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        west china medical publishers
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        find Author "朱洪生" 18 results
        • 冠狀動脈旁路移植術患者術后早期運動耐量改善的影響因素

          目的 探討冠狀動脈旁路移植術(CABG)患者術后早期運動耐量改善的影響因素,以提高手術療效.方法隨機選擇30例行CABG患者,術前和術后1~3個月進行平板運動試驗(TET),以手術前后運動功量的差值為應變量,各項臨床指標與手術情況為自變量,進行Logistic多元回歸分析. 結果 無手術死亡.術后運動功量等運動耐量指標及心肌缺血指標有明顯改善(Plt;0.001),術前左心功能、心肌梗死史、心絞痛、高血壓和乳內動脈(IMA)移植是影響手術療效的主要因素. 結論 CABG能顯著提高運動耐量,改善心肌缺血,了解并重視這些影響因素將有助于更好地選擇手術病例,預測手術療效.

          Release date:2016-08-30 06:32 Export PDF Favorites Scan
        • P-選凝素與心肌缺血-再灌注損傷

          研究心肌缺血-再灌注損傷中P-選凝素(P-selectin)的重要作用.P-selectin是一種糖蛋白黏附因子, 存在于內皮細胞和血小板,并介導血小板、內皮細胞和多形核白細胞(PMNs)等之間的相互作用,且與一氧化氮有著密切的關系,形成了許多復雜的炎癥病理過程,在心肌缺血-再灌注損傷中起到了關鍵的作用.特別是P-selectin與晚期再灌注損傷、血小板及心肌損傷中治療作用、最新的P-selectin基因缺陷小鼠和糖尿病小鼠等的心肌缺血-再灌注損傷中表現的深入研究,使其在缺血-再灌注損傷中的重要性和復雜性顯得更加突出.

          Release date:2016-08-30 06:32 Export PDF Favorites Scan
        • 自身成體干細胞移植治療心肌梗死

          心血管疾病,尤其是心肌梗死已成為人類死亡的主要疾病.自身成體干細胞移植為心肌梗死的治療帶來了新的希望.目前可供移植的種子細胞包括骨骼肌衛星細胞,骨髓干細胞,內皮祖細胞,自體移植避免了免疫排斥和倫理道德問題.近期實驗表明移植的干細胞能在心肌疤痕中存活,增強心功能.當前需要進一步研究干細胞移植后與心肌微環境的聯系,理想的移植細胞數目和移植技術以及對整個心功能可能產生的影響.

          Release date:2016-08-30 06:32 Export PDF Favorites Scan
        • 血管緊張素轉換酶抑制劑對心肌再灌注損傷的作用

          心肌再灌注損傷可表現為再灌注性心律失常、心肌頓抑和心肌壞死.研究表明心臟局部的腎素血管緊張素系統和冠狀動脈內皮細胞功能失常在心肌再灌注損傷中起重要作用.血管緊張素轉換酶抑制劑能抑制轉換酶活性,減少血管緊張素Ⅱ的形成,并能作用于激肽酶Ⅱ,抑制緩激肽的降解,后者可促進前列環素和一氧化氮(NO)的產生.近年來血管緊張素轉換酶抑制劑被用于防護心肌再灌注損傷,在防護再灌注性心律失常、心肌頓抑和心肌壞死等方面顯示了較好的治療效果.

          Release date:2016-08-30 06:35 Export PDF Favorites Scan
        • 胸腺瘤合并重癥肌無力及單純紅細胞再生障礙性貧血二例

          Release date:2016-08-30 06:23 Export PDF Favorites Scan
        • 部分性房室管畸形外科治療及療效探討

          目的 探討外科治療部分性房室管畸形的手術方法及其療效.方法 48例部分性房室管畸形患者均在體外循環心內直視術下縫合二尖瓣大瓣裂缺及修補房間隔缺損,其中9例同時行瓣膜成形手術.結果 術后早期(30天內)死亡2例,死亡率4.17%.發生Ⅲ度房室傳導阻滯2例,再次手術4例.術后39例隨訪3個月~12年,平均隨訪9年.結論 經隨訪,手術后二尖瓣無反流或少量反流者長期療效良好,中等量以上反流者長期療效差.

          Release date:2016-08-30 06:35 Export PDF Favorites Scan
        • The Short and Medium Term Effect on Myocardial Contractile Force after Implantation of Autologous Endothelial Progenitor Cells

          Objective To study the short and medium term effect of myocardial contractile force by implantation of endothelial progenitor cells (EPCs) in the myocardial infarction model. Methods Hundred and twenty SD rats were equally and randomly divided into experimental group and control group (60 rats in each group). Acute myocardial infarction model was created by ligation of LAD. Autologous EPCs were purified from peripheral blood then implanted into the acute myocardial infarct site via topical injection. IMDM were used in control group. Specimens and muscle strip were harvested at 3, 6 weeks, 6, 8 and 12 months after EPCs implantation for contractile force study and to detect the expression of vascular endothelial growth factor(VEGF), basic fibroblast growth factor (bFGF) and Ⅷ factor by immunohistology and video image digital analysis system. Results The expression of VEGF, bFGF and the microvessel counts in experimental group were much higher than those of control group(P〈 0.01) at 3, 6 weeks and 6 months after transplantation. The contractile force in experimental group was better than that in control group(P〈0.01) at the same time. But from 8 months after implantation, the contractile force and so on were not up in the experimental group. Conclusion EPCs, after being implanted into infarct myocardium, shows the ability of improvement of the contractile performance in infarcted myocardium by means of angiogenesis and vasculogenesis and the medium term results are persistent.

          Release date:2016-08-30 06:23 Export PDF Favorites Scan
        • bFGF緩釋微膠囊埋藏部位對兔血管新生的影響

          目的 通過局部心外膜下應用堿性成纖維細胞生長因子(bFGF)緩釋微膠囊,探討其治療心肌梗死的最佳埋藏部位,為進一步臨床應用提供理論依據. 方法 24只新西蘭大白兔隨機分為對照組(Ⅰ組),空白膠囊組(Ⅱ組),bFGF緩釋微膠囊組(Ⅲ組,每只膠囊含bFGF 1μg),每組8只.開胸結扎冠狀動脈前降支根部,Ⅱ組、Ⅲ組于左旋支,前降支交界區心外膜下埋藏空白微膠囊,bFGF緩釋微膠囊各5只.術后5周,免疫組織化學測定心肌梗死邊緣區,膠囊埋藏區微血管數. 結果 與Ⅰ組、Ⅱ組相比較,Ⅲ組心肌梗死邊緣區微血管數目明顯增多(Plt;0.01),膠囊埋藏區3組間微血管數差別無顯著性意義(Pgt;0.05). 結論 bFGF緩釋微膠囊組織相容性較好,在靠近缺血心肌的正常心肌心外膜下埋藏,可以達到理想的誘導缺血心肌血管新生的效果.

          Release date:2016-08-30 06:30 Export PDF Favorites Scan
        • 體外培養人大隱靜脈新內膜形成模型的建立

          目的 為了更好地研究靜脈再狹窄的機制及預防治療,建立一種人的大隱靜脈體外培養模型,并對新內膜進行初步研究. 方法 取6例冠狀動脈旁路移植手術患者大隱靜脈,體外培養14天,常規病理學染色,圖象分析; 通過α-平滑肌細胞骨架(α-actin)免疫組織化學染色方法檢測內膜增生細胞,末端脫氧核苷酸轉移酶介導的dUTP缺口末端標記(TUNEL)方法檢測內膜凋亡細胞. 結果 培養的大隱靜脈在14天后有新內膜形成和顯著的中膜增厚,與正常血管相比差別具有顯著性意義(P<0.01).新內膜細胞α-actin免疫組織化學染色結果呈陽性細胞,較正常血管內膜明顯增多.在新內膜中熒光和核邊聚分裂數目極少,與正常血管相比差別無顯著性意義. 結論 在人的大隱靜脈體外培養中有新內膜形成和中膜增厚,增生的細胞可能是肌成纖維細胞,故抑制肌成纖維細胞增生遷移的同時,促進凋亡將是靜脈移植血管病變潛在的治療方法.

          Release date:2016-08-30 06:32 Export PDF Favorites Scan
        • The influence of autologous bone mesenchymal stem cells on myocardial structure and cardiac function after being implantated into acute infarcted myocardium

          Objective To study the influence of autologous bone mesenchymal stem cells (BMSCs) on myocardial structure and cardiac function after being implantated into acute infarcted myocardial site. Methods Bone marrow was aspirated from the posterosuperior iliac spine of Guizhou Xiang swine. After being isolated, cultured and co cultured with 5 azacytidine, either autologous BMSCs (total cells 2×10 6, experimental group, n =12), or a comparable volume of culture medium (control group, n =12), was injected into the left anterior descending(LAD) branch of coronary artery just distal to the ligation site of the LAD. The same volume of BMSCs or culture medium was injected into several spots in the infarcted myocardium. Echocardiographic measurements were performed three or six weeks after implantation to assess the myocardial structure and cardiac function. Results Left ventricular function, including eject fraction(EF), fractional shortening and wall thickening, were higher in experimental group when compared with control group. The thickness of the ventricular wall and septum was also found increased while the left ventricular chamber size was smaller in experimental group. Conclusion Implantation of BMSCs into the infarcted myocardium is believed to attenuate the remodeling process, inhibit the extent of wall thinning and dilatation of the ventricular chamber. BMSCs implantation may also improve the contractile ability of the myocardium and cardiac function.

          Release date:2016-08-30 06:27 Export PDF Favorites Scan
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