活体和离体猪肝模型中微波消融尖端功率与凝固区大小的关系

目的 探讨活体和离体猪肝模型2 450 MHz微波消融尖端功率与凝固区大小的关系.方法 微波消融研究包括30个离体猪肝和25个活体猪肝消融位点.尖端功率分别设置为40、60和80 W,消融时间设置为6min.球形指数简化为r12/r22(r1:短轴;r2:长轴).结果 在活体和离体猪肝模型中,微波消融凝固区的大小随尖端功率的提高明显增大.在离体猪肝模型中,尖端功率为80W,凝固区最大短径和长径分别为(25.8±0.8) mm和(49.3-±2.2) mm;活体猪肝模型中凝固区最大短径和长径分别为(38.0±3.8) mm和(52.8±9.1) mm.尖端功率提高可以显著减小凝固区球形指数(40 W为0.4±0.2,80 W为0.3±0.0),差异有统计学意义(P=0.018).病理提示消融区包括3部分:中心区域的碳化区、围绕碳化区周围的凝固坏死区以及最外层的充血边缘.结论 微波消融中尖端功率可以显著影响凝固区的大小.     

应用氯化三苯基四氮唑染色快速判定超声引导下微波凝固范围

目的: 探讨应用氯化三苯基四氮唑(2,3,5 Triphenyltetrazolium chloride,TTC)染色快速判定微波凝固范围的可行性。方法： 纯种新西兰长耳大白兔18只,随机分成即时、1d、3d、7d、10d、21d 6组。超声引导下,45W微波辐射肝组织3min。取凝固标本,肉眼观察,并行TTC染色、HE染色、电镜观察。结果：活体兔肝凝固灶,电镜、HE染色证明凝固坏死区TTC不染色;非凝固坏死区TTC染色成玫瑰红色。活检标本TTC染色后,染色区域行HE染色,仍然可以观察细胞形态和组织结构。结论： TTC大体染色判定微波凝固范围,即时、准确、经济且操作简单。TTC不染色区域为凝固区,染成玫瑰红色区域为非凝固区。     

经皮微波凝固疗法肝组织热场分布的实验研究

目的 :探讨微波凝固肝组织局部热场分布规律。方法 :采用单微波电极对离体新鲜猪肝及活体兔、猪肝进行微波凝固 ,观察热场中凝固区最大短轴上序列点温度随时间的动态变化 ,同时观察凝固区边缘、移性区各部位的温度。结果 :某一时刻短轴上各点温度 (y)和其与中心的距离 (x)符合函数x2 =-2py b ;随x递增和 /或功率递减 ,各测温点的温度上升速度渐次减慢 ,并相继达到渐次减低的饱和温度 ;远隔组织在中、后期温升相对较快 ;离体凝固的中心温度恒定为 1 0 5℃ ,而活体凝固则因有、无供血而异 ,凝固功率 4 5W时其温度分别为83℃、92℃ ,血流对微波凝固范围、形态有显著影响 ;凝固区边缘、移行区温度较恒定 ,分别为 5 0℃～ 5 2 .5℃、4 8℃～ 5 0℃ ;6.36mm天线的热场内组织凝固形态最佳。结论 :在人体组织中微波的热场分布是微波物理特性、微波天线性能、组织热传导性、血供等因素的综合作用 ;合适的天线长度、适当地增加凝固功率、延长凝固时间、中断组织供血有利于显著扩大凝固区。     

激素对油酸及大肠杆菌所致大鼠急性肺损伤疗效观察

用油酸（０．１ｍｌ／ｋｇ）及大肠杆菌（６．０×１０９／ｋｇ）分别注入大鼠，２小时后用激素或庆大霉素治疗，第８天取血和肺，分别进行病理学和免疫学检查。光镜下见肺小血管内中性粒细胞浸润、肺间质水肿、灶性肺不张，油酸组还出现肺灶性纤维化。血浆和肺组织匀浆中测得的肿瘤坏死因子显著增加。而治疗组与对照组的病理改变和测得肿瘤坏死因子经统计学处理后表明，激素可以明显减轻油酸或大肠杆菌所致大鼠的肺损伤。     

多电极射频对狗肾作用的急慢性实验研究

目的了解多电极射频对狗肾脏消融效果的急慢性病理变化及其与不同影像学间的关系。方法在急性实验组（3只），通过手术暴露双侧肾脏，分别在两侧肾脏的上、下极外侧进针进行射频消融（RFA）治疗后处死动物。慢性实验组（6只）在B超引导下对双肾下极进行消融治疗，并于实验后7、15和30d处死动物。每只动物在实验前后均行B超，CT和MRI检查，处死前再次行上述检查，并和病理结果进行对比。结果肉眼观察急性期消融灶呈棕褐色尖端指向髓质的楔形凝固性坏死，外围绕有O．2-0．4cm的淡红色环。镜检消融灶凝固性坏死区、周围区和正常肾组织的细胞学形态结构未见明显差异，坏死区周围炎症反应，间质血管有血栓。慢性实验随时间延长消融灶坚韧，但不随时间减小。15d始细胞核完全变性，肾组织形态结构渐消失，渐被纤维组织取代，距离消融灶边缘1cm肾组织学形态正常。消融灶大小和电极针伞镜相近。超声能准确的引导电极针到达肾内治疗区，并能观察到电极散开启状况，但不能监测损毁灶大小。MRI表现为稍短的T1，长T2信号，边界清晰。CT平扫对消融灶的辨别差，强化CT消融灶不被强化。并发症有血尿和肾包膜下小血肿。结论RFA导致消融肾组织发生凝固性坏死，急性期消融灶和正常肾组织细胞形态结构无明显差异。RFA无严重并发症。超声能安全准确的引导电极针到达治疗部位，但不能监测消融灶的大小。MRI和强化CT能用于消融范围的随访。     

联合应用前列腺素E1和还原型谷胱甘肽对大鼠啼缺血再灌注损伤的保护作用

目的观察联合应用前列腺素E1和还原型谷胱甘肽对大鼠肺缺血再灌注损伤的保护作用。方法90只雄性清洁级SD大鼠随机分为5组,假手术组（S）,缺血再灌注组（IR）,治疗组1（RG1）,治疗组2（RG2）,治疗组3（RG3）。每组分别于夹闭缺血的第45分钟、缺血再灌注后1h、2h3个时间点处死大鼠,取10％左肺匀浆测定肿瘤坏死因子（TNF—α）、肺组织干／湿重比值（D／W）及在光镜下观察肺组织病理变化。结果（1）TNF—α含量在IR组缺血再灌注后含量明显增加,较S、RG组显著增高（P〈0．05）;（2）IR组肺组织损伤进行性加重,毛细血管充血、肺泡间隔炎性细胞浸润、肺泡腔内炎性细胞及炎性液体渗出显著,RG组肺组织充血水肿及炎性细胞浸润较IR组减轻,RG3组较RG1以及RG2组减轻;（3）IR组和RG各组的肺组织D／W比值呈进行性下降（P〈0．05）。结论联合应用前列腺素E1和GSH对大鼠肺缺血再灌注损伤的保护作用优于单独使用。     

PEPT2 mRNA在内毒素致急性肺损伤大鼠肺组织表达的研究(摘要)

目的:研究PEPT2(Peptide transporter 2)mRNA在急性肺损伤大鼠肺组织表达.方法:(1)实验动物与分组:随机将健康SD大鼠60只[200±20)g,雌雄各半]分为3组:①正常对照组(n=12),不作任何处理;②生理盐水组(n=12),气管内滴入0·2 mL生理盐水,2 h后放血处死,检测各项指标;③LPS组(n=36),气管内滴入0·5 mg/kg LPS(E·coli O111:B4,Sigma公司),溶于0·2 mL生理盐水中,分别于给药后2、4、8 h放血处死,观测各项指标.(2)评价急性肺损伤方法:①HE染色光镜观察肺组织病理变化;②测定肺湿/干比(W/D);③支气管肺泡灌洗,采用Folin-酚试剂法测定支…     

Nd：YAG激光对兔咽部黏膜热损伤的研究

目的：探讨Nd:YAG激光功率密度与黏膜组织热损伤程度的关系,以及激光照射后黏膜组织愈合的过程。方法：激光功率密度221W/cm^2(10W)、442W/cm^2(20W)、663W/cm^2(30W)、884W/cm^2(40W),持续时间5s,非接触照射新西兰兔舌和咽后壁黏膜组织,测量急性热损伤的深度;相同剂量照射兔咽后壁,术后1、3、7、14d观察咽后壁愈合情况。结果：221W／cm^2（10W）时,组织热损伤深度为0．32－0．53mm;442W/cm^2(20W)时,为0．61－1．27mm;663/cm^2(30W)时,为1．22－1．76mm;884W/cm^2(40W)时,为1．68－2．29mm。激光照射后,黏膜组织主要表现为凝固性坏死和继发性炎症反应,创面愈合过程主要是创面炎症渗出和表皮凝固坏死痂皮下直接愈合。组织热损伤深度随激光功率密度增强而增加。结论：在激光治疗中,采用适宜剂量参数的Nd:YAG激光非接触照射安全、有效。     

64层螺旋CT颈椎采集模式放射剂量的临床分析

目的:探讨64层螺旋CT颈椎不同采集模式的放射剂量,以供临床工作参考使用。方法:采用64层螺旋CT对同一个水模进行扫描,分别采用64 mm×0.6 mm(A组)和20 mm×0.6 mm(B组)两组采集方式,其扫描范围为30 cm,记录两组扫描结果的扫描时间、平均容积剂量指数和有效放射剂量。结果:64 mm×0.6 mm组的平均容积剂量、有效放射剂量明显高于20 mm×0.6 mm组,两组比较差异有统计学意义(P<0.05)。结论:对64层螺旋CT颈椎扫描可采用20 mm×0.6 mm模式,其放射剂量较小,值得在临床应用。     

植入型微波固化犬肝的研究

目的　采用微波组织热凝固器进行肝脏微波固化的动物实验研究。方法　应用犬进行肝脏局部微波固化 ,输入功率 6 0W ,时间 2 5s。实验犬分为A、B两组 ,A组行全肝叶每叶单点微波固化 ;B组行部分肝叶多点微波固化。术后测定凝固区的温度分布、肝脏病理以及血清SGPT改变。结论　微波热凝固对肝细胞的坏死作用确实 ;固化体积占全肝的比例不宜太大     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.