二尖瓣置换同期行改良迷宫双极射频消融术治疗房颤效果观察

目的观察16例二尖瓣置换同期行改良迷宫双极射频消融术治疗房颤的临床疗效。方法选择2010-03—2015-05间收治16例风湿性心脏病二尖瓣病变合并房颤者,在瓣膜置换同时采用双极射频消融系统,用改良迷宫手术路线治疗房颤。观察和记录术前、术后当日、出院后1、3、6个月常规心电图等指标变化。结果全组无手术死亡,术后即刻恢复窦性心律16例,转窦率100%。术后当日恢复窦性心律15例(93.8%),房颤1例。术后1个月窦性心律14例(87.5%),房颤2例。术后3、6个月窦性心律均为12例(75.0%),房颤4例。结论改良迷宫双极射频消融术治疗瓣膜病合并房颤,安全、简便、有效。     

伐地那非联合疏肝益阳胶囊治疗勃起功能障碍的效果观察

目的探讨伐地那非联合疏肝益阳胶囊治疗勃起功能障碍的效果。方法抽取2020年6月至2023年6月在郑州大学附属郑州中心医院男科门诊诊治的勃起功能障碍患者100例, 根据治疗方案分为常规组和研究组, 每组50例。常规组予以伐地那非进行治疗, 研究组予以伐地那非联合疏肝益阳胶囊进行治疗。比较两组患者的阴茎勃起功能[国际勃起功能评分表(iIIEF-5)及勃起质量量表(EQS)评分]、临床疗效、血清性激素[睾酮(T)、雌二醇(E2)、催乳素(PRL)]水平、阴茎血流动力学指标[收缩期最大血流速度(PSV)、舒张末期血流速度(EDV)]及不良反应发生情况等。结果治疗后, 两组IIEF-5评分及EQS评分均较治疗前升高, 且研究组高于常规组(P<0.05)。研究组治疗总有效率(92.00%, 46/50)高于常规组(76.00%, 38/50), P<0.05。治疗后, 两组血清T水平均较治疗前升高, E2及PRL水平均较治疗前降低, 且研究组变化更显著(P<0.05);治疗后, 两组患者PSV均较治疗前升高, EDV均较治疗前降低, 且研究组变化更显著(P<0.05)。研究...     

序贯式旁路移植术在非体外循环冠状动脉旁路移植术中的应用

目的总结非体外循环下序贯式旁路移植术治疗冠状动脉粥样硬化性心脏病的临床疗效。方法 26例冠心病患者接受非体外循环下冠状动脉旁路移植术,采用序贯式吻合移植技术。术中采用即时血流测量仪评价桥血管通畅情况。结果 26例患者共搭桥83支,平均3.19支,其中搭4支桥患者5例。术中无中转体外循环,术中测量序贯桥血管主干流量(45.56±9.23)m L/min,搏动指数(PI)3.56±0.66;测量终末桥血管流量(16.15±5.09)m L/min,搏动指数(PI)3.02±0.24。术后随访26例患者1年内均未出现心绞痛症状,患者心电图及心脏超声较术前均有所改善。结论非体外循环下序贯式旁路移植术治疗冠心病安全、有效、近中期疗效满意,是治疗冠心病多支病变患者的有效方法。     

探讨腋下小切口实施肺癌根治术的效果

目的探讨采用腋下小切口实施肺癌根治术的效果。方法随机将90例原发性肺癌患者分为2组,每组45例。观察组采用腋下小切口行肺癌根治术,对照组采用传统后外侧标准切口行肺癌根治术。比较2组手术效果。结果观察组的开胸时间、术中出血量、关胸时间、引流量均显著优于对照组(P0.05),差异有统计学意义;观察组术后并发症发生率为6.7%(3/45),对照组为64.4%(29/45),2组差异有统计学意义(P0.05)。结论经腋下小切口行肺癌根治术较传统后外侧标准切口对患者创伤小、开胸和关胸时间短、术后并发症少,利于患者术后恢复。     

（十）前列腺增生患者日常保健9要点

在日常生活中，前列腺增生患者如果不重视养生保健，经常大量地饮酒、过于操劳或频繁地过性生活，就会使病情加重，甚至诱发尿潴留、血尿、急性膀胱炎、肾盂肾炎、肾积水和肾功能不全等严重的并发症。相反，此病患者若能积极进行自我保健则可避免病情进一步恶化。早期前列腺增生患者若能积极进行日常保健，合理调整自己的生活习惯，还可以有效地改善临床症状，从而避免终生服药或进行手术治疗。     

人脐血单个核细胞中CD133+细胞移植治疗心力衰竭的评价

BACKGROUND:Cell purification can eliminate the biological variability of cells, providing new insight into cell regeneration therapy. OBJECTIVE:To study the Influence of CD133⁺ cells on human umbilical cord blood mononuclear cell transplantation for treatment of heart failure. METHODS:Human cord blood mononuclear cells were isolated using lymphocyte separation medium method, and CD133⁺ and CD133^- cells were sorted using immunomagnetic beads at a cell density of 1×10⁸/L. Forty Sprague-Dawley rats were randomized into five groups: sham group, model group, CD133⁺ cell group, CD133^- cell group and mononuclear cell group. Animal models of heart failure were made using intraperitoneal injection of isoproterenol in all the groups except for the sham group. Rats in the CD133⁺ cell group and CD133^- cell group were given 1 mL CD133⁺ cells plus 1 mL PBS and 1 mL CD133^- cells plus 1 mL PBS via the tail vein, respectively. Rats in the mononuclear cell group were given 1 mL CD133⁺ cells plus 1 mL CD133^- cells via the tail vein, and those in the sham and model groups given 2 mL PBS via the tail vein. After 4 weeks, cardiac pathology, degree of myocardial fibrosis and colonization of CD133⁺ cells in myocardial tissues were observed. RESULTS AND CONCLUSION:Hematoxylin-eosin staining showed that myocardial tissues arranged disorderly in the model group, but regularly in the sham group; myocardial disorders were mildest in the CD133⁺ cell group, successively followed by the mononuclear cell group, and severest in the CD133^- cell group and model group. Masson staining showed that in the model group, collagen fibers were proliferated, arranged irregularly and even broken, while in the sham group, the collagen fibers were less in number and arranged in order. Additionally, there was less reduction in collagen fibers and milder myocardial disorders in the CD133⁺ cell group compared with the other groups. Area of collagen fibers was increased significantly in all the groups except for the sham group (P < 0.05), but this increment was the minimal in the CD133⁺ cell group. Findings from immunohistochemistry and immunofluorescence staining showed that there were no CD133⁺ cells in the myocardial tissues of rats. Therefore, our data indicate that compared with the mononuclear cell transplantation, CD133⁺ cell transplantation exerts superiorities in relieving myocardial damage and reducing myocardial fibrosis. However, CD133⁺ cells are not colonized in the myocardial tissue after transplantation.