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        west china medical publishers
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        find Author "李彤" 23 results
        • 體外膜式氧合的臨床應用

          目的 總結體外膜式氧合(ECMO)在臨床的應用經驗,以提高對危重患者的治療效果。 方法 2006年7月至2008年2月, 27例患者使用ECMO,其中非手術急性心肺功能衰竭8例,心臟手術后的心功能輔助4例,心臟不停跳冠狀動脈旁路移植術中心臟功能輔助13例,體外循環與ECMO相互轉換應用于心臟手術中和術后的心功能輔助2例。 結果 27例患者應用ECMO輔助時間為2~61 h,26例成功撤離ECMO,1例82歲患者成功撤離ECMO后24 h出現輕度二氧化碳潴留,患者家屬要求出院;2例院內死亡;24例康復出院。 結論 ECMO是搶救心肺功能衰竭的有效方法,對非手術患者或高危患者行心臟不停跳冠狀動脈旁路移植術以及心臟手術中、手術后的心臟功能輔助亦有明顯的效果。

          Release date:2016-08-30 06:05 Export PDF Favorites Scan
        • Expression of Donor Major Histocompatibility Complex Gene in Thymus by Gene Transfer to Mitigate Xenograft Rejection

          Abstract: Objective To assess the feasibility of transferring major histocompatibility complex (MHC) gene into the thymus to mitigate xenograft rejection. Methods By molecular cloning technique, we extracted and proliferated the-H-2K d gene from donor mice (MHC class Ⅰ gene of Balb/c mice) and constructed the expression vector plasmid of pCI-H-2K d. Twenty SD rats were selected as receptors, and by using random number table, they were divided into the experimental group and the control group with equal number of rats in each group. By ultrasoundguided puncture and lipofection method, the pCI-H-2Kd was injected into thymus of SD rats in the experimental group and meanwhile, empty vector plasmid of pCIneo was injected into thymus of SD rats in the control group. Subsequently, we transplanted the donor mice myocardium xenografts into the receptor rats, and observed the xenograft rejection in both the two groups. Results The survival time of the xenotransplanted myocardium in the experimental group was significantly longer than that in the control group (14.61±2.98 d vs. 6.40±1.58 d, t=-7.619,Plt;0.05). Microtome section of transplanted myocardium in the control group showed a relatively large amount of lymphocyte infiltration and necrosis occurred to most part of the transplanted myocardium, while microtome section of experiment group showed no lymphocyte infiltration and most of the cells of the transplanted myocardium were still alive. After mixed lymphocyte culture, the reaction of receptors to donor cells in the experiment group was obviously lower than that in the control group (t=4.758, P=0.000).After the count by flow cytometer, the xenoMHC molecules were expressed in the receptors’ thymus with a transfection efficiency of 60.7%. Conclusion Our findings suggest that xenograft rejection can be mitigated substantially by donor’s MHC gene transferring into receptor’s thymus. This may provide theoretical and experimental evidence for inducing xenotransplantation tolerance.

          Release date:2016-08-30 06:02 Export PDF Favorites Scan
        • 一側頸內動脈閉塞致眼部缺血綜合征一例

          Release date:2016-09-02 05:46 Export PDF Favorites Scan
        • 妊娠合并心血管疾病的手術方法及文獻復習

          目的 介紹剖腹產術(CS)加同期體外循環(CPB)心臟手術方法,并探討妊娠合并心血管疾病手術方法的選擇。 方法 1例27歲、妊娠38周合并先天性心臟病患者出現亞急性細菌性心內膜炎、三尖瓣和右心室流出道有贅生物、心力衰竭、先兆早產、胎兒窘迫患者,在局部麻醉+靜脈麻醉下先行CS,再行CPB心臟手術,包括三尖瓣和右心室流出道贅生物摘除、室間隔缺損修補、房間隔缺損修補。 結果 CS中順利取出一健康成活女嬰。CPB時間87min,升主動脈阻斷時間59min。手術后母嬰平安、恢復順利。隨訪11個月,患者心功能Ⅰ級,嬰兒發育正常。 結論 在妊娠合并心血管疾病影響孕婦及胎兒生命安全的情況下,可以在施行CS后同期施行心內直視手術。但手術方法的選擇應慎重。

          Release date:2016-08-30 06:15 Export PDF Favorites Scan
        • 同種原位心臟移植四例

          目的 總結4例終末期心臟病患者施行原位心臟移植術的經驗. 方法 2000年1月26日~2000年9月26日,先后對4例終末期心臟病患者施行原位心臟移植術.供者均為腦死亡者,供者心肌保護采用冷晶體心臟停搏液順行性灌注;手術方法為中度低溫體外循環下標準原位心臟移植術;術后采用新三聯(FK506、驍悉和強的松)免疫治療. 結果 1例因肝、腎功能衰竭,術后18天死亡.3例患者存活至今,且生活質量良好. 結論 掌握適應證、術后防治感染和合理的免疫治療,是提高心臟移植存活率的重要因素.

          Release date:2016-08-30 06:30 Export PDF Favorites Scan
        • 體外膜式氧合在心臟不停跳冠狀動脈旁路移植術中應用二例

          Release date:2016-08-30 06:09 Export PDF Favorites Scan
        • Research progress of cyclic guanosine monophosphate in inherited retinal degeneration

          Inherited retinal degeneration (IRD) is a group of fundus diseases characterized by a high degree of genetic heterogeneity and clinical heterogeneity, and more than 300 genetic mutations have been identified in association with IRD. Dysregulation of the intracellular second messenger cyclic guanosine monophosphate (cGMP) plays an important role in the development of IRD. cGMP participates in phototransduction process in photoreceptors. Abnormally elevated cGMP over-activate protein kinase G and cyclic nucleotide-gated channel, causing protein phosphorylation and Ca2+ overload, respectively, and these two cGMP-dependent pathways may individually or collectively drive photoreceptor degenerative lesions and death; therefore, reducing cGMP synthesis and blocking downstream signaling can be considered as treatment strategies. Investigating the molecular mechanisms of cGMP dysregulation in photoreceptor degeneration may provide a more comprehensive picture of the pathogenesis of IRD, as well as ideas for finding new therapeutic targets and designing therapeutic programs.

          Release date:2024-11-20 10:40 Export PDF Favorites Scan
        • 1,6-二磷酸果糖和巰甲丙脯酸對心臟術后心肌缺血-再灌注損傷的保護

          摘要 目的 探討1,6-二磷酸果糖(FDP)和巰甲丙脯酸(CAP)增強心臟停搏液對缺血心肌保護的臨床效果。方法 將60例患者隨機分成三組。Ⅰ組:作為對照組,應用我院體外循環下心肌保護方法,即首劑應用冷鉀晶體心臟停搏液,從第二劑量開始改用15℃稀釋氧合血灌注;Ⅱ組:在冷鉀晶體心臟停搏液中加入FDP(5mmol/L);Ⅲ組:在冷鉀晶體心臟停搏液中加FDP(5mmol/L)和CAP(12.5mg/L)。觀察血漿丙二醛(MDA)、肌酸磷酸激酶同工酶(CPK-MB)、血栓素B2(TXB2)、6-酮-前列腺素F1α(6-酮-PGF1α)及電子顯微鏡檢查結果。結果 與Ⅰ組比較,Ⅱ組和Ⅲ組MDA,CPK-MB明顯降低,且Ⅲ組較好地維持了TXB2和6-酮-PGF1α二者的比例平衡。Ⅱ組和Ⅲ組對線粒體也有較好地保護及提高毛細血管通暢率的作用。結論 FDP和CAP能明顯增強心臟停搏液對缺血心肌保護的效果。

          Release date:2016-08-30 06:33 Export PDF Favorites Scan
        • 頸闊肌肌皮瓣修復顏面瘢痕攣縮小口畸形

          Release date:2016-09-01 11:12 Export PDF Favorites Scan
        • Effects of Inflammatory Reaction Related to Different Cerebral Protective Methods on Brain

          Objective To observe the changes of inflammatory cytokines in brain protective methods, study the inflammatory mechanism during cerebral protection tissues in different cerebral Methods Eighteen healthy adult dogs were randomly divided into three groups (6 dogs in each group): normothermic cardiopulmonary bypass (NCPB group), deep hypothermic circulatory arrest (DHCA group), and intermittent selective antegrade cerebral perfusion (ISACP) during DHCA(DHCA+ISACP group). After operation the water contents in brain tissue were measured ,the hippocampus were removed, and radio-immunity analysis (RIA) was used to measure the content of interleukin-1β(IL-1β) and tumor necrosis factor-alpha (TNF-α) of the hippocampus tissue. The morphology of the hippocampus were examined by transmission electron (TE) microscopy. Results The contents of IL-1β and TNF-α of DHCA group was higher significantly than those of NCPB group and DHCA+ISACP group (P〈0.01), there was no significant difference between NCPB group and DHCA+ISACP group (P〉0.05). And the contents of TNF-α and IL-1β were positive linear correlated with degree of edema of brain tissues (r = 0. 987, 0.942; P〈 0.01). TE examination revealed that the damage of the uhrastructure in the DHCA group was more severe than that in NCPB group and DHCA+ISACP group. Conclusions This experiment revealed that long duration DHCA can bring some damages to the brain and that ISACP during long-term DHCA has brain protective effects to some extent. IL-1β and TNF-α play an effective role in the brain damage of long-term DHCA.

          Release date:2016-08-30 06:18 Export PDF Favorites Scan
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