新发结直肠癌患者膳食模式分析

目的 探讨新发结直肠癌患者的膳食模式与发病的关系,为结直肠癌的发生提供科学的干预方向。方法 以2018—2019年辽宁省某肿瘤医院就诊并经病理学确诊的新发结直肠癌患者和同期在该医院体检中心参加健康体检者为研究对象,新发结直肠癌患者为病例组,按同性别、同年龄1∶1选取健康体检者作为对照组,采用主成分分析法对调查对象的膳食模式进行分析,利用Logistic回归模型分析不同膳食模式对结直肠癌发病风险的影响。结果 本研究共对新发结直肠癌患者232例、健康体检者232人进行调查,2组人群在性别、年龄、文化程度、家庭人均月收入和体力劳动强度分布差异均无统计学意义（均P>0.05）。多因素Logistic回归分析结果显示坚果薯类膳食模式（OR=0.482）、水产奶类膳食模式（OR=0.666）和果蔬素食膳食模式（OR=0.800）是结直肠癌发生的保护性因素,西式膳食模式（OR=1.441）、辛辣熏制膳食模式（OR=1.195）、肉类膳食模式（OR=1.397）和高脂肪膳食模式（OR=1.349）为结直肠癌发病的危险因素。结论 坚果薯类、水产奶类和果蔬素食是结直肠癌发生的保护性因素。西式、辛辣熏制、肉类和高脂肪膳食为结直肠癌发病的危险因素,在结直肠癌的防病宣传健康教育中应该加强饮食健康宣传,提高防病意识,有效降低发病率。     

脑卒中肺部感染危险因素及血清免疫炎性因子的预测价值

目的基于主成分分析(PCA)-决策树模型分析脑卒中肺部感染的危险因素及血清免疫炎性因子的预测价值。方法回顾性分析2014年12月-2019年12月江西省上饶市人民医院确诊的176例脑卒中患者,根据是否发生肺部感染,分为感染组40例和未感染组136例。记录患者临床特征,检测血白细胞(WBC)计数、血清C-反应蛋白(CRP)、降钙素原(PCT)和可溶性白细胞介素-2受体(SIL-2R)水平。采用Logistic回归和卡方自动交叉检验(CHAID)模型分析影响脑卒中后肺部感染的危险因素;受试者工作特征曲线(ROC)分析血WBC、CRP、PCT、SIL-2R预测肺部感染的价值。结果脑卒中肺部感染与患者年龄、卒中类型、是否合并糖尿病、吸烟史、吞咽困难、意识障碍、侵入性操作有关(P<0.05);感染组患者血WBC、CRP、PCT和SIL-2R水平高于未感染组(P<0.05);糖尿病、侵入性操作、CRP和PCT均为影响脑卒中患者肺部感染的独立危险因素(P<0.05);PCA-ROC分析显示,血WBC、CRP、PCT、SIL-2R和联合预测主成分1(PC1)的曲线下面积(AUC)分别为0.670、0.816、0.854、0.686、0.918;PCA-卡方自动交互检测(CHAID)模型分析显示,WBC、CRP、PCT、SIL-2R和PC1预测肺部感染的准确率为77.33%、84.72%、86.90%、79.02%和89.24%。结论血清PCT水平可用于预测脑卒中患者肺部感染的发生,临床可重点关注合并糖尿病、意识障碍和侵入性操作的患者。     

Are We Being Fooled by Fluoroscopy? Distortion May Affect Limb-Length Measurements in Direct Anterior Total Hip Arthroplasty

BackgroundDistortion is an intrinsic phenomenon associated with image-intensified fluoroscopy that is both poorly understood and infrequently appreciated by orthopedic surgeons. Little information exists regarding its potential influence on intraoperative parameters during orthopedic surgery, let alone during direct anterior (DA) total hip arthroplasty (THA). The purpose of this study was to quantify the amount of potential error caused by fluoroscopic distortion during DA THA.MethodsIntra-operative fluoroscopic pelvic images from 74 DA THAs were reviewed by two independent readers. All images were obtained using the same fluoroscopic C-arm unit with a radiopaque grid attached to the image intensifier. The vertical distortion from a straight central horizontal line at the peripheries of images were measured and summed to yield the combined vertical distortion similar to how a surgeon calculates a side to side comparison of limb lengths. Simple linear regression was used to evaluate associations between total distortion and patient demographics, operating theaters, and various operative parameters.ResultsThe average combined distortion was 10.0mm (range 2.0-20.0mm). There was a significant difference in the average distortion observed in different theaters (P < .001). There was no association between distortion and patient demographics or fluoroscopic time (all, P > .05).ConclusionFluoroscopic distortion is unpredictable and can cause a substantial amount of error when comparing limb lengths during DA THA. This is a critical finding as this amount of inaccuracy could lead to unintended implant positioning and limb-length discrepancies if unaccounted for.     

Alignment in Medial Fixed-Bearing Unicompartmental Knee Arthroplasty: The Limb Has a Leg Up on the Component

BackgroundTo assess how implant alignment affects unicompartmental knee arthroplasty (UKA) outcome, we compared tibial component alignment of well-functioning UKAs against 2 groups of failed UKAs, revised for progression of lateral compartment arthritis (“Progression”) and aseptic loosening (“Loosening”).MethodsWe identified 37 revisions for Progression and 61 revisions for Loosening from our prospective institutional database of 3351 medial fixed-bearing UKAs performed since 2000. Revision cohorts were matched on age, gender, body mass index, and postoperative range of motion with “Successful” unrevised UKAs with minimum 10-year follow-up and Knee Society Score ≥70. Tibial component coronal (TCA) and sagittal (TSA) plane alignment was measured on postoperative radiographs. Limb alignment was quantified by hip-knee-ankle (HKA) angle on long-leg radiographs. In addition to directly comparing groups, a multivariate logistic regression examined how limb and component alignments were associated with UKA revision.ResultsIn the Progression group, component alignment was similar to the matched successes (TCA 3.6° ± 3.5° varus vs 5.1° ± 3.5° varus, P = .07; TSA 8.4° ± 4.4° vs 8.8° ± 3.6°, P = .67), whereas HKA angle was significantly more valgus (0.3° ± 3.6° valgus vs 4.4° ± 2.6° varus, P < .001). Loosening group component alignment was also similar to the matched successes (TCA 6.1° ± 3.7° varus vs 5.9° ± 3.1° varus, P = .72; TSA 8.4° ± 4.6° vs 8.1° ± 3.9°, P = .68), and HKA was significantly more varus (6.1° ± 3.1° varus vs 4.0° ± 2.7° varus, P < .001). Using a multivariate logistic regression, HKA angle was the most significant factor associated with revision (P < .001).ConclusionIn this population of revised UKAs and long-term successes, limb alignment was a more important determinant of outcome than tibial component alignment.Level of EvidenceLevel III case-control study.     

广山楂HPLC指纹图谱建立及其活血化瘀作用谱效关系研究

目的 建立广山楂Malus doumeri指纹图谱,测定各批次广山楂的“活血化瘀”药效学指标,探讨广山楂化学成分与活血化瘀功效的谱效关系。方法 采用HPLC法建立18批广山楂的指纹图谱。利用大鼠高脂模型,测定不同批次广山楂的“活血化瘀”药效学指标,包括高密度脂蛋白胆固醇（high density lipoprotein cholesterol,HDL-C）、低密度脂蛋白胆固醇（low density lipoprotein cholesterin,LDL-C）、总胆固醇（total cholesterol,TC）、三酰甘油（triglyceride,TG）含量及血液流变学指标等。运用偏最小二乘回归法（partial least-square method regression,PLSR）、灰色关联度分析法,分析广山楂化学成分与活血化瘀药效指标间的谱效关系。结果 构建了广山楂的HPLC图谱,确定了6个共有峰,并指认了其中的2个共有峰（绿原酸、根皮苷）。活血化瘀实验表明,不同批次广山楂活血药效指标间具有明显差异,在标定的广山楂6个特征峰中,峰2～6与HDL-C呈正相关,峰1、5、6与LDL...     

基于水-醇双提方式下中药复方粉末影响颗粒流动性的关键物性参数辨识研究

目的 探究水-醇双提工艺下中药复方粉末影响颗粒流动性的关键物性参数。方法 以水-醇双提工艺下杏贝止咳颗粒(Xingbei Zhike Keli,XZK)、桂枝茯苓胶囊(Guizhi Fuling Jiaonang,GFJ)以及参乌益肾片(Shenwu Yishen Pian,SYP)3个中药复方品种的制粒前粉末与制粒后颗粒为研究对象,采用多元统计分析方法,绘制粉末物理指纹图谱,结合Pearson相关系数评价粉末质量一致性;采用主成分分析(principal component analysis,PCA)结合因子分析评价颗粒流动性;并构建以松装密度(D_a)、振实密度(D_c)、休止角(α)、豪斯纳比(IH)、粒径<50μm百分比(Pf)、均匀性(HG)、均齐度(UN)、粒径(D₁₀、D₅₀、D₆₀、D₉₀)、分布宽度(span)、分布范围(width)、比表面积(SSA)、孔隙率(I_e)、卡尔指数(IC)、含水量(HR)、吸湿率(H...     

基于指纹图谱和多组分定量分析的半枝莲质量评价研究

目的 基于HPLC指纹图谱与多成分含量测定,并结合主成分分析,评价半枝莲Scutellaria barbata的质量。方法 采用RP-HPLC法,流动相为乙腈-0.1%甲酸水溶液进行梯度洗脱,对19批人工栽培和市售半枝莲药材进行指纹图谱及4种黄酮类成分含量测定研究,应用主成分分析法对半枝莲质量进行评价。结果 建立了半枝莲药材的共有模式指纹图谱,共标定16个共有峰,半枝莲药材的相似度为0.817～0.989,野黄芩苷、野黄芩素、木犀草素、芹菜素的质量分数分别为0.015%～0.850%、0.010%～0.180%、0.00034%～0.07400%、0.0019%～0.0690%;主成分分析结果筛选出累计贡献率达到96.268%的4个主成分（野黄芩苷;野黄芩素;木犀草素;芹菜素）,以它们计算所有样本的综合得分,可对半枝莲药材质量进行排序。结论 通过指纹图谱与含量测定相结合,应用主成分分析可全面综合评价半枝莲质量。此方法的建立为半枝莲药材的质量控制及评价提供了了分析方法和数据支撑。     

基于趁鲜切制与传统切制工艺的人参饮片质量评价分析

目的 优选人参Panax ginseng趁鲜切制饮片工艺,比较分析趁鲜切制与传统切制人参饮片的质量,为人参趁鲜切制的合理性提供数据支持。方法 考察切片厚度、烘干温度、烘干时间等因素优选人参趁鲜切制饮片最佳制备工艺;建立指纹图谱结合化学计量法评价2种炮制工艺人参饮片质量差异性;并定量分析2种人参饮片中指标性成分人参皂苷含量差异。结果 人参趁鲜切制饮片的最佳制备工艺为人参鲜药材含水量65%,烘干温度50℃、烘干时间8 h、切片厚度1.5 mm;指纹图谱分别确定了人参趁鲜切制饮片和传统切制工艺饮片22个共有峰,指认了其中7个共有峰,2种炮制工艺所得人参饮片指纹图谱相似度分别在0.983～0.992、0.948～0.996。趁鲜切制与传统切制工艺饮片之间的指纹图谱相似度为0.960～0.993,相似度良好;主成分分析（principal component analysis,PCA）将人参趁鲜切制饮片和传统切制饮片归为2类,正交偏最小二乘法-判别分析（orthogonal partial least squares-discriminant analysis,OPLS-DA）确定2种炮制工艺项...     

基于Heracles NEO超快速气相电子鼻麸炒白术炮制全过程气味变化识别研究

目的 建立麸炒白术Atractylodis Macrocephalae Rhizoma炮制全过程的定性判别模型,筛选出可以表征麸炒白术不同炮制程度的气味成分。方法 制备麸炒白术饮片,不同时间点取样进行分析。采用Heracles NEO超快速气相电子鼻采集气味图谱,与Arochembase数据库对比得到气味成分信息,结合峰面积分析气味成分的变化规律并进行化学计量学分析。结果 通过判别因子分析（discriminant factor analysis,DFA）、正交偏最小二乘-判别分析（orthogonal partial least squaresdiscriminant analysis,OPLS-DA）、层次聚类分析（hierarchical cluster analysis,HCA）等将麸炒白术炮制全过程样品成功分为4类：生品、炮制不及、炮制成品和炮制太过。在炮制过程中,3-甲基十五烷、十二烷基丙酸酯、正辛基环己烷、1,3-二硝基苯、8-甲基十五烷5个气味成分的峰面积占比较高,其中1,3-二硝基苯在炮制全过程中峰面积呈降低趋势;3-甲基十五烷从炮制不及到炮制成品的过程中峰面积呈增加...     

饮片细粉对肠炎宁半浸膏片压缩成型的影响研究

目的 研究半浸膏颗粒中饮片细粉含量对其物理性质和压缩性能的影响。方法 以肠炎宁片为模型药物,测定含不同饮片细粉比例的肠炎宁颗粒的粉体学性质、压缩过程参数、抗张强度等指标,采用不同压缩方程对片剂抗张强度-压力、孔隙率-压力、抗张强度-孔隙率的变化规律进行拟合,阐明肠炎宁半浸膏片的成型机制,并用主成分分析对粉体学性质、压缩过程参数及拟合系数之间的相关性进行分析。结果 当肠炎宁颗粒中的饮片细粉含量小于6%时,随着饮片细粉含量的增加,粒子间的结合力增强,粉体的成型性增强;当含量超过6%后,饮片细粉弹性作用增强,粒子间结合力减弱,抑制成型。结论 从压缩成型角度说明了肠炎宁半浸膏片中饮片细粉含量的临界值为6%,可为半浸膏片的处方工艺优化提供较好的理论和实验依据。