1405例冠状动脉旁路移植、激光心肌血运重建术的临床分析

目的总结冠心病患者行冠状动脉旁路移植术(CABG)和激光心肌血运重建术(TMLR)中的治疗难点、围术期处理要点,以提高冠心病患者的外科治疗效果。方法1997年5月~2006年1月,1405例冠心病患者中在体外循环下行CABG825例,其中单纯CABG666例,CABG+心瓣膜手术98例,CABG+室壁瘤手术55例,CABG+左心房粘液瘤摘除术2例,CABG+室间隔穿孔修补术2例,CABG+升主动脉成形术1例,CABG+纵隔内肿瘤切除术1例;非体外循环下CABG(OPCAB)500例;单纯TMLR30例,CABG+TMLR50例。结果每例移植旁路血管2.9±1.0支。住院死亡42例(3.0%),死亡原因包括出血、心肌梗死、低心排血量综合征、肾功能衰竭、多器官功能衰竭等。术后发生并发症70例,包括出血、低心排血量综合征、心肌梗死、肾功能不全等,均经积极的对症处理后治愈或好转。术前心绞痛(CCS)为~级的1177例患者中,术后1154例(98.0%)改善为0~级。术后随访857例(62.9%),随访时间8.3±2.9个月。随访6个月时788例(91.9%)无心绞痛发作,复查超声心动图提示:左心室射血分数0.66±0.10,较术前提高7.9%,生活质量较术前大为提高。结论CABG已成为治疗冠心病最有效的常规手术,只要能正确掌握适应证,有效地加强围术期管理,便可以扩大手术适应证范围,降低手术死亡率和并发症发生率,提高手术疗效。     

AGFA LR5200激光相机的保养与维护

阐述了AGFALR5200激光相机的工作原理、日常使用保养。     

A stereotactic approach to deep-seated central nervous system neoplasms using the carbon dioxide laser

This report describes a technique in which deep-seated CNS neoplasms, the volume and shape of which had been determined and stereotactically localized by computer reconstruction of CT data, were vaporized with a carbon dioxide laser attached to a stereotactic frame. The clinical results with 6 patients treated by this technique are presented.     

鼻内镜下激光凝固中鼻甲前端治疗变应性鼻炎

（1）目的 探讨鼻内窥镜下Nd:YAG激光治疗变应性鼻炎的方法。（2）方法 应用鼻内镜下Nd:YAG激光凝固中务甲前1／3端治疗变应性鼻炎126例。（3） 结果 随访1年，显效109例（86．5％），有效13例（10．3％），无效4例（3．2％），总有效率96．8％。（4）结论 鼻内镜下Nd:YAG激光凝固中鼻甲前1．3端治疗变应性鼻炎，具有视野清楚，操作简便，疗效好等优点，值得临床应用。     

荷瘤鼠乳腺癌组织的飞秒双光子荧光诊断

目的：检测荷瘤鼠乳腺癌组织的双光子荧光光谱。方法：乳腺癌荷瘤鼠腹腔注射血卟啉（HpD)。以飞秒激光照射小鼠的癌组织部位及周围正常组织部位。观察HpD双光子荧光光谱。结果：小鼠的癌组织部位可观察到外源性HpD双光子荧光光谱，而正常组织部位未观察到明显的双光子荧光光谱。结论：结论：飞秒激光外源性血卟啉双光子荧光诊断可作为癌症诊断的新方法。     

YAG激光器谐振腔光振状态的调整

本文介绍了调整谐振腔光振状态的方法和要点，它包括调整谐振腔体和其它的光学部件。本法可应用于YAG激光器谐振腔的维修拆卸重装工作中。     

Histological and clinical responses of articular cartilage to low-level laser therapy: Experimental study

This study was carried out to evaluate the effects of low-level laser irradiation on experimental lesions of articular cartilage. A standard lesion was practised on the femoral trochlea of both hindlimbs of 20 clinically normal Californian rabbits. These animals were divided into two groups of 10 individuals each, depending on the laser equipment used for treatment. Onc group was treated with He-Ne laser (8 J cm^-2, 632.8 nm wavelength) and the other with infra-red (IR) laser (8 J cm^-2, 904 nm wavelength). In both groups, five points of irradiation to the right limb alone were irradiated per session for a total of 13 sessions, applied with an interval of 24 h between sessions. These points were the following: left and right femoral epicondyles, left and right tibial condyles and the centre of articulation. The distance between these points was approximately 1 cm. The untreated left limb was left as a control. During treatment, extension angle and periarticular thickness were considered. At the end of the treatment, samples were collected for histopathologi-cal study and stained with: Haematoxylin-Eosin, PAS and Done. The results show a statistically higher anti-inflammatory capacity of the IR laser (p < 0.0001). The functional recovery was statistically similar for both treatments (p < 0.176). Histological study showed, at the end of the treatment, hyaline cartilage in the IR group, fibrocartilage in the He-Ne group and granulation tissue in the control limbs. Clinical and histological results indicated that this laser treatment had a clear anti-inflammatory effect that provided a fast recuperation and regeneration of the articular cartilage.     

Development and experimental in vivo validation of mathematical modeling of laser coagulation

Most clinical procedures using the laser are based on thermal laser-tissue interactions. The treatment often consists of inducing damage of given degree and extent by heating the tissue. The aim of this study was to develop a model called HELIOS. The ability of HELIOS to predict thermal coagulation was evaluated by comparison with in vivo experimental results. Conversion of laser light in tissue was studied using the beam-broadening model. Temperature was described by the heat conduction equation solved using the finite difference method. The tissue dena-turation was modeled by the Henriques equation leading to the determination of the damage coefficient ω. For a given set of laser and tissue parameters, HELIOS makes a graphic representation of coagulation necrosis and temperature evolution in tissue. HELIOS was validated by experimental studies in vivo on rat liver using a CW Nd:YAG laser, a CO₂ laser, and an argon laser. For given sets of laser parameters, temperature measurements were performed using an infrared camera. Histological examinations were carried out on samples to quantify the depth of coagulation necrosis. Experimental data obtained in vivo were compared with those calculated using HELIOS and similar sets of parameters. The difference between the predicted temperature evolution on tissue surface and that measured by the infrared camera was < 5°C in all cases. The difference between the predicted coagulation necrosis depth and the corresponding experimental one was < 10%. In conclusion, HELIOS allows good prediction of tissue temperature and coagulation necrosis. © 1994 Wiley-Liss, inc.     

Skin reactions to irritants assessed by non-invasive bioengineering methods

Pathophysiological components of irritant contact dermatitis caused by 3 chemically-different irritants were investigated. 20 healthy volunteers were patch tested with sodium lauryl sulphate, nonanoic acid and hydrochloric acid on the flexor side of the upper arm. The skin response was evaluated after 24, 48 and 96 h by visual scoring and measured by the following bioengineering methods: transepidermal water loss measurement, electrical conductance for measurement of skin hydration, laser Doppler flowmetry for measurement of cutaneous blood flow and 20 MHz ultrasound A-scan for measurement of skin thickness. In spite of homogeneous inflammatory responses, significant differences in the severity of the injury to the skin barrier function caused by the different irritants were found. Also significant differences between irritants were found in the time course of development of maximum irritant reactions. Bioengineering methods indicating inflammatory responses (measurement of blood flow and skin thickness) were helpful in quantifying the irritant response in general, while bioengineering methods indicating epidermal damage (measurement of TEWL and electrical conductance) were helpful in classifying the individual irritants.     

经尿道非接触式激光前列腺切除技术的应用与改进

１９９３年１１月至１９９６年５月应用改进的经尿道非接触式激光治疗前列腺增生１２０例，并对病人进行术前术后的症状评分，尿动力学，残余尿检查，随访病人１－２４个月，结果显示病人无论是症状评分，还是尿流率，残余尿等各项指标均有明显的改善，此种手术具有简单，安全，副作用小，术后恢复快，治疗效果好等优点。