高血压左室肥厚伴发左心衰竭行心脏彩色多普勒超声的临床诊断价值分析

目的:分析在高血压左室肥厚并左心力衰竭患者诊断中应用心脏彩色多普勒超声的诊断价值。方法:随机抽取2017年8月~2019年9月本院73例高血压左室肥厚并左心力衰竭病例并纳入观察组,另选择健康体检者70例并纳入对照组。均进行心脏彩色多普勒超声诊断,对比组间各指标的差异以及不同心功能分级患者的心脏彩超指标测定结果。结果:观察组的SBP、DBP、LVM、LVEF、LVFS、LVESD、LVEDD检测结果均高于对照组,且两组各指标比较中P<0.05;心功能Ⅲ级组患者的LVEDD、LAD、E/Ea均高于Ⅰ级与Ⅱ级组患者,同时LVEF低于Ⅰ级与Ⅱ级组患者,且各组间比较中P<0.05;心功能Ⅱ级组患者的LVEDD、LAD、E/Ea均高于Ⅰ级患者,同时LVEF低于Ⅰ级组患者,且组间比较中P<0.05。结论:实施心脏彩色多普勒超声检查有利于实现患者的明确诊断,可对其心功能情况的有效判别提供参考依据。     

肥大心肌磷脂酶C的活性变化及卡托普利对其影响

目的 :探讨肾性高血压所致肥大心肌组织磷脂酶C(PLC)活性改变在心肌肥大发生发展中的作用。方法 :制作两肾一夹 (two kindneyoneclip ,2KIC)高血压动物模型 ,以未进行两肾一夹者为假手术组。观察术后 1周、2周、4周和 8周时动脉血压 ,心肌肥大指数 ,心肌ACE活性及PLC活性的变化 ;术后 4周给予卡托普利 (captopril) ,观察 8周时动物的动脉血压 ,心肌肥大指数 ,心肌ACE活性及PLC活性的变化。结果 :术后 2周开始发生高血压与心肌肥大 ,心肌ACE活性于术后 2周、4周、8周显著增高 ;PLC活性于术后 2周、4周、8周分别增高 6 4 6 5 % (P<0 0 5 )、81 5 3 % (P <0 0 5 )、97 2 2 % (P <0 0 1) ,术后 4周给予captopril ,至 8周动脉血压、心肌肥大指数、心肌ACE活性及PLC活性均回降至假手术组水平。结论 :肾性高血压所致肥大心肌组织磷脂酰肌醇特异性PLC活性升高 ,AngⅡ可能通过活化的PLC参与心肌肥大的发生过程     

倍他乐克逆转高血压左室肥厚的临床观察

目的　比较 2药对高血压左室肥厚患者的疗效及运动后对心率、血压的影响。方法　采用随机分组法将 80例高血压左室肥厚的病人分成两组 ,倍他乐克组和硝苯地平组 ,治疗前后查超声心动图 ,测定IVST、PWT及LVMI ,心率及血压。结果　① 2药降压效果无明显差异。② 2组患者IVST、PWT、LVMI的下降幅度相同。③中度体力活动后 ,倍他乐克组心率增快 9± 2次 ,收缩压、舒张压上升均小于 3kPa(7 5mmHg) ,硝苯地平组心率增快 2 0± 4次 ,2组相比P <0 0 1,具有显著意义 ;收缩压、舒张压上升幅度均为 3 4± 1 2kPa(2 6±9mmHg) ,明显大于倍他乐克组。④结论　 2药对高血压患者的左心室肥厚有相似的逆转作用 ,但倍他乐克可减少体力活动时血压及心率的上升 ,对心脏更具有保护作用。     

Schafer列线图在良性前列腺增生术前评价中的应用

目的 :研究Schafer列线图在确定前列腺手术适应证中的作用。方法 :对 45例前列腺增生症 (BPH)患者进行了压力 -流率测定 ,经Schafer列线图和线性被动尿道阻力关系 (Lin -PURR)定量分析BPH患者膀胱出口梗阻 (BOO)程度和逼尿肌收缩强度。结果 :本组患者无BOO和轻度BOO者为 2 0 .0 % ,逼尿肌收缩强度很弱者为 8.9% ,不适合前列腺手术者为 2 8.8%。结论 :对BPH患者术前作出准确的评价 ,在前列腺治疗的方法选择方面有十分重要的意义     

改良Madigan术切除前列腺中叶增生

目的：改良Madigan术式治疗前列腺中叶增生。方法：对22例前列腺增生患者采用了先行耻骨后保留尿道切除膀胱颈以远的腺体;再经膀胱入路,在突入膀胱腔内的增生中叶腺体的前壁作远离尿道内口2cm的弧形切口,直视下分离膀胱颈和尿道后壁的粘膜,完整切除腺体,直视下修剪并缝合固定粘膜,将膀胱与腺窝隔离,同时处理膀胱内的其它病变。结果：本组22例手术顺利,出院时测最大尿流率14．0－24．5ml/s,IPSS平均4．5分,B超测定剩余尿≤20ml。术后21例随访3－30个月,最大尿流率未降低,无尿道狭窄,排尿通畅。结论：我们在实际操作过程中达到切除全部增生腺体,完整保留了尿道组织,直视下修剪并缝合固定膀胱后唇粘膜,将膀胱与腺窝隔离,同时处理了膀胱内的其它病变,操作方便,无后顾之忧。     

女性单纯声带肥厚和声带小结的嗓音参数分析比较

目的：通过比较和分析单纯声带肥厚和声带小结的嗓音参数的变化,评价这些参数在两种疾病中诊断及疗效。方法：应用Dr.Speech(DSS)软件对成人女性30例单纯声带肥厚和声带小结患者做噪音测试,对其主要声学参数进行比较分析。结果：声带小结的嗓音声学参数、基频微扰、声门噪声能量NEE值均较声厚的各指标高。其中声门噪声能量在声结中异常者占99．6％,声带肥厚占80％,两组之间有显著性差异（P＜0．05）。其频微扰和振幅微扰的异常占有率,两组之间无显著性差异（P＞0．05）。结论：嗓音参数对诊断和区别声带肥厚和声结有一定的价值,特别是声门噪声能量有更高的敏感性,对诊断和治疗声带疾病有一定的价值。     

三类降压药物对高血压大鼠心肌细胞凋亡及左室重构的对比研究

目的 :评价氯沙坦、福辛普利、氨氯地平对自发性高血压大鼠 (SHR)心肌细胞凋亡及左室重构的效应。方法 :将 40只 16周龄SHR随机分为氯沙坦治疗组 (SHR -L)、福辛普利治疗组 (SHR -F)、氨氯地平治疗组 (SHR -A)及空白对照组 (SHR -C)。采用末端脱氧核糖核苷酸转移酶介导dUTP缺口末端标记、放免及病理检查方法对SHR治疗 8周、16周心肌细胞凋亡指数 (APOI)、血浆和组织血管紧张素II(PAngII,MAngII)及左室重构指标检测。结果 :①各治疗组治疗 8周、16周收缩压均明显下降 ,组间差异无显著性 ;各治疗组左室重量 (LVW)、左室重量指数 (LVMI)均有显著性改善 ,SHR -F组治疗 16周较其他两组LVMI显著减低。②仅SHR -F组治疗 8周APOI显著性下降 ,治疗 16周各治疗组APOI均有显著下降 ,尤以SHR -F组下降明显。③SHR -L组治疗 8周及 16周PAngII,MAngII显著增加。SHR -F组治疗 8周MAngII显著下降 ,治疗 16周SHR -F ,SHR -A两组MAngII均明显下降 ,且前组较后组下降显著 ,但对PAngII无明显影响。结论 :3药物均能有效逆转心脏肥厚及抗心肌细胞凋亡 ,其中以福辛普利显著。上述作用可能是拮抗心肌组织肾素 -血管紧张素 -醛固酮系统的效应。     

Optimization of the future remnant liver: review of the current strategies in Europe

Liver resection still represent the treatment of choice for liver malignancies, but in some cases inadequate future remnant liver (FRL) can lead to post hepatectomy liver failure (PHLF) that still represents the most common cause of death after hepatectomy. Several strategies in recent era have been developed in order to generate a compensatory hypertrophy of the FRL, reducing the risk of post hepatectomy liver failure. Portal vein embolization, portal vein ligation, and ALLPS are the most popular techniques historically adopted up to now. The liver venous deprivation and the radio-embolization are the most recent promising techniques. Despite even more precise tools to calculate the relationship among volume and function, such as scintigraphy with ^99mTc-mebrofenin (HBS), no consensus is still available to define which of the above mentioned augmentation strategy is more adequate in terms of kind of surgery, complexity of the pathology and quality of liver parenchyma. The aim of this article is to analyse these different strategies to achieve sufficient FRL.     

Lysosomal and energy enzyme activities in hypertrophied rat soleus muscle after denervation

Muscle hypertrophy was induced in the soleus muscle of young rats by tenotomy of the gastrocnemius and plantaris muscles. Three and 7 days afterwards the sciatic nerve was sectioned. The loss of weight of muscles subjected to this combined procedure three days after denervation was 30–40%. Lysosomal enzyme activities (acid phosphatase, -glucosidase, -galactosidase and N-acetyl--d-glucosaminidase) and energy enzyme activities (lactate dehydrogenase, LDH, triose-3-phosphate dehydrogenase, TPDH,d-hexokinase, HK and citrate synthase, CS) were determined 3 days after denervation, 3, 7 and 10 days after hypertrophy had been induced and 3 days after denervation of hypertrophying muscles on day 3 and 7. Normal non-operated rats of corresponding body wieght served as controls and their enzyme activities were estimated on the same day. In the course of muscle hypertrophy, the 4 lysosomal enzyme activities increased progressively. Although 3 days' denervation of control muscles did not alter lysomal enzyme activities, denervation of hypertrophying muscles greatly enhanced the activity of these enzymes. Enzymes of energy metabolism were affected to a lesser degree. The results suggest that denervation of hypertrophying muscles causes more extreme changes in muscle weight and lysosomal enzyme activities than denervation alone. The possible implications of this finding are discussed in relation to the rapid atrophy.