BACKGROUND & AIMS: :A number of groups have developed libraries of siRNAs to identify genes through functional genomics. While these studies have validated the approach of making functional RNAi libraries to understand fundamental cellular mechanisms, they require information and knowledge of existing sequences since the RNAi sequences are generated synthetically. An alternative strategy would be to create an RNAi library from cDNA. Unfortunately, the complexity of such a library of siRNAs would make screening difficult. To reduce the complexity, longer dsRNAs could be used; however, concerns of induction of the interferon response and off-target effects of long dsRNAs have prevented their use. As a first step in creating such libraries, long dsRNA was expressed in mammalian cells. The 250 nt dsRNAs were capable of efficiently silencing a luciferase reporter gene that was stably transfected in MDA-MB-231 cells without inducing the interferon response or off-target effects any more than reported for siRNAs. In addition, a long dsRNA expressed in the same cell line was capable of silencing endogenous c-met expression and inhibited cell migration, whereas the dsRNA against luciferase had no effect on c-met or cell migration. The studies suggest that large dsRNA libraries are feasible and that functional selection of genes will be possible.

背景与目标： : 许多小组已经开发了sirna文库，以通过功能基因组学鉴定基因。尽管这些研究已经验证了制作功能性RNAi文库以了解基本细胞机制的方法，但由于RNAi序列是合成生成的，因此它们需要现有序列的信息和知识。另一种策略是从cDNA创建RNAi文库。不幸的是，复杂性的文库sirna将筛选困难.为了降低复杂性，可以使用更长的dsrna; 然而，对干扰素反应的诱导和长dsrna的脱靶效应的担忧阻止了它们的使用。作为创建此类文库的第一步，长dsRNA在哺乳动物细胞中表达。250 nt dsrna能够有效地沉默在MDA-MB-231细胞中稳定转染的荧光素酶报告基因，而不会比sirna所报道的更多诱导干扰素应答或脱靶效应。此外，在同一细胞系中表达的长dsRNA能够沉默内源性c-met表达并抑制细胞迁移，而针对荧光素酶的dsRNA对c-met或细胞迁移没有影响。研究表明，大型dsRNA文库是可行的，并且基因的功能选择将是可能的。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: The clinical outcome of treatment using conical crown-retained dentures was evaluated. Of the initial 25 patients provided with 26 conical crown-retained dentures, 18 patients with 18 restorations could be examined after a time ranging between 73 and 92 months. Of the eight restorations lost, four had been changed as a result of factors that might have been related to the prosthodontic care. Most of the patients were very satisfied with the restorations both functionally and esthetically and found their chewing comfort to be better after treatment with conical crown-retained dentures. However, 50% of the patients reported speech problems related to treatment. Technical failures were not insignificant but were treatable. The survival rate after 73 to 92 months was 78.3%.

背景与目标： 评估了使用锥形冠保留义齿治疗的临床结果。在最初提供26个圆锥形冠保留义齿的25例患者中，可以在73至92个月的时间内检查18例具有18个修复体的患者。在丢失的八个修复物中，有四个由于可能与口腔修复有关的因素而被更改。大多数患者在功能和美学上都对修复体感到非常满意，并发现在使用圆锥形冠保留义齿治疗后，其咀嚼舒适度更好。然而，50% 患者报告了与治疗相关的言语问题。技术故障并非微不足道，但可以治愈。73 ~ 92个月后的生存率为78.3%。

BACKGROUND & AIMS: Etoposide produces reversible inhibition of topoisomerase II, leading to cleavage of DNA, and thereby has an antitumor effect. This mechanism suggests that the longer treatment is continued, the greater the antitumor effect will be. In the present study, both therapeutic and adverse effects of long-term treatment with low-dose oral etoposide were studied in 29 patients aged > or = 65 years with non-Hodgkin's lymphoma (NHL) for whom standard chemotherapy was not effective or refractory. These patients received etoposide at a dose of 50 mg/d for as long as possible. Treatment was continued until white blood cell count decreased to < or = 2,000/microL or the platelet count decreased to < or = 5 x 10(4)/microL. According to the World Health Organization (WHO) criteria of therapeutic effects, 6 (20.7%) of the 29 patients achieved complete remission and 13 patients (44.8%) had partial remission, for a response rate of 65.5%. Adverse effects of > or = grade 3 included leukopenia in 24 patients (82.8%) and anemia in 7 (24.1%). Granulocyte colony-stimulating factor (G-CSF) was given in combination with etoposide to eight patients because of leukopenia (granulocyte count < or = 1,000/microL). In view of the excellent subjective tolerance, low incidence of serious adverse effects, and good activity, single agent oral etoposide given continuously over prolonged periods represents a useful treatment for elderly patients with NHL.

背景与目标： 依托泊苷产生拓扑异构酶II的可逆抑制，导致DNA裂解，从而具有抗肿瘤作用。这种机制表明，持续治疗的时间越长，抗肿瘤作用就越大。在本研究中，对29例年龄> 或 = 65岁的非霍奇金淋巴瘤 (NHL) 患者进行了低剂量口服依托泊苷长期治疗的治疗和不良反应的研究，这些患者的标准化疗无效或难治性。这些患者尽可能长时间地接受依托泊苷50 mg/d的剂量。继续治疗直到白细胞计数降低至 <或 = 2,000/microL或血小板计数降低至 <或 = 5 × 10(4)/microL。根据治疗效果的世卫组织标准，29例患者中有6例 (20.7% 例) 完全缓解，13例 (44.8% 例) 部分缓解，缓解率为65.5%。> or = 3级的不良反应包括白细胞减少24例 (82.8%) 和贫血7例 (24.1%)。由于白细胞减少 (粒细胞计数 <或 = 1,000/microL)，将八名患者与依托泊苷联合给予粒细胞集落刺激因子 (g-csf)。鉴于其良好的主观耐受性，低的严重不良反应发生率和良好的活性，长期连续给予单药口服依托泊苷代表了对老年NHL患者的有用治疗。

BACKGROUND & AIMS: OBJECTIVE:The authors' goal was to test the hypothesis that the antidepressant effect of total sleep deprivation can be maintained by initially avoiding sleep during a supposedly "critical" time period in the early morning.

METHOD:They studied 33 inpatients with major depression, melancholic type, all of whom responded positively to total sleep deprivation. Twelve of the patients were men and 21 were women; their mean age was 46.7 years (SD = 13.7). After total sleep deprivation, the patients started a sleep schedule from 5:00 p.m. to 12:00 midnight, which then was shifted back by 1 hour each day until a sleep time of 11:00 p.m. to 6:00 a.m. was reached.

RESULTS:Twenty (61%) of the 33 patients who responded to total sleep deprivation with an improved state of mood maintained this improvement during sleep phase advance therapy. Drug-free and medicated patients did not differ from each other.

CONCLUSIONS:The rapid amelioration of mood observed with total sleep deprivation can be preserved with a succeeding phase shift of the sleep period.

背景与目标： 目的 : 作者的目标是检验以下假设: 完全睡眠剥夺的抗抑郁作用可以通过最初在清晨的一个所谓的 “关键” 时期避免睡眠来维持。
方法 : 他们研究了33名患有抑郁症，忧郁型的住院患者，他们都对完全睡眠不足有积极的反应。12名患者为男性，21名患者为女性; 他们的平均年龄为46.7岁 (SD = 13.7)。完全睡眠剥夺后，患者开始从下午5:00到午夜12:00的睡眠计划，然后每天向后转移1小时，直到达到下午11:00上午6:00的睡眠时间。
结果 : 33名对完全睡眠剥夺有改善的情绪状态有反应的患者中有20名 (61% 名) 在睡眠阶段提前治疗期间保持了这种改善。无药物和药物治疗的患者彼此之间没有差异。
结论 : 完全睡眠剥夺所观察到的情绪迅速改善可以通过睡眠期的后续相移来保持。

BACKGROUND & AIMS: CONTEXT:Chronic pain in patients with advanced cancer poses a serious clinical challenge. The Δ9-tetrahydrocannabinol (THC)/cannabidiol (CBD) oromucosal spray (U.S. Adopted Name, nabiximols; Sativex(®)) is a novel cannabinoid formulation currently undergoing investigation as an adjuvant therapy for this treatment group. OBJECTIVES:This follow-up study investigated the long-term safety and tolerability of THC/CBD spray and THC spray in relieving pain in patients with advanced cancer. METHODS:In total, 43 patients with cancer-related pain experiencing inadequate analgesia despite chronic opioid dosing, who had participated in a previous three-arm (THC/CBD spray, THC spray, or placebo), two-week parent randomized controlled trial, entered this open-label, multicenter, follow-up study. Patients self-titrated THC/CBD spray (n=39) or THC spray (n=4) to symptom relief or maximum dose and were regularly reviewed for safety, tolerability, and evidence of clinical benefit. RESULTS:The efficacy end point of change from baseline in mean Brief Pain Inventory-Short Form scores for "pain severity" and "worst pain" domains showed a decrease (i.e., improvement) at each visit in the THC/CBD spray patients. Similarly, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 scores showed a decrease (i.e., improvement) from baseline in the domains of insomnia, pain, and fatigue. No new safety concerns associated with the extended use of THC/CBD spray arose from this study. CONCLUSION:This study showed that the long-term use of THC/CBD spray was generally well tolerated, with no evidence of a loss of effect for the relief of cancer-related pain with long-term use. Furthermore, patients who kept using the study medication did not seek to increase their dose of this or other pain-relieving medication over time, suggesting that the adjuvant use of cannabinoids in cancer-related pain could provide useful benefit.

背景与目标：

BACKGROUND & AIMS: :The transection of the inferior alveolar nerve (IANx) produces allodynia in the whisker pad (V2 division) of rats. Ectopic discharges from injured trigeminal ganglion (TG) neurons and thalamocortical reorganization are possible contributors to the sensitization of uninjured V2 primary and CNS neurons. To test which factor is more important, TG and ventroposterior medial nucleus (VPM) neurons were longitudinally followed before, during, and after IANx for up to 80 d. Spontaneous discharges and mechanical stimulation-evoked responses were recorded in conscious and in anesthetized states. Results show (1) a sequential increase in spontaneous activities, first in the injured TG neurons of the IAN (2-30 d), followed by uninjured V2 ganglion neurons (6-30 d), and then VPM V2 neurons (7-30 d) after IANx; (2) ectopic discharges included burst and regular firing patterns in the IAN and V2 branches of the TG neurons; and (3) the receptive field expanded, the modality shifted, and long-lasting after-discharges occurred only in VPM V2 neurons. All of these changes appeared in the late or maintenance phase (7-30 d) and disappeared during the recovery phase (40-60 d). These observations suggest that ectopic barrages in the injured IAN contribute more to the development of sensitization, whereas the modality shift and evoked after-discharges in the VPM thalamic neurons contribute more to the maintenance phase of allodynia by redirecting tactile information to the cortex as nociceptive.

背景与目标： : 下牙槽神经 (IANx) 的横切在大鼠的晶须垫 (V2分区) 中产生异常性疼痛。受损的三叉神经节 (TG) 神经元的异位放电和丘脑皮层重组可能是未受损的V2初级和CNS神经元致敏的原因。为了测试哪个因素更重要，在IANx之前，期间和之后纵向跟踪TG和腹后内侧核 (VPM) 神经元长达80 d。在有意识和麻醉状态下记录自发放电和机械刺激诱发反应。结果表明 (1) 自发活动依次增加，首先是IAN损伤的TG神经元 (2-30 d)，其次是未损伤的V2神经节神经元 (6-30 d)，然后是VPM V2神经元 (7-30 d)。IANx后的d); (2) 异位放电包括TG神经元的IAN和V2分支中的爆发和规则放电模式; (3) 感受野扩大，模态改变，并且仅在VPM V2神经元中发生持久的放电。所有这些变化都出现在后期或维护阶段 (7-30 d)，并在恢复阶段 (40-60 d) 消失。这些观察结果表明，受伤的IAN的异位弹幕对敏化的发展做出了更大的贡献，而VPM丘脑神经元的模态变化和诱发的放电后放电通过将触觉信息重定向到皮层作为伤害性，对异常性疼痛的维持阶段做出了更大的贡献。

BACKGROUND & AIMS: PURPOSE:To identify risk factors for corneal graft rejection and rejection irreversibility. DESIGN:Retrospective cohort study. METHODS:setting: Institutional. patients: A total of 1438 consecutive eyes of 1438 patients who underwent corneal transplantation for optical indication at the Centre Hospitalier National d'Ophtalmologie des XV-XX, Paris, France, between December 1992 and December 2010 were studied. Surgical technique was penetrating keratoplasty (PK) in 1209 cases, anterior lamellar keratoplasty (ALK) in 165 cases, and Descemet stripping with endothelial keratoplasty in 64 cases. main outcome measures: Cumulative incidence of rejection episodes and rejection irreversibility rate. RESULTS:A total of 299 cases of rejection episodes were identified, of which 145 (48.5%) were irreversible after treatment. In multivariate analysis, the cumulative incidence of rejection episodes was influenced by recipient age (P = .00002), recipient rejection risk (P = .0003), lens status (P = .00003), and surgical group (P = .035). A higher incidence of rejection episodes was observed in young patients (<20 years) and patients aged from 41 to 50, high-risk recipients, aphakic eyes and eyes with anterior chamber intraocular lens, and eyes with PK (compared with eyes with ALK). Rejection episodes were more likely to be irreversible for high-risk recipients (P = .02), for eyes with preoperative hypertony (P = .009), and for eyes with poor visual acuity at presentation (P = .002). CONCLUSIONS:Recipient rejection risk and surgical group are the main risk factors for rejection as they both influence the incidence of rejection and the reversibility rate. Recipient age and lens status are predictive factors for the occurrence of rejection. Preoperative hypertony is a predictive factor for rejection irreversibility.

背景与目标：

BACKGROUND & AIMS: :Leiomyosarcoma of the innominate vein is a rare but usually lethal disease. We report the case of a 50-year-old woman, undergoing a curative resection of the tumor. She is alive and free of disease at 88-month follow-up. Surgical excision remains the current optimal treatment able to provide a chance of cure. KEY WORDS: Late survival, Venous leiomyosarcoma.

背景与目标： : 无名静脉平滑肌肉瘤是一种罕见但通常致命的疾病。我们报告了一名50岁的女性，正在接受肿瘤的根治性切除。在88个月的随访中，她还活着并且没有疾病。手术切除仍然是目前能够提供治愈机会的最佳治疗方法。关键词: 晚期生存，静脉平滑肌肉瘤。

BACKGROUND & AIMS: AIM:There is still no consensus about the optimal surgical approach for esophageal replacement in the case of long-gap esophageal atresia (LGEA) or extensive corrosive strictures. The aim of this article was to perform a meta-analysis comparing the most widely used techniques for esophageal replacement in children: jejunal interposition (JI), colon interposition (CI), and gastric pull-up (GPU). METHODS:Review of the English-language literature published in the past 5 years about esophageal replacement in children was done. The focus was on postoperative survival rate, morbidity (gastrointestinal complications such as anastomotic stenosis/leakage and respiratory complications such as pneumothorax, pneumonia, and atelectasis), and long-term follow-up when available. Among long-term gastrointestinal outcomes were dysphagia, reflux, and dumping; among long-term respiratory outcomes were recurrent pneumonia and recurrent aspiration leading to chronic lung disease. Data were computed by Comprehensive Meta-Analysis software (Version 2.2.064). MAIN RESULTS:A total of 15 studies (4 comparative retrospective, 8 retrospective, and 3 prospective) including 470 patients (264 LGEA) were identified; 344 (73%) patients underwent CI, 99 (21%) GPU, and 27 (6%) JI. Among these 15 studies, 9 provided data about long-term follow-up. CONCLUSION:Proper prospective comparative studies are lacking. GPU and CI appear comparable regarding postoperative mortality, anastomotic complications, and graft loss. On the long-term, GPU seems to be associated with a higher respiratory morbidity but fewer gastrointestinal complications than CI. Based on this article only two series provide data about JI, and they show highly divergent results. JI appears to be a valid replacement technique when performed by experienced centers; however larger numbers are needed to assess the outcomes of this procedure.

背景与目标：

BACKGROUND & AIMS: :In human cerebral cortex slices noradrenaline, isoproterenol (a beta-adrenergic agonist), dopamine, apomorphine (a dopaminergic agonist), and serotonin stimulated cyclic AMP formation: noradrenaline greater than or equal to isoproterenol greater than dopamine = apomorphine = serotonin. Clonidine (and alpha-adrenergic agonist) was ineffective in stimulating cyclic AMP formation in temporal cortex slices. The stimulatory effect of noradrenaline and isoproterenol was blocked by propranolol (a beta-adrenergic blocker) but not by phentolamine (an alpha-adrenergic blocker). Pimozide (a selective dopaminergic antagonist) inhibited the increase of cyclic AMP formation induced by dopamine or apomorphine but not that induced by noradrenaline, isoproterenol, or serotonin. Neither propranolol or phentolamine had any effect on dopamine- or serotonin-stimulated cyclic AMP formation. Chlorpromazine blocked the increase of cyclic AMP formation induced by noradrenaline, dopamine or serotonin, while cyproheptadine, a putative central serotonergic antagonist, was ineffective. These observations suggest that there may be at least two monoamine-sensitive adenylate cyclases in human cerebral cortex which have the characteristics of a beta-adrenergic and a dopaminergic receptor, respectively, and also possibly a serotonergic receptor.

背景与目标： : 在人大脑皮层切片中去甲肾上腺素，异丙肾上腺素 (β-肾上腺素能激动剂)，多巴胺，阿扑吗啡 (多巴胺能激动剂) 和5-羟色胺刺激的环状AMP形成: 去甲肾上腺素大于或等于异丙肾上腺素大于多巴胺 = 阿扑吗啡 = 5-羟色胺。可乐定 (和 α-肾上腺素能激动剂) 在刺激颞叶皮质切片中的环状AMP形成方面无效。去甲肾上腺素和异丙肾上腺素的刺激作用被普萘洛尔 (一种 β-肾上腺素能阻滞剂) 阻断，而酚妥拉明 (一种 α-肾上腺素能阻滞剂) 则不能。Pimozide (一种选择性多巴胺能拮抗剂) 抑制多巴胺或阿扑吗啡诱导的环AMP形成的增加，但不能抑制去甲肾上腺素，异丙肾上腺素或5-羟色胺诱导的环AMP形成。普萘洛尔或酚妥拉明均不会对多巴胺或5-羟色胺刺激的环状AMP形成产生任何影响。氯丙嗪阻止了由去甲肾上腺素，多巴胺或5-羟色胺引起的环状AMP形成的增加，而被认为是中枢5-羟色胺能拮抗剂的赛庚啶无效。这些观察结果表明，人大脑皮层中可能至少存在两种单胺敏感的腺苷酸环化酶，它们分别具有 β-肾上腺素能受体和多巴胺能受体的特征，也可能具有血清素能受体的特征。

BACKGROUND & AIMS: :The development of antibiotic resistance in the opportunistic pathogen Pseudomonas aeruginosa is a major cause of the pathogen's morbidity and is strongly correlated with the biofilm formation. Motility and adherence capacity in long-term stressed cells have not been extensively analyzed even though P. aeruginosa considered a model organism for the study of biofilm formation. In this investigation, P. aeruginosa ATCC 27853 strain has been stored for 12 months in LB broth with 0.5 M NaCl. Several experiments demonstrated that the strain recovery from the salty microcosm had the ability to increase the biofilm formation and to reduce motility comparing with that of the original strain. To identify genes involved in the regulation of biofilm and/or in stress response by the recovered P. aeruginosa, differential display "DDRT-PCR" technique was used. The genes speD and ccoN2, coding, respectively, for an S-adenosylmethionine decarboxylase and Cbb3-type cytochrome oxidase, were identified in recovered strain of P. aeruginosa ATCC 27853 as two differentially expressed gene fragments. A comparison of the biofilm produced by the wild-type strain PA14 and the transposon insertion mutant for speD gene suggested that spermidine has a potential role in the adaptive response in P. aeruginosa incubated in long-term stress conditions.

背景与目标： : 机会性病原体铜绿假单胞菌中抗生素耐药性的发展是病原体发病的主要原因，并且与生物膜的形成密切相关。尽管铜绿假单胞菌被认为是研究生物膜形成的模式生物，但长期应激细胞的运动和粘附能力尚未得到广泛分析。在这项研究中，铜绿假单胞菌ATCC 27853菌株已在含有0.5 M NaCl的LB肉汤中储存12个月。几项实验表明，与原始菌株相比，从咸微观世界中恢复的菌株具有增加生物膜形成并降低运动性的能力。为了鉴定与回收的铜绿假单胞菌调节生物膜和/或应激反应有关的基因，使用了差异显示 “ddrt-pcr” 技术。在回收的铜绿假单胞菌ATCC 27853菌株中鉴定了分别编码S-腺苷甲硫氨酸脱羧酶和Cbb3-type细胞色素氧化酶的基因speD和ccoN2，作为两个差异表达的基因片段。对野生型菌株PA14和speD基因转座子插入突变体产生的生物膜的比较表明，亚精胺在长期胁迫条件下培养的铜绿假单胞菌的适应性反应中具有潜在作用。

BACKGROUND & AIMS: :There are two general approaches to preoperative radiotherapy (RT) in rectal cancer: short-course (25 Gy in 5 fractions) radiation with immediate surgery and long-course 5-fluorouracil (5-FU)-based chemoradiotherapy (CRT; 50.4 Gy in 28 fractions) with surgery scheduled 6-8 weeks thereafter. While it is clear that downsizing and downstaging effects are more pronounced with long-course CRT and delayed surgery, a Polish randomized trial and, more recently, an Australian phase III trial demonstrated no significant differences in long-term oncologic outcomes and late toxicity rates between either preoperative concept. Ongoing studies currently address short-course preoperative RT with a longer interval to surgery (Stockholm III trial), and short-course RT with sequential combination chemotherapy in patients with synchronous distant metastasis. With respect to the long-course CRT approach, newer-generation chemotherapeutics as well as molecularly targeted agents have been tested within phase I-III studies, both as induction/adjuvant chemotherapy as well as during concomitant CRT. Evidently, the monolithic approaches to either apply the same schedule of preoperative 5-FU-based CRT to all patients with TNM stage II/III rectal cancer or to give preoperative short-course RT for all patients with resectable rectal cancer irrespective of tumor stage and location need to be questioned. The inclusion of different multimodal treatments into the surgical oncological concept, adapted to tumor location, stage, and individual patient risk factors and preferences is upcoming. Clearly, future developments will aim at identifying and selecting patients for ideal treatment alternatives.

背景与目标： : 直肠癌术前放疗 (RT) 有两种常规方法: 短期 (25 Gy，5个部分) 立即手术放疗和基于5-氟尿嘧啶 (5-FU) 的长期放化疗 (CRT; 50.4 Gy，28个部分)，术后6-8周进行手术。尽管很明显，长期CRT和延迟手术的缩小和缩小分期效果更为明显，但波兰的一项随机试验以及最近的一项澳大利亚III期试验均显示，两种术前概念之间的长期肿瘤学结局和晚期毒性率均无显着差异。目前正在进行的研究针对具有较长手术间隔的短期术前放疗 (Stockholm III试验)，以及同步远处转移患者的短期放疗和序贯联合化疗。关于长期CRT方法，已在i-iii期研究中测试了新一代化学疗法以及分子靶向药物，包括诱导/辅助化疗以及伴随CRT期间。显然，对于所有TNM II/III期直肠癌患者，采用相同的术前基于5-fu的CRT时间表，或者对所有可切除直肠癌患者进行术前短期RT，无论肿瘤分期和位置如何都需要质疑。即将将不同的多模式治疗纳入外科肿瘤学概念，以适应肿瘤的位置，阶段和个体患者的风险因素和偏好。显然，未来的发展将旨在识别和选择理想治疗方案的患者。

BACKGROUND & AIMS: :The feasibility of using a subcutaneously implanted portal system attached to a conventional 16-gauge epidural catheter has been evaluated in 50 patients with sever pain associated with cancer. This technique allowed for the percutaneous epidural administration of morphine at 8-12-hourly intervals for pain control. The mean duration of implantation was 12 weeks and the longest period a portal remained in situ was 36 weeks. Five portals had to be removed for various reasons. The injection system has blocked on eight occasions due to catheter blockage (six times) and portal blockage (two occasions). These patients have continued to obtain excellent analgesia when either catheter or portal were replaced. In a cadaver, 300 injections were simulated using either 22-gauge Huber point needles or disposable needles (25 gauge) and the injectate examined by both light and scanning electron microscopy. Both needle types resulted in particulate contamination which was greater with the recommended Huber point needles.

背景与目标： : 已在50例与癌症相关的严重疼痛患者中评估了使用固定在常规16号硬膜外导管上的皮下植入门静脉系统的可行性。该技术允许以8-12小时的间隔经皮硬膜外施用吗啡以控制疼痛。植入的平均持续时间为12周，而原位保留的最长时间为36周。由于各种原因，必须删除五个门户。由于导管阻塞 (六次) 和门静脉阻塞 (两次)，注射系统有八次阻塞。当更换导管或门静脉时，这些患者继续获得出色的镇痛效果。在尸体中，使用22号Huber点针或一次性针 (25号) 模拟300注射，并通过光学和扫描电子显微镜检查注射物。两种类型的针头都会导致颗粒污染，推荐的Huber点针头会更大。

BACKGROUND & AIMS: :Purpose. To evaluate whether 3T clinical MRI with a small-animal coil and gradient-echo (GE) sequence could be used to characterize long-term left ventricular remodelling (LVR) following nonreperfused myocardial infarction (MI) using semi-automatic segmentation software (SASS) in a rat model. Materials and Methods. 5 healthy rats were used to validate left ventricular mass (LVM) measured by MRI with postmortem values. 5 sham and 7 infarcted rats were scanned at 2 and 4 weeks after surgery to allow for functional and structural analysis of the heart. Measurements included ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), and LVM. Changes in different regions of the heart were quantified using wall thickness analyses. Results. LVM validation in healthy rats demonstrated high correlation between MR and postmortem values. Functional assessment at 4 weeks after MI revealed considerable reduction in EF, increases in ESV, EDV, and LVM, and contractile dysfunction in infarcted and noninfarcted regions. Conclusion. Clinical 3T MRI with a small animal coil and GE sequence generated images in a rat heart with adequate signal-to-noise ratio (SNR) for successful semiautomatic segmentation to accurately and rapidly evaluate long-term LVR after MI.

背景与目标： : 目的。评估是否可以使用半自动分割软件 (SASS) 在大鼠模型中使用带有小动物线圈和梯度回波 (GE) 序列的3t临床MRI来表征非再灌注心肌梗死 (MI) 后的长期左心室重塑 (LVR)。材料和方法。5只健康大鼠用于验证MRI测量的左心室质量 (LVM) 和死后值。在手术后2周和4周对5只假手术大鼠和7只梗死大鼠进行扫描，以进行心脏的功能和结构分析。测量包括射血分数 (EF)，舒张末期容积 (EDV)，收缩末期容积 (ESV) 和LVM。使用壁厚分析来量化心脏不同区域的变化。结果。健康大鼠的LVM验证表明MR与死后值之间存在高度相关性。MI后4周的功能评估显示EF显着降低，ESV，EDV和LVM增加以及梗塞和非梗塞区域的收缩功能障碍。结论。具有小动物线圈和GE序列的临床3T MRI在大鼠心脏中生成的图像具有足够的信噪比 (SNR)，可成功进行半自动分割，以准确，快速地评估MI后的长期LVR。