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Objective To investigate association between postural changes of blood pressure and carotid atherosclerosis in the elderly.Methods Standardized questionnaires,physical examination and biochemical blood tests were performed to acquire clinical characteristics of the participants.Presences of carotid plaques were identified by carotid ultrasound examination.Orthostatic hypotension (OH) and orthostatic hypertension (OHT) were defined according to the international consensus.Multivariable logistic regression analysis was performed to analyze the associations of carotid plaques with OH and OHT.Results 377 old people were finally included,of which 101 had OH and 33 had OHT.After full adjustment for possible confounders,old people with carotid plaques had significantly increased risk for OH as compared with those without carotid plaques (OR=2.27,95％ CI:1.32-3.90,P=0.003).Participants with bilateral carotid plaques were associated with significantly increased risk for OH (OR=3.45,95％CI:1.74 6.84,P=0.001),while the association between unilateral carotid plaques and OH was not significant (OR=1.71,95％ CI:0.88-3.32,P=0.112).No significant association was identified between carotid plaques (bilateral or unilateral) and OHT.Conclusions Presence of carotid plaques,particularly bilateral plaques,may be an independent risk factor for OH.
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Objective To evaluate the interventional treatment of Budd-Chiari syndrome (BCS)with regard to different types of the disease.Methods One hundred and fifty-nine consecutive cases with BCS underwent interventional treatments with regard to different types of the diseases,including percutaneous angioplasty (PTA),transcatheter thrombolysis,endovascular stent implantation and modified transjugular intrahepatic portosystemic shunt(MTIPS).Among them,147 cases that underwent complete follow-up were enrolled in this study.Simple obstruction of HV,membranous obstruction of IVC,membranous obstruction of IVC combined with thrombosis in the distal lumen and segmental obstruction of IVC constituted 13.6/(20),66.0/(97),6.1/(9)and 14.3/(21/147),respectively.The technical success rate of each type Was determined.They were followed up for(67.3±9.0)months (16 h-104 months).Overall primary patency rote was evaluated.The late effect on liver function Was analyzed according to the Child-Push score.Results The primary patency rate of PTA was 65.6/ (86/131)and the secondary pateney rate was 96.9/(124/128).The primary patency rate of stent implantation was 78.9/(15/19)and the secondary patency rate Was 92.3/(24/26).One patient of type Ⅲa that received recanalization,catheter-directed thrombolysis and PTA in IVC died of hemoptysis 72 h after the procedtire.One patients of type I b who received MTIPS died of DIC 16 hrs after the procedure.And one patient of type Ⅳb who received MTIPS died of hver failure 13 months after the procedure.Twelve patients died in 7-79 months after the interventional procedure due to unrelated causes.At the end of follow-up,the liver function of the patients Was improved. Conclusions Optimal application of various vascular interventional techniques has a satisfactory primary and secondary patency rate and improves the long-term liver function.
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Objective To study the efficacy of the percutaneous thrombectomy for the no-reflow of acute myocardial infarction(AMI)in elderly patients with angiographically proven thrombus.Methods A total of 46 patients(≥60 years old)with AMI and coronary thrombus shown by angiography were randomly divided into group of PCI therapy(23 cases)and group of PCI plus percutaneous thrombectomy(23 cases).At 24 hours and 1 week after PCI,real-time imaging was performed by contrast pulse sequencing technology.Contrast score index(CSI),endocardial length of contrast defect(CDL),regional wall motion score index(WMSI)and wall motion abnormality(WML)were calculated. Results At each time point,in patients treated with a pereutaneous thrombectomy,CSI,CDL/LV length(%),WMSI and WML/LV length(%)were significantly lower than in PCI group[(2.0±0.3)vs.(2.5±0.7),(1.5±0.4)vs.(2.0±0.5),(15.5±5.4)%vs.(22.8±4.9)%,(9.6±2.5)%vs.(21.5±4.6)%,(2.1±0.5)vs.(2.4±0.7),(1.5±0.5)us.(2.1±0.5),(24.5±5.3)%vs.(35.6±8.3)%,(15.9±5.0)vs.(27.6±6.4)%,P<0.05 or P<0.01]. Conclusions The beneficial effect of the thrombectomy occurs at the microvascular level.Thrombectomy reduces the no-flow and the extent of microvascular obstruction,thus it was a feasible therapy in elderly patiens with AMI.
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OBJECTIVE:To observe the influence of total Saponin of Frucius Tribuli on hemorheological and thrombosis in vitro in model rats with blood stasis.METHODS:The model rats were randomly divided into control,model,ligustrazine and total saponin of Frucius Tribuli(high,medium,and low dosage)group,all administered drugs through stomach irriga?tion.Except the control group,blood stasis models were established in the rest five groups,and hemorheological parameters and thrombosis indices were determined in these groups.RESULTS:In the model group,blood viscosity increased;red blood cell electrophoresis period was prolonged;fibrinogen content,thrombus length and weight increased too.However,blood viscosity,red blood eletrophoresis period,fibrinogen content as well as the wet and dry weight and length of thrombus in mice of total saponin group decreased significantly,as compared with the model group(P