Primary malignant pericardial mesothelioma (PMPM) is an extremely rare and lethal cardiac tumor. This article presents a 62-year-old man with recurrent pericardial fluid. The patient’s clinical symptoms and imaging features were nonspecific. Initial diagnosis was constrictive pericarditis. After admission, the patient’s symptoms worsened, and echocardiography indicated increased pericardial effusion. To diagnose and improve the patient’s symptoms, pericardiotomy was performed; however, the procedure was unsuccessful because the pericardium was densely adherent to the myocardium. Histopathological examination, including immunohistochemical staining of the pericardial specimen revealed malignant mesothelioma. We recommended adjuvant therapy for the patient with cis-platinum and pemetrexed; however, the patient and his family refused treatment. The patient was discharged 11 days after surgery. The patient survived for more than 15 months with surgical treatment. In this report, the patient’s symptoms improved, and the patient survived beyond the median survival after surgical treatment. Conclusion: The definitive diagnosis of PMPM mostly has been obtained from specimens obtained by surgery. Surgery is an effective treatment method because it prevents cardiac tamponade and can improve symptoms or prognosis, but complete resection is impossible.

越来越多的学者认识到三尖瓣反流对许多疾病状态预后的影响,同时二尖瓣及主动脉瓣的介入治疗取得长足进展之际,三尖瓣介入治疗受到极大的关注,已成为新的研究热点和难点.本综述将着重通过三尖瓣反流的病理生理学机制、三尖瓣反流的超声评估,讨论三尖瓣反流疾病的现状及介入治疗新进展.

目的 探讨法洛四联症(TOF)与NOTCH1和JAG1基因3'非编码区(3'UTR)变异的相关性,为TOF患者临床诊断提供遗传依据.方法 采用民族-病例-对照的研究方法,收集20例汉族TOF患者及14例回族TOF患者,并分别以20名汉族及20名回族健康体检者为对照组,筛选出TOF患者在两个民族人群中,NOTCH1和JAG1基因3'UTR存在的变异.通过PCR技术,结合DNA序列测序,测定、验证、确定样本人群中这些变异位点;进一步运用TargetScan、PicTar和microRNA.org等软件对变异位点可能结合miRNA进行分析,推测其和TOF发生、发展的相关性.结果 检测出TOF患者NOTCH1基因3'UTR存在3个单核苷酸多态性(SNP),JAG1基因3'UTR存在6个SNP位点.9个SNP位点在4组对象中的分布频数存在差异,但差异无统计学意义(P>0.05).其中JAG1基因3'UTR rs542746042位点在汉族对照组与汉族病例组之间的分布,差异有统计学意义(P<0.05).预测结果显示,JAG1基因3'UTR有差异的SNP位点(486delT)可与miRNA结合.结论 NOTCH1和JAG1基因3'UTR的核苷酸变异可能与TOF的发生相关.

肺动脉肉瘤是一种极其罕见的肺血管系统恶性肿瘤,常起源于肺动脉内膜,其病因及发病机制不明.患者的临床表现、实验室及影像学检查常无明显特异性,故诊断难度大,常误诊为急慢性肺栓塞.CT肺动脉造影及MRI检查对肺动脉肉瘤的诊断有重要意义.当患者临床表现与影像学表现不符,溶栓治疗无效时,应高度警惕本病可能,其最终诊断需组织病理学检查.肺动脉内膜剥脱术、肺切除术等外科手术治疗可以改善患者的临床症状并延长患者的生存期,术后辅以放化疗可以增加存活率,但整体预后欠佳.

目的 研究粪菌移植在体外循环术后肠道菌群失调患者中的应用,探讨其有效性及安全性.方法 回顾性分析2015年1月-2017年12月兰大一院心外科重症监护室行粪菌移植治疗肠道菌群失调的患者20例,对比治疗前及治疗后患者降钙素原、肠道菌群失调程度、Hart腹泻计分的变化,统计痊愈率并随访1个月关注不良反应的发生.结果 与治疗前相比,粪菌移植治疗后所有患者降钙素原明显下降[(2.79±2.93) vs (0.83±0.86) ng/mL],Hart腹泻计分明显减少[(20.40士2.62)vs(4.15士2.70)],差异均具有统计学意义(Ps＜0.05).治疗后患者肠道菌群失调程度明显改善(P＜0.05).患者痊愈率达95％.治疗期间及随访1个月无不良反应发生.结论 粪菌移植可以明显改善体外循环术后患者肠道菌群失调情况及临床症状,降低患者炎症反应,且无不良事件发生,有利于患者术后康复,安全性好.

随着心脏病治疗技术的发展,微创治疗已经成为心脏病治疗的主要研究方向.其中,先天性心脏病因为解剖结构复杂,受限于影像技术,大部分仍未开展微创手术.本研究回顾近年先天性心脏病微创治疗影像支持的相关研究后,主要介绍新兴的3D旋转血管造影、心脏3D打印技术和辐射安全技术,并提出展望.

[This corrects the article DOI: 10.1155/2016/9782031.].

Background Obstructive sleep apnea (OSA) and its main feature, chronic intermittent hypoxia (IH) during sleep, is closely associated with insulin resistance (IR) and diabetes. Rimonabant can regulate glucose metabolism and improve IR. The present study aimed to assess the effect of IH and rimonabant on glucose metabolism and insulin sensitivity, and to explore the possible mechanisms. Material/Methods Thirty-two rats were randomly assigned into 4 groups: Control group, subjected to intermittent air only; IH group, subjected to IH only; IH+NS group, subjected to IH and treated with normal saline; and IH+Rim group, subjected to IH and treated with 10 mg/kg/day of rimonabant. All rats were killed after 28 days of exposure. Then, the blood and skeletal muscle were collected. We measured fasting blood glucose levels, fasting blood insulin levels, and the expression of glucose transporter 4 (GLUT4) in both mRNA and protein levels in skeletal muscle. Results IH can slow weight gain, increase serum insulin level, and reduce insulin sensitivity in rats. The expressions of GLUT4 mRNA, total GLUT4, and plasma membrane protein of GLUT4 (PM GLUT4) in skeletal muscle were decreased. Rimonabant treatment was demonstrated to improve weight gain and insulin sensitivity of the rats induced by IH. Rimonabant significantly upregulated the expression of GLUT4 mRNA, PM GLUT4, and total GLUT4 in skeletal muscle. Conclusions The present study demonstrates that IH can cause IR and reduced expression of GLUT4 in both mRNA and protein levels in skeletal muscle of rats. Rimonabant treatment can improve IH – induced IR, and the upregulation of GLUT4 expression may be involved in this process.

目的:探讨大蒜素对肝癌小鼠模型肿瘤细胞经血道转移的影响及相关机理.方法:取昆明小鼠36只,尾静脉接种H22肝癌细胞悬液后用不同浓度的大蒜素溶液干预1周,处死小鼠,取肺组织观察肺部转移瘤生长情况,取脾和胸腺称重后分别计算脾指数和胸腺指数.结果:实验组小鼠脾指数明显增高且具较明显的剂量效应关系,胸腺指数有一定程度的增高,各实验组均表现出一定程度的肿瘤抑制作用,高浓度组(F组)最明显.结论:大蒜素能显著促进脾的生长,且能一定程度促进胸腺的生长,从而提高机体免疫力；较高浓度的大蒜素具有抑制H22肝癌血道转移模型肺转移作用.

Objective: To study the inhibition and growth effects of Astragalus mahoschanicus on metastatic liver cancer.Methods: Established the tumor metastasis mouse model by injecting H22 hepatoma cell suspension to tail vein,divided into 6 groups randomly.one day later,treated with saline,CTX,low,medium,high doses Astragalus mahoschanicus,and Astragalus mahoschanicus combined with CTX respectively for 20 days.Then sacrificed mouse,measured body weights,spleen weights and thymus weights,calculated phagocytosis rate of macrophages,observed the growth of metastatic carcinoma in lung.Results Compared with the saline group,the number of metastatic nodules in lung was decreased in Astragalus mahoschanicus high-dose,middle-dose,low-dose groups and Astragalus mahoschanicus combined with CTX group.The spleen index,thymus index and the phagocytosis rate of macrophages were increased in high-dose,middle-dose groups.Conclusion: Astragalus mahoschanicus can inhibit tumor metastasis and growth,and can regulate immune function.

目的:比较研究红芪和黄芪水煎剂对老龄小鼠的免疫调节作用.方法:60只老龄小鼠用统计软件产生随机数字表编号,随机分成6组,分别给予生理盐水,左旋咪唑,黄芪高、低浓度,红芪高、低浓度30日.观察脾脏指数、胸腺指数和巨噬细胞吞噬作用.结果:红芪、黄芪水提物能提高老龄小鼠脾指数、胸腺指数(P＜0.05),可以增强老龄小鼠腹腔巨噬细胞的吞噬作用(P＜0.05),但同浓度的红芪与黄芪之间比较差异无统计学意义(P＞0.05).结论:红芪和黄芪水提物均能提高老龄小鼠的免疫作用,且两者作用相似.

目的:研究红芪多糖(THPS)对肝癌小鼠模型肿瘤细胞经血道转移生长的影响.方法:昆明种小鼠50只,尾静脉注射肝癌H22细胞悬液,制备肿瘤细胞经血道转移生长模型,分别给予N.S,低、中、高不同剂量THPS及环磷酰胺(CTX)处理,观察THPS对荷瘤小鼠肺部转移瘤生长情况的影响.结果:THPS中、高剂量组的瘤结节数少于N.S组.结论:THPS对肝癌小鼠模型肿瘤细胞经血道转移有一定抑制作用.