重复住院呼吸道病毒感染患儿病因及临床特征

目的探讨重复住院呼吸道病毒感染患儿的临床特征,以更好地指导呼吸道病毒感染的诊断和治疗。方法通过对重复住院患儿(观察组)和一次住院患儿临床资料、发病特征、病毒感染等进行统计学分析,总结重复住院患儿的主要临床特征。结果观察组和对照组在临床基本资料和病毒检出方面并无统计学差异(P>0.05)。在主要临床症状上,观察组和对照组在发热、流涕、咳嗽、咳痰和呼吸困难等方面无统计学差异(P>0.05),但是在喘息和腹泻方面有统计学差异(P<0.05)。结论喘息和腹泻是呼吸道病毒感染患儿重复住院的主要参考症状。如患儿存在上述症状,要采取更有针对性的治疗,以提升治疗效果。     

Echocardiography and Cardiac Magnetic Resonance‐Based Feature Tracking in the Assessment of Myocardial Mechanics in Tetralogy of Fallot: An Intermodality Comparison

We investigated intermodality agreements of strains from two‐dimensional echocardiography (2DE) and cardiac magnetic resonance (CMR) feature tracking (FT) in the assessment of right (RV) and left ventricular (LV) mechanics in tetralogy of Fallot (TOF). Patients were prospectively studied with 2DE and CMR performed contiguously. LV and RV strains were computed separately using 2DE and CMR‐FT. Segmental and global longitudinal strains (GLS) for the LV and RV were measured from four‐chamber views; LV radial (global radial strain [GRS]) and circumferential strains (GCS) measured from short‐axis views. Intermodality and interobserver agreements were examined. In 40 patients (20 TOF, mean age 23 years and 20 adult controls), LV, GCS showed narrowest intermodality limits of agreement (mean percentage error 9.5%), followed by GLS (16.4%). RV GLS had mean intermodality difference of 25.7%. GLS and GCS had acceptable interobserver agreement for the LV and RV with both 2DE and CMR‐FT, whereas GRS had high interobserver and intermodality variability. In conclusion, myocardial strains for the RV and LV derived using currently available 2DE and CMR‐FT software are subject to considerable intermodality variability. For both modalities, LV GCS, LV GLS, and RV GLS are reproducible enough to warrant further investigation of incremental clinical merit.     

用谐波小波包变换法提取GIS局部放电信号多尺度特征参数

超高频(UHF)法在GIS局部放电(PD)检测中已得到了广泛应用，UHF PD信号的特征提取对准确识别GIS内部绝缘缺陷类型和指导检修工作具有重要意义，但目前仍然缺乏有效的特征提取方法。为此，本文利用谐波小波具有严格盒形频谱的优点，提出一种提取UHF PD特征信息的谐波小波包变换(HWPT)方法，对实验室获取的4种典型放电模型产生的UHF PD信号，采用HWPT进行多尺度分解，以克服实小波包分解子带间存在频谱混叠和能量泄漏的缺陷，利用UHF PD信号在不同尺度能量和复杂度的差异，提取多尺度能量和多尺度样本熵参数作为模式识别的特征量，更加精确地描述了UHF PD信号的时频域信息。最后利用支持向量机分类识别的结果表明，该方法可以取得比实小波包更好的识别效果，多尺度能量和多尺度样本熵特征参数均能有效识别4种绝缘缺陷。     

胃肝样腺癌的诊治现状

目的了解胃肝样腺癌(GHA)的研究现状,以期为临床诊治提供参考。方法查阅近年来国内外关于GHA研究的相关文献并进行综述。结果 GHA是一种具有腺样分化和肝细胞分化的特殊类型胃癌,在所有胃癌中发生率≤1%。GHA的组织学形态与肝细胞癌相似,常伴有血清甲胎蛋白升高,极易出现淋巴结转移和肝转移。根治性手术及化疗是其最主要的治疗方法,但即使是根治性切除后仍常见复发和转移,且目前尚无针对GHA的标准化疗方案。结论 GHA是一种恶性度较高的特殊胃癌亚型,临床进展迅速,预后差。组织病理学结果是诊断GHA的金标准。GHA治疗以手术与化疗为主的综合治疗方式,基因分子特征及靶向治疗是未来的研究方向。     

慢性精神分裂症患者合并肺部感染临床资料分析

目的：探讨慢性精神分裂症患者合并肺部感染的临床特征。方法对162例慢性精神分裂症合并肺部感染患者的临床资料进行回顾性分析。结果162例肺部感染者，其中节段性肺炎124例，慢性肺部感染38例。急性肺炎以中青年，精神病病程＜3 a居多，感染部位以右肺中叶和左肺舌叶为主，对症治疗后均痊愈；慢性感染以中老年多见，精神病病程＞3a，感染部位以两肺下叶、肺底及脊柱两旁慢性感染为主，对症治疗后痊愈率为71．1％，临床症状消失率为28．9％。结论精神分裂症患者合并肺部感染率较高，临床症状不典型，应制定有效的预防和控制对策，减少感染的发生。     

Different clinical features between patients with ROS1-positive and ALK-positive advanced non-small cell lung cancer

ObjectiveTo compare the baseline clinical characteristics between patients with ROS1-positive and ALK-positive advanced non-small cell lung cancer (NSCLC), and the correlations of these subtypes with the distribution of metastases.MethodsWe compared the clinical characteristics and imaging features of patients with ROS1-positive and ALK-positive NSCLC using statistical methods.ResultsData for 232 patients were analyzed. Compared with ALK-positive NSCLC, ROS1-positive NSCLC was more likely to occur in women (71% vs 53%), and primary lesions ≤3 cm were more common in patients with ROS1-positive compared with ALK-positive NSCLC (58% vs 37%). There was no significant difference in the distribution of metastases between the two groups. Subgroup analysis within the ROS1-positive group showed that, compared with primary lesions >3 cm, primary lesions ≤3 cm were more likely to present as peripheral tumors (72% vs 43%) and more likely to exhibit non-solid density (44% vs 4%).ConclusionsAlthough ROS1-positive and ALK-positive NSCLCs show similar clinical features, the differences may help clinicians to identify patients requiring further genotyping at initial diagnosis.     

High-Throughput In-Use and Stress Size Stability Screening of Protein Therapeutics Using Algorithm-Driven Dynamic Light Scattering

Stability of therapeutic proteins (TPs) is a critical quality attribute that impacts both safety and efficacy of the drug. Size stability is routinely performed during and after biomanufacturing. Dynamic light scattering (DLS) is a commonly used technique to characterize hydrodynamic size of the TPs. Herein, we have developed a novel method to evaluate in-use and thermal stress stability of TPs using algorithm-driven high-throughput DLS. Five marketed TPs were tested under the guidance of customized algorithms. The TPs were evaluated at relevant temperature conditions as well as under dilution and thermal stress for size stability. We found that the TPs were stable under the in-use conditions tested; however, sample loss due to evaporation can lead to large protein aggregates. A combined assessment of autocorrelation function and photos of sample well could be useful in formulation screening. Dilution of TPs also has an impact on the hydrodynamic size. Thermal stress experiments showed the importance of using different data processing methods to access size distribution. Polydispersity index was useful in evaluating sample heterogeneity. Herein, we show that algorithm-driven high-throughput DLS can provide additional supportive information during and after biomanufacturing and the potential to be used in a quality control environment.     

Nanomedicine for acute respiratory distress syndrome: The latest application,targeting strategy,and rational design

Acute respiratory distress syndrome (ARDS) is characterized by the severe inflammation and destruction of the lung air–blood barrier, leading to irreversible and substantial respiratory function damage. Patients with coronavirus disease 2019 (COVID-19) have been encountered with a high risk of ARDS, underscoring the urgency for exploiting effective therapy. However, proper medications for ARDS are still lacking due to poor pharmacokinetics, non-specific side effects, inability to surmount pulmonary barrier, and inadequate management of heterogeneity. The increased lung permeability in the pathological environment of ARDS may contribute to nanoparticle-mediated passive targeting delivery. Nanomedicine has demonstrated unique advantages in solving the dilemma of ARDS drug therapy, which can address the shortcomings and limitations of traditional anti-inflammatory or antioxidant drug treatment. Through passive, active, or physicochemical targeting, nanocarriers can interact with lung epithelium/endothelium and inflammatory cells to reverse abnormal changes and restore homeostasis of the pulmonary environment, thereby showing good therapeutic activity and reduced toxicity. This article reviews the latest applications of nanomedicine in pre-clinical ARDS therapy, highlights the strategies for targeted treatment of lung inflammation, presents the innovative drug delivery systems, and provides inspiration for strengthening the therapeutic effect of nanomedicine-based treatment.     

Appearance benefits of skin moisturization

Background/purpose: Skin hydration is essential for skin health. Moisturized skin is generally regarded as healthy and healthy looking. It is thus speculated that there may be appearance benefits of skin moisturization. This means that there are corresponding changes in the optical properties when skin is moisturized. Methods: The appearance of the skin is the result of light reflection, scattering and absorption at various skin layers of the stratum corneum, epidermis, dermis and beyond. The appearance benefits of skin moisturization are likely primarily due to the changes in the optical properties of the stratum corneum. We hypothesize that the major optical effect of skin moisturization is the decrease of light scattering at the skin surface, i.e., the stratum corneum. This decrease of surface scattering corresponds to an increase of light penetration into the deeper layers of the skin. An experiment was conducted to measure the corresponding change in skin spectral reflectance, the skin scattering coefficient and skin translucency with a change in skin hydration. In the experiment, skin hydration was decreased with the topical application of acetone and alcohol and increased with the topical application of known moisturizers and occlusives such as PJ. Result and conclusion: It was found that both the skin spectral reflectance and the skin scattering coefficient increased when the skin was dehydrated and decreased when the skin was hydrated. Skin translucency increased as the skin became moisturized. The results agree with the hypothesis that there is less light scattering at the skin surface and more light penetration into the deeper skin layers when the skin is moisturized. As a result, the skin appears darker, more pinkish and more translucent.     

可逆性后部白质脑病综合征临床特点及影像学改变--附12例临床分析

目的：探讨可逆性后部白质脑病综合征（PRES ）的临床特点和影像学改变。方法回顾性分析12例PRES患者的临床和影像学资料。结果原发病为慢性酒精中毒1例，系统性红斑狼疮伴特发性血小板减少性紫癜1例，余10例均与妊娠相关，其中7例原发病为妊娠高血压综合征（妊高征）。临床主要表现为癫痫发作（9例）、视力障碍（5例）、意识障碍（9例）、头痛（7例）、恶心呕吐（3例）；10例患者存在肾功能损害。颅脑C T 及M R检查示病灶累及顶枕叶（10例）、额叶（3例）、基底节（3例）、小脑（2例）和脑干（2例），M RI均呈长T1长T2信号，T2 flair高信号，DWI等信号（7例）或略高信号（1例）；颅脑CT 呈低密度（8例）或等密度（2例）；边界欠清。经积极对因对症治疗，本组患者症状在中位数4d（QL3.25d，QU5d）后几乎完全缓解，影像学表现在中位数9 d（QL 7.25 d ，QU 10.75 d）后得到完全或大部分恢复。结论 PRES以癫痫发作、视力障碍、意识障碍、头痛、恶心呕吐为主要临床表现，影像学改变以可逆的、多分布于后循环供血区的皮层下脑白质血管源性水肿为特点， MRI呈T1低信号、T2及T2 flair高信号，DWI等/略高信号，CT呈低/等密度。积极治疗后多数患者症状可完全缓解，影像学表现可完全或大部分恢复。