平板式全数字心血管造影机在周围血管及非血管介入中的应用

目的 :评价平板式全数字心血管造影机在周围血管及非血管介入中的应用价值。方法 :对平板探测器(FPDD)X线成像与影像增强器 电视 (IITV)X线成像在动态范围、成像均匀性、对比度线性、对比分辨率等图像质量指标的检测及比较。随机选择上述两机型在周围血管及非血管介入诊疗病例图像资料各 6 0例 ,由三名高年资医师对其图像质量进行综合评价 ,记录评价结果 ,并进行比较。结果 :FPDD成像在动态范围、成像均匀性、对比度线性、对比分辨率等图像质量指标均优于IITV成像 ;在人体各部位周围血管及非血管介入诊疗中的图像综合评价结果也优于IITV成像。结论 :平板式全数字化心血管造影机不仅适用于心血管介入 ,同时能满足全身各部位周围血管及非血管介入诊疗的需要。     

Technique for ipsilateral rescue embolization of common femoral side branch vessel injury.

We report a novel double wire technique for ipsilateral access of the external iliac/common femoral artery transition side-branches in a patient with active extravasation. The case is noteworthy in that asymptomatic extravasation was noted in both the inferior epigastric and deep circumflex iliac branches on femoral angiography prior to intraaortic balloon pump insertion following emergent diagnostic left heart cathetrization. We speculate the side branch injury was related to the J-wire and describe how this complication may be best treated by the ipsilateral technique reported herein.     

热应激对血管内皮细胞增殖的影响及其机制初探

目的　探讨热应激条件下对血管内皮细胞增殖的影响 ,进一步从DNA损伤后P5 3mRNA、P2 1mRNA表达改变角度探讨增殖调控的机理。方法　以建立的血管内皮细胞热应激 (4 3℃ ,2小时 )为实验模型 ,应用流式细胞仪观察热应激后血管内皮细胞株ECV30 4的细胞周期变化 ,单细胞凝胶电泳方法观察热应激对血管内皮细胞DNA的损伤 ,RT PCR检测P5 3mRNA、P2 1mRNA表达改变情况。结果　热应激可使血管内皮细胞DNA产生显著损伤 (P <0 .0 5 ) ,继而P5 3mRNA表达增高 ,并促进P2 1mRNA的上调表达 ,最终使细胞产生G1期阻滞。结论　热应激可损伤血管内皮细胞DNA ,并通过P5 3、P2 1通路抑制细胞增殖     

Triple lumen venous access for pediatric bone marrow transplantation candidates

Multiple routes of vascular access are required in children undergoing bone marrow transplantation to facilitate total parenteral nutrition (TPN); blood withdrawal; and administration of blood products, antibiotics, fluids, and immunosuppressive drugs. Placement of multiple catheters frequently requires multiple venotomies in separate vessels. We have found that both a Broviac catheter and pediatric dual-lumen Raaf catheter can be placed through separate venotomies in the external jugular vein, which provides sufficient routes of vascular access without complications. This technique places only one vessel at risk while minimizing the chance for infection by utilizing two exit sites. We consider this to be the procedure of choice in young patients requiring multiple routes of vascular access.     

氟伐他丁对高血压患者血管内皮依赖性舒张功能的影响

目的　探讨他丁类降脂药是否具有改善高血压患者血管功能的作用。　方法　 ～ 级轻中度高血压患者 5 5人 ,在常规抗高血压治疗的同时 ,加用氟伐他丁 (Flu) 2 0～ 4 0 m g/ d,并与 37例单纯常规抗高血压治疗病人对比。采用彩色多普勒超声检查肱动脉 (BA)和胫前动脉 (TA)的管腔内径。采用充血法测定血管内皮依赖性舒张功能 (Δ Dia- P)。　结果　 Flu治疗 3个月 ,血脂水平明显下降 ,可见 TA血管 Δ Dia- P改善 (% :8.5 1± 3.0 7vs14 .19± 5 .4 1,n=6 ,P<0 .0 5 ) ,以后均维持在较高水平。治疗 3个月时 BA的 ΔDia- P也有改善 ,但未达统计学差异水平 ,治疗 12个月时 BAΔ Dia- P明显改善。多元逐步回归分析在所观察的参数中未发现和血管功能有固定关系的因素。　结论　 Flu能够使接受常规降压药治疗的高血压患者的 Δ Dia- P改善。小剂量长时间的 Flu可以改善血管舒张功能。药物干预后 TA的功能变化出现较早 ,是反映血管功能变化的敏感靶点     

妊高征合并胎儿宫内发育迟缓者胎盘病理改变与血管细胞粘附分子-1表达水平的关系

目的探讨妊高征(PIH)合并胎儿宫内发育迟缓(IUGR)时胎盘病理改变与胎盘组织中血管细胞粘附分子-1(VCAM-1)表达水平变化的关系。方法选取本院2001年1~9月分娩的妊高征合并IUGR患者(实验组)胎盘30例、单纯IUGR(IUGR组)28例、单纯PIH(PIH组)25例、正常妊娠(正常妊娠组)30例,常规HE染色及PAS染色,观察胎盘形态学变化。利用免疫组化方法对胎盘组织切片染色,观察子宫蜕膜层中螺旋动脉、绒毛组织滋养细胞及绒毛中毛细血管的VCAM-1表达。结果实验组中22例(73.33%)胎盘有明显病理改变,有病理改变的胎盘蜕膜组织内血管内皮细胞及胎盘绒毛毛细血管内皮VCAM-1的表达显著高于无病理改变者(P<0.001);而绒毛上皮组织滋养层细胞VCAM-1的表达则显著低于无病理改变者(P=0.019)。结论妊高征合并IUGR时胎盘发生了明显的病理改变,这种病理改变与胎盘中VCAM-1的异常表达密切相关。     

视网膜特异性表达人血管内皮生长因子 基因载体的构建

目的构建在视网膜组织特异性表达的人血管内皮生长因子（VEGF）₁₆₅基因。方法用聚合酶链反应(PCR)方法从BLAB/C鼠全基因组扩增能在视网膜组织特异性表达的rho启动子，经限制性内切酶纯化后克隆于质粒pcDNA^3.1+-VEGF₁₆₅中，建立重组质粒pcDNA^3.1+-rho-VEGF₁₆₅，通过限制性内切酶酶切分析及PCR鉴定筛选出正确重组质粒pcDNA^3.1+-rho-VEGF₁₆₅,由jetPEI介导转染人视网膜色素上皮细胞和人脐静脉内皮细胞，并通过免疫组织化学染色以及绘制细胞生长曲线检测在人视网膜色素上皮细胞和人脐静脉内皮细胞中VEGF蛋白的表达。结果在人视网膜色素上皮细胞中，重组质粒pcDNA^3.1+-rho-VEGF₁₆₅比质粒pcDNA^3.1+-rho-VEGF₁₆₅的VEGF蛋白表达强，在人脐静脉内皮细胞，两者的表达量无明显差别。结论pcDNA^3.1+-rho-VEGF₁₆₅载体的构建为进一步研究VEGF在视网膜新生血管形成中的致病机理提供基础材料，并为进一步建立视网膜特异性表达VEGF转基因鼠模型建立了基础。(中华眼底病杂志,2005,21:106-109)     

Effects of chlorpromazine as a systemic vasodilator during cardiopulmonary bypass in neonates

OBJECTIVES: Vasodilator use during cardiopulmonary bypass is important in pediatric cardiac surgery, but the full range of their effects on hemodynamics remains to be clarified. We studied the effects of chlorpromazine, a potent alpha-blocking agent, in neonates. METHODS: Subjects were 60 neonates undergoing arterial switch operations for complete transposition of the great arteries with an intact ventricular septum. Of these, 37 received 2.1 to 6.5 mg/kg of chlorpromazine during cardiopulmonary bypass (CPZ group) and 23 received no vasodilator (control group). We then compared hemodynamic parameters between groups during and early after surgery. RESULTS: The systemic vascular resistance index and mean arterial pressure during cardiopulmonary bypass were significantly lower in the CPZ group (p < 0.05), but systolic pressure 15 minutes after cessation of cardiopulmonary bypass did not differ between groups. The rise in peripheral temperature during rewarming after hypothermia was significantly higher and the acid-base status 40 minutes after cardiopulmonary bypass less acidotic in the CPZ group. Urine output during cardiopulmonary bypass was higher in the CPZ group. CONCLUSIONS: Chlorpromazine effectively counteracts systemic vasoconstriction induced by cardiopulmonary bypass without serious side effects in neonatal cardiac surgery.     

Pulmonary vascular disease in secundum atrial septal defect in childhood: an unusual evolution

Reported is a case of a 16-month-old girl with an isolated atrial septal defect in whom severe pulmonary hypertension has developed in 26 months in spite of an important functional gradient across the pulmonic valves at a first catheterization. Individual susceptibility to an increased pulmonary blood flow is evoked.