经皮二尖瓣狭窄球囊扩张术对心功能的影响

目的:探讨经皮二尖瓣球囊扩张术(PBMV)治疗非单纯性二尖瓣狭窄(Ms)的效果.方法:使用超声心动图检测65例单纯性MS、MS合并轻、中度二尖瓣关闭不全(MR)和MS合并轻、中度主动脉瓣关闭不全(AR)3组患者PBMV术前及术后复查时左室射血分数(LVEF)值和心脏房、室内径大小变化.结果:3组PBMV术后复查时LVEF值较术前明显增大(P<0.001);左室内径与术前比较差异无统计学意义(P>0.05);单纯性MS组和MS合并轻、中度AR组PBMV术后复查时左房内径比术前明显减小(P<0.05);MS合并轻、中度MR组PBMV术后左房内径与术前比较差异无统计学意义(P>0.05).结论:非单纯性MS患者PB-MV术后心功能有明显好转.     

双球囊导管促宫颈成熟在延期妊娠 引产中的应用效果及对妊娠结局的影响研究

目的 研究双球囊导管促宫颈成熟在延期妊娠引产中的应用效果及对妊娠结局的影响.方法 前瞻性选择2016年1月至2019年12月安徽医科大学附属宿州医院产科收治的80例延期妊娠产妇作为研究对象,采用随机数字表法将其分为2组:对照组40例采用传统的缩宫素引产,研究组40例采用双球囊导管引产.比较2组宫颈成熟度、引产效果、分娩...     

普罗布考和科素亚对血管成形术后生长因子表达的影响

目的 :研究普罗布考和科素亚对血管成形术后再狭窄的预防作用和对生长因子表达的影响。方法 :新西兰白兔30只均予高脂饮食 ,1周后进行髂动脉球囊拉伤术 ,随机分为对照组 (C组 )、普罗布考组 (P组 )、科素亚组 (L组 )。术后第 4周进行血管形态学检查 ,用免疫组化方法检测胰岛素样生长因子 - 1受体 (IGF- 1 R)、血管内皮生长因子(VEGF)、增殖细胞核抗原 (PCNA)表达。结果 :与 C组相比 ,P组和 L 组血管腔面积明显扩大 (P<0 .0 1 ) ,IGF- 1 R、VEGF和 PCNA表达明显减少 (P<0 .0 1 ) ,P组和 L组相比无显著性差异 (P>0 .0 5 )。结论 :普罗布考和科素亚可以显著减轻兔髂动脉血管成形术后再狭窄的形成 ,抑制 IGF- 1、VEGF和 PCNA的表达 ,而两药之间则无显著性差异     

内镜乳头球囊扩张术治疗非扩张性肝外胆管结石的疗效分析

目的 分析内镜乳头球囊扩张术(EPBD)和EST治疗非扩张性肝外胆管结石的疗效.方法 回顾性分析1999年1月至2008年4月太钢总医院收治的317例非扩张性肝外胆管结石患者的临床资料.其中119例行EPBD治疗,198例行EST治疗.各选取62例进行对照研究,分别设为EPBD组和EST组.EPBD组的患者在经ERCP检查确诊后,沿导丝置入柱状球囊,使其中部位于十二指肠乳头开口处.完成扩张后,用网篮或拖石气囊取石,术后常规行ENBD.EST组的患者在经ERCP检查确诊后,采用退刀切开法切开十二指肠乳头,在数字减影血管造影X线监视下,用网篮或拖石气囊取石.两组疗效分析采用χ2检验.结果 EPBD组和EST组的一次取石成功率分别为92%(57/62)和94%(58/62),两组比较,差异无统计学意义(χ2=0.222,P>0.05).EPBD组患者发生高淀粉酶血症、胰腺炎的例数略多于EST组,而发生十二指肠穿孔的例数略少于EST组,两组比较,差异均无统计学意义(χ 2=0.286,1.000,2.000,P>0.05).EPBD组患者发生乳头出血和胆道感染的例数明显少于EST组(χ2=4.000,7.000,P<0.05).两组患者均随访24个月.在术后的第6、12、24个月的随访统计中,EPBD组出现胆管结石复发及胆道逆行感染的例数明显少于EST组(χ2=4.000、5.000、6.000,6.000、8.000、11.000,P<0.05).结论 EPBD后取石+ENBD是治疗非扩张性肝外胆管结石的首选.该方法具有保护十二指肠乳头的功能、创伤小、恢复快等优点.     

Underlying mechanisms of saphenous vein graft stenosis after coronary artery bypass caused by clipping of the side branches: an experimental study

BackgroundSaphenous veins are regular bypass conduits selected in non-left anterior descending artery (LAD) coronary artery bypass graft (CABG) surgery. Despite the technical errors, acute thrombosis, intimal hyperplasia and arteriosclerosis which could lead to saphenous vein graft (SVG) failure, the metal-clipping-related SVG failure is unique and rare. This study was conducted to investigate the clinical and underlying mechanisms of the metal-clipping-related SVG failure.MethodsWe collected 6 typical cases of the metal-clipping-related SVG failure in 41 patients who were diagnosed graft stenosis by coronary angiograph after CABG in the Department of Cardiology, Beijing Anzhen Hospital, from January 2020 to September 2021. Furthermore, we built an in vitro model to verify the identical intravascular ultrasound (IVUS) pattern of metal clip.ResultsThere were 6 in 41 cases of SVG stenosis caused by clipping of the side branches. We found that the stenosis of SVG caused by metal clipping mostly occurred at the corner and multipole clipping points. In this situation, great resistance could be felt when pushing the instruments through the stenosis and crystallized cholesterol was rarely caught by the distal protection device. We verified the similar IVUS pattern of metal clip at the side-branches of SVG in vitro.ConclusionsThe metal-clipping-related stenosis may lead to SVG failure. The stenosis of SVG caused by metal clipping mostly occurred at the corner and multipole clipping points. IVUS showed great modality for clarification.     

马来酸罗格列酮胃漂浮型缓释片的研究

目的：根据流体动力学平衡控释原理（HBS）研制了马来酸罗列酮胃漂浮型缓释片。方法;以体外释放度和漂浮情况为筛选指标,采用单因素考察和正交试验设计相结合, 对胃漂浮缓释片的处方、制备工艺及体外释放条件进行优化筛选;采用γ闪烁照相技术对优化处方的内漂浮情况进行胃内动态观察。结果：马来酸罗格列酮胃漂浮缓释片在释放介质中迅速起漂,持漂时间超过12h,12h达最大累积释放;初步确定在胃内滞留时间达3h以上。结论：优化处方的释放过程符合Higuchi方程,释放机制为异常扩散;胃漂浮片在胃滞时间明显长于普通片。     

Clinical Evaluation of the Cook Advance Enforcer 35 Focal-Force PTA Balloon Catheter for Treatment of Hemodialysis Fistula Stenoses: A Feasibility Study

Purpose

A prospective, single-center, single-arm feasibility study evaluated procedural and short-term performance of the Advance Enforcer 35 focal-force percutaneous transluminal angioplasty (PTA) balloon catheter in treating stenoses of mature native arteriovenous (AV) hemodialysis access circuits.

Changes in the National Endovascular Management of Femoropopliteal Arterial Disease: An Analysis of the 2011–2019 Medicare Data

PurposeTo describe national trends in the utilization of endovascular approaches (including balloon angioplasty, atherectomy, and stent placement) for the management of femoropopliteal peripheral arterial disease (PAD).Materials and MethodsThe Medicare Physician/Supplier Procedure Summary dataset containing 100% of Part B claims was interrogated for years 2011–2019. The Current Procedural Terminology codes specific for femoropopliteal angioplasty, stent placement, and atherectomy were used to create summary statistics for utilization by year, place of service (hospital inpatient, hospital outpatient, and office-based laboratory), and provider specialty (cardiology, radiology, and surgery).ResultsThe use of atherectomy increased from 34,732 (33%) procedures in 2011 to 75,435 (53%) procedures in 2019, and atherectomy became the dominant treatment strategy for femoropopliteal PAD. The relative utilization of stent placement (36,793 [35%] to 28,899 [20%]) and angioplasty only (34,398 [32%] to 38,228 [27%]) decreased concomitantly from 2011 to 2019. By 2019, the use of atherectomy was twofold higher in office-based laboratories than in the outpatient hospital setting (44,767 and 20,901, respectively). Treatment strategy varied by provider specialty in 2011 when cardiologists used atherectomy most frequently (17,925 [43%]), whereas radiologists used angioplasty alone (5,928 [6%]) and surgeons stented (18,009 [37%]) most frequently. By 2019, all specialties utilized atherectomy most frequently (29,564 [59%] for cardiology, 10,912 [58%] radiology, and 33,649 [47%] surgery).ConclusionsThe national approach to endovascular management of femoropopliteal PAD has changed since 2011 toward an implant-free strategy, including a multifold increase in the use of atherectomy. Discordant rates of atherectomy use between the ambulatory hospital and office-based settings highlight the need for comparative effectiveness studies to guide management.