Enhanced Predictive Power of Quantitative TWA during Routine Exercise Testing in the Finnish Cardiovascular Study

Introduction: We examined whether quantification of T-wave alternans (TWA) enhances this parameter's capacity to evaluate the risk for total and cardiovascular mortality and sudden cardiac death (SCD).
Methods and Results: The Finnish Cardiovascular Study (FINCAVAS) enrolled consecutive patients (n = 2,119; 1,342 men and 777 women) with a clinically indicated exercise test with bicycle ergometer. TWA (time domain-modified moving average method) was analyzed from precordial leads, and the results were grouped in increments of 10 μV. Hazard ratios (HR) for total and cardiovascular mortality and SCD were estimated for preexercise, routine exercise, and postexercise stages. Cox regression analysis was performed. During follow-up of 47.1 ± 12.9 months (mean ± standard deviation [SD]), 126 patients died: 62 were cardiovascular deaths, and 33 of these deaths were sudden. During preexercise, TWA ≥ 20 μV predicted the risk for total and cardiovascular mortality (maximum HR >4.4 at 60 μV, P < 0.02 for both). During exercise, HRs of total and cardiovascular mortality were significant when TWA measured ≥50 μV, with 90 μV TWA yielding maximum HRs for total and cardiovascular death of 3.1 (P = 0.03) and 6.4 (P = 0.002), respectively. During postexercise, TWA ≥60 μV indicated risk for total and cardiovascular mortality, with maximum HR of 3.4 at 70 μV (P = 0.01) for cardiovascular mortality. SCD was strongly predicted by TWA levels ≥60 μV during exercise, with maximum HR of 4.6 at 60 μV (P = 0.002), but was not predicted during pre- or postexercise.
Conclusion: Quantification of TWA enhances its capacity for determination of the risk for total and cardiovascular mortality and SCD in low-risk populations. Its prognostic power is superior during exercise compared to preexercise or postexercise.     

时间-温度阈值控制肝脏激光间质热消融治疗的实验研究

目的:探讨应用时间-温度阈值控制肝脏LITT的可行性.方法:16只实验兔,分成2组,均在介入性MRI引导下行LITT.组1和组2分别加热到60℃和时间-温度阈值.测量光导纤维尖端至测温针尖的距离(D1),以及光导纤维尖端至凝固性坏死最外缘的距离(D2).结果:阈值温度54℃最为多见.组1D1与D2的差异有显著性统计学意义.组1达到时间-温度阈值平均节约时间(或能量)26.63%.结论:时间-温度阈值控制肝脏LITT能完全消融肝组织,节约消融时间和能量,减少正常组织损伤.     

多层螺旋CT不同延迟技术的血管成像的比较

目的：探讨团注（Bolus）技术在多层螺旋CT血管成像（multi—slice spiral CT angiography，MSCTA）最佳延迟时间设定中的作用和意义。材料和方法：随机选取患者326例分三组进行比较，第一组87例采取经验值设定延迟时间；第二组109例运用智能跟踪技术启动扫描；第三组130例采取Test Bolus技术，根据测得目标血管的时间一密度曲线设定延迟时间。结果：第一组图像质量优22例、良38例、差27例；第二组图像质量优62例、良44例、差3例；第三组图像质量优120例、良8例、差2例；Test Bolus技术组图像质量明显优于经验值组，有显著差异（P〈0．05）；而与智能组，腹主A组无显著差异（P〉0．05），优于其余各组（P〈0．05）。结论：用Test团注测试扫描技术设定延迟时间能得到优质的CTA原始图像，有利于多层螺旋CT取得更好的三维血管重建图像。     

免疫规划智能化网络信息系统的研究目标与实现方法

目的：免疫规划实现计算机网络智能化管理。方法：利用现有卫生信息网络的资源，以国家计划免疫管理办法和技术规范为需求，研制免疫规划智能化网络信息系统。结果：自2000年以来，先后在惠安第4县区应用，证明系统功能与性能达到设计目标与指标要求。系统界面友好，操作简单；性能稳定，维护方便；提高工作效率和统计的准确性、实时性；实现一地建卡、 异地接种，解决流动人口儿童免疫管理问题；提供计划免疫保偿和免疫规划综合信息的查询，实现网络对免疫现场的监督、监测工作，防止漏种、漏报和虚报现象的发生；提供通过电话自动通知、催种与接种结果查询，免疫知识咨询和抱怨服务等功能。可为基层创造一定的免疫规划发展基金。结论：系统满足了现行计划免疫和扩大免疫服务的组织、实施、信息共享、信息咨询和决策服务等全过程的网络智能化管理，为我省乃至全国免疫规划管理的智能化、制度化、规范化与网络化管理打下基础。     

Endothelial progenitor cells modulated by IL-1β in multiple organ dysfunction syndrome in porcine

Objective To investigate the modulation of EPCs by interleukin 1β (IL-1β) and p38 mitogen activated protein kinase (p38MAPK) and the pathogenesis resulting from their dysdifferenfiation after trauma.Method Thirty pigs were divided into a control group (n = 15) and a multiple organ dysfimction syndrome (MODS) group (n = 15), the latter of which were subjected to a "two-hit" injury including hemon'hagic shock and endotoxemia. Phosphorylation of p38MAPK in peripheral blood mononuclear cells was monitored by western blotting. The concentration of IL-1β in peripheral blood plasma was determined by ELISA and the numbers of EPCs with FCM in peripheral blood plasma were monitored. The morbidity rates in the two groups were compared by chi square test. The levels of phosphorylation of p38MAPK in peripheral blood mononuclear cells, the concentmtions of IL-1β in peripheral blood plasma and the numbers of EPCs in the peripheral blood were compared between groups using with Student's t lest. Results The level of p38MAPK phosphorylation was more augmented and the concen-tration of IL-1β higher in peripheral blood mononuelear cells and plasma from MODS pigs compared with those from control pigs; nevertheless the mauler of EPC conspicuously decreased in the peripheral blood (P <0.01). The morbidity rate in the MODS group was much higher than that in the control group (P < 0.01). There were fewer EPCs in the peripheral blood of animals in group M than in the peripheral blood of animals in group C (P <0.01). Conclusions p38MAPK phosphorylation is important for the pathogenesis of MODS. p38MAPK phospho-rylation might cause the concentration of IL-1β in the peripheral blood plasma to rise and could cause a drop in the numbers of EPCs, thereby aggravating the inflanmmatory reaction in MODS.     

数字人体信息获取的热红外技术研究

本文主要阐述了数字人体信息获取的热红外技术基础和数字人体信息获取的热红外技术应用.在热红外技术基础中介绍了热红外、黑体、比辐射和辐射照度及热惯量;在热红外技术应用中概述了方法和优点等.为数字人体信息获取的热红外技术研究提供了理论依据.     

大鼠局灶性脑缺血再灌注后血浆肾上腺髓质素的表达及与内皮素的关系

目的：探讨大鼠局灶性脑缺血再灌注后血浆肾上腺髓质素含量的变化及其与内皮素的相互关系。方法：54只SD大鼠分为正常组（A组）6只、假手术组（B组）6只和模型组（C组）42只。C组大鼠制作成局灶性脑缺血2h再灌注模型并应用放射免疫分析法检测不同时间段血浆肾上腺髓质素和内皮素的含量，同时与A、B组进行比较分析。结果：C组再灌注后血浆肾上腺髓质素和内皮素的含量均升高，与A、B组比较，差异有显著性意义（均P〈0．01）。肾上腺髓质素的含量与大鼠局灶性神经功能缺损症状的严重程度、梗死体积及内皮素含量均呈显著正相关（均P〈0．01），且高峰值出现在缺血再灌注后2h，随后逐渐下降，约166h又有所上升，但与A、B组比较仍差异有显著性意义（P〈0．01）。结论：局灶性脑缺血再灌注后血浆肾上腺髓质素含量变化可有助于判断病情严重程度、梗死灶的体积大小及病情预后。     

大鼠充血性心力衰竭模型的制作

目的建立大鼠心肌梗死后心力衰竭的动物模型,完善制作方法。方法W istar大鼠结扎冠状动脉左前降支,造成左心室大面积心肌梗死,同时记录心电图。术后4周处死,对心脏进行病理组织学检查。结果大鼠术后出现明确的心肌梗死改变。术后成活率80%。病理组织学检查可见大量炎性细胞浸润,纤维组织增生。结论本实验可较理想地制造模型,对心衰的实验研究有重要意义。     

大网膜及纤维蛋白胶在结肠手术中的应用

目的总结大网膜及纤维蛋白胶（FG）粘贴在结肠手术中的治疗效果。方法回顾分析48例实行结肠手术的患者的临床资料，在吻合口吻合完毕后采取大网膜及纤维蛋白胶粘贴治疗。结果结肠手术患者采用大网膜及纤维蛋白胶粘贴治疗降低了术后吻合口瘘的发生率。结论结果表明，大网膜及FG的作用一定程度上减少了发生吻合口瘘的危险因素，促进了吻合口的生长。只要正确掌握手术适应证，采用该方法做结肠一期吻合，尤其对于急性梗阻患者，大大降低了术后吻合口瘘的发生率。     

Reconstruction of Humeral Shaft Defect with an Intercalary Endoprosthesis Following Resection of Tumor

Diaphyseal defects in long bones of extremities following segmental resection are very common in the clinic, and reconstruction remains a great challenge. Although there are many treatments for diaphyseal defects at present, reconstruction with an intercalary endoprosthesis may be an optimal method. We demonstrate a surgical technique for reconstruction of a humeral shaft defect with an intercalary endoprosthesis following tumor resection, and achieve a good clinical outcome. We conclude that in comparison with other methods, reconstruction with an intercalary endoprosthesis is simple, effective, and allows for earlier weight bearing and more rapid restoration of function.