目的:评价改良扩大Morrow手术(室间隔心肌切除术)治疗青少年肥厚型梗阻性心肌病(HOCM)的早期手术疗效。方法:回顾性分析我院2011年至2015年改良扩大Morrow手术治疗29例青少年(≤21岁)HOCM患者的临床资料,评价早期手术疗效。术前、术后...目的:评价改良扩大Morrow手术(室间隔心肌切除术)治疗青少年肥厚型梗阻性心肌病(HOCM)的早期手术疗效。方法:回顾性分析我院2011年至2015年改良扩大Morrow手术治疗29例青少年(≤21岁)HOCM患者的临床资料,评价早期手术疗效。术前、术后超声心动图检查比较左心房前后径、左心室舒张末期内径、左心室射血分数、室间隔厚度、左心室流出道峰值压差、二尖瓣收缩期前向运动征和二尖瓣反流分级变化,同时抽血检测术前、术后血浆N末端B型利钠肽原水平变化,采用纽约心脏协会心功能分级评估心功能。结果:本组患者中,接受单纯改良扩大Morrow手术者17例(58.6%),同时行冠状动脉旁路移植术者8例(27.6%)。与术前比较,改良扩大Morrow手术后患者的室间隔厚度显著减小[(24.6±6.8)mm vs(16.9±7.1)mm,P<0.01],左心室流出道峰值压差明显降低[(68.8±15.7)mm Hg(1 mm Hg=0.133 k Pa)vs(10.7±4.2)mm Hg,P<0.01],二尖瓣反流明显减轻[(1.7±1.3)级vs(0.2±0.4)级,P<0.01],纽约心脏协会心功能分级显著改善[(3.4±0.8)级vs(1.4±0.5)级,P<0.01],血浆N末端B型利钠肽原水平显著下降[(1957.6±392.5)ng/ml vs(458.7±161.0)ng/ml,P<0.01]。无围手术期死亡。术后第12、24、36个月患者的生存率分别为100.0%、86.7%和86.7%。结论:改良扩大Morrow手术是治疗青少年HOCM安全、有效的手段,术中充分暴露是保证手术效果的重要措施。展开更多
目的:总结改良扩大Morrow术治疗肥厚型梗阻性心肌病的临床经验,分析其近中期结果。方法:回顾性分析2012年5月至2019年6月,在我院行改良扩大Morrow术的26例肥厚型梗阻性心肌病患者临床资料。其中女性18例,男性8例,年龄31~67岁,平均年龄(4...目的:总结改良扩大Morrow术治疗肥厚型梗阻性心肌病的临床经验,分析其近中期结果。方法:回顾性分析2012年5月至2019年6月,在我院行改良扩大Morrow术的26例肥厚型梗阻性心肌病患者临床资料。其中女性18例,男性8例,年龄31~67岁,平均年龄(45.6±13.5)岁。所有患者均经主动脉切口行改良扩大Morrow术,合并心脏病变同期处理,比较术前、术后及随访时超声心动图、心电图结果及并发症情况。结果:全组无手术死亡,单纯行改良扩大Morrow术18例,同期冠状动脉旁路移植术1例,二尖瓣成形或置换术5例,主动脉瓣置换术1例,心房颤动改良迷宫术1例。随访3~90个月,左心室流出道压差[(20.3±17.5)vs.(65.2±27.5)mm Hg,1 mm Hg=0.133 k Pa]、最大室间隔厚度[(18.6±6.4)vs.(26.3±5.1)mm]均较术前明显降低,LVEDD[(43.3±4.1)vs.(38.7±4.9)mm]较术前增加,差异均有统计学意义(P<0.05);24例(92.3%)患者NYHA心功能分级Ⅰ或Ⅱ级,较术前明显改善(P<0.01),二尖瓣反流程度减轻(P<0.01),二尖瓣收缩期前向运动现象消失。术后并发症包括:III°房室传导阻滞2例(8.3%);2例患者因切除范围不够致术后残余左心室流出道压差,1例再次行改良扩大Morrow术。结论:肥厚型梗阻性心肌病患者行改良扩大Morrow术可获得良好的近中期效果,不良事件发生率低,远期结果有待进一步随访观察。展开更多
Exotic bush honeysuckles (</span><i><span style="font-family:Verdana;">Lonicera</span></i><span style="font-family:Verdana;"> spp.) are becoming increasingly com...Exotic bush honeysuckles (</span><i><span style="font-family:Verdana;">Lonicera</span></i><span style="font-family:Verdana;"> spp.) are becoming increasingly common in the eastern and mid-western United States, but little is known about their impacts on invertebrates. We used a modified leaf vacuum to sample invertebrates in the shrub strata and understory of three shrub types (and open plots </span><span><span style="font-family:Verdana;">in the understory): single Morrow’s honeysuckle (</span><i><span style="font-family:Verdana;">L</span></i><span style="font-family:Verdana;">. </span><i><span style="font-family:Verdana;">morrowii</span></i><span style="font-family:Verdana;"> A. Gray) shrubs, </span></span><span style="font-family:Verdana;">single native southern arrowwood (</span><i><span style="font-family:Verdana;">Viburnum</span></i></span></span><span><span><i><span style="font-family:""> </span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">recognitum</span></i></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Fernald) shrubs, and dense thickets of Morrow’s honeysuckle, in southwestern PA, USA during 2004 and 2005. We also assessed the degree of </span><a name="OLE_LINK26"></a><a name="OLE_LINK25"></a><span style="font-family:Verdana;">herbivory</span><span style="font-family:Verdana;"> on the two species of shrubs. Within the shrub strata, invertebrate biomass was lower in southern arrowwood shrubs, but there was no difference in invertebrate abundance or family richness. Invertebrate abundance and richness were lowest </span><span style="font-family:Verdana;">in August, but there was no difference in biomass among the months. Invertebrate</span><span style="font-family:Verdana;"> abundance, biomass, and family richness were lowest in the understory below dense thickets of Morrow’s honeysuckle. Overall, the percent cover of herbs was the proximate factor responsible for driving patterns of invertebrate abundance, though ultimately these patterns were being driven by shrub type. Abundance and biomass of larval leaf chewers were highest in the native shrub;Morrow’s honeysuckle had a mean of 29.7 cm</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> of leaf area consumed per 1 m</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> of leaf area, while the native shrub had a mean of 284.3 cm</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> of leaf area consumed. Our results suggest that areas dominated by the exotic shrub negatively impact invertebrate biomass, which may in turn affect organisms at higher trophic levels.展开更多
文摘目的:评价改良扩大Morrow手术(室间隔心肌切除术)治疗青少年肥厚型梗阻性心肌病(HOCM)的早期手术疗效。方法:回顾性分析我院2011年至2015年改良扩大Morrow手术治疗29例青少年(≤21岁)HOCM患者的临床资料,评价早期手术疗效。术前、术后超声心动图检查比较左心房前后径、左心室舒张末期内径、左心室射血分数、室间隔厚度、左心室流出道峰值压差、二尖瓣收缩期前向运动征和二尖瓣反流分级变化,同时抽血检测术前、术后血浆N末端B型利钠肽原水平变化,采用纽约心脏协会心功能分级评估心功能。结果:本组患者中,接受单纯改良扩大Morrow手术者17例(58.6%),同时行冠状动脉旁路移植术者8例(27.6%)。与术前比较,改良扩大Morrow手术后患者的室间隔厚度显著减小[(24.6±6.8)mm vs(16.9±7.1)mm,P<0.01],左心室流出道峰值压差明显降低[(68.8±15.7)mm Hg(1 mm Hg=0.133 k Pa)vs(10.7±4.2)mm Hg,P<0.01],二尖瓣反流明显减轻[(1.7±1.3)级vs(0.2±0.4)级,P<0.01],纽约心脏协会心功能分级显著改善[(3.4±0.8)级vs(1.4±0.5)级,P<0.01],血浆N末端B型利钠肽原水平显著下降[(1957.6±392.5)ng/ml vs(458.7±161.0)ng/ml,P<0.01]。无围手术期死亡。术后第12、24、36个月患者的生存率分别为100.0%、86.7%和86.7%。结论:改良扩大Morrow手术是治疗青少年HOCM安全、有效的手段,术中充分暴露是保证手术效果的重要措施。
文摘目的:总结改良扩大Morrow术治疗肥厚型梗阻性心肌病的临床经验,分析其近中期结果。方法:回顾性分析2012年5月至2019年6月,在我院行改良扩大Morrow术的26例肥厚型梗阻性心肌病患者临床资料。其中女性18例,男性8例,年龄31~67岁,平均年龄(45.6±13.5)岁。所有患者均经主动脉切口行改良扩大Morrow术,合并心脏病变同期处理,比较术前、术后及随访时超声心动图、心电图结果及并发症情况。结果:全组无手术死亡,单纯行改良扩大Morrow术18例,同期冠状动脉旁路移植术1例,二尖瓣成形或置换术5例,主动脉瓣置换术1例,心房颤动改良迷宫术1例。随访3~90个月,左心室流出道压差[(20.3±17.5)vs.(65.2±27.5)mm Hg,1 mm Hg=0.133 k Pa]、最大室间隔厚度[(18.6±6.4)vs.(26.3±5.1)mm]均较术前明显降低,LVEDD[(43.3±4.1)vs.(38.7±4.9)mm]较术前增加,差异均有统计学意义(P<0.05);24例(92.3%)患者NYHA心功能分级Ⅰ或Ⅱ级,较术前明显改善(P<0.01),二尖瓣反流程度减轻(P<0.01),二尖瓣收缩期前向运动现象消失。术后并发症包括:III°房室传导阻滞2例(8.3%);2例患者因切除范围不够致术后残余左心室流出道压差,1例再次行改良扩大Morrow术。结论:肥厚型梗阻性心肌病患者行改良扩大Morrow术可获得良好的近中期效果,不良事件发生率低,远期结果有待进一步随访观察。
文摘Exotic bush honeysuckles (</span><i><span style="font-family:Verdana;">Lonicera</span></i><span style="font-family:Verdana;"> spp.) are becoming increasingly common in the eastern and mid-western United States, but little is known about their impacts on invertebrates. We used a modified leaf vacuum to sample invertebrates in the shrub strata and understory of three shrub types (and open plots </span><span><span style="font-family:Verdana;">in the understory): single Morrow’s honeysuckle (</span><i><span style="font-family:Verdana;">L</span></i><span style="font-family:Verdana;">. </span><i><span style="font-family:Verdana;">morrowii</span></i><span style="font-family:Verdana;"> A. Gray) shrubs, </span></span><span style="font-family:Verdana;">single native southern arrowwood (</span><i><span style="font-family:Verdana;">Viburnum</span></i></span></span><span><span><i><span style="font-family:""> </span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">recognitum</span></i></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Fernald) shrubs, and dense thickets of Morrow’s honeysuckle, in southwestern PA, USA during 2004 and 2005. We also assessed the degree of </span><a name="OLE_LINK26"></a><a name="OLE_LINK25"></a><span style="font-family:Verdana;">herbivory</span><span style="font-family:Verdana;"> on the two species of shrubs. Within the shrub strata, invertebrate biomass was lower in southern arrowwood shrubs, but there was no difference in invertebrate abundance or family richness. Invertebrate abundance and richness were lowest </span><span style="font-family:Verdana;">in August, but there was no difference in biomass among the months. Invertebrate</span><span style="font-family:Verdana;"> abundance, biomass, and family richness were lowest in the understory below dense thickets of Morrow’s honeysuckle. Overall, the percent cover of herbs was the proximate factor responsible for driving patterns of invertebrate abundance, though ultimately these patterns were being driven by shrub type. Abundance and biomass of larval leaf chewers were highest in the native shrub;Morrow’s honeysuckle had a mean of 29.7 cm</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> of leaf area consumed per 1 m</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> of leaf area, while the native shrub had a mean of 284.3 cm</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> of leaf area consumed. Our results suggest that areas dominated by the exotic shrub negatively impact invertebrate biomass, which may in turn affect organisms at higher trophic levels.
