急诊输尿管镜钬激光碎石治疗输尿管结石致肾绞痛

目的：探讨急诊输尿管镜下钬激光碎石术治疗输尿管结石并发肾绞痛的疗效。方法：对76例因输尿管结石并发肾绞痛患者,采用输尿管镜下钬激光碎石术。结果：2例因结石上移至肾盂,2例因输尿管下段狭窄使输尿管无法到达结石部位手术失败,其余72例均碎石成功,术后当天肾绞痛缓解,碎石成功率为94.7%,术后肾绞痛缓解率为97.4%。结论：输尿管镜下钬激光碎石术治疗输尿管结石引起的肾绞痛,是一种安全、有效的方法。     

激光捕获显微切割联合SELDI蛋白质芯片筛选肺腺癌早期诊断标志蛋白

目的 探讨应用激光显微切割(LCM)联合表面增强激光解吸离子化飞行时间质谱蛋白质芯片(SEL,DI-TOF-MS)及模式识别分类技术-支持向量机(SVM)筛选肺腺癌标志蛋白的可行性.方法 将6例新鲜肺腺癌组织标本及其配对的4例正常肺组织制备8μm厚度冰冻切片,改良HE染色;用LCM技术选择性获取同质腺癌细胞和配对正常肺组织细胞.应用PBSⅡ+型SELDI-TOF-MS分析仪(IMAC芯片)分析腺癌及其配对正常细胞的蛋白质表达谱,比对差异点;应用SVM筛选并验证候选标志蛋白的判别效能.结果 平均每个LCM帽子的激光点数约4000 shots,获得了同质性>95%的肿瘤细胞和正常细胞.比较腺癌和配对正常细胞之间的SELDI谱图,共筛选出84个蛋白峰.将差异最明显的10个蛋白峰作为候选标志蛋白.和正常组织相比,6种蛋白在腺癌中呈低表达,4种蛋白在腺癌中呈高表达.差异有统计学意义(P<0.05).初步筛选出3191 m/z蛋白峰作为腺癌诊断标志蛋白.结论 LCM联合SEIDI蛋白质芯片技术有可能筛选出敏感性高、特异性强的肺腺癌标志蛋白;该技术将为肺腺癌早期诊断研究提供新的强有力的工具.     

半导体激光联合中频治疗慢性肥厚性咽炎50例疗效观察

目的探讨半导体激光联合中频治疗慢性肥厚性咽炎的疗效。方法150例慢性肥厚性咽炎患者随机分为激光+中频组、激光组、对照组,每组50例,观察疗效。结果激光+中频组患者治疗前、后各项症状评分比较,差异有统计学意义（P均<0.01）,起效时间为2周,4～8周疗效最佳。激光组与对照组患者治疗前、后各项症状评分比较,差异无统计学意义（P均>0.05）,激光+中频组疗效明显高于激光组和对照组。结论半导体激光联合中频治疗慢性肥厚性咽炎疗效显著。     

吗啡预处理兔心肌MALDI-TOF-MS分析

目的：对吗啡预处理兔心肌进行基质辅助激光解吸飞行时间质谱（matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, MALDI-TOF-MS）分析。方法：将6只新西兰大白兔随机分为对照组和吗啡预处理组,每组3只。对照组静脉注射生理盐水1 mL/kg, 吗啡预处理组静脉注射吗啡3 mg/kg。用双向凝胶电泳法分离两组24 h后的心肌组织蛋白,图像分析后找出差异蛋白。用MALDI-TOF-MS鉴定部分差异蛋白。结果：两组的差异明显点共有51个,取15个差异蛋白质进行质谱分析,初步鉴定出8个蛋白质,包括应激蛋白（醛糖还原酶、锌指蛋白312）、信号转导蛋白（Src相关的酪氨酸激酶）、代谢相关蛋白（碳酸酐酶12前体、电子转移黄素蛋白β亚单位、甘油醛-3-磷酸脱氢酶）、炎性反应相关蛋白（肿瘤坏死因子配体超家族成员11）和跨膜转运蛋白。结论：这些差异表达的蛋白可能在吗啡对心肌延迟性保护中发挥作用。     

Neurophysiological techniques to detect early small‐fiber dysfunction in transthyretin amyloid polyneuropathy

Introduction: Transthyretin familial amyloid polyneuropathy (TTR‐FAP) is characterized by early selective involvement of small nerve fibers. Initial clinical diagnosis is complicated by psychosocial factors. We evaluated diagnostic accuracy of sural sensory nerve action potentials, plantar sympathetic skin response (SSR), and cortical laser‐evoked potentials (LEP) to dorsal foot stimulation in the early diagnosis of TTR‐FAP.Methods: Sixty‐three subjects with TTR‐FAP (Val30Met) mutation were split into 2 groups (asymptomatic carriers and early‐symptomatic patients) and compared with 33 healthy controls. Results: The diagnostic accuracy of plantar SSR amplitude and LEP N2 latency was similar; all had very high specificity (94 to 97%) but low sensitivity (22 to 32%) in distinguishing controls from carriers and early‐symptomatic patients. No control had abnormal results on both tests. Conclusions: Plantar SSR and LEPs have similar diagnostic performance in detecting small‐fiber dysfunction in early TTR‐FAP; we propose that both tests should be used to investigate this population. Muscle Nerve 49 : 181–186, 2014     

Assessment of muscle stiffness using a continuously scanning laser‐Doppler vibrometer

Introduction: A stand‐alone and low‐cost elastography technique has been developed using a single continuously scanning laser Doppler vibrometer. Methods: This elastography technique is used to measure the propagation velocity of surface vibrations over superficial skeletal muscles to assess muscle stiffness. Results: Systematic variations in propagation velocity depending on the contraction level and joint position of the biceps brachii were demonstrated in 10 subjects. Conclusions: This technique may assist clinicians in characterizing muscle stiffness (or tone) changes due to neuromuscular disorders. Muscle Nerve 50 : 133–135, 2014     

超声内镜引导下钬激光对裸鼠胰腺原位种植瘤消融效果的实验研究

目的：本研究的主要目的是探索超声内镜引导下钬激光对裸鼠胰腺原位种植瘤消融治疗的有效性,为超声内镜引导下钬激光对肿瘤的消融治疗应用于临床提供实验基础。方法：选取4-6周龄的雄性balb/c裸鼠20只,将胰腺癌细胞株SW1990接种至裸鼠胰腺,构建裸鼠原位种植瘤模型,随机分配裸鼠成2组,每组10只,实验组给予超声内镜引导下钬激光的消融治疗,对照组不给予任何治疗。于治疗后第7天,第14天和第28天予超声内镜下测量实验组及对照组裸鼠肿瘤的大小,观察裸鼠活动、食欲等变化。解剖裸鼠,取出肿瘤,行HE染色显微镜下观察胰腺肿瘤组织的病理变化。结果：所有裸鼠均可耐受超声内镜引导下钬激光的消融治疗,实验组裸鼠术后无明显不适反应,精神状态、活动量及食欲较好,对照组裸鼠精神状态逐渐恶化,身材极度消瘦,消融后28天实验组裸鼠肿瘤体积缩小,对照组裸鼠肿瘤增大,两组肿瘤体积的变化差异具有统计学意义,钬激光的治疗疗效大约持续28天左右。HE染色可见消融部位呈凝固性坏死。结论：超声内镜引导下钬激光对裸鼠原位种植瘤的消融治疗是有效的,治疗疗效大约持续28天,主要引起肿瘤组织的凝固性坏死。     

Rho-kinase inhibition improves ischemic perfusion deficit in hyperlipidemic mice

Hyperlipidemia is a major cardiovascular risk factor associated with progressive cerebrovascular dysfunction and diminished collateral perfusion in stroke. Rho-associated kinase (ROCK) may be an important mediator of hyperlipidemic vascular dysfunction. We tested the efficacy of acute or chronic ROCK inhibition on the size of dynamic perfusion defect using laser speckle flowmetry in hyperlipidemic apolipoprotein E knockout mice fed on a high-fat diet for 8 weeks. Mice were studied at an age before the development of flow-limiting atherosclerotic stenoses in aorta and major cervical arteries. Focal ischemia was induced by distal middle cerebral artery occlusion (dMCAO) during optical imaging. The ROCK inhibitor fasudil (10 mg/kg) was administered either as a single dose 1 hour before ischemia onset, or daily for 4 weeks. Fasudil decreased both baseline arterial blood pressure and cerebrovascular resistance (CVR) by ∼15%, and significantly improved tissue perfusion during dMCAO. Interestingly, peri-infarct depolarizations were also reduced. Chronic treatment did not further enhance these benefits compared with acute treatment with a single dose. These data show that ROCK inhibition improves CVR and ischemic tissue perfusion in hyperlipidemic mice.     

Impaired fear extinction in mice lacking protease nexin‐1

The serine protease inhibitor protease‐nexin‐1 (PN‐1) has been shown to modulate N‐methyl‐d ‐aspartate receptor (NMDAR)‐mediated synaptic currents and NMDAR‐dependent long‐term potentiation of synaptic transmission. Here, we analysed the role of PN‐1 in the acquisition and extinction of classical auditory fear conditioning, two distinct forms of learning that both depend on NMDAR activity in the amygdala. Immunostaining revealed that PN‐1 is expressed throughout the amygdala, primarily in γ‐aminobutyric acid containing neurons of the central amygdala and intercalated cell masses (ITCs) and in glia. Fear extinction was severely impaired in mice lacking PN‐1 (PN‐1 KO). Consistent with a role for the basal nucleus of the amygdala in fear extinction, we found that, compared with wild‐type (WT) littermate controls, PN‐1 KO mice exhibited decreased numbers of Fos‐positive neurons in the basal nucleus after extinction. Moreover, immunoblot analysis of laser‐microdissected amygdala sub‐nuclei revealed specific extinction‐induced increases in the level of phosphorylated alpha‐calcium/calmodulin protein kinase II in the medial ITCs and in the lateral subdivision of the central amygdala in WT mice. These responses were altered in PN‐1 KO mice. Together, these data indicate that lack of extinction in PN‐1 KO mice is associated with distinct changes in neuronal activity across the circuitry of the basal and central nuclei and the ITCs, supporting a differential impact on fear extinction of these amygdala substructures. They also suggest a new role for serine protease inhibitors such as PN‐1 in modulating fear conditioning and extinction.     

低强度激光联合照射口咽部和犊鼻穴对实验性膝骨关节炎兔氧自由基代谢的影响

背景：目前激光照射治疗膝骨关节炎以局部照射为主、输出功率和信号较为单一,多次照射易产生生物适应而降低疗效。 目的：探讨携带有针灸补泻信息的低能量激光联合多部位照射对实验性膝骨关节炎兔血清和滑膜组织中氧自由基代谢的影响。 方法：向兔膝关节腔内注入木瓜蛋白酶制备兔膝骨关节炎模型。穴位照射组和联合照射组分别以低能量激光单独照射犊鼻穴或联合照射口咽部及犊鼻穴,10 min /d,5 d为1个疗程,连续3个疗程。参照试剂盒方法测定血清一氧化氮、丙二醛水平和超氧化物歧化酶活性及膝关节滑膜组织丙二醛水平和超氧化物歧化酶活性;苏木精-伊红染色观察膝关节软骨组织形态学变化。 结果与结论：兔膝骨关节炎后,软骨出现明显的病理损伤,血清一氧化氮、丙二醛水平均显著升高(P < 0.01或P < 0.05),超氧化物歧化酶活性显著降低(P < 0.05)。经激光穴位照射和激光联合照射后病理损伤有所减轻,血清一氧化氮、丙二醛水平均下降,超氧化物歧化酶活性升高,以联合照射组效果显著(P < 0.05)。兔膝关节滑膜组织中丙二醛水平和超氧化物歧化酶活性变化与血清中相一致。说明低能量激光联合照射口咽部和犊鼻穴能够纠正膝骨关节炎兔氧自由基代谢紊乱,减轻关节软骨细胞结构损伤,其效果优于激光单独照射犊鼻穴。