Permanent Cerebral Vessel Occlusion via Double Ligature and Transection

Stroke is a leading cause of death, disability, and socioeconomic loss worldwide. The majority of all strokes result from an interruption in blood flow (ischemia) ¹. Middle cerebral artery (MCA) delivers a great majority of blood to the lateral surface of the cortex ², is the most common site of human stroke ³, and ischemia within its territory can result in extensive dysfunction or death ^1,4,5. Survivors of ischemic stroke often suffer loss or disruption of motor capabilities, sensory deficits, and infarct. In an effort to capture these key characteristics of stroke, and thereby develop effective treatment, a great deal of emphasis is placed upon animal models of ischemia in MCA.Here we present a method of permanently occluding a cortical surface blood vessel. We will present this method using an example of a relevant vessel occlusion that models the most common type, location, and outcome of human stroke, permanent middle cerebral artery occlusion (pMCAO). In this model, we surgically expose MCA in the adult rat and subsequently occlude via double ligature and transection of the vessel. This pMCAO blocks the proximal cortical branch of MCA, causing ischemia in all of MCA cortical territory, a large portion of the cortex. This method of occlusion can also be used to occlude more distal portions of cortical vessels in order to achieve more focal ischemia targeting a smaller region of cortex. The primary disadvantages of pMCAO are that the surgical procedure is somewhat invasive as a small craniotomy is required to access MCA, though this results in minimal tissue damage. The primary advantages of this model, however, are: the site of occlusion is well defined, the degree of blood flow reduction is consistent, functional and neurological impairment occurs rapidly, infarct size is consistent, and the high rate of survival allows for long-term chronic assessment.     

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Despite the considerable progress made in the stent development in the last decades, cardiovascular diseases remain the main cause of death in western countries. Beside the benefits offered by the development of different drug-eluting stents, the coronary revascularization bears also the life-threatening risks of in-stent thrombosis and restenosis. Research on new therapeutic strategies is impaired by the lack of appropriate methods to study stent implantation and restenosis processes. Here, we describe a rapid and accessible procedure of stent implantation in mouse carotid artery, which offers the possibility to study in a convenient way the molecular mechanisms of vessel remodeling and the effects of different drug coatings.     

彩色多普勒超声测量椎动脉血流量对后循环缺血的诊断价值

目的：探讨彩色多普勒超声技术测量椎动脉血流量对后循环缺血（PCI）的诊断价值。方法：选取2012年1月至2013年1月在本院神经内科住院并接受治疗的PCI患者58例作为观察组,另选取同期住院并确诊为非后循环缺血症的患者50例作为对照组。所有患者均接受颈部血管超声检查,测量椎动脉内径及血流量,观察组患者需行头颅CTA检查,比较两组患者的椎动脉内径、血流量及颈动脉硬化斑块发生率等。结果：观察组患者的椎动脉内径及血流量明显低于对照组,两组比较差异有统计学意义（P〈0．01）;观察组颈动脉硬化斑块的发生率为77．5％（44例）,对照组颈动脉硬化斑块的发生率为42％（21例）,两组比较差异有统计学意义（P〈0．05）。无狭窄、轻度狭窄、重度狭窄及闭塞的椎动脉血流量的变化（此处所指的血流量是指小于200mL/min那部分患者）有明显差异（P〈0．05）。结论：与头颅CTA对比检查,彩色多普勒具有直接、准确、方便及可重复性等优点,可有效的诊断后循环缺血症状。     

大剂量阿托伐他汀对冠心病合并高尿酸血症PCI术后Scr、hsCRP及NGAL的影响

摘要目的：探讨大剂量阿托伐他汀对冠心病合并高尿酸血症PCI术后scr、hsCRP及NGAL的影响。方法：选取2010年6月至2012年6月间于我院接受诊断和治疗的冠心病合并高尿酸血症患者64例,随机分为观察组与对照组,每组32例。观察组给予大剂量阿托伐他汀治疗,对照组给予常规剂量阿托伐他汀治疗。结果：两组患者治疗前Scr、hsCRP及NGAL水平之间相互比较无显著性差异（P〉0．05）。观察组患者术后24hhsCRP水平为（6．7±1．5）m∥L,72hhsCRP水平回落至（5．7±1．0）mg门L,均明显低于对照组（P〈0．05）。观察组患者术后24hNGAL水平为（59．1±12．3）ng／L,72hNGAL水平回落至（47．8±10_3）ngm,均明显低于对照组（P〈0．05）。观察组心脏不良事件发生率明显低于对照组（P〈O．05）。结论：大剂量阿托伐他汀对于冠心病合并高尿酸血症患者PCI术后有一定的肾脏保护作用,且其安全性良好。     

支气管动脉灌注化疗与栓塞治疗中晚期肺癌的疗效观察

目的：对比分析支气管动脉灌注化疗与支气管动脉灌注化疗十栓塞术治疗中晚期肺癌的临床疗效。方法：将我院2011年1月-2013年1月期间收治的76例中晚期肺癌患者随机分为两组,即观察组38例,对照组38例。观察组患者行支气管动脉灌注化疗联合栓塞术治疗,对照组患者行单纯支气管动脉灌注化疗治疗。分别对两组患者治疗后的临床治疗效果进行评价,同时观察两组患者治疗后的不良反应及并发症的发生情况。结果：观察组患者临床治疗的总有效率为84．21％,对照组为64．78％．两组比较,差异具有统计学意义（P〈0．05）。两组患者治疗后,观察组患者总不良反应率为23．67％,对照组为21．04％,两组比较．差异无统计学意义（P〉0．05）。且经对症处理后,均得到有效改善。结论：支气管动脉灌注化疗联合栓塞术治疗中晚期肺癌的,临床疗效明显优于单纯支气管动脉灌注化疗,且无明显不良反应及并发症的发生,安全性好,值得临床推广与应用。     

Myocardial bridging: what have we learned in the past and will new diagnostic modalities provide new insights?

The clinical significance of myocardial bridging has been a subject of discussion and controversy since the introduction of coronary arteriography (CAG) in the early 1960s. More recently computed tomography coronary angiography (CTCA) has made it possible to visualise the overlying muscular bands and appears to have a higher sensitivity for detecting myocardial bridging than CAG. Combining CTCA with invasive techniques such as CAG should make it possible to improve our understanding of the pathophysiology of myocardial bridging and to provide answers to hitherto unresolved questions. This paper critically reviews the outcomes of previous studies and defines remaining questions that should be answered to optimise the management of the presumably fast growing number of patients in whom a diagnosis of myocardial bridging has been made.     

左室主动固定电极在心脏再同步化治疗中的临床应用

目的：探讨左室主动固定电极在心脏再同步化治疗（cardiac resynchronization therapy,CRT）中的作用并总结其临床经验。方法：收集2008年1月至2013年1月由梅州I市人民医院心内科植入CRT的患者,共56例（男34例,女22例）。根据植入冠状窦电极的不同,分为左室主动固定电极组（17例）和被动电极组（39例）,观察和比较两组的手术时间、透视时间和造影剂用量。结果：左室主动固定电极组的手术时间[（61±36）minvs（143＋61）min,P=0．035]和透视时间[（10±5）minvs（45＋11）min,P=0．042]均较被动电极组显著缩短,而造影剂用量[（36±20）mlvs（87±46）ml,P=0．041]也较被动电极组明显减少。结论：左室主动固定电极用于心脏再同步化治疗可明显缩短手术时间,降低造影剂用量,使患者和术者均获益。     

两种途径介入治疗急性心肌梗塞疗效分析

目的：探讨对急性心梗患者行不同途径急诊经皮冠状动脉治疗（PCi）的临床疗效及预后。方法：选取我院自2011年1月至2012年12月收治的75例sT段抬高的急性心肌梗死患者作为研究对象进行回顾性调查,对比分析经桡动脉PCI（TRA—Pet）和经股动脉PCI（TFA—PCI）两组治疗疗效及出现并发症情况,包括比较两组穿刺成功率,手术时间,术中出血及术后局部及其他并发症等方面,并作统计分析,取P〈0．05为有统计学意义。结果：两组穿刺成功率及PCI手术成功率差异无统计学意义,P〉0．05。在手术操作时间上,TFA—PCI组明显长于TRA—PCI组,差异有统计学意义,P〈0．05。TFA．PCI组局部并发症发生率为11．8％．远期并发症为2．9％。TRA-PCI组局部并发症发生率为2．4％,远期并发症为7．3％,两组差别显著,P〈0．05。结论：TRA—PCI和TFA—PCI在手术时间及术后并发症上有差异,TRA—PCI术中花时间较少,术后局部并发症要轻,值得在临床上推广,但是由于有远期并发症的危险,故术后应加强肝肾功能等的监测。     

剖宫产术后切口妊娠介入治疗与保守治疗效果的临床研究

目的:研究子宫动脉介入化疗栓塞术在临床上对剖宫产切口妊娠的治疗效果.方法:回顾性分析我院2007年1月至2012年12月的收治的切口妊娠患者53例.并将53例患者随机分为介入治疗组28例、保守治疗组25例,介入治疗组患者采用双侧子宫动脉栓塞术后进行刮宫术的治疗,保守治疗组患者采用口服米非司酮以及肌内注射MTX后进行刮宫术的治疗.对两组患者的临床资料包括出血量,住院时间,降血HCG时间等进行统计学分析.结果:介入治疗组患者的出血量,住院时间,降血HCG时间明显低于保守治疗组患者的情况,差异具有显著性(P＜0.05).介入治疗组和保守治疗组间的不良反应差异无统计学意义(P＞0.05).结论:对患者采用子宫动脉介入对剖宫产切口妊娠进行治疗的方式,可以对切口妊娠大出血进行有效的控制,同时也可以对妊娠物进行有效的杀死.