ULTRASONOGRAPHIC LOCALIZATION OF A CAUDAL VENA CAVA THROMBUS IN A DOG WITH LEISHMANIASIS

A dog with visceral leishmaniasis developed rear limb edema, and distension of the caudal epigastric veins. Glomerular disease with nephrotic syndrome and hypercoagulable state was diagnosed. Sonographically there was massive thrombosis of the caudal vena cava.     

D-Dimer Improves the Prognostic Value of Combined Clinical and Laboratory Data in Equine Gastrointestinal Colic

The discriminating ability of 15 parameters alone or in combinations, including results from analysis of plasma endotoxin, the Nycomed plasma D-Dimer test and phospholipase A₂, were analyzed to predict morbidity and mortality in equine gastrointestinal colic. Endotoxaemia was a characteristic feature of the colic horses. The problem of adequately predicting non-survivors among colic horses required several parameters to be included in the logistic model: if the “classical parameters”, (heart rate, respiratory rate, PCV, anion gap) were included in the model, addition of plasma D-dimer, phospholipase A₂, and Cl^- significantly improved the predictive value of the logistic model. Increasing heart rate and D-dimer together with decreasing chloride was a risk factor for nonsurvival. The sensitivity of this three-parameter logistic model to predict nonsurvival was 78% and specificity 77%. The Nycomed D-Dimer test is recommended as a horse-site test to predict disseminated intravascular coagulation and nonsurvival in equine colic.     

苗药小血藤对缺血性脑卒中大鼠的作用研究

目的 研究苗药小血藤对缺血性脑卒中大鼠的治疗作用,并初步探讨其可能的作用机制。方法 用改良线栓法制作大鼠大脑中动脉闭塞（middle cerebral artery occlusion,MCAO）模型。将造模成功的大鼠随机分为假手术组、模型组、阳性组、苗药小血藤高、中、低剂量组（3.75、1.875、0.937 5 g/kg）,给予相应药物1次/d灌胃给药,连续7 d。TTC染色观察脑梗死面积;试剂盒检测血清超氧化物歧化酶（superoxide dismutase,SOD）、丙二醛（maleic dialdehyde,MDA）含量;HE染色观察脑组织病理改变。结果 与模型组比较,小血藤水煎液各剂量组脑梗死面积明显减少（P<0.05）,大鼠脑组织匀浆中所含SOD活性显著提高（P<0.05）;MDA含量显著降低（P<0.05）;HE染色发现,小血藤水煎液各剂量组可一定程度上改善MCAO大鼠海马区病理损伤。结论 小血藤水煎液对MCAO导致的脑缺血大鼠可以减少梗死面积,促进其神经功能恢复,对缺血造成的损伤具有一定的保护作用,其机制可能与小血藤抗氧化应激损伤有关。     

血液透析患者动静脉内瘘血栓形成的治疗方法探讨

目的总结血液透析患者动静脉内瘘后血栓形成的治疗经验。方法 156例动静脉内瘘后血栓形成患者,早期采用溶栓治疗,而晚期采用手术治疗。结果 47例采用溶栓治疗,成功率为53.2%,其中6h内、6h后溶栓成功率分别为85.7%、26.9%(P<0.01)。131例(含溶栓失败22例)手术治疗者中,成功率为84.7%,其中静脉-动脉端侧吻合、取栓加吻合口扩张的成功率分别为94.2%、48.1%(P<0.01)。结论动静脉内瘘后血栓形成患者在阻塞6h内采用溶栓治疗,而阻塞超过72h者首选静脉-动脉端侧吻合手术。     

维持性血液透析患者Palindrome导管晚期功能不良相关因素的Cox回归分析

目的探讨维持性血透(MHD)患者Palindrome导管晚期功能不良的相关因素。方法收集53例使用Palindrome导管的MHD患者临床资料,用Cox风险回归分析导管晚期功能不良的相关因素。结果单因素Cox回归分析显示原发病、置管部位、临时导管留置时间、低血压发生次数、红细胞压积、超滤率与导管晚期功能不良相关(P<0.01或0.05)。多因素Cox回归分析显示置管部位、红细胞压积、超滤率是导管晚期功能不良的独立影响因素(P<0.01或0.05),相对危险度分别为2.310、1.254、1.623。结论置管部位、红细胞压积、超滤率是MHD患者Palindrome导管晚期功能不良的独立影响因素。     

Thromboelastography: a tool for measuring hypercoagulability, hypocoagulability, and fibrinolysis

Objective: To describe the technique of thromboelastography (TEG) and review the applications of this coagulation test in humans and small animals. Data sources: Data sources included scientific reviews and original research publications. Human data synthesis: TEG in humans has been used for documentation of hypercoagulable and hypocoagulable states and has been shown to be beneficial in patient management. Veterinary data synthesis: Clinical evaluation of TEG in veterinary medicine is limited; however, recent reports have documented evidence of hypercoagulability in dogs with parvovirus and protein‐losing nephropathy. Additionally, many of the research models may be relevant to veterinary patients. Conclusions: TEG provides information about coagulation that is not available through routine coagulation tests. The application of TEG monitoring to veterinary patients shows promise; however, prospective clinical studies are needed.     

THE HILAR PERIVENOUS HYPERECHOIC TRIANGLE AS A SIGN OF ACUTE SPLENIC TORSION IN DOGS

Diagnosis of acute primary splenic torsion is challenging. The ultrasonographic appearance of this condition has been described, but other splenic diseases, such as diffuse infarction because of thrombosis, can appear very similar. We describe an additional ultrasonographic sign of acute splenic torsion; a triangular hyperechoic area at the hilus between the veins and the splenic parenchyma that is continuous with the hyperechoic mesentery. In a group of animals where acute splenic torsion was part of the ultrasound report differential diagnosis, we compared findings in dogs with torsion with findings in dogs with other splenic conditions. The presence of a hilar hyperechoic perivenous triangle was significantly associated with splenic torsion (P = 0.005). We speculate that this sign is associated with torsion because of the secondary severe, diffuse splenic enlargement. Although not pathognomonic, this sign could be used to more accurately diagnose splenic torsion in light of other findings consistent with this condition.     

ULTRASONOGRAPHY OF THE FEMORAL ARTERY IN SIX NORMAL HORSES AND THREE HORSES WITH THROMBOSIS

Ultrasonography of the femoral artery in the horse, including color, power and spectral Doppler, provides morphologic and dynamic information. This paper describes the use of the techniques in six clinically normal horses and three with femoral artery thrombosis. Useful landmarks for orientation are the saphenous artery and the medial saphenous vein. The lateral circumflex femoral artery can not be visualized. Recognition of the genus descendens artery is complicated due to the presence of multiple distal caudal femoral arteries. The femoral artery feeds a high resistance bed. In normal horses the peak systolic velocity varies between 50–90 cm/sec. Echoic tissue in the femoral artery lumen with stenosis, occlusion and collateral blood flow formation are features encountered in the patients.