目的 总结难治性主动脉夹层动脉瘤的血管腔内治疗经验。方法 2001年1月至2004年10月，对68例主动脉夹层和夹层动脉瘤的患者进行血管腔内治疗，其中对13例难治性病例进行临床分析。StanfordA型9例：主动脉夹层撕裂口在升主动脉3例，撕裂口在主动脉弓三大主干区域内3例，撕裂口在主动脉弓下段，累及升主动脉3例。StanfordB型4例。8例有2个以上撕裂口，其中3例术前近段夹层主动脉瘤破裂。13例均行血管腔内带膜支架植入术。2例先开胸行升主动脉与左颈总动脉、左锁骨下动脉旁路术，1例行颈总-颈总动脉旁路术，然后再行血管腔内治疗。StanfordB型多撕裂口主动脉夹层动脉瘤中有3例行多撕裂口一期或二期植入多个带膜支架腔内治疗。结果 全组随访2个月～3年。撕裂口在升主动脉病例中1例术后1个月死于消化道大出血，1例StanfordA型在近段夹层动脉瘤治疗后，因远段动脉瘤破裂，于术后27h死亡。其余11例术后半年复查CT、MR、多普勒超声等均证实原撕裂口封闭良好，假腔内血栓形成，未见新的夹层。结论 血管腔内带膜支架植入是治疗撕裂口位于升主动脉或主动脉弓区域内的难治性主动脉夹层动脉瘤的有效方法，手术成功率高，死亡率低。对于瘤体破裂病例也是可行的。

目的 探讨白细胞浸润和新生血管与下肢静脉性溃疡的关系。方法 采用不同体位下肢血常规白细胞计数和免疫组织化学法测定微血管密度，比较溃疡组、无溃疡组和对照组的白细胞计数和微血管密度。结果 溃疡组中，患肢下垂位血白细胞计数比平卧位减少237%，与其他组相比差异有统计学意义（P<0.05）；患肢皮肤中白细胞和微血管密度比其他组明显升高，差异有统计学意义（P<0.01）；白细胞与微血管密度呈显著正相关（rE0.73，P<0.05）。结论 白细胞浸润和新血管生成是下肢静脉性溃疡发生发展的重要因素。

Despite the availability of effective treatments for Graves' disease, there are patients who are unable to tolerate, or choose not to accept, current therapies (oral medication, radioactive iodine, or surgery). In this study, we have examined the use of thyroid arterial embolization as an option for patients who suffer from Graves' disease and who fit into one of the preceding patient groups. Selective arteriography, followed by embolization of thyroid arteries, was performed using Seldinger's technique in 22 patients with Graves' disease. Six of the patients received both arterial embolization and surgery at 2-3 wk after embolization. No serious complications were noted in any patient. In those who were treated with only interventional embolization, 14 of 22 (63.6%) became euthyroid and remained in this state for the duration of the study. The remaining 2 patients required a maintenance dose of antithyroid drug therapy (tapazole, 5-10 mg/d; or propylthiouracil, 50-100 mg/d). Patients were followed for a median time of 27 months (range, 6-50). At the end of the follow-up period, all 22 patients were euthyroid, the size of thyroid gland had decreased by one third to one half its original volume, but 2 patients continued to require antithyroid drugs. Histologic analysis of thyroid tissue from 6 patients who had embolization followed by surgery showed that embolization blocked both the superior and inferior thyroid arteries plus most of their branches. Evidence of chemical inflammation, necrosis, and fibrosis were observed in embolized thyroid tissue. The average diameter of capillary network within the body of the thyroid adjacent to superior and inferior artery was 0.12-0.25 mm, with the smallest ones ranging from 0.04-0.11 mm. The diameter of the capillaries in the isthmus ranged from 0.13-0.15 mm. The average diameters of the superior and inferior arteries were 2-5.5 and 3-3.75 mm, respectively, measured using radiographs from angiography. Based on the measured diameters of arteries, the appropriate size of embolizing granules can be selected, and complete embolization of the majority of the thyroid glands was achieved with a high frequency of therapeutic success. Histological examination of the thyroid tissue and clinical follow-up after embolization indicate that this procedure is an effective, minimally invasive, and safe method for the treatment of Graves' disease patients who cannot, or choose not to, accept current therapies.

目的 筛选和克隆原发性下肢深静脉瓣膜功能不全的大隐静脉曲张的致病相关基因。方法 利用mRNA荧光差异显示技术比较原发性下肢深静脉瓣膜功能不全患者的曲张大隐静脉隐-股瓣膜区组织中mRNA表达与对照组的差异，获得的差异表达cDNA片段经Northernblot验证后进行克隆和测序以探明其基因来源。结果 共获得37条差异表达的cDNA条带，经杂交验证其中30条为阳性（阳性率80%）。克隆及测序结果显示C610片段（NO.18克隆）与麦-考综合征（Mckusick-Kaufmansyndrome，MKKS）基因的mRNA序列有96%的同源性。结论 C610片段（NO.18克隆）与麦-考综合征基因高度同源，与下肢大隐静脉曲张的发病密切相关。