A gender-based comparison of academic rank and scholarly productivity in academic neurological surgery

The number of women pursuing training opportunities in neurological surgery has increased, although they are still underrepresented at senior positions relative to junior academic ranks. Research productivity is an important component of the academic advancement process. We sought to use the h-index, a bibliometric previously analyzed among neurological surgeons, to evaluate whether there are gender differences in academic rank and research productivity among academic neurological surgeons. The h-index was calculated for 1052 academic neurological surgeons from 84 institutions, and organized by gender and academic rank. Overall men had statistically higher research productivity (mean 13.3) than their female colleagues (mean 9.5), as measured by the h-index, in the overall sample (p < 0.0007). When separating by academic rank, there were no statistical differences (p > 0.05) in h-index at the assistant professor (mean 7.2 male, 6.3 female), associate professor (11.2 male, 10.8 female), and professor (20.0 male, 18.0 female) levels based on gender. There was insufficient data to determine significance at the chairperson rank, as there was only one female chairperson. Although overall gender differences in scholarly productivity were detected, these differences did not reach statistical significance upon controlling for academic rank. Women were grossly underrepresented at the level of chairpersons in this sample of 1052 academic neurological surgeons, likely a result of the low proportion of females in this specialty. Future studies may be needed to investigate gender-specific research trends for neurosurgical residents, a cohort that in recent years has seen increased representation by women.     

基于眼部图像特征的肝肾疾病病证比较研究

目的:基于五轮学说及眼部图像特征提取技术,探讨不同证候(湿热内蕴证、肝郁脾虚证、肝肾阴虚证)的肝硬化及慢性肾脏疾病患者眼部图像特征及其差异性,以期从眼部图像特征上为肝硬化临床诊断及证候辨识提供数据支持。方法:选取2017年10月至2018年3月在上海中医药大学附属曙光医院肝硬化科住院的湿热内蕴证、肝郁脾虚证及肝肾阴虚证3种证候的肝硬化患者118例为研究对象,运用眼科裂隙灯采集受试者的眼部图像,并以年龄、性别、体质量指数匹配的非肝病(慢性肾脏疾病)患者115例及健康志愿者112例眼部图像特征为对照进行比较研究。剔除因受到各种因素干扰眼部图像不符合要求的患者,最终3组各纳入60例进行眼部图像分析。基于图像局部二值模式(LBP)特征提取法,将彩色图像转化为共生矩阵,计算图像LBP特征面积百分比。通过方差分析、秩和检验等统计学方法对相关指标进行比较分析,找出组间差异性。结果:肝硬化患者、慢性肾脏疾病患者与健康人3组眼部图像LBP特征面积百分比差异均有统计学意义(P<0.05)。与健康人组相比,在255层面积百分比中,肝硬化组有245层差异有统计学意义(P<0.05),慢性肾脏疾病组有246层差异有统计学意义(P<0.05)。肝硬化组与慢性肾脏疾病组相比,2组共有15层面积百分比差异有统计学意义(P<0.05)。对2种疾病间不同证候的LBP特征频数面积百分比进行比较,慢性肾脏疾病患者湿热内蕴证、肝郁脾虚证及肝肾阴虚证3组证候间共19层差异有统计学意义(P<0.05),而肝硬化组患者3组证候间差异无统计学意义(P>0.05)。比较3种证候不同疾病间的LBP特征频数面积百分比,湿热内蕴证中,肝硬化与慢性肾脏疾病组患者间有54层差异有统计学意义(P<0.05);肝肾阴虚证中共有46层差异有统计学意义(P<0.05);而肝郁脾虚证的2种疾病间差异无统计学意义(P>0.05)。比较湿热内蕴证、肝郁脾虚证与肝肾阴虚证3种证候间频数面积百分比,发现有2层差异存在统计学意义(P<0.05)。结论:基于眼部图像LBP特征发现,肝硬化及慢性肾脏疾病2种疾病间存在明显差异,且2种疾病的相同证候间比较亦有显著性差异,但同一疾病的3种不同证候间比较,仅肾脏病患者在一定程度上有差异,而肝硬化患者各证候间区分不明显。提示运用眼部图像LBP特征提取技术对不同疾病区分的敏感性优于对证候的区分。     

黄芪多糖的不同提取优化工艺

目的：比较不同提取工艺的黄芪多糖提取率。方法：选用超声波辅助提取法对黄芪多糖进行提取,比较正交实验最优提取工艺和响应面试验最优提取工艺的提取率。结果：经由响应面优化得出：最优提取时间22 min,最优提取温度50 ℃,最优料液比16:1（mL/g）,理论提取率为9.93%;经过正交设计优化得出：最优提取时间20 min,最优提取温度40 ℃,最优料液比15:1（mL/g）,理论提取率为9.56%。结论：经二种优化结果进行验证比较,研究结果表明响应面法优化结果更为准确、合理,更适宜推广。     

Categorical or Dimensional: How Do Attachment Measures Inform Clinicians in Couple Therapy?

Self-report measures of adult romantic attachment have been widely used in research but their application in clinical practice has not been adequately examined. One important issue is the selection of a practical and reliable attachment measure that therapists can rely on in couple therapy. In the present study, the three-category Attachment Style Prototype (Hazan & Shaver, 1987) representing the original classic conceptualization of attachment, and the Experiences in Close Relationships (Brennan, Clark, & Shaver, 1998), a more recent scale with two dimensions representing a new conceptualization, were compared. Experiences in Close Relationships data were also used to establish four clusters based on the scores of the two dimensions. The Experiences in Close Relationships and Attachment Style Prototype categories were related in meaningful ways; however, Attachment Style Prototype was less effective in detecting a group of insecurely attached individuals who tended to self-identify as securely attached. Experiences in Close Relationships clearly shows an advantage over Attachment Style Prototype in clinical application, and therefore was recommended. Examples of the clinical utilization of Experiences in Close Relationships in couple therapy were provided using Experiences in Close Relationships scores from couples seeking therapy.     

Conventional Versus Computer-Assisted Technique for Total Knee Arthroplasty: A Minimum of 5-Year Follow-up of 200 Patients in a Prospective Randomized Comparative Trial

In the literature, studies of computer-assisted total knee arthroplasty (TKA) after mid-term period are not conclusive and long-term data are rare. In a prospective, randomized, comparative study 100 conventional TKAs (group REG) were compared with 100 computer-assisted TKAs (group NAV). Minimum follow-up was 5 years. No difference in implant failure was found with 1.1% in group NAV versus 4.6% in group REG (P = 0.368). Group NAV showed a significantly less mean deviation of mechanical limb axis (P = 0.015), more TKAs (90% versus 81% in group REG) were within 3° varus/valgus and a higher tibial slope and lateral distal femoral angle (LDFA) accuracy was found (P ≤ 0.034). Clinical investigational parameters showed no differences (P ≥ 0.058). Insall and HSS score total were also higher in group NAV (P ≤ 0.016).     

加速康复外科和传统外科在肋骨骨折围手术期的应用比较

目的：比较加速康复外科（fast track surgery,FTS）理念和传统外科方法在肋骨骨折围手术期的应用。方法选择肋骨骨折患者84例,围手术期应用加速康复理念42例（FTS组）,应用传统外科手术42例（传统组）,将两组手术后疼痛VAS评分、血清白蛋白检测结果、肠鸣音恢复时间、首次通气时间、术后并发症（消化道症状、消化性溃疡、胸腔出血、肺不张、肺部感染、胸腔积液、心脏并发症、泌尿系统并发症、切口感染、深静脉血栓）发生率、住院时间及住院总费用、患者满意度等进行比较。结果 FTS组术后疼痛VAS评分较传统组低,血清白蛋白较传统组高,肠鸣音恢复时间及首次通气时间提前,术后并发症发生率较低,住院时间缩短,住院费用降低,患者满意度提高,两组比较差异有统计学意义（P＜0．05）。结论 FTS应用于肋骨骨折围手术期患者的术后疼痛VAS评分低,营养状况较好,肠道恢复较早,术后并发症发生率较低,住院时间缩短,治疗费用降低,患者满意度提高,值得进一步推广。     

Comparison of phosphotungstate and dextran sulfate-Mg2+ precipitation procedures for determination of high density lipoprotein cholesterol

Because of the controversy over the best method for assaying high density lipoprotein (HDL) cholesterol in the clinical laboratory, a commonly used phosphotungstate method for precipitating low density and very low density lipoproteins (LDL and VLDL) was compared with a recently recommended dextran sulfate precipitation method. The accuracy and precision of HDL cholesterol determinations were similar for both methods. Either of these procedures would appear to be equally satisfactory for the assay of HDL cholesterol in the clinical laboratory.     

鼻内镜下射频治疗鼻腔毛细血管瘤

目的探讨经鼻内镜下射频治疗鼻腔毛细血管瘤的临床疗效。方法患者随机分为两组,治疗组采用射频治疗,对照组采用微波治疗。观察术中出血情况、治疗时间及疗效。结果治疗组和对照组总有效率100%,差异无显著性;两者治疗时间、术中出血比较,P<0.05,差异有统计学意义。两组随访6个月￣1a无1例复发。结论经鼻内镜下射频治疗鼻腔毛细血管瘤具有操作精确、微创、治疗时间短、无出血和病人痛苦小等优点,值得临床推广应用。     

不同型号仪器测定凝血酶原时间的可比性研究

目的探讨不同型号血凝仪检测凝血酶原时间（PT）的检测结果是否具有可比性。方法分别采用不同水平STAGO质控物、DADE质控物和75例不同浓度的患者新鲜血浆，在2个不同的检测系统（STA—R、CA7000）测定PT，并对其检测结果进行相关的统计学分析。结果5个水平的质控物测定结果经t检验，各组间的差异均有显著性（P〈0．01）。各检测系统间不同浓度的患者新鲜血浆测定结果差异有非常显著性（P〈0．01）；相关系数均=0．975。以STA—R作标准检测系统对其他检测系统作临床可接受性能评价，CA7000可接受。结论2个检测系统测定PT精密度和临床可接受性能评价均符合临床要求，应定期对以上的检测系统进行比对实验，以保证检验结果间的可比性。