斑点追踪技术研究冠状动脉介入术对左室心功能的影响

目的探讨二维斑点追踪成像(STI)技术的心肌扭转与旋转指标对评价急性前壁心肌梗死(AMI)的意义。方法 49例患者PCI术前和术后72 h内行超声心动图检查,进行常规超声参数及STI参数测定。结果常规超声指标仅LVEF值有统计学意义(P<0.05);前壁心尖段术后局部扭转速度与解旋速度较术前提高,扭转时间与解旋减半时间较术前减少,左室基底段和心尖段的整体解旋角度术后均增加(P﹤0.05)。结论 STI技术的左室扭转解旋指标可定量评价心肌梗死患者术后左心整体与节段舒缩功能。     

斑点追踪技术对评价急性心梗患者 PCI术后左室功能恢复的临床应用价值

目的：应用二维斑点追踪显像技术（ STI）检测急性心肌梗死（ AMI）患者在经皮冠状动脉介入治疗术（PCI）前后不同时期左心室收缩及舒张功能的变化,探讨斑点追踪显像技术对定量评价再灌注后心肌功能恢复的临床应用价值。方法选择成功行PCI术治疗的急性心肌梗死患者35例,分别于PCI术前、术后7天及术后2个月行超声心动图检查及相关参数采集,并选择同期健康体检者32例作为对照组进行相同检查及图像采集分析。测量二尖瓣E峰和A峰,并计算出E／A值;用改良的Simpson′s公式测量左心室射血分数（ LVEF）;采用斑点追踪显像技术测量狭窄冠脉供血的缺血心肌和正常冠脉供血的非缺血心肌应变指标： LS、RSpeak、TP、SRe及SRa值。结果急性心肌梗死会导致心脏整体及局部的收缩及舒张功能改变,再灌注后,心肌舒张功能的恢复较收缩功能需更长时间;心脏整体功能恢复正常时,其局部心肌运动功能仍可存在异常。结论应用STI技术可以定量评价急性心肌梗死患者经PCI术治疗后左心室的整体及局部功能的恢复情况。     

多普勒组织成像对冠心病患者PCI术后左室舒张功能的评价

目的应用多普勒组织成像（DTI）对冠心病患者PCI术后左室舒张功能进行评价,为临床治疗提供帮助。方法测定冠心病患者PCI术后的左室舒张功能,指标包括：二尖瓣口舒张期血流速度E和A峰、E/A值;二尖瓣环舒张早期运动速度（Ea）以及舒张晚期运动速度（Aa）,Ea/Aa值。结果与对照组比较,冠心病组二尖瓣环DTI的Ea值、Ea/Aa比值有非常显著性差异（P〈0.01或P〈0.05）,E、E/A比值有显著性差异（P〈0.05）。结论利用DTI可对左室整体舒张功能进行评价。     

心功能彩超新技术的应用研究

目的:本文报道了自行研制的组织多普勒(DTI)直条图、舒张早期左室流入血流色阶图、曲线M型超声心肌速率阶差(MVG)等彩超新技术,并将其应用于分析心肌梗死(AMI)的局部心肌运动与测定左心室舒张功能。材料和方法:选择心肌梗死患者30例,对照组26例。用常规仪器采集彩超图像,用自制彩超分析系统作图像分析。结果:①自行研制的彩超分析系统能够显示心肌DTI直条图,AMI组8个心肌局部心肌节段收缩运动速率均较对照组显著下降(P<0.001);②AMI组的舒张早期左室流入血流平均压力阶差较对照组显著减低(P<0.001)。③AMI组的MVG均明显较对照组降低(P<0.001)。结论:本文报道的DTI直条图、舒张早期左室流入血流色阶图、曲线M型超声MVG技术,适合我国基层医院应用于普通彩超仪,进行心脏功能分析。     

多巴酚丁胺超声心动图检测存活心肌的局限性研究

目的利用小剂量多巴酚丁胺超声心动图（LDDE）识别存活心肌,并对冠脉再通术前后心脏收缩功能进行对比研究,阐述多巴酚丁胺（Dobu）超声心动图检测存活心肌的局限性。方法选择急性前壁心梗（AMI）4周后左前降支（LAD）完全闭塞或濒临闭塞病变,拟行介入性治疗（PCI）的患者20例,PCI术前进行LDDE,根据收缩性储备功能（CR）分组：有CR组和无CR组,对术前静息、术前小剂量Dobu、术后静息状态下进行左室舒张末容积指数（EDVI）、左室收缩末容积指数（ESVI）、室壁运动积分指数（WMSI）、左室射血分数（LVEF）进行分组对比分析。结果 LDDE术前判断无收缩功能的心肌（无CR组）,PCI术后部分恢复收缩功能（占32%）,其LVEF术前、术后对比亦有明显差异（P〈0.05）。结论多巴酚丁胺超声心动图术前检测存活心肌具有一定的局限性。     

冠状动脉搭桥术与冠状动脉介入术患者左心室收缩功能的评估

目的 比较冠状动脉搭桥术(CABG)或经皮冠状动脉介入术(PCI)对心脏收缩功能的影响。方法 采用回顾性分析方法,CABG组28人,PCI组33人,应用Acuson公司的Aspen彩色多谱勒超声诊断仪,于术前、术后3个月和术后6个月进行多谱勒组织成像(DTI)及常规超声心动图检查患者心脏收缩功能。结果 CABG及PCI术后,左室射血分数(EF值)及应用DTI技术检测的二尖瓣环四点(室间隔、侧壁、前壁、下壁)收缩期主峰速度的平均值(S值)均较术前提高,但两种手术对左室EF值及S值改善情况差异无统计学意义。结论 GABG及PCI重建冠心病患者心肌血运后,存活心肌功能逐步恢复,左室收缩功能逐步改善;这两种手术方法在改善冠心病患者左室收缩功能方面无显著差异。     

脉冲多普勒组织成像频谱速度图对肥厚性心肌病左室功能的评价作用研究

目的应用脉冲多普勒组织成像(DTI)频谱速度图测量肥厚性心肌病(HCM)二尖瓣环4个节段的运动速度，以评价患者左室收缩和舒张功能。方法对HCM组(n=30)和正常对照组(n=25)分别测量射血分数(EF)、室壁厚度、二尖瓣血流速度(E、A、E／A)、等容舒张时间(IVRT)及肺静脉血流速度(S、D、A)，并用DTI脉冲频谱速度图分别测量两组二尖瓣环4个节段(室间隔、侧壁、前壁、下壁)的收缩期峰值速度(Sa)和舒张期峰值速度(Ea、Aa)以及IVRT。结果常规超声检查：HCM组室间隔、后壁较正常对照组明显增厚，IVRT、DT延长，EF、二尖瓣血流速度两组间未见明显差别。DTI检查：HCM组二尖瓣环4个节段收缩期和舒张早期速度都较正常对照组减低，IVRT延长，提示心肌主动收缩和舒张功能都减弱，E／Ea比值增加，提示左房充盈压增高。另外，HCM组二尖瓣环的各节段中，室间隔段收缩期和舒张早期速度最低，且与平均收缩期、舒张早期速度相关性最强，提示心肌越肥厚，对局部心肌的收缩和舒张功能影响越明显。结论DTI技术可以定量评价肥厚性心肌病患者左室收缩和舒张功能，并且比常规超声指标更加敏感。     

定量组织速度成像对冠心病节段舒张功能的临床评价

探讨定量组织速度成像（QTVI）评价冠心病左室节段舒张功能的临床应用价值。应用QTVI检测40名正常人与30例冠心病患者左室长轴方向等容舒张期、快速充盈期、心房收缩期节段心肌运动速度VIR、VE、VA和VE/VA比值以及二尖瓣口血流频谱的快速充盈速度（E）、左房收缩充盈速度（A）和E/A比值，并进行对比分析。结果显示，冠心病患者缺血心肌节段舒张早期峰值速度较正常人降低，VE/VA比值小于1。提示QTVI能敏感定量评价左室心肌节段舒张功能导演，对冠心病节段心肌缺血的早期诊断有重要价值。     

应用血流向量成像评价AMI患者PCI术前术后左室涡流变化特点

【摘要】 目的：应用血流向量成像（VFM）技术评价急性心肌梗死（AMI）患者经皮冠状动脉介入术（PCI）术前、术后左心室收缩期涡流状态变化。方法：选择健康检查者25例（正常对照组）和AMI患者30例（AMI组）,分别对健康检查者和AMI患者PCI术前、术后1个月行超声心动图检查,采集连续三个心动周期标准三切面彩色血流动态图,分析左心室收缩期涡流横径、纵径、横向、纵向位置及最大向量速度,比较涡流在正常对照组、AMI组术前、术后的变化并进行统计学分析。结果：与正常对照组相比,AMI组术前左心室收缩早期涡流纵径增大［分别为（27.08±4.37）和（21.64±5.41）min,P<0.05］,最大向量速度减小［分别为（25.23±8.42）和（32.83±12.23）cm/s,P<0.05］。术后1个月AMI组涡流流量、强度、最大向量速度较术前增加（P<0.05）。结论：健康成人左心室收缩期涡流遵循一定的规律,AMI患者左室收缩期涡流不规则,导致能量的损耗,PCI术后患者的涡流状态有所改善。VFM技术为评价急性心肌梗死患者及PCI术前、术后心腔内血流变化提供了一种新途径。     

应用血流向量成像评价AMI患者PCI术前术后左室涡流变化特占

目的：应用血流向量成像（VFM）技术评价急性心肌梗死（AMI）患者经皮冠状动脉介入术（PCI）术前、术后左心室收缩期涡流状态变化。方法：选择健康检查者25例（正常对照组）和AMI患者30例（AMI组）,分别对健康检查者和AMI患者PCI术前、术后1个月行超声心动图检查,采集连续三个心动周期标准三切面彩色血流动态图,分析左心室收缩期涡流横径、纵径、横向、纵向位置及最大向量速度,比较涡流在正常对照组、AMI组术前、术后的变化并进行统计学分析。结果：与正常对照组相比,AMI组术前左心室收缩早期涡流纵径增大[分别为（27．08±4．37）和（21．64±5．41）min,P〈0．05],最大向量速度减小[分别为（25．23±8．42）和（32．83±12．23）cm／s,P〈0．05]。术后1个月AMI组涡流流量、强度、最大向量速度较术前增加（P〈0．05）。结论：健康成人左心室收缩期涡流遵循一定的规律,AMI患者左室收缩期涡流不规则,导致能量的损耗,PCI术后患者的涡流状态有所改善。VFM技术为评价急性心肌梗死患者及PCI术前、术后心腔内血流变化提供了一种新途径。     

Physiologic and pathologic calcifications and ossifications in the face and neck

The aim was to give a systematic presentation of physiologic and pathologic calcifications and ossifications in the face and neck with a special emphasis on clinical relevance. In a sometimes subacute setting one should recognize specific calcifications which often lead to important diagnoses such as fungal sinusitis or sclerosing labyrinthitis. In a more chronic situation intraocular calcifications in small children are pathognomonic for retinoblastoma. Juxtatumoral sclerosis of the laryngeal cartilage in laryngopharyngeal carcinoma is usually caused by tumor infiltration of the cartilage resulting in a higher tumor stage and, this way, has a major impact on the therapeutical strategy. Calcified lymph nodes are mainly unspecific but can be the result of tuberculosis or metastases of thyroid cancer. Cross-sectional imaging methods, most of all computed tomography, are ideally suited to reveal head and neck calcifications and ossifications, especially those which are clinically relevant.     

Head and neck infection and inflammation

This article discusses the imaging manifestations of infectious and inflammatory conditions of the head and neck. Special attention is paid to the sites, routes of spread, and complications of neck infections. Because the clinical signs and symptoms and the complications of these conditions are often determined by the precise anatomic site involved, anatomic considerations are stressed. Familiarity with the fascial layers, spaces of the neck, and the contents of each space is helpful for this discussion. The fascial layers of the neck are important barriers to infection, and once infection is established, the fascial layers play a part in directing its spread.     

幽门螺杆菌分泌与重组表达的VacA蛋白的分离纯化及其致细胞空泡效应与凋亡的对比研究

目的：分离纯化幽门螺杆菌分泌和重组表达的细胞空泡毒素抗原（ VacA）蛋白,并评价其致细胞空泡效应及致细胞凋亡效应。方法分别从幽门螺杆菌ATCC26695菌株培养上清和重组表达VacA蛋白的pQE30-VacA-E．coliM15基因工程菌中分离纯化VacA蛋白,经酸化后,以不同终浓度（5,10 ng／ml）分别与人胃腺癌AGS细胞共孵24 h,观察致空泡效应,并通过流式细胞术检测细胞凋亡。结果成功分离纯化出幽门螺杆菌分泌和重组表达的VacA蛋白;幽门螺杆菌分泌的VacA蛋白能显著引起AGS细胞的空泡样改变及凋亡（P＜0．01）,而重组表达的VacA蛋白致细胞空泡样改变及凋亡不显著（ P＞0．05）。结论幽门螺杆菌分泌的VacA蛋白有良好的空泡毒性及致凋亡效应,而重组表达的VacA蛋白无致空泡及凋亡效应,幽门螺杆菌分泌的VacA蛋白可用于VacA作用机制的研究。     

化学和生物学融合对国际武器公约履约的影响

化学武器公约（ CWC）和生物武器公约（ BWC）是为禁止生产、发展、储存和使用化学武器和生物武器而制定的国际公约。近年来,科学技术快速发展,知识交叉渗透,学科之间出现整合和融合,促进了科技进步和经济发展。其中化学和生物学融合在有力促进制药、健康卫生、绿色化学和环境保护等产业进步的同时,也对化学和生物武器公约的履约产生了重要的影响。该文综述了与化学武器和生物武器公约相关的化学和生物学融合进展,并分析其对公约履约的影响。     

Oxygen uptake and ventilation during rowing and running in females and males

This study evaluated if the ventilatory response to exercise is impaired by the cramp position of rowing. Maximal oxygen uptake (VO2max), maximal expiratory volume (VEmax), and maximal heart rate (HRmax) during rowing and running were compared in 55 males (age, mean +/- SD, 21 +/- 3 years; height 176 +/- 5 cm; body mass 72 +/- 6 kg) and 18 females (age 20 +/- 2 years; height 164 +/- 5 cm; body mass 61 +/- 4 kg). VEmax was larger during rowing than during running (males, 157 +/- 16 vs. 147 +/- 13 L min(-1); 114 +/- 9 vs. 105 +/- 11 L min(-1), P<0.01). Also VO2max was larger during rowing than during running (males, 4.5 +/- 0.5 vs. 4.3 +/- 0.4 L min(-1); females, 3.3 +/- 0.4 vs. 3.2 +/- 0.4 L min(-1), P<0.01). However, HRmax was lower during rowing than during running (males, 194 +/- 8 vs. 198 +/- 11 beats min(-1); females, 192 +/- 6 vs. 196 +/- 8 beats min(-1), P<0.05). VEmax was correlated to body mass and fat-free mass, as was VO2max. Thus, the oxygen pulse (VO2max/HRmax) was larger during rowing than during running, while the ventilatory equivalent for oxygen (VEmax/VO2max) was similar. We showed that bending the body during rowing does not seem to impair ventilation either in males or in females. The results indicate that VEmax and VO2max relate to body size and fat-free mass for both females and males. The findings indicate that the involvement of more muscles, the entrainment, and the body position during rowing facilitates ventilation and venous return and lowers maximal heart rate.     

Coracoclavicular and coracoacromial ligament calcification and ossification

Thirty-six patients with calcification or ossification at or around the coracoclavicular and coracoacromial regions were analyzed with regard to type, location, and configuration of the deposits and related clinical history. Calcification or ossification in the coracoclavicular region resulted largely from trauma (36%) or renal failure (28%). Trauma patients may develop punctate calcification or ossification but do not develop the tumoral type of calcification. About 5% of the renal failure patients had coracoclavicular ligament calcifications, one-half of which were of the tumoral type. Renal failure patients may have punctate or tumoral calcifications but do not develop ossification.     

CLIP相关技术的研究进展

在真核生物基因表达的转录后调节中,RNA结合蛋白（ RBP）起着关键作用,很多RBP的异常与人类疾病的发生密切相关。自2000年的RNA免疫沉淀和芯片分析方法（ RNA immunoprecipitation with differential display or microarray analysis , RIP-ChIP）出现以来,人们开始就RBP与RNA相互作用进行了系统而广泛的研究。经过改良和发展,基于体内实时紫外交联免疫沉淀法（ ultraviolet crosslinking and immunoprecipitation , CLIP ）、交联免疫沉淀cDNA文库高通量测序法（ high-throughput sequencing of CLIP cDNA library , HITS-CLIP）、光催化核糖核苷增强交联和免疫沉淀法（ photoactivatable-ribonucleoside-enhanced crosslinking and immunprecipitation , PAR-CLIP）以及提高个别核苷酸分辨率交联和免疫共沉淀法（ individual nucleotide resolution CLIP , iCLIP）等RIP-ChIP衍生方法相继产生,使用这些方法,可以解析RBP的RNA识别特异性,而且通过与高通量测序技术结合,可以实现转录组尺度的RBP的靶序列的鉴定,分辨率也得到极大提高。该文就RNA与蛋白的相互作用的基本原理及其研究进展、相关技术存在的问题以及发展趋势进行简要综述。     

Cross-sectional and longitudinal comparisons of self-reported and device-assessed physical activity and sedentary behaviour

ObjectivesTo examine the longitudinal associations and differences between self-reported and device-assessed physical activity (PA) and sedentary behaviour (SB), using a multifaceted statistical approach.DesignLongitudinal measurement burst.MethodsIn total, 52 university students (78% female) aged 18–38 years (mean = 21.94 ± 4.57 years) participated. The study consisted of three blocks of six days of measurement, during which participants wore an accelerometer on their wrist for the entire block, and self-reported their PA over the 6 days at the end of each block.ResultsMeaningful latent differences between methods were observed for moderate PA and SB across all three assessment periods, such that participants underreported the time spent in each activity. Bland–Altman plots revealed a positive mean difference for vigorous PA, with over-reporting increasing as mean levels increased. Negative mean differences were observed for all other intensities. Underreporting of moderate PA increased as the mean level increased, whereas for light PA and SB, underreporting decreased at high levels. Repeated measures correlations revealed a meaningful association for vigorous PA only, suggesting that as self-reported minutes increase so too do device-measured minutes.ConclusionsWe found evidence of cross-sectional and longitudinal differences and weak associations between self-reported and device-assessed PA and SB. Future work is needed to enhance the quality of self-reported methods to assess PA and SB (e.g., face and content validity), and consider improvements to the processing of device-based data.     

Old and dangerous: Prison and dementia

Older prisoners are the fastest growing group of prisoners in many countries. The purpose of this study is to explore the phenomenon of detention of persons suffering from dementia. Medline searches were conducted for relevant articles, chapters and books published until August 2016. Search terms included dementia, elderly, prison and criminal. Publications found through this indexed search were reviewed for further relevant references. As results, there is a lack of data about elderly with dementia in prisons. Given the rise in the average age, it is reasonable to hypothesize that the number of older prisoners is growing. Moreover, some elderly are imprisoned with a concomitant cognitive impairment or psychiatric disorder while others will develop such diseases once incarcerated. At the present time, legal and social systems seem unprepared to handle the phenomenon of dementia in prison. As proposal, health assessments for older first time offenders should become a practice inside the correctional facilities and include an evaluation for specific health issues, such as psychiatric comorbidity and cognitive impairment.