经胸超声在Amplatzer封堵器介入治疗先天性房室间隔缺损中的临床应用

目的探讨经胸超声在AmpLatzer封堵器介入治疗先天性房间隔缺损、室间隔缺损中的临床应用价值。方法术前应用经胸超声筛选封堵术适应证36例先心病,其中26例房间隔缺损、10例室间隔缺损。术中用经胸超声监测指导释放封堵器,即刻观察疗效。于胸骨旁四腔观、房间隔短轴观、心尖四腔观、心尖五腔观、大动脉短轴观、剑突下四腔心观分别观察封堵器的形态,瓣膜反流及封堵器周围分流情况。术后进行定期复查。结果26例房间隔缺损、10例室间隔缺损封堵成功,总成功率100%。其中16例出现二、三尖瓣反流或残余分流,经调整封堵器的位置和方向后,10例反流即刻消失,6例术后1个月消失。结论经胸超声可用来筛选房间隔缺损、室间隔缺损封堵术病例,术中指导Amplatzer封堵器定位和释放,疗效评估和预后评价方面有不可替代的临床应用价值。     

隐源性缺血性脑卒中患者的食管超声心动图解析

目的 探讨食管超声心动图（TEE）诊断隐源性缺血性脑卒中（CS）患者房间隔异常的特点。方法 收集我院CS患者181例,根据年龄分为＜30岁组、31~50岁组、＞51岁组。所有患者均行TEE检查,观察房间隔情况。结果 所有患者中,PFO患者63例,占34.81%,房间隔膨出瘤患者6例,占3.31%,房间隔膨出瘤并缺损患者19例,占10.50%,房间隔组织稀疏并分流患者24例,占13.26%;小于30岁组房间隔组织稀疏并分流患者4例,占44.44%;31~50岁组房间隔结构异常者以PFO居多,占33.33%;大于51岁组PFO最多,占37.36%。CS患者中房间隔异常的TEE超声特点:①卵圆孔未闭类型:卵圆瓣较长,与房间隔组织贴合欠佳,有明显裂隙,形似“隧道”样;卵圆瓣较短,与房间隔组织贴合处有间隙。②房间隔膨出瘤或合并房间隔缺损,即房间隔组织菲薄,随心脏舒缩活动膨向右房、左房或摆动于左右房之间,部分患者可合并房间隔小缺损。③房间隔组织薄弱、稀疏,形同“筛子”样,可合并心房水平多股细小分流信号。结论 PFO是CS的重要致病原因之一,TEE作为目前诊断PFO和房间隔病变的首选方法,可精准描述房间隔结构和准确判断心房水平的分流情况,为临床尽早识别和预防脑血管卒中提供客观依据。     

国产封堵器介入治疗房间隔缺损的疗效及安全性

目的 评价应用国产房间隔封堵器治疗房间隔缺损的疗效及安全性。方法 12例房间隔缺损患者，男性4例，女性8例，年龄18-45岁。对患者均使用经体表超声心动图（TTE）监测。封堵器选用国产房间隔封堵器（北京华圣杰科技有限公司研制）。房间隔缺损封堵术后48h进行TTE复查，术后1、3、6个月随访得查心电图、TTE、X线，并观察疗效及安全性。结果 11例封堵手术成功，即刻手术成功率91.67%，术中及术后48hTTE星移斗转测均无残余分流。术后1、3、6个月随访，原有临床不适症状缓解，TTE显示封堵器位置稳定，房间隔水平无分流。结论 国产房间隔封堵器对房间隔缺损进行介入治疗，临床使用有效、安全。     

牛心包补片修复心脏间隔缺损的应用

背景：心脏涤纶补片因其质地薄、质量轻、生物相容性好等优点常规用于心脏手术,但最近几年发现,用心脏涤纶补片对心室间隔缺损修补后,一旦发生术后残余漏,较易引起溶血、细菌或真菌感染。 目的：探讨应用牛心包补片修复心脏间隔缺损的疗效。 方法：采用戊二醛固定的牛心包补片修补152例心脏间隔缺损患者,其中房间隔缺损56例,室间隔缺损78例,部分房室间隔缺损18例。术后复查心电图、胸片、心脏超声,观察其术后早期病情、血流动力学和心脏功能。 结果与结论：152例患者均完成修补手术,术后无早期死亡,患者随访2-6个月,牛心包补片在使用过程中及术后早期均未发现漏血、溶血、血栓、感染、排斥反应等并发症。1例患者因合并肺动脉高压,术后第1天出现高血压危象,经过抢救后好转。复查心电图、胸片、心脏超声可见心脏间隔缺损修补完全,无残余分流;肺动脉压力明显下降;活瓣已关闭无分流;心脏功能正常。证实牛心包补片可以有效修复心脏间隔缺损,改善患者的血流动力学和心功能,近期效果满意,是一种良好的心脏间隔缺损修补材料。     

经食道心脏超声对应用Amplatzer封堵器治疗房间隔缺损的观察

目的 :观察应用Amplatzer封堵器经导管治疗二孔型ASD的疗效 ,并评价经食道超声 (TEE)在介入治疗ASD中的价值。方法 :全组共 1 8例 ,均为二孔型ASD ,年龄 1 4～ 4 1岁 ,平均 2 1 .6岁。TEE测ASD最大直径 3 3mm ,平均 2 1 .4mm ,缺损周边有足够的房间隔空间。在透视及TEE监视下经导管置入Amplatrzer封堵器封堵ASD ,术后即刻、2 4h、3个月分别行TEE检查 ,评价治疗效果。结果 :全组技术成功率为 1 0 0 % ,术后 2 4hTEE检查显示 1 4例ASD完全闭合 ,4例存在微量残余分流 ,术后 3个月均无残余分流 ,无任何并发症。结论 :应用Amplatzer封堵器经导管治疗二孔型ASD操作简便 ,成功率高 ,是目前导管介入治疗ASD的首选治疗器材。TEE在对病例的筛选、引导封堵器的置入及术后疗效评价等方面有极重要的作用。     

食道心脏超声在成人心脏外科应用分析

目的探讨分析成人心脏外科中食道心脏超声(TEE)的应用价值。方法回顾性分析60例心脏外科手术患者的临床资料。结果根据术中TEE观察结果可知,初始诊断结果 6例错误。术后,所有以TEE监测显示,观察区有轻度反流信号,运动良好,较术前改善明显。结论成人心脏外科中食道心脏超声的应用可纠正术前失误判断,为手术施行和疗效评价提供依据,值得推广和深入研究。     

电视胸腔镜辅助下房间隔缺损修补术36例报告

目的探讨电视胸腔镜下房间隔缺损修补的体外循环方法。方法36例房间隔缺损患者采用股动脉、股静脉和上腔静脉插管建立体外循环,经第七肋间置入胸腔镜,另选第四肋间打两个手术操作孔,在电视胸腔镜下行房间隔缺损修补。结果1例患者因体外循环停机后血氧饱和度在80%-88%,而延长第四肋间切口重新作心内探查;其他患者手术顺利,术后无并发症。结论电视胸腔镜体外循环下行房间隔缺损修补术安全可靠。     

心脏人工机械瓣相关并发症外科治疗初步经验

目的　总结 15例心脏人工机械瓣相关并发症外科治疗初步经验。方法　本组 15例患者中 ,男 7例 ,女 8例 ,年龄 315 9岁 ,平均 (4 5 .5± 8.0 )岁。术前均明确诊断 ,人工机械瓣心内膜炎 4例 ,单纯主动脉瓣周漏 4例 ,单纯二尖瓣周漏 4例 ,单纯主动脉瓣并二尖瓣周漏 2例 ,二尖瓣栓塞 1例。肺水肿 10例 ,充血性心力衰竭 6例。再次手术距首次手术时间间隔 1个月至 72个月 ,平均 (2 1.9± 18.2 )个月。本组在全麻中度低温体外循环下行再次主动脉瓣替换术 4例 ,再次二尖瓣替换术 2例 ,主动脉瓣周漏修补术 2例 ,二尖瓣周漏修补术 5例 ,主动脉瓣和二尖瓣周漏修补术 2例。同期手术包括主动脉右心室交通残余漏修补术 1例 ,三尖瓣成形术 4例 ,主动脉瓣替换术 1例 ,冠状动脉旁路移植术 1例。结果　手术死亡 5例 (33.3% )。术后低心排、多脏器功能衰竭 (3例 )为死亡主要原因。 1例为劈胸骨时损伤主动脉大出血 ,术后深昏迷死亡 ,中毒性休克死亡 1例。存活 10例 ,随访 ,死亡 1例为再次主动脉瓣替换术后半年瓣膜栓塞 ,余 9例心功能明显改善。结论　人工机械瓣膜病外科治疗值得 ,但手术危险性较高     

再次三尖瓣手术治疗左心瓣膜术后孤立性三尖瓣反流的疗效分析

目的 探讨再次三尖瓣手术治疗左心瓣膜术后孤立性三尖瓣反流的临床疗效。方法 回顾性研究。纳入2005年9月—2021年9月在安徽医科大学第一附属医院心脏大血管外科接受再次三尖瓣手术治疗的32例左心瓣膜术后孤立性三尖瓣反流患者的临床资料。其中男3例,女29例;年龄32~74（53.8±9.2）岁;三尖瓣置换术30例,三尖瓣成形术2例;16例于胸腔镜辅助下完成手术,16例经传统胸骨正中切口完成手术。观察患者体外循环时间、重症监护病房（ICU）时间、术后机械通气时间、术后住院时间、围术期死亡率及并发症发生率。根据随访结果,采用Kaplan-Meier法绘制生存曲线并计算术后生存率。结果 32例患者手术均顺利完成。体外循环时间121.0（80.5,187.3）min,ICU停留时间4.0（2.0,10.5）d,术后机械通气时间41.0（16.3,87.3）h,术后住院20.0（12.0,29.0）d。围术期死亡8例（25.0%,8/32）,24例（75.0%,24/32）治愈出院。围术期主要并发症：32例患者中,低心排综合征6例（18.8%）、呼吸衰竭10例（31.3%）、再次气管插管8例（25.0%）、气管切开5例（15.6%）、肺部感染8例（25.0%）、胸腔积液5例（15.6%）、急性肾衰竭6例（18.8%）、急性肝衰竭1例（3.1%）、消化道出血2例（6.3%）、切口愈合不良3例（9.4%）。随访22例（91.7%,22/24）,随访时间26.5（17.3,42.0）个月,随访期间死亡4例,18例存活患者中纽约心脏协会心功能分级均恢复至Ⅰ~Ⅱ级。患者术后1、2、5年累积生存率分别为71.9%、68.5%、63.2%。结论 再次三尖瓣手术治疗左心瓣膜术后孤立性三尖瓣反流安全有效,围术期及术后近、中期临床效果满意。     

经胸超声心动描记术在房间隔缺损封堵中的作用

目的探讨超声心动描记术在房间隔缺损（ASD）封堵术术前诊断筛选、术中监测指导、术后随访评价中的作用。方法 11例中央型ASD患者,其中男性4例,女性7例;年龄4～65岁,平均年龄29岁。术前应用彩色多普勒超声心动描记术经胸观察、测量ASD大小、位置及与周围组织结构的关系,并观察周缘软硬情况,选择封堵器型号。术中监测封堵过程、观察封堵器的牢固性,彩色多普勒观察有无残余分流,术后进行随访。结果术前检查ASD大小5～34mm,术中选用的封堵器大小8～38mm,所有患者手术顺利完成,无并发症发生,经3个月以上的随访,封堵器固定牢固,无脱落,无残余分流。结论超声心动描记术在ASD封堵术术前诊断筛选、术中监测指导、术后随访评价中发挥了重要作用。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.     

A comparative study of the effects of dimebon,obsidan, finoptin,and cordaron on the functional state of ischemic focus and size of necrotic zone in experimental myocardial infarction

Dimebon, an antihistamine agent, exerts a moderate antianginal effect, improving the function of ischemic focus in the myocardium and decreasing the necrotic zone in experimental myocardial infarction. Dimebon is less active than obsidan, finoptin (except for the size of the necrotic zone), and cordaron. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 122, No. 12, pp. 642–644, December, 1996     

Effects of sex steroid hormones on lipid peroxidation and glutathione antioxidant system in rat skin

Effects of estradiol and testosterone on the intensity of lipid peroxidation and contents of glutathione redox system components in the dermis and epidermis of rat skin were studied. Only estradiol induced considerable dose-dependent and tissue-specific biphasic antioxidant effects on the skin. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 128, No. 12, pp. 663–666, December, 1999     

Adhesion and growth of CaCo2 cells on surface-modified PEEK substrata

A series of surface-functionalized poly(ether ether ketone) (PEEK) films has been prepared by selective wet-chemistry; they are hydroxylated polymer (PEEK-OH) obtained by reduction, aminated polymer (PEEK-[]-NH2) prepared by coupling a diisocyanate reagent to PEEKOH (PEEK-[]-NCO) followed by hydrolysis, and carboxylated and aminocarboxylated polymers (PEEK-[]-GABA and PEEK-Lysine) resulting from the coupling of aminoacids to PEEK-[]-NCO. The aminated and carboxylated substrata promoted the adhesion and growth of CaCo2 cells in the presence of serum. Fibronectin (FN), an extra-cellular matrix protein, has been covalently fixed and/or adsorbed on various PEEK substrata, in the presence or not of a polymeric surfactant (Pluronic F68). The performances of the FN-grafted substrata (PEEK-[]-FN(1) and PEEK-[]-FN(2)) were significantly higher than those of reference substrata simply coated with FN (PEEK-OH(+FN)(1) and (2), PEEK-[]-NH2(+FN)(1) and (2)), considering the adhesion and spreading of CaCo2 cells in the absence of serum. Moreover, the stability of the adherent cells on the FN-adsorbed substrata dramatically depended on the experimental conditions applied during the PEEK coating with FN.