Free‐wall perforation of the left ventricle after acute myocardial infarction complicated with pericardial tamponade that mimicked ascending aortic dissection: A case report

Life‐threatening cardiac events may be misdiagnosed as acute aortic dissection because of notable symptom mimicry. We report the case of a 72‐year‐old male patient with presentations presumed to be of aortic origin. However, surgery revealed posterior free‐wall perforation in the left ventricle caused by the occlusion of an obtuse marginal branch.     

曹志群基于气机升降理论运用药串治疗消化系统疾病经验

"药串"是指相对固定的3味或3味以上的药物组合,作为中药配伍的独立单元,是针对一定病证,从历代医家用药经验中提炼出来的行之有效的、符合一定理论依据和法度的固定配伍。曹志群提出了"脏腑气血升降—在经(气)、入络(血)—久病及肾"的辨证模式,运用药串升降、消补、燥润、清化等方法治疗消化系统疾病,积累了丰富经验。从肺大肠、脾胃、肝胆气机升降三个方面列举运用药串治疗反流性食管炎、溃疡性结肠炎、功能性便秘、消化道溃疡、慢性胃炎、消化吸收不良综合征、胆囊炎、反流性胃炎等消化系统疾病经验。     

《傅青主女科》学术特色举隅

《傅青主女科》学术特色体现在以下四方面:①别出心裁,补中寓散治带下;②匠心独运,升降结合调月事;③运筹帷幄,养血保精求子嗣;④注重二天,健脾固肾愈胎病。     

普济宣肺消毒饮治疗急性支气管炎化痰作用临床观察

目的 观察普济宣肺消毒饮对急性支气管炎化痰作用.方法 用随机、对照、前瞻性研究方法,将87例急性支气管炎（表寒里热证）患者随机分为治疗组44例和对照组43例,治疗组服用普济宣肺消毒饮,对照组用急支糖浆治疗,观察对咯痰的影响,疗程为7d.结果 治疗组对咯痰、发热、头痛、恶风等症状有明显治疗作用,治疗后咯痰疗效和评分低于对照组,化痰疗效优于对照组（P＜0.05）.结论 普济宣肺消毒饮有一定的化痰作用.     

Single-stage off-pump repair of coarctation of the aorta and ventricular septal defects in children

Open in a separate window OBJECTIVESThe appropriate approach for surgical repair of coarctation of the aorta with a ventricular septal defect (VSD) remains controversial. This study evaluated the outcomes of primary repair of VSDs with periventricular device closure without cardiopulmonary bypass through a left thoracotomy in patients without arch hypoplasia.METHODSWe selected 21 patients aged <1 year, including 7 neonates, who underwent repair of coarctation of the aorta with periventricular device closure of a VSD.RESULTSThe median occluder size was 6 (range, 5–8) mm. The median mechanical ventilation time was 14 (range, 2–68) h, and the median duration of hospital stay was 11 (range, 7–16) days. No reoperations were required to correct VSD shunting, and the median residual shunt size was 1 (range, 1–2) mm. The median follow-up period was 13 (range, 4–31) months. No late deaths were reported, and no haemodynamically significant pressure gradient at the anastomotic site was observed. The median distal aortic arch z-score was 0.39 (range, −0.1–to 0.9). Only 1 patient had a permanent pacemaker implanted towards the end of the follow-up period.CONCLUSIONSPeriventricular device closure can be used safely for closure of VSD in children with coarctation of the aorta without a hypoplastic aortic arch, even in neonates, to reduce the risk of prolonged cardiopulmonary bypass. This hybrid approach can be performed with a low incidence of rhythm disturbances and residual shunting. However, a meticulous assessment of the VSD anatomy is essential to avoid any unfavourable events.     

安心颗粒对血脂紊乱家兔血脂及主动脉超微结构的影响

目的:研究安心颗粒对家兔实验性血脂紊乱的防治作用.方法:采用食饵性血脂紊乱新西兰家兔为模型,以脂必妥片为对照药,观察安心颗粒对血脂、主动脉超微结构的影响.将32只新西兰家兔随机分为正常对照组、模型组、脂必妥片组、安心颗粒组等4组,分别给予普通饲料、高脂饲料、高脂饲料加脂必妥片、高脂饲料加安心颗粒.10周后,测定各组动物血清总胆固醇(total cholesterol,TC)、甘油三酯(triglycerides,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、载脂蛋白A1(apolipoprotein A1,ApoA1)、载脂蛋白B(apolipoprotein B,ApoB)水平,同时用电镜观察主动脉超微结构.结果:安心颗粒可以显著降低血脂紊乱新西兰兔血清TC、TG、LDL-C、ApoB水平;电镜下主动脉超微结构观察显示:安心颗粒组主动脉硬化病变较模型组和脂必妥片组轻,血管内皮细胞质内偶见小脂滴空泡,各种细胞器存在,内弹力膜存在,中层平滑肌细胞质内无脂滴空泡.结论:安心颗粒能调节兔的血脂代谢,对动脉粥样硬化病变有明显的抑制作用.     

Endovascular stenting for nutcracker syndrome

Nutcracker syndrome (NCS) is a rare pathology manifested by pain or hematuria in males and females alike. It can be easily overlooked, and should be considered in young men or women with symptoms of extended duration. We present a case of a 54-year-old female with chronic lower abdominal pain radiating to the left thigh of 4 years in duration. Computed tomography (CT) eventually revealed engorged left renal, gonadal, and uterine veins due to compression between the superior mesenteric artery (SMA) and the abdominal aorta, consistent with NCS. After a successful endovascular stenting and a 6-month period of antiplatelet and anticoagulant therapy, the patient returned to stable health. NCS, while rare, should be suspected in patients of both sexes with persistent pain or hematuria.     

Comparison of laparoscopic and retroperitoneoscopic approaches to the great vessels in a porcine model

Summary

Conventional laparoscopy has not yet been widely adopted for procedures involving the retroperitoneal organs, due to the problems of adequate bowel retraction and the poor access afforded by the position of the root of the mesentery. Developments in retroperitoneal laparoscopy facilitated by balloon dissection have afforded a new minimally invasive approach to the retroperito-neum. We have compared retroperitoneoscopic and laparoscopic approaches to the great vessels in a porcine model.     

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.     

超声心动图诊断小儿主动脉缩窄

目的 探讨超声心动图对小儿主动脉缩窄的诊断价值.方法 经超声心动图诊断的主动脉缩窄50例,男33例,女17例,年龄5天～11岁(中位年龄9个月零9天),均经手术和(或)造影证实.超声心动图检查在胸骨上主动脉弓长轴切面观显示主动脉弓及其三分支,确定缩窄范围和类型.彩色多普勒超声心动图显示主动脉缩窄处血流,频谱多普勒测量缩窄处血流速度.结果 50例患儿中,局限性缩窄23例,占46.00%;管状缩窄27例,占54.00%;33例合并动脉导管未闭.结论 将小儿主动脉缩窄分为管状缩窄和局限性缩窄可能更为合理;管状主动脉缩窄较常见.