关于低强度激光疗法的机理及其临床应用研究

刘承宜等人提出了低强度激光疗法的生物信息模型。根据ＢＩＭＬ,绿,兰和紫等冷色兴奋Ｇａ蛋白介导的生理过程,红,产黄等暖色兴奋Ｇｑ或Ｇｉ蛋白或受体关联蛋白酶介导的生理过程。本文将激光的生物效应分为直接效应和间接效应两类,根据ＢＩＭＬ成功地解释了已知第二信使生理功能的系统的低强度激光照射的作用机理和临床应用,可望用于开发低强度激光疗法的临床新应用。     

低强度激光血管内照射肿瘤病人治疗前后心电图观察

低强度激光血管内照射肿瘤病人治疗前后心电图观察龙敬伦方勇广西医科大学附属肿瘤医院心电图室南宁５３００２７低强度激光血管内照射（ＩｎｔｒａｖａｓｃｕｌａｒＬｏｗＬｅｖｅｌＬａｓｅｒＩｒｒａｄｉａｔｉｏｎＴｈｅｒａｐｙ简称ＩＬ－ＬＬＩ）,是一项新的治疗技...     

低强度激光生物效应机理研究

结合低强度激光生物效应研究的现状,对低强度激光生物效应机理研究的各种观点进行了归纳分析,提出了对低强度激光生物效应机理研究的一些初步思考,把低强度激光生物效应的一般过程归纳为：激光（辐射)→初始光受体→信号传导与放大→生物效应。并指出探讨低强度激光生物效应机理,应着重于寻找并研究初始光受体与激光的相互作用,以及随后的信号传导与放大过程。     

低功率半导体激光血管外照射疗法及其临床应用研究

本文介绍了一种低功率半导体激光血管外照射疗法,同了5000倍电镜下血红细胞照射前后的变化。在临床上分别给出了激光血管外照射和药物及血管内照射疗效对比及血脂,血流变指标的影响的对比得出了半导体激光血管外照射疗法是优于药物,和He-Ne激光血管内照射有相似的疗效。     

He-Ne激光治疗Bell′s面瘫的研究

本文报导了激光在治疗Ｂｅｌ′ｓ面瘫中的应用。五例病人通过Ｈｅ－Ｎｅ激光穴位照射、低强度血管内照射,和辅以外敷中药。经随访全部治愈。本治疗具有高疗效、不出血、操作简单等优点。该方法值得进一步研究和推广。     

穴位激光照射的剂量和机理初探

穴位激光照射疗法是一种通过低强度激光束直接照射穴位的治疗方法,具有针灸作用。阐述了激光照射机体穴位在临床应用的本质,并对其使用的光剂量和作用机理做了初步讨论和分析。     

低强度激光血管照射治疗脑损伤的实验研究

本实验采用ＳＤ大鼠脑损伤模型,设对照组和照射组,采用低能量半导体激光器对大鼠股静脉进行血管外照射,水迷宫试验测定大鼠记忆功能,并测定脑组织和血ＳＯＤ、ＭＤＡ含量。结果发现低强度激光血管照射能促进照射组记忆功能的恢复,使ＳＯＤ活性提高,ＭＤＡ含量降低。这提示低强度激光照射改善了脑损伤后脑组织的缺血缺氧状态,从而减轻了氧自由基反应造成的继发性脑损害     

蝮蛇抗栓酶伍用低强度He—Ne激光血管内照射治疗脑梗死50例

目的探讨蝮蛇抗栓酶伍用低强度Ｈｅ－Ｎｅ激光血管内照射治疗脑梗死。方法用蝮蛇抗栓酶静滴伍用低强度Ｈｅ－Ｎｅ激光血管内照射（ＩＬＩＢ）治疗一疗程。结果治疗后临床效果明显（总有效率９４．００％）,血流变学值和脑动脉平均血流速度（Ｖｍ）均有显著或非常显著性差异（Ｐ＜０．０５或Ｐ＜０．０１）。结论该方法治疗脑梗死效果满意。     

低功率激光照射诱导的细胞外调节蛋白激酶的激活促进一氧化氮的产生

低功率激光(632.8 nm)照射(Low-power laser irradiation,LPLI)生物组织作为一种无损伤的物理疗法,可以加速细胞生长、血管再生及伤口愈合等过程。一氧化氮(Nitric oxide,NO)是伤口愈合的关键因素之一,其促进炎性细胞的趋化,增强胶原的合成和沉积,刺激细胞增殖和新生血管生成。我们研究发现LPLI可以促进NO的产生,并且抑制细胞外调节蛋白激酶(Extracellular signal-regulated protein kinases,ERK)的活性阻碍了NO的产生,证明LPLI通过活化ERK调控NO的生成。这一研究将为低功率激光照射加速伤口愈合在临床上的应用奠定基础。     

532nm 激光血管内照射血液实验方法

根据现有的低强度５３２ｎｍ激光器的输出特性,建立了简便、可靠的激光血管内照射血液实验方法。通过选择合适的滤光片,可以确保５３２ｎｍ激光的单纯性;通过分束监视,实现了激光输出功率的准确计量;在实验过程中,根据监视功率值对激光输出功率进行实时调节,可以使其比较稳定地保持在设定附近。该实验方法亦可供其它激光生物效应实验参考。     

New methods of making blocked coronary arteries patent again.

The use of percutaneous transluminal coronary angioplasty is limited by procedural complications and the serious drawback of restenosis, but some new techniques have been developed in an attempt to lower the complication rate for difficult lesions and reduce the rate of restenosis. These include devices to physically remove atheromatous plaque, such as the Simpson Coronary AtheroCath and the transluminal extraction catheter, as well as devices to ablate the plaque in situ, including the Rotablator and the excimer laser catheter. Although each device may have advantages in certain types of lesion, few data on their use have been reported in properly controlled randomised trials. The data available so far do not suggest that these devices will be safer than balloon angioplasty or that they will reduce restenosis. However, using metallic stents to support coronary arteries after balloon angioplasty seems to reduce acute complications and to lower the rate of restenosis, and the use of stents is likely to increase.     

Angina pectoris: interventional therapies and treatment of restenosis

Angina pectoris is a clinical syndrome of symptoms caused by myocardial ischaemia due to oxygen demand exceeding supply. The most common cause is coronary artery stenosis due to progressive atherosclerotic disease. Angina has a prevalence of approximately 5% and increases with age. Despite improvements in treatment there remains a yearly mortality of 2-3%. A major advance in the treatment of symptomatic angina was the introduction of percutaneous transluminal coronary angioplasty (PTCA). This initial enthusiasm was dampened by significant numbers developing symptomatic restenosis from vascular elastic recoil and neointimal hyperplasia (NI). The widespread introduction of stent deployment following the initial angioplasty reduced the rates of elastic recoil but failed to prevent NI and may actually stimulate it. Currently, there is much interest in mechanisms that alter cell proliferation thereby decreasing NI. Techniques include brachytherapy, photodynamic therapy and drug-eluting stents. Provisional data for these new stents, which slowly release medication that inhibits cell turnover, are very good with few occurrences of restenosis. Results from larger randomised trials are awaited.     

可降解冠状动脉支架的研究进展

冠脉内支架植入是临床上预防PTCA术后再狭窄并发症的有效措施,但金属支架仅在植入早期发生作用,在冠脉内壁修复完成后则成为多余的负担,可能激活血小板及多种凝血因子聚集导致血栓形成及刺激血管壁造成心脏事件及再狭窄的发生。针对上述问题,生物可降解冠状动脉支架的研究得到了相当的发展。本文就可降解支架的发展及现状作一简要综述。     

Deep Sea Water Prevents Balloon Angioplasty-Induced Hyperplasia through MMP-2: An In Vitro and In Vivo Study

Major facts about the development of restenosis include vascular smooth muscle cells (VSMCs) proliferation and migration. A previous study showed that in vitro treatment with magnesium chloride has the potential to affect the proliferation and migration of VSMCs. Magnesium is the major element in deep sea water (DSW) and is a biologically active mineral. It is unclear whether DSW intake can prevent abnormal proliferation and migration of VSMCs as well as balloon angioplasty-induced neointimal hyperplasia. Thus, we attempted to evaluate the anti-restenotic effects of DSW and its possible molecular mechanisms. Several concentrations of DSW, based on the dietary recommendations (RDA) for magnesium, were applied to a model of balloon angioplasty in SD rats. The results showed that DSW intake markedly increased magnesium content within the vascular wall and reduced the development of neointimal hyperplasia. The immunohistochemical analysis also showed that the expression of proteins associated with cell proliferation and migration were decreased in the balloon angioplasty groups with DSW supplement. Furthermore, in vitro treatment with DSW has a dose-dependent inhibitory effect on serum-stimulated proliferation and migration of VSMCs, whose effects might be mediated by modulation of mitogen-activated protein kinase (MAPK) signaling and of the activity of matrix metalloproteinase-2 (MMP-2). Our study suggested that DSW intake can help prevent neointimal hyperplasia (or restenosis), whose effects may be partially regulated by magnesium and other minerals.     

赖诺普利对血管成形术后平滑肌细胞增殖影响的研究

为研究赖诺普利对血管成形术后平滑肌细胞（ＳＭＣ）增殖的影响,用体外血管平滑肌细胞培养及氚标记胸腺嘧啶核苷（３Ｈ－ＴｄＲ）掺入技术,观察了不同浓度赖诺普利（１～２０μｇ／ｍｌ）对培养的球囊血管成形术后的兔髂动脉ＳＭＣ增殖情况的影响。结果表明：加入赖诺普利后ＳＭＣ对３Ｈ－ＴｄＲ的摄取及细胞计数明显比对照组低（Ｐ＜０．０１或Ｐ＜０．０５）,各浓度组均有作用,浓度越高作用越明显。提示赖诺普利可抑制血管成形术后平滑肌细胞的增殖,有预防血管成形术后再狭窄的作用。     

Severe acute coronary spasm following intracoronary radiation for in-stent restenosis: A case report

Intracoronary radiation therapy is currently the only available treatment for the prevention of recurrence of in-stent restenosis. We report a case of severe coronary spasm after excimer laser angioplasty, balloon angioplasty, and intracoronary gamma radiation in the right coronary artery (RCA) that resulted in an acute myocardial infarction. Treatment with 600 μg of intracoronary nitroglycerin resulted in minimal improvement; therefore, diltiazem 400 μg was administered intracoronary with total resolution of the spasm, restoring normal coronary blood flow without trace of acute dissection or thrombus inside the artery.     

Brachytherapy with gamma radiation of a coronary artery for in-stent restenosis may induce the regression of in-stent restenosis of an adjacent coronary artery without angioplasty. First case report and review of the literature

Here, we present a case of a 63-year-old male who presented with in-stent restenosis of two coronary arteries simultaneously (mid circumflex and proximal ramus). After the brachytherapy of the circumflex artery for in-stent restenosis, the patient refused the staged procedure for the ramus in-stent restenosis. After approximately 2 years, the patient underwent coronary angiography for recurrent chest pain. Surprisingly, the proximal ramus stent showed marked regression of in-stent restenosis. We hypothesized that the gamma brachytherapy of the circumflex artery could have induced the regression of in-stent restenosis of the adjacent ramus artery due to the deep tissue penetration of gamma radiation. Based on our observation, we believe that in the treatment of in-stent restenosis of a coronary artery, the initial balloon angioplasty may not be as important as the radiation itself. This observation warrants further study to evaluate the effect of external or internal radiation on in-stent restenosis without balloon angioplasty. If our hypothesis is confirmed, the treatment of in-stent restenosis with external radiation could substantially simplify the treatment of this disease. This case report follows a brief review of the literature.     

A study of the functional activity of macrophages of peritoneal exudate of mice exposed to low-intensity laser radiation in vitro and in vivo

The effect of low-intensity laser radiation generated by semiconductor devices in the red (650 nm) and infrared (850 nm) regions of the spectrum in vitro and in vivo on the phagocytic activity and synthesis of proinflammatory cytokines by peritoneal macrophages during the phagocytosis of bacterial cells has been studied. A culture of the clinical strain of the enteropathogenic bacterium Escherichia coli was used as an object. The radiation dose was varied by changing the power and duration of exposure. The results obtained indicate that infrared low-intensity laser radiation has a stimulating effect on the phagocytic activity of macrophages. It was shown that the effect of low-intensity laser radiation on the activity of the phagocytic process, the enhancement of the adhesion of bacteria by macrophages, killing of bacteria, and the production of proinflammatory cytokines is dose-dependent. The exposure to the rays of the red region of the spectrum on phagocytizing macrophages induced a decrease in their activity; as the dose was increased, the destruction of cells was registered.     

Intravascular brachytherapy to prevent restenosis: dosimetric considerations.

Acute myocardial infarction is often the result of occlusion of one or more coronary arteries. Occlusion and restenosis (re-closing of the vessel) are principal reasons that percutaneous transluminal coronary angioplasty (PTCA) may fail to provide long-term benefit. PTCA has been a popular treatment, which is less invasive than surgeries involving revascularization of the myocardium, promising a better quality of life for patients. Unfortunately, the rate of restenosis after balloon angioplasty is high (approximately 30-50% in the first year after treatment). Recent data suggest that intraluminal irradiation of coronary arteries in conjunction with balloon angioplasty and/or stent implantation reduces the proliferation of smooth muscle cells and neointima formation, thereby inhibiting restenosis. In order to study radiation dosimetry in the patient and for this therapy, dose distributions for electrons and photons, with discrete energies, were simulated for blood vessels of diameter 1.5, 3 and 4.5 mm irradiated with balloon and wire sources. Electron and photon transport was performed in a simple model representing the system used for irradiation using the MCNP 4B code (Monte Carlo N-Particles). Specific calculations for balloon and wire sources were also carried out for a few radionuclides. In this work, strengths and drawbacks conceming the use of each radionuclide simulated, as well as source geometries are discussed. The dosimetry performed in this study will improve understanding of the benefit-to-risk ratio in intracoronary brachytherapy.