目的:探讨基质细胞衍生因子-l与围生期心肌病患者心力衰竭的相关性.方法:采用前瞻性研究纳入59例围生期心肌病并发心力衰竭患者,33例单纯围生期心肌病患者作为对照组.患者均接受体检、实验室检查、心电图、心脏彩超评估.选取基质细胞衍生因子-1(SDF-1)、超敏C反应蛋白(hs-CRP)、氨基末端脑钠肽前体(NT-proBNP)、血清肌钙蛋白(TNI)及心脏彩超相关参数为评价指标.结果:(1)围生期心肌病患者循环中基质细胞衍生因子-1水平明显高于对照组;(2)循环中基质细胞衍生因子-1与超敏C反应蛋白(CRP)、氨基末端脑钠肽前体(NT-proBNP)呈正相关,与超声心动图左心室射血分数(LVEF)呈负相关.结论:基质细胞衍生因子-1与围生期心肌病患者心力衰竭具有显著相关性.

This study used optical coherence tomography (OCT) to investigate the effects of systemic methotrexate, in combination with a drug-eluting stent, on in-stent neoatherosclerosis in a rabbit model. Sirolimus-eluting stents were surgically implanted in the right common carotid arteries of 200 male New Zealand White rabbits; the animals received a high-fat diet, beginning one week before stent implantation. Each animal was randomly assigned to 1 of 4 groups, receiving intravenous injections of either methotrexate (0.4 mg/kg) or placebo weekly for 4 or 12 weeks. Stented arterial segments were harvested after stenting for 4 or 12 weeks, and processed for OCT and histological analysis. Prior to harvesting the arterial segments, blood was collected for the determinations of cytokine levels. Compared with the control animals, the methotrexate-treated animals showed lower rates of lipid-rich intima and per-strut low-signal intensity layers, smaller neointimal areas, and reduced neointimal thickness; larger fibrous cap thicknesses and smaller lumen areas were also seen in the animals receiving methotrexate. The levels of serum interleukin, adhesion molecules, and nuclear factor-κB p65 decreased and IL-10 level increased in the methotrexate-treated animals. Targeting the pro-inflammatory pathways may be an effective way to prevent restenosis without the long-term risk of late thrombosis.

目的:随机、平行对照的临床试验验证先健科技(深圳)有限公司生产的TM陶瓷膜VSD封堵器治疗室间隔缺损的安全性及有效性.方法:根据试验的要求入选术前确诊为室间隔缺损的病人42例,随机分为实验组(A组)和对照组(B组),每组各21例,对A组病人植入CeraTM陶瓷膜VSD封堵器,对B组病人植入普通镍钛合金VSD封堵器,在超声心动图下或X线下观察室间隔缺损大小、位置、形态、类型,选择合适的封堵伞,经输送系统置入封堵器闭合VSD,分别于术前、术后24小时、术后30天、90天及术后180天进行随访,主要随访内容包括临床症状和体征、超声心动图、心电图、胸片、24小时动态心电图检查等.比较这两组患者的即刻手术成功率以及随访过程中终点事件发生率的不同.结果:试验组和对照组的成功率均为100％,残余分流率分别为0和4.8％,试验组的并发症发生率与对照组未见明显差异(P＜0.005).结论:试验组与对照组安全性与疗效相当,应用国产陶瓷封堵器是安全、有效的.但由于该项技术是一项新技术,临床试验样本量较少,其安全性和疗效特别是中远期疗效仍需进一步观察.

目的:研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆线粒体偶联因子6(CF6)水平并探讨其与OSAHS患者血压的关系.方法:对45名OSAHS患者、20名高血压患者以及15名健康体检者进行研究.所有受试者接受整夜多导睡眠监测以及血压测量.根据有无高血压分为OSAHS合并高血压组(Ⅰ组)以及单纯OSAHS组(Ⅱ组),单纯高血压组(Ⅲ组)以及健康对照组(Ⅳ组).分析比较多导睡眠监测结果,将Ⅰ组中12例首诊高血压且未服药物的OSAHS患者作为OS-AHS合并初诊高血压组(A组).匹配年龄、性别、是否吸烟以及体重指数,从Ⅱ组和Ⅲ组中分别随机选择11名OSAHS血压正常患者和11名初诊高血压且未服用药物患者分别作为单纯OSAHS组(B组)以及单纯高血压组(C组),选择10例健康体检者作为健康对照组(D组).四组共44例研究对象均于次日清晨采空腹肘静脉血,采用酶联免疫吸附法检测血浆CF6水平.结果:健康对照组(D组)、单纯OSAHS组(B组)和单纯高血压组(C组)、OSAHS合并高血压组(A组)血浆CF6水平明显递增,且OSAHS合并高血压组血浆CF6水平明显高于单纯OSAHS组和单纯高血压组,但单纯OSAHS组和单纯高血压组之间无明显差别.结论:OSAHS患者血浆CF6水平显著升高,其可能通过减少前列环素I2 (PGI2)的合成导致OSAHS患者继发高血压.

Objective:To study the effects of perculaneous balloon mitral valvuloplasly on mitral stenosis of patients wish rheumatic hears disease.Methods:123 patients of rheumatic mitral stenosis healed by percusaneouse balloon mitralvalvuloplasty.Left aerial pressure,mitral pressure of gradient and the area of valve orific were recorded before and after PBMV.Results:Left aerial pressure,mitral pressure of gradient decreased after PBMV and the area of valve orific increased after PBMV.Conclusion:PBMV can improve cardiac function on mitral stenosis of patients wish rheumatic hears disease.