一种新型Visionwire标测导丝在心脏再同步化治疗中的应用

目的探讨一种新型Visionwire标测导丝在心脏再同步化治疗(CRT)左室电极植入过程中的应用价值。方法 5例因心力衰竭接受CRT的患者,分别采用Visionwire导丝及左室电极到达可植入左室电极的冠状静脉(CS)分支内进行起搏参数测试及电生理标测,比较两种方法的起搏参数测试、电生理标测结果及手术时间。结果在5例患者的16个CS分支中,两种方法所测的起搏参数值无显著性差异,二者的起搏阈值有强相关性(r=0.90,P<0.01),感知亦有相关性(r=0.67,P<0.01),二者最大起搏电压引起膈肌刺激的部位相似。应用Visionwire导丝可以进行局部电位电激动顺序标测。Visionwire导丝对单个CS分支进行起搏参数测定比应用左室电极进行起搏参数测定所需时间明显缩短(12.4±7.5 min vs 18.3±12.2 min,P<0.01)。结论应用Visionwire标测导丝可以预测CS分支的左室电极起搏参数,根据局部电位延迟可准确定位左室电极植入部位。     

8项生化指标对酒精性脂肪肝诊断的临床价值研究

目的探讨血清天冬氨酸氨基转移酶（AST）、AST同功酶（m—AST）、m—AST／AST比值、丙氨酸氨基转移酶（ALT）、γ-谷氨酰转肽酶（GGT）、尿素氮（BUN）、肌酐（SCR）和尿酸（uA）对酒精性脂肪肝（AFLD）的诊断价值。方法对291例AFLD、189例非酒精性脂肪肝（NAFLD）和256例健康对照进行上述生化指标的检测,并对结果进行分析。结果AFLD组与NAFLD组ALT、AST、m—AST、m—AST／AST、GGT、UA均显著高于健康对照组（P〈0．01）,AFLD组AIJT、AST与NAFLD组没有明显差异（P〉0．05）,但AFLD组的m—AST、m—AST／AST、GGT、BUN、SCR、UA均显著高于NAFLD组（P〈0．01）。结论m—AST、m—AST／AST、GGT、BUN、SCR、UA测定有助于AFLD肝损伤的评估,它们的联合检测有助于AFLD的诊断及鉴别诊断。     

HRV信号关联维计算中参数选取的研究

健康和有疾病的心率变异性（HRV）参数有明显差异,计算关联维是识别这种差异的一种重要手段。用传统的G—P算法计算关联维时,嵌入维数m、延迟时间τ、及序列长度N等参数的选取会对最终计算结果有很大影响。本文从理论和实验方面论述了如何选取这些参数以获得正确的结果,并且将其应用于正常组和心率不齐疾病组进行对照,结果显示关联维可以有效地表征由于疾病对于心脏节律造成的影响。     

Intraductal carcinoma of the prostate: What we know and what we do not know

Intraductal carcinoma of the prostate (IDC-P) is a malignant, clonal proliferation of cells growing within the basement membrane-bound structures of the prostate. IDC-P is usually associated with unfavorable clinicopathologic parameters such as large tumor volume, high-grade Gleason score, extra prostatic extension and seminal vesicle invasion. Majority of laboratory and patient data suggest that IDC-P represents intraductal spread of invasive carcinoma, rather than a precursor lesion. Additionally, relationship of IDC-P and adjacent invasive carcinoma has been investigated in a series of molecular studies. The differential diagnosis of IDC-P from other lesions is critical for patient management. In this article, we summarize current literatures regarding what we know about IDC-P, including its pathological morphology, incidence, differential diagnosis, molecular features and clinical significance. In addition, we propose several issues that we currently do not know about IDC-P. Further research is needed to better understand the biological nature of IDC-P.     

The Influences of Thermal Stress on Serum Biochemical Parameters of Dromedary Camels and Their Correlation with Thyroid Activity

In order to study the influences of thermal stress on serum biochemical parameters of dromedary camels and their correlation with thyroid activity, blood samples were taken from the jugular vein of 40 clinically healthy Iranian dromedary camels from December to February (3 times: mean temperature 11°C) and from June to August (3 times: mean temperature 41°C). There were significant differences in the concentrations of serum total protein, glucose, blood urea nitrogen (BUN), sodium, potassium, calcium, inorganic phosphorus, triiodothyronine (T3) and thyroxine (T4) and the activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), creatine kinase (CK) and lactate dehydrogenase (LD) in heat stress and cold stress conditions (p<0.05). The concentrations of BUN, sodium, potassium, calcium, inorganic phosphorus and the activities of CK and LD in winter months were higher than summer months, and in contrast, the concentrations of total protein, glucose, T3 and T4 and the activities of AST, ALT and ALP were higher in summer than in winter (p<0.05). Thyroidal hormones (T3 and T4) showed significant correlations with serum total protein, glucose, BUN, AST, ALT, ALP, LD and CK. Our results revealed that very hot and cold conditions had a profound effect on serum biochemical parameters.     

Endoscopy in Canada: Proceedings of the National Roundtable: Toronto,Ontario, February 7, 2014

This 2014 roundtable discussion, hosted by the Canadian Association of General Surgeons, brought together general surgeons and gastroenterologists with expertise in endoscopy from across Canada to discuss the state of endoscopy in Canada. The focus of the roundtable was the evaluation of the competence of general surgeons at endoscopy, reviewing quality assurance parameters for high-quality endoscopy, measuring and assessing surgical resident preparedness for endoscopy practice, evaluating credentialing programs for the endosuite and predicting the future of endoscopic services in Canada. The roundtable noted several important observations. There exist inadequacies in both resident training and the assessment of competency in endoscopy. From these observations, several collaborative recommendations were then stated. These included the need for a formal and standardized system of both accreditation and training endoscopists.     

大段负重骨移植中的生物力学实验研究

用大段自体骨和同种异体骨在羊负重的胫骨上移植后,植骨要产生替代和再生过程。由于组织抗原与移植骨固有性的差异,对上述过程要有不同的力学反应。结果表明：植入骨的愈合,生长过程与其力上关。不同类型移植骨在愈合、生长过程生物力学性质和明显差异。同时也也证明深冷冻、辐照处理的同种异体骨是代替自体移植骨最可受的材料。     

利用脉搏波特征参数连续测量血压的方法研究

通过研究血压与脉搏波特征参数的关系，提出了一个选择多个与血压相关的脉搏波特征参数,通过回归分析建立适合不同人的特征方程，进行血压的连续测量的新方法，为了验证测量结果的准确性；研制了张力计。实验结果表明：该方法具有较高的测量精度，可以应用于临床危重病人的血压监护和一般医学研究中，经过进一步地改进和完善后可应用于载人航天和日常动态环境。