Risks and benefits of Twitter use by hematologists/oncologists in the era of digital medicine

Twitter use by physicians, including those in the hematology–oncology field, is increasing. This microblogging platform provides a means to communicate and collaborate on a global scale. For the oncology professional, an active Twitter presence provides opportunities for continuing medical education, patient engagement and education, personal branding, and reputation management. However, because Twitter is an open, public forum, potential risks such as patient privacy violations, personal information disclosures, professionalism lapses, and time management need to be considered and managed. The authors have summarized the benefits and risks of Twitter use by the hematology–oncology physician. In addition, strategies to maximize benefit and minimize risk are discussed, and resources for additional learning are provided.     

新型传染病公众威慑力评价研究

新型传染病爆发后将产生明显的社会负面影响,威慑公众,使公众产生恐惧心理,并影响其日常的生活、学习、工作。本文对新型传染病的威慑力进行定性与定量评价,从新型传染病自身威慑力与媒体报道附加实现的威慑力出发,提出了其威慑力指标定量评价方法,并以"非典"为例结合医学破解力,阐述新型传染病威慑力与医学破解力的博弈规律。     

基于传统煎药工艺的黄芪药材HPLC指纹图谱及化学计量学质量评价研究

目的基于传统煎药工艺建立不同产地黄芪的HPLC指纹图谱,用于黄芪药材质量的评价。方法采用中药色谱指纹图谱相似度评价系统(2004A版)对15批不同产地的黄芪药材的HPLC指纹图谱进行相似度评价,并使用SPSS22.0软件进行聚类分析和主成分分析。结果选取了12个色谱峰作为指纹图谱共有峰,15批样品的相似度计算结果均大于0.990,说明各产地黄芪药材具有较好的一致性;通过聚类分析可将15批样品聚为4类;主成分分析采用3个主成分对黄芪药材进行综合评价,综合得分结果显示,甘肃民乐县所产批号为HQ-18001(S1)、HQ-18002(S2)和甘肃岷县所产批号为HQ-18007(S7)、HQ-18006(S6)的黄芪药材在所有样品中的综合得分位于前4名。结论建立基于传统煎药工艺的黄芪药材质量评价方法操作简单,重复性好,结果可靠,可以用于黄芪药材的质量控制和评价。     

Dyna CT与Embolization Guidance技术在前列腺动脉栓塞中的应用

目的探讨Dyna CT与Embolization Guidance技术在前列腺动脉栓塞中的应用。方法收集我科使用SIEMENS Artis Zeego数字减影血管造影机检查和图像采集进行前列腺动脉栓塞的38例患者,用Dyna CT技术明确前列腺癌供血动脉与其他侧支的情况,Embolization Guidance技术指导进行安全性的前列腺癌供血动脉栓塞。结果 38例患者经两名高年资主任医师指导分别进行前列腺癌动脉栓塞术。Dyna CT联合DSA确认前列腺动脉65侧,比例达85.5%(65/76),其中24例患者显示双侧前列腺动脉,10例确认单侧前列腺动脉;前列腺动脉开口起源于髂内动脉38条,起源于闭孔动脉11条,起源于膀胱下动脉9条,起源于阴部内动脉5条,起源于直肠下动脉2条。利用Embolization Guidance技术完成前列腺动脉栓塞89.2%(58/65),其中24例患者完成双侧栓塞,10例完成单侧栓塞,4例因血管迂曲不能进行超选择栓塞。结论 Dyna CT联合Embolization Guidance技术能够准确地显示前列腺优势供血动脉,在前列腺动脉栓塞治疗中具有重要的应用价值。     

多层螺旋 CT血管造影在原发性肝癌肝动脉－门静脉瘘诊断中的应用

目的 分析多层螺旋CT血管造影(MSCTA)诊断原发性肝癌(PHC)病人肝动脉-门静脉瘘(HAPVF)的价值及影响HAPVF发生危险因素.方法 选择无锡市第五人民医院2017年9月至2019年4月收治的129例PHC病人作为研究对象,根据是否并发HAPVF分为HAPVF组和非HAPVF组.统计PHC病人HAPVF的发生情况,并以DSA检查结果为"金标准",分析MSCTA评估PHC病人HAPVF的准确性,此外分析与HAPVF发生相关的危险因素.结果 129例PHC病人经DSA检查检查共发现40例HAPVF(占31.0％),其中周围型17例(占42.5％),中央型23例(占57.5％);经MSCTA检查37例HAPVF病人获得了正确分型诊断,诊断准确率为92.5％(37/40),与DSA检查结果表现出良好的一致性(Kappa=0.85);单因素分析初步筛选出了4个(肝功能Child-Pugh分级、肿瘤数目、肿瘤最大径、合并肝硬化)与PHC病人并发HAPVF有关的因素;多因素logistic回归分析显示肝功能Child-Pugh分级(OR=10.341,P<0.001)、肿瘤最大径(OR=3.385,P=0.037)、合并肝硬化(OR=4.440,P=0.028)为PHC病人并发HAPVF的危险因素.结论 PHC病人出现HAPVF的发生率高,MACTA可发现HAPVF并对其分型做出正确评估,能用于指导治疗.此外,肝功能Child-Pugh分级、肿瘤最大径、合并肝硬化等均为影响PHC病人并发HAPVF的危险因素.     

20 years of arterial switch operation for simple TGA

Background : Arterial switch operation became the golden treatment for simple transposition of the great arteries (sTGA). We describe our experience with the arterial switch operation regarding long-term outcome and the need for re-intervention. Nevertheless, supravalvular pulmonary stenosis (SPS) remains a concern in the long run. We assess the evolution of SPS over time and evaluate the effect of technical modifications on SPS during our experience. Methods : We performed a retrospective study on 133 patients operated with ASO for TGA between October 1991 and November 2009. Last report method was used. We reviewed our pediatric cardiology and cardiac surgery database to examine the echocardiography data and electrocardiograms. A mean follow-up of 9.2 years (± 5.83 SD) was reached. Results : One (0.8%) patient deceased postoperatively due to cardiogenic shock. The overall actuarial freedom from reoperation (open and percutaneous) was 88.1%, 78.5% and 76.9% at 1, 5 and 10 years. SPS needed to be treated in 17 patients. Valve regurgitation at final investigation was maximal moderate in 5 patients for the aortic valve, 10 for pulmonary valve and 3 in tricuspid valve.

Conclusions : ASO shows excellent long-term results in sTGA with a very low morbidity and mortality and is therefore the procedure of choice. Re-intervention rate is determined by SPS. Since the extensive mobilization of the pulmonary arteries and the creation of a longer neo-pulmonary root, reduction in SPS was seen with no re-interventions in the second half of the group. To obtain a final comparison with the atrial switch operation, a longer Follow-up is necessary.