肺癌候选抑瘤基因HLCDG1片段的验证及全长序列的克隆

目的： 对肺癌候选抑瘤基因HLCDG1片段（已知序列）进行验证,并克隆其全长cDNA序列。方法: 采用RT-PCR和末端快速扩增技术(RACE),对正常人肺组织中HLCDG1基因片段进行验证和克隆其全长cDNA序列,登录基因数据库进行比对分析。结果: 从正常人肺组织中钓取到HLCDG1基因未知的3’端和5’端序列分别为1 304 bp和1 548 bp。HLCDG1基因与人酪蛋白激酶Ⅰα（CSNK1A1）基因2号转录变体相似性达99%,score=5 544,E=0。结论: HLCDG1基因为已知的CSNK1A1基因的2号转录变体,可能参与肺癌发生发展。     

多导同步心电图的QRS波检测及起止点的确定

本文采用从单导到多导的检测方法,首先利用小波变换实现单导ＱＲＳ波的检测,在此基础上,利用位置相关法进行多导ＱＲＳ波的检测,并利用心电信号的２＾１迟度小波变换的平方值来确定ＱＲＳ波的起止点,经过大量数据的检测证明取得了很好的效果。     

Wire ThRoUgh Snare Twice (Wire TRUST) technique: A novel method to grasp a lead with inaccessible ends as a supportive femoral approach for transvenous lead extraction

Introduction

Transvenous lead extraction (TLE) is a crucial procedure for managing cardiac implantable electronic devices. The use of a combined superior and femoral approach has been found to enhance the success rate of TLE. This report introduces a novel technique, named “Wire ThRoUgh Snare Twice” (Wire TRUST), for effectively grasping a lead without a free end during TLE.

Method

The Wire TRUST technique was applied in a case involving a 49-year-old male patient requiring TLE due to electrical artifact on the right ventricular (RV) lead, replacement of the RV lead, and pacemaker generator exchange. The Wire TRUST technique involved the insertion of a 4-Fr pigtail catheter and a 6-Fr snare catheter through the 14-Fr sheath inserted from the right common femoral vein. The 4-Fr pigtail catheter was hooked to the RV lead under multidirectional fluoroscopic guidance in the right atrium. The 0.014-in. guidewire was advanced through the pigtail catheter, crossing the RV lead until reaching the inferior vena cava. Subsequently, the distal end of the 0.014-in. guidewire was captured using a snare and pulled, facilitating externalization of the guidewire. After externalization, both ends of the 0.014-in. guidewire were passed through the snare outside the body and reinserted into the 14-Fr sheath. By simultaneously advancing and closing the snare while applying tension to the 0.014-in. guidewire, a secure grip on the lead without free ends was achieved.

Results

The Wire TRUST technique enabled successful lead extraction and replacement without any complications. The technique facilitated the co-axial alignment of the powered sheath with the RV lead, ensuring safe and efficient extraction.

Conclusion

The Wire TRUST technique presents a novel and effective approach for grasping leads with inaccessible ends during TLE.     

Determination of Optimal Flat-End Head Geometries for Pressure Vessels Based on Numerical and Experimental Approaches

The experimental and numerical analyses of the pressure vessels with different flat ends are presented and discussed in the paper. The main aim of the study is to propose the optimal flat head end geometry. The analyses are focused on the comparison of standardized geometries and with the proposed elliptical cut-out. The experimental tests with the application of strain-gauge measurements and numerical modeling of the pressure vessel are conducted. The behavior under low and high pressures and the influence of the residual welding stresses, material properties, and geometrical tolerances on the level of the plastic deformation in the flat end is discussed. It is presented that the rules given in the recent standard are not sufficient for optimal selection of the optimal geometry. It is observed that in certain geometries the deviations of the pipe thickness may lead to a significant increase of the equivalent stresses. The residual welding stresses have a significant influence on the stress and strain level—particularly in the stress relief groove (SRG). The performed study and comparison of the different geometries allow for the proposal of the optimal shape of the flat end. It appeared that the pressure vessels with SRG are the most optimal choice, particularly when elliptic shapes are in use. In some cases (i.e., pipe with wall-thickness equal to 40 mm and the flat end with circular SRG), the optimal configuration is reached for dimensions beyond the admissible by code range.     

腋路臂丛神经两点与两侧阻滞临床研究应用

目的:科学阻滞腋路臂丛神经,使之达到完全阻滞,减轻手术过程中患者的痛苦,减少术中辅助用药的应用,克服常规阻滞法的缺点,为手术创造更优的条件。方法:采用腋动脉两侧进针进行阻滞,将药液分注在腋动脉的两侧,注药过程中加压腋鞘远端,注药后立即回收上肢贴于躯干。结果:阻滞侧腋路臂丛神经达到了完全阻滞,阻滞时间平均每例延长1.5 h,差异有统计学意义(P<0.05),且麻醉阻滞平面有所上升。结论:腋路臂丛神经两点、两侧阻滞法是腋路臂丛神经科学的阻滞方法,克服了常规阻滞法的缺点,减轻了患者痛苦,为手术创造了更优的条件,有推广应用价值。