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find Author "刘志刚" 24 results
  • 异体巩膜替代治疗双行睫三例

    Release date:2016-09-01 11:10 Export PDF Favorites Scan
  • Curative Effect of Homoharringtonine United Program on Patients with Chronic Myelocytic Leukemia

    【摘要】 目的 探讨高三尖杉酯碱(HHT)联合三氧化二砷(As2O3)、羟基脲治疗高白细胞慢性粒细胞白血病(CML)的疗效和毒副作用。 方法 对2004年11月-2009年12月行高三尖杉酯碱联合As2O3、羟基脲治疗高白细胞CML患者21例的疗效和不良反应进行分析。 结果 经高三尖杉酯碱联合As2O3、羟基脲治疗后3~6个疗程,21例CML患者中完全缓解15例,占71%;部分缓解2例,占10%;总有效率81%;未缓解4例,占19%。不良反应仅表现乏力、纳差、恶心、脱发。 结论 HHT联合As2O3、羟基脲是治疗高白细胞CML一种有效率高,临床容易开展,安全性好的方法。【Abstract】 Objective To investigate the effects and side effects of homoharringtonine combined with arsenic trioxide or hydroxycarbamide on hyperleukocytic chronic myelocytic leukemia (CML). Methods The therapeutic effects and adverse effects of homoharringtonine combined with arsenic trioxide or hydroxycarbamide administered in 21 cases with CML from November 2004 to December 2009. Results In 21 patients with CML, the CR rate was 71% (15/21) and PR rate was 10% (2/21). The total respondence rate was 81% and the side effects were slight. The side effect only shows short of strength, appetite decrease, naupathia, hair loss and no heart side effect. Conclusion Homoharringtonine combined with arsenic trioxide or hydroxycabamide has a high effect rate on CML with good safety.

    Release date:2016-09-08 09:50 Export PDF Favorites Scan
  • 人体乳内动脉、桡动脉与大隐静脉内皮细胞一氧化氮和超极化因子的差异及其临床意义

    Objective To study the differences in nitric oxide (NO) release and endotheliumderived hyperpolarizing factor (EDHF)mediated hyperpolarization among human internal mammary artery (IMA), radial artery (RA), and sephenous vein (SV) by direct measurement of the signal of NO and membrane potential. Methods The present study was divided into four groups: IMA (n=15), RA (n=6), SV (n=23), and surgically prepared SV group(dilatation with normal saline solution at a pressure of 100600 mm Hg, PV, n=9). All vascular segments taken from 29 patients undergoing coronary artery bypass grafting between October 2009 and September 2010 in the Fu 〖CM(159mm]Wai Hospital Beijing. The vascular segments were placed in an organ chamber, and the NOsensitive electrode and intracellular glass microelectrode were used to directly measure the NO release and membrane potential changes in response to acetylcholine (ACh) and bradykinin (BK) before and after incubation with NGnitroLarginine, indomethacin, and oxyhemoglobin. Results (1)The basal release of NO in IMA group was 16.8±1.6 nmol/L, n=13, significantly greater thanthat in SV group (9.9±2.8 nmol/L, n=13, Plt;0.05) and RA group (11.9±1.8 nmol/L, n=6, Plt;0.05). Compared with SV group, NO basal release in RA group was greater (Plt;0.05). (2)The AChinduced NO release was greater in IMA group than in RA group or SV group, while BKinduced NO release was greater in SV group than in RA group. (3) Both basal(3.4±1.4 nmol/L, n=9, Plt;0.05) and ACh, and BKinduced NO release in PV group were significantly reduced.(4) EDHFmediated hyperpolarization was greater in IMA group than in SV group orRA group [ACh -5 log M: -9.4±1.5 mV(n=10) vs. -4.5±1.1 mV(n=17), -9.7±1.9 mV(n=6), Plt;0.05;BK -7 log M: -10.9±1.5 mV(n=8) vs. -5.1±0.5 mV(n=8), RA -5.8±0.9 mV(n=6), Plt;0.05). Compare with SV group AChinduced EDHFmediated hyperpolarization in RA group was greater(ACh -5 log M:-9.7±1.9 mV, n=6, vs. -4.5±1.1 mV, n=17, Plt;0.01). Conclusions (1) IMA is superior to RA and SV in terms of NO basal and stimulated release and EDHFmediated hyperpolarization. (2) Compared with SV, both NO basal release and EDHFmediated hyperpolarization in RA were significantly greater. (3) After surgical preparation and pressure dilatation, both basal and stimulated release of NO in SV were severely impaired.

    Release date:2016-08-30 05:57 Export PDF Favorites Scan
  • SPINAL PATHOLOGIC CHANGES AND AXONAL REGENERATION AFTER BRACHIAL PLEXUS ROOT ANASTOMOSIS IN RATS

    Objective To evaluate the feasibil ity of direct anastomosis in the rat model of the brachial plexus extravertebral foramen nerve root division of C5-7. Methods Forty-eight SD rats (male or female) aging 4-6 months and weighing 250-300 g were selected to make the model of extravertebral foramen nerve root division of C5-7. The left C5-7 nerve roots, as the experimental sides, were separated to the brachial plexus nerve trunk and the transected roots were sutured to theproximal stump immediately after cutting off the brachial plexus extravertebral foramen nerve root division. The right C5-7nerve roots, as the control sides, received no operation. The general condition of rats after operation was observed. The gross observation, the histological observation and BDA nerve tracing technology were adopted to observe the wet weight of musculus biceps brachii, the cross section of biceps brachii and the spinal cord and distal nerve trunk at 3 weeks, 3 months and 6 months after operation. Results All rats survived well after operation. Claudication and unfold claw reflex were observed in the experimental sides, and the unfold claw reflex disappeared 3 months later. Comparatively, the control sides were normal. Nerve adhesion aggravated gradually and the neural stems were shriveled within 6 months after operation in the experimental sides. Comparatively, the control sides were normal. The wet weight of biceps brachii in the experimental sides and the control sides at 3 weeks, 3 months and 6 months after operation was (0.28 ± 0.12), (1.37 ± 0.33), (0.58 ± 0.10), (1.36 ± 0.35), (1.39 ± 0.31), (1.37 ± 0.38) g, respectively, indicating significant differences between two sides at 3 weeks and 3 months (P lt; 0.05), but no significant difference at 6 months (P gt; 0.05). The modified Marsland and the LFB staining of spinal cord and superior trunk of brachial plexus showed that the number of neurons, cell nuclear and Nissl body decreased and cell bodies changed from swell ing to shrinkage, dyeing nerve fibers increased, neural axone was thin and myel in sheath was sl ightly stained at each time point in experimental side. The number of motor neurons in cornu anterius medullae spinal is in the experimental side was 84.5% ± 3.2%, 74.4% ± 4.5%, 73.7% ± 3.8% of that in the control side at each time point, respectively. HE staining of biceps brachii detected thatthe muscle denaturation was very serious at 3 months after operation and then recovered. Neural tracing used BDA showed that the closer to the proximal of nerve trunk, the more obviously stained it was of myel in sheath and the more massive of axon at 6 months after operation. And there was almost no myel in and axon stained in musculocutaneous nerve. Conclusion In the rat model of brachial plexus extravertebral foramen nerve root division, the motoneuron in cornu anterius medullae spinal is necrosis rate reaches 20%-30%, and most of the residual neurons are pathologic. The regenerated fibers manifest as insufficient dynamic power and incomplete development, making no sense for the recovery of end organ function. Therefore, the exact mechanism of the recovery of biceps brachial muscle demands further study.

    Release date:2016-09-01 09:17 Export PDF Favorites Scan
  • 足跟慢性溃疡的修复

    目的 回顾分析外科治疗足跟慢性溃疡的临床资料、治疗方法及疗效。方法 1997年5月~2006年12月,收治足跟慢性溃疡患者23例。男20例,女3例;年龄18~79岁,平均45.6岁。病程1个月~7年。良性溃疡18例,恶性溃疡5例。溃疡创面2.5 cm×1.5 cm~10.5 cm×7.0 cm。患者予以局部扩创或溃疡扩大切除后,采用足底内侧皮瓣修复7例,带足背皮神经的足背皮瓣修复1例,小腿前外侧逆行岛状皮瓣修复4例,腓肠神经营养血管皮瓣修复11例,切取皮瓣4.0 cm×2.5 cm~18.0 cm×9.0 cm。供区游离植皮覆盖。结果 术后创面均Ⅰ期愈合。20例皮瓣完全成活,1例出现静脉危象,予以蒂部缝线拆除后成活;2例皮瓣远端部分坏死,经换药后愈合。供区植皮均成活,切口Ⅰ期愈合。21例获随访3个月~2年,平均11个月。皮瓣质地及外观良好,足底内侧皮瓣及足背皮瓣感觉恢复良好,小腿前外侧逆行岛状皮瓣及腓肠神经营养血管皮瓣痛温觉部分恢复。患足可正常负重,足跟溃疡未见复发。结论 足跟慢性溃疡以预防为主,创面应早期手术行皮瓣修复,以防止溃疡复发。

    Release date:2016-09-01 09:22 Export PDF Favorites Scan
  • EXPERIMENTAL STUDY ON BRACHIAL PLEXUS INJURY INDUCED BY RADIATION IN RATS

    Objective To explore the changes of morphology and ventricornual motor neuronsin SD rats’ ventral horn of spinal cord after radiated as the therapy protocol for breast cancer, to discover the rule of radiationinduced injury of brachialplexus, and also if there exits the reversible conversion in neurons. Methods Twenty SD rats were selected. The left side of the rats was used as the radiation side, and the right side as the control side. The RIBPI animal models were established by divideddose of radiation. Using 2 Gy/time and 5 times/week, a total administered dose reached 30 Gy after 3 weeks. The behaviour of the rats was observed after radiation. At 3, 5, 7 and 9 weeks after the last radiation (n=4), the wet weights of biceps brachii muscle, upperlimb circumference and compound action potential were examined; the pathological changes of biceps brachiimuscle, the morphological changes, counts of the motor neurons in ventral horn and axons of bilateral spinal cord were observed by HE staining, argentums staining and toluidine blue staining. Results The rats showed lameness and a “claw hand” 3 weeks after radiation. Compared with control side, thewet weights of biceps brachii muscle and upperlimb circumference were significantly reduced, meanwhile, the compound action potential significantly decreased, and its latent period was also significantly prolonged 3, 5, 7 and 9 weeks (Plt;0.05). The histological observation: Musculocutaneous nerve showed decreased medullated fibers, heterogeneous ditribution and decreased density, thin myelin sheath, damaged nerve structure and collagen hyperplasia; biceps brachii muscle showed degeneration, fiber breakage and inflammatory cell infiltration; The account of motor neurons in ventral horn was significantly decreased in the radiation side with time extending, the sign of cell death, such as, the neurons crimple, and karyolysis were observed(Plt;0.05). Conclusion Large dose of X-ray can inducedbrachial plexus injury, and the lameness, a “claw hand”, biceps brachii muscle atrophy and the compound action potential abnormality. The account of motor neurons in ventral horn was significantly decreased. The motor neurons showed oxonal degeneration and myelinec degeration.

    Release date:2016-09-01 09:23 Export PDF Favorites Scan
  • REPAIR OF SOFT TISSUE DEFECTS OF WRIST AND FINGERS BY ANTEGRADE AND RETROGRADE DORSAL METACARPAL FLAPS WITH CUTANEOUS BRANCHES AS PEDICLES

    Objective To investigate the procedure and applications ofantegrade and retrograde dorsal metacarpal flaps with cutaneous branches as pedicles in repairing soft tissue defects of wrist and fingers. Methods From 1995 to 2003, we observed that the proximal and distal branches, deriving from the dorsal metacarpal artery, formed a consistent anastomosis arc subdermally. The anastomosis arc was paralleled to the dorsal metacarpal artery. Antegrade and retrograde dorsal metacarpal flaps could be designed using proximal anddistal branches as pedicles. Twenty-seven cases of soft tissue defects were treated by use of dorsal metacarpal flaps with cutaneous branches as pedicles, including 3 cases of defects on dorsum of hand with antegrade flaps, and 24 cases of defects on fingers with retrograde flaps ( index finger:12 cases; middle finger: 6 cases; ring finger: 4 cases; and little finger:2 cases). The dimensions of the antegrade flaps were 2.0 cm×4.0 cm~4.0 cm×6.0 cm, and the dimensions of theretrograde flaps were 2.5 cm×3.5 cm~3.0 cm×7.0 cm.The incision of the donor site was closed directly. Results All flaps survived. After a follow-up of 13 years, the texture and color of the flaps were good, and the shape and function of the donors were normal. Conclusion The antegrade or retrograde flap pedicled with the distal or proximal cutaneous branches of thedorsal metacarpal artery, is an optimal flap in repairing finger or wrist softtissue defects.

    Release date:2016-09-01 09:33 Export PDF Favorites Scan
  • 手骨间肌室综合征的早期诊断和治疗

    Release date:2016-09-01 11:38 Export PDF Favorites Scan
  • 浅谈诊断学教学中医患沟通技能的培养

    医患沟通技能是成为一名合格医师的必备素质。当今医疗现状不仅对医务人员的人文观念和沟通技能制定了更高标准,也对相应的医学生教育提出了更高要求。诊断学中加强对医学生在医患沟通技能方面的培养,不仅提高了该课程床旁见习的教学质量,也为提升医学生将来的职业素养和执业效果奠定了坚实基础。

    Release date:2016-09-07 02:38 Export PDF Favorites Scan
  • Risk factors of new-onset postoperative atrial fibrillation after off-pump coronary artery bypass grafting

    Objective To investigate the risk factors of new-onset postoperative atrial fibrillation (POAF) in patients who underwent isolated off-pump coronary artery bypass grafting (OPCAB). Methods Between January 2016 and January 2018, a total of 583 patients who underwent OPCAB in TEDA International Cardiovascular Hospital were retrospectively analyzed. There were 434 males and 149 females with an average age of 62.79±8.08 years. The patients were divided into 2 groups, a POAF group (n=158) and a non-POAF group (n=425) , in accordance with the occurrence of POAF. The perioperative clinical parameters of the two groups were analyzed by univariate analysis. Then, statistically significant factors in the univariate analysis were subjected to multivariate logistic regression analysis to determine if it was an independent risk factor for POAF. Results Univariate analysis showed that age≥65 years (P=0.012), history of chronic obstructive pulmonary disease (COPD, P=0.028), left atrial diameter (LAD)≥38 mm (P=0.016) and neutrophil-lymphocyte ratio (NLR, P=0.002) were related to POAF. Logistic multivariate regression analysis showed that age≥65 years (OR=1.717, P=0.006), LAD≥38 mm (OR=1.562, P=0.023) and higher NLR level (OR=1.215, P=0.022) were the independent risk factors of POAF after OPCAB, but not previous history of COPD (OR=2.489, P=0.326). Conclusion In patients with OPCAB, advanced age (≥65 years), LAD enlargement (≥38 mm) and higher NLR level are the independent risk factors of POAF after OPCAB.

    Release date:2019-03-01 05:23 Export PDF Favorites Scan
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