不同激光美容治疗技术的临床应用分析

目的探讨不同激光美容治疗技术的临床应用效果。方法选取2014年1月—2016年9月期间温州医科大学附属眼视光医院收治的48例色素暗沉病症和良性皮肤增生相关病症患者作为研究对象,随机分为对照组和观察组,各24例。两组患者均根据美容需求制定YAG激光治疗方案,对照组单纯采用YAG激光(Q一Switehing Nd:YAGLaser Deviee)技术治疗,观察组在对照组基础上增加强脉冲光治疗,观察两组患者治疗1个月后临床疗效、皮肤损伤程度及损伤愈合时间。结果观察组患者激光美容治疗,治疗总有效率为95.83%(23/24),显著高于对照组(79.17%,19/24),组间差异有统计学意义(P0.05)。观察组皮肤损伤愈合时间(11.36±5.69)d显著低于对照组(15.23±6.58)d,组间差异有统计学意义(P0.05)。观察组和对照组患者两组皮肤损伤程度比较,无显著差异P0.05,无统计学意义。结论 YAG激光联合强脉冲光技术应用于临床医学美容治疗效果较好,且缩短了患者恢复时间,该激光美容治疗技术临床应用可靠。     

小剂量奈达铂同步放疗对中晚期宫颈癌作用

目的对小剂量奈达铂与顺铂周疗方案同步放疗治疗中晚期宫颈癌的临床疗效及毒副反应进行分析。方法收集2012年7月至2015年12月中晚期宫颈癌患者(均为鳞状细胞癌)86例随机分两组。顺铂组采用顺铂周疗方案同步放疗治疗,奈达铂组采用小剂量奈达铂周疗方案同步放疗治疗。比较两组患者中晚期宫颈癌治疗总有效率,毒副作用发生率,治疗前和治疗后患者生存质量评分以及KPS评分的差异。结果奈达铂组患者中晚期宫颈癌治疗总有效率和顺铂组无显著差异,P0.05;奈达铂组肾脏毒性、恶心呕吐等毒副作用发生率低于顺铂组,而血液毒性反应明显高于顺铂组,P0.05。治疗前两组生存质量评分以及KPS评分比较无显著差异,P0.05;治疗后奈达铂组生存质量评分以及KPS评分改善幅度更大,P0.05。结论小剂量奈达铂周疗方案同步放疗治疗中晚期宫颈癌的临床疗效确切,优于顺铂周疗方案同步放疗治疗,可有效改善病情,减少肾脏毒性、恶心呕吐等毒副作用的发生,但也增加了血液毒性,需引起注意。     

超声引导椎旁神经阻滞治疗带状疱疹后遗神经痛的疗效及可行性分析

本文对超声引导椎旁神经阻滞治疗带状疱疹后遗神经痛（post-herpetic neuralgia，PHN）的疗效及可行性进行了分析。研究对象为2015年12月~2017年12月于我院就诊的94例PHN患者，按就诊顺序随机均分为两组，对照组给予普瑞巴林常规治疗，观察组在此基础上联合超声引导椎旁神经阻滞治疗，连续治疗4周。本文比较了治疗前、治疗1周、2周、4周后的匹兹堡睡眠质量指数（PSQI）评分、疼痛视觉模拟（VAS）评分，并评价了治疗后的综合疗效，记录了治疗期间发生不良反应情况。结果显示，较治疗前，治疗1周、2周、4周后两组VAS评分均逐渐降低，且观察组治疗后各时间点的VAS评分显著低于对照组，差异具有统计学意义（P<0.05）；较治疗前，两组治疗1周、2周、4周后PSQI评分均逐渐降低，且观察组治疗后各时间点的PSQI评分显著低于对照组，差异具有统计学意义（P<0.05）；观察组治疗总有效率为89.36%，对照组为78.72%，观察组显著高于对照组，差异具有统计学意义（P<0.05）；两组治疗期间各项不良反应发生率差异无统计学意义（P>0.05）。本文证实了超声引导椎旁神经阻滞治疗PHN能显著改善患者神经疼痛症状，提升睡眠质量，同时具有安全性保障。     

格列美脲与二甲双胍联合短期内强化治疗初诊2型糖尿病的疗效及安全性分析

目的 研究格列美脲与二甲双胍联合短期内强化治疗初诊2型糖尿病的疗效及安全性。方法 以天津市武清区河西务医院2015年1月—2016年11月初诊2型糖尿病患者106例随机分两组。A组采用常规饮食、运动等干预,并口服格列美脲治疗,B组在A组基础上联合二甲双胍治疗,共治疗12周。比较两组患者低血糖、肝肾和胃肠不良反应发生率;血糖达标时间;施行治疗前和施行治疗后患者血糖水平、胰岛素分泌指数、胰岛素抵抗指数的差异。结果 两组患者低血糖、肝肾和胃肠不良反应发生率无显著差异,P0.05;B组血糖达标时间短于A组,P0.05;施行治疗前两组血糖水平、胰岛素分泌指数、胰岛素抵抗指数比较无显著差异,P0.05;施行治疗后B组血糖水平、胰岛素分泌指数、胰岛素抵抗指数改善幅度更大,P0.05。结论格列美脲与二甲双胍联合短期内强化治疗初诊2型糖尿病的疗效及安全性高,可有效改善患者血糖水平和胰岛素分泌情况,低血糖风险低,安全可靠,值得推广。     

舒芬太尼与瑞芬太尼在急诊脑外伤手术麻醉中应用研究

目的在急诊脑外伤手术中分别对患者行舒芬太尼、瑞芬太尼麻醉,对比治疗效果。方法选取广州市番禺区钟村医院于2014年8月—2016年4月期间收治的脑外伤患者82例,按照患者入院时间,划分为治疗组与参照组,每组各41例。对参照组患者行瑞芬太尼麻醉,对治疗组患者行舒芬太尼麻醉,对比两组患者的临床治疗效果。结果治疗组患者的麻醉持续时间、苏醒时间、气管插管拔管时间、术后视觉模拟评分法(VAS)评分均明显优于参照组患者,组间差异P0.05,存在统计学意义,但是两组患者为治疗后的心率(HR)、平均动脉压(MAP)并无显著差异(P0.05);此外,治疗组患者的不良反应发生率为9.76%,与参照组患者的17.07%对比,组间优势不具有明显性,即P0.05,不存在统计学意义。结论在急诊脑外伤手术过程中,对患者行舒芬太尼麻醉,不仅可以改善临床麻醉效果,提高临床疗效,保证临床治疗安全,还能促进患者术后恢复,临床应用与推广价值较为显著。     

乙腈团簇增强的激光高价电离现象的质谱研究

利用脉宽为25 ns的脉冲Nd：YAG1064 nm激光, 在10¹⁰～10¹¹ W•cm^－２强度下, 用飞行时间质谱对乙腈分子束激光电离过程进行了研究, 发现了高价态的原子离子N^q+(q＝1～5)和C^q+(q＝1～4). 类氦离子N⁵⁺、C⁴⁺的最可几平动能分别高达566 eV和427 eV. 激光延时以及不同束源压力的实验结果表明, 这些高价离子可能来源于乙腈团簇的库仑爆炸过程. 提出一个多光子电离引发, 逆韧致吸收加热- 电子碰撞电离模型来解释高价离子的产生.     

40例幼儿肱骨髁上骨折临床治疗观察

目的分析切开复位克氏针内固定方法和手法复位外固定方法治疗幼儿肱骨髁上骨折的临床疗效。方法收集2013年1月到2014年1月东莞市中堂镇医院收治40例幼儿肱骨髁上骨折患者临床资料,按照不同的治疗方法,分为治疗组与对照组,各20例。治疗组采取切开复位克氏针内固定方法,对照组采取手法复位外固定方法,最后分析两组患儿临床治疗效果。结果治疗组患儿治疗总有效率为95%,明显高于对照组的80%,差异显著P0.05;治疗组患儿UCLA评分和ASAES评分明显高于对照组,差异显著P0.05;治疗组并发症的发生率为5%,明显低于对照组的25%,差异显著P0.05。结论切开复位克氏针内固定治疗于幼儿肱骨髁上骨折患者,治疗有效率较高,促进术后康复,有利于改善患儿预后情况,值得临床推广。     

硝苯地平联合硫酸镁治疗妊娠期高血压疾病的临床效果

目的探讨硝苯地平联合硫酸镁治疗妊娠期高血压疾病的临床效果。方法将天津市武清区中医医院妊娠期高血压患者中随机分为研究组和对照组(n=25),研究组患者给予硝苯地平联合硫酸镁治疗,对照组给予硫酸镁治疗,比较两组治疗效果。结果研究组治疗总有效率为88.00%,显著高于对照组的68.00%(P0.05);研究组患者治疗后的血压、2 h尿蛋白定量和血液黏稠度明显优于对照组(P0.05);两组新生儿Apger评分无明显差异(P0.05)。结论硝苯地平联合硫酸镁在妊娠期高血压患者治疗中疗效显著,可以有效控制患者血压水平,具有不良反应发生率小和对胎儿影响小的优点,值得推广和应用。     

肺康复联合无创通气对慢阻肺急性加重患者生活质量的影响

目的观察肺康复治疗在无创通气基础上对慢阻肺急性加重期患者肺功能指标、运动耐力、生活质量的影响。方法选择2014年10月—2016年10月于广东医科大学附属厚街医院住院的71例慢阻肺急性加重期患者作为研究对象,随机分为两组,对照组28例,观察组43例,对照组给予有效抗感染、吸入糖皮质激素+长效β2受体激动剂(ICS/LABA)及氧疗,无创辅助通气,观察组在对照组基础上给予肺康复治疗,比较两者患者在肺功能指标、运动耐力、生活质量的变化。结果 (1)两组患者治疗前肺功能指标(FEV1、FEV1/FVC(%)、FEV1%Pred(%))6MWD、CAT评分差异无统计学意义。(2)两组患者治疗后观察组FEV1高于对照组,但差异无统计学意义(P0.05)。但治疗后第7天FEV1、FEV1/FVC(%)、FEV1%Pred(%)观察组高于对照组,差异有统计学意义;两组患者治疗后较治疗前6 min步行距离(6 MWD)明显升高,差异有统计学意义(P0.05);CAT评分明显下降,差异有统计学意义(P0.05)。(3)治疗后观察组6 MWD对照组,差异有统计学意义(P0.05);治疗后观察组CAT评分对照组,差异有统计学意义(P0.05),结论肺康复治疗联合无创通气能够明显改善COPD急性加重期患者运动耐力及生活质量,但肺通气功能指标FEV1无明显优于单用无创通气治疗。     

腹腔镜手术联合药物治疗子宫内膜异位症的临床疗效分析

目的评价腹腔镜手术联合药物治疗子宫内膜异位症的临床疗效。方法选取东莞市第三人民医院于2015年1月至2017年1月收治的150例子宫内膜异位症患者,按随机盲选法分为两组,对照组75例给予腹腔镜手术治疗,观察组75例给予腹腔镜手术联合药物治疗,对比两组临床治疗效果。结果在治疗总有效率方面,观察组为94.67%,明显要比对照组的70.67%高,两组数据差异有统计学意义(P<0.05)。在不良反应发生率方面,观察组为5.33%,明显要比对照组的22.67%低,两组数据差异有统计学意义(P<0.05)。结论对于子宫内膜异位症患者,采取腹腔镜手术联合药物进行治疗,具备显著疗效,能够降低不良反应发生率,因此,值得在临床中采纳及应用。     

Iron Oxide Nanocrystals Synthesis by Laser Ablation in Water: Effect of Laser Wavelength

In this research the synthesis of nanocrystalline iron oxides by laser ablation in pure water has been performed by two different wavelengths (first and second harmonics) of high frequency Nd:YAG laser. The obtained results from the X-ray diffraction and transmission electron microscopy analysis of the synthesized samples show the formation of spherical nanocrystalline magnetite with narrow particle size distribution and average diameters of 7 and 17 nm for the samples obtained by first and second harmonics of laser, respectively. According to the hysteresis loops measured by vibrating sample magnetometer, formation of the superparamagnetic nanoparticles (NPs) is confirmed. Investigating the magnetic properties of the two samples indicates a rise in the amount of magnetization of the sample produced by first harmonic of the laser compared to the one produced by the second harmonic wavelength. So it is obtained that the main wavelength of Nd:YAG laser (1,064 nm) results to finer iron oxide NPs with better magnetic properties.     

Analysis of glass by UV laser ablation inductively coupled plasma atomic emission spectrometry. Part 2. Analytical figures of merit

Two lasers working in the UV part of the spectrum have been used for the direct analysis of glass samples by laser ablation ICP-AES. An XeCl excimer laser (308 nm) and a Nd:YAG laser operating at the third harmonic (355 nm) and the fourth harmonic (266 nm) have been selected. The energy was 70 mJ and 5 mJ for the excimer laser and the Nd:YAG laser, respectively, with a 10 Hz repetition rate. Figures of merit such as repeatability, reproducibility, accuracy and limits of detection have been studied. Si was used as an internal standard to improve the repeatability, the reproducibility and the accuracy. Use of internal standardardization led to an RSD of less than 1% for most elements and to a linear calibration graph irrespective of the colour of the glass samples. Limits of detection in the solid were of the same magnitude as those obtained using sample dissolution and pneumatic nebulization. Results confirmed that the XeCl laser provided the best results of detection whereas the Nd:YAG laser, particularly at 266 nm, was less sensitive to glass colour.     

Pulse timing and optical interface between a neodymium: yttrium aluminum garnet laser and a Fourier transform ion cyclotron resonance mass spectrometer.

Laser desorption/ionization combined with pulsed (time-of-flight or Fourier transform ion cyclotron resonance) mass spectrometric detection is a powerful technique for analysis of involatile compounds and mixtures. Such experiments were originally conducted with pulsed CO2 lasers. Although a pulsed CO2 laser can be operated in single-shot mode, Nd: YAG lasers perform best with multiple flashes for warm-up before the final Q-switch output light pulse, thus creating the need to synchronize the desired final laser-output pulse with the event sequence for mass spectrometric analysis. In this paper, we describe a new and simple interface (both optical and electronic components) between a Continuum (formerly Quantel) Model YG 660A Nd:YAG laser and an Extrel FTMS-2000 mass spectrometer. The optics are modified from a prior pulsed CO2 laser interface from Extrel. Synchronization between the Nd:YAG laser and the mass spectrometer event sequence is achieved by means of a simple timing circuit that uses an inexpensive pulsing device and is triggered by pulses generated directly from the Extrel 1280 data system and cell controller, in contrast to the only prior published method that required an auxiliary microcomputer. The present interface method is highly flexible, and makes possible complex sequence events involving laser pulses for e.g.: desorption/ionization of solids; photoionization of gaseous neutrals; and photodissociation and photodetachment of gaseous ions.     

Laser flash photolysis studies of alkoxyl radical kinetics using 4-nitrobenzenesulfenate esters as radical precursors

4-Nitrobenzenesulfenate esters were used as precursors for the generation of alkoxyl radicals under laser flash photolysis conditions. The esters were efficiently cleaved using the Nd:YAG third harmonic (355 nm) to produce alkoxyl radicals and the 4-nitrobenzenethiyl radical. Rate constants for beta-scission and 1, 5-hydrogen abstraction reactions of alkoxyl radicals were measured.     

Experimental determination of laser induced breakdown thresholds of metals under nanosecond Q-switched laser operation

Laser-induced breakdown thresholds for several pure metals were determined using a nanosecond laser. A Q-switched pulsed Nd:YAG laser operating at infrared (1064 nm), visible (532 nm) and ultraviolet (266 nm) wavelengths has been used. The plasma was generated by focusing the Nd:YAG laser on the target in air at atmospheric pressure. The dispersed plasma light was detected using a two-dimensional intensified charge-coupled device (CCD) detector. The studied elements were chosen according to their different thermal and physical properties, particularly boiling point, melting point and thermal conductivity. The effect of wavelength on the plasma threshold has been discussed. Laser fluence thresholds in the ultraviolet were larger than those obtained using visible and infrared radiation, while the energy threshold is larger using infrared radiation. Correlations between the plasma threshold of metal targets and the melting point and boiling point at 266, 532 and 1064 nm have been established. The results indicate that thermal effects have an important influence on the ablation behavior of metals at the three wavelengths used.     

Laser fragmentation in liquid medium: a new way for the synthesis of PbTe nanoparticles

Synthesis of PbTe nanoparticles has been performed by pulsed laser fragmentation of PbTe micron-sized powders in distilled water with a Nd:YAG laser. The influence of various experimental parameters (wavelength, treatment duration, and output energy) on the yield of fragmentation, the size and the crystallographic structure of the nanoparticles produced has been investigated. Characterization of the nanopowders was performed by X-ray diffraction analyses and transmission electron microscopy observations. Thanks to a careful control of the synthesis parameters, PbTe nanoparticles with an average diameter close to 6 nm and exhibiting a sharp distribution in size have been produced.     

Clinical experience with the integral photodynamic therapy of bladder carcinoma

Photodynamic therapy (PDT) was given to 20 patients who had recurring superficial tumours after unsuccessful application of other treatments. The phototherapeutic results were evaluated by check-ups at 3 month intervals (endoscopy, cytology, bladder mapping, renal ultrasonography) and computed tomography (CT) examination at 8-13 month intervals. In six patients treated with PDT no tumour recurrence was found over the whole observation period up to nearly 5 years. Four patients remained free of tumour (12 and 14 months) after repeated transurethral resection (TUR) and Nd:YAG laser therapy following PDT. Due to an initial application of insufficient irradiation, four patients required a second photodynamic treatment. In one of these cases a circumscribed dysplasia which appeared at the left ostium 26 months following PDT was treated successfully using the Nd:YAG laser following TUR. In six patients slight mucosal atypia persisted for a period of at least 2.5 years. One cystectomy had to be performed because of bladder shrinkage. The dissected bladder was free of tumour. According to these preliminary results, PDT with strict patient selection (worst case situation with recommended cystectomy) is justified in the case of recurrent superficial TIS bladder carcinoma.     

Analysis of glass by UV laser ablation inductively coupled plasma atomic emission spectrometry. Part 1. Effects of the laser parameters on the amount of ablated material and the temporal behaviour of the signal for different types of laser

Two lasers working in the UV part of the spectrum have been used for the analysis of glass samples. An XeCl excimer laser (308 nm) and a Nd:YAG laser operating at the third harmonic (355 nm) and the fourth harmonic (266 nm) have been selected. The energy was 100 mJ and 5 mJ for the excimer laser and the Nd:YAG laser, respectively. Because of different spot sizes, the fluence was of the same magnitude for both lasers. Crater characterization indicated that the laser ablation efficiency was similar for the two lasers when normalized to the same energy. However, the XeCl was found to be more efficient when the results were normalized to irradiance unit. The amount of probed material and ablated material was measured, leading to an efficiency higher than 80%. The influence of the glass colour and the laser wavelength was evaluated. The XeCl laser provided the largest amount of material but was sensitive to the glass colour. This laser was mainly suitable for bulk analysis. In contrast, the Nd:YAG, particularly at 266 nm, was insensitive to the glass colour and was appropriate for localized analysis. Inductively coupled plasma atomic emission spectrometry was used for atomization and excitation of the ablated material. A good agreement was found between the temporal behaviour of the amount of ablated material and the analyte signal.