弹性成像技术在子宫肌瘤射频治疗中的应用价值

目的:探讨实时超声弹性成像(Real-time ultrasound elastography,RTE)在子宫肌瘤射频消融治疗(radiofrequency ablation,RFA)中的应用价值。方法:对34例行RFA治疗的子宫肌瘤患者(共38个病灶)于术前、术后1小时、术后3个月进行阴式超声、RTE及超声造影(contrast-enhanced ultrasonography,CEUS)检查。在2D、RTE、CEUS三种条件下分别测量病灶的直径。分析术前弹性图特征并分组,测量病灶弹性应变比率(E/E_0),对比分析组间、组内的E/E_0。比较2D、RTE、CEUS条件下病灶直径之间的差异。术后以弹性图像上病灶显示蓝绿相间为判定消融不全的标准,与CEUS对比,分析RTE与CEUS对消融程度评估的一致性。结果:根据术前肌瘤弹性图像将病灶分为蓝色组8个(21.1%),蓝色为主组20个(52.6%),绿色为主组10个(26.3%),术前3组病灶之间E/E_0差异明显,术后1小时、术后3个月E/E_0差异无统计学意义(P0.05),组内RFA术后1小时、3个月病灶E/E_0较术前明显增大,术后3个月E/E_0大于术后1小时(P0.05);术前RTE检测病灶直径大于2D及CEUS(P0.05),术后1小时2D测量直径大于RTE及CEUS(P0.05),三种成像技术在术后3个月测量病灶直径差异无统计学意义(P0.05);RFA术后1小时及术后3个月RTE对病灶消融程度评估结果与CEUS基本一致,Kappa值分别为0.46、0.54。结论:RFA术后肌瘤逐步变硬,RTE检查能够反映这种硬度变化,并且能够评估消融病灶的范围并预估消融程度,因此RTE在子宫肌瘤RFA治疗中有一定的应用价值。     

透明质酸钠预防微波消融术后局部粘连的实验研究

目的:通过实验探讨透明质酸钠预防微波消融术后局部组织粘连的效果。方法:120只健康SD大鼠随机分为三组,每组40只,分别为微波消融组(A组,对照组)、微波消融加透明质酸钠组(B组)、微波消融加生理盐水组(C组)。通过对大鼠背部肌肉进行微波消融建立术后局部粘连模型,并在该模型基础上应用透明质酸钠,术后3 d、1 w、2 w、4 w分别对背部组织进行粘连分级、HE染色及免疫组化观察和分析。结果:消融术后3 d、1 w、2 w,B组在粘连分级方面A、B及C 3组间水平差异具有统计学意义P0.05);4 w时A、B、C组间的差异无统计学意义(P=0.458)。两两比较,A、C两组在四个时间点水平差异无统计学差异(P均0.05),而B组在消融术后3 d、1 w和2 w时,粘连分级明显优于A、C组,P=0.029(3 d)、P=0.011(1W)、P=0.004(2W),水平差异显著,有统计学意义;4 w时,P=0.391,无统计学意义。消融术后A、C组HE染色及免疫组化染色光镜下观察,淋巴细胞、巨噬细胞等炎症浸润情况及成纤维细胞数目均较B组多,且A、C组胶原纤维沉积明显多于B组。结论:透明质酸钠能够有效减轻微波消融术后发生的局部组织粘连。     

Genetic engineering of reproductive incompetence in radiata pine

Summary An important application of genetic engineering to commercial forestry is the generation of reproductively incompetent trees. This requires isolation and characterisation of the regulatory regions of the genes expressed at the different stages of male and female reproductive-organ development. A gene family showing specific expression inPinus radiata immature male and female cone buds has been isolated and characterised. We discuss different strategies for genetic engineering of reproductive incompetence, concentrating on cell ablation and the problems and possible solutions associated with this approach.Abbreviations DSB dwarf shoot bud - LSTB long-shoot terminal bud - PCB pollen cone bud - SCB seed cone bud     

Catheter microwave ablation therapy for cardiac arrhythmias

This article describes three microwave catheter antennas for percutaneous cardiac ablation. A particular design feature of these antennas is that there is no reflected microwave current from the antenna flowing up the transmission line. Thus, it minimizes heating of the coaxial cable. The power reflection coefficients are very low (4% or less) in phantom equivalent materials. These antennas can also serve as bipolar electrodes for sensing endocardiac electrograms. Our studies in dogs, during both cardiopulmonary bypass and closed‐chest operations via the femoral vein, have shown microwave energy greater than 200 joules (J) delivered to the heart through a split‐tip dipole catheter antenna can produce irreversible block of the heart rhythms. This energy was achieved either by increasing the delivered power from 20 to 40 watts or by increasing the treatment duration from 7 to 11 s (210 to 330 J per application). It produced an endocardium temperature of about 65 ºC. We found that the percutaneous, transcatheter microwave system is capable of inducing AV blocks consistently in dogs using the flexible, curved tip, split‐tip catheter antenna. In addition, our studies have shown that the width and height of SAR distributions for cap‐choke and split‐tip catheter antennas are similar for the same antenna length. The cap‐slot design had a much longer SAR distribution compared to the others. Moreover, a longer (4 mm) split‐tip antenna can also induce larger lesions. These results suggest that it could be possible to ablate a ventricular tachycardia focus using the 4 mm split‐tip as well as the cap‐slot microwave catheter antennas. Bioelectromagnetics 20:120–132, 1999. © 1999 Wiley‐Liss, Inc.     

Indirect Liftoff Mechanism for High-Throughput,Single-Source Laser Scribing for Perovskite Solar Modules

A high-throughput, single-source laser scribing method exploiting a transparent conducting oxide (TCO) indirect liftoff mechanism is developed to produce serially interconnected perovskite solar modules. The TCO-based indirect liftoff mechanism relies solely on laser absorption in the front transparent electrode material reducing thermal damage to the overlying layers and allowing for fast scribing speeds with low-cost μs-pulse duration fiber laser systems. Minimal resistive power losses are observed with the method compared to conventional ablative laser scribes, maintaining the power conversion efficiencies of small-area devices (≈0.2 cm²) across significantly larger deposition areas (≈1 cm²). Demonstrating > 3 m s⁻¹ processing speeds, TCO-based liftoff provides the highest throughput laser scribing method for thin-film photovoltaic devices produced on glass/TCO substrates, capable of processing large-area perovskite solar modules at a manufacturing scale.     

FDG-PET for detecting local tumor recurrence of ablated liver metastases: a diagnostic meta-analysis

Context: Scanty reports have focused on FDG-PET after radiofrequency ablation (RFA), for recurrence of hepatic metastases. Objective: To assess FDG-PET diagnostic accuracy on detection of recurrent hepatic lesions. Methods: After a comprehensive search of PubMed and EMBASE, we performed a patient-based diagnostic meta-analysis of post-RFA FDG-PET. Results: Across nine included articles, independent, random-effects sensitivity and specificity were 0.73(0.50–0.88) and 0.85(0.72–0.93), respectively. A symmetrical SROC curve was produced with no significant heterogeneity. Specificity was optimal for surgical RFA and colorectal origin of metastases. Conclusion: Synthesis of published evidence suggests PET/CT as an appropriate tool for optimizing post-ablation follow-up.     

超声引导下经皮射频消融子宫腺肌症的近期疗效观察

摘要 目的：探讨超声引导下经皮射频消融（RFA）治疗子宫腺肌症（ADM）的近期疗效。方法：选取2016年3月-2020年10月我院收治的ADM患者共计138例作为研究对象,根据数字随机表法将患者分为对照组和观察组,每组69例,对照组接受手术切除病灶治疗,观察组接受RFA治疗。比较两组患者子宫体积变化情况、临床症状、血红蛋白变化、术后不良反应发生情况。结果：两组患者术后子宫体积逐渐缩小,术后各随访时期与术前比较,差异均有统计学意义（P＜0.05）,术后1个月与术后3个月、6个月与12个月分别比较,差异均有统计学意义（P＜0.05）,术后3个月、6个月与12个月比较,差异无统计学意义（P＞0.05）。观察组月经过多、痛经等临床症状缓解率明显高于对照组（P＜0.05）,两组下腹包块、泌尿系统症状等临床症状缓解率比较（P＞0.05）,两组均无临床症状加重情况发生。两组患者术前、术后1天血红蛋白情况比较（P＞0.05）,观察组术后6个月血红蛋白量明显多于对照组（P＜0.05）。两组少量阴道排液及出血、月经紊乱、下腹痛、白带异常等轻微并发症总发生率比较无差异（P＞0.05）。少量阴道排液、出血患者持续10～60天自愈;月经紊乱患者给予肾上腺色腙片或激素处理;下腹痛患者持续时间约为2周,予镇痛处理;白带异常患者嘱其注意清洁卫生,预防感染。结论：超声引导下水冷循环电极经皮RFA治疗ADM具有微创、安全、高效的优势,可明显减小子宫体积,缓解临床症状,提高血红蛋白含量。     

超声引导下射频消融治疗联合泡沫硬化治疗对下肢静脉曲张疼痛应激反应、血流动力学及凝血功能的影响

摘要 目的：探讨与分析超声引导下射频消融联合泡沫硬化治疗对下肢静脉曲张疼痛应激反应、血流动力学及凝血功能的影响。方法：2021年8月到2022年5月选择在本院诊治的下肢静脉曲张60例作为研究对象,根据简单分配原则把患者分为联合组与泡沫硬化组各30例。联合组给予超声引导下泡沫硬化联合射频消融治疗,泡沫硬化组给予超声引导下泡沫硬化治疗,观察与记录患者疼痛应激反应、血流动力学及凝血功能变化情况。结果：两组术后1 d的疼痛VAS评分都显著低于术前1 d（P<0.05）,联合组也显著低于泡沫硬化组（P<0.05）。两组术后1 d的血清缓激肽（BK）、P物质（SP）含量都显著低于术前1 d（P<0.05）,联合组也显著低于泡沫硬化组（P<0.05）。两组术后1周的血浆纤维蛋白原（Fib）、纤溶酶原激活物抑制物（PAI-1）都低于术前1 d（P<0.05）,联合组也显著低于泡沫硬化组（P<0.05）。联合组术后1个月的总有效率为100.0 %,明显高于泡沫硬化组的86.7 %（P<0.05）。结论：相对于泡沫硬化,超声引导下射频消融联合泡沫硬化治疗下肢静脉曲张能改善患者的凝血功能,还能有效缓解疼痛,改善患者的血流动力学状况,提高总体治疗效果。     

冷冻球囊消融术与射频导管消融术治疗阵发性心房颤动的疗效比较及术后1年复发的危险因素探讨

摘要 目的：对比冷冻球囊消融术（CBA）与射频导管消融术（RFCA）治疗阵发性心房颤动（AF）的疗效,并探讨术后1年复发的危险因素。方法：选择2019年2月～2021年2月期间我院收治的阵发性AF患者100例,根据手术方案的不同将患者分为A组（n=48,RFCA）和B组（n=52,CBA）。对比两组手术相关指标、并发症发生率和术后1年复发率情况。根据是否复发将所有患者分为复发组和无复发组,多因素Logistic回归分析术后1年复发的危险因素。结果：B组的手术时间、消融时间、X线曝光时间短于A组（P<0.05）。B组的并发症总发生率低于对照组（P<0.05）。两组复发率组间对比差异无统计学意义（P>0.05）。单因素分析显示,阵发性AF患者术后1年复发与B型利钠肽（BNP）、年龄、白细胞计数（WBC）、体质量指数、肌酐（Cr）、合并高血压、超敏C反应蛋白（hs-CRP）、合并糖尿病、左心房内径（LAD）、合并冠心病、病程、尿酸、心电图f波类型有关（P<0.05）。多因素分析结果显示：病程偏长、尿酸偏高、LAD偏大、年龄偏大、hs-CRP偏高、心电图f波类型为细波、BNP偏高是阵发性AF患者术后1年复发的危险因素（P<0.05）。结论：CBA与RFCA治疗阵发性AF,均可获得较好的疗效,CBA在改善患者手术情况及安全性方面的效果较好。阵发性AF患者术后1年的复发率较高,病程、尿酸、LAD、年龄、hs-CRP、BNP、心电图f波类型均是其影响因素。     

Maxillary appendages used by western corn rootworms, Diabrotica virgifera virgifera, to discriminate between a phagostimulant and -deterrent

Ablation of maxillary appendages on western corn rootworm, Diabrotica virgifera virgifera LeConte (Coleoptera: Chrysomelidae), were used to determine which mouthparts were involved in discrimination between the phagostimulant, cucurbitacin B, and the phagodeterrent, strychnine. Strychnine deterred feeding in unablated beetles when its concentration on disks was equal to or higher than cucurbitacin B. Unilateral or bilateral lacinea ablation did not affect discrimination between cucurbitacin B and strychnine. Galeal ablations abolished strychnine deterrence at equimolar concentrations of both compounds but not at higher strychnine concentrations, whereas maxillary palp ablation had no effect. However, bilateral ablation of both galea and maxillary palps resulted in a loss of deterrence at all strychnine concentrations. These results indicated strychnine sensitive chemoreceptors were primarily located on the galeae and maxillary palps. However, beetles without galeae and palps still feed on disks suggesting that cucurbitacin B sensitive chemoreceptors were located on other mouthparts and contributed to cucurbitacin B phagostimulation.