The Oxford Clinical Cataract Classification and Grading System

A composite slit-lamp based system for the clinical classification and grading of cataract is described. Cataract features are classified morphologically, and individual features are graded by comparison with standard diagrams mounted adjacent to the slit-lamp. Attention has been paid to relevant aspects of measurement theory, with equal interval steps between the grades. The image degrading effect of the cataract is assessed using a resolution target projection ophthalmoscope. The method may be used in conjunction with photographic and image analysing techniques.     

肾综合征出血热患者血清炎性细胞因子与疾病进程及预后的相关性

目的分析肾综合征出血热患者不同临床分期及不同临床分型血清中C反应蛋白、白细胞介素-1、白细胞介素-6、肿瘤坏死因子-α水平与疾病的相关性,为HFRS临床诊治提供依据。方法以2018年6月至2020年1月在锦州医科大学附属第一医院住院的37例HFRS患者和15例健康体检者(对照组)为研究对象,用ELISA法分别检测患者血清炎性细胞因子CRP、IL-1、IL-6和TNF-α水平,并分析其与临床分期、临床分型的相关性。结果临床分期为急性期和恢复期的患者血清中CRP、IL-1、IL-6和TNF-α水平均高于正常组(P<0.01),且急性期各细胞因子显著高于恢复期(P<0.01);临床分型轻型、中型、重型、危重型患者血清CRP、IL-1、IL-6和TNF-α水平较比对照组有不同程度的增加(P<0.05)。Spearman相关分析显示,CRP、IL-1、IL-6和TNF-α水平与不同临床分期呈负相关(r=-0.48,P<0.01;r=-0.59,P<0.01;r=-0.33,P=0.03;r=-0.47,P<0.01);与不同临床分型呈正相关(r=0.42,P=0.01;r=0.56,P<0.01;r=0.52,P<0.01;r=0.34,P=0.04);与预后(存活)呈负相关(r=-0.32,P=0.02;r=-0.46,P<0.01;r=-0.40,P<0.01;r=-0.37,P=0.01)。结论HFRS患者血清炎性细胞因子水平与疾病严重程度及预后密切相关。     

超声弹性成像联合BI-RADS分类在乳腺微小癌诊断中的临床价值

目的:探讨在乳腺微小癌诊断中联合应用超声弹性成像及数据系统(BI-RADS)分类的临床价值。方法:选择2018年3月~2019年3月本院接收的疑似乳腺微小癌的96例患者作为研究对象。均进行超声弹性成像检查、BI-RADS分类,以病理检查结果为诊断金标准,比较单项检查与联合检查的准确率、灵敏度、特异度。结果:数据显示,在96例疑似乳腺微小癌患者中,共80例患者经病理检查确诊为乳腺微小癌,同时乳腺钼靶联合超声检查的准确性、灵敏度均高于单项检测,数据之间的差异有统计学意义(P<0.05)。此外,单项与联合检测的特异度对比,差异无统计学意义(P>0.05)。结论:在乳腺微小癌诊断中联合应用超声弹性成像及BI-RADS分类检查,可有效提高诊断准确性及灵敏度,对早期疾病诊断、临床治疗具有重要意义。     

沈阳地区76例非何杰金淋巴瘤的分类及其免疫表型病理分析

目的：探讨我国沈阳地区非何杰金淋巴瘤（NHL）的病理特点及免疫组化表型分析。方法：对76例NHL按照WHO新分类进行病理观察和10种抗体免疫表型测定。结果：B系占78．9％,其中弥漫性大B细胞淋巴瘤（DLBL）最多;其次为MALT型（＋／－单核细胞样B细胞）及淋巴浆细胞性淋巴瘤（LPL）。T系占21．1％,以外周T非特殊型最多。CD79a对B－NHL染色阳性率达100％,未见与T细胞的交叉反应。CD3对T－NHL染色阳性率为88％,与B细胞仅有5％的交叉反应。结论：我国沈阳地区NHL以DLBL和外周T非特殊型为最多见,结内单核B和淋巴浆细胞性比例较高。CD79a和CD3分别是具有高度敏感性和特异性的B、T细胞标志抗体。     

The clinical impact of Prostate Imaging–Reporting and Data System classification in patients with haemospermia undergoing multiparametric magnetic resonance imaging of the prostate

In this study, we evaluated the role of the Prostate Imaging–Reporting and Data System (PI-RADS) classification of multiparametric magnetic resonance imaging (mpMRI) to determine the likelihood of prostate cancer (PCa) in patients with haemospermia. Fifty-one patients presenting with haemospermia between 2018 and 2020 were included in this retrospective study. Forty-two of the patients (82.4%) were over 40 years, and the median prostate-specific antigen (PSA) level was 1.4 ng/ml. Fourteen of the patients (27.5%) had recurrent haemospermia. All patients underwent mpMRI, and assessments were classified according to PI-RADS v2. The mpMRI revealed PI-RADS one to four lesions in 10 (19.6%), 30 (58.8%), 6 (11.8%) and 5 (9.8%) patients respectively. One patient with PI-RADS 3 and five with PI-RADS 4 lesions underwent cognitive fusion prostate biopsy depending on MRI findings, and two patients with PI-RADS 4 lesions were diagnosed with PCa. Patients with haemospermia and risk factors, that is aged over 40 years, a high PSA level or familial history of PCa, need a more thorough evaluation with mpMRI.     

Success Rates of Debridement,Antibiotics, and Implant Retention in 230 Infected Total Knee Arthroplasties: Implications for Classification of Periprosthetic Joint Infection

BackgroundProsthetic joint infection (PJI) is the most common cause of failure following total knee arthroplasty (TKA). This study aimed to determine the success of debridement, antibiotics, and implant retention (DAIR) in a large cohort of TKA PJIs and assess the utility of current classification systems in predicting DAIR outcomes in early postoperative, late hematogenous, and chronic PJIs.MethodsIn a multicenter review over 15 years, 230 patients underwent DAIR for first episode PJI following primary TKA. Patient demographics, disease and surgical factors, treatment regime, and outcomes were identified. Univariate and multivariate survival analyses were performed to identify factors associated with successful DAIR. Continuous variables with predictive value were further analyzed using receiver operating characteristic curves. The ability to predict DAIR outcomes of multiple classification systems was also assessed.ResultsPatients were followed for an average of 6.9 years. The overall success rate of DAIR was 53.9%. On receiver operating characteristic analysis, 3 months (area under the curve = 0.63) and 1-year age (area under the curve = 0.66) of implant cut-offs was similarly predictive of outcomes. On multivariate survival analysis, DAIR was successful in 64% of “early” PJIs (implant <1 year) vs 38% of “late hematogenous” PJIs (implant >1 year; odds ratio [OR] 1.78, P = .01). For late PJIs (implant >1 year), Staphylococcus aureus (OR 4.70, P < .001) and gram-negative infections (OR 2.56, P = .031) were risk factors for DAIR failure.ConclusionDAIR has a high failure rate in all PJIs occurring more than a year post primary TKA, particularly when caused by S aureus or gram-negative bacteria. The age of implant is an important predictor of DAIR outcomes.     

原发性骨肉瘤影像学表现与病理分型的关系

目的探讨原发性骨肉瘤影像学表现与病理分型的关系。方法分析82例原发性骨肉瘤患者X线、CT、MRI等影像学表现与病理分型的关系。结果82例原发性骨肉瘤患者病理分型:普通型67例,小细胞型6例,髓内高分化型2例,毛细血管扩张型2例,高级别骨表面型1例,骨膜型2例,骨旁型2例。不同病理分型的原发性骨肉瘤X线、CT、MRI等影像学表现均存在差异。结论原发性骨肉瘤的病理分型以普通型较常见,骨高密度成骨灶是各病理分型均具有的影像学表现,通过X线、CT、MRI等影像学表现可对不同病理分型的原发性骨肉瘤作出鉴别,可为制定合适的临床治疗方案提供重要的参考和依据。     

基于人工智能感官与多源信息融合技术的五味药性二分类辨识方法探讨

目的 探究人工智能感官与多源信息融合技术用于中药五味药性二分类辨识方法的可行性,为中药药性评价提供新的方法借鉴。方法 选取122种仅含单一味不含兼味的5类代表性中药饮片（源自《中国药典》2020年版）及14种常用的食品类样本,使用PEN3型电子鼻及ASTREE、SA402B型电子舌采集136种样本的智能感官信息,以得到的信息矩阵作为自变量（X）,药典项下的性味描述等作为标杆信息（Y）,利用主成分分析-判别分析（principal component analysis-discriminant analysis,PCA-DA）、最小二乘-支持向量机（least squares-support vector machine,LS-SVM）2种化学计量学方法,分别基于单一型号智能感官设备（单源）和多智能感官信息融合（多源）建立五味二分类（酸/非酸、咸/非咸、辛/非辛、甘/非甘、苦/非苦）辨识模型Y=F(X),以交互验证的正判率作为模型优选指标。结果 经留一法交互验证,基于单源信息的五味二分类模型中最大正判率分别是98.53%(ASTREE/PCA-DA、LS-SVM)、97.06%(ASTR...     

单味药药性成因假说下的范式方法研究淫羊藿药性

科学合理的中药药性研究方法是中医药药性科学内涵研究的基础和客观要求。在既往创建的“单味药药性成因假说”理论指导下,在国内外首次创建“单味药药性形成演变分类范式模块”研究方法。运用此方法,在利用现代药效物质基础研究成果解析淫羊藿四气药性合理性的基础上,在中医学理论语境下,分析单味药淫羊藿四气药性历史形成、演变过程及影响因素,并将研究结果纳入模块类别单元分类。为建立系统、科学合理的中药药性研究方法与手段,提供了新思路。