龙胆泻肝胶囊治疗肝胆湿热型分泌性中耳炎临床研究

目的:研究龙胆泻肝胶囊治疗肝胆湿热型分泌性中耳炎(SOM)的效果。方法:选取78例肝胆湿热型分泌性中耳炎患者,按随机数字表法分为试验组和对照组各39例。2组均采用鼓膜穿刺术治疗,对照组术后给予头孢克洛和氯雷他定抗感染治疗,试验组给予龙胆泻肝胶囊。评价2组治疗效果,检测治疗前后血清干扰素γ(IFN-γ)和白细胞介素-4(IL-4)水平,计算IFN-γ/IL-4,进行中医证候评分,观察患耳含积液情况。结果:试验组总有效率为92.31%,高于对照组71.79%(P<0.05)。治疗前,2组IFN-γ、IL-4和IFN-γ/IL-4比较,差异无统计学意义(P>0.05)。治疗后,2组IFN-γ、IL-4和IFN-γ/IL-4较治疗前降低,且试验组IFN-γ、IL-4和IFN-γ/IL-4均低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组各项中医症状评分比较,差异无统计学意义(P>0.05)。治疗后,2组各项中医症状评分及总分较治疗前降低,试验组各项中医症状评分及总分均低于对照组,差异有统计学意义(P<0.05)。试验组耳内含积液率为71.79%,低于对照组89.74%(P<0.05)。结论:采用龙胆泻肝胶囊治疗肝胆湿热型分泌性中耳炎,疗效令人满意,能够显著改善患者症状,可下调IFN-γ、IL-4表达,调节Th1/Th2平衡,值得临床推广应用。     

Pasireotide (SOM230): development, mechanism of action and potential applications

Pasireotide (SOM230) is a multi-receptor ligand somatostatin analogue with high binding affinity for somatostatin receptor subtypes sst(1,2,3) and sst(5). Pasireotide potently suppresses GH, IGF-I and ACTH secretion, indicating potential efficacy in acromegaly and Cushing's disease. The prolonged inhibition of hormone secretion by pasireotide in animal models and expression of multiple sst receptors in carcinoid tumors suggests that pasireotide may have clinical advantages over octreotide in patients with carcinoid tumors. Direct and indirect antitumor activity has been observed in vitro with pasireotide, including sst receptor-mediated apoptosis and antiangiogenesis, suggesting a possible role for pasireotide in antineoplastic therapy. In summary, preclinical evidence, as well as preliminary results from clinical studies suggests that pasireotide is a promising new treatment for patients with symptoms of metastatic carcinoid tumors refractory or resistant to octreotide, de novo or persistent acromegaly, and that pasireotide has the potential to be the first directed medical therapy for Cushing's disease.     

临床实验室检验知识的数据挖掘和表达

目的探索基于自组织映射（SOM）的数据挖掘方法从历史积累的临床实验室检验数据中发现知识的能力,并尝试利用本体方法将该领域相关知识进行标准化表达。方法本研究的基本思想是采用自组织映射神经网络技术,从过去积累的数据中挖掘出专家经验基础上的临床检验项目的应用规律（知识）。以2009--2011年西安市两所综合医院的内科门诊患者就诊资料为训练样本,采用自组织映射方法建立门诊患者的聚类模型。采用通用的本体构建原则和方法,提取领域内相关概念及相互关系,建立临床实验室检验领域本体框架。结果SOM网络将就诊患者聚为8个类别,每个类别都具有较明显的临床意义,即每个类别中的患者具有相似的临床实验室检验项目的应用规律。聚类结果可以涵盖69．73％的患者。患者性别、年龄、3年累计临床检验项目数、疾病特征对聚类模型的贡献较大。构建了临床实验室检验领域本体框架,该框架的构建过程符合本体的建立准则,本体中的概念及其关系相对完整。结论自组织映射方法对门诊患者聚类效果较好,说明采用数据挖掘方法从历史数据中发现临床实验室检验项目的应用规律是可行的。采用本体方法将该领域知识进行标准化表达是一种有益的尝试。     

通耳窍汤结合鼓膜置管治疗分泌性中耳炎35例观察

目的:观察用通耳窍汤结合鼓膜置管治疗反复发作分泌性中耳炎的临床疗效。方法:70例随机分为治疗组和对照组各35例,治疗组行鼓膜置管同时口服通耳窍汤,对照组行鼓膜置管同时口服消炎药,6个月后判定疗效。结果:治疗组显效30耳,有效9耳,无效3耳,总有效率92.9%。对照组45耳,显效18耳,有效16耳,无效11耳,总有效率75.6%。两组总有效率比较有显著性差异(P<0.05)。结论:通耳窍汤及鼓膜置管治疗分泌性中耳炎疗效优于单用西医治疗。     

Adaptive training of cortical feature maps for a robot sensorimotor controller

This work investigates self-organising cortical feature maps (SOFMs) based upon the Kohonen Self-Organising Map (SOM) but implemented with spiking neural networks. In future work, the feature maps are intended as the basis for a sensorimotor controller for an autonomous humanoid robot. Traditional SOM methods require some modifications to be useful for autonomous robotic applications. Ideally the map training process should be self-regulating and not require predefined training files or the usual SOM parameter reduction schedules. It would also be desirable if the organised map had some flexibility to accommodate new information whilst preserving previous learnt patterns. Here methods are described which have been used to develop a cortical motor map training system which goes some way towards addressing these issues. The work is presented under the general term ‘Adaptive Plasticity’ and the main contribution is the development of a ‘plasticity resource’ (PR) which is modelled as a global parameter which expresses the rate of map development and is related directly to learning on the afferent (input) connections. The PR is used to control map training in place of a traditional learning rate parameter. In conjunction with the PR, random generation of inputs from a set of exemplar patterns is used rather than predefined datasets and enables maps to be trained without deciding in advance how much data is required. An added benefit of the PR is that, unlike a traditional learning rate, it can increase as well as decrease in response to the demands of the input and so allows the map to accommodate new information when the inputs are changed during training.