目的 总结一期或分期血管腔内治疗多撕裂口主动脉夹层的临床经验。方法 在DSA监控下，通过一侧或双侧股动脉入路将多枚带膜支架植入主髂动脉，一期或分期封闭这些部位的多个撕裂口。结果 从2001年1月至2004年6月，共有8例患者接受了一期或分期血管腔内治疗，其中5个撕裂口者1例，4个撕裂口者2例，3个撕裂口者2例，2个撕裂口者3例。降主动脉撕裂口11个，腹主动脉撕裂口11个，髂动脉撕裂口4个。一期血管腔内治疗6例，分期腔内治疗2例。共植入带膜支架23枚，其中直管型20枚，分叉型3枚。手术均获成功。术后3、6、12及24个月CT或MRA复查显示夹层均消失，假腔内血栓形成，无内漏发生，患者均健康生存。结论 血管腔内多枚带膜支架一期或分期植入治疗多撕裂口主动脉夹层是一种可行，安全和有效的方法。

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】总结原发性甲状腺机能亢进症外科治疗的经验。【方法】对100例原发性甲亢病人的外科治疗进行回顾性临床分析。【结果】全部病例均接受双甲状腺次全切除术，术后1例出现呼吸困难需行气管切开，手术治愈率98%。随访4-54个月，平均24.6个月，2例出现甲亢复发，无1例发生甲低。【结论】外科手术是目前治疗原发性甲亢的较佳选择，而正确和充分的术前准备是手术成功的关键。

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。