缺血性糖尿病下肢病变的膝下动脉成形术

目的探讨膝下动脉的球囊成形术在治疗糖尿病缺血性下肢病变中的价值。方法对５３例糖尿病合并缺血性下肢病变患者６４侧缺血性下肢进行膝下动脉Deep球囊扩张成形术。对比患者手术前后临床症状的改变及足部溃疡的变化。结果５３例患者共１１９支动脉分支接受PTA治疗，５０例患者的１０１个分支成功地开通，技术成功率为８４．９％，所有５０例患者的临床症状均明显缓解，足部溃疡均变小，无需截肢。结论膝下动脉的球囊成形术是治疗缺血性糖尿病下肢病变安全有效的微创手段     

Identification, ontogeny, and regulation of an interleukin-6-like factor in the rat seminiferous tubule

The present study's aims are to search for the presence of interleukin-6 bioactivity (IL-6) in medium conditioned by various testicular cell types and to investigate the cellular and hormonal regulation of testicular IL-6 production. Sertoli cells prepared from rats of increasing ages (20, 35, and 45 days) secreted IL-6 in vitro, whereas medium conditioned by pachytene spermatocytes, early spermatids, and peritubular cells showed no activity. Lipopolysaccharide (LPS) and latex beads, two known stimulators of monocyte/macrophage IL-6 production, markedly stimulated IL-6 secretion by Sertoli cells at all the ages investigated. Maximum levels of IL-6 were reached after 6 h of culture of Sertoli cells with LPS and after 24 h with latex beads. When Sertoli cells were cocultured with pachytene spermatocytes, early spermatids, or fractions containing residual bodies and cytoplasts from elongated spermatids, only the latter significantly stimulated IL-6 levels. Maximum levels of IL-6 were attained by adding 2 x 10(6) residual bodies to Sertoli cells; a significant increase in IL-6 secretion was seen after 6 h, and maximum levels were observed after 24 h. The levels of IL-6 varied throughout different stages of the seminiferous epithelium cycle; highest levels were observed in stages II-VI and lowest in stages VII-VIII. IL-6 bioactivities induced by LPS and residual bodies and cytoplasts from elongated spermatids could be totally neutralized with a specific monoclonal antibody at all of the ages studied. FSH, phorbol myristate acetate, and IL-1 alpha augmented Sertoli cell IL-6 secretion in a dose-dependent manner. Furthermore, FSH and (Bu)2cAMP differentially stimulated IL-6 secretion during the seminiferous epithelial cycle. It is concluded that the release of IL-6 from Sertoli cells is regulated by a complex interplay between residual bodies and humoral factors.     

锁骨下动脉闭塞机械再通的方法研究

目的研究锁骨下动脉闭塞血管内机械再通方法和疗效。方法选择３２例症状性锁骨下动脉闭塞患者行血管内机械再通治疗，观察再通率及疗效。结果３２例锁骨下动脉闭塞患者中，用不同方法成功完成血管内机械再通后行血管内支架成形术，术后全部患者后循环缺血症状和上肢缺血症状明显改善。结论采用适当方法行机械再通治疗锁骨下动脉闭塞安全、可行。     

分子蒸馏对高酸值花椒籽油脱酸的初步探讨

利用分子蒸馏装置对高酸值花椒籽油进行脱酸来表明脱酸效果显著,重馏份（油脂）的得率高,对酸值在10mgKOH/g-40mgKOH/g花椒籽油进行脱酸,得到的油脂酸值均小于4mgKOH/g,同时所得到轻馏份（脂肪酸）酸值均在192mgKOH/g-198.5mgKOH/g之间。     

介入诊疗后并发两种不同类型肺栓塞的诊断与治疗

目的总结介入诊疗后严重并发症肺栓塞的类型、临床表现、治疗方法及预后的差异,以提高介入医师对此严重并发症的认识。方法收集３所医院１９９８－２００５年介入诊疗过程中所遇到的少见并发症肺栓塞病例,按照栓塞物不同分为碘油肺栓塞和血栓肺栓塞两种类型,就每种类型的临床特点及诊治经验加以总结。结果３所医院临床诊断介入诊疗后肺栓塞１０例,其中肺血栓栓塞５例,肺碘油栓塞５例。５例肺血栓栓塞患者表现为次日离床活动后突发性呼吸困难伴晕厥,２例死亡,３例经抗休克及局部溶栓治疗痊愈或好转。５例碘油肺栓塞患者表现为术后１～３d出现渐近性呼吸困难,无休克表现,经以给氧为主的综合治疗１５～５０d症状消失。结论肺栓塞是介入诊疗后的急重并发症,无深静脉血栓史患者也可发生急性血栓性肺栓塞,维持有效循环和溶栓治疗是有效疗法。碘油肺栓塞起病慢,治疗以保证供氧为主,肺内碘油可在１个月左右完全清除消失。肺增强CT对两者的诊断和鉴别诊断有重要意义。     

DSA在急性缺血性脑血管病介入治疗中的应用

目的探讨DSA在急性缺血性脑血管病介入检查及治疗中的应用价值。方法分析５５０例急性缺血性脑血管病患者进行介入治疗过程中DSA设备使用情况,总结合理利用DSA设备的经验。结果DSA的应用将有助于急性缺血性脑血管病快速诊断和介入治疗疗效评价;DSA实用投照角度的应用能够清晰显示目标血管狭窄病变的形态、程度等信息,为介入治疗提供最佳工作位置,有助于缺血性脑血管病的影像诊断和介入治疗;旋转DSA图像采集及图像三维重建技术的应用将有助于成功地开展介入治疗手术;应用DSA图像测量技术能够为操作医师选择介入材料提供精确的数据信息。结论合理利用DSA设备对于急性缺血性脑血管病的诊断和介入治疗手术成败起着至关重要的作用。DSA设备为介入治疗提供了良好的操作平台,DSA是诊断急性缺血性脑血管病的金标准。     

胰腺癌综合治疗现状及其价值

任何单一疗法治疗胰腺癌都难以获得理想的疗效。目前,可切除胰腺癌的治疗仍以根治性切除为主。放射治疗与手术联合应用,可提高手术切除率,减少肿瘤扩散;术中放疗可以缓解疼痛,提高生存率;对术后辅助放化疗的作用仍有争议。区域性化疗理论上有诸多优势,但仍需数据支持。物理治疗和生物治疗在胰腺癌的治疗中也已经得到广泛的重视。但只有建立以手术切除为主,联合放疗、化疗、物理及生物治疗的综合治疗体系,才有可能根本改变治疗现状,显著提高长期生存率,并改善生活质量。介入治疗作为重要的姑息治疗方法之一,近年来得到了长足的发展。     

阻塞性黄疸经皮经肝胆管引流术中胰管显影的原因分析

目的探讨阻塞性黄疸（OJ）患者在经皮肝穿刺胆管引流术（PTCD）中造影时胰管显影的原因及临床意义。方法回顾性分析１９９９年１月－２００７年２月间２５７例因OJ 经经皮经肝胆管造影（PTC）行介入治疗的患者的临床及影像学资料,其中DSA下胆胰管同时显影者３５例,观察胆胰汇合部解剖结构特点,归纳分析胰管显影的原因。结果３５例胰管显影者,确诊为胰胆管合流异常（PBM）３１例,另４例考虑与Oddi 括约肌功能障碍或解剖缺陷相关。结论PBM是导致阻塞性黄疸PTCD术中胰管显影的主要因素,探究胰管显影原因,有助于提高对壶腹部结构、功能的认识。     

基质细胞衍生因子－１介入治疗股骨头坏死的实验研究

目的探讨基质细胞衍生因子－１（SDF－１）治疗股骨头坏死的机制和疗效。方法选用日本大耳白兔３０只,制成激素性股骨头坏死模型后,随机分为３组。A组为对照组;B组为髓心减压＋生理盐水治疗组;C组为髓心减压＋SDF－１治疗组。各组动物均于治疗后８周处死,处死后分别进行股骨头骨密度测定及组织病理观察。结果SDF－１治疗后８周,骨密度明显增高,病理组织学表现血管数目增多,空骨陷窝减少。SDF－１治疗后显示股骨头修复效果明显。结论髓芯减压SDF－１移植治疗股骨头缺血性坏死效果明显,具有较广的临床应用前景。