经颈外与颈内静脉途径中心静脉置管的临床应用

目的:寻找一种操作简单、并发症少,又具有中心静脉置管优点的导管置入法。方法:采取随机对照分组。经颈外静脉中心静脉置管组50例,经颈内静脉中心静脉置管组56例,比较两种置管途径的效果。结果:经颈外静脉组未发现并发症,但有5例导管不能插入上腔静脉。经颈内静脉组有2例动脉损伤,3例穿刺失败。两组穿刺成功率和并发症的差异无统计学意义。结论:经颈外静脉中心静脉置管是一种操作简单、并发症少的中心静脉置管方法。     

活络育阴方治疗糖尿病模型大鼠的实验观察

目的　探讨活络育阴方治疗消渴病 (糖尿病 )的药理学机制。方法　用四氧嘧啶制备糖尿病模型大鼠 ,观察活络育阴方和中汇糖脉康对糖尿病模型大鼠血糖、总胆固醇、甘油三酯、血液流变学的影响。结果　观察组总有效率 80 0 0 % ,对照组总有效率 6 8 75 % ,两组疗效有显著性差异 (P <0 0 1)。结论　二药物对糖尿病均有疗效 ,但活络育阴汤对降低化验指标方面优于中汇糖脉康。     

Are myocardial infarction and venous thromboembolism associated? Population-based case–control and cohort studies

Introduction

Because the association of myocardial infarction (MI) and venous thromboembolism (VTE) is uncertain, we tested MI as a VTE risk factor and VTE as a predictor of MI.

Materials and Methods

Using Rochester Epidemiology Project resources, we identified all Olmsted County, MN residents with objectively-diagnosed incident VTE over the 13-year period, 1988–2000 (n = 1311), one to two resident controls per VTE case (n = 1511), and all residents with incident MI over the 31-year period, 1979–2010. For VTE cases and controls, we reviewed their complete medical records in the community for VTE and MI risk factors. Using conditional logistic regression we tested MI as a potential VTE risk factor, both unadjusted and after adjusting for VTE risk factors. We also followed VTE cases and controls without prior MI forward in time for incident MI through 12/31/2010, and using Cox proportional hazards modeling, tested VTE as a predictor of MI, both unadjusted and after adjusting for MI risk factors.

Results

The number (%) of MI prior to VTE among cases and controls were 75 (5.7) and 51 (3.4), respectively, and the number (%) of MI after VTE among cases and controls were 58 (4.4) and 77 (5.1), respectively. In univariate analyses, MI was significantly associated with VTE but not after adjusting for VTE risk factors. In both univariate and multivariate analyses, VTE (overall or idiopathic) was not a predictor of MI.

Conclusions

MI is not an independent risk factor for VTE, and VTE is not a predictor of MI.     

五输穴形态学基础的探讨

目的:为更合理地解释五输穴理论寻找形态学依据。方法:研读《黄帝内经》并结合现代解剖学知识,进行比较性研究。结论:五输穴理论与血管理论密切相关,四肢肘、膝关节远端的浅静脉分布模式是五输穴理论的形态学基础。     

Use of the Wallstent in the venous system including hemodialysis-related stenoses

Eighteen patients with a total of 23 venous stenoses or occlusions were treated with the Wallstent. In 5 patients treated for malignant stenosis there was one primary failure due to insufficient stent expansion. The other 4 patients showed rapid relief of their inflow obstruction, all remaining asymptomatic despite later stent occlusion in 1 patient. Four patients were treated for benign postoperative stenoses of the iliac or femoral vein. All stents remained patent for a period of 6 weeks-58 months. Nine patients were treated for one or multiple stenoses along the venous outflow tract of hemodialysis fistulas. Of 14 lesions that were eventually stented, 12 are still patent after 3–27 months (mean 19). However, 10 secondary interventions (eight percutaneous transluminal angioplasty (PTA), two stents) and three additional stent procedures for new lesions were necessary. Although our experience is limited, we believe that patients with tumor compression or postoperative strictures of large veins benefit from treatment with stents. Stenting of venous outflow stenoses in hemodialysis fistulas can significantly prolong stent function, however, PTA should always be the first treatment of choice.     

Venous structures associated with thermoregulation of phocid seal reproductive organs

Backgound: Seal reproductive systems are surrounded by thermogenic muscle and insulating blubber, suggesting elevated temperatures at the gonads and uterus. In the limbs of terrestrial mammals, cooled blood returning from superficial veins is mixed proximally with warm blood returning from deep veins. Thus, mixed cool-superficial and warmdeep venous blood from the hind limbs is returned to the central circulation. Methods: We describe structures observed in salvaged carcasses of harbor (Phoca vitulina), gray (Haliochoerus gryphus), harp (Phoca groendlandica), hooded (Cystophora cristata), and ringed (Phoca hispida) seals. Vessels were identified by dissection of injected and uninjected material. Results: In contrast to terrestrial mammals, phocid seals have anastomoses between the veins of the distal hind limb and the pelvis which allow large volumes of cool blood returning from the skin surface of the flipper to enter the gluteal, pelvic, or pudendo-epigastric veins. This provides a cool-superficial venous return that remains separate from the warm-deep venous return of the femoral veins. The cooled venous blood from the hind flippers supplies venous plexuses lining the inguinal region and the abdominal and pelvic cavities. Conclusions: Cooled blood may prevent hyperthermic insult to seal reproductive systems. © 1995 Wiley-Liss, Inc.     

Calcification in the portal and collateral veins wall: CT findings

We report an uncommon case of calcification of the portal and collateral vein wall, in a patient with thrombosis of the portal vein secondary to cirrhosis, demonstrated by computed tomography.     

Venography with carbon dioxide as a contrast agent

Purpose The purpose of this study was to evaluate the feasibility, safety, and potential role of carbon dioxide (CO₂) as a contrast agent for venography.Methods Consecutive patients with contraindications to iodinated contrast agents or with unsatisfactory iodinated contrast studies underwent CO₂ digital subtraction venography. The images were rated by three experienced angiographers. Image quality and complications were assessed.Results Over a 14-month period, 66 vein segments were studied in 21 patients. There was good correlation between experienced angiographers on CO₂ image quality (R_i = 0.80) and good agreement on diagnosis (k = 0.62). In 91% of the vein segments evaluated with CO₂ there was interobserver agreement on the diagnosis. Upper extremity veins were adequately imaged with CO₂ alone in all (6/6) patients with contraindications to iodinated contrast. Following suboptimal iodinated contrast studies in six patients, CO₂ produced significantly better quality upper extremity central vein images (p < 0.05). Pain following injection into peripheral veins was the only CO₂-related complication. Inferior vena cava (IVC) filters were successfully deployed with CO₂ alone in 78% (7/9) of patients; two required iodinated contrast.Conclusion Based upon initial experience, CO₂ venography can be recommended in patients with contraindications to iodinated contrast or unsatisfactory iodinated contrast studies.Presented before the Annual Meeting and Postgraduate Course, Cardiovascular and Interventional Radiological Society of Europe, June 7, 1994, Aghia Pelaghia, Crete, Greece.