Nd∶YAG激光照射大鼠皮肤组织的温度实验

目的验证激光与组织光热效应预示模型和计算结果,考查激光功率密度和照射时间与组织温度和损伤的定量关系,获得组织热效应的温度数据。方法连续Nd∶YAG激光照射活体皮肤组织,组织为全身麻醉状态下大鼠腹部皮肤,每次实验同时测量三路信号:表面照射点辐射温度、皮下1mm的内部温度和环境温度。为了获得不同条件下的温度数据,根据照射功率和时间进行分组。结果得到连续Nd∶YAG激光相同照射时间(t=1s)时不同功率(P=2、3、4、5W)、相同功率(P=5W)时不同照射时间(t=0·5、0·8、1·0s)以及照射功率较高时(t=0·5s,P=5、10、15W)的大鼠皮肤组织皮下1mm的温度。温度随着功率和照射时间的增加相应升高,温度响应形状相似,温度上升时间与照射时间相关。结论Nd∶YAG激光表面辐射温度远远低于皮下温度,对热效应研究意义不大。热电偶所测内部温度能够很好地反映激光功率、照射时间的变化,可用来验证相关模型和数值模拟结果。     

脉冲Nd:YAG激光照射唇部静脉湖温度场分布模型的建立和验证

正目的:探讨脉冲Nd:YAG激光照射唇部静脉湖后热传输的特点,提供脉冲Nd:YAG激光作用唇部静脉湖后组织热效应的有效预测平台。方法:建立唇部静脉湖有限元分析模型,模拟不同照射时间(2、3、5和7 s)Nd:YAG激光照射唇部静脉湖模型后的温度响应。建立Nd:YAG激光照射唇部静脉湖生物模型,获取激光照射过程中生物模型温度的变化规律,验证有限元分析模型的准确性。     

脉冲Nd:YAG激光照射唇部静脉湖温度场分布模型的建立和验证

目的探讨脉冲Nd:YAG激光照射唇部静脉湖后热传输的特点,提供脉冲Nd:YAG激光作用唇部静脉湖后组织热效应的有效预测平台。方法建立唇部静脉湖有限元分析模型,模拟不同照射时间下(2s、3s、5s、7s)Nd:YAG激光照射唇部静脉湖模型后的温度响应。建立Nd:YAG激光照射唇部静脉湖生物模型,获取激光照射过程中生物模型温度的变化规律,验证有限元分析模型的准确性。结果理论模型显示,随着照射时间的延长,距离照射点轴向3mm处的温度呈曲线上升。在不考虑血液灌注的情况下,2s、3s、5s、7s时的温度分别为(51±0.12)℃、(56±0.20)℃、(77±0.20)℃、(90±0.12)℃(P0.05)。生物模型显示,随着照射时间的延长,距离照射点轴向3mm处的温度呈曲线逐渐上升,在7s时的温度为(90±0.20)℃,实际温度变化曲线和不考虑血液灌注的理论曲线基本吻合(P0.05)。结论有限元分析模型可以比较好地预测组织的反应,对于研究激光治疗血管性病变有一定的参考价值。根据有限元分析模型结果提示,临床治疗唇部静脉湖中应注意单点照射时间不宜超过7s,以免造成组织不可逆的热损伤。     

GaAlAs，InGaAs，Nd：YAG三种激光热凝固效应的比较

目的 比较GaAlAs和InGaAs半导体激光与Nd：YAG激光热凝固效应。方法 GaAlAS、InGaAs、Nd：YAG激光以石英光纤输出，照射鸡蛋蛋清，每种激光照射10点，测量蛋白凝固团的直径和高度。光纤输出端功率10w，芯径1mm光斑、直径2mm，照射时间30s。结果 三种波长的激光照射活性蛋白形成凝固的体积大小差异明显，其中InGaAs激光热凝固最强，Nd：YAG激光次之，GaAlAs激光最弱。结论 三种激光的热凝固效应有差异。     

倍频Nd:YAG激光击穿犬眼视网膜全层最佳参数的选择

目的 寻求倍频Nd：YAG激光击穿犬眼视网膜全层(含Bruch膜)的最佳激光参数，为临床提高激光诱导脉络膜视网膜静脉吻合支的成功率提供实验依据。方法 以不同激光参数击射犬眼视网膜的不同部位，用HE染色的组织切片和KS400型图像分析系统验证击射效果。结果 激光功率、光斑直径与击射部位对击穿犬眼视网膜层次均有影响(P=0．0001)，击穿犬眼视网膜全层(含Bruch膜)的激光参数组合为：1．2～1．8W、50μm、0．1s；1．8W、100μm、0．1s。结论 倍频Nd：YAG激光击穿犬眼视网膜全层(含Bruch膜)的最佳参数为1．2～1．5W、50μm、0．1s。     

Nd：YAG激光结合局部化疗治疗食管癌

目的：评价Nd:YAG激光结合局部化疗治疗食管癌的疗效。方法：食管癌患者84例，其中肿块型53例，溃疡型31例。Nd:YAG激光功率60－80W，光斑直径0．2cm，照射距离0．5－1．0cm，每次治疗平均能量7000J。在内镜下将光伸至肿瘤远端开始进行环形照射，边照射边向近端退出，照射后清除坏死组织。局部注入丝裂霉素4－10mg与5－Fu500mg(肿块型）或平阳霉素16mg(溃疡型）。注射时将上述药物稀释为10－20ml，分20－40点注射，每点注射0．5ml，每2周注射1次，共5－8次。治疗前后观察病灶大小，取材行病理检查。结果：完全效应36例（42．9％），明显效应30例（35．7％，稍有效应15例（17．8％），无效3例（3．6％）。梗阻解除率100％。治疗中未出现骨髓抑制及肝、脾、肾功能损害。结论：内镜激光结合局部化疗治疗食管癌有较好的临床疗效，全身毒副作用较少。     

倍频Nd:YAG激光治疗视网膜静脉阻塞的疗效

目的 探讨倍频Nd：YAG激光对视网膜静脉阻塞(RVO)的治疗效果。方法 应用倍频Nd：YAG激光对82例101眼RVO患者行视网膜光凝术。激光波长532nm，功率0.3～0．5W，光斑直径200～500μm，照射时间0．1～0．25s。随访3～18个月，对比分析光凝前后视力及眼底荧光血管造影(FFA)的变化情况。结果 激光治疗后视力提高78眼，占77．23％；无变化者16眼，占15．84％；视力降低者7眼，占6．93％。FFA示激光治疗后有效87眼，其中CRVO患者32眼，有效26眼，有效率81．25％；BRVO69眼，有效61眼，有效率88，41％。结论倍频Nd：YAG激光治疗RVO有显著疗效。     

Nd:YAG激光在口腔及耳鼻咽喉外科的临床应用

随着激光和光纤两大技术的发展，采用光纤将激光束导人人体狭小而深的孔腔，可灵活达到手术野的任何部位。现将我院对23种疾病、941例进行Nd：YAG激光手术治疗应用情况报告如下：临床资料与方法本组941例中男560例、女381例，年龄最小30天、最大73岁，多数20～50岁。手术部位：头面部、耳腔、鼻腔、口腔、咽腔、喉腔。设备：Nd：YAG激光器波长1．06μm，光纤末端最大输出功率100W。国产石英导光纤维芯径400～600μm，一般治疗功率40～50W，脉冲时间0．5～1．0秒。石英纤维顶端距病灶组织约0．5～1．0cm，根据病灶大小亦可分点插入照射。…     

Nd：YAG激光和CO2激光治疗重度宫颈糜烂的疗效比较

目的比较Nd：YAG激光和CO2激光治疗重度宫颈糜烂的疗效。 方法以Nd：YAG激光或CO2激光治疗重度宫颈糜烂各79例，比较其术中和术后出血情况、术后阴道排液时间及治愈牢和伤口愈合时间，评价两种方法治疗重度宫颈糜烂的疗效。 结果Nd：YAG激光组术中术后出血发生率低于CO2激光组，而术后阴道排液时间、一。次性治愈率则高于CO2激光组，愈合时间则短于CO2激光组。其中术巾术后出血发生率和一次性治愈率、术后阴道排液停止的时间（P〈0．001）、愈合时间（P〈0．01），两组比较差异均有非常显著意义。 结论Nd：YAG激光治疗重度宫颈糜烂术中术后出血发生率低，治愈率高，愈合时间快，疗效确切。     

KTP激光与Nd：YAG激光对兔泪道损伤程度的比较

目的：探讨倍频Nd:YAG激光（以下简称KTP激光）与Nd:YAG激光对兔泪小管的损伤程度，为临床应用KTP激光治疗泪小管阻塞提高实验依据。方法：新西兰纯种白兔30只，对每兔左右泪小管分别用KTP与Nd:YAG激光击射，激光击射后第7、30和90天分别采集10只兔泪小管标本。另取10只兔，其左眼泪小管插入光纤，右眼不做处理，7d后取泪小管标本。两种激光的功率密度均为12W／cm^2，击射时间均为4s。采用免疫组化染色（SP法）和特殊染色（VG法），利用计算机图像分析检测V型胶原纤维积分光密度（IOD），分析两种激光对泪小管的损伤程度。结果：激光照射后第7、30、90天，KTP激光组的V型胶原和胶原纤维的IOD值均低于Nd:YAG激光组，而仅插入光纤不照射激光组的V型胶原和胶原纤维的IOD值与空白对照组的IOD值近似。结论：KTP激光照射引起的兔泪小管损伤程度比Nd:YAG激光轻。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.