目的探讨超声对宫角妊娠与输卵管间质部妊娠的诊断价值。方法应用经阴道或经腹部超声检查,对110例经手术病理和临床保守治疗证实的宫角妊娠和间质部妊娠的声像图特征进行分析比较;应用彩色多普勒及频谱多普勒观察妊娠囊或者包块的血供应情况。结果 71例宫角妊娠,超声诊断符合率79.2%,14例笼统称为异常妊娠。39例间质部妊娠,超声诊断符合率50%,20例笼统称为异位妊娠。结论经阴道或经腹部超声检查对宫角妊娠与输卵管间质部妊娠具有较高的定位诊断价值,对临床选择治疗方案具有明确的指导意义,对于已经破裂的异位妊娠定位价值不大。

Objective To explore the diagnostic value of ultrasonography for angular pregnancy and interstitial preg-nancy. Methods Characteristics of ultrasonogram of 110 patients with angular pregnancy and interstitial pregnancy who were confirmed by surgical pathology and clinical conservative treatment was analyzed and compared via transvaginal and transabdominal ultrasonography; color Dopplor and spectral Dopplor were applied to observe the blood supply of gestational sac or mass. Results There were 71 patients with angular pregnancy, and the accordance rate of ultra-sonography was 79.2%, in which 14 patients were collectively referred to as abnormal pregnancy. There were 39 pa-tients with interstitial pregnancy,and the accordance rate of ultrasonography was 50%, in which 20 patients were col-lectively referred to as ectopic pregnancy. Conclusion Transvaginal and transabdominal ultrasonography has a high di-agnostic value for angular pregnancy and interstitial pregnancy, and has a significant

目的初步探讨经永存左上腔静脉植入起搏电极导线的方法。方法 4例永存左上腔静脉合并右上腔静脉缺如的缓慢性心律失常患者,经左上腔静脉植入右心房和右心室起搏电极导线,心房起搏电极固定于右心耳(4例),心室起搏电极分别固定至右心室间隔部(2例)或心尖部(2例)。术后当天、术后3个月及1年分别测试起搏电极参数。结果 4例患者均成功放置右心房(心耳处)和右心室(间隔部或心尖部)起搏电极导线,随访1年,起搏电极参数良好。结论经左上腔静脉植入起搏电极导线具有一定的挑战性,但通过适当的导丝塑形和操作,通常可将导线固定于右心房心耳部和右心室间隔部或心尖部。

Objective To explore the methods for implantation of pacing lead through persistent left superior vena cava. Methods Four patients who need implant pacemakers for suffering from bradyarrhythmias were found to have persistent left superior vena cava and absent right superior vena cava. Through the left superior vena cava, the atrial pacing leads of four patients were fixed in the right atrial appendage, and the ventricular pacing leads of two patients were screwed into the right ventricular septum and another two were placed at the right ventricular apex. Pacing leads parameters were measured on 1 day, 3 months and 1 year after the operation. Results Four patients were successfully implanted the atrial and ventricular pacing leads. And the parameters of both atrial and ventricular pacing leads were satisfactory. Conclusion By means of appropriate stylet shaping and careful operation, the atrial and ventricular pacing leads may be screwed into the right atrial appendage and right ventric

目的：对比古今针灸治疗失眠处方规律之不同。方法收集古今针灸治疗失眠处方文献，运用频数、百分数对针灸治疗失眠常用穴位、所用穴的十四经分布及取穴部位、特定穴应用情况及处方用穴特点进行比较。结果古代医家选穴较为分散，取穴主要集中在胸腹部、下肢部；现代医者选穴相对集中，处方相对固定，取穴主要集中在头颈部、下肢部；取穴主要集中在足太阳膀胱经上，古代医家还多选用任脉穴，现代医家则更多选用督脉穴。结论古今医家组方选穴差异较大，但在用穴的归经、类型上较为相似，选穴多集中在足太阳膀胱经，均看重俞穴的使用。

Objective To compare the differences of insomnia prescription laws between ancient and mordern acupuncture. Methods Collected ancient and mordern acupuncture treatment of insomnia prescriptions literature, using fourteen frequency, percentage of acupuncture acupoints, the points of the distribution and distribution in different parts of the body, the specific acupoint application and prescription features for statistical description. Results The ancient physicians selected points more dispersed, acupoints are mainly concentrated in the chest , abdomen and leg. Modern physicians point selection is relatively concentrated, prescription relatively fixed, the acupoints are mainly concentrated in the head and neck and lower limb;acupoints are mainly concentrated in the Urinary bladder meridian of foot Taiyang, the ancient physicians also more choice of Ren pointss, modern physicians are more optional Du points. Conclusion The physicians prescriptions are quite different, but in the meridian

目的探讨耳甲迷走神经刺激术的脑通路,为耳迷走神经刺激调制孤束核-边缘叶脑网络假说提供证据。材料与方法随机录用16名健康志愿者,参加经皮电刺激右耳甲部迷走神经分布区（t VNS）,以同侧上耳舟部刺激为对照,记录刺激的耳部感觉,观察全脑6 min扫描的Bold-f MRI信号变化,分析脑功能激活特点,应用SPM8处理f MRI数据。结果两组电流、感觉频率及强度未见明显区别。经皮电刺激耳甲部t VNS正常人激发了左侧孤束核及边缘叶脑区广泛而较强的负激活效应,局限性激活位于体感区及岛叶等,而对照部产生了右侧三叉神经核等脑干核团负激活及脑部体感区明显的激活现象。结论经皮电刺激迷走神经产生了孤束核-边缘叶脑网络的调制效应,为经皮电刺激耳甲部迷走神经治疗抑郁症等脑中枢机制打下基础。

Objectives: To investigate the BOLD fMRI response to transcutaneous vagus nerve electronical stimulation (tVNS) at auricular concha region (ACR) on the healthy. It is hypothesized that tVNS modulates the network of nucleus of tract solitary-limbic system. Materials and Methods: Sixteen healthy subjects (18-27 y) were enrolled in the fMRI study. The fMRI was conducted during tVNS on ACR controlled with sham-tVNS on the superior scapha respectively. Subjects’ sensations were recorded after every fMRI scan. Each functional scan lasted 6 minutes. SPM8 was employed for the fMRI data processing.Results: The current, and the sensations’ frequency and strength of electronical stimulation were similar between two groups. The tVNS induced the predominant deactivation in the left nucleus of tract solitary and brain regions involving in limbic function, and the activation was limited in left SII, left anterior insula, etc. However, the sham tVNS showed the deactivation in the areas of

[目的]探讨CARTO系统指导下行心房颤动经导管射频消融治疗术病人的护理。[方法]对52例心房颤动病人行射频消融治疗,经穿刺房间隔,常规置管,在CARTO指导下构建左房电解剖图,所有病人均完成环肺静脉消融,部分病人加行左房顶部线,二尖瓣峡部线和(或)三尖瓣峡部线消融,同时加强护理。[结果]52例心房颤动病人成功接受经导管射频消融治疗术;术后并发心包渗出1例,迷走神经反射5例,局部出血与血肿2例;18例病人术后因心房颤动发作出现明显的紧张、焦虑、抑郁、失望等心理问题。[结论]加强CARTO系统指导下行心房颤动经导管射频消融治疗术的护理是手术成功的保证。

Obj ective:To probe into Nursing care of catheter ablation of atrial fibrillation under guidance of CARTO system.Methods:A total of 52 cases of patients with atrial fibrillation received radiofrequency ablation,through atrial septal puncture and conventional catheter,left atrial electro anatomi-cal map constructed under the guidance of CARTO,all patients completed circumferential pulmonary vein ablation,top line of left atrial,mitral isthmus line and (or)tricuspid isthmus line ablation were added in some patients,at the same time,the nursing care for them was strengthened.Results:5 2 cases of patients with atrial fibrillation accepted catheter radiofrequency ablation successfully;The postoperative complications with pericardial effusion in 1 case,vagus nerve reflex in 5 cases,local hemorrhage and hematoma in 2 ca-ses.In addition,18 cases of patients appeared obvious psychological problems such as stress,anxiety,depression and despair because of postoperative atrial fibrillation attack.