AdCMVCD／5FC自镣基因系统治疗CABG术后再狭窄

目的 研究胞嘧啶脱氨酶基因/5—氟胞嘧啶自杀基因系统对冠状动脉旁路移植术后再狭窄的治疗作用。 方法将含AdCMVCD的病毒上清加压注入兔颈外静脉管腔,半小时后剪下该静脉并用Cuff技术移植于兔颈动脉上,以单纯移植组和AdCMVLacz为对照,通过光镜和电镜观察平滑肌细胞的形态变化,并对血管桥外径、管腔、内膜、中膜面积和外弹力膜周长及管腔相对丧失率进行定量分析,以观察抑制内膜和中膜增生、防止血管再狭窄的效果。 结果 治疗组的内膜和中膜面积明显小于两个对照组;管腔丧失率亦明显减少,AdCMVCD组为3.68±0.42％,单纯移植组为9.68±0.41％.P<0.01。结论 AdCMVCD自杀基因系统对冠状动脉旁路移植术后再狭窄有明显的治疗作用。     

冠状动脉血管成形术后再狭窄的研究现状

经皮冠状动脉腔内成形术是目前冠心痛的重要治疗手段，而术后再狭窄的发生严重影响病人的远期疗效与生活质量。本文介绍了再狭窄的发生机制，并从药物、机械、涂层支架、放射及基因方面对再狭窄的防治研究现状进行了综述分析。     

应用药物球囊与药物洗脱支架治疗左主干再狭窄分叉病变的对比研究

目的 对比应用药物球囊(DCB)血管成形术与再次植入药物洗脱支架(DES)治疗左主干再狭窄分叉病变对患者的长期影响.方法 回顾性纳入2014年10月-2018年10月在天津市胸科医院因左主干再狭窄分叉病变行介入治疗的患者48例,其中DCB组24例,DES组24例,术前、术后均行冠状动脉造影定量分析,39例(81.3％)...     

Soluble guanylate cyclase

Soluble guanylate cyclase (sGC) is a heterodimeric haemoprotein, which represents the intracellular receptor for the ubiquitous biological messenger nitric oxide (NO). Activation of the enzyme facilitates conversion of GTP to the intracellular second messenger cGMP, and it is this molecule which mediates the majority of biological actions attributed to NO. sGC is expressed in virtually all mammalian cells and is important in mediating numerous physiological processes, including vascular and non-vascular smooth muscle relaxation, peripheral and central neurotransmission, platelet reactivity and phototransduction. Due to its ubiquitous nature, the pathogenesis of various disease states has been linked to aberrations in sGC signalling. This is especially true of the cardiovascular system, where inappropriate activation of sGC may underlie conditions such as stroke, atherosclerosis, impotence and septic shock; however, altered sGC activation has also been associated with the pathogenesis of asthma and certain neurodegenerative disorders. Therefore, agents that can modulate sGC function selectively will have considerable therapeutic potential, particularly in the treatment of cardiovascular disease.     

The effectiveness of Salvianolate injection for in-stent restenosis after percutaneous coronary intervention: A protocol for systematic review and meta-analysis

Background:In-stent restenosis (ISR) caused by vascular remodeling after percutaneous coronary intervention limits the long-term efficacy of this method. Salvianolate injection is now widely used in the clinical treatment of ISR. However, there is no systematic review or meta-analysis to evaluate the effects of Salvianolate injection on ISR.Methods:We will search articles in 8 electronic databases, including the Cochrane Central Register of Controlled Trials, PubMed, Embase, the Web of Science, China National Knowledge Infrastructure, the Chinese Biomedical Literature Database, Wanfang Database, and the Chinese Scientific Journal Database for randomized controlled trials of ISR treated by Salvianolate injection from their inception to February 27, 2022. The primary outcome measure will be the restenosis rate. The data meeting the inclusion criteria were analyzed by RevMan V.5.4 software. Two authors evaluated the study using the Cochrane collaborative risk bias tool. We will use a scoring method to assess the overall evidence supporting the main results.Results:This study will analyze the clinical effectiveness of Salvianolate injection in the treatment of ISR.Conclusion:The findings of this systematic review will provide evidence to evaluate the effectiveness of Salvianolate injection for the treatment of ISR.INPLASY registration number:INPLASY202220117.     

冠状动脉旁路移植术后心绞痛复发患者冠状动脉造影特点分析

目的:总结冠状动脉旁路移植术(CABG)后心绞痛复发患者桥血管造影特点,分析桥血管病变及危险因素。方法:分析CABG术后心绞痛复发的患者430例冠状动脉造影(CAG)结果,按病变情况分为桥血管病变组253例和开通组177例,考察桥血管病变类型、桥血管病变时长、病变部位,靶血管直径等对其影响,并对其影响因素进行分析。结果:(1)左内乳动脉-前降支(LIMA)、大隐静脉-靶血管(SVG)及桡动脉-靶血管(RA)的病变率和闭塞率差异均有统计学意义(P<0.01)。(2)LIMA体部病变率高于SVG,差异有统计学意义(P<0.01),但远端吻合口病变率差异无统计学意义(P>0.05)。(3)靶血管直径≥2.0mm与直径<2.0mm病变组LIMA及SVG病变率差异均有统计学意义(P<0.05)。1~5年组,6~10年组SVG病变率高于LIMA,差异有统计学意义(P<0.05)。糖尿病、脂蛋白a[LP(a)]和极低密度脂蛋白(VLDL)是SVG病变发生的危险因素,而高密度脂蛋白(HDL)为其保护因素。结论:靶血管直径≥2.0mm,SVG患者行CABG术中应用体外循环者及序贯吻合术式者桥血管病变率会偏高。     

切割球囊联合血管内近距离放射治疗支架内再狭窄

目的　探讨切割球囊 (CBA)联合血管内近距离放射疗法 (IVBT)治疗冠状动脉支架内再狭窄 (ISR)的临床应用价值。方法　距支架植入平均 6 7个月、冠状动脉造影 (CAG)证实的ISR患者 36例 ,1组 (2 0例 )用 10mm长、直径与参考血管比为 1 1∶1的CBA ,2组 (16例 )用普通球囊(POBA) ,扩张满意后均放置 4 0mm长的放疗导管覆盖病变处并行照射 ;CAG测量最小管腔直径(MLD)、即刻所得 (AG) ;随访 4～ 8个月 ,观察终点为主要心血管事件 (MAE ,即死亡、急性心肌梗死、靶血管的血运重建 ) ,CAG复测MLD及晚期丢失 (LL)、丢失指数 (LI)、再再狭窄 (RRS)率等参数。结果　AG 1组略高于 2组 (P >0 0 5 ) ;MAE发生率 1组 (10 % )显著低于 2组 (18 8% ,P <0 0 5 ) ;LL、LI、MAE、RRS参数 1组 (0 16± 0 2 7mm ,0 0 5± 0 0 1,10 % ,15 % )明显低于 2组 (0 32±0 31mm ,0 11± 0 0 2 ,4 3 8% ,37 5 % ) ,均P <0 0 5。结论　CBA联合IVBT治疗ISR安全、可行 ,其疗效优于POBA联合IVBT。     

食管支架置入后再狭窄的介入治疗(附9例报告)

目的 探讨食管支架置入术后再狭窄的介入治疗方法。方法 回顾性分析了50例食管支架置入术治疗食管狭窄的病例，收集并总结了其中9例食管再狭窄的介入治疗。结果 9例介入治疗中，3例再次支架置入，1例校正支架位置，3例球囊扩张，2例清除支架腔内食物，均保持食管再通。结论 对食管术后吻合口狭窄的患者，接受支架置入术后再出现狭窄，仍可再次行食管球囊扩张治疗和食管支架再置入术，其效果良好。     

丹红注射液防治冠脉支架术后再狭窄的临床观察

目的探讨丹红注射液对冠心病患者冠脉支架植入术后再狭窄（in stent restenosis,ISR）的影响。方法78例实施经皮冠状动脉介入（percutaneous comnary inte nrernjon,PCI）治疗的冠心病患者,随机分为丹红治疗组（n＝32）和对照组（n=46）,对照组常规采用肠溶阿司匹林片和氯比格雷片口服,治疗组在此基础上静脉滴注丹红注射液,术后6个月常规行冠状动脉造影（cAG）,比较两组支架植入术后再狭窄率的差别。结果CAG示：治疗组冠脉支架术后再狭窄率明显低于对照组,两组相比差异有统计学意义（P〈0．01）,无论是普通支架亚组还是药物涂层支架亚组（DES）均有相似的结果（P均〈0．01）。两组均无严重不良反应发生。结论丹红可明显降低冠脉支架术后再狭窄率,安全性良好。     

Evaluation of in-stent stenosis by magnetic resonance phase-velocity mapping in nickel-titanium stents

PURPOSE: To evaluate different grades of in-stent stenosis in a nickel-titanium stent with MRI. MATERIALS AND METHODS: Magnetic resonance phase velocity mapping (MR-PVM) was used to measure flow velocity through a 9-mm NiTi stent with three different degrees of stenosis in a phantom study. The tested stenotic geometries were 1) axisymmetric 75%, 2) axisymmetric 90%, and 3) asymmetric 50%. The MR-PVM data were subsequently compared with the velocities from computational fluid dynamic (CFD) simulations of identical conditions. RESULTS: Good quantitative agreement in velocity distribution for the 50% and 75% stenoses was observed. The agreement was poor for the 90% stenosis, most likely due to turbulence and the high-velocity gradients found in the small luminal area relative to the pixel resolution in our imaging settings. CONCLUSION: The accuracy of the MRI velocities inside the stented area renders MRI a modality that may be used to assess moderate to severe in-stent restenosis (ISR) in medium-sized vascular stents in peripheral vessels, such as the iliac, carotid, and femoral arteries. Advances in MR instrumentation may provide sufficient resolution to obtain adequate velocity information from smaller vessels, such as the coronary arteries, and allow MRI to substitute for invasive and expensive catheterization procedures currently in clinical use.