人心房肌细胞钠通道的增龄性变化

目的 通过观察人心房肌细胞钠通道的增龄性变化,探讨心房颤动(房颤)发病率随年龄增加的原因.方法 23例接受换瓣手术的患者按年龄分为成年组和老年组,所有患者均为正常窦性心律,采用全细胞膜片钳技术记录右心耳细胞的钠电流.结果 两组的钠电流密度和时间依赖性恢复动力学差异均无统计学意义,但老年组电压依赖性失活曲线向更正的方向偏移.结论 增龄对钠通道电流和恢复动力学无影响,老年组患者房颤发病率增高可能与钠通道无关.     

Cost analysis of recall strategies for non-invasive diagnosis of small hepatocellular carcinoma

Background

Which is the least expensive recall policy for nodules in the cirrhotic liver remains unclear.

Aim

Aim of the study was to analyze the costs of different recall diagnostic strategies of hepatocellular carcinoma (HCC) on cirrhosis on a real series of patients.

Methods

75 consecutive small liver nodules (10–30 mm) detected at conventional ultrasonography in 60 patients with cirrhosis were submitted to contrast-enhanced ultrasound, computed tomography and gadolinium-magnetic resonance imaging with a final diagnosis established according to the latest guidelines which include different strategies for nodules 10–19 mm or ≥20 mm. The actual costs required to fully characterise any nodule and staging HCC in every patient, if one or the other imaging modality had been used as the first diagnostic step, were calculated. The theoretical hypothesis that each nodule was present in each patient was also investigated from an economical point of view.

Results

The recall strategy starting with contrast-enhanced ultrasound plus computed tomography is the least expensive strategy for patients with at least one nodule 10–19 mm in size, in nearly all combinations (single or double nodules). In patients with single 20–30 mm nodules the least expensive strategy is to start with computed tomography and to use contrast-enhanced ultrasound as a second step technique.

Conclusions

wider use of contrast-enhanced ultrasound has the potential to save healthcare costs after first ultrasound detection of a single small nodule in cirrhosis.     

冠心病非侵入性影像诊断技术的优缺点及研究进展

尽管冠脉造影可能低估较重的冠脉弥漫性病变,但冠状动脉的血管造影仍是诊断冠心病的“金标准”。冠脉造影不仅价格昂贵,而且因为是侵入性检查,可造成为数较少的严重的并发症。在要求安全性更高和花费更合理的情况下,非侵入性冠脉血管造影应运而生。     

医学实验室质量和能力的专用要求在宫颈癌、乳腺癌筛查中的意义

目的探讨“医学实验室质量和能力的专用要求”（IS015189）流程管理规范在宫颈癌、乳腺癌筛查中的作用。方法收集2009年度及2010年度在合肥艾迪康临床检验所进行宫颈细胞学筛查的安徽省阜南县妇保所送检细胞学涂片10050、28436例作为研究对象,分析其在按照IS015189流程管理规范执行前后细胞涂片在检测前、中、后过程中形成的结果差异。结果宫颈细胞涂片的质量及阳性率均有较大的提高,客户满意度大幅提升。结论IS015189流程管理规范的执行为宫颈癌、乳腺癌筛查工作中的宫颈细胞学筛查提供了质量保证。     

An overview of recent studies on the analysis of pharmaceutical polymorphs

Pharmaceutical solids are well known to be able to exist in different solid-state forms and there are a wide variety of solid-state analytical techniques available to characterize pharmaceutical solids and solid-state transformations. In this review, the commonly used solid-state analytical techniques, the type of information collected, and advantages and disadvantages of each technique are discussed, with the focus on their application in solid-state characterization and monitoring solid-state transformations, such as amorphization, crystallization, hydrate formation/dehydration and cocrystal formation. The information gathered from recent literature is compiled in various tables to aid the reader to get a quick overall picture about what type of phenomena have recently been studied and which analytical technique(s) have been used.     

MRI导向立体定向开颅切除脑胶质瘤疗效观察

目的观察MRI导向立体定向开颅切除脑胶质瘤的临床效果。方法应用MRI导向立体定向开颅切除脑胶质瘤9例,比较术前术后患者的神经功能变化,并随访6个月。结果9例患者的病灶均定位精确,一次手术切除,无死亡病例。术后复查MRI提示肿瘤全切,症状改善7例,无变化1例,加重1例。随访6个月,肢体感觉运动障碍者症状均有不同程度的好转。结论MRI导向立体定向开颅术可以对胶质瘤精确定位并确定手术切除范围,有助于提高胶质瘤的全切除率及降低手术并发症。     

无框架立体定向显微手术切除脑内小病灶33例分析

目的:探讨应用无框架立体定向技术结合显微手术微侵袭治疗脑内小病灶的方法及疗效。方法:应用CAS-R-2型无框架立体定向仪和CAS-BH5型机器人对33例脑内小病灶患者,行术前精确定位后,在显微镜下切除病灶,并观察疗效。结果:本组病变全切除30例,占90.9%,次全切除2例,占6.0%,大部分切除1例,占3.0%,无手术死亡。本组19例症状性癫痫起病的患者,15例(78.9%)病灶清除后症状消失,4例(21.0%)发作次数明显减少,效果良好。结论:采用无框架立体定向技术微侵袭治疗脑内小病灶,具有微创伤、精确性高、可重复性好及安全性强等优点,是临床疗效满意的治疗手段。     

河南省农村中医适宜技术需求调查

目的筛选适宜在农村地区推广应用的中医适宜技术。方法采用典型抽样的方法,对河南省项目县126名从事中医治疗工作的从业人员进行问卷调查和半结构式访谈。结果 93.65%的调查对象赞成中医适宜技术在本地区推广,98.41%的调查对象非常愿意或掌握新的中医适宜技术。126名调查对象共筛选出了5项适宜在农村推广的卫生技术;同时,调查对象的培训需求较强。结论农村中医适宜技术的科学筛选是保证其推广应用工作成效的基础,适宜性是筛选中医适宜技术的要点。     

多层螺旋CT后处理技术在下颌骨骨折中的应用

目的分析多层螺旋CT(Multi-slice Spiral CT,MSCT)后处理技术在下颌骨骨折中的应用及临床价值。方法 26例下颌骨骨折病人行MSCT扫描,图像经工作站处理后进行多平面重建(multi-planarreconst ruction,MPR)、表面遮盖显示(shaded surface display,SSD)及容积再现(volume rendering,VR)三维重建。由两位副高职称以上放射科CT室医师共同阅片分析,统一评定,并与普通X线片检查结果进行比较。结果本组26例均可以通过MSCT后处理技术明确判断骨折情况,普通X线片漏诊6例,经统计学分析两者差异有显著性意义(X2=6.783,P=0.009,P0.05)。结论 MSCT后处理技术能清晰、直观地显示下颌骨骨折情况,减少漏诊、误诊,有利于临床诊断及治疗方案的确定。     

实时组织弹性成像与二维灰阶超声诊断结节性甲状腺疾病的对照研究

目的 探讨实时组织弹性成像与二维灰阶超声在诊断结节性甲状腺疾病中的价值.方法 以病理诊断为金标准,对比分析实时组织弹性成像与二维灰阶超声诊断结节性甲状腺疾病的准确性.结果 实时组织弹性成像诊断结节性甲状腺疾病的敏感性、特异性和准确性分别为88.03％、88.23％、88.09％.二维灰阶超声诊断结节性甲状腺疾病的敏感性、特异性和准确性分别为52.94％、71.64％、73.81％.结论 实时组织弹性成像诊断结节性甲状腺疾病的准确性高于二维灰阶超声,但两者结合可望提高良恶性病变诊断的准确性.