通络生骨胶囊加微创内固定术治疗非创伤性股骨头缺血性坏死患者的护理

对185例口服中药通络生骨胶囊加微创植骨支撑内固定术治疗围塌陷期非创伤性股骨头缺血性坏死患者进行护理,认为术前做好各项检查及心理护理,术后注意观察病情变化,保持术肢体位正确,加强基础护理,预防并发症,正确指导患者服用中药及功能锻炼,并做好出院指导工作,对患者恢复髋关节功能起重要作用。     

Bilateral proximal deep vein thrombosis and COVID‐19 in a patient with absence of inferior vena cava: A case report and review of literature

Bilateral proximal deep vein thrombosis (DVT) in the lower extremities of young patients should raise suspicion over pro‐thrombotic conditions and venous anatomical abnormalities, even in the presence of other precipitating factors, such as viral infection. The authors present a 33‐year‐old man with bilateral DVT and absence of inferior vena cava (AIVC), who also had concurrent COVID‐19, and discuss the management of this patient.     

Modeling Time to Cure of Deep Vein Thrombosis Using Cox Proportional Model in Southwest of Ethiopia

BackgroundGlobally, there are about 10 million cases of deep vein thrombosis every year, and it is the third leading cardiovascular disease after myocardial infarction and stroke. The objective of the study is to assess risk factors of time to cure patients of deep vein thrombosis in southwest Ethiopia.MethodsA retrospective cohort study design was used. The study population was deep vein thrombosis patients at purposively selected hospitals in Southwest Ethiopia from January 2017 to December 2020. Cox proportional hazard model was used to identify risk factors associated with deep vein thrombosis.ResultsOut of the total 1068 registered as deep vein thrombosis patients, 263(24.6%) were cured during the study period, and 805(75.4%) were censored. Results of the Cox proportional hazard model show that; age, gender, family history of deep vein thrombosis, smoking status, immobilize and alcohol consumption were factors associated with deep vein thrombosis (p-value<0.05).ConclusionThe patients with a family history of deep vein thrombosis, prolonged immobilization, greater the 50 years, smoking cigarettes, female (non-pregnant) and alcohol users had a longer curing time of deep vein thrombosis compared to others.     

原发性肝癌全肝切除标本的病理解剖学特征及其启示

目的 探讨原发性肝癌的病理解剖学特征及其意义.方法 2000年8月至2007年12月共有89例肝硬化合并原发性肝癌患者接受肝移植手术,收集手术切除标本及受侵犯的邻近组织和肿大的淋巴结.将标本沿冠状切面每隔1.0 cm切开,观察肝癌的大小、数目、分布、包膜、门静脉瘤栓、卫星灶,并记录卫星灶与主瘤问的距离、受肝癌侵犯的组织、淋巴结等,然后送病理学检查,最终诊断以病理报告为准.结果 89例患者中,肝细胞肝癌86例,胆管细胞性肝癌3例;多发肿瘤53例,单发肿瘤36例;13例主瘤在右叶,但左叶存在小癌灶;14例有较完整的包膜,75例无包膜,无包膜病例中11例边界不清;术中所见侵犯邻近组织的25例患者中,8例经病理证实,16例的肿大淋巴结中7例有癌浸润;有门静脉主干或分支瘤栓者42例(47.2%),有卫星灶者39例(43.8%),瘤栓与卫星灶随肿瘤体积、数目增加而增加;卫星灶距主瘤距离多为0.5～3.0 cm,少数达5.0 cm.结论 全肝切除标本能全面地反映肝癌牛长和浸润特征.应警惕门静脉瘤栓及卫星灶的存在,特别是距主瘤较远的卫星灶及门静脉小支内的瘤栓,以及分布在另一肝叶的小癌灶.这些因素在影像学检查时容易漏诊,但会影响肝切除术或肝移植术的疗效.     

门静脉、肠系膜上静脉的解剖与临床应用的初步研究

目的 为提高肝门胆管癌和壶腹周围癌的手术切除率,使该区域受肿瘤浸润的血管能同时切除,血管直接重建提供解剖学依据.方法 在实施肝门胆管癌切除术及胰十二指肠切除术中,对病人的肝蒂内门静脉干、胰腺钩突内的肠系膜上静脉干进行解剖学定位并分段测量长度及可以纵向折叠的长度,以此估计可切除的静脉长度及重新再建血管的长度.结果 测量肝蒂内门静脉干104例,男性(5.8±1.99)cm,女性(5.5±O.81)cm,优势长度大于4.5cm者,男性56例占76.7%,女性25例占80.6%.胰腺钩突内段肠系膜上静脉干测量54例,男性(3.7±0.77)cm,女性(3.5±0.64)cm,优势长度大于3.0cm者,男性28例占77.6%,女性14例占77.8%.门静脉纵向折叠移动的范围在1.8～4.2cm,平均折叠2.2(1.8～2.4)cm者占66.3%,平均折叠2.8(2.5～4.2)cm者占33.7%.切除胰十二指肠后胰腺钩突内肠系膜上静脉段纵向折叠范围平均4.0cm,最长达5.2cm.结论 肝门胆管癌和壶腹周围癌切除术合并受浸血管切除在一定范围是可行的.     

散血明目片对非缺血型视网膜静脉阻塞患者血液流变学的影响

目的探讨散血明目片对非缺血型视网膜静脉阻塞患者血液流变学及血清相关生化指标的影响及作用机制。方法将34例非缺血型视网膜静脉阻塞患者随机分为治疗组（17例17眼）与对照组（17例18眼）,治疗组口服散血明目片,对照组口服血栓通片,两组均同时配合其他中西医常规治疗方法。治疗2个月后比较两组临床疗效、血液流变学及血清相关生化指标的差异。结果治疗组总显效率与对照组比较,差异有显著统计学意义（P〈0.01）;治疗组治疗前后低切和高切全血比黏度、红细胞电泳、血浆黏度、红细胞聚集指数、AT-Ⅲ、lp（a）、NO、A-CL IgG阳性率、ACL IgM阳性率、LA阳性率差异有显著统计学意义（P〈0.01）;ET-1、ACL IgA阳性率差异有统计学意义（P〈0.05）。结论散血明目片是治疗非缺血型视网膜静脉阻塞的有效药物,其作用机制可能与升高AT-Ⅲ、降低lp（a）、APL在血浆中的含量、稳定ET-1/NO比值有关,在外可反映于血液流变学指标的变化。     

吸毒人员感染性股动脉破裂的治疗体会

目的：探讨股动脉结扎对吸毒人员感染性股动脉破裂的疗效。方法：回顾性分析2004年4月至2009年4月我院收治的21例吸毒人员股动脉感染破裂的治疗经过。在术中进行远端动脉测压,远端动脉的压力大于50mmHg时,采用股总动脉、股浅动脉、股深动脉结扎和局部清创。结果：21例病人无术后死亡和出血,22条下肢无截肢。均随访6个月无间歇性跛行。结论：吸毒人员股动脉感染破裂需紧急手术,远端动脉的压力大于50mmHg时,采用股总动脉、股浅动脉、股深动脉结扎和局部清创治疗效果好,手术操作安全简单,易在基层医院开展。     

同样的抗凝，为何不同的开通？——门静脉血栓程度的临床意义

《肝脏病学》（Hepatology）杂志2010年1月刊登了一项有关急性门静脉血栓形成的抗凝治疗的前瞻性队列研究。这项研究较此前所有关于抗凝治疗门静脉血栓的研究更为重要。研究显示,在应用抗凝治疗后,门静脉比肠系膜上静脉和脾静脉的开通率更高。这一看似矛盾的现象引起了我们的关注．并对此作了进一步的分析。     

Accuracy of atrial fibrillation detection by an insertable cardiac monitor in patients undergoing catheter ablation: Results of the BioVAD study

BackgroundInsertable cardiac monitors (ICMs) are increasingly used to evaluate the atrial fibrillation (AF) burden after catheter ablation of AF. BioMonitor III (BM3) is an ICM with a long sensing vector, which enhances sensing capabilities. The AF detection algorithm of the BM3 is based on R–R interval variability.ObjectiveTo evaluate the performance of the AF detection algorithm of BM3 in patients before and after catheter ablation of AF using simultaneous Holter recordings.MethodsIn this prospective study, we enrolled patients scheduled for catheter ablation of paroxysmal or persistent AF. After BM3 implantation, patients had a 4 days Holter registration before and 3 months after ablation. All true AF episodes ≥2 min on the Holter were annotated and matched with BM3 detected AF detections.ResultsThirty‐one patients were enrolled (mean age 60 ± 8, 74% male, 68% paroxysmal AF). Fifty‐six Holter registrations were performed in 30 patients. Twelve patients demonstrated at least one true AF episode with a total AF duration of 570 h. The AF burden accuracy of BM3 before catheter ablation was 99.6%, with a duration sensitivity of 98.6% and a duration specificity of 99.9%. The AF burden accuracy of BM3 after catheter ablation was 99.8%, with a duration sensitivity of 90.2% and a duration specificity of 99.9%. Overall, the AF burden detected on the Holter and BM3 demonstrated a high Pearson correlation coefficient of 0.996.ConclusionBM3 accurately detects AF burden in patients before and after catheter ablation of AF.     

Aqueous Extracts of Tribulus terrestris Protects Against Oxidized Low-Density Lipoprotein-Induced Endothelial Dysfunction

Objective:To investigate the role of aqueous extracts of Tribulus terrestris(TT) against oxidized low-density lipoprotein(ox-LDL)-induced human umbilical vein endothelial cells(HUVECs) dysfunction in vitro.Methods:HUVECs were pre-incubated for 60 min with TT(30 and 3 μg/mL respectively) or 10~(-5) mol/L valsartan(as positive controls) and then the injured endothelium model was established by applying 100 μg/mL ox-LDL for 24 h.Cell viability of HUVECs was observed by real-time cell electronic sensing assay and apoptosis rate by Annexin V/PI staining.The cell migration assay was performed with a transwell insert system.Cytoskeleton remodeling was observed by immunofluorescence assay.The content of endothelial nitric oxide synthase(eNOS) was measured by enzyme-linked immunosorbent assay.Intracellular reactive oxygen species(ROS) generation was assessed by immunofluorescence and flow cytometer.Key genes associated with the metabolism of ox-LDL were chosen for quantitative real-time polymerase chain reaction to explore the possible mechanism of TT against oxidized LDL-induced endothelial dysfunction.Results:TT suppressed ox-LDL-induced HUVEC proliferation and apoptosis rates significantly(41.1%and 43.5%after treatment for 3 and 38 h,respectively;P0.05).It also prolonged the HUVEC survival time and postponed the cell's decaying stage(from the 69 th h to over 100 h).According to the immunofluorescence and transwell insert system assay,TT improved the endothelial cytoskeletal network,and vinculin expression and increased cell migration.Additionally,TT regulated of the synthesis of endothelial nitric oxide synthase and generation of intracellular reactive oxygen species(P0.05).Both 30 and 3 μg/mL TT demonstrated similar efficacy to valsartan.TT normalized the increased mRNA expression of PI3Kα and Socs3.It also decreased mRNA expression of Akt1,AMPKα1,JAK2,LepR and STAT3 induced by ox-LDL.The most notable changes were JAK2,LepR,PI3 K α,Socs3 and STAT3.Conclusions:TT demonstrated potential lowering lipid benefits,anti-hypertension and endothelial protective effects.It also suggested that the JAK2/STAT3 and/or PI3K/AKT pathway might be a very important pathway which was involved in the pharmacological mechanism of TT as the vascular protective agent.