人结直肠锯齿状腺癌的研究现状

结直肠锯齿状腺癌（serrated adenocarcinoma，SAC）作为大肠癌的一种特殊临床类型，因其癌变途径的特殊性，检测以及较差的治疗反应和预后逐渐引起众多研究者的兴趣。其产生的途径主要为“锯齿状通路”途径，锯齿状通路途径以BRAF突变、微卫星体不稳定（microsatellite instability，MSI））和CpG岛的甲基化（CpG island methylator phenotype，CIMP）为特征。由于特殊的形态和内镜特征及特殊的发生部位，在结肠镜检查时很容易漏诊，甚至病理评估时也极易被忽视，临床确诊时往往已处于进展期，患者预后差，生存率低。本文针对锯齿状结直肠腺癌流行病学、危险因素、临床特征、病理学特征、分子特征等作一综述。     

Downscaling land surface temperature data by fusing Suomi NPP-VIIRS and landsat-8 TIR data

Land surface temperature (LST) is a key parameter of great interest in many remote sensing applications. However, no single satellite system can produce thermal infrared (TIR) images at both high spatial and temporal resolution to retrieve LST. Various algorithms have been developed to enhance the spatial or temporal resolution of TIR data in the past decades. Among them, the Spatio-temporal Adaptive Data Fusion Algorithm for Temperature mapping (SADFAT) model is one of the most widely used algorithms for fusing Landsat and Moderate Resolution Imaging Spectroradiometer (MODIS) imagery. To our knowledge, Visible Infrared Imaging Radiometer Suite (VIIRS) TIR data have not yet been used in thermal downscaling with Landsat-8 TIR data. This study aims to generate daily LST images at Landsat-8 resolution (100 m) by fusing VIIRS and Landsat-8 TIR data for the first time with the SADFAT algorithm. The results indicate that the prediction accuracy for the study area ranged from 1.1 K to 1.4 K, which suggests that VIIRS data can be used as a good alternative for MODIS data for generating daily LST images by fusing Landsat TIR data.     

GC-MS同时测定复方鲜竹沥液中8个酚类有效成分

目的 建立GC-MS同时测定复方鲜竹沥液中苯酚、愈创木酚、甲基愈创木酚、乙基愈创木酚、乙烯基愈创木酚、2,6-二甲氧基苯酚、香兰素和丁香醛8个酚类有效成分含量的方法。方法 样品经乙醚萃取后,采用DB-35MS UI色谱柱(30 m×0.25 mm,0.25 μm)进行分离,采用离子监测模式(SIM)进行质谱检测,外标法定量。结果 在优化实验条件下,8种酚类成分分离良好,在0.1~129.4 μg·mL^-1内线性良好,相关系数均>0.999 0,方法检出限均<0.043 μg·mL^-1;在3个不同加标浓度下的回收率为93.76%~101.33%,RSD值均≤ 3.08%。结论 该方法简单、灵敏、准确并且可靠,可为复方鲜竹沥液的质量控制提供科学依据。     

A randomised study of intranasal dexmedetomidine and oral ketamine for premedication in children

We studied the effects of intranasal dexmedetomidine combined with oral ketamine for premedication in children. One hundred and sixty children aged between 2 and 6 years were randomly allocated to one of four groups: 1 μg.kg^?1 intranasal dexmedetomidine with 3 mg.kg^?1 oral ketamine (Group 1); 1 μg.kg^?1 intranasal dexmedetomidine with 5 mg.kg^?1 oral ketamine (Group 2); 2 μg.kg^?1 intranasal dexmedetomidine with 3 mg.kg^?1 oral ketamine (Group 3); and 2 μg.kg^?1 intranasal dexmedetomidine with 5 mg.kg^?1 oral ketamine (Group 4). Sedation levels 10, 20 and 30 min after premedication were evaluated using a 5‐point sedation scale. A 4‐point emotional state score was used to evaluate patients when they were separated from their parents and their response to intravenous cannulation or facemask application. Approximately 90% of patients readily accepted premedication and onset times of acceptable sedation were similar in all four groups. Patients in Group 4 were significantly more sedated than those in Group 1 after 30 min (p = 0.036). A significantly higher proportion of patients in Group 3 (84%) and Group 4 (87%) accepted intravenous cannulation compared with those in Group 1 (40%) and Group 2 (54%) (p = 0.001). We conclude that the administration of 2 μg.kg^?1 intranasal dexmedetomidine and 3 mg.kg^?1 oral ketamine was the optimal combination, with children being easily separated from their parent, accepting intravenous cannulation and without causing excessive side‐effects or postoperative complications.     

联合免疫阻断乙肝病毒母婴传播儿童母乳喂养安全性调查

目的 了解乙肝疫苗和乙肝免疫球蛋白(HBIG)联合免疫阻断乙型肝炎(HBV)儿童母乳喂养的安全性.方法 运用回顾性流行病学调查方法,选取2005-2017年山东省寿光市二级医院住院分娩的HBsAg阳性母亲及所生儿童为研究对象,开展问卷调查并采集血清.以酶联免疫吸附试验法(ELISA)检测乙型肝炎病毒(HBV)血清学5项指标,检出儿童HBsAg阳性为阻断失败.结果 共调查儿童1 939人,年龄1.5～14岁、平均年龄5.02岁;母乳喂养1 469人、人工喂养470人,检出HBsAg阳性55人、阻断失败率为2.84％;母亲HBeAg阳性的儿童,母乳喂养组(7.21％)和人工喂养组(8.47％)阻断失败率差异无统计学意义(x2=0.220,P＞0.05);母亲HBeAg阴性的儿童,母乳喂养组(1.20％)和人工喂养组(3.76％)阻断失败率差异有统计学意义(x2=5.400,P＜0.05).结论 HBV感染的母亲,无论是HBsAg单阳性,还是HBsAg和HBeAg双阳性,所生儿童在联合免疫阻断后母乳喂养均为安全.     

Gut microbiota interacts with intrinsic brain activity of patients with amnestic mild cognitive impairment

AimsTo explore the potential relationships among gut microbiota (GM), local brain spontaneous activity, and neuropsychological characteristics in amnestic mild cognitive impairment (aMCI) patients.MethodsTwenty aMCI and 22 healthy control (HC) subjects were recruited. The GM composition was determined by 16S ribosomal RNA gene sequencing. Resting‐state functional magnetic resonance imaging scans were performed, and fractional amplitude of low‐frequency fluctuations (fALFF) was calculated across different frequencies. The Spearman or Pearson correlation analysis was used to analyze the relationship between spontaneous brain activity and cognitive function, and GM composition.ResultsaMCI patients had altered GM state and local spontaneous brain activity as compared with HC subjects. Correlation analysis showed that aMCI and HC groups had different “GM‐intrinsic brain activity interaction” patterns. In aMCI group, at the typical band (0.01‐0.08 Hz), the relative abundance (RA) of Bacteroides from phylum to genus level was negatively correlated with fALFF value of cerebellar vermis IV‐V, and the Ruminococcaceae RA was negatively correlated with fALFF values of left lenticular nucleus and pallidum. The Clostridiaceae RA and Blautia RA were positively correlated with the left cerebellum lobules IV‐V at the slow‐4 band (0.027‐0.073 Hz). The Veillonellaceae RA was positively correlated with fALFF values of left precentral gyrus at the slow‐5 band (0.073‐0.08 Hz). Correlation analysis showed that Clostridium members (Lachnospiraceae and Blautia) were positively, while Veillonellaceae was negatively, correlated with cognition test. Bacteroides was positively correlated with attention and computation, and negatively correlated with the three‐stage command score.ConclusionsaMCI patients have a specific GM‐intrinsic brain activity‐cognitive function interaction pattern.     

Generalized multinucleate cell angiohistiocytoma with possible origin from fibroblasts: A clinicopathological study of 15 cases

Multinucleate cell angiohistiocytoma (MCAH) is a vascular and fibrohistiocytic proliferation with unknown pathogenesis. Clinical lesions tend to be localized to an anatomical area. Exceptionally, the generalized variant is rare. This study reports three cases of generalized MCAH, and analyzes the clinicopathological features of 15 cases reviewed in the published work. Compared with the localized variant, generalized MCAH affected both sexes equally, had an earlier age of onset and a predilection for the trunk and extremities. Histopathologically, the most characteristic feature is the giant, bizarre multinucleate cells with angulated cytoplasm. Systemic diseases or abnormal immune conditions were revealed in six patients with generalized MCAH. For the first time, we found that the present cases showed increased elastic fibers in the affected areas, suggesting that the synthetic function of fibroblasts was active. This study suggested that MCAH originates from fibroblasts and is a distinct entity with potential correlation with abnormal immune states.     

Subcutaneous tunneling technique to improve outcomes for patients undergoing chemotherapy with peripherally inserted central catheters: a randomized controlled trial

ObjectiveTo compare the value of the subcutaneous tunneling technique versus the normal technique in improving the outcomes of patients undergoing chemotherapy with peripherally inserted central catheters (PICCs).MethodsOne hundred thirty patients were randomly divided into an experimental group (subcutaneous tunneling technique) and control group (normal technique) according to the PICC placement technique, and clinical data were compared between the groups.ResultsIn total, 129 PICCs were successfully inserted. Compared with the control group, the experimental group had a lower occurrence of complications after placement (especially catheter dislodgement: 3.1% vs. 15.4%, venous thrombosis: 3.1% vs. 15.4%, and wound oozing: 14.1% vs. 27.7%), lower occurrence of unscheduled PICC removal (3.1% vs. 13.8%), greater comfort during placement (14.16 ± 2.21 vs. 15.09 ± 2.49 on a scale ranging from 6 to 30 points, with higher scores indicating lower degrees of comfort), and lower costs of PICC maintenance (median (interquartile range) per-day maintenance cost: 13.90 (10.99–32.83) vs. 15.69 (10.51–57.46) Yuan). The occurrence of complications and amount of bleeding during placement were not significantly different between the two groups.ConclusionsThe subcutaneous tunneling technique can improve PICC placement by reducing complications and costs of maintenance with better patient comfort during placement.     

Pointwise SAR image change detection using stereo-graph cuts with spatio-temporal information

In this letter, a pointwise approach using stereo-graph cuts (SGC) with spatio-temporal information is proposed for synthetic aperture radar (SAR) image change detection. The SGC is based on stereo-graph, which is designed to connect the local maximum pixels on two SAR images and can be used to capture the spatio-temporal information. With the support of stereo-graph, a novel SGC energy function is presented to quantify the spatio-temporal information and implicitly measure the difference information between the SAR images. Therefore, the change detection results can be obtained by minimizing the energy function with graph cuts technology. Experimental results on real SAR datasets confirm the validity of the proposed approach in which SGC and spatio-temporal information offer great contributions on improving the robustness and accuracy of detection.