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冠状动脉疾病 1

剖宫产瘢痕妊娠 1

动脉粥样硬化 1

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子宫动脉栓塞术 1

子宫瘢痕妊娠；个体化治疗；保留生育功能；子宫动脉栓塞 1

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Treatment of severe diffuse cavernous hemangioma of the lower limb by combination of superficial femoralartery ligation and supergenual thigh amputation

Yin XIA, Dan SHANG, Qin LI, Xiaoqin RUN, Chenxi OUYANG, Yiqing LI, Bi JIN

《医学前沿（英文）》 2009年 第3卷 第2期   页码 240-244 doi: 10.1007/s11684-009-0031-8

摘要： Severe diffuse cavernous hemangioma of the lower limb is rarely seen among young people and sometimes can be a fatal challenge for operation. We reported a case of diffuse cavernous hemangioma involving both skin and muscles of the left lower limb and perineal region in an adolescent patient. The patient who had previously undergone a local hemangioma resection of the foot ultimately ended in superficial femoral artery ligation and supergenual thigh amputation of the left upper leg because of uncontrollable massive bleeding of anastomotic stoma.

关键词： cavernous hemangioma     femoral artery     ligation     amputation    

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Successful infrainguinal revascularization with autologous vein for inadvertent stripping of superficial femoralartery: a case report

Yin XIA MD , Dan SHANG MD, PhD , Qin LI MD , Wenyi LI MD , Hanqing WU MD , Guofu HU MD , Chao YANG MD , Yiqing LI MD , Bi JIN MD ,

《医学前沿（英文）》 2009年 第3卷 第3期   页码 375-378 doi: 10.1007/s11684-009-0048-z

摘要： A referral patient who had previously undergone varicose vein surgery was admitted as an emergency case. On admission, the patient complained of intolerable pain, paralysis and paresthesia of the affected limb, which was characterized by acute arterial ischemia symptoms. Color Doppler of the artery of the affected limb indicated that no blood flow signal existed in the superficial femoral artery. During exploratory operation, we found that the right superficial femoral artery instead of the great saphenous vein of the affected limb had been stripped and ligated. Therefore, the intact right great saphenous vein was taken for auto-transplantation by inverse end-to-end anastomosis to the proximal and distal residual superficial femoral artery, which resulted in gradual recovery. Except for ischemic reperfusion injury, no other post-operative complications occurred after a 10 month follow-up; however, the long-term curative effect needs further observation. Here we report our treatment experience.

关键词： revascularization     saphenous vein     end-to-end anastomosis     stripping    

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Contemporary coronary artery bypass grafting

null

《医学前沿（英文）》 2014年 第8卷 第4期   页码 395-398 doi: 10.1007/s11684-014-0374-7

摘要：

Current evidence clearly demonstrates that coronary artery bypass grafting (CABG) remains the “gold standard” treatment for most patients with multivessel and left main stem disease. This article summarizes the relevant evidence basis demonstrating that CABG, in comparison to stenting, reduces mortality and subsequent myocardial infarction and the need for repeat revascularization. The article also describes the evidence basis to support the use of more arterial grafts during CABG and the current role of off-pump CABG.

关键词： coronary artery bypass grafting (CABG)     coronary artery disease     left main     arterial grafts     internal mammary artery     off-pump CABG    

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Coronary leukocyte activation in relation to progression of coronary artery disease

null

《医学前沿（英文）》 2016年 第10卷 第1期   页码 85-90 doi: 10.1007/s11684-016-0435-1

摘要：

Leukocyte activation has been linked to atherogenesis, but there is little in vivo evidence for its role in the progression of atherosclerosis. We evaluated the predictive value for progression of coronary artery disease (CAD) of leukocyte activation markers in the coronary circulation. Monocyte and neutrophil CD11b, neutrophil CD66b expression and intracellular neutrophil myeloperoxidase (MPO) in the coronary arteries were determined by flow cytometry in patients undergoing coronary angiography. The primary outcome included fatal and nonfatal myocardial infarction or arterial vascular intervention due to unstable angina pectoris. In total 99 subjects who were included, 70 had CAD at inclusion (26 patients had single-vessel disease, 18 patients had two-vessel disease and 26 patients had three-vessel disease). The median follow-up duration was 2242 days (interquartile range: 2142–2358). During follow-up, 13 patients (13%) developed progression of CAD. Monocyte CD11b, neutrophil CD11b and CD66b expression and intracellular MPO measured in blood obtained from the coronary arteries were not associated with the progression of CAD. These data indicate that coronary monocyte CD11b, neutrophil CD11b and CD66b expression and intracellular MPO do not predict the risk of progression of CAD.

关键词： coronary artery disease     inflammation     integrin     myeloperoxidase     leukocyte activation    

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Overexpression of netrin-1 improves neurological outcomes in mice following transient middle cerebral artery

null

《医学前沿（英文）》 2011年 第5卷 第1期   页码 86-93 doi: 10.1007/s11684-011-0118-x

摘要：

Netrin-1 (NT-1) is one of the axon-guiding molecules that are critical for neuronal development. Because of its structural homology to the endothelial mitogens, NT-1 may have similar effects on vascular network formation. NT-1 was shown to be able to stimulate the proliferation and migration of human cerebral endothelial cells in vitro and also promote focal neovascularization in adult brain in vivo. In the present study, we reported the delivery of NT-1 using an adeno-associated virus (AAV) vector (AAV-NT-1) into mouse brain followed by transient middle cerebral artery occlusion (tMCAO). We found that AAV vectors did not elicit a detectable inflammatory response, cell loss or neuronal damage after brain transduction. The level of NT-1 was increased in the AAV-NT-1-transduced tMCAO mice compared with the control mice. Furthermore, the neurobehavioral outcomes were significantly improved in AAV-NT-1-transduced mice compared with the control animals (P<0.05) 7 days after tMCAO. Our data suggests that NT-1 plays a neuronal function recovery role in ischemic brain and that NT-1 gene transfer might present a valuable approach to treat brain ischemic disorders.

关键词： adeno-associated virus     angiogenesis     gene transfer     ischemia     middle cerebral artery occlusion     netrin-1    

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SinoSCORE: a logistically derived additive prediction model for post-coronary artery bypass grafting

null

《医学前沿（英文）》 2013年 第7卷 第4期   页码 477-485 doi: 10.1007/s11684-013-0284-0

摘要：

This study aims to construct a logistically derived additive score for predicting in-hospital mortality risk in Chinese patients undergoing coronary artery bypass surgery (CABG). Data from 9839 consecutive CABG patients in 43 Chinese centers were collected between 2007 and 2008 from the Chinese Coronary Artery Bypass Grafting Registry. This database was randomly divided into developmental and validation subsets (9:1). The data in the developmental dataset were used to develop the model using logistic regression. Calibration and discrimination characteristics were assessed using the validation dataset. Thresholds were defined for each model to distinguish different risk groups. After excluding 275 patients with incomplete information, the overall mortality rate of the remaining 9564 patients was 2.5%. The SinoSCORE model was constructed based on 11 variables: age, preoperative NYHA stage III or IV, chronic renal failure, extracardiac arteriopathy, chronic obstructive pulmonary disease, preoperative atrial fibrillation or flutter (within 2βweeks), left ventricular ejection fraction, other elective surgery, combined valve procedures, preoperative critical state, and BMI. In the developmental dataset, calibration using a Hosmer-Lemeshow (HL) test was at =β0.44 and discrimination based on the area under the receiver operating characteristic curve (ROC) was 0.80. In the validation dataset, the HL test was at =β0.34 and the area under the ROC (AUC) was 0.78. A logistically derived additive model for predicting in-hospital mortality among Chinese patients undergoing CABG was developed based on the most up-to-date multi-center data from China.

关键词： coronary artery bypass grafting     risk stratification     in-hospital mortality    

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Drug-coated balloon-only strategy for percutaneous coronary intervention of left main coronary artery

《医学前沿（英文）》 2023年 第17卷 第1期   页码 75-84 doi: 10.1007/s11684-022-0950-1

摘要： This retrospective single-center registry study included all consecutive patients who underwent percutaneous coronary intervention (PCI) for a de novo left main coronary artery lesion using drug coated-balloon (DCB)-only strategy between August 2011 and December 2018. To best of our knowledge, no previous studies of DCB-only strategy of treating de novo left main coronary artery disease, exist. The primary endpoint was major adverse cardiovascular events (MACEs) including cardiac death, non-fatal myocardial infarction, and target lesion revascularization (TLR). The cohort was divided into two groups depending on weather the lesion preparation was done according to the international consensus group guidelines. Sixty-six patients (mean age 75±8.6, 72% male), 52% of whom had acute coronary syndrome, underwent left main PCI with the DCB-only strategy. No procedural mortality and no acute closures of the treated left main occurred. At 12 months, MACE and TLR occurred in 24% and 6% of the whole cohort, respectively. If the lesion preparation was done according to the guidelines, the MACE and TLR rates were 21.2% and 1.9%. Left main PCI with the DCB only-strategy is safe leading to acceptable MACE and low TLR rates at one year, if the lesion preparation is done according to the guidelines.

关键词： drug-coated balloon     left main     high bleeding risk     predilatation     calcifield lesion     percutaneous coronary intervention    

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Plasma soluble C-type lectin-like receptor-2 is associated with the risk of coronary artery disease

Min Fei, Li Xiang, Xichen Chai, Jingchun Jin, Tao You, Yiming Zhao, Changgeng Ruan, Yiwen Hao, Li Zhu

《医学前沿（英文）》 2020年 第14卷 第1期   页码 81-90 doi: 10.1007/s11684-019-0692-x

摘要： Accumulating evidence suggests that C-type lectin-like receptor-2 (CLEC-2) plays an important role in atherothrombosis. In this case-control study, we investigated the association between CLEC-2 and incidence of coronary artery disease (CAD). A total of 216 patients, including 14 cases of stable angina pectoris (SAP, non-ACS) and 202 cases of acute coronary syndrome (ACS), and 89 non-CAD control subjects were enrolled. Plasma levels of soluble CLEC-2 (sCLEC-2) were measured using the enzyme-linked immunosorbent assay (ELISA). Compared with the control group (65.69 (55.36–143.22) pg/mL), the plasma levels of sCLEC-2 were significantly increased in patients with CAD (133.67 (88.76–220.09) pg/mL) and ACS (134.16 (88.88–225.81) pg/mL). The multivariate adjusted odds ratios (95% confidence interval) of CAD reached 2.01 (1.52–2.66) ( <0.001) for each 1-quartile increase in sCLEC-2. Restricted cubic splines showed a positive dose-response association between sCLEC2 and CAD incidence ( <0.001). The addition of sCLEC-2 to conventional risk factors improved the C statistic (0.821 vs. 0.761, = 0.004) and reclassification ability (net reclassification improvement: 57.45%, <0.001; integrated discrimination improvement: 8.27%, <0.001) for CAD. In conclusion, high plasma sCLEC-2 is independently associated with CAD risk, and the prognostic value of sCLEC-2 may be evaluated in future prospective studies.

关键词： soluble C-type lectin-like receptor-2     coronary artery disease     risk factor    

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肺动脉压无创伤估测系统及其应用价值研究

王威琪,陈树宝,汪源源,刘斌,张玉奇,余建国,孙锟,陈斯中

《中国工程科学》 2000年 第2卷 第1期   页码 41-46

摘要：

肺动脉压是临床诊断、生理研究的一项重要指标，常规采用有创伤的心导管术测量。文章提出了一种基于超声和心电的无创伤估测方法，研制了肺动脉压无创伤估测系统。文中报告了所用的关键技术要点，动物实验和临床试用。所用的关键技术是小波变换降噪；新型百分比法提取声谱包络；小波变换识别定位超声；心电信号特征点。经9条狗的动物实验和60例临床试用，与心导管术相关性在80%以上。

关键词： 肺动脉压     无创伤估测     小波变换     降噪     包络     特征点    

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Evaluation of the effect of myocardial perfusion after percutaneous coronary intervention in coronary artery

WANG Hong, HUANG Lan, JIN Jun, SONG Yaoming, GENG Zhaohua, YU Xuejun, QIN Jun, ZHAO Gang, GAO Yunhua, LIU Zheng

《医学前沿（英文）》 2007年 第1卷 第1期   页码 62-67 doi: 10.1007/s11684-007-0013-7

摘要： Detection of abnormal myocardial perfusion is crucial to the prognosis of patients with coronary artery disease (CAD) after they have undergone percutaneous coronary intervention (PCI). The objective of this study is to evaluate the effect of myocardial perfusion by three different methods intra-coronary myocardial contrast echocardiography (ICMCE), corrected thrombolysis in myocardial infarction frame count (CTFC), and coronary blood flow velocity (BFV) and to determine the value of these different methods in the evaluation of the effect of myocardial perfusion post-PCI. For the study sixty-eight patients were divided into four groups based on selective coronary angiography results: group A (normal coronary artery), group B (75% 95% coronary artery stenosis), group C (coronary artery stenosis >95%) and group D (acute total coronary occlusion). The effect of myocardial reperfusion was evaluated using the above mentioned three methods 15 min after PCI. IC-MCE was also performed before PCI in group D. The quantitative parameters of MCE involved: contrast peak intensity, time to peak intensity and area under the curve, representing myocardial blood volume, reperfusion velocity and myocardial blood flow, respectively. No difference was found in CTFC between the coronary artery stenosis group and the normal group. BFV was slower in group D than in group A (<0.05). The myocardial blood volume and the myocardial blood flow of the IC-MCE quantitative parameters were markedly lower in group C compared with those in group A (<0.05), and there were significant differences in the three MCE parameters between group D and group A (<0.05). For those patients with acute or total occlusion, the levels of myocardial perfusion before and after PCI were similar, as determined by IC-MCE and visually analyzed from 61 segments (<0.05). Quantitative IC-MCE evaluation of myocardial reperfusion is more accurate than with the other two methods. Moreover, with qualitative IC-MCE the level of myocardial reperfusion can be viewed directly and rapidly. Thus, the IC-MCE method is of great value to coronary artery disease (CAD) patients undergoing PCI, especially for those with acute myocardial infarction (AMI).
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肠道菌群与冠状动脉疾病的发生风险 Article

胡嘉禄, 姚志峰, 唐敏娜, 唐春, 赵晓璠, 苏曦, 卢淡泊, 李秋荣, 王张生, 颜彦, 王则能

《工程（英文）》 2021年 第7卷 第12期   页码 1715-1724 doi: 10.1016/j.eng.2020.05.025

摘要：

在过去的几年中，小规模队列研究发现肠道菌群随冠状动脉疾病出现而改变。既往研究中所发现的冠状动脉疾病患者肠道中富集或减少的微生物群，在其他冠状动脉疾病队列中是否具有可重复性，有待进一步研究和验证。本研究共纳入78 名受试者，其中19 例受试者无冠状动脉狭窄（Ctrl 组），14 例受试者冠状动脉狭窄程度小于50%（LT50 组），45 例受试者冠状动脉狭窄程度大于50%（GT50 组）。采集受试者粪便标本，并提取DNA 进行16S 核糖体RNA 基因测序。对可执行的分类操作单位（operational taxonomic units, OTU）进行分析以确定不同类群的分类单元，采用多变量logistic 回归分析检验所定义的分类单元是否能独立预测冠状动脉疾病风险。结果显示，δ-变形杆菌纲、梭杆菌属、嗜胆菌属、放线菌属和梭菌XIX属在Ctrl 组中富集；普雷沃氏菌科、副拟杆菌属和芽孢杆菌属在LT50 组中富集；罗氏菌属和丁酸单胞菌属在GT50 组中富集。δ-变形杆菌纲、梭杆菌属、嗜胆菌属和脱硫弧菌科种群的增加与冠状动脉疾病风险降低相关。在相对丰度高于中位数的个体中，冠状动脉疾病风险分别降低为相对丰度低于中位数的个体的0.26 倍、0.21 倍、0.18 倍和0.26 倍（p < 0.05），而普雷沃氏菌科种群的增加与冠状动脉疾病风险增加相关，冠状动脉疾病风险增加5.63 倍（p < 0.01）。使用20 种微生物群联合诊断LT50组与Ctrl组、GT50组与Ctrl组、LT50组+GT50组与Ctrl组、GT50组与Ctrl组+LT50组，受试者工作特征
（ROC）曲线下的面积均高于0.88。然而，除拟杆菌属外，既往研究所报道的在冠状动脉疾病或健康对照组受试者中富集的肠道菌群在本队列并未观察到。总之，冠状动脉疾病与健康对照组受试者具有不同的菌群特征。不同队列研究所发现的冠状动脉疾病富集的肠道菌群特征不具有重复性，提示肠道菌群较难应用于冠状动脉疾病的早期诊断和预防。综合本研究与既往研究结果，只有拟杆菌属丰度减少是冠状动脉疾病进展的可靠标志物。

关键词： 肠道菌群     动脉粥样硬化     冠状动脉疾病    

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Clinical study on the related markers of blood coagulation in the patients with ANFH after SARS

WU Lianhua, GAO Chunjin, WANG Guozhong, YANG Lin, HOU Xiaomin, GE Huan, XIA Chengqing, QI Man

《医学前沿（英文）》 2007年 第1卷 第4期   页码 410-412 doi: 10.1007/s11684-007-0080-9

摘要： The aim of this research was to investigate the blood coagulation function in the patients with avascular necrosis of the femoral head (ANFH) after severe acute respiratory syndrome (SARS). The expression of CD31, CD61, CD62p, CD63 and PAC-1 on platelet membrane was measured respectively by flowcytometry, and the plasma prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (Fbg) were measured by blood clotting instrument in 26 patients with ANFH after SARS and in 17 healthy adults. The expression of CD31, CD61, CD 62p, CD63 and PAC-1 on platelet membrane in 26 patients was all lower than that in 17 healthy subjects (<0.01). The levels of PT, APTT, TT and Fbg in 26 patients were all normal. There is no significant difference (>0.05) in those markers between patients and 17 healthy adults. The blood may not be in hypercoagulable state in patients with ANFH after SARS.

关键词： significant difference     partial thromboplastin     coagulation function     femoral     healthy    

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子宫动脉灌注栓塞联合清宫术治疗子宫剖宫产瘢痕妊娠的效果评价

冯颖,李坚,陈素文,李长东,张晓峰,胡乔飞

《中国工程科学》 2014年 第16卷 第5期   页码 4-10

摘要：

为了探讨经子宫动脉甲氨蝶呤灌注+子宫动脉栓塞联合清宫术对剖宫产瘢痕妊娠（CSP）的治疗价值，本文回顾性地分析了2003 年2 月至2013 年4 月首都医科大学附属北京妇产医院收治的140 例CSP患者的临床资料。2003 年2 月至2010 年3 月35 例CSP患者采用甲氨蝶呤全身及局部注射（简称MTX组）联合清宫术治疗。2010 年4 月至2013 年4 月105 例CSP患者采用子宫动脉甲氨蝶呤灌注+子宫动脉栓塞（简称子宫动脉灌注栓塞，UACE组），栓塞术24～72 h 内在超声引导下行超声/宫腔镜/腹腔镜监测下清宫术，分析其临床疗效。比较两组的手术时间、术中出血、血清人绒毛膜促性腺激素（HCG）转阴时间、住院时间和住院费用，并观察远近期副反应。结果表明，140 例CSP的病例中，阴道超声和腹部超声联合检查确诊140例，北京妇产医院首诊108 例病人，误诊3 例。外院转诊32 例中，均被误诊为宫内早孕而行流产术，术中发生大出血，来北京妇产医院确诊为CSP。采用甲氨蝶呤全身及局部注射联合清宫术，33 例患者治疗成功，2 例因过程中出现大出血而行全子宫切除术。105 例患者采用子宫动脉甲氨蝶呤灌注+子宫动脉栓塞联合清宫术治疗，100 例患者治疗顺利，余下3 例患者因清宫过程中再次大出血而行二次介入术，2 例患者因介入术后血清HCG下降不满意，病理回报考虑滋养细胞疾病转至肿瘤科全身化疗。MTX保守治疗组和UACE治疗组的患者年龄、剖宫产次、妊娠时间、孕囊直径及血清β人绒毛膜促性腺激素（β—HCG）之间，差异无统计学意义，但UACE治疗组在清宫术中出血量，血清β—HCG恢复正常的时间及住院时间上，要明显少于MTX保守治疗组，两组差异有统计学意义。综上，早期诊断是成功治疗CSP的关键，阴道超声是CSP的首选确诊方法，经子宫动脉化疗栓塞联合清宫术治疗瘢痕妊娠是目前安全、快速、防止大出血的有效方法。

关键词： 剖宫产瘢痕妊娠     子宫动脉栓塞术     甲氨蝶呤     清宫术    

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Assessment of global and regional left ventricular twist and displacement in anterior myocardial infarction using 2-dimensional strain imaging

Wei HAN MM, Ming-Xing XIE MD, Qing LV MD, Xin-Fang WANG MD, Li ZHANG MM,

《医学前沿（英文）》 2010年 第4卷 第1期   页码 71-76 doi: 10.1007/s11684-010-0006-9

摘要： The recent development of 2-dimensional strain (2D strain) imaging can provide a powerful alternative for assessing left ventricular (LV) torsion. This study was conducted to evaluate the global and regional left ventricular twist by 2D strain in patients with anterior wall myocardial infarction (AMI). A total of 55 AMI patients were divided into two groups according to their ejection fraction (EF) values (group A: LVEF≥50%; group B: LVEF<50%), and 35 normal people served as the control group. Using 2-dimensional strain software, global and regional LV rotation and displacement were obtained at two planes. Compared with the control group, patients of group A showed reduced peak LV twist of the anterior and anterior-septal wall (9.26±1.89 10.74±2.67; 9.71±1.71 11.36±2.29, both <0.05), but the radial displacement and global twist were maintained (>0.05). Differently, regional and global LV twist and radial displacement in patients of group B deceased significantly, especially in the anterior and anterior-septal wall, as compared with patients in the control or group A (both <0.05). Moreover, a strong correlation was noted between peak twist and radial displacement; the twist-displacement loop was markedly distorted in patients of group B. This study demonstrated that 2D strain has a potential ability for quantification of left ventricular global and segment twist and radial displacement in patients with coronary artery disease.

关键词： echocardiography     twist     two-dimensional strain imaging     coronary artery disease    

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CSP保留生育功能治疗的探讨——附46例病例分析

管睿,刘玉环,徐明娟,张俊洁,惠宁,崔英

《中国工程科学》 2015年 第17卷 第6期   页码 45-49

摘要：

探讨剖宫产子宫瘢痕妊娠（CSP）的保留生育功能治疗方法的选择。对2000—2014年第二军医大学附属长海医院收治的46例CSP患者临床资料进行回顾性分析。孕早期45例，孕中期1例，13例（28.9 %）早孕患者早期误诊而行负压吸引术或药流+清宫术。其余32例，根据CSP临床分型标准，Ⅰ型19例，Ⅱ型13例，全部病例均成功保留子宫，63.1 %Ⅰ型CSP采用B超监护下清宫，21.0 %Ⅰ型CSP采用子宫动脉栓塞（UAE）+B超监护下清宫；84.6 %Ⅱ型CSP采用病灶切除+疤痕修补。1例中孕16+周外院引产发生产后大出血，UAE 30天后下肢血栓坏死转我院治疗，期间再次阴道大出血，手术探查证实为CSP，行病灶切除+瘢痕修补术。CSP治疗原则是早期诊断，及早处理，根据CSP临床分型、β-HCG等情况，选择个体化治疗是关键。临床上对CSP要保持高度警惕，尽早诊断，保留生育功能治疗是完全可行的。此外，UAE后仍存在一定风险，选择UAE要谨慎。

关键词： 子宫瘢痕妊娠；个体化治疗；保留生育功能；子宫动脉栓塞    

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