CT纹理分析对卵巢上皮肿瘤的鉴别诊断

目的探讨基于CT平扫图像的纹理分析对鉴别卵巢上皮肿瘤良性、交界性及恶性的诊断价值。方法选取经病理证实的55例卵巢上皮肿瘤的术前CT图像和临床资料,其中良性、交界性及恶性肿瘤分别为21例、14例及20例。采用纹理分析软件于轴位CT平扫图像上提取病灶的纹理参数,各组间纹理参数比较采用独立样本t检验或Mann-Whitney U检验,对差异有统计学意义的纹理参数进行ROC曲线分析,评价其鉴别卵巢上皮肿瘤良性、交界性及恶性的诊断效能。结果恶性组的紧密度(Compactness)、熵(GlcmEntropy)高于交界性组,恶性组的熵(GlcmEntropy)、相对偏差(RelativeDeviation)高于良性组,均匀性(Uniformity)、表面积(SurfaceArea)、紧密度(Compactness)、立体像素值总和(VoxelValueSum)低于良性组,交界性组的均匀性低于良性组,差异均有统计学意义(P均<0.05)。ROC曲线显示部分纹理参数对卵巢上皮肿瘤各组间的诊断效能良好。结论基于CT平扫的部分纹理参数对鉴别卵巢上皮肿瘤的良性、交界性及恶性具有一定的临床价值,有利于临床对卵巢上皮肿瘤的早期诊断和干预。     

Expert Tool Users Show Increased Differentiation between Visual Representations of Hands and Tools

The idea that when we use a tool we incorporate it into the neural representation of our body (embodiment) has been a major inspiration for philosophy, science, and engineering. While theoretically appealing, there is little direct evidence for tool embodiment at the neural level. Using functional magnetic resonance imaging (fMRI) in male and female human subjects, we investigated whether expert tool users (London litter pickers: n = 7) represent their expert tool more like a hand (neural embodiment) or less like a hand (neural differentiation), as compared with a group of tool novices (n = 12). During fMRI scans, participants viewed first-person videos depicting grasps performed by either a hand, litter picker, or a non-expert grasping tool. Using representational similarity analysis (RSA), differences in the representational structure of hands and tools were measured within occipitotemporal cortex (OTC). Contrary to the neural embodiment theory, we find that the experts group represent their own tool less like a hand (not more) relative to novices. Using a case-study approach, we further replicated this effect, independently, in five of the seven individual expert litter pickers, as compared with the novices. An exploratory analysis in left parietal cortex, a region implicated in visuomotor representations of hands and tools, also indicated that experts do not visually represent their tool more similar to hands, compared with novices. Together, our findings suggest that extensive tool use leads to an increased neural differentiation between visual representations of hands and tools. This evidence provides an important alternative framework to the prominent tool embodiment theory.SIGNIFICANCE STATEMENT It is commonly thought that tool use leads to the assimilation of the tool into the neural representation of the body, a process referred to as embodiment. Here, we demonstrate that expert tool users (London litter pickers) neurally represent their own tool less like a hand (not more), compared with novices. Our findings advance our current understanding for how experience shapes functional organization in high-order visual cortex. Further, this evidence provides an alternative framework to the prominent tool embodiment theory, suggesting instead that experience with tools leads to more distinct, separable hand and tool representations.     

Performance evaluation of the Becton Dickinson Kiestra™ IdentifA/SusceptA

ObjectivesNew automated modules are required to provide fully automated solutions in diagnostic microbiology laboratories. We evaluated the performance of a Becton Dickinson Kiestra™ IdentifA/SusceptA prototype for MALDI-TOF identification (ID) and Phoenix™ antibiotic susceptibility testing (AST).MethodsThe performance of the IdentifA/SusceptA coupled prototype was compared with manual processing for MALDI-TOF ID on 1302 clinical microbial isolates or ATCC strains and for Phoenix™ M50 AST on 484 strains, representing 61 species.ResultsOverall, the IdentifA exhibited similar ID performances than manual spotting. Higher performances were observed for Gram-negative bacteria with an ID at the species level (score >2) of 96.5% (369/382) and 86.9% (334/384), respectively. A significantly better performance was observed with the IdentifA (95.2%, 81/85) compared with manual spotting (75.2%, 64/85) from colonies on MacConkey agar. Contrariwise, the IdentifA exhibited lower ID performances at the species level than manual processing for streptococci (76.1%, 96/126 compared with 92%, 115/125), coagulase-negative staphylococci (73.3%, 44/60 compared with 90%, 54/60) and yeasts (41.3%, 19/46 compared with 78.2%, 36/46). Staphylococcus aureus and enterococci were similarly identified by the two approaches, with ID rates of 92% (65/70) for the IdentifA and 92.7%, (64/69) for manual processing and 94.8%, (55/58) for the IdentifA and 98.2%, (57/58) for manual processing, respectively. The SusceptA exhibited an AST overall essential agreement of 98.82% (6863/6945), a category agreement of 98.86% (6866/6945), 1.05% (6/570) very major errors, 0.16% (10/6290) major errors, and 0.91% (63/6945) minor errors compared to the reference AST.ConclusionsOverall, the automated IdentifA/SusceptA exhibited high ID and AST performances.     

Extra phalangeal crease – A trait in forensic identification

In the past, many biological, anthropological and forensic studies have been conducted on variations in finger and palm ridge patterns, however, finger crease patterns have not received much attention in the literature. The photocase shows an obvious extra phalangeal crease in the little finger as an extremely rarely reported characteristic. Similar unique characteristics need to be reported for their rarity and significance in forensic investigations.     

促血管生成素-1基因重组腺病毒载体的构建及鉴定

目的构建携带小鼠促血管生成素-1(Ang-1)基因的重组腺病毒载体并鉴定。方法化学合成小鼠Ang-1基因经PCR扩增后亚克隆至穿梭质粒,重组质粒转化感受态细胞,所得转化子经PCR电泳分析并测序鉴定,携带外源基因的腺病毒穿梭质粒与携带腺病毒大部分基因组的辅助包装质粒共转染人胚肾细胞系HEK 293细胞,反复冻融获取重组腺病毒,终点稀释法测定重组腺病毒滴度,所得腺病毒转染293T细胞48 h收集培养上清,通过Western Blot分析Ang-1蛋白的表达。结果 PCR产物电泳分析可见大小约1.5 kbp的特征性条带,测序结果显示基因序列与Gen Bank提供的Ang-1序列一致,经HEK293细胞包装后腺病毒滴度为1×109pfu/ml,转染293T细胞后培养上清Western Blot分析可见大小58 k D特征性条带,即转染后能分泌正确大小的重组Ang-1蛋白。结论 Ang-1基因重组腺病毒载体可成功构建,为进一步研究Ang-1蛋白对造血干细胞动员及血管新生的作用提供实验依据。     

The use of think-aloud and instant data analysis in evaluation research: Exemplar and lessons learned

While health information technologies have become increasingly popular, many have not been formally tested to ascertain their usability. Traditional rigorous methods take significant amounts of time and manpower to evaluate the usability of a system. In this paper, we evaluate the use of instant data analysis (IDA) as developed by Kjeldskov et al. to perform usability testing on a tool designed for older adults and caregivers. The IDA method is attractive because it takes significantly less time and manpower than the traditional usability testing methods. In this paper we demonstrate how IDA was used to evaluate usability of a multifunctional wellness tool, discuss study results and lessons learned while using this method. We also present findings from an extension of the method which allows the grouping of similar usability problems in an efficient manner. We found that the IDA method is a quick, relatively easy approach to identifying and ranking usability issues among health information technologies.     

口腔潜在恶性疾病相关生存质量评估工具的研究进展

口腔潜在恶性疾病作为有癌变风险的一类疾病,不仅会损害身体功能,而且会严重影响患者的心理、家庭、社交等。作为新医学模式发展的产物,口腔健康相关生存质量评估得到了越来越多的关注与应用,但是纵观国内外研究,很少将口腔健康相关生存质量评价体系应用于口腔潜在恶性疾病的诊疗过程。本文就口腔潜在恶性疾病的分类及流行现状、生存质量的定义及评估重要性、口腔潜在恶性疾病相关生存质量评估工具以及OHRQoL在口腔潜在恶性疾病中的应用等方面内容进行综述,以探讨口腔潜在恶性疾病相关生存质量的发展方向。     

DIFFERENTIATION BETWEEN Nocardia spp. AND Mycobacterium spp.: CRITICAL ASPECTS FOR BACTERIOLOGICAL DIAGNOSIS

New methodologies were developed for the identification of Nocardia but the initial diagnosis still requires a fast and accurate method, mainly due to the similarity to Mycobacterium, both clinical and bacteriologically. Growth on Löwenstein-Jensen (LJ) medium, presence of acid-fast bacilli through Ziehl-Neelsen staining, and colony morphology can be confusing aspects between Nocardia and Mycobacterium. This study describes the occurrence of Nocardia spp. in a mycobacterial-reference laboratory, observing the main difficulties in differentiating Nocardia spp. from Mycobacterium spp., and correlating isolates with nocardiosis cases. Laboratory records for the period between 2008 and 2012 were analyzed, and the isolates identified as Nocardia sp. or as non-acid-fast filamentous bacilli were selected. Epidemiological and bacteriological data were analyzed as well. Thirty-three isolates identified as Nocardia sp. and 22 as non-acid-fast bacilli were selected for this study, and represented 0.12% of isolates during the study period. The presumptive identification was based on macroscopic and microscopic morphology, resistance to lysozyme and restriction profiles using the PRA-hsp65 method. Nocardia spp. can grow on media for mycobacteria isolation (LJ and BBL MGIT™) and microscopy and colony morphology are very similar to some mycobacteria species. Seventeen patients (54.8%) were reported and treated for tuberculosis, but presented signs and symptoms of nocardiosis. It was concluded that the occurrence of Nocardia sp. during the study period was 0.12%. Isolates with characteristics of filamentous bacilli, forming aerial hyphae, with colonies that may be pigmented, rough and without the BstEII digestion pattern in PRA-hsp65 method are suggestive of Nocardia spp. For a mycobacterial routine laboratory, a flow for the presumptive identification of Nocardia is essential, allowing the use of more accurate techniques for the correct identification, proper treatment and better quality of life for patients.