Speckle Tracking Echocardiography Assessment of Global and Regional Contraction Dysfunction in the Mice Model of Pressure Overload

Speckle tracking echocardiography(STE) has been applied to the evaluation of cardiac contraction dysfunction. However, there were few studies on alteration of global and regional STE parameters in the process of myocardial hypertrophy and heart failure. In this study, STE was applied to evaluate the global and regional cardiac function under heart failure and hypertrophy in the mice model of pressure overload. Adult mice were subjected to mild or severe aortic banding with a 25 Gauge(G) or 27 G needle. After surgery, STE and conventional echocardiography were used in the sham group(n=10), mild trans-aortic banding(TAB) group(n=14) and severe TAB group(n=10) for 8 weeks. The results showed that the mice subjected to severe TAB showed a significant change in fractional shortening(FS), left ventricular(LV) mass, and left ventricular end diastolic diameter(LVEDD)(P<0.05 for each). Meanwhile, there were no significant differences in FS and LVEDD between the sham group and mild TAB group during the experimental procedures(P>0.05 for both). STE analysis revealed that longitudinal strain(LS) was significantly decreased in the severe TAB group as compared with the sham and mild TAB groups(P<0.05 for both) from the postoperative week 1. LS in the mild TAB group was reduced as compared to the sham group(P<0.05). Radial strain(RS) and circumferential strain(CS) were significantly decreased in the severe TAB group as compared to the sham group and the mild TAB group(P<0.05 for both) from the postoperative week 1(P<0.05 for both). Compared to the sham group, CS in the mild TAB group maintained unchanged during the test period, and RS was reduced only on the postoperative week 6(P<0.05). Finally, regional contraction dysfunction was analyzed in both hypertrophic and failing myocardium in longitudinal and radial directions. It was found that LS was largest in the apex region and RS was smallest in the apex region in the healthy and hypertrophic myocardium. It was also found that compared to the sham group, only base longitudinal strain in the mild TAB group was decreased. Each of regional strain in the severe TAB group was uniformly depressed in radial and longitudinal directions. It is concluded that STE has provided a non-invasive and highly feasible way to explore the global and regional contraction dysfunction in hypertrophic and heart failure myocardium in the murine model of pressure overload.     

探讨一种新型输尿管通道鞘内芯在输尿管软镜术中的应用研究

目的探讨一种新型的输尿管通道鞘内芯在输尿管软镜术中的应用。方法根据目前临床手术中所使用的输尿管软镜通道鞘结构自行设计出一种新型的输尿管通道鞘内芯,进行体外模型试验以及猪输尿管软镜术实验,观察其使用效果。结果体外模型试验中,通道鞘置入模型后,在显示器屏幕可见模型内管壁,输尿管软镜内灌注冲洗液,同样可见模型内管壁图像;猪输尿管软镜术实验均顺利完成,并且随着操作次数的增加,置鞘时间逐渐变短。实验后所有猪均正常苏醒,未发现输尿管壁损伤,无严重并发症发生。结论新型输尿管通道鞘内芯经过体外模型试验及动物实验,达到了可视下置鞘的目的,并可较好地放置到位,避免了C臂机使用所引起的辐射损伤,是一种全新的置鞘方式,缩短了输尿管软镜术的学习曲线。     

数学建模在输尿管镜术前预测尿源性脓毒血症的作用

目的探究输尿管镜术前预测尿源性脓毒血症的危险因素,初步建立数学模型预测术后尿源性脓毒血症。方法收集2011年12月至2016年12月在本院及浙江省人民医院进行输尿管镜治疗的2105例输尿管结石患者的一般病史资料,通过多元回归分析确定输尿管镜术前预测尿源性脓毒血症的危险因素并建立预测模型。结果肾积水程度、结石直径以及菌尿是输尿管镜术后尿源性脓毒血症发生的危险因素(P0.05);Logistic预测概率模型,公式为P=1/(1+exp-(3.17+1.88×肾积水程度+1.27×结石直径+1.67×菌尿),其作为预测指标,ROC曲线,曲线下面积约为0.891,灵敏度为84.21%,特异度为82.19%。结论肾积水程度、结石直径以及菌尿是输尿管镜术后尿源性脓毒血症发生的独立危险因素,通过这3个独立危险因素建立的输尿管镜术后尿源性脓毒血症发生概率模型预测尿源性脓毒血症的发生具有可行性。     

巨大BPH的开放手术治疗(附16例报告)

目的：探讨巨大BPH行开放手术治疗的方法及效果。方法：回顾性分析16例巨大BPH患者行开放手术治疗的临床资料。结果：早期出现并发症5例，其中术中损伤包膜2例，术后出现大出血1例，排尿困难1例，短期尿禁失1例，其余患者术后均排尿通畅，排尿控制良好。结论：开放手术治疗巨大BPH，其梗阻解除彻底，是一种合理的治疗方法。恰当的手术方法是提高疗效及降低并发症的关键。     

闭合性肾损伤138例诊治体会

目的：提高闭合性肾损伤诊治效果。方法：回顾分析138例闭合性肾损伤的诊治占同期各种多发性损伤4．71％（138／2934)。结果：血尿136例（98．55％）。B超检查137例，其中110例（80．29％），有异常表现。CT检查69例，阳性63例(90．3％）。多发伤67例(48．91％）。保守治疗110例，成功105例，并发症5例，（4．5％）。治愈率(95．45％）。随访75例1-3年，尿常规，肾功能正常。结论：尿液检查和B超检查快速安全损伤，CT检查准确丰高，并能同时了解其它脏器损伤的程度。如果损伤严重，需行外科处理，应及时手术探查。     

酷似肺炎的肺腺癌伴肠型分化1例报告

腺癌是最常见的肺癌组织学亚型,但肺腺癌伴肠型分化为罕见的原发肺腺癌组织类型[1].近期我们诊断1例酷似肺炎的肺腺癌伴肠型分化患者,报道如下.     

前列腺导管腺癌3例诊治分析

前列腺导管腺癌（ductal adenocarcinoma of the prostate,DAP）是前列腺癌罕见的亚型,早期常缺乏前列腺质硬结节或血清前列腺特异性抗原（PSA）升高等典型临床表现,故确诊时肿瘤常分期较晚。目前,临床上关于DAP的来源及诊治等仍存在争论。近年来,余杭第二人民医院及浙江大学医学院附属第一医院共收治3例DAP患者,现对其作一回顾性分析,报道如下。     

表达心脏SCN5A基因的人胚肾细胞钠电流特性及其对钠通道阻滞剂的反应性

目的 利用人胚肾293细胞表达心脏钠通道SCN5A基因并研究其钠电流特性和对钠通道阻滞剂的反应性.方法 野生型SCN5A基因和SCN1B基因共表达于人胚肾293细胞,应用全细胞膜片钳技术记录给药(氟卡尼与利多卡因)前后的钠电流.结果 SCN5A基因转染效率约为60%;测试电压为-40 mV时记录到钠电流峰值大小约为-8 nA;100 μmol/L的氟卡尼轻度抑制钠电流,使钠电流峰值减少(21.1±4.6)%[(-435.8±30.5) pA/pF vs.(-343.9±27.1) pA/pF,P＜0.01];氟卡尼使钠通道激活曲线和失活曲线均呈负向移动,改变的幅值分别是-6.08 mV[(-51.88±1.20) mV vs.(-57.96±0.79) mV,P＜0.05]和-9.08 mV[(-94.12±0.13) mV vs.(-103.20±0.11) mV,P＜0.05];1 Hz和10 Hz频率刺激时,氟卡尼使钠电流分别减少(64.5±10.7)%和(83.5±12.2)%(P＜0.01);30 μmol/L利多卡因使钠通道失活后快恢复时间常数和慢恢复时间常数分别延长2倍和3倍.结论 表达心脏钠通道SCN5A基因的人胚肾293细胞模型可用于基因特异性的钠通道阻滞剂安全性与药效学筛查.     

云南白药气雾剂与推拿?法对兔骨骼肌损伤急性期核因子-κB信号通路及炎症因子变化的影响

目的 通过观察核因子-κB(NF-κB)信号通路和炎症因子相关指标,分析骨骼肌损伤急性期云南白药气雾剂与推拿?法分别对兔骨骼肌损伤修复的影响,探究其对骨骼肌损伤修复的作用机制。方法 选取32只新西兰兔,用随机分组的方法分为空白组、模型组、?法治疗组及云南白药组,每组8只,每组进一步随机分为2个亚组(对应损伤后24 h、72 h),每个亚组4只。除空白组外,其余各组采用重力锤形成钝挫伤造模,在损伤后24 h、72 h?法治疗组用自制?法按摩器治疗3 d,云南白药组用云南白药气雾剂治疗3 d。治疗结束后24 h,采用苏木精-伊红(HE)染色观察局部受损组织,酶联免疫吸附试验(ELISA)检测受损组织中肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)含量;Western blot法检测受损组织NF-κB p65蛋白和核因子-κB抑制蛋白α(IκBα)含量。结果 (1)HE结果显示:与空白组比较,模型组炎症浸润,肌肉损伤严重,造模成功;与模型组比较,24 h时?法治疗组肌纤维断裂严重,中性粒细胞广泛释放;与模型组比较,24 h、72 h时云南白药组与72 h时?法治疗组损伤程度减轻,...