选择性激光熔化技术在口腔医学中的应用

选择性激光熔化（Selective laser melting,SLM）技术是一种快速成型技术,它以其制作方便、快捷、产品组织结构密度高、精度高、避免传统加工方式原材料浪费等优点,被逐渐运用于各个行业。然而,在口腔医学中的应用还报道较少,主要集中在冠桥修复、可摘局部义齿支架、骨替代物及生物植片等方面。本文介绍了SLM技术的原理,分类以及在口腔医学中的应用特点和前景。     

A Prospective,Randomized Comparison of Modified Pulmonary Vein Isolation Versus Conventional Pulmonary Vein Isolation in Patients with Paroxysmal Atrial Fibrillation

Modified Pulmonary Vein Isolation in AF Ablation. Introduction: Pulmonary vein isolation (PVI) is the primary ablation therapy in patients with atrial fibrillation (AF). We hypothesized that high dominant frequency (DF) sites (AF nests during sinus rhythm [SR]) adjacent to the PV ostia are associated with the atrial substrate that maintains AF, and PVI incorporating the high‐frequency AF nests may have a higher efficacy. Methods and Results: In a prospective and randomized comparison, 126 symptomatic paroxysmal AF patients that underwent PVI were enrolled. We compared the efficacy of a modified PVI (ablation line: 1.0–1.5 cm from the PV ostium with encircling the AF nests [spectral analysis with DF >70 Hz during SR, Group II]) versus the anatomy‐guided conventional PVI (Group I). In Group II, the DF value along the PV ostium was lower than 70 Hz after the PVI. The primary endpoint was the freedom from symptomatic atrial arrhythmias after a single procedure. We also followed the autonomic function by a time‐domain analysis of the heart rate variability. In both groups, AF nests were observed and electric isolation was successfully obtained in all patients. With a mean duration of 16 ± 6.1 months of follow‐up, Group II had a higher single procedure efficacy without drugs (78.7% vs 66.1%, log‐rank test: P = 0.02), and fewer repeat procedures (6.6% vs 23%; P = 0.04), as compared to Group I. Conclusion: PVI incorporating the high frequency AF nests adjacent to the PV ostia had a better single procedure efficacy. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1155–1162, November 2012)     

窄带成像电切镜治疗膀胱子宫内膜异位症1例报告并文献复习

目的：提高对膀胱子宫内膜异位症诊治的认识。方法：报告1例窄带成像电切镜治疗膀胱子宫内膜异位症患者的临床资料并结合文献讨论有关临床症状,诊断和治疗。结果：术后病理为（膀胱）子宫内膜异位症。免疫组化检测显示CDIO＋,CK7＋,CK2O-,ER＋,PR＋。术后随访半年,恢复良好。结论：膀胱子宫内膜异位症较为罕见,其临床和影像学表现与膀胱肿瘤难以鉴别,主要靠病理学结果确诊。而窄带成像电切镜对鉴别诊断及治疗膀胱子宫内膜异位症有重要价值。     

腹腔镜下肾部分切除术减少出血策略研究进展

腹腔镜下肾部分切除术（Laparoscopic partial nephrectomy,LPN）是治疗肾脏肿瘤的有效方法之一,尤其对于具有适应证的肾肿瘤而言,其控瘤效果、手术并发症发生率与根治性肾切除术（Radical nephrectomy,RN）接近,因此容易被患者和医师所接受。但LPN术中出血是很常见且棘手的问题,不仅影响术区视野,延长手术时间,而且增加肿瘤切缘阳性、术后输血、肾功能不全等并发症发生率。减少术中出血是LPN重要的研究内容之一,有助于LPN技术的推广和发展。影响出血的因素主要包括肾脏血管走形、动脉阻断方式、缝合技术、止血材料、止血器械、手术入路等,本文对这些影响术中出血的因素进行综述。     

黄河裸裂尻鱼MSTN基因RNA干扰研究

目的 利用反义寡合甘酸技术抑制肌肉生长抑制素（myostatin, MSTN）的表达,评估MSTN基因的沉默效果,并检测RNA干扰后对下游基因的影响。方法 通过构建黄河裸裂尻鱼（Schizopygopsis pylzovi）MSTN基因RNA干扰（RNAi）重组腺病毒载体1P3（DSP MSTN 273+250+1737）和1P2（DSP MSTN 195+1670）,并将其注射黄河裸裂尻鱼肌肉组织,进行活体RNA干扰;利用Real-time PCR和Western-blotting评估MSTN基因的沉默效果,并检测MSTN基因RNA干扰后肌肉肌酸激酶（muscle-type creatine kinase, M-CK）基因转录水平的调控作用。结果 Real-time PCR分析结果表明,与HK组（病毒通用阴性对照组）和N组（空白对照组）相比,重组腺病毒载体1P3对黄河裸裂尻鱼肌肉MSTN基因的转录具有明显的干扰作用（P<0.05）,抑制率达53.5%;而重组腺病毒载体1P2对MSTN基因的转录无明显干扰作用（P>0.05）。Western-blotting分析结果与Real-time PCR结果相一致。同时,经1P3干扰后随着MSTN基因转录水平的下降,其肌肉肌酸激酶M-CK基因表达水平显著上升。结论 通过RNAi技术能够有效的抑制MSTN基因的表达,并能够上调M-CK基因的表达量。因此,证明了在黄河裸裂尻鱼中MSTN能够抑制M-CK的转录。揭示高原土著鱼类MSTN 基因的对肌肉的生长发育起到调控作用。     

HBV-M在慢乙肝、肝硬化及肝癌中的表达及意义

目的 比较HBsAg、HBeAg滴度与HBV DNA水平在慢性乙型肝炎、乙型肝炎肝硬化及HBsAg 阳性的原发性肝癌患者中的变化,并探讨其对病情进展的影响。方法 在149例慢性乙型肝炎患者,115例乙型肝炎肝硬化患者及146 例肝癌患者中,采用荧光PCR定量法和Abbott化学发光微粒子免疫分析技术分别测定HBV DNA定量水平及HBsAg和HBeAg的滴度, 分析它们在这三组患者中的变化。结果1.HBeAg定量值在三组患者中比较有统计学意义(F=9.944,P=0.007);乙型肝炎组与肝硬化组、肝癌组比较均有统计学意义(x2=4.147,P=0.042; x2=9.499,P=0.002);肝硬化组与肝癌组比较无统计学意义(x2=0.747,P=0.387)。2.在不同HBeAg状态下,HBsAg定量值在乙型肝炎组与肝硬化组患者中比较均有统计学意义(t=2.549,P=0.012;t=2.428,P=0.017);HBsAg定量值在肝癌组中无统计学意义(t=1.375,P=0.171);HBVDNA定量值在三组患者中比较,差异均有统计学意义(Z分别为3.148、6.544、4.520,P<0.05)。 结论 定量检测慢性乙型肝炎、肝硬化及肝癌患者血清中的HBsAg、HBeAg及HBV DNA的变化有一定的临床意义,将三者结合能更好地为临床提供准确可靠的诊断和治疗数据。     

红参提取物对普罗帕酮所致大鼠急性心力衰竭的保护作用

通过观察红参中间体对普罗帕酮所致大鼠急性心力衰竭的作用,研究红参中间体抗心力衰竭的作用。股静脉注射盐酸普罗帕酮致大鼠急性心力衰竭。用BL-420E生理记录仪系统观察记录红参中间体对心力衰竭大鼠的作用。红参中间体可迅速(5 min内)恢复心力衰竭大鼠的心率,左心室内压最大上升速率和左心室内压最大下降速率与模型组相比有显著性差异。红参中间体对普罗帕酮所致的大鼠急性心力衰竭有一定的保护作用。     

Enhanced Ultraviolet Damage Resistance in Magnesium Doped Lithium Niobate Crystals through Zirconium Co-Doping

MgO-doped LiNbO₃ (LN:Mg) is famous for its high resistance to optical damage, but this phenomenon only occurs in visible and infrared regions, and its photorefraction is not decreased but enhanced in ultraviolet region. Here we investigated a series of ZrO₂ co-doped LN:Mg (LN:Mg,Zr) regarding their ultraviolet photorefractive properties. The optical damage resistance experiment indicated that the resistance against ultraviolet damage of LN:Mg was significantly enhanced with increased ZrO₂ doping concentration. Moreover, first-principles calculations manifested that the enhancement of ultraviolet damage resistance for LN:Mg,Zr was mainly determined by both the increased band gap and the reduced ultraviolet photorefractive center O^2−/−. So, LN:Mg,Zr crystals would become an excellent candidate for ultraviolet nonlinear optical material.     

人类miRNA-613的靶基因预测及生物信息学分析

目的利用生物信息学技术分析及预测人类miRNA-613(hsa-miR-613)的靶基因及其可能参与的生物学过程,为更深入的研究微小RNA与心脏疾病的关系提供基础。方法通过miRbase数据库和UCSC Genome Browser获取hsa-miR-613的序列及其染色体定位和物种间保守性等基本信息。应用miRDB、Target Scan、miRanda、DIANA-microT对hsa-miR-613进行靶基因预测取交集,合并miRTarbase数据库中已被实验证实的靶基因作为基因集,进行功能注释(GO分析)和pathway信号通路富集分析。结果 hsa-miR-613在物种间高度保守,其靶基因功能富集于血管发育、细胞增殖发育等生物学过程。靶基因存在于细胞各个组分,例如细胞质、细胞器、黏着斑等,其分子功能富集于蛋白结合和转录因子活性的调控等(P 0.05)。信号通路分析提示靶基因的信号通路显著富集于突触囊泡循环、剪接体、PI3K-Akt信号通路、mTOR信号通路、黏着斑等通路中,以及包括先天性心脏病的先天性疾病、心血管系统疾病的相关通路中(P 0.05)。结论 hsa-miR-613预测的靶基因富集于多个生物学过程,与心脏发育过程密切相关,为进一步研究提供了生物学基础。