目的 探讨捆绑式胰肠吻合术在预防胰十二指肠切除术后胰肠吻合口漏的可行性及临床应用价值。 方法 我院在2002年3月至2006年10月期间对32例胰十二指肠切除术患者采用捆绑式胰肠吻合术。结果 32例患者手术均顺利,无一例发生胰瘘,无手术死亡病例。 术后发生胆瘘2例,经腹腔引流治愈。结论 捆绑式胰肠吻合术操作简便,预防胰瘘效果可靠,值得推广。
Objective To investigate the change of vasa vasorum in vessel wall of varicose vein of the lower extre-mity. Methods Thirty-two patients with varicose vein of the lower extremity were collected, in which of 12 patients with simple varicose veins (varicose group), 9 patients with recurrent varicose veins (recurrent group), 11 patients withthrombophlebitis of varicose vein (thrombophlebitis group), 9 patients with normal venous tissue as control group. HE staining was performed to observe the distribution of vasa vasorum and detect the vasa vasorum density. Results The increasing vasa vasorums were observed in the adventitia and media, but few was observed in the intima in the varicose, recurrent, and thrombophlebitis groups. The distribution of vasa vasorum was in the adventitia in the control group. The vasa vasorum densities (/mm2) in the varicose, recurrent, and thrombophlebitis groups (5.65±1.45,6.20±1.73, and 5.94±1.63, respectively) were greater than those in the control group (2.87±0.54), the difference wasstatistically significant (P<0.05), but there was no significant difference of the vasa vasorum density among the varicosevein, recurrent, and thrombophlebitis groups (P>0.05). Conclusion Change of vasa vasorum is an important pathol-gical change with the nosogenis of varicose vein of the lower extremity.
Implantable left ventricular assist device (LVAD) has become an essential treatment for end-stage heart failure, and its effect has been continuously improved. In the world, magnetic levitation LVAD has become mainstream and is increasingly used as a destination treatment. China has also entered the era of ventricular assist device. The continuous improvement of the ventricular assist device will further improve the treatment effect. This article reviews the current situation and development trend of LVAD treatment in China and abroad.
目的检测曲张大隐静脉管壁各参数,并探讨曲张大隐静脉管壁发生、发展过程中组织形态学特征与临床病期之间的关系。方法回顾性分析我院2008年7月至2009年7月期间收治的49例高位结扎剥脱加旋切治疗的大隐静脉曲张患者的临床资料,按临床CEAP分级分为单纯静脉曲张组(C2~C3级,简称单纯曲张组),24例; 静脉曲张并皮肤改变组(C4~C6级,简称皮肤改变组),25例; 另选6例因外伤行截肢术但大隐静脉正常无损伤者作为对照组。采用Masson染色测量静脉内膜和中膜厚度,以测量静脉截面的最大直径作为管腔内径值,采用免疫组织化学SP法观察静脉管壁的结构变化。结果管腔内径: 与对照组比较,单纯曲张组及皮肤改变组上、中、下三段静脉管腔内径均明显增大(Plt;0.05); 皮肤改变组上、中段静脉管腔内径较下段也明显增大(Plt;0.05); 单纯曲张组三段静脉管腔内径变化差异无统计学意义(Pgt;0.05)。单纯曲张组和皮肤改变组的静脉管壁结构改变大致相似,主要表现为内膜不均匀增厚,管壁厚薄不等,以胶原纤维和细胞外基质增生为主,伴有平滑肌增生,中膜厚度略增加,平滑肌束排列紊乱,部分萎缩、凋亡,部分局灶增生,肌束间纤维胶原间质增生,两者相互穿插,排列混乱,弹力纤维断裂。皮肤改变组还可见内膜继发性改变,包括黏液变性、玻璃样变性、内膜炎、血栓形成等。单纯曲张组和皮肤改变组上、中、下三段静脉内膜厚度明显大于对照组(Plt;0.05); 单纯曲张组上、下段静脉内膜厚度明显小于中段(Plt;0.05); 单纯曲张组中段内膜厚度明显大于皮肤改变组中段(Plt;0.05)。中膜厚度单纯曲张组、皮肤改变组和对照组之间以及同一组内上、中、下三段间比较差异均无统计学意义(Pgt;0.05)。结论下肢曲张静脉管腔扩张,内膜增厚,内膜改变以中段出现较早且显著,上、下二段血管壁的重塑与临床病期之间无关。
【摘要】 目的 探讨瑞舒伐他汀对慢性肾病患者抗炎疗效。 方法 选取2009年11月-2010年12月90例慢性肾病患者,随机分为A、B两组,A组50例,给予瑞舒伐他汀钙10 mg/d;B组40例,给予阿托伐他汀钙10 mg/d,两组患者的年龄和性别相匹配。分别测定其治疗前及治疗后12周时血白细胞、高敏反应蛋白、纤维蛋白原、白介素-6、肿瘤坏死因子-α。 结果 两组治疗前各炎症指标水平差异无统计学意义(Pgt;0.05)。与治疗前相比,两组患者治疗12周后炎症指标水平均较前明显下降(Plt;0.01),瑞舒伐他汀钙组比阿托伐他汀钙组炎症指标下降更为明显。 结论 瑞舒伐他汀可有效改善慢性肾病患者的炎症反应。【Abstract】 Objective To explore the anti-inflammatory effect of rosuvastatin on chronic kidney disease (CKD) patients. Methods Ninety CKD patients treated in our hospital between November 2009 and December 2010 were randomly divided into two groups. One group was given rosuvastatin calcium 10 mg/d, which the other group was given atorvastatin calcium 10 mg/d. The two groups matched in terms of age and gender. We determined blood leukocyte (WBC), high sensitivity reactive protein (hs-CRP), fibrinogen (FIG), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) of the patients before and after treatment for 12 weeks. Results The inflammatory marker levels of both groups before treatment had no significant difference (Pgt;0.05). The inflammatory marker levels of two groups after treatment for 12 weeks were significantly decreased compared with the levels before treatment (Plt;0.01), and rosuvastatin calcium group decreased more apparently than atorvastatin calcium group. Conclusion Rosuvastatin can improve the anti-inflammatory response in CKD patients.