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find Author "陈林" 56 results
  • Research Progress of Protective Effects and Mechanism of Mangiferin on Myocardial Remodeling

    Myocardial remodeling is one of the important pathological basis when myocardial infarction or pressure overload occurs, whereas mangiferin which is a naturally occurring xanthone has a broad range of therapeutic effect on postinfarction myocardial remodeling. Mangiferin attenuates myocardial infarction by preventing the accumulation of myocardial collagen and the development of intercellular fibrosis. Mangiferin's inhibition to p38 mitogen activated protein kinases plays an important role in the cardioprotective effect. Inhibition of p38 mitogen activated protein kinases significantly decreases TNF-α and then brings the cardioprotective effect. Similarly, p38 mitogen activated protein kinases in pressure overload disease also play a very important role. Understanding of these has direct implications for clinical therapy.

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
  • 左炔诺孕酮宫内节育器应用于维持性血透患者一例

    Release date:2016-08-26 02:21 Export PDF Favorites Scan
  • Application of Lower Sternal Incision with On-pump, Beating Heart Intracardiac Procedures in Mitral Valve Replacement

    Abstract: Objective To explore the application of lower sternal incision with on-pump, beating heart intracardiac procedures in mitral valve replacement (MVR). Methods We retrospectively analyzed clinical data of 42 patients (minimal incision group) with valvular heart diseases who underwent MVR via lower sternal incision under the beating heart condition in Xinqiao Hospital of the Third Military Medical University from January 2011 to December 2011. There were 16 male and 26 female patients with their average age of 42.3±12.7 years in the minimal incision group. We also randomly selected 42 patients with valvular heart diseases who underwent MVR via routine midline sternotomy during the same period in our department as the control group. There were 18 male and 24 female patients with their average age of 43.8±13.1 years in the control group. Operation time, cardiopulmonary bypass time, major complications, chest drainage  in postoperative 24 hours, skin incision length and average postoperative hospital stay were observed and compared  between the two groups. Results There was no major perioperative complication such as in-hospital death. There was no reexploration for postoperative bleeding, complete atrioventricular block, embolism or perivalvular leakage in the minimal incision group. There was no statistical difference in cardiopulmonary bypass time, operation time, or the incidence of  reexploration for postoperative bleeding, wound infection and perivalvular leakage between the two groups(P>0.05). The skin incision length in the minimal incision group was shortened by 5.2 cm compared to that in the control group (7.9±1.4 cm vs. 13.1±3.3 cm, P=0.000). Chest drainage in postoperative 24 hours in the minimal incision group was significantly less than that of the control group (183.6±40.2 ml vs. 273.4±59.9 ml, P=0.000). Postoperative hospital stay in the minimal incision group was significantly shorter than that of the control group (8.1±1.3 d vs. 10.6±2.1 d, P=0.000). Forty patients in the minimal incision group were followed up for 3-15 months and 2 patients were lost during follow-up. Four patients had postoperative wound pain, and the majority of patients didn’t have significant wound scar formation but a satisfactory quality of life. Thirty-eight patients in the control group were followed up for 3-15 months, 4 patients were lost during follow-up, and 17 patients had postoperative wound pain. Conclusion Lower sternal incision with beating heart can reduce the surgical injury, simplify the operation procedure and improve the therapeutic efficacy. It is a safe, effective and esthetic surgical approach for MVR.

    Release date:2016-08-30 05:28 Export PDF Favorites Scan
  • 体重小于10 kg婴幼儿心内直视术后早期心律失常的防治

    目的 分析体重lt;10 kg行心内直视手术后早期发生心律失常婴幼儿的临床特点,探讨其防治措施。 方法 回顾性分析2007年6月~2009年6月第三军医大学附属新桥医院收治的88例体重lt;10 kg行心内直视手术后早期发生心律失常婴幼儿患者的临床资料,其中男49例,女39例;年龄1.0个月~25岁(12.4±5.5个月);体重2.5~9.7 kg(6.4±2.8 kg)。术后对发生窦性心动过速和室上性心动过速患者给予对症处理,如无效,给予西地兰或普罗帕酮或胺碘酮治疗;对Ⅱ°和Ⅲ°房室传导阻滞合并心率缓慢患者,给予异丙肾上腺素、激素,临时/永久心脏起搏器;对室性心律失常患者给予利多卡因或胺碘酮治疗。 结果 围术期共死亡4例,病死率45%。死于低心排血量综合征2例,多器官功能衰竭1例,室性心动过速1例。术后发生窦性心动过速58例,室上性心动过速18例(心率200~300次/分);房室传导阻滞6例(Ⅰ°1例、Ⅱ°4例、Ⅲ°1例);室性心律失常6例;均经给予对症处理、抗心律失常药物或安置临时/永久心脏起搏器治疗好转或治愈。随访76例,随访时间6~40个月(20.4±11.5个月),所有患者健康状况良好,无严重心律失常发生。失访8例。 结论 体重lt;10 kg的婴幼儿行心内直视手术后早期心律失常发生率高,应加强监护,慎重选择抗心律失常药物;复杂型心内畸形,体重lt;6 kg、年龄lt;6个月的婴幼儿术后早期更易出现室性心律失常,应加强防治。

    Release date:2016-08-30 05:57 Export PDF Favorites Scan
  • 7262例体外循环管理经验总结

    目的总结体外循环(CPB)管理的经验及教训,为更安全的CPB方式提供参考。方法回顾性分析我院1964年2月~2004年12月施行的CPB心内直视手术7262例患者的临床资料,并对硬件设备、转流技术、灌注师经验、术中监测及心肌保护等方面进行分析,其中3748例患者采用心脏不停跳CPB。结果全组死亡248例,总死亡率3.4%(248/7262)。1964年2月~1983年12月施行CPB手术464例,死亡52例,死亡率11.2%;1984年1月~1996年12月施行CPB手术1709例,死亡78例,死亡率4.6%;1997年1月~2004年12月施行CPB手术5089例,死亡118例,死亡率2.3%;1997年3月~2004年12月,对3748例患者采用心脏不停跳CPB,手术顺利,未发生与CPg相关的并发症及死亡。结论灌注师的经验和硬件设备的完善、使用高质量的人工心肺机和氧合器、多种转流技术的应用、完善的监测系统等可明显提高CPB的安全性。心脏不停跳下CPB是安全且易于管理的一种方式。

    Release date:2016-08-30 06:18 Export PDF Favorites Scan
  • Effect of Calcium-dependent Proline-rich Tyrosine Kinase on Cardiac Fibrosis in Rheumatic Heart Disease

    Abstract:Objective To observe the expression of calcium-dependent proline-rich tyrosine kinase-2(Pyk2) in myocardium of rheumatic heart disease, the relationship between its role and cardiac fibrosis and clinical significance. Methods The blue myocardium collagen stain were analysed after Masson staining in 30 patients with rheumatic heart disease (RHD group) and 6 normal myocardium specimens (control group). The contents of hyaluronic acid (HA), laminin(LN) and type IV collagen(IV-C) were detected by radio-immunity method,and the expressions of Pyk2 protein and messenger ribonucleic acid(mRNA) were explored by immunohistochemistry methods and reverse transcriptase polymerase chain reaction (RT PCR),then the correlations of these results were statistically analyzed. Results The contents of HA,LN and IV C in RHDgroup increased compared to control group(174.95±76.14μg/L vs. 70.06±15.63μg/L, 153. 86 ± 20. 72μg/L vs. 90.01±14. 11μg/L, 95. 26±7.66μg/L vs. 63. 21±10.62μg/L; P= 0.003, 0. 013, 0. 035). The Pyk2 absorption and the ratio of Pyk2 mRNA/glyceraldehyde phosphate dehydrogenase (GAPDH) in RHD group were significantly higher than those in control group (0. 325 ± 0. 032 vs. 0.106±0.013, 0.870±0.085 vs. 0.573±0.042; P=0.048, 0.006).There were positive correlativity between the expression of Pyk2 protein and HA, LN and IV-C (r=0. 611, 0. 743, 0. 829, P〈0. 01), there were positive correlativity between the expression of Pyk2 mRNA and LN, IV-C (r=0. 794, 0. 766, P〈0.05). Conclusion Pyk2 may play a key role in the proceeding of cardiac fibrosis in rheumatic heart disease by increasing collagen synthesis in myocardium.

    Release date:2016-08-30 06:23 Export PDF Favorites Scan
  • 完全性肺静脉异位引流的外科治疗

    目的 报道完全性肺静脉异位引流 ( total anomalous pulm onary venous drainage)的外科治疗疗效和体会。 方法  2 7例患者中 (心上型 19例、心内型 8例 ) ,18例采用全身麻醉体外循环心脏停搏下手术 ,9例采用心脏不停跳手术。心上型横切右心房和左心房后壁 ,纵行切开肺总静脉 ,切口 3.5~ 5 .0 cm,与左心房后壁吻合 ,用自体心包片修补房间隔缺损 ( ASD) ,停机后结扎垂直静脉 ;心内型切开 ASD与冠状静脉窦口之间的残余房间隔壁 ,以扩大ASD,自体心包修补 ASD,并将肺静脉异位连接口与冠状静脉窦一并隔入左心房。 结果 结性心律 4例 ,呼吸衰竭 3例 ,全身水肿 1例 ,大量胸腔积液 5例 ;早期死亡 1例 ,死亡原因为低心排血量综合征。其余患者均痊愈出院 ,随访 6个月~ 10年 ,恢复良好 ,无吻合口狭窄发生。 结论 完全性肺静脉异位引流手术治疗的关键在于左心房与肺总静脉吻合口应足够大 ,避免狭窄 ,该手术对早晚期病变疗效均良好。

    Release date:2016-08-30 06:27 Export PDF Favorites Scan
  • 逆行性灌注浅低温氧合血心脏不停跳与冷血心脏停搏液对cTn I的影响

    目的 对比研究逆行性灌注浅低温氧合血心脏不停跳与低温冷血心脏停搏液对外周血清心肌肌钙蛋白I(cTn I)的影响. 方法 将18例双瓣膜置换术患者分为心脏不停跳组和心脏停搏组,观察围手术期外周血清cTn I、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)及主动脉阻断前后用透射电子显微镜观察心肌超微结构变化.结果 心脏不停跳组主动脉开放后各个时相点CK虽略低于心脏停搏组,但差别无显著性意义(Pgt;0.05);主动脉开放后6小时CK-MB明显低于心脏停搏组(Plt;0.05),主动脉开放后各个时相点心脏不停跳组cTn I明显低于心脏停搏组(Plt;0.05).两组患者主动脉阻断前心肌超微结构均有轻度改变,主动脉阻断90分钟心脏停搏组心肌超微结构损伤较心脏不停跳组明显. 结论 逆行性灌注浅低温氧合血心脏不停跳围手术期外周血清cTn I较低,可能与该方法使体外循环期间发生不可逆损伤的心肌细胞较少,心肌超微结构损伤较轻有关.

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
  • 先天性心脏病心脏不停跳心内直视手术

    摘要 目的 介绍体外循环心脏不停跳下心内直视手术治疗先天性心脏病心内畸形的应用体会。 方法 327例先天性心脏病心内畸形行浅低温体外循环心脏不停跳心内直视手术。常规建立体外循环,置左心房引流管,降温至32±1℃并维持,仅阻断上、下腔静脉,不阻断升主动脉,维持灌注压在60mmHg左右,在心脏不停跳下施行心脏畸形矫正术,方法同心脏停搏手术。 结果 死亡7例,死亡率2.1%,其余均痊愈出院,随访1~13个月,恢复良好。 结论 心脏不停跳下心内直视手术有较好的心肌保护作用,能减少并发症的发生,并简化操作,缩短体外循环时间。

    Release date:2016-08-30 06:33 Export PDF Favorites Scan
  • 色素性静脉旁视网膜脉络膜萎缩二例

    Release date:2016-09-02 06:08 Export PDF Favorites Scan
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