丁胺卡那封管治疗双腔股静脉管感染疗效观察

目的观察丁胺卡那封管治疗双腔静脉管感染的疗效。方法将双腔股静脉管感染的患者随机分为两组,一组采用单纯丁胺卡那封管治疗感染,另一组采用丁胺卡那封管联合静脉抗生素治疗感染;比较两种方法对导管相关感染(catheter-related infection,CRI)的疗效。结果单纯用丁胺卡那封管治疗双腔股静脉管感染疗效可靠,与加上全身静脉用药治疗差异无统计学意义。结论单纯用丁胺卡那封管是临床上治疗双腔股静脉管感染理想的治疗方案。     

Endovascular stenting for nutcracker syndrome

Nutcracker syndrome (NCS) is a rare pathology manifested by pain or hematuria in males and females alike. It can be easily overlooked, and should be considered in young men or women with symptoms of extended duration. We present a case of a 54-year-old female with chronic lower abdominal pain radiating to the left thigh of 4 years in duration. Computed tomography (CT) eventually revealed engorged left renal, gonadal, and uterine veins due to compression between the superior mesenteric artery (SMA) and the abdominal aorta, consistent with NCS. After a successful endovascular stenting and a 6-month period of antiplatelet and anticoagulant therapy, the patient returned to stable health. NCS, while rare, should be suspected in patients of both sexes with persistent pain or hematuria.     

Venous Reactivity in Canine Renovascular Hypertension

The responsiveness of arterial smooth muscle to vasoactive stimuli is enhanced hypertension. It is however, unclear whether this increased reactivity is a generalised property of vascular smooth muscle, involving veins as well. We examined the responses of rings of cephalic veinin vitro taken from 11 dogs with chronic renovascular hypertension and 10 normal dogs. Mean blood pressure was 129 ± 3 mmHg in the hypertensive dogs, 26% above control. Veins from hypertensive dogs had steeper passive circumference-tension relationships than veins from normal dogs, indicating reduced compliance. Sensitivity (defined as location of EC₅₀) to potassium depolarisation was unchanged, but maximal contractile force (Fmax) developed was 35% greater in hypertension when compared with normotensive dogs. With noradrenaline and the selective alpha₁-adrenoceptor agonist methoxamine, there was no difference between normotensive and hypertensive dogs in either location of the EC₅₀ or in the Fmax. With the selective alphaz-adrenoceptor agonist UK 14304, there was a tenfold decrease in sensitivity in hypertension when compared with normotensive dogs, but no change in Fmax. There was, however a tenfold increase in sensitivity to serotonin in hypertension when compared to normotensive dogs, and a 22% increase in Fmax. Contractile responses to transmural sympathetic nerve stimulation were similar in the two groups. As desipramine caused equal increases in responses to neural stimulation, there was no demonstrable abnormality of neuronal uptake in hypertension. Morphometric examination showed no change in media thickness, media thickness/radius ratios or media cross sectional area in hypertension. Therefore, veins from dogs with chronic renovascular hypertension are stiffer but not hypertrophied, and exhibit some specific differences in contractile responses to vasoconstrictor agents when compared with veins from normotensive dogs.     

When To Hospitalize The Emphysema Patient

With emphysema now ranking second among causes of disability in men past 40, Dr. Haas believes that careful reappraisal of the criteria for hospitalization in this disease is indicated. Critical to this reappraisal, he maintains, is recognition that many patients now “written oil'” as hopeless cripples may be returned to “the dignity of economic and social independence.”     

Echocardiography

Echocardiography occupies a unique place as an investigative tool in cardiology. This introduction to the technique reviews the basic principles and outlines the diagnosis of common cardiac lesions. Being entirely noninvasive, echocardiography can be repeated to ascertain the severity and observe the progression of cardiac lesions.     

Is it safe to perform endoscopic band ligation for the duodenum? A pilot study in ex vivo porcine models

Abstract

Aim: In the digestive tract, endoscopic band ligation (EBL) has been routinely used for the treatment of variceal bleeding and superficial malignancies. In recent years, endoscopic treatments for duodenal varices, adenoma, and cancer have also actively incorporated EBL. Although there have been a number of reports on the risks associated with the use of EBL in the esophagus, stomach, and colon, few studies have focused on EBL in the duodenum. We performed EBL procedures to evaluate the risks associated with the use of EBL in the duodenum. Material and methods: Overall, EBLs were performed at nine sites in duodenum sampled from a pig immediately after sacrifice. Submucosal saline injections were placed in three of the nine studied sites. Results: Regardless of saline injection, the full thickness of the duodenal wall was ligated in all attempts. Conclusions: Routine EBL is not recommended in the duodenum because the risk of perforation is unacceptably high.     

内镜下抗反流黏膜切除术和贲门缩窄术治疗胃食管反流病的临床疗效对比

目的 对比内镜下抗反流黏膜切除术（anti-reflux mucosectomy,ARMS）和贲门缩窄术（endoscopic cardial constriction ligation,ECCL）治疗胃食管反流病的临床疗效。方法 回顾性分析2015年12月—2018年8月在郑州大学第一附属医院行ARMS或ECCL治疗,并定期随访的48例胃食管反流病患者病例资料,其中20例行ARMS（ARMS组）,28例行ECCL（ECCL组）,比较两种术式短期及长期临床疗效。结果 两种术式的操作成功率均为100.0%,ECCL组手术时间明显短于ARMS组[（8.43±1.59）min比（34.05±12.35）min,t=－9.227,P＜0.001]。术后2个月随访,ECCL组和ARMS组症状改善有效率分别为89.3%（25/28）和60.0%（12/20）,差异有统计学意义（χ2=4.128,P=0.042）,ECCL组GERD Q评分低于ARMS组[（6.24±1.22）分比（7.35±1.79）分,t=-2.400,P＝0.023]。术后1年随访,两组症状改善有效率、GERD Q评分,以及DeMeester评分和pH＜4时间百分比差异均无统计学意义（P＞0.05）。结论 ARMS和ECCL治疗胃食管反流病的长期临床疗效相当,但ECCL短期疗效更具优势。     

视网膜静脉阻塞和Eales病患者玻璃体内皮生长因子含量测定

目的：了解血管内皮生长因子(vascular endothelial growth factor，VEGF)在视网膜血管增殖性疾病患者玻璃体中的含量。 方法：采用酶联免疫吸附实验(enzyme linked immunosorbent assay，ELISA)测定伴有新生血管的视网膜静脉阻塞(retinal vein occlusion，RVO)和视网膜静脉周围炎(Eales病)患者玻璃体VEGF含量。 结果：RVO患者(7例)和Eales病患者(7例)玻璃体VEGF含量分别为(4.67士3.38)ng/ml和(1.79土0.44)ng/ml，是正常人(0.35土0.15)ng/ml的13倍和5倍(P<0.01)。 结论；RVO和Eales病患者玻璃体VEGF水平明显升高，提示VEGF可能参与其眼内新生血管增殖机制。 （中华眼底病杂志，1997，13：171-173）     

纵切横缝分段结扎治疗环形混合痔180例临床观察

[目的]探讨治疗环形混合痔的有效方法。[方法]对180例患者采用纵切横缝分段结扎的手术方法。[结果]180例患者均痊愈,总有效率达100%,切口愈合时间15-30 d。随防2-5年,均无肛门狭窄及肛门失禁,肛门功能正常。[结论]纵切横缝分段结扎治疗环形混合痔,疗效高,无并发症及后遗症。