Complicated transseptal puncture during intervention catheter ablation on atrial fibrillation concomitant with straight back syndrome

Straight back syndrome (SBS) is a thoracic deformity with absence of upper thoracic spine kyphosis and heart compression. The anatomic abnormity of SBS may raise the difficulty of introcardial operation and increase the complicated risk of intervention performance. Here we report a case of SBS with complicated transseptal puncture during intervention catheter ablation of atrial fibrillation.     

外伤性脾切除术后中医证候及免疫功能的研究

目的:研究外伤性脾切除术后中医辨证与免疫功能变化的关系.方法:选择15例脾切除和15例非脾切除患者作为观察对象,以其症状、舌苔、脉象及免疫功能的测定作为观察指标,观察其中医辨证与免疫功能变化.结果:脾切除组在术后早期可出现脾胃虚弱的证候群,同时免疫功能测定补体C3、免疫球蛋白IgG、免疫球蛋白IgM的水平明显降低,与非脾切除组有显著性差异.结论:脾切除容易造成患者术后出现的脾胃虚弱症候群,并降低患者的免疫功能.     

富氧水防治急性高原病的效果观察

目的:观察饮用富氧水防治急性高原病的效果。方法:36名受试者自海拔1400m驻地乘汽车2天到达海拔3700m当日随机分两组,实验组(18人)口服5%葡萄糖注射液制成的富氧水,对照组(18人)口服5%葡萄糖注射液,均每次500mL,一日2次,直至进入海拔5200m某哨卡第6天,共服液8天。以军用卫生标准GJB1098-91"急性高原反应的诊断和处理原则"随访记录受试者进入哨卡第2天、4天、6天急性高原反应症状,然后分度与评分。同时检测血氧饱和度(SaO2)和脉率。结果:进驻哨卡第2天和第4天实验组较对照组急性高原反应分值减少,而SaO2增高(P<0.05或P<0.01),进驻哨卡第2天实验组较对照组脉率降低(P<0.05)。结论:饮用富氧水有防治急性高原病的效果。     

腹腔镜下处理输卵管积水对体外受精胚胎移植结局的影响

目的探讨腹腔镜下处理输卵管积水对体外受精胚胎移植(in vitro fertilization and embryo transfer, IVF-ET)结局的影响.方法 2002～2005年在我院行IVF-ET伴输卵管积水的53例分3个研究组:①未处理组17例,仅行IVF-ET,未对积水进行处理;②直接切除组17例,行IVF-ET术前在腹腔镜下处理输卵管积水;③失败后切除组19例,IVF-ET失败后腹腔镜下处理输卵管积水后再行IVF-ET.结果未处理组新鲜移植周期妊娠率15.8%(3/19),解冻周期妊娠率10.5%(2/19),平均周期妊娠率13.2%(5/38),累积活胎率17.6%(3/17);直接切除组分别为36.8%(7/19),23.1%(3/13),30.3%(10/32),41.7%(8/17);失败后切除组分别为16.7%(2/12),58.3%(14/24),44.4%(16/36),73.7%(14/19).失败后切除组的解冻周期妊娠率、平均周期妊娠率及累积活胎率均高于未处理组(χ2＝10.374,P＝0.001;χ2＝8.903,P＝0.003;χ2＝11.305,P＝0.001),直接切除组平均周期妊娠率及累积活胎率呈高于未处理组的趋势(χ2＝3.377,P＝0.066;χ2＝3.360,P＝0.067).结论输卵管积水降低IVF-ET的妊娠率,妊娠结局不良,腹腔镜下处理输卵管积水后再行IVF-ET提高妊娠率,获得良好的妊娠结局.     

无症状性炎性前列腺炎对血清PSA、fPSA的影响

目的　探讨无症状性炎性前列腺炎(NIH分类Ⅳ型)对血清PSA、fPSA的影响。方法　对比分析36例NIH分类Ⅳ型、42 例有症状性慢性前列腺炎(NIH分类ⅢA型)患者以及22例健康对照组的血清PSA、fPSA、fPSA/tPSA之间的差异。结果　血 清PSA、fPSA、fPSA/tPSA在Ⅳ型和ⅢA型前列腺炎患者间差异无显著性(P>0.05),但与正常对照组比较差异有显著性(P< 0.01)。结论　NIH分类Ⅳ型前列腺炎可引起血清PSA、fPSA升高。对无症状、高血清PSA患者行前列腺活检前,应考虑到患 Ⅳ型前列腺炎的可能。     

Double-crowned valved stents for off-pump mitral valve replacement.

OBJECTIVE: An animal model has been designed to assess the feasibility of off-pump mitral valve replacement using valved stents. METHODS: Glutaraldehyde-preserved homograft was sutured inside a prosthetic tube (Dacron). Then, two self-expandable nitinol Z-stents were sutured on the external surface of the prosthesis in such a way to create two self-expanding crowns for fixation. In adult pigs and under general anesthesia, the left atrium was exposed through a left thoracotomy and atrio-ventricular roadmapping was performed with intravascular ultrasound (IVUS) and fluoroscopy. The double-crowned valved stents were loaded into a delivery sheath. The sheath was then introduced into the left atrium and the valved stents was deployed in mitral position in such a way that the part in between the two stents was at the level of the mitral annulus. Intracardiac Unltrasound (ICUS) was used to assess the valve function. Hemodynamic parameters were gathered as well. Animal survived for no more than 3h after the valve deployment and gross anatomy examination of the left heart was carried out. RESULTS: The mean height of the valved stents was 29.4+/-0.2 mm, with an internal diameter of 20.4+/-1.0mm, and an external diameter of 25.5+/-0.8 mm. The procedure was successfully carried out in eight animals. In vivo evaluation showed a native mitral annulus diameter of 24.9+/-0.6 mm, and a mean mitral valve area of 421.4+/-17.5 mm2. ICUS showed a mild mitral regurgitation in three out of eight animals. Mean pressure gradient across the valved stents was 2.6+/-3.1 mmHg. Mean pressure gradient across the left ventricular outflow tract (LVOT) was 6.6+/-5.2 mmHg. The mean survival time was 97.5+/-56.3 min (survival time range was 40-180 min). One animal died due to the occlusion of the LVOT because of valved stents displacement. Postmortem evaluation confirmed correct positioning of the valved stent in the mitral position in seven out of eight animals. No atrial or ventricular lesions due to the valved stents were found. CONCLUSIONS: Off-pump implantation of a self-expandable valved stent in the mitral position is technically feasible. Further studies will assess if this procedure is also feasible in humans.     

Novel IgE peptide-based vaccine prevents the increase of IgE and down-regulates elevated IgE in rodents

BACKGROUND: Immunotherapy with anti-IgE antibodies for treatment of allergy is promising but a short half-life and extremely high cost limit its application. OBJECTIVE: We sought to develop IgE vaccines that induce longer-lasting auto-antibodies to neutralize self-IgE as an alternative therapy. METHODS: The vaccine was made by conjugating three synthetic peptides corresponding to human IgE receptor-binding sites to a carrier, hepatitis B surface antigen. To test the immunogenicity of the vaccine, rats were immunized with the vaccine or hepatitis B surface antigen as control. Serum IgG titres to human IgE and the IgE of other species were measured. The inhibition by rat antisera of the binding of human IgE to its receptor was assessed by ELISA, flow cytometry analysis, and passive cutaneous anaphylaxis (PCA), and its ability to recognize receptor-bound IgE was examined. The in vivo effect of the vaccine was evaluated in trichosanthin-sensitized mice and rats. In the preventative study, vaccination started before sensitization commenced, while in the treatment study, vaccination started after sensitization. Sensitized mice and rats receiving injections of the carrier served as controls. Trichosanthin-specific IgE was measured using PCA. RESULTS: Sera from vaccine-immunized rats contained high titre antibodies that reacted with soluble and plate-bound but not with receptor-bound human IgE; they also reacted with mouse, rat, and dog IgE. Furthermore, the sera inhibited the binding of human IgE to its receptor in a dose-dependent manner. In preventative and treatment studies, serum trichosanthin-specific IgE levels were significantly reduced in vaccinated groups compared with controls. CONCLUSION: Antibodies against self-IgE can be induced by IgE peptide-based vaccines, which are effective in preventing the increase of IgE and in down-regulating IgE in sensitized animals.     

2001年与2004年抗菌药物应用情况比较

目的　了解抗菌药物应用的基本情况。方法　将 2 0 0 1年 3月 14 3 0例住院患者病历与 2 0 0 4年 3月的 2 0 66例住院患者病历进行回顾性调查和对比分析。结果　 2 0 0 1年的 14 3 0例中有 948(66 3 % )例 ,和 2 0 0 4年的 2 0 66例有 10 60例 (5 1.3 % ) ,应用了抗菌药物。结论　定期检查考评 ,严格掌握用药指征 ,是加强抗菌药物应用管理的关键。     

Comparison of Marker Intervals and Number of Sib Pairs Used for Linkage Analysis on Simulated Nuclear Family Data

Using a two‐stage global scan design, we analyzed general population replicates 1 and 42 of the Genetic Analysis Workshop (GAW) 12 simulated data set using three methods: revisited Haseman‐Elston (HER), maximum likelihood variance estimation (ML), and variance components (VC). Three marker densities, 5‐, 10‐, and 15‐cM intervals, were examined in the first‐stage scan. We found that the 10‐cM interval appears to be the most cost‐effective approach in genotyping without sacrificing power when using a first stage significance level of 0.01. Subsequently, we performed the second‐stage scan at 1‐cM intervals for those putative positive regions identified in the first‐stage scan at a significance level of 0.01. We also compared the power to detect linkage using different numbers of sib pairs for a genome‐wide scan at a 10‐cM interval and found that power decreases nonlinearly as the number of sib pairs decreases. © 2001 Wiley‐Liss, Inc.     

33例肝占位性病变MRI误诊的分析

我院１９８８年以来４０００余例腹部ＭＲＩ中，发现肝占位性病变误诊３３例。所用机型为美国Ｄｉｓｏｎｉｃｓ公司０．５Ｔ超导ＭＲＩ，自旋回波序列（ＳＥ序列）、常规Ｔ１加权（Ｔ１ＷＩ）、质子加权（ＰＤＷＩ）、Ｔ２加权（Ｔ２ＷＩ），覆盖全肝。其中，ＰＨＣ误诊为ＭＨＣ５例、ＭＨＣ误诊为ＰＨＣ６例、ＰＨＣ误为ＨＨＥ５例、ＭＨＣ误诊为ＨＨＥ２例、ＨＨＥ误诊为ＰＨＣ６例、肝硬化结节误诊为ＰＨＣ２例、炎性假瘤误诊为ＰＨＣ３例、肝结核误诊为ＰＨＣ１例、ＨＣＹ误诊为ＨＨＥ３例。本文从病变的影像学特征和扫描技术方面详细探讨了误诊的原因和鉴别诊断要点。