伤口组织与电刺激调控的相关性研究*

慢性伤口迁延不愈。外源性电刺激提供促进慢性伤口愈合的电流，其独特优势是使电荷调控伤口，促进伤 口愈合，具有良好的应用前景，并成为目前组织学研究者和临床医生的研究热点之一。现介绍一些常见慢性伤口 的形态学和电生理特性，主要探讨目前电荷调控伤口愈合的形态学改变、可能作用机制及其影响因素。     

基于维修数据的医用超声设备常见故障与易损部件分析

目的 对超声设备故障现象和易损部件进行分类统计,探讨针对性的超声设备预防性维修维护策略.方法 对2016～2019年间457次超声设备故障进行统计分析,从故障现象、导致该故障现象的易损部件等方面进行分类统计.结果 超声设备高发的故障现象依次为显示故障(34％)、开机故障(23％)、面板故障(16％)和探头故障(11％),高发的易损部件依次为探头(38％)、面板(17％)、电源(12％)、计算机硬件(9％)和板卡(8％),且进口设备与国产设备之间、台式设备与便携式设备之间的高发易损部件存在差异;进口设备高发易损部件依次为探头(37％)、面板(18％)和电源(13％),国产设备高发易损部件依次为探头(40％)、软件(21％)和面板(12％);台式设备高发易损部件依次为探头(42％)、面板(20％)和计算机硬件(9％),便携式设备高发易损部件为电源(34％)、探头(22％)和计算机硬件(8％).结论 超声设备高发的易损部件主要为探头、面板、电源、计算机硬件和板卡,且进口设备与国产设备之间、台式设备与便携式设备之间的高发易损部件存在差异,对超声设备的预防性维修维护应主要针对这些高发易损部件展开,同时应根据设备之间的差异具有针对性.     

基于统计形状模型的三维足形状建模

目的构建足的三维统计形状模型(statistical shape model,SSM),揭示足形状的三维变化特征。方法 50名中国青年男性正常足数据用于三维统计形状建模,通过足面网格配准、点对齐及主成分(principal component,PC)降维分析等步骤,获得平均足形态及在各PC维度标准差等参数化的足形态。结果通过PC降维分析,三维足型主要在长短及宽窄(PC1,48.01%)、足弓高度及足背厚度(PC2,11.38%)及大脚趾展收(PC3,7.48%)等维度变化。结论通过构建参数化的足三维SSM,可运用至基于该人群的鞋楦制作、鞋垫定制及临床足病快速诊断等应用。     

Prediction of lymph node metastasis in rectal cancer: comparison between shear-wave elastography based ultrasomics and MRI

PURPOSEWe aimed to explore the diagnostic efficiency of shear-wave elastography (SWE) ultrasomics in the preoperative prediction of lymph node (LN) metastasis in rectal cancer.METHODSThis study included 87 patients with pathologically confirmed rectal cancer, with data gathered from August 2017 to August 2018. A total of 1044 ultrasomics features of rectal tumor were collected with AK software from the SWE examinations. The least absolute shrinkage and selection operator (LASSO) regression model was used for feature selection and building a SWE ultrasomics signature. The diagnostic performance was evaluated with an area under the receiver operating characteristic curve (AUC) analysis. Then, the diagnostic performance of the SWE ultrasomics signature was compared with magnetic resonance imaging (MRI).RESULTSOf the 87 patients, 40 (46.0%) had LN metastasis. Thirteen ultrasomics features of rectal tumor were selected as the most significant features. The SWE ultrasomics signature correlated with LN metastasis (p < 0.001). Patients with LN metastasis had higher signature than patients without LN metastasis. In terms of diagnostic performance, SWE ultrasomics signature was significantly superior to MRI (AUC, 0.883 vs. 0.760, p = 0.034). The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SWE ultrasomics signature were 82.8%, 87.5%, 78.8%, 77.8%, and 88.1%, respectively, while those of MRI were 75.9%, 77.5%, 74.5%, 72.1%, and 79.6%, respectively.CONCLUSIONSWE ultrasomics is a more accurate predictive method for identifying LN metastasis preoperatively than MRI. Thus, SWE ultrasomics might be used to better guide preoperative individual therapies for patients with rectal cancer.

Colorectal cancer is the third most common cancer and the fourth frequent cause of cancer death worldwide; approximately one-third of these tumors is rectal cancer (1). Accurate identification of lymph node (LN) involvement is important in determining whether rectal cancer patients require preoperative neoadjuvant therapy (2, 3). Therefore, accurate prediction of LN metastasis can provide valuable information and is crucial for treatment decisions and prognosis (4).According to ESGAR guidelines (European Society of Gastrointestinal and Abdominal Radiology) 2016 recommendations, magnetic resonance imaging (MRI) is considered the gold standard for rectal cancer staging (3, 5–7). However, MRI is not perfect for determination of LNs status, and the criteria used to indicate LN metastasis may vary in different institutions (8). A meta-analysis found MRI to be 77% sensitive (95% CI, 69%–84%) and 71% specific (95% CI, 59%–81%) for detection of LN involvement (9). In addition, endoscopic ultrasonography (EUS) is also a widely used method for patients with rectal cancer, but the accuracy of EUS to identify LN involvement is inferior to that of both computed tomography (CT) and MRI because of a lack of visualization of the entire mesorectum and the difficulty in accurately distinguishing benign from malignant nodes based only on the shape, echo feature and size criterion (10–13). Given these limitations, neither MRI nor EUS is an ideal method for diagnosing LN status in rectal cancer.Radiomics, extracted from CT, MRI, or positron emission tomography images, uses a set of quantitative features to describe the geometrical structure, intensity distribution and texture of a region of interest (ROI). These features include shape, edge, and texture metrics, which can provide important insights into the tumor phenotype and the interaction of the tumor with its microenvironment (14, 15). Similarly, we have applied the concept to computing quantitative ultrasound imaging, a term defined as “ultrasomics” (16). Shear-wave elastography (SWE), an ultrasound elastography technique that provides a real-time two-dimensional (2D) quantifiable image of tissue stiffness (17), has emerged as an efficient tool in detection of malignancies. The report of Wang et al. (18) confirmed that the deep learning of elastography showed a better prediction of liver fibrosis staging compared with transient elastography, 2D-SWE, and serological examinations. Therefore, SWE-based ultrasomics has a promising future in staging and prediction.To our knowledge, there has been no study that combines SWE and ultrasomics to predict the LN metastasis. In order to build a robust model, we hypothesized that SWE ultrasomics could be a better option in LN status prediction of colorectal cancer patients. Therefore, the purpose of this study was to evaluate the accuracy of LN metastasis identification before surgical resection using SWE ultrasomics of primary tumor and compare it with MRI.     

医院-社区-家庭闭环式模式在老年糖尿病周围神经病变患者中的应用价值

【摘要】目的 探讨“医院-社区-家庭”闭环式管理模式在老年糖尿病周围神经病变（DPN）患者中的应用价值。方法 选取2017年6月～2019年6月我院收治的老年DPN患者96例，随机分为观察组与对照组，每组各48例。对照组采用常规护理，观察组采用医院-社区-家庭闭环式管理模式。比较两组患者治疗依从性、血糖控制、心理健康状况、周围神经病变情况以及神经传导速率。结果 干预后，观察组患者用药、饮食、血糖测量、健康行为等方面依从率均高于对照组（P＜0.05）；观察组空腹血糖、饭后2 h血糖、糖化血红蛋白均低于对照组（P＜0.05）；观察组SCL-90症状自评量表躯体化、人际关系敏感、抑郁、焦虑、敌对以及睡眠饮食情况得分均低于对照组（P＜0.05）；观察组密西根糖尿病周围神经病变量表（MDNS）和多伦多临床神经病变评分量表（TCSS）评分均低于对照组（P＜0.05）；观察组正中神经、腓总神经神经传导速度（SNCV）和运动神经传导速度（MNCV）均高于对照组（P＜0.05）。结论 对老年DPN患者应用医院-社区-家庭闭环式管理模式能有效提高患者自我管理效能，维持血糖平稳，缓解不良情绪以改善DPN病情。     

超声引导下针刺足三里穴对胃窦收缩功能的影响：随机对照研究＊

目的 观察超声引导下针刺足三里穴得气与不得气对胃窦收缩功能的影响。方法 将符合纳入标准的72例健康受试者，按照1∶1随机分配到观察组和对照组，每组36例。在超声引导下针刺受试者右侧足三里穴，观察组针刺深度到达小腿骨间膜处，施以提插捻转手法使之得气，对照组针刺深度到达浅筋膜处，不运针，不要求得气，应用受试者针感临床评价量表、胃脘部热红外成像与胃窦运动超声数据进行评估，比较两组针刺前后胃窦收缩频率的变化。结果 观察组完成35例，脱落1例；对照组完成34例，脱落2例。两组间比较，受试者针感临床评价量表评分、胃窦收缩频率、胃窦运动幅度与胃窦运动指数在针刺得气后差异具有统计学意义（P < 0.05）；观察组针刺前后胃窦收缩频率、胃窦运动幅度与胃窦运动指数比较差异具有统计学意义（P < 0.05），以胃窦收缩频率增加、运动幅度增大及运动指数增加为主要表现；对照组针刺前后胃窦收缩频率、胃窦运动幅度与胃窦运动指数比较差异均无统计学意义（P > 0.05）；观察组与对照组针刺前后胃脘部皮肤温度变化差异无统计学意义（P < 0.05）。结论 针刺足三里穴得气可一定程度改变胃窦运动功能，超声成像技术能有效引导针刺操作并实时观察记录胃窦运动变化，安全高效，值得临床推广与应用。     

新疆生产建设兵团第十师羊小反刍兽疫抗体监测与评价

为了评估新疆生产建设兵团第十师北屯市(以下简称师市)羊群小反刍兽疫强制免疫效果,应用酶联免疫吸附试验(ELISA)对2017-2020年全师8个农牧团场采集的4 010份血清进行小反刍兽疫抗体检测,并按单位、年份、类别对检测结果进行了统计分析。结果表明,2018-2020年全师8个农牧团场小反刍兽疫血清抗体平均合格率为84.69%(3 396/4 010),均符合国家农业农村部相关规定,高于平均值的三家单位是E 87.22%(157/180)、G 86.45%(268/310)、H 88.67%(798/900),合格率最低的是D 76.11%(137/180);养殖合作社的抗体合格率为84.81%(1 340/1 580),养殖大户为84.65%(2 057/2 430)均接近于平均合格率,两者差异不显著(P>0.05)。总体来看,师市羊群小反刍兽疫免疫效果较好,为确保师市辖区内重大动物疫病免疫无疫提供技术保障。     

胞宫胞脉胞络理论与子宫内膜容受性关系探析

胞宫胞脉胞络理论是中医基于脏腑理论对女子生殖功能的基本认识.子宫体、宫颈、卵巢、输卵管、盆壁及其相关的血管、神经、韧带及受体当属胞宫、胞脉、胞络功能范畴.胞脉和胞络属于胞官的一部分.胞脉、胞络将脏腑化生之气血全面布散于胞官,心、肾通过胞脉、胞络与胞官相联系."精满" "血足"是良好子宫内膜环境的体现.肾气亏损,胞脉失疏,冲任不充,胞官瘀滞,藏泻失序,表现为子宫内膜较薄及血供不足,不利于孕卵的着床.治疗子宫内膜容受性低下应予补肾气,通胞脉,自拟二补助育汤,可以改善子宫内膜血液循环,增加子宫内膜厚度,提高辅助妊娠成功率.     

CO2点阵激光联合伊可尔治疗难治性掌跖疣疗效观察

目的观察CO₂点阵激光联合伊可尔治疗难治性掌跖疣的临床疗效及安全性。方法:选取掌跖部多发,经其他疗法治疗后复发的难治性掌跖疣患者58例,患者平均分为两组,对照组29例先选择激光功率0.5-2W将皮损磨削薄直至焦痂或点状出血,之后采用CO₂点阵模式10-20mJ/cm2治疗,每周治疗一次,连续治疗4周。观察组29例观察组:CO₂点阵激光治疗仪器及治疗方法与对照组相同。激光治疗完毕,使用伊可尔药水棉片湿敷患处2小时,激光治疗后连续湿敷伊可尔棉片5天,停药2天至下一次激光治疗后继续湿敷,连续治疗4周。2组均随访观察6个月。结果:58例患者均完成治疗,治疗4周后,观察组总有效率93.10%,病损清除率为77.82%,均高于对照组的72.41%、60.81%,组间差异均有统计学意义(P<0.05)。6个月后,观察组复发率10.34%,对照组复发率37.93%,组间差异有统计学意义(P<0.05),两组不良反应差异无统计学差异。结论:CO₂点阵激光联合伊可尔治疗难治性掌跖疣疗效优于单用CO₂点阵激光。联用伊可尔降低了难治性掌跖疣的复发率,并且操作简便,安全性高。