NS-398对高糖诱导的系膜细胞结缔组织生长因子表达的影响

［摘要］目的研究选择性环氧化酶 2抑制药NS 398对高糖诱导的系膜细胞刺激结缔组织生长因子（CTGF）表达的影响。 方法20 μmol•L-1 NS 398加入30 mmol•L-1高糖培养的大鼠肾小球系膜细胞中，分别培养0，12，24，48，72 h，应用逆转录聚合酶链反应的方法评价CTGF mRNA的表达改变，应用免疫细胞化学方法评价CTGF蛋白的表达水平。结果未加高糖刺激的肾小球系膜细胞CTGF mRNA和蛋白表达水平较低，高糖刺激后肾小球系膜细胞CTGF mRNA和蛋白表达水平增加，6 h活性已渐增高，12 h达高峰，18 h开始下降，24 h降至较低水平。用NS 398干预30 min后再用30 mmol•L-1高糖刺激，未见 CTGF mRNA和蛋白表达水平增加（P＞0.05）。 结论高糖能上调肾小球系膜细胞CTGF mRNA和蛋白的表达，NS 398能抑制高糖诱导系膜细胞CTGF的表达。     

对择期手术患者家属术前焦虑状况调查与心理干预

目的了解患者家属术前焦虑的影响因素，为有效的心理干预措施提供参考。方法对102对调查对象采用SPSS统计软件对可能影响家属焦虑状况的因素进行分析。结果患者自付医疗费对家庭经济影响及患者术前住院天数两种因素与家属焦虑状况有关。结论加强对家属的健康教育，使家属了解疾病和自我保健的相关知识，可以缓解家属不必要的焦虑情绪。     

脑电双频指数调控麻醉深度在选择性脊神经后根切断手术中的应用

目的探讨选择性脊神经后根切断手术中最佳的麻醉深度，为手术治疗提供可靠依据。方法选择痉挛性脑瘫患者30例，年龄7—17岁。随机分为三组，脑电双频指数（BIS）监护仪监测麻醉深度，A组10例，术中维持BIS为60—70；B组10例，BIS为50—59；C组10例，BIS为40-49。观察三组患者在电刺激腰2（L2）后根时运动阈值、体动反应；同期记录电刺激L2后根2min内BIS的最大值（BISmax）及肌电信号值（EMG）；记录电刺激L2前后的平均动脉压（MAP）及心率（HR），记录肌松剂的停药时间和电刺激开始至缝硬膜的手术时间。结果（1）运动阈值：A、B两组分别为（0．17±0．05）mg、（0．21±0．14）mA均低于C组的（0．78±0．25）mA，P〈0．01。（2）MAP及HR：A组在电刺激后与刺激前比较显著升高（P〈0．01），并显著高于B、C两组。（3）体动反应：BIS在60—70时体动反应发生率为60％，BIS在40—59时水平体动反应发生率为10％，两组比较差异有统计学意义（P〈0．01）。（4）A组BISmax为76．29±8．46。三组患者术后24h随访均无术中知晓发生。结论选择性脊神经后根切断手术中麻醉深度在BIS50—59时，运动阈值适当，有利于后根神经的选择，体动反应发生率低，且能避免术中知晓。     

动脉造影及栓塞在胆道出血的诊治价值

目的 探讨运用选择性动脉造影和超选择性动脉栓塞术对胆道大出血的诊断和治疗价值。方法 运用Seldinger技术对10例胆道大出血患者进行急诊选择性肝动脉及其分支造影和超选择性动脉栓塞术．栓塞材料为明胶海绵粒或弹簧圈。结果 10例均为胆道术后出血的患者，其中1例为术后3个月发生，行选择性肝动脉及其分支造影均发现异常．表现为造影剂外溢征3例，血管染色征2例和假性动脉瘤形成5例。3例经超选择性动脉栓塞术后。患者出血均停止。痊愈出院。结论 胆道大出血的急诊选择性动脉造影和超选择性动脉栓塞术是一种快速、安全、有效的诊治方法。     

双源CT成像在评价冠状动脉狭窄中价值的初步探讨

目的：通过与选择性冠状动脉造影（SCA）对比,评价双源CT（DSCT）在冠状动脉狭窄患者中的应用价值,并系统分析其对不同程度冠状动脉狭窄的诊断价值.方法：52例疑似冠心病患者,男44例,女8例,平均年龄70.59岁,分别予以SCA和DSCT检查.由两位医师采用双盲法对检查结果进行比较.结果：发现DSCT对冠状动脉重度狭窄评价的敏感性为92.31%,特异性为99.82%,阳性预测值为90.57%,阴性预测值为99.32%.结论：提示DSCT可以用于判断冠状动脉狭窄情况,尤其对冠状动脉重度狭窄患者的敏感性和特异性较高,可作为冠心病患者筛查、冠状动脉手术患者术前评价和术后随访的可靠方法.     

选择性动脉灌注化疗加放疗联合治疗晚期食管癌的临床研究

１９９０年６月至１９９２年６月选择晚期初诊食管癌６０例，随机分为两组：选择性动脉插管灌注化疗加放疗组和单纯放疗组，前组选用阿霉素６０ｍｇ，５－氟脲嘧啶１ｇ，顺铂４０ｍｇ灌注化疗２疗程后即行放疗。放疗量为ＤＴ５０Ｇｙ／５周。后组放疗量ＤＴ６０－７０Ｇｙ／６～７周。近期疗效判断前组明显优于后组，１年生存率分别为６３．３％和３６．７％，有显著差异。两组副作用无显著差别。     

Selective photothermal interaction using an 805-nm diode laser and indocyanine green in gel phantom and chicken breast tissue

. Laser immunotherapy, a novel therapy for breast cancer, utilises selective photothermal interaction to raise the temperature of tumour tissue above the cell damage threshold. Photothermal interaction is achieved with intratumoral injection of a laser-absorbing dye followed by non-invasive laser irradiation. When tumour heating is used in combination with immunoadjuvant to stimulate an immune response, antitumour immunity can be achieved. In this study, the selective photothermal effect was investigated using gel phantom and chicken breast tissue. An 805-nm diode laser and indocyanine green (ICG) were used. An ICG-containing gelatin phantom was constructed to simulate targeted tumour tissue. The target gel was buried inside chicken breast tissue and the tissue–gel construct was irradiated by the laser. Temperatures at different locations in the construct were measured during the laser irradiation. For comparison, the thermal effect of an Nd:YAG laser on the tissue–gel construct was also investigated. Selective heating of target gel containing 0.27% ICG and buried 1 cm below the chicken tissue surface was achieved with the 805-nm diode laser using a power of 0.85 W and beam radius of 1 cm. The target gel experienced a temperature increase of more then 6°C whereas the surrounding chicken breast tissue experienced only a minor temperature increase. The feasibility of this experimental set-up has been shown. It will be used in the future to optimise treatment parameters such as laser power, laser beam radius, and dye concentration. Paper received 17 April 2002; accepted 3 May 2002. Correspondence to: W.R. Chen, Biomedical Engineering Program, Department of Physics and Engineering, University of Central Oklahoma, Edmond, OK 73034, USA. Tel.: (405) 974-5198; Fax: (405) 974-3812; e-mail: wchen@ucok.edu     

Does the cerebellum contribute to specific aspects of attention?

We present data on attentional and neuropsychological functions of 16 patients with focal cerebellar lesions (13 tumours, 3 haematomas) compared to normative test data, and to 11 control subjects matched for age, gender, and years of education. Patients showed distinct deficits in qualitative aspects of a divided attention task, and in a working memory task. Performance in selective attention was unimpaired. The results support the concept that the cerebellum plays a role not only in motor, but also in higher cognitive functions. They are discussed on the basis of the idea that prediction and preparation are fundamental functions of the cerebellum. Therefore, the results confirm the idea that cerebellar lesions lead to reduced performance in specific attention tasks.     

增强CT、选择性血管造影对胰腺癌手术不可切除性的评估

背景与目的：胰腺癌手术不能切除的主要原因是胰周大血管受侵,本文旨在探讨增强CT、选择性血管造影（selective angiography,SAG)评估胰腺癌手术不可切除性的可靠性。方法：回顾性分析我院自1996年8月7日－2000年8月12日期间收治的经手术探查证实为胰腺导管腺癌患者67例,其中胰头癌63例,胰体尾癌4例;术前行增强CT、SAG者分别为31、54例。根据具体的判定指标,由手术医师对患者术前CT或SAG片中胰周大血管的受侵程度进行评估（放射医师的报告作为参考）,评估结果与术中血管的实际受侵情况比较,评估上述方法的可靠性。结果：31例行增强CT检查者中,CT提示不可切除者13例,手术证实不可切除者12例,预告值为91％。54例行SAG者中,造影提示不可切除者28例,手术证实不可切除者23例,预告值为82％。增强CT和SAG对于评估胰腺癌不可切除的敏感性、特异性、阳性预告值分别为60％、91％、92％和77％、79％、82％。增强CT和SAG联合评估胰腺癌不可切除的敏感性、特异性、阳性预测值分别为91％、100％、100％。结论：增强CT、SAG作为非手术技术手段是术前评估胰腺癌不可切除性的可靠方法,两种方法联合使用可提高预测的敏感性、特异性和阳性预告值。     

Watching where you look: modulation of visual processing of foveal stimuli by spatial attention

Two experiments investigated the effect of sustained selective spatial attention upon the perceptual analysis of stimuli within the center of gaze. Spatial attention has typically been studied in relation to peripheral stimuli, and its relevance to the processing of central stimuli has remained relatively ignored. Here, behavioral measures in normal human volunteer participants showed that focused spatial attention can also influence responses to central stimuli, over and beyond the advantage conferred by their foveation. Event-related potentials (ERPs) showed that the action of attention upon foveal stimuli included the modulation of perceptual processing in extrastriate visual areas. Surprisingly, the visual modulation revealed an intriguing and consistent pattern of hemispheric asymmetry, in both experiments. These findings show that in addition to the established right hemisphere dominance of the brain areas that direct attention, the consequences of directed attention may also be asymmetrical.