创伤性颈动脉海绵窦瘘的介入栓塞治疗(附34例分析)

目的:探讨创伤性颈动脉海绵窦瘘的临床表现和血管内介入栓塞治疗效果。方法:回顾性分析34例创伤性颈动脉海绵窦瘘的临床表现,采用可脱性球囊微导管技术经股动脉途径闭塞颈内动脉破口处。结果:33例均一次性治愈,1例在等待手术过程中因致命性鼻出血而死亡。33例成功地闭塞了瘘口,32例颈内动脉主干保持通畅,1例同时闭塞了瘘口及颈内动脉主干。33例获随访6个月～6年,无复发。结论:采用可脱性球囊栓塞技术是治疗创伤性颈动脉海绵窦瘘的首选方法。     

可脱性球囊栓塞治疗创伤性颈动脉海绵窦瘘的临床观察

目的探讨经动脉途径可脱性球囊栓塞创伤性颈动脉海绵窦瘘(TCCF)的疗效。方法回顾性分析17例TCCF患者的资料,采用经动脉途径可脱性球囊栓塞瘘口或闭塞患侧颈内动脉主干。结果 9例使用1枚球囊栓塞,5例使用2枚,3例使用3枚。17例中13例使用可脱性球囊成功闭塞瘘口并且保留颈内动脉通畅(76.47%),4例使用可脱性球囊闭塞颈内动脉主干。术中未发生与血管内栓塞相关并发症。术后约15d2例患者瘘口复发,1例形成无症状性假性动脉瘤。结论经动脉途径栓塞TCCF疗效确切,应作为治疗创伤性颈动脉海绵窦瘘的首先方式。     

球囊栓塞术治疗外伤性颈动脉海绵窦瘘(附10报告)

通过对１０例外伤性颈动脉海绵窦瘘（ＴＣＣＦ）球囊栓塞治疗的分析总结,以提高对本病的诊治水平。采用可脱性球囊导管栓塞治疗,提出临床诊治过程中难以成功的原因。结果经栓塞治疗８例病人保持颈内动脉通畅,２例闭塞瘘口同时闭塞颈内动脉。认为可脱性球囊导管栓塞技术为治疗外伤性颈动脉海绵窦瘘最为有效的治疗方法。     

可脱性球囊栓塞治疗外伤性颈内动脉海绵窦瘘

目的：探讨可脱性球囊栓塞治疗外伤性颈内动脉海绵窦瘘的临床意义。方法：应用可脱性球囊经动脉途径栓塞治疗21例颈内动脉海绵窦瘘。结果：21例患者中,瘘口栓塞17例,闭塞颈内动脉4例,均治愈。其中瘘口栓塞后1例并发球囊早泄瘘口复发,经再次球囊栓塞成功。颈内动脉通畅率为80.9%。随访3-6个月未见复发。结论：可脱性球囊栓塞术是治疗外伤性颈内动脉海绵窦瘘的首选术式。     

运用DSA行可脱球囊栓塞治疗颈内动脉海绵窦瘘11例

目的:探讨运用数字减影血管造影(DSA)行颈内动脉海绵窦瘘球囊栓塞治疗效果。方法:对11例颈内动脉海绵窦瘘患者在DSA下进行可脱性球囊栓塞治疗。结果:11例患者中8例行可脱性球囊闭塞瘘口,颈内动脉通畅,2例行球囊闭塞颈内动脉远端和近端,1例行孤立闭塞术,术后复发。结论:DSA检查和可脱性球囊栓塞治疗是TCCF理想的检查和治疗方法     

血管内栓塞治疗外伤性颈内动脉海绵窦瘘7例

探讨颈内动脉海绵窦瘘(CCF)血管内栓塞治疗的效果.方法:7例均经DSA全脑血管造影明确瘘口部位,采用可脱性球囊或电致血凝性可脱性铂金弹簧圈(GDC)进行栓塞.结果:7例中,3例球囊栓塞成功并保持颈内动脉通畅;2例表现为假性动脉瘤,用球囊闭塞患侧颈内动脉;1例因瘘口太小,用GDC填塞海绵窦;另1例两次试放球囊入海绵窦均破裂失败,其中一枚瘪陷球囊滞留于海绵窦,患者不愿闭塞患侧颈内动脉未予进一步治疗,但术后一周临床症状和体征均消失.结论:颈内动脉海绵窦瘘全脑血管造影可明确瘘口部位、大小,首选治疗方法是血管内栓塞治疗.     

可脱性球囊血管内栓塞治疗颈内动脉海绵窦瘘27例

目的：探讨颈内动脉海绵窦瘘（CCF）血管内治疗的技术。方法：对27例颈内动脉海绵窦瘘患者采用Seldinger技术行股动脉插管，先做全脑血管造影，明确瘘口大小及位置，后置人8F导引管，经引管行可脱性球囊栓塞治疗。结果：27例共进行28次栓塞治疗，其中24例保持了患侧颈内动脉的通畅，3例闭塞了患侧颈内动脉，l例1周后术前症状重新出现，再次可脱性球囊栓塞治疗痊愈。24例术后眼部症状及颅内杂音完全消失，3例术后颅内杂音减弱，眼部症状有所缓解，无术后死亡和症状加重病例，随访1个月～2年，未见复发。结论：经股动脉用可脱性球囊栓塞治疗颈内动脉海绵窦瘘是比较理想、行之有效的方法。     

可脱性球囊血管内治疗外伤性颈内动脉海绵窦瘘(附112例报告)

目的探讨用可脱性球囊栓塞技术治疗高流量外伤性颈内动脉海绵窦瘘的方法及疗效.方法回顾性分析112例采用可脱性球囊栓塞技术治疗的高流量外伤性颈内动脉海绵窦瘘患者的临床资料,全部患者均经全脑数字减影血管造影术明确诊断.结果采用可脱性球囊栓塞后,瘘口闭合且颈内动脉通畅97例(87.6%),瘘口闭合但颈内动脉闭塞15例.术后随访2个月至9年,复发4例,行二次栓塞后无复发.本组病例均无合并症.结论可脱性球囊栓塞技术是治疗高流量外伤性颈内动脉海绵窦瘘的首选术式.     

复发性、难治性颈内动脉海绵窦瘘的治疗

目的:探讨对复发性、难治性颈内动脉海绵窦瘘的治疗。方法:6例复发性、难治性颈内动脉-海绵窦瘘患者,采用经皮股动脉径路、可脱球囊栓塞,其中2例结合开颅手术治疗。结果:6例复发性、难治性颈内动脉-海绵窦瘘患者主要症状消失,1例患侧失明未恢复。结论:可脱球囊手术闭塞患侧颈内动脉或结合开颅手术进一步孤立瘘口的方法对治疗复发性、难治性颈内动脉海绵窦瘘有一定的价值。颈动脉海绵窦瘘(CCF)以外伤性颈内动脉-海绵窦瘘多见,其诊断和介入治疗、手术治疗已不成问题,但少数的复发性、难治性CCF治疗往往很困难。我院于2000~2005年来收治了6例复发性、难治性CCF,4例通过可脱球囊技术堵塞颈内动脉,1例通过可脱球囊 开颅颈内动脉夹闭,1例通过可脱球囊 开颅颈内动脉夹闭海绵窦瘘内注NBCA胶等治疗。现就复发、难治性CCF的治疗探讨如下。     

颈内动脉-海绵窦瘘应用可脱性球囊介入栓塞治疗

目的探讨应用可脱性球囊介入栓塞治疗颈内动脉-海绵窦瘘的价值.方法 30例颈内动脉-海绵窦瘘患者据术中造影瘘口部位及大小分别选用不同型号的球囊进行栓塞治疗.结果治愈者27例(90%),24例1次1个球囊栓塞成功,3例两个球囊栓塞成功.单纯瘘口闭塞而保持颈内动脉畅通者23例(76.7%).结论选择性DSA全脑血管造影是诊断本病的可靠方法.可脱性球囊介入栓塞是治疗颈内动脉-海绵窦瘘的首选方法.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.