内抑制显著;夹闭第28~30 min(即松开动脉夹前2 min内)的胃运动各项指标较夹闭前2 min均无显著差异。(2)松开动脉夹30 min过程中,松开后最初2 min内与松开前2 min内相比,胃运动抑制显著;但松开后第28~30 min的胃运动与松开前2 min内的胃运动相比,无显著差异。这些结果说明:夹闭双侧颈总动脉造成脑局部供血不足初期,对胃运动有抑制作用,但随着结扎时间的延长,这种抑制作用逐渐消除,可能是椎-基底动脉环起了代偿作用。     

脾内动脉吻合的临床意义初探

目的:探讨脾内动脉吻合与部分脾栓塞术(PSE) 及部分脾切除术的关系。材料与方法:回顾性分析110 例脾动脉造影病例,着重观察脾内动脉吻合的出现率、吻合形式、部位及吻合点远端脾动脉分支直径。结果:脾内动脉吻合的显示率为22-7 % ,其中叶间吻合10 % 、段间吻合7-3 % 。吻合形式分为短交通支吻合、弓形吻合、汇集型吻合三种。吻合点远端脾动脉分支直径≤1m m 者占5-5 % 。结论:若采用1m m3( 或以下) 容积的栓塞剂行PSE 术,栓塞剂绝大部分滞留在吻合点远端的脾动脉分支内,吻合动脉不能向被栓塞的脾实质供血。但行部分性脾切除术时,应警惕叶间、段间吻合动脉的出现并慎重处理这些吻合动脉。     

超选择性脑动脉内插管灌注尿激酶治疗急性脑梗塞

采用超选择性脑动脉内插管灌注尿激酶溶栓治疗急性脑梗塞患者１１例，结果５例再通，６例部分再通。治疗前肌力０度者５例，Ⅱ度者２例，Ⅲ度者４例。治疗后肌力提高Ⅰ￣Ⅱ度者３例，提高Ⅲ度者２例，提高Ⅴ度者１例，肌力恢复正常者３例，死亡３例，总有效率７２．７％。并发颅内出血２例。     

颈动脉壁结构变化与心脑血管事件关系的研究

目的研究老年人颈动脉血管壁结构变化与心脑血管事件的关系。方法采用高分辨率彩色多普勒超声仪,对255例老年疗养干部颈动脉结构进行超声检测和临床观察,并将心脑血管疾病组患者的血管壁结构、血流动力学参数及临床检测结果与对照组作比较。结果心脑血管疾病组老人颈部血管硬化指标IMT、PI、R I以及脂质代谢指标TG、HDL等显著大于对照组(P<0.05),Vs、Vd显著低于对照组(P<0.05)。结论颈动脉超声检测对于评估和防治心脑血管疾病有重要临床价值。     

健康成人颈动脉弹性特征的研究

目的 应用速度向量成像(VVI)技术分析健康成人颈总动脉(CCA)短轴方向管壁运动和弹性参数特点及其与影响因素间的关系.方法 2013年12月至2015年7月我院健康体检者400例依据年龄、性别分组,采用Siemens Acuson Sequoia 512彩色多普勒超声诊断仪采集CCA动态短轴二维图像,以VVI技术测量各组颈总动脉管壁短轴方向各侧壁(前壁、外侧壁、后壁、内侧壁)的收缩期峰值速度(Vmax)、峰值应变(Smax)及峰值应变率(SRmax).结果 健康成人颈总动脉各侧壁的弹性参数Smax、SRmax比较差异均无统计学意义(P>0.05),而外侧壁和前壁的运动参数Vmax分别为(6.65±0.80)×10-2 cm/s、(5.66±0.73)×10-2 cm/s,明显高于后壁和内侧壁的(3.70±0.81)×10-2 cm/s、(3.86±0.36)×10-2 cm/s,差异均有统计学意义(P<0.05);运动参数Vmax男性组均数为(6.25±1.17)×10-2 cm/s,均大于女性组的(4.66±1.28)×10-2 cm/s,而弹性参数Smax、SRmax女性组均数分别为(3.72±0.42)%、(0.21±0.17)/s,均大于男性组的(3.02±0.42)%、(0.17±0.20)/s,各项指标比较差异均有统计学意义(P<0.05);随着年龄的增长,各项指标呈下降趋势,差异有统计学意义(P<0.05).结论 VVI技术可用于研究健康成人CCA管壁的运动力学特点及其与影响因素之间的关系.     

瑞芬太尼对人肠系膜小动脉平滑肌细胞L-型钙通道电流的影响

目的观察瑞芬太尼对人肠系膜小动脉平滑肌细胞(MASMCs)L-型钙通道电流的影响,探讨其扩张血管的机制。方法酶解法分离人肠系膜小动脉单个平滑肌细胞,采用全细胞膜片钳技术,以钡电流作为载流子,观察19.4nmol／L瑞芬太尼在不同钳制电压下以及不同浓度瑞芬太尼在最大激活电压下对MASMCs L-型钡电流(TBa-L)的影响。结果19．4 nmol／L瑞芬太尼可抑制TBa-L,使电流密度-电压曲线上移,最大激活电压及翻转电压均向膜的负电位方向移动(P<0．01)。瑞芬太尼浓度依赖性地抑制TBa-L,其半数最大抑制效应的浓度为(39±4)nmol／L。结论瑞芬太尼浓度依赖性地抑制人肠系膜小动脉平滑肌细胞L-型钙通道,从而产生扩张血管的作用。     

Suture-mediated percutaneous closure of the arterial puncture site after abdominal aortic stent implantation

Summary

We report the use of a vascular surgical device to provide safe closure of the arterial access site after abdominal aortic-stent implantation. After suture-mediated percutaneous closure of the arterial puncture site, bleeding stopped immediately. There was no need for adjunctive compression. Immobilisation of the patient lasted only 1 h.     

肺癌支气管动脉CTA成像及其在介入治疗中的应用价值

目的探讨肺癌支气管动脉CTA成像及其在介入治疗中的应用价值。方法分析15例经支气管动脉介入治疗前的肺癌病例,其中中央型13例,周围型2例。15例均行螺旋CT增强扫描,薄建后传至工作站利用多平面重组(MPR)、最大密度投影(MIP)和容积再现(VR)等后处理技术观察支气管动脉。结果13例中央型肺癌均由肿瘤性支气管动脉供血,图像清晰显示肿瘤性支气管动脉的起点、分支及走行;2例周围型肺癌中有1例由肿瘤性支气管动脉供血,1例找不到明确发自支气管动脉的供血血管。结论肺癌支气管动脉CTA成像能够显示肺癌特别是中央型肺癌的肿瘤性支气管动脉,并能为介入治疗提供准确定位和其他参考数据。     

Accessory renal artery stenosis and hypertension: are these correlated? Evaluation using multidetector-row computed tomographic angiography

Background: Renal artery stenosis may produce hypertension, and this condition is referred to as renovascular hypertension (RVH).

Purpose: To evaluate, by using multidetector-row spiral computed tomographic angiography (MDCTA), whether a relationship between accessory renal artery stenosis and hypertension may be hypothesized.

Material and Methods: 214 patients (142 males, 72 females; mean age 66 years) who had previously undergone an MDCTA to study the abdominal vasculature were retrospectively studied. Patients with renal artery stenosis (RAS) were excluded from this analysis. The patients were studied by means of a four-detector-row CT, and scans were obtained after intravenous bolus administration of 110-140 ml of a nonionic contrast material with a 3-6 ml/s flow rate. As a second step, by means of statistical analysis, hypertension data were compared with findings of accessory artery stenosis. Two radiologists first independently reviewed the MDCTA images and then, in case of disagreement, in consensus. Interobserver agreement was calculated for all measurements.

Results: The overall number of detected accessory renal arteries was 74 in 56 of the 214 patients. Accessory renal artery stenosis was detected in 21 of the 56 patients. There was a difference in the prevalence of hypertension between patients with (n = 21) and without (n = 35) accessory renal artery stenosis (P = 0.0187). Interobserver agreement was good (kappa value 0.733).

Conclusion: Any statistical association between the presence of accessory renal artery stenosis and hypertension could not be disclosed. However, accessory renal artery stenosis, detected by MDCTA, is an important pathological sign that the radiologist has to assess in the light of its possible association with hypertension.