冠脉护理在320排螺旋CT冠状动脉造影中提高图像质量的作用

目的：探讨320排螺旋CT心脏冠状动脉护理的作用及其临床意义。方法：2009年11月至2010年3月,于我院行心脏检查1024例行320排螺旋CT冠状动脉造影检查的患者,检查前对每一患者进行心理辅导,减轻紧张情绪;进行心率控制、屏气训练等护理措施准备;在扫描过程中配合影像技师使用高压注射器;检查完成后积极与患者交谈,严密观察患者状态,预防造影剂不良反应的发生。结果：受检患者中987例患者顺利完成检查,图像重建后血管显示效果优;16例血管显示良;有1例患者造影剂未全部进入血管内,导致血管显影不充分。有2例出现轻度过敏反应;无空气栓塞或任何心脑血管意外的发生。受检病例中432例同时进行了冠状动脉造影,98%（425/432）与检查结果完全一致,有2%（8/432）与检查结果有轻度误差。结论：检查前细致的护理对提高心脏冠状动脉血管成像成功率、提高至关重要。     

五指山小型猪两种股动脉穿刺方法的比较

目的比较五指山小型猪在急性心肌梗死造模前行股动脉穿刺所使用的两种方法的成功率和并发症发生率以及所花费时间,为动物实验时行股动脉穿刺提供依据。方法拟行股动脉穿刺的五指山小型猪16头随机分为两组即切开直视穿刺组（n：8）和超声引导穿刺组（n=8）,比较两组穿刺的成功率、并发症发生率以及穿刺所花费时间。结果切开直视穿刺组的成功率及感染发生率均无差异,但出血发生率前者显著低于后者（P〈0．05）,且花费时间也明显少于后者（P〈0．05）。结论切开直视股动脉穿刺术是一种成功率高,安全性好,花费时间相对较少的方法。     

老年人冠状动脉狭窄程度与超敏C反应蛋白及脂蛋白(a)水平的研究

目的:探讨老年人冠脉狭窄程度与超敏C反应蛋白(hs-CRP)及脂蛋白(a()LP(a))水平的关系。方法:分析研究260例年龄>60岁的经行冠脉造影检查明确诊断冠心病的患者的冠脉狭窄程度,以及术前空腹采血测定其hs-CRP及LP(a)的水平。结果:①冠脉病变组(186例)与对照组(76例)比较,冠脉病变组Lp(a)和hs-CRP水平分别为(3.30±4.30)mg/L和(146.30±3.21)mg/L,对照组分别为(1.32±2.32)mg/L和(40.26±2.44)mg/L,二者存在差别(P<0.01),差别有统计学意义。②各个亚组病与对照组比较各亚组(单支病变组、双支病变组、三支病变组)hs-CRP和LP(a)与对照组相比较存在明显差异,单支病变组51例,双支病变组72例,三支病变组63例。单支病变组hs-CRP和Lp(a)水平分别为(2.11±1.31)mg/L和(41.58±2.32)mg/L,双支病变组分别为(2.97±2.11)mg/L和(47.12±1.21)mg/L,三支病变组分别为(3.42±2.16)mg/L和(60.13±3.54)mg/L,P<0.05,差别有统计学意义,且随着病变支数的增加,hs-CRP和LP(a)呈增高趋势。并行单因素相关分析,hs-CRP和LP(a)与冠脉病变支数有正相关关系(P<0.05)。③男性病变组(107例)和女性病变组(79例),男性组hs-CRP和LP(a)水平分别为(1.87±2.11)mg/L和(43.60±2.18)mg/L,女性病变组hs-CRP和LP(a)水平分别为(3.33±1.70)mg/L和(50.77±2.47)mg/L,二者存在差别,P>0.05,差别无统计学意义。结论:老年人冠脉狭窄程度与血清Lp(a)和hs-CRP水平变密切相关,呈正相关,老年男性冠心病患者与女性冠心病患者相比,血清Lp(a)和hs-CRP水平无显著差异。     

A new formula for predicting the position of severe arterial stenosis

Noninvasive location of an occlusion or a severe stenosis in the arterial system is of a great interest for surgical interventions. Here, we present a new method to determine the location of arterial 99% stenosis in the arterial (sub) system. The method requires a measurement of propagation constant and the instantaneous flow rate or velocity at two sites of an arterial tree. The method was successfully tested using Womersley’s oscillatory flow theory and the data obtained by a simulation of Fluid structure interaction (FSI). The effect of noise has been investigated to simulate experimental conditions. The results demonstrate that location of 99% severe stenosis could be accurately obtained. The spatial resolution was approximately a few centimeters and the differences between exact and computed values didn’t exceed 13%. However, the identifications of stenotic sites decreased with the distance. Further investigation of the developed method in vivo and in vitro is required.     

Arterial wall remodeling under sustained axial twisting in rats

Blood vessels often experience torsion along their axes and it is essential to understand their biological responses and wall remodeling under torsion. To this end, a rat model was developed to investigate the arterial wall remodeling under sustained axial twisting in vivo. Rat carotid arteries were twisted at 180° along the longitudinal axis through a surgical procedure and maintained for different durations up to 4 weeks. The wall remodeling in these twisted arteries was examined using histology, immunohistochemistry and fluorescent microscopy. Our data showed that arteries remodeled under twisting in a time-dependent manner during the 4 weeks post-surgery. Cell proliferation, MMP-2 and MMP-9 expressions, medial wall thickness and lumen diameter increased while collagen to elastin ratio decreased. The size and number of internal elastic lamina fenestrae increased with elongated shapes, while the endothelial cells elongated and aligned towards the blood flow direction gradually. These results demonstrated that sustained axial twisting results in artery remodeling in vivo. The rat carotid artery twisting model is an effective in vivo model for studying arterial wall remodeling under long-term torsion. These results enrich our understanding of vascular biology and arterial wall remodeling under mechanical stresses.     

Egr-1的特异性脱氧核酶对大鼠颈总动脉损伤后内膜增生的影响

目的 探讨早期生长反应因子-1(Egr-1)的特异性脱氧核酶对大鼠颈总动脉损伤后新生内膜形成的影响。方法 对Wistar大鼠行颈总动脉损伤后,在转染试剂Fugene6介导下经血管腔内转染Egr-1的特异性脱氧核酶(ED5),以假手术组、单纯损伤组及空白转染试剂组(Fu gene 6组)作为对照,于术后3、7、14和21d4个时间点取材,检测内膜增生程度及增殖细胞核抗原(PCNA)、转化生长因子-β(TGF-β)和Egr-1的表达变化。结果单纯损伤组及Fugene6组7d时可见内膜增生,14d、21d时内膜增厚更明显,PCNA及TGF-β于损伤后3天明显表达,7d时在新生内膜及中膜中表达达到高峰,14d后逐渐下降,而Egr-1呈持续高表达。经ED6作用后,内膜增生减轻,动脉中PCNA、TGF-β及Egr-1表达明显降低,与单纯损伤组和Fu Gnene 6组比较差异有显性。结论结果提示ED5可能是通过特异性抑制其相应基因的表达来阻遏动脉损伤后的内膜增生。