单频和多频刺激骨导听性稳态反应的比较

目的测试听力正常青年人单频及多频刺激骨导听性稳态反应(BC-ASSR)阈值,比较两者是否有差异。方法选取听力正常青年人28例(56耳),进行骨导ASSR及纯音听阈测试,记录0.5、1、2、4kHz单频刺激及多频刺激的BC-ASSR反应阈及纯音听阈,比较两种刺激方式所得结果。结果在0.5、1、2、4kHz频率单频刺激骨导的ASSR反应阈分别为53、47、53、51dB SPL,多频刺激骨导ASSR反应阈分别为59、54、63、61dB SPL,两者间有高度显著性差异(P<0.01),且高频处的差异相对较大。结论BC-ASSR测试时,单频刺激和多频刺激方法所得听阈值存在一定的差异,且高频处的差异相对较大,因而临床应用测试时宜采用单频刺激方式。     

Synchronous Tricompartmental Benign CNS Tumors with Tonsillar Herniation, Cervicodorsal Syringomyelia and Hydrocephalus

In this study, three primary central nervous system tumors of different histological cell types occurring together without neurofibromatosis are reported. These included a sellar pituitary adenoma with apoplexy, a large torculo-tentorial meningioma in the posterior fossa, and a cervical spinal intramedullary schwannoma. Displacement of primitive multipotent cells in different central nervous system compartments or the oncogenic effects of activated signaling of growth factor receptors are the proposed pathophysiological mechanisms for the simultaneous genesis of different types of tumors. There was associated tonsillar herniation, cervicodorsal syringomyelia, and hydrocephalus. The radiological features and treatment strategy of these rare synchronous tumors are highlighted.     

前列腺癌同步加量放疗dIMRT和RapidArc比较研究

目的 前列腺大分割照射与盆腔常规分割预防照射相结合的同步加量放疗可提高前列腺癌临床疗效,本研究比较固定野动态调强(dynamic intensity modulated radiotherapy,dIMRT)与快速旋转调强(RapidArc)在前列腺癌同步加量放疗中的剂量分布、治疗效率和执行精度的差异,为临床应用提供参考.方法 选取2013-01-04-2013-12-31在中山大学肿瘤防治中心行放疗的10例前列腺癌高危风险患者,靶区包括前列腺、精囊和盆腔淋巴结.以相同的剂量目标和优化参数分别设计9野dIMRT、单弧和双弧RapidArc同步加量治疗计划,分别用9F、1ARC和2ARC表示.比较分析3种计划的靶区剂量学特点,直肠、膀胱、小肠和双侧股骨头等危及器官的受照剂量及体积,机器跳数,治疗时间以及剂量验证通过率.结果 对于PTV1,9F的D2％为(69.37±0.89) Gy,D50％为(66.92±0.63) Gy,HI为0.09±0.02,CI为0.83±0.05;1ARC的D2％为(71.13±1.21) Gy,D50％为(68.50±0.76) Gy,HI为0.12±0.02,CI为0.74±0.07;9F均优于1ARC,差异均有统计学意义,P＜0.05;9F与2ARC的各参数差异均无统计学意义,P＞0.05.对于PTV2,9F的V5％为(99.45±0.78)％,优于1ARC的(99.35±1.28)％,差异有统计学意义,P＜0.05;9F与2ARC各参数的差异均无统计学意义,P＞0.05.对于膀胱Dmean,3组计划差异无统计学意义,P＞0.05;对于直肠V67.5Gy,9F与2ARC的差异无统计学意义,P＞0.05;对于左右股骨头Dmean,1ARC和2ARC低于9F,差异有统计学意义,P＜0.05;各OAR其余评价指标9F均低于1ARC和2ARC,差异均有统计学意义,P＜0.05.1ARC和2ARC相比于9F机器跳数平均减少了70.0％和67.2％,治疗时间平均缩短了81.7％和61.0％.9F、1ARC和2ARC的3％/3 mm标准的γ通过率分别为97.8％、98.9％和99.4％,差异均具有统计学意义,P＜0.05.结论 相比于dIMRT,RapidArc可显著提高治疗效率,其双弧计划具有相仿的靶区覆盖,但对膀胱、直肠和小肠的保护更差,dIMRT更适用于前列腺癌同步加量放射治疗.     

非血管化髂骨移植同期种植重建下颌骨节段缺损的临床研究

目的：研究非血管化髂骨移植同期种植重建下颌骨节段缺损的方法及临床效果。方法：选取下颌骨节段缺损的病人，通过非血管化髂骨移植建立下颌骨连续性，同期植入牙种植体。结果：移植的骨块成活，植入的种植体可以实现骨结合并完成种植义齿修复，行使功能。结论：此方法可以实现下颌骨的功能重建。     

Acid volatile sulfide and simultaneously extracted metals in the sediment cores of the Pearl River Estuary, South China

The acid-volatile sulfide (AVS), simultaneously extracted metals (SEM), total metals, and chemical partitioning in the sediment cores of the Pearl River Estuary (PRE) were studied. The concentrations of total metals, AVS, and SEM in the sediment cores were generally low in the river outlet area, increased along the seaward direction, and decreased again at the seaward boundary of the estuary. The amounts of AVS were generally greater in deeper sediments than in surface sediments. SEM/AVS was >1 in the surface sediments and in the river outlet cores. The ratio was <1 in the sediments down the profiles, suggesting that AVS might play a major role in binding heavy metals in the deep sediments of the PRE. The SEM may contain different chemical forms of trace metals in the sediments, depending on the metal reaction with 1M cold HCl in the AVS procedure compared with the results of the sequential chemical extraction. The SEM/AVS ratio prediction may overestimate trace metal availability even in the sediments with high AVS concentrations.     

淋巴结≥2 cm的晚期宫颈癌患者后程缩野加量调强放疗的疗效观察

目的比较淋巴结直径≥2 cm的局部晚期宫颈癌患者接受调强放疗(IMRT)时选择后程缩野加量或同步加量照射的疗效及不良反应。方法入组153例经病理确诊为宫颈癌,伴盆腔和(或)腹主动脉旁淋巴结转移且直径≥2 cm的患者,调强放疗(IMRT)时随机接受后程缩野加量(n=76)及同步加量(n=77)照射。后程缩野加量组:计划靶体积(PTV):45 Gy/25 F/1.8 Gy,完成治疗后行第2次CT定位扫描,仅勾画可见肿瘤靶体积(GTV)即转移淋巴结:14.4 Gy/8 F/1.8 Gy。同步加量组:PTV:45 Gy/25 F/1.8 Gy,GTV:同步加量至60 Gy/25 F/2.4 Gy。结果后程缩野加量组与同步加量组相较,两组近期有效率为82.9%vs.87%;远期有效率分别为77.6%vs.81.8%(P>0.05);复发率为15.8%vs.13%(P>0.05)。两组均未出现Ⅲ~Ⅳ级的近期及远期放射性反应。其中,两组患者Ⅰ~Ⅱ级的近期放射性反应主要为放射性皮炎(1.3%vs.3.9%;P<0.05)、放射性肠炎(3.9%vs.15.6%;P<0.05)、放射性胃炎(1.3%vs.5.2%;P<0.05)、放射性膀胱炎(6.5%vs.1.3%;P<0.05)。Ⅰ~Ⅱ级的远期放射性反应主要为放射性肠炎(7.8%vs.1.3%;P<0.05)、放射性膀胱炎(3.9%vs.1.3%;P<0.05)。结论对于淋巴结≥2 cm的局部晚期宫颈癌患者,后程缩野加量放疗疗效并不劣于同步加量放疗,但不良反应的发生率却明显低于后者。因此后程缩野加量放疗或可成为该部分患者的临床选择。     

双眼白内障同期行超声乳化术的效果观察

目的观察双眼白内障同期行超声乳化术的临床效果。方法随机将200例双眼白内障行超声乳化手术患者分为实验组100例,对照组100例。实验组采取同期手术:双眼手术间隔1天;对照组采取常规手术方法:双眼手术间隔6个月以上。术后随访1年,检测不同时间矫正视力,调查患者对治疗满意度,患者自我评价视觉质量。结果两组患者术后1周、1月、3月、6月分别查单眼矫正视力均提高,比较无统计学意义(P>0.05);试验组患者对治疗满意度明显提高,自我评价术后视觉质量较好,两组差异性比较(P<0.05)。结论双眼白内障同期行超声乳化术可保证治疗的安全及效果,并能有效提高患者生存质量。     

基于频繁项集和关联规则挖掘名老中医王行宽肝心同治胸痹心痛遣方规律

目的:挖掘名医王行宽辨治胸痹心痛的遣方规律。方法:收集王行宽教授近1年来在湖南中医药大学第一附属医院门诊收治的胸痹心痛患者医案267份,规范其中出现的中药术语,制定经方、验方判定标准,建立Excel数据库,运用Weka3.6软件,对药味进行描述性统计,采用Apriori算法对药味进行频繁项集分析,并对常用经方、验方进行频繁项集与关联分析。结果:王老辨治胸痹心痛善用经方,予小陷胸汤、瓜蒌薤白半夏汤、茯苓杏仁甘草汤等;活用古验方,遣生脉散、柴胡陷胸汤等;创"心痛治肝"之法,拟心痛灵系列(Ⅰ、Ⅱ、Ⅲ号),兼予平肝煎、养心安神饮等;项集支持度≥0.60的挖掘结果多为生脉散、小陷胸汤与活血通络药(丹参)或疏肝解郁药(柴胡)之间的配伍;生脉散==柴胡陷胸汤的关联可信度最高(0.97),且两方的项集支持度均≥0.66,昭示了生脉散合柴胡陷胸汤为王老临床肝心同治胸痹心痛的基本方。结论:"肝心同治,善用经方,活用验方"乃王老临床辨治胸痹心痛的遣方规律。     

Acid Volatile Sulfides and Simultaneously Extracted Metals in a Metal-Polluted Area of Taihu Lake,China

There were similar distribution characteristics for acid volatile sulfides (AVS) and simultaneously extracted metals (SEM) in surface sediments, and the concentrations of AVS and SEM decreased from the deposition area to the center of the bay (lake). The ratio of AVS to SEM was <1 in the surface sediments, indicating that heavy metals in surface sediments may be bioavailable. The concentration of AVS increased with sediment depth, followed by a decrease with large variation, while the concentration of SEM remained constant. By comparing the concentration of SEM with total metals, it was shown that extracted Cu and Ni decreased with sediment depth, indicating increasing association of Cu and Ni with sulfides in deeper sediment layers. The lower extracted ratios for Pb and Zn compared with sulfidic sediment illustrated that AVS should not have strong control on sediment Pb and Zn. The molar ratio of AVS and reactive iron showed that heavy metals were dynamic and active in sediments in this lake.     

HPLC法测定对羟基苯甲酸甲(丙)酯、阿斯巴甜

目的同时测定液态食品和可溶性固态食品中的对羟基苯甲酸甲(丙)酯、阿斯巴甜的含量。方法高效液相色谱法。结果样品加标回收率为91%~104.3%,RSD<3%。结论该法操作简单、方便,令人满意。