光动力学疗法对不同妇科肿瘤细胞的体外杀伤效应

光动力学疗法 (photodynamic therapy,PDT)用于恶性肿瘤治疗效果满意 ,近来正受到广泛关注 [1] 。寻找吸收波长介于 6 5 0 nm～ 80 0 nm的新型光敏剂及研制相应激光器 ,提高对恶性肿瘤组织的穿透力是光动力学治疗发展的趋势[2 ] 。本研究旨在应用吸收峰值在 6 6 7nm 的叶绿素衍     

CartoXP Guided Catheter Ablation for Paroxysmal Atrial Fibrillation Without Three-dimensional Modeling of Left Atrium and Pulmonary Veins

Objectives This study was to investigate the differences between modeling and non-modeling left atrium （LA） in CartoXP system guided catheter ablation for paroxysmal atrial fibrillation （PAF）. Methods From Jan to Dec in 2008 total 31 cases with PAF were enrolled. All were treated by the same electrophysiologist with CartoXP guidance. Catheter ablation was accomplished without left atrium and pulmonary veins modeling in 17 patients （non-modeling group） and with left atrium modeling in 14 patients （modeling group）. The detailed ablation method was based on circumferential pulmonary veins isolation （CPVI）. And linear ablation of tricuspid valvular isthmus was performed individually. The ablation endpoint was a complete isolation of pulmonary vein potential from left atrium and no further induced continuous fast atrial arrhythmia including atrial fibrillation （AF）, atrial flutter （AFL） and atrial tachycardia （AT）. Each step for the procedures and the follow-up outcomes were compared correspondingly. Results The total procedure time was 107.23 ± 28.92 min in modeling group vs 93.47 ±26.09 min in non-modeling group （ P 〉 0.05 ）. The X-ray exposure time was significantly longer in modeling group （21.09 ±6. 49 rain） than in non-modeling group （14. 16 ± 5.35 min）. The CPVI times of right pulmonary veins and left pulmonary veins were 28. 14 ± 9. 26 min was 27.29 ± 18.53 min in modeling group respectively, vs 18.00 ±4. 51 min and 23.94 ± 7. 10 min in non-modeling group respectively, （P 〈 0. 05 ）. There is no significant difference between modeling group （85.7%） and non-modeling group （82.4%） over follow-up period of 2 to 13 months. Confusions CartoXP system guided catheter ablation of PAF without modeling of left atrium and pulmonary veins took less time in X-ray exposure and ablation steps, comparing with left atrium modeling procedure.     

坐骨神经压迫性损伤大鼠背根神经节NaN/SNS2钠通道表达的变化

目的:观察电压门控钠通道NaN/SNS2在大鼠坐骨神经慢性压迫性损伤(chronic constrictioninjupy,CCI)14天后的变化,探讨慢性神经痛的发生机制.方法:以逆转录多聚酶链反应(RTPCR)半定量分析CCI后大鼠背根神经节(Dorsal root gamglion,DRG)钠通道NaN/SNS2转录物的变化,以及全细胞膜片钳技术记录CCI对急性分离大鼠背根神经节TTX-R钠电流的影响.结果:CCI术后14天,感觉神经元特异性的TIX-R钠通道转录物NaN/SNS2下调,与对照组相比,下降了大约30%,TTX-R钠电流密度明显减弱,但不影响其激活与稳态失活.其激活曲线的V1/2分别为-26.6378mV、-26.6306mV,k为6.7864mV、6.7323mV;失活曲线的V1/2分别为-35.5844mV、-37.2188mV,k为8.2792 mV、8.4647mV.结论:钠通道NaN/SNS2与慢性神经痛后初级感觉神经元过度兴奋有关.     

卡维地洛对老年慢性心力衰竭合并糖尿病病人糖代谢和脂代谢的影响

目的探讨新型B受体阻滞剂卡维地洛对老年慢性心力衰竭的疗效和对糖、脂代谢的影响。方法60例年龄65岁以上慢性心力衰竭伴糖尿病病人(男性53例，女性7例)随机分为卡维地洛 常规抗心力衰竭治疗组(卡维地洛组30例)和单纯常规抗心力衰竭治疗组(对照组30例)。各例都进行临床检查及血糖和血脂测定。其中NYHA心功能分级Ⅱ级30例，Ⅲ级24例，稳定的Ⅳ级6例。卡维地洛初始剂量3．125mg Bid；一周后如无不良反应，增加至6．25mg Bid；如耐受两周后则递增剂量12．5mg Bid；再两周后25mg Bid；以此剂量维持治疗，共12周。结果两组入院时年龄、性别、血压、心率、及血糖和血脂无差异。两组治疗后收缩压和舒张压较治疗前显著降低，心率减慢。卡维地洛组和对照组治疗后空腹血糖和餐后2小时血糖及血脂均较治疗前显著减低。结论卡维地洛对糖、脂代谢无不良影响，为此对伴有糖尿病的老年慢性心力衰竭的治疗安全、有效。     

EnSite NavX指导下无肺静脉造影的阵发性心房颤动导管消融术

目的探讨不作肺静脉造影行阵发性心房颤动(房颤)环肺静脉电隔离术的有效性和可行性。方法 34例阵发性房颤患者分为无肺静脉造影组(n=18)和肺静脉造影组(n=16),无肺静脉造影组不作肺静脉造影,余步骤与肺静脉造影组相同,两组均在EnSiteNavX三维标测系统指导下重建左心房及肺静脉,再分别行左、右环肺静脉电隔离术,消融终点为肺静脉与心房完全电隔离。结果无肺静脉造影组消融术时间[(92.78±19.46)minvs.(106.44±20.18)min,P0.05]及X-线曝光时间[(11.47±4.32)minvs.(16.06±8.72)min,P0.05]少于肺静脉造影组,差异有统计学意义。两组左心房三维重建时间[(6.22±2.65)minvs.(6.31±3.00)min,P0.05]、左、右侧环肺静脉消融时间[(21.61±7.66)minvs.(20.50±8.09)min,P0.05;(17.33±10.22)minvs.(17.48±7.86)min,P0.05]及即刻消融成功率[100%(18/18)vs.100%(16/16),P0.05]比较,差异无统计学意义。结论不作肺静脉造影,仅在三维标测系统指导下行房颤消融治疗,可达到相同消融效果,可节省消融术及X-线曝光时间,减少手术步骤、耗材和费用。     

广西地区宫颈癌患者HPV感染情况分析

目的观察基因芯片技术对宫颈癌人类乳头状瘤病毒（HPV）分型检测的可行性,探讨广西地区宫颈癌患者HPV感染情况及其亚型分布规律。方法采用基因芯片技术对163例宫颈癌组织标本进行HPV分型检测。结果HPV总感染率为95．1％,其中鳞癌131例,HPV阳性率为98．5％;腺癌分别为32例和81．3％（P〈0．05）。鳞癌最常见的感染亚型是HPV16（78．6％）,其次是HPV18（11．5％）、HPV59（5．3％）、HPV58（3．1％）、HPV33（3．1％）、HPV31（3．1％）;腺癌最常见的亚型是HPV18（59．4％）,其次是HPV16（21．9％）、HPV52（6．3％）、HPV35（3．1％）。鳞癌患者单一感染106例（82．2％）,双重感染27例（17．8％）;腺癌患者分别为22例（84．6％）、4例（15．4％）;均未见三重及以上多重感染。结论基因芯片技术检测宫颈癌组织中HPV分型简便、高通量。广西地区宫颈癌中HPV感染率极高,其中鳞癌中以HPV16最常见,腺癌中以HPV18最常见。     

应用ROC曲线评价TIMI危险评分对急性胸痛患者中非ST段抬高急性冠状动脉综合征的诊断价值

目的探讨TIMI危险评分在急诊就诊的急性胸痛患者中鉴别非ST段抬高急性冠状动脉综合征(NSTE-ACS)的诊断价值。方法回顾性分析52例就诊于四川大学华西医院急诊科的急性胸痛患者。按TIMI危险评分的7个变量进行计分,以冠状动脉CT血管成像检查或(及)冠状动脉造影作为确诊标准,应用受试者工作特征(ROC)曲线以及Youden指数评价TIMI危险评分在急性胸痛患者中NSTE-ACS的诊断价值。结果 TIMI危险评分≥4分对于急性胸痛患者的NSTE-ACS有诊断价值。结论 TIMI危险评分增高的急性胸痛患者对于急性胸痛患者的NSTEACS有较好的诊断意义。     

前列地尔治疗糖尿病周围神经病变临床观察

目的观察并评价前列地尔治疗糖尿病周围神经病变（DPN）的临床疗效。方法纳入我院2009年2月~2010年2月住院部治疗的84例2型糖尿病患者,将患者随机分为A、B两组,各42例,分别采用前列地尔注射液和甲钴胺治疗,疗程均为2周。结果 A组患者的显效人数为37例,有效人数为3例,有效率为95.2%。A组患者的治疗效果显著好（P〈0.05）。两组患者的神经传导速度、空腹血糖（FPG）、餐后2 h血糖（2hPG）、糖化血红蛋白（HbA1c）差异均无统计学意义。结论采用前列地尔治疗糖尿病周围神经病变,可有效控制临床症状,增加神经传导速度,延缓病情发展,适合于临床上推广使用。     

中国西部地区青年临床医师及基层医疗机构执业医师急诊急救短期技能培训的必要性和合理模式探讨

目的通过问卷调查和临床/模拟培训相结合的方式,探讨在中国西部地区广泛开展急诊急救技能短期培训的必要性和合理的培训模式。方法通过对各级医院的青年临床医师和基层医疗机构执业医师进行问卷调查,了解目前常用基本急诊急救技能的掌握和应用情况,同时对其中的部分人员采用临床实践和课堂情景模拟教学相结合的短期培训模式,探讨该培训模式的合理性。结果 117名临床医师对拟定培训的22项基本急诊急救技能均有培训需求,其中的6项技能有超过50%医师具有强烈培训需求。经过培训,73名医师所有项目的掌握情况较培训前具有明显改进,各级医院的青年临床医师对于培训中大部分项目的掌握情况优于基层医疗机构执业医师。结论目前西部地区青年临床医师及基层医疗机构的常用基本急诊急救技能的掌握和应用情况尚待加强,对青年临床医师和基层医疗机构医师进行急诊急救技能培训是非常必要的。     

基于行为反应量的醒睡变换动态探测

BACKGROUND： According to observable behaviors, sleep and wakefulness are two fundamentally different behavioral states. Although electroencephalogram （EEG） is traditionally used to define sleep stage, it is difficult to detect or to quantify microarousals or disruptions during sleep. In addition initial sleep cannot be defined. It is thought that the wake-sleep transition cannot be defined by EEG patterns.
OBJECTIVE： To observe the behavioral response magnitude during wake-sleep transition by EEG monitoring and to define the wake-sleep transition.
DESIGN, TIME AND SETTING： A behavioral and neural network study was performed at the Key Lab of Human Being Development and Mental Health of Central China Normal University, and Lab of Brain and Cognitive Science of South Central University for Nationalities, China in July 2007.
PARTICIPANTS： A total of 30 healthy volunteers, of equal gender and aged （19.7 ± 1.1 ） years, were recruited from the Central China Normal University, China for this study. None of the subjects had undergone EEG recording prior to this study or received any medication for sleep disturbances.
METHODS： A novel adaptive approach was applied to detect wake-sleep transition, which avoided stimulus-induced waking. To test the difference between wake state and wake-sleep transition, the amount of self-information and mutual-information were effective parameters to analyze wake-sleep transition.
MAIN OUTCOME MEASURES： The following parameters were measured： morphological changes in reaction time-magnitude, as well as correlation between phase changes and sleep, and wake and wake-sleep transition.
RESULTS： There were three typical phases in morphological changes of reaction time-magnitude. With regard to the behavioral definition and criterion for sleep, the phase morphological characteristics displayed good correlation with behavioral states, such as sleep, wakefulness, and sleep onset. Entropy as an indicator of brain cognitive processes was introduced to test for differences between the wakefulness and sleep onset phase. Results indicated a cognitive declined transitional period different between sleep and wake. After staggered cognitive changes during the wake-sleep transition, the brain underwent marked alterations and transitioned into sleep quickly with no bi-directional EEG changes.
CONCLUSION： Wake-sleep transition exists as an independent stage.