基于D-H参数方法的微创手术机器人运动仿真研究

目的:为了更好地研究外科微创手术机器人的工作性能,提出一种基于D-H参数方法的机器人运动仿真研究方法。方法:通过分析机器人各关节的几何关系,建立其D-H参数模型,分别对机器人系统进行正运动学和逆运动学分析,利用Matlab软件中的Sim Mechanics模块对机器人机电系统进行建模和仿真实验。结果:仿真实验结果表明,末端执行机构的期望轨迹与实际轨迹基本一致,运动误差都在实际允许范围内,验证了机器人运动学仿真研究方法的正确性。结论:采用D-H参数方法对微创手术机器人进行运动学仿真分析具有很好的实用性和准确性,对外科手术机器人的精密设计和系统改进具有普遍的适用意义。     

过表达钙整合素结合蛋白CIB诱导SHG44胶质瘤细胞凋亡的实验研究

目的 观察CIB基因对人胶质瘤SHG44细胞体外生长和细胞凋亡的影响.方法 构建重组质粒pcDNA3-CIB,转染人胶质瘤细胞株SHG44,MTT观察各组细胞的体外生长情况,流式细胞术(FCM)测定各组细胞的细胞周期和凋亡细胞数量,Western-blot检测CIB转染后凋亡相关蛋白的表达变化.结果 RT-PCR、Western印迹显示pcDNA3-CIB转染组CIB的mRNA及CIB蛋白表达水平明显高于对照组;与对照组细胞相比,转染CIB的SHG44-CIB组细胞牛长明显减缓(P＜0.01),SHG44-CIB组细胞G_1、S期细胞减少,G_2期细胞增多,凋亡细胞增加至19.2%;凋亡相关蛋白Bcl-2表达下调,Bax表达上调.结论 CIB在体外明显抑制SHG44细胞的生长并诱导其发生凋亡,CIB诱导的凋亡可能与Bcl-2及Bax表达的变化相关.     

Atrial Tachycardia Confined Within the Left Atrial Appendage

AT Confined Within the LAA. Left atrial tachycardias are often seen following catheter ablation of persistent atrial fibrillation (AF). We report here an unusual case where AF was converted to sinus rhythm following catheter ablation, but ongoing atrial tachycardia confined within the left atrial appendage (LAA) was observed. Although the LAA tachycardia was dissociated from the atrium in sinus rhythm, bidirectional conduction between the left atrium and the LAA was, however, demonstrated after tachycardia termination. (J Cardiovasc Electrophysiol, Vol. 21, pp. 933‐935, August 2010)     

Association and prognostic impact of persistent left ventricular hypertrophy after live-donor kidney transplantation: a prospective study

Aim  

Persistent or de novo left ventricular hypertrophy (LVH) is a risk factor for cardiovascular diseases and congestive heart failure following renal transplantation (RT). Our aim was to determine the associations and impact of persistent LVH on RT outcome.     

额颞开颅治疗重症高血压脑出血69例临床分析研究

目的总结额颞开颅经外侧裂入路治疗高血压脑出血的手术经验。方法回顾我院于2006年1月至2008年6月收治的基底节区为主的高血压脑出血患者69例,均采用额颞开颅经外侧裂、岛叶入路,在显微镜下清除血肿。其中对瞳孔散大、脑疝形成患者行去骨瓣减压术45例,余24例行血肿清除骨瓣还纳术。结果全部血肿清除满意,术后除1例出血量大,术后12h死亡外,其余患者脑疝解除,当日清醒8例,意识朦胧13例,浅昏迷34例,深昏迷13例。手术后1个月功能恢复至Ⅰ～Ⅱ级19例,Ⅲ～Ⅳ级37例,Ⅴ级7例,死亡5例（7.4%）。结论本手术方法能充分利用脑组织正常间隙及非重要功能区进行操作,手术路径较短,脑组织损伤小,减少了手术的创伤;手术显微镜下能清晰看清出血点,准确有效地止血,降低了手术后再出血的风险,不受血肿量大小的限制,彻底清除。能够降低重症高血压脑出血患者病死率,提高存活者生存质量。     

重组人血管内皮抑素联合白介素-2灌注治疗恶性胸/腹腔积液的临床研究

目的:观察重组人血管内皮抑素联合白介素-2(IL-2)治疗恶性胸/腹腔积液的疗效及安全性。方法:回顾性分析我院经病理学及细胞学检查证实为恶性胸/腹腔积液患者(PS评分>2)59例,随机分为2组,试验组应用重组人血管内皮抑素联合IL-2胸/腹腔内灌注,对照组应用IL-2胸/腹腔内灌注,均每周给药1次。评估2组近期疗效、KPS评分和毒副反应及中位总生存时间。结果:试验组有效率为36.7%,对照组为13.8%,差异有统计学意义(P=0.044);试验组临床获益率为60.0%,对照组为31.0%,差异有统计学意义(P=0.026)。试验组生活质量改善16例,稳定10例,下降4例;对照组生活质量改善7例,稳定11例,下降11例,2组差异有统计学意义(P=0.033)。2组毒副反应及总生存时间差异无统计学意义。结论:重组人血管内皮抑素联合IL-2治疗PS>2的晚期恶性胸/腹腔积液疗效好,毒副反应小,值得临床推广。     

Management of sensitized patients awaiting renal transplantation: does sequential therapy of intravenous immunoglobulin and simvastatin offer a solution?

The value of intravenous immunoglobulin and simvastatin as potential modalities for the treatment of sensitized patients was studied. We aimed to test their efficacy as solo agents to inhibit anti-human leukocyte antigen (HLA) antibodies. We tested samples from 11 adult hemodialysis patients who were waiting for renal allotransplantation at our center, all of whom had persistently positive crossmatches with their living related donors and panel reactive antibody titers more than 20%. All patients received intravenous immunoglobulin (500 mg/kg/day on alternate days for 6 doses). Panel reactive antibody titer measurement and crossmatch testing were carried out after each dose and before each subsequent one. Two months later, 8 patients received simvastatin (20 mg/day) for 2 months. Panel reactive antibody measurement titer and crossmatch testing were carried out every 2 weeks. Only 4 patients showed an insignificant reduction in panel reactive antibody activity (P=0.36). None of them attained a negative crossmatch. Furthermore, simvastatin also resulted in an insignificant reduction of HLA antibodies in 3 patients (P=0.32). We concluded that intravenous immunoglobulin or simvastatin alone cannot effectively inhibit preformed anti-HLA antibodies to allow successful renal transplantation. Further trials of the use of intravenous immunoglobulin and simvastatin with other modalities to desensitize these patients may be warranted.     

肾移植术后恶性肿瘤39例临床分析

目的分析总结肾移植术后恶性肿瘤的发生情况,探讨其诊断方法和治疗措施。方法回顾性分析1978年9月至2009年12月接受免疫抑制治疗的肾移植受者中恶性肿瘤的发生情况。结果1945例（2106例次）肾移植共发生恶性肿瘤39例,发生率为2％。恶性肿瘤于移植术后8～124个月（中位时间57个月）得到明确诊断,其中泌尿系统肿瘤22例,消化系统肿瘤8例,肺癌、淋巴瘤、乳腺癌各2例,硬脑膜小细胞癌、胸膜低分化癌各1例,另有1例转移性肝癌患者人院后3d死亡,原发肿瘤不明。28例获手术治疗,随访至2010年12月,生存16例,其余12例在术后3-96个月（中位时间33个月）死于肿瘤转移;11例未手术者于诊断后3d一36个月（中位时间5个月）死亡。结论肾移植受者中恶性肿瘤的发生以泌尿系统肿瘤最为多见,肿瘤恶性程度高,早期发现、早期治疗是提高生存率的关键,治疗上应尽早采取以手术为主的综合治疗。     

前列爽颗粒对慢性前列腺炎模型大鼠血清中IL-10,TNF-α含量的影响

目的:观察前列爽颗粒对慢性前列腺炎(CAP)模型大鼠血清,白细胞介素-10(IL-10)和肿瘤坏死因子-α(TN F-α)表达的影响,并初步探讨其作用机制.方法:将60只SD大鼠随机分为正常对照组、CAP模型组、前列回春胶囊组(0.18 g·kg-1)、前列爽低剂量组(0.79 g·kg-1)、前列爽中剂量组(1.58 g·kg-1)、前列爽高剂量组(3.15 g·kg-1),每组10只.观察大鼠前列腺病理形态学改变,ELISA法检测IL-10,TNF-α.结果:CAP模型大鼠的组织病理学改变符合CAP的特点,治疗组炎症明显消退.模型组血清中IL-10,TNF-α水平明显高于正常组(P＜0.05),前列回春胶囊组、前列爽颗粒中、高剂量组血清TNF-α水平明显低于模型组(P＜0.05),前列回春胶囊组、前列爽颗粒中、高剂量组,血清中IL-10水平明显升高.结论:前列爽颗粒可通过调节抗炎/促炎因子分泌而发挥治疗CAP的作用.