Assessment of optic nerve and optic tract alterations in patients with orbital space-occupying lesions using probabilistic diffusion tractography

AIM: To investigate the diffusion changes in both the optic nerve and optic tract in orbital space-occupying lesion patients with decreased visual acuity, and its clinical significance using probabilistic diffusion tractography (PDT). METHODS: Twenty patients with orbital space-occupying lesions and 25 age- and gender-matched healthy persons were included. All patients and controls underwent routine orbital magnetic resonance imaging and diffusion tensor imaging (DTI), using a 3.0T magnetic resonance scanner (Trio Tim Siemens). After the image data were preprocessed, each DTI parameters of the optic nerve and optic tract was obtained by PDT, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD). The asymmetry index (AI) of each parameter was calculated. Compared the parameters of the affected side optic nerve and ipsilateral optic tract with the contralateral side by paired sample t-test; compared AI of parameters of optic nerve and optic tract between the patient group and the control group by independent sample t-test. Patients were divided into three subgroups according to the low vision grade standard of WHO, compared the FA and AI of FA between the three subgroups by single factor variance analysis. RESULTS: The affected side optic nerve presented significantly decreased FA, increased MD, AD, and RD values compared to the unaffected side (P<0.05). The AI of FA, MD, AD, and RD of optic nerve in the patients was significantly higher than that of the controls (P<0.05). The comparison results of the optic tract showed that there was no significant difference between the patient group and control group in terms of the bilateral optic tracts in patients (P>0.05). The AIs of the FA value of the optic nerve in the eyesight <0.1 subgroup was significantly higher than that in the other groups (P<0.05). CONCLUSION: FA, MD, AD, and RD of the affected side optic nerve of the orbital space-occupying lesions have significantly changed, the FA value is the most sensitive. The PDT could be a useful tool to provide valid quantitative markers of optic nerve injuries and evaluate the severity of orbital diseases, which other examinations cannot be acquired.     

可调节带袢锁扣钛板-自体半腱肌肌腱全内重建前交叉韧带断裂的效果

 目的 探讨可调节带袢锁扣钛板-自体半腱肌肌腱全内重建膝关节前交叉韧带(anterior cruciate ligament,ACL)断裂的可行性、优缺点及并发症。方法 选择2014-07至2015-07应用可调节带袢锁扣钛板-自体半腱肌肌腱全内重建膝关节ACL断裂47例。2～6周,关节镜下应用可调节带袢锁扣钛板-自体半腱肌肌腱全内重建膝关节ACL断裂,伴发内侧副韧带损伤,用股薄肌肌腱修复或直接缝合。取同侧半腱肌肌腱,修整后将肌腱移植物对折成4股,并与可调节带袢锁扣钛板相连,移植物长度为6～6.5 cm,直径为7～9 mm。在ACL胫骨侧、股骨侧印迹定位并用倒打钻钻孔,制作骨隧道,经前内侧入路将肌腱移植物牵入骨道,并两侧逐步锁紧线环,将胫骨向后复位,将钛板固定在骨皮质上。根据重建手术前、后膝关节前抽屉实验、Lachman 试验、侧方挤压实验、IKDC 膝关节功能评价表、 Lysholm 评分对患者进行主观和客观评分,以评定疗效。结果 本组47例随访2～3年,平均随访时间为2.1年。末次随访时,患者膝关节疼痛、肿胀、屈伸活动受限等症状明显改善,前抽屉实验(-),Lachman试验(-),IKDC膝关节功能评分、Lysholm评分较重建前明显提高。膝关节屈曲达115°～130°;膝关节IKDC评分结果:正常41例(87.2%),接近正常4例(8.5%),异常2例(4.3%);膝关节功能Lysholm评分:术前(51.4±5.4)分,术后(92.2±4.6)分,差异有统计学意义(P<0.05)。结论 应用可调节带袢锁扣钛板-自体半腱肌肌腱全内重建膝关节ACL,创伤小,能恢复膝关节的稳定性,功能恢复良好,疗效确切。     

全科护理管理模式在洪灾救援中的应用

2010年7月下旬历史罕见的水灾席卷巴基斯坦,全国四分之一土地被淹,2 000余万人受灾。中国国际救援队两批次78人赴巴基斯坦开展洪灾救援。这是中国国际救援队成立近10年以来最大规模的一次救援,历时最长、派出人员最多、完成救治病人数量最多,先后救治2万余名灾区病人,圆满完成了医疗救援和卫生防疫任务。在总结以往国际救援护理经验基础上,结合洪灾现场实际,将全科护理管理模式应用于此次洪灾救援实践中,收到了良好效果。     

QuickCheck检测加速器的能力测试与评估

目的：在改变测量条件和标准条件的情况下进行测量，对比测量结果，检测QuickCheck的性能，为加速器的晨检及检测结果判读提供依据。方法：通过改变输出剂量、射野大小、SSD、准直器角度和机架角，评估QuickCheck的检测能力。QuickCheck检测的射野参数与三维水箱等测量进行对比。结果：输出剂量增大1 cGy或减小6 cGy，射野改变≥0.2 cm；SSD减小2 cm或增大1 cm，准直器旋转≥2 o，机架角旋转≥6 o，检测结果超过阈值。与三维水箱测量的结果相比，平坦度、对称性（G/T）和（L/R）及剂量率分别相差3.84%、0.67%、0.47%，1.2 MU/min。结论：QuickCheck在检测输出剂量、射野大小、准直器角度、平坦度、对称性及剂量率方面准确度很高，能够满足日常加速器质量保证的需要。在检测SSD、机架角偏差方面能力较弱。     

Four years data of raltegravir-based salvage therapy in HIV-1-infected,treatment-experienced patients: the SALIR-E Study

Apart from the BENCHMRK study, there are no large observational experiences describing the long-term efficacy and safety of rescue regimens for human immunodeficiency virus type 1 (HIV-1) infection. Antiretroviral-experienced patients with detectable viraemia starting a raltegravir (RAL)-based regimen between March 2007 and June 2009 were consecutively enrolled and followed for ≥4 years. Data were censored at Week 206 for homogeneity. Of 333 patients, 258 (77.5%) were still on RAL-based therapy at Week 206, and 241 had undetectable HIV-1 RNA (73% in intention-to-treat analysis). Of the 75 subjects who discontinued RAL therapy, 36 were lost to follow-up, 15 changed their regimen due to virological failure, 2 simplified their regimen stopping RAL, 9 stopped all antiretrovirals and 13 died. Overall, 100 subjects (30.0%) had at least one detectable viraemia, but only 32 (9.6%) had true viral failure. Seventeen patients continued their failing regimen. ‘Blips’ were experienced by 53 patients (15.9%), whilst 15 (4.5%) had confirmed viral rebound due to adherence issues and were re-suppressed upon treatment re-introduction. In a multivariate analysis of predictors of interruption or failure, each baseline HIV-1 RNA log₁₀ increase was associated with an adjusted hazard ratio for failure of 1.6; having more than 13 previous treatment courses also emerged as a predictor. Overall, adverse events were rare (n = 64), with 13 deaths. Tumours were mainly early events, often fatal (7/15), mainly non-Hodgkin's lymphomas (8), followed by hepatocarcinoma (2). RAL proved effective and well tolerated in this cohort, and few patients experienced viral failure after 4 years.     

Uncertainty of antioxidant profiling in complex mixtures using liquid chromatography involving post-column derivatisation

The main goal of this paper is to discuss the problems associated with antioxidant profiling in complex samples using a high-throughput HPLC system coupled with post-column derivatisation reactor. Based on the experimental data reported in the literature, we demonstrated that improper optimisation of temperature and/or pH assay conditions performed using an on-line derivatisation reactor may substantially change the antioxidant peaks ratio of targeted phytochemical compounds. It has been found that despite the relatively high stability of flavonoids at high temperature and under binary mobile phase HPLC conditions, the reaction of target compounds with common ABTS, FCR and DPPH radicals at elevated regions (particularly above 100 °C) dramatically changes their antioxidant activity values expressed, for example, as TEAC (Trolox equivalent antioxidant capacity) parameters. In principle, separation and detection processes of antioxidant profiling assay must not significantly affect the antioxidant activity of target compounds. In the case of foods eaten by humans or animals, critical experimental parameters such as pH and temperature concerning interaction of target analytes with derivatisation reagent should be as close as possible to the real physiological values.     

Effects of trophic 2,2′, 4,4′-tetrabromodiphenyl ether (BDE-47) exposure in Oreochromis niloticus: A multiple biomarkers analysis

Polybrominated diphenyl esters are emerging environmental contaminants with few toxicological data, being a concern for the scientific community. This study evaluated the effects of BDE-47 on the health of Oreochromis niloticus fish. The animals were exposed to three doses of BDE-47 (0, 0.253, 2.53, 25.3 ng g⁻¹) every 10 days, for 80 days. The BDE-47 affected the hepatosomatic and gonadosomatic index in female and the condition factor by intermediate dose in both sexes. The levels of estradiol decreased and the T4 are increased, but the vitellogenin production was not modulated in male individuals. Changes in AChE, GST, LPO and histopathology were observed while the integrated biomarker response index suggests that the lowest dose of BDE-47 compromised the activity of antioxidant enzymes. The oral exposure to BDE-47 in environmental concentrations is toxic to O. niloticus and the use of multiple biomarkers is an attribution in ecotoxicology studies and biomonitoring programs.