Objective To systematically review the effectiveness of amiodarone in treating repurfusion arrhythmia (RA) after thrombolytic therapy for acute myocardial infarction (AMI), so as to provide high quality evidence for formulating the rational thrombolytic therapy for AMI. Methods Randomized controlled trails (RCTs) on amiodarone in treating RA after thrombolytic therapy for AMI were electronically retrieved in PubMed, EMbase, The Cochrane Library (Issue 3, 2012), CBM, CNKI, VIP and WanFang Data from inception to January, 2013. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed quality. Then RevMan 5.1 software was used for meta-analysis. Results A total of 5 RCTs involving 440 patients were included. The results of meta-analysis suggested that, compared with the blank control, amiodarone reduced the incidence of RA after thrombolytic therapy in treating AMI (RR=0.60, 95%CI 0.48 to 0.74, Plt;0.000 01) and the incidence of ventricular fibrillation (RR=0.47, 95%CI 0.26 to 0.85, P=0.01). It neither affected the recanalization rate of occluded arteries after thrombolytic therapy (RR=1.00, 95%CI 0.88 to 1.15, P=0.94) nor decreased the mortality after surgery (RR=0.33, 95%CI 0.10 to 1.09, P=0.07). Conclusion Current evidence indicated that, amiodarone can decrease the incidence of RA. Unfortunately, the mortality rate can’t be reduced by amiodarone. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion
目的 總結頸動脈體瘤的診斷和外科手術治療的經驗。 方法 分析我院1991年9月至2009年2月期間手術治療的16例頸動脈體瘤患者的臨床資料。 結果 術前均行彩色多普勒超聲檢查，9例行CT檢查，6例行數字減影血管造影檢查。3例首診時誤診為其他疾病。11例行單純瘤體切除； 5例采用大隱靜脈行頸動脈重建。術后1例出現聲音嘶啞，1例出現伸舌右偏，1例出現呼吸困難。10例獲得7個月～15年（平均67個月）隨訪，未見復發和轉移。 結論 臨床醫師應提高對頸動脈體瘤的認識,注意選擇合適的檢查方法以免誤診，外科手術切除是首選的治療措施，大隱靜脈重建頸動脈是一種較安全、有效的治療方法。
Objective To discuss the early diagnosis and surgery of intestinal necrosis caused by superior mesenteric venous thrombosis （SMVT）. Methords The clinical data of 32 patients with intestinal necrosis caused by SMVT were reviewed retrospectively and analyzed, which included 6 cases of primary SMVT, 26 cases of secondary SMVT, 9 cases with pylethrombosis, 24 patients had been dignosed definitely as SMVT by imageology examination before surgery. All the patients accepted surgery therapy, within which 9 patients accepted Fogarty catheter, and anticoagulation and thrombolytic therapy were administrated postoperatively. Results All patients had recovered except for one with short bowel syndromle and one died. Conclusions SMVT is a rarely ischemic intestinal disease, which has complicated pathogenesis and difficulty in early diagnosis. Intestinal necrosis often occurs as a result of delayed treatment and the effective way is to cut off necrotic intestines in time. Intra-and postoperative anticoagulation and thrombolytic therapy could reduce recurrency effectively.
目的 探討肢體假性動脈瘤的病因、發病機理以及手術方式的選擇，評價各種手術的治療效果，以提高對假性動脈瘤的診治水平。方法 30例假性動脈瘤患者（股動脈18例，腘動脈7例，肱動脈2例，橈動脈3例），其中8例為感染或破裂性假性動脈瘤，1例肢體壞死。30例患者均行外科手術治療,其中11例行假性動脈瘤破口修補術，2例行股動脈結扎術，2例行血管端端吻合術，8例行自體大隱靜脈移植術，6例行人工血管移植術，1例行截肢術。結果 30例患者術后恢復順利，除1例行下肢截肢術外，其余29例術后效果良好。隨訪7個月～8年,平均(4.4±2.3）年； 行人工血管移植術者4例移植段發生血栓，經溶栓治療后好轉，其余血供狀況良好。結論 外科手術治療肢體假性動脈瘤是一種有效的方法。
ObjectiveTo detect the inhibitory effect of early growth response gene-1 DNA enzyme (EDRz) on proliferation of vascular smooth muscle cell (VSMC) and intimal hyperplasia, and confirm the effect of gene therapy on stenosis and occlusion after vein transplantation. MethodsEDRz was constructed, and autogenous vein graft model was established with Wistar rats, transplanting the right jugular vein to infra renal abdominal aorta by microsurgical technique. EDRz was transfected to the graft veins and the vein graft samples were harvested at hour 1, 2, 6, 24 and on day 3, 7, 14, 28, 42 after grafting, 10 Wistar rats were randomly selected in every time. The expression of EDRz in transfected vein graft was detected by fluorescent microscope. Egr-1 mRNA was measured by reverse transcription-PCR (RT-PCR) and in situ hybridization, respectively. The protein expression of Egr-1 was detected by Western blot and immunohistochemistry, respectively. HE stained vein grafts were observed under microscope. Results① The results of EDRz transfected vein graft: At hour 1 after grafting, EDRz was mainly located in adventitia, tunica media, and partial endothelial cells of vein graft; At hour 2, 6, and 24, EDRz was located in tunica media of vein graft; and on day 7, it was mainly located in intima of vein graft. There wasn’t EDRz in vein grafts on day 14, 28, and 42. ② The results of expression of Egr-1 mRNA: Detection by RT-PCR: At hour 1 after transfecting, the expression of Egr-1 mRNA arrived at the peak, and declined at hour 2, 6, and 24. The expression was tenuity on day 3. Egr-1 mRNA expression was not found on day 7, 14, 28, and 42. The expression of Egr-1 mRNA at hour 1 was significantly higher than that of the other time point (Plt;0.01). The result of in situ hybridization was coincident with RT-PCR. ③ The results of expression of Egr-1 protein: The result of Western blot: There was no expression of Egr-1 protein in normal veins. At hour 2 after grafting, expression of Egr-1 protein was found, and declined at hour 6, 24, and on day 3. There was no expression of Egr-1 protein at hour 1, and on day 7, 14, 28, and 42. The expression of Egr-1 protein at hour 2 was significantly higher than that of the other time point (Plt;0.01). The result of immunohistochemistry was coincident with Western blot. ④The degree of VSMC hyperplasia and intimal thickness were lighter in EDRz transfected vein grafts than that in nottransfected vein grafts contemporarily. ConclusionsEDRz could reduce the expression of Egr-1 in autogenous vein graft, and could effectively restrain VSMC proliferation and intimal hyperplasia, and prevent vascular stenosis and occlusion after vein grafting.