超声导向肝组织微波固化的实验研究

目的：探讨不同穿刺方案形成的肝组织微波凝固区的大小、形态，为临床治疗，特别是大肝癌的治疗，提供实践基础。方法：利用离体新鲜牛肝，比较ＵＭＣ－Ｉ型微波仪单针、两针及多针组合所形成凝固区的大小、形态。结果：单针穿刺可形成３．０ｃｍ×４．０ｃｍ头宽尾窄的滴水状凝固区。两针组合，距离在２．５～３．０ｃｍ之间造成的完全凝固区最大。不同穿刺方案，可形成８ｃｍ以下不同直径的球形凝固区。结论：适当的穿刺方案可使８ｃｍ以下的球形区域完全凝固     

Should Radiofrequency Therapy Be Performed in Every Symptomatic Patient with Supraventricular Tachycardia? (Pro Drug Position)

The indication for treatment of paroxysmal supraventricular tachycardia depends on the frequency and severity of the tachycardia attacks. If the tachycardia attacks are mildly symptomatic and occur only once or twice a year, there is no indication for either continuous drug therapy or radiofrequency oblation. The only therapeutic measure required is termination of each acute event. If symptoms occur frequently, long-term antiarrhythmic drug therapy is then indicated and will be effective for chronic prophylaxis in most individuals with a low risk of proarrhythmic events. Only in patients with severe or life-threatening symptoms or cases refractory to drug therapy would radiofrequency ablation possibly be justified.     

射频消融治疗房室结折返性心动过速

评价射频消融治疗室上性心动过速的安全和有效性。方法：１１例房室结折返性心动过束这患者，采用下位法或中位法消融慢径。结论：ＲＦＡ治疗ＡＶＮＲＴ效果佳，方法安全可靠。／     

心房颤动治疗的未来发展方向——混合消融

心房颤动是临床常见的心律失常,已有研究证明其与严重不良心脑血管事件(心力衰竭、脑卒中和心肌梗死)有关,目前全球心房颤动的患病人数超过了3 300万,预计未来40年内其患病率将增加1倍以上。多年来,医学相关人员在探究心房颤动的病理生理机制及开创改进其治疗方法等方面付出了大量努力。目前心房颤动的治疗管理仍是临床医学上的一个难题,尽管心房颤动治疗的手术消融和导管消融技术已逐渐趋于成熟,但对于心房颤动最佳的治疗方式、消融能量的选择尚无统一定论。导管消融通常需要多次手术且成功率低,而手术消融术后不良事件发生率较高。近年来,鉴于心脏外科医生和电生理学家之间的密切合作,结合导管及微创手术消融诞生了一种治疗心房颤动的新型策略——混合消融模式。混合消融克服了导管消融和微创手术消融的缺点,减少了不良结局,在治疗持续性心房颤动,尤其是长期持续性心房颤动上取得了可观的成效。本文主要通过回顾心房颤动消融的研究进展,对比分析目前混合消融模式治疗心房颤动的现有研究成果,归纳总结这种新型心房颤动治疗策略的优势与挑战,以期为临床心房颤动的治疗提供更多选择。     

基于FT-CMR的心脏功能评估参数对心房颤动冷冻球囊消融患者治疗后复发的预测效能分析

目的 探讨分析基于心脏磁共振特征追踪技术(FT-CMR)的心脏功能评估参数对心房颤动冷冻球囊消融患者治疗后复发的预测效能。方法 选取2019年6月至2020年12月收治的126例预行冷冻球囊消融术的心房颤动患者为研究对象,术前均进行心脏磁共振检查,根据术后6个月内患者有无复发将其分为窦性心律组72例和房颤复发组54例。比较两组患者左心房应变及应变率参数,采用FT-CMR评估患者心脏功能,并进行单因素、多因素logistic回归分析,探讨FT-CMR心脏功能评估参数对心房颤动冷冻球囊消融术后复发的预测价值。结果 房颤复发组患者女性、高血压、糖尿病、非阵发性心房颤动比例显著高于窦性心律组(P<0.05)。房颤复发组患者左心房总应变(Es)、左心房正向应变率峰值(SRs)、左心房被动应变(Ee)、心室舒张早期负向应变率峰值(SRe)、左心房整体纵向应变(PLAS)参数值低于窦性心律组(P<0.05)。Logistic多因素回归分析结果显示,性别(OR=3.511,95%CI:1.036～11.906)、PLAS(OR=1.089,95%CI:1.039～1.141)是心房颤动冷冻...     

经皮射频消融与手术切除治疗直径≤ 3 cm原发性小肝癌的疗效分析

目的 分析经皮射频消融（PRFA）与手术切除治疗直径≤3 cm原发性小肝癌的疗效。方法 选取2015年1月—2017年6月兰州市第二人民医院收治的原发性小肝癌患者78例。将36例接受PRFA治疗的患者作为观察组,另外42例行手术切除的患者作为对照组。采用全自动生化分析仪检测血清谷草转氨酶（AST）、谷丙转氨酶（ALT）、总胆红素（TBIL）水平,电化学发光全自动免疫分析仪检测血清甲胎蛋白（AFP）水平。结果 观察组手术时间、术中出血量、住院时间均少于对照组（P <0.05）;观察组治疗前后AST、ALT、TBIL、AFP的差值均高于对照组组（P <0.05）。两组术后并发症比较,差异无统计学意义（P>0.05）;两组治疗后1、2、3、5年的生存率和复发率比较,差异均无统计学意义（P>0.05）。结论 与手术切除比较,PRFA治疗直径≤3 cm原发性小肝癌可缩短手术时间,减少术中出血量,促进肝功能恢复,但两者术后并发症发生率、生存率和复发率接近。     

Radiofrequency Ablation of Symptomatic but Benign Ventricular Arrhythmias

Two cases are presented where ablation of severely symptomatic ventricular arrhythmias not responding to medical therapy was accomplished with radiofrequency current application. After a routine programmed stimulation protocol, a quadripolar ablation catheter with a 4-mm tip was advanced percutaneously into the left ventricle in one case and into the right ventricle in the second case; and after precise pace mapping, the arrhythmogenic focus was successfully ablated using radiofrequency current. The postablation ambulatory recording revealed virtual eradication of ventricular ectopy in both cases. In conclusion, in severely symptomatic cases of "benign" ventricular arrhythmias, radiofrequency ablation offers an effective therapeutic alternative.     

He-Ne激光、微波、红外线和TDP灯照射对血粘度与红细胞影响的比较研究

目的比较研究He-Ne激光、微波、红外线和TDP灯照射对高血粘的影响,探索能否利用He-Ne激光、微波、红外线和TDP灯照射降低血液粘度,改善血循环.方法每份血样等分5份,1份作对照,对另外4份分别作He-Ne激光、微波、红外线和TDP灯照射处理.结果高血粘血样经He-Ne激光、微波、红外线和TDP灯照射作用后,全血表观粘度η降低(P＜0.01)、红细胞电泳率EPM加快(P＜0.01),血沉速度ESR提高(P＜0.01),一氧化氮、全血黏度、全血还原黏度降低(P＜0.01).红细胞变形指数降低(P＜0.01),红细胞聚集时间增加(P＜0.01),红细胞压积降低(P＜0.01),纤维蛋白降低(P＜0.01).结论He-Ne激光、微波、红外线和TDP灯照射能改善高血粘血样的流变特性.而且激光效果最好,依次是TDP灯、微波和红外线.进一步了解物理与临床治疗的密切关系.     

Retention of successive position reversals in rats with septal and fronto-polar lesions

Eight successive position reversals were given preoperatively to establish position reversal sets in rats. Six animals received septal lesions, six fronto-polar cortex ablations, and six normals served as a control group. During a series of eight postoperative reversals, rats with septal lesions committed significantly more errors and approach errors than normals while fronto-polar ablations had no detectable effect.     

Temporal-spatial ablation of neural crest in the mouse results in cardiovascular defects.

Neural crest cells are thought to play a critical role in human conotruncal morphogenesis and dysmorphogenesis. Much of our understanding of the contribution of neural crest to cardiovascular patterning comes from ablation and transplantation experiments in avian species. Although fate mapping experiments in mice suggests a conservation of function, the functional requirement for neural crest in cardiovascular development in mammals has not been formally tested. We used a novel two component genetic system for the temporal-spatial ablation of neural crest in the mouse. Affected embryos displayed a spectrum of cardiovascular outflow tract defects and aortic arch patterning abnormalities. We show that the severity of the cardiovascular phenotype is directly related to the level and extent of neural crest ablation. This is the first report of cardiac neural crest ablation in mammals, and it provides important insight into the role of the mammalian neural crest during cardiovascular development.