改良后的家兔动脉深低温保存实验研究

目的：为探讨家兔动脉在改良的深低温保存后，其作为血管材料替代物的优越性。方法：无菌条件下取新鲜兔动脉，分别给予改良后的营养液经慢速深低温冷冻和快速深低温冷冻处理，6个月后异体和自体移植，12周后，取移植的血管组织，观测其组织活性，组织形态、血管通畅率。结果：改良的营养液保护的血管经慢冻法处理后与自体血管活性相近，经改良的营养液保护的血管，移植前后血管内膜的连续性，血管的组织结构良好；慢冻法处理的血管通畅率比速冻法处理的高，与自体移植组相当。结论：复方氨基酸可以替代传统冷冻保护液中的小牛血清用于血管的深低温保存，降低了该保存技术的成本；快速深低温冷冻保存的动脉血管活力移植效果不如慢速冷冻处理的异体动脉好。     

阿托伐他汀对冠心病患者肱动脉内皮依赖性舒张功能的影响

目的：应用高频超声观察冠心病（CAD）患者，经阿托伐他汀治疗后对肱动脉内皮依赖性舒张功能（EDD）的改善作用。方法：经冠脉造影（CAG）确诊为CAD患者59例，利用高频超声血管技术检测阿托伐他汀对CAD患者治疗前后肱动脉EDD的疗效。结果：阿托伐他汀治疗2年后，EDD比治疗前有明显改善（P〈0．05），与对照组相比无显著性差异（P〉0．05）。常规治疗组治疗2年后，EDD无明显改善（P〉0．05），与阿托伐他汀组治疗后及对照组相比差异有显著性（P〈0．05）。结论：阿托伐他汀具有改善EDD的作用。     

Cholesterol-based personal risk assessment in coronary heart disease

Using data from the National Health and Nutrition Examination Survey (NHANES II) 1976-1980, we demonstrate how cross-sectional total serum cholesterol surveillance data can be used by an individual to assess current and future personal cholesterol risk status. We propose statistical models, based on a person's current measured cholesterol level and the relationship between cross-sectional age and cholesterol percentile estimates, that will allow prediction of future cholesterol levels or the age at which specified cholesterol risk levels will be reached if no cholesterol-altering intervention is taken. These models incorporate the observed variation in the NHANES II data and expected intraperson biological variation and intralaboratory analytical variation. We illustrate the adequacy of the models using data from the longitudinal Framingham Study.     

腹壁下动脉插管化疗在子宫颈及阴道恶性肿瘤的应用

我科6年中对子宫颈及阴道恶性肿瘤施行腹壁下动脉插管化疗共34例,作为配合放疗及争取手术的综合疗法之一,提高晚期宫颈癌的放疗效果,对Ⅱ期早宫颈癌施行根治术者6例,但对腺癌、肉瘤及恶性黑色素瘤等效果差。     

Combined evaluation of first pass radionuclide angiography and equilibrium radionuclide ventriculography in the diagnosis of coronary artery disease

Results of 203 patients who underwent first pass radionuclide angiography (FP) and quantitative equilibrium radionuclide ventriculography (qERNV) were stored in a data base system and evaluated statistically. Eighty eight of these patients also underwent exercise equilibrium radionuclide ventriculography (E-qERNV). In patients with coronary artery disease (CAD) without previous myocardial infarction (MI), evaluation of global and regional ejection fraction (gEF, rEF) at rest revealed a poor sensitivity of 64%, the specificity was about 71% (qERNV). FP at rest revealed similar values of sensitivity (69%) and specificity (83%). Additional assessment of stress induced changes of gEF, significantly (P<0.05) improved sensitivity of qERNV in CAD patients without a history of previous MI to 84% (specificity 86%). In patients with one previous MI, however, similar values of sensitivity were found (RFP: 87%, R-qERNV: 84%, E-qERNV: 93%). In patients with several MI's, sensitivity was above 90% at rest and during exercise (R-FP: 96%, R-qERNV: 93%, E-qERNV: 100%).     

肾动脉狭窄支架植入术的临床疗效观察

目的探讨肾动脉狭窄支架植入术的临床疗效.方法1997年1月～2004年12月,我院行支架介入治疗肾动脉狭窄27例.对27例术前、术后及随访期内血压、肾功能以及生活质量进行评估,并与同期单纯药物治疗肾动脉狭窄27例进行比较.结果介入组27例植入支架40枚,手术成功24例(88.9%,24/27),失败3例(11.1%,3/27),手术并发症5例(18.5%,5/27).术后在血压下降(包括收缩压舒张压)肌酐下降,肾小球滤过率增加方面,介入组获益率明显优于药物组,两组比较差异均有显著性,术后随访6个月～8年6个月,中位数为1年9个月,介入组有19例能比较健康的生活和工作,药物组仅12例能维持生活和工作.结论支架介入治疗较单纯药物治疗肾动脉狭窄疗效显著.     

经股动脉导管药盒系统植入术的并发症分析

目的研究经股动脉途径植入导管药盒系统导致并发症的原因,进一步提高其临床应用的价值。方法对76例中晚期恶性肿瘤采用经股动脉途径植入导管药盒系统,定期或不定期经皮经药盒灌注化疗和栓塞,总结其并发症。结果发生并发症13例,发生率为17.1%(13/76)。包括留置导管尖端移位4例,靶动脉闭塞2例,迟发出血2例,留置导管堵塞1例,切口延期愈合1例,药盒外露1例,留置导管与药盒分离1例,靶动脉假性动脉瘤形成1例。结论经皮股动脉途径导管药盒系统植入术的并发症只要处理得当,是可以控制的。本技术不失为一种安全可靠的治疗手段,值得临床应用。     

腹腔镜辅助下大隐静脉隔绝术治疗大隐静脉曲张60例

目的探讨腹腔镜辅助下大隐静脉隔绝术的疗效。方法2000年1月～2004年1月对60例66条大隐静脉曲张腹腔镜辅助下行大隐静脉隔绝术,腹腔镜辅助下高位结扎、电灼大腿段大隐静脉,阻断其小腿段所有属支及交通支,使大隐静脉与体循环隔绝。结果手术时间30～60min,(50±9)min;术后住院时间3～5d,(3.5±0.6)d。60例随访1～36个月,平均28个月,无复发。结论腹腔镜辅助下大隐静脉隔绝术创伤小,疗效好,复发率低,是治疗大隐静脉曲张的理想术式。     

Use of an aortic connector system for vein grafting

OBJECTIVE: The aortic connector system was used to minimize cerebrovascular complications when performing the proximal anastomosis of vein grafts during coronary artery bypass grafting (CABG). The goal of this study was to investigate the intermediate outcomes of patients undergoing CABG with the aortic connector system. METHODS: The aortic connector was used on nine patients undergoing CABG between November 2002 and July 2003. Intermediate outcomes of the patients were examined, and the results of coronary angiography, which were performed before patient discharge and at least 6 months after discharge, were evaluated. RESULTS: There were no operative deaths or cerebrovascular accidents. One patient died 9 months after discharge, one patient had angina, and the remaining seven patients were asymptomatic. When evaluating the results of angiography performed before patient discharge, two of the 21 distal vein graft anastomoses were occluded (patency rate, 90.5%), but there was no stenosis or occlusion at the proximal anastomoses sites that were performed using the aortic connector. When evaluating the results of the second angiography performed after patient discharge, four of the eight proximal anastomoses were patent, one was completely occluded, two had 90% stenosis and one had 75% stenosis. Further, four of the 18 distal anastomoses were occluded (patency rate, 77.8%). There was no significant difference in graft flow or device size when comparing patients with patent vein grafts and those with stenotic or occluded vein grafts. CONCLUSION: Intermediate outcomes of vein grafting using the aortic connector were suboptimal. Long-term outcome data are forthcoming.