fMRI、PET和MSI在脑肿瘤诊断和治疗中的应用

脑肿瘤手术的目的是最大化地切除肿瘤的同时保存重要的脑功能区,提高患者生存期和生活质量。综合运用各种功能检查方法,可对脑肿瘤的形态、血流动力学状态等以及相邻重要功能区进行评价．有助于手术医生制订合理的手术方案和帮助临床医生观察治疗效果、判断预后等。本文就fMRI、PET和MSI在脑肿瘤诊断和治疗中的应用作一综述。     

经阴道三维能量多普勒超声定量分析卵巢肿块的良恶性

［摘要］ 目的　探讨经阴道三维能量多普勒超声（three-dimensional power Doppler transvaginal ultrasound,3DPD-TVS）定量分析卵巢肿块血流灌注参数并评估其鉴别卵巢肿块良恶性的价值．方法　应用3DPD-TVS对101个卵巢肿块进行检查并测量以下参数:阻力指数（resistance index,RI）、血管化指数（vascularization index,VI）、血流指数（flow index,FI）、血管化血流指数（vascularization flow index,VFI）,分析数据并与术后病理结果对照．结果　卵巢肿块恶性组VI、FI、VFI值明显高于良性组［（1.57±2.37）vs （5.10±4.68）、（35.53±7.91）vs（40.92±6.82）、（0.61±0.99）vs（2.18±2.06）］,差异有统计学意义（P＜0.05）;而2组间比较,RI无明显差异（P＞0.05）．结论　经阴道三维能量多普勒超声能较客观定量分析卵巢肿块的血供情况,为鉴别卵巢肿块良恶性提供一定的参考价值．     

Dietary Sodium Intake Is Positively Associated with Sugar-Sweetened Beverage Consumption in Chinese Children and Adolescents

Sugar-sweetened beverage (SSB) consumption among children and adolescents is steadily increasing in China, while the main taste of Chinese food is salty. The present study aimed to determine the relationships between SSB and total fluid consumption and dietary sodium and salt intake among children and adolescents in China. The data were obtained from a cross-sectional investigation in 2015. A total of 3958 participants were included. A 24-h dietary record for three consecutive days was collected to determine the SSB intake and food consumption across school days and rest days. After adjusting for age, sex, yearly household income, maternal education, intentional physical exercise, and instances of eating out in the last week, the dietary sodium intake was positively associated with the SSB consumption (p < 0.05), but salt was not. After stratifying by sex, grades, and puberty status, the associations between dietary sodium intake and SSB consumption were significant in girls, in grades 1–5 and before puberty (p < 0.05). Dietary sodium intake was positively associated with SSB consumption in Chinese children and adolescents, particularly in young children. A reduction of the sodium intake might help reduce SSB consumption among children and adolescents.     

Clinical study on anti-aging action of herbal cake-partition moxibustion

目的：探讨隔药饼灸抗衰老的t临床疗效和免疫学机理。方法：采用隔药饼灸治疗223例老年人，观察隔药饼灸治疗前及治疗1疗程结束后衰老见症积分值，并检测血T淋巴细胞亚群、IL-2和D-内啡肽的变化。结果：223例老人经灸治后，衰老积分明显下降，在临床症状改善同时细胞免疫功能增强，T淋巴细胞总数增加，CD4＋／CD8＋比值恢复正常，IL-2合成分泌增加。β-EP作为免疫调节的神经介质，灸治后明显提高。结论：衰老过程与免疫功能密切相关。艾灸能纠正异常免疫状态、稳定机体内环境达到延缓衰老目的。     

血源性乙肝疫苗远期免疫效果研究

[目的]通过评价新生儿血源性乙肝疫苗免疫后的远期保护效果,为进一步完善乙肝免疫预防策略提供依据。[方法]采用三层抽样方法,从上海市2个区1986-1996年出生的有全程血源性乙肝疫苗接种史的人群中抽取2692人作为调查对象,按免疫后不同时间分11个组,进行问卷调查,并采集静脉血进行乙肝表面抗体（anti—HBs）定量、乙肝表面抗原（HBsAg）与乙肝核心抗体（anti-HBc）检测。[结果]HBsAg阳性率平均为1．75％,未见随年龄增加而上升的趋势。anti—HBc阳性率平均为3．64％,呈随年龄增长而上升趋势。anti—HBs阳性率平均为40．16％;18岁以下青少年anti—HBs阳性率随年龄增长而下降,19岁以上者anti—HBs阳性率随年龄增长而上升。15～19岁组人群anti-HBs阴性率最高（66．80％）。多因素分析显示母亲孕期乙肝e抗原（HBeAg）阳性、家庭成员HBsAg阳性、男性、年龄增大是青少年感染乙肝的危险因素。[结论]血源性乙肝疫苗具有较持久的保护效果。建议开展15岁以上人群的定期随访,对anti—HBs阴性者需加强免疫。     

基于COM-B模型的心力衰竭患者移动健康平台的构建与应用

目的构建基于COM-B模型的移动健康平台,并评价其对心力衰竭患者自我管理的影响。方法通过文献检索及专家咨询初步构建心力衰竭患者的移动健康平台,包含健康信息传播模块、自我管理反馈模块、护患沟通支持模块、门诊随访助手4个模块。将207例患者随机分为干预组105例和对照组102例。对照组实施心力衰竭常规护理;干预组在此基础上,使用移动健康平台实施护理。干预6个月后,评价两组患者的心力衰竭知识水平、自我护理能力、服药依从性。结果干预后,干预组心力衰竭知识水平、自我护理能力及服药依从性评分显著高于干预前;且与对照组比较,差异有统计学意义(均P0.01)。结论基于COM-B模型的心力衰竭移动健康平台可以提高心力衰竭患者的心力衰竭知识水平、自我护理能力及服药依从性,实现便捷、有效、低成本的心力衰竭慢病延续管理。     

老年人膳食平衡指数的建立及验证

目的建立适用于老年人的膳食平衡指数(E-DBI-16),并验证E-DBI-16的可靠性。方法依据《中国居民膳食指南(2016)》、《中国老年人膳食指南(2016)》及《中国居民膳食营养素参考摄入量(2013)》,参考中国膳食平衡指数(DBI-16)的框架,采用分段取值的评分方法构建E-DBI-16。通过《中国居民膳食指南(2016)》中的老年人推荐食谱及上海市老年居民食物摄入资料,对其可靠性进行验证。结果构建了符合老年人特征的E-DBI-16,《中国居民膳食指南(2016)》中的推荐食谱被E-DBI-16评为适宜(0~14分),老年人膳食能量以及营养素摄入与E-DBI-16的负端分、膳食质量距呈负相关,与正端分呈正相关,差异有统计学意义(均P<0.001),且高能量、高蛋白质膳食和高能量、高脂肪膳食在正端分评价为无摄入过量的比例非常低,多数为较适宜或过量;在负端分和膳食质量距中评价为失衡的比例均超过90%。结论E-DBI-16能较好地反映老年人的膳食质量和实际膳食摄入状况。     

补肾活血中药治疗慢性肾功能不全30例

为探讨中药治疗慢性肾功能衰竭（CRF）的方法与疗效。以自拟益气补肾活血降浊方（主要药物：黄芪、丹参、山药、泽泻、大黄、益母草、生山楂、车前草）治疗CRF30例，观察治疗3个月前后临床症状及肾功能的变化，并与包醛氧淀粉治疗对照组30例比较，结果治疗组的临床症状改善率（99.6%）与肾功能改善率（77％），治疗组优于对照组（P＜0.05-0.01）。提示：补肾活血中药对CRF有效好疗效。     

Perihematomal endothelin-1 level is associated with an increase in blood-brain barrier permeability in a rabbit model of intracerebral hematoma

Background Endothelin-1 (ET-1) has deleterious effects on water homeostasis,cerebral edema,and blood-brain barrier (BBB) integrity.Highly expressed ET-1 was observed after intracerebral hemorrhage (ICH...     

Alcohol consumption and metabolic syndrome among Shanghai adults： A randomized multistage stratified cluster sampling investigation

AIM： To examine the relations of alcohol consumption to the prevalence of metabolic syndrome in Shanghai adults. METHODS： We performed a cross-sectional analysis of data from the randomized multistage stratified cluster sampling of Shanghai adults, who were evaluated for alcohol consumption and each component of metabolic syndrome, using the adapted U.S. National Cholesterol Education Program criteria. Current alcohol consumption was defined as more than once of alcohol drinking per month. RESULTS： The study population consisted of 3953 participants （1524 men） with a mean age of 54.3 ± 12.1 years. Among them, 448 subjects （11.3%） were current alcohol drinkers, including 405 males and 43 females. After adjustment for age and sex, the prevalence of current alcohol drinking and metabolic syndrome in the general population of Shanghai was 13.0% and 15.3%, respectively. Compared with nondrinkers, the prevalence of hypertriglyceridemia and hypertension was higher while the prevalence of abdominal obesity, low serum high-density-lipoprotein cholesterol （HDL-C） and diabetes mellitus was lower in subjects who consumed alcohol twice or more per month, with a trend toward reducing the prevalence of metabolic syndrome. Among the current alcohol drinkers, systolic blood pressure, HDL-C, fastingplasma glucose, and prevalence of hypertriglyceridemia tended to increase with increased alcohol consumption. However, low-density-lipoprotein cholesterol concentration, prevalence of abdominal obesity, low serum HDL-C and metabolic syndrome showed the tendency to decrease. Moreover, these statistically significant differences were independent of gender and age.CONCLUSION： Current alcohol consumption is associated with a lower prevalence of metabolic syndrome irrespe- ctive of alcohol intake （g/d）, and has a favorable influence on HDL-C, waist circumference, and possible diabetes mellitus. However, alcohol intake increases the likelihood of hypertension, hypertriglyceridemia and hyperglycemia. The clinical signi