超声内镜在胃癌术前诊断中的应用分析

目的探讨超声内镜(EUS)在胃癌术前TN分期中的应用经验。方法术后病理检查证实为胃癌而且使用超声内镜进行了术前TN分期的患者352例,对其资料进行回顾性分析。结果 EUS胃癌术前T分期总正确率为81.25%,其中T1为85.58%,T2为73.91%,T3为82.14%,T4为83.33%,与术后病理结果比较具有高度一致性(Kappa系数为0.75)。EUS对胃癌术前N分期总的正确率为52.84%,其中N0为85.56%,N1为56.69%,N2为28.09%,N3为26.09%,与术后病理结果比较具有一般一致性(Kappa系数为0.33)。将病变部位分为贲门、胃底、胃体、胃窦、幽门,不同部位之间的检测正确率比较,差异无统计学意义(P0.05)。结论EUS在胃癌术前诊断中具有临床意义,其中T分期可为合理制定治疗方案提供依据,N分期准确性有待提高。     

Non-constraining sleep/wake monitoring system using bed actigraphy

This paper introduces a new method, bed actigraphy (BACT) for user-friendly sleep-wake monitoring. BACT provides a non-intrusive acquisition of activity data, and in particular does not require that sensors be attached to the subject’s body. The system consists of four load-sensing cells supporting the bed, an A/D converter, and a microcontroller with appropriate software. The performance of BACT was compared to that of standard polysomnography (PSG) recordings and wrist-worn actigraphy (ACT). Ten normal volunteers underwent overnight PSG recordings and were examined simultaneously with BACT and ACT. An automatic scoring algorithm scored each 30-s epoch of the BACT recordings for either ‘Wake’ or ‘Sleep.’ A sleep specialist manually scored the PSG recordings, and the results were divided into ‘Wake’ and ‘Sleep’ categories. The three methods showed a significant correlation when compared with in the contingency test. The mean epoch-by-epoch agreements between the BACT and PSG, ACT and PSG, and BACT and ACT recordings were 95.2, 92.9, and 94.3%, respectively. The mean absolute differences in sleep percentage (SP) between them were 1.8 ± 0.82, 3.4 ± 1.45, and 1.9 ± 1.16 %, respectively. BACT differentiation of the ‘Wake’ and ‘Sleep’ stages proved to be sufficiently robust, and its results were comparable to PSG analysis. This finding supports the experimental and clinical value of bed-activity monitoring during sleep.     

The effect of using different types of periodic contact rate on the behaviour of infectious diseases: a simulation study

This paper studies the effect of using different types of seasonally varying contact rate on the behaviour of the seasonally varying infectious diseases for an SEIR epidemic model. Our target is to investigate the long term behaviour of the system in response to changes in beta(1), the amplitude parameter of the seasonal contact rate, which is our bifurcation parameter. This amplitude parameter is used as a filter to plot the length in years of the period of the stable endemic periodic solution of the SEIR model. Another main aim of this simulation study is to explain how can the type of the contact rate affect the behaviour of the disease dynamics. The simulation results have indicated that using different functional forms of seasonally varying contact rate generates different patterns of solutions for each disease parameter set and type of contact rate. So prediction of the type of disease outbreaks depends on the form of contact rate. Thus it is important to determine which type of contact rate is more likely to match the actual dynamics of each disease. Also these results have shown how the dynamics of the disease depend on the amplitude of the seasonally varying contact rate. Apart from some of the results for measles with a sinusoidal periodic function the simulation results are original and give a clear and a much broader insight into the features of the dynamics of these diseases [D. Greenhalgh, I.A. Moneim, SIRS epidemic model and simulations using different types of seasonal contact rate, Syst. Anal. Modelling Simul. 43(5) (2003) 573-600; I.A. Moneim, D. Greenhalgh, Threshold and stability results for an SIRS epidemic model with a general periodic vaccination strategy, J. Biol. Syst. 13(2) (2005), to appear].     

不同剂型桂枝葛根汤治疗颈性眩晕的疗效比较

摘 要 目的：观察不同剂型桂枝葛根汤治疗颈性眩晕的疗效差异,并初步探讨其作用机制。方法：96例颈椎病患者随机分为饮片组、配方颗粒组和葛根定眩胶囊组各32例,分别采用桂枝葛根汤饮片、配方颗粒和葛根定眩胶囊治疗14 d,比较3组患者的疗效和治疗前后血流动力学指标变化,酶联免疫法测定3组患者治疗前后IL-6及IL 1β的表达。结果：3组总有效率比较,差异无统计学意义（P＞0.05）。治疗后3 组患者眩晕和头痛评分均较治疗前明显改善（P＜0.01）,饮片组眩晕评分优于胶囊组（P＜0.05）。治疗后3组患者基底动脉和双侧椎动脉的Vs和Vm均较治疗前明显增加（P＜0.01),且配方颗粒组和胶囊组椎动脉的Vm低于饮片组（P＜0.05或P＜0.01）。治疗后,饮片组和配方颗粒组血清IL 6水平较治疗前明显降低(P<0.05),饮片组和胶囊组血清IL-1β水平较治疗前明显降低(P<0.05);胶囊组血清IL-6水平显著高于其他两组(P<0.05),饮片组血清IL 1β水平显著低于配方颗粒组和胶囊组(P<0.05)。结论：桂枝葛根汤三种剂型治疗颈性眩晕的总有效率相当,部分疗效指标饮片相比配方颗粒和胶囊更优。此作用可能与增加脑血流及抑制相关炎症因子IL-6及IL-1β的表达有一定关联。     

高乌头炮制品的HPLC指纹图谱研究及其2种生物碱成分含量测定

目的 建立不同产区高乌头炮制品的HPLC指纹图谱,并测定2种生物碱成分的含量,为高乌头制品质量控制提供参考依据。方法 通过HPLC梯度洗脱建立高乌头炮制品的指纹图谱,并采用中药指纹图谱相似度评价系统(2012版)、主成分分析(PCA)和聚类分析(CA)对指纹图谱进行分析。结果 建立了高乌头炮制品指纹图谱,10批高乌头制品的相似度均大于0.90,标定共有峰18个,并对其中2主要成分(高乌甲素、冉乌头碱)进行含量测定;聚类分析(CA)将所有批次高乌头制品分为4类,反映了10批不同产区高乌头制品的质量特征;主成分分析(PCA)筛选出累计贡献率达到88.824%的4个主成分,得到决定高乌头药材质量7个化学成分。结论 该方法重现性好、特征性强可用于高乌头炮制品全面质量评价。     

红旱莲不同部位金丝桃苷含量测定

目的 比较了红旱莲药材不同部位（茎、叶、花、果）中金丝桃苷的含量差异。方法 采用高效液相色谱法进行测定,采用C₁₈（4.6 mm×250 mm,5 μm）色谱柱,乙腈-0.1%磷酸为流动相,360 nm为检测波长,流速为1.0 mL·min^-1,柱温30 ℃。结果 金丝桃苷的线性范围为2.904～58.08 μg·mL^-1,相关系数r=0.999 8,平均回收率为 95.1%,RSD为1.3%;红旱莲药材不同部位（茎、叶、花、果）中金丝桃苷的含量分别为0.405、3.221、2.260、0.371 mg·g^-1。结论 红旱莲中不同部位中金丝桃苷含量具有显著差异,叶中含量最高。     

白桦茸不同部位多糖含量比较分析及抗疲劳作用研究

目的 建立白桦茸多糖含量测定方法,比较不同部位多糖含量及抗疲劳作用。方法 采用紫外分光光度法测定比较不同部位多糖含量,小鼠负重力竭游泳实验比较不同部位抗疲劳作用。结果 重复性RSD=1.77%（n=6）,加样回收率为99.93%,RSD=1.96%（n=6）。白桦茸菌肉多糖含量3.18%,外壳含量8.57%。与空白组比较,菌肉与外壳组小鼠负重游泳力竭时间显著延长。结论 该方法准确、简便,可用于白桦茸多糖含量测定。外壳多糖含量显著高于菌肉,白桦茸外壳提升正常小鼠抗疲劳能力较菌肉强。     

基于“冲任失调、伏邪致病”探讨女性复发性生殖器疱疹的辨治

基于"冲任失调、伏邪致病"理论探讨女性复发性生殖器疱疹的中医病因病机及治疗,因房事不洁而使外在毒邪藏于体内损伤气血阴阳,日久则冲任失调,其发病具有一定的特殊性和规律性,随月经气血阴阳周期性变化。治疗上,经前期以疏肝清热为主,月经期以行气通经为要,经后期治以益气养血为宜,使冲任调和,机体阴阳气血平衡,为冲任失调所致的皮肤性病诊治提供一定的借鉴意义。     

中医药诊治新冠肺炎的思考

新冠肺炎属于疫病,疠气从口鼻而入,与六淫邪气相合(以湿邪为主),可化寒、化热、化毒、化燥,主要伤及肺脾功能。病机认识上不同学者有寒湿与湿热的差异,与受邪轻重、气候差异、患者体质等有关。分期辨证可有效整合不同辨证方法,初期可从辨口气、辨鼻气、辨鼻涕、辨面色、辨小便来区分寒热。中期热盛于湿易从阳化燥、化毒,或湿胜于热从阴化寒而出现多种病变,临床根据寒、湿、热(毒)病邪的多少而随证治疗。中医诊治新冠肺炎既要突出中医理论特色,也要积极彰显中西医结合的优势。     

Empyema thoracis

The actual incidence of empyema thoracis is still increasing worldwide and remains a clinical challenge with significant impact on public health; early recognition and prompt evaluation are of prime importance. Despite a lack of standardization of treatments, management should be planned according to stage, avoiding delays on referral. Exudative empyema (stage I) should be treated by aspiration or tube thoracostomy. Fibrinopurulent empyema (stage II) can be treated effectively by video-assisted thoracic surgery. Debridement and decortication are the main components of surgical treatment of stage III empyema. It is worthwhile to assess most cases by video-assisted thoracoscopy.