紫杉醇药物涂层球囊成形术治疗症状性椎动脉开口处狭窄的疗效

目的 探讨紫杉醇药物涂层球囊（P-DCB）成形术治疗症状性椎动脉开口狭窄的安全性和有效性。方法 回顾性分析2017 年12月至2019年6月经P-DCB成形术治疗的43例症状性椎动脉开口处狭窄的临床资料。结果 所有病人均完成介入治疗，成功率为100%。术后即刻狭窄率[（12.03±2.15）%]较术前[（86.32±10.26）%]明显降低（P<0.05）。围手术期发生动脉夹层1例，无其他并发症。随访12~16个月，平均13.5个月；症状改善43例，无变化例，症状改善率为95.3%（41/43）；全部病人接受DSA或CTA随访，随访狭窄率[（16.1±3.12）%]与术后即刻无统计学差异（P>0.05）；5例发生再狭窄，再狭窄率为11.6%。结论 P-DCB成形术治疗椎动脉开口狭窄具有较好的临床疗效。     

基于中医古籍文献的升降散应用溯源及探析

通过对中医古籍中有关升降散论述的文献梳理,全面探讨其内涵。本方是在大黄、僵蚕为雏形的基础上增加蝉蜕、姜黄而成方,几经易名,终在杨璿《伤寒瘟疫条辨》中为后人所熟知。本方广泛用于治疗瘟疫,以丸剂、散剂为主,方便携带,便于服用;重用大黄旨在祛邪、逐秽;应用时视人之体质强弱和量其毒之轻重而判断用药多寡,并辅以米酒、生蜜等以顾护正气。杨璿将其由治疗“热疫”的专方扩展为治疗“表里三焦大热”的通用方剂,扩大了本方治疗疾病范围。     

Pediatric cardiac computed tomography angiography: Expert consensus from the Filiale de Cardiologie Pédiatrique et Congénitale (FCPC) and the Société Française d’Imagerie Cardiaque et Vasculaire diagnostique et interventionnelle (SFICV)

This article was designed to provide a pediatric cardiac computed tomography angiography (CCTA) expert panel consensus based on opinions of experts of the Société Française d’Imagerie Cardiaque et Vasculaire diagnostique et interventionnelle (SFICV) and of the Filiale de Cardiologie Pédiatrique Congénitale (FCPC). This expert panel consensus includes recommendations for indications, patient preparation, CTA radiation dose reduction techniques, and post-processing techniques. The consensus was based on data from available literature (original papers, reviews and guidelines) and on opinions of a group of specialists with extensive experience in the use of CT imaging in congenital heart disease. In order to reach high potential and avoid pitfalls, CCTA in children with congenital heart disease requires training and experience. Moreover, pediatric cardiac CCTA protocols should be standardized to acquire optimal images in this population with the lowest radiation dose possible to prevent unnecessary radiation exposure. We also provided a suggested structured report and a list of acquisition protocols and technical parameters in relation to specific vendors.     

沙苑子本草考证

沙苑子为我国常用中药,药用历史悠久。通过查阅本草文献,对沙苑子名称、基原、功效、产地及伪品5个方面进行考证,得知其名称演变大致经过"白蒺藜""沙苑蒺藜""沙苑子"3个阶段;历代本草记载沙苑子基原为扁茎黄芪的干燥成熟种子,古今应用品种基本一致;沙苑子补肾固精功效的记载自宋《本草衍义》起逐渐清晰明确;沙苑子道地产区自宋时起为陕西沙苑,明清时期产地逐渐转到陕西潼关、山西等地,建国后以陕西省为主向北扩散,以陕西潼关为佳;沙苑子建国前有马薸子、色微绿伪品及紫云英子等混伪品,建国后有紫云英、猪屎豆、华黄芪和直立黄芪的种子等混伪品。为沙苑子正本清源,并为其进一步深入开发提供参考。     

Geographical Origin and Level Identification of Frankincense Based on Hyperspectral Image

Background: As the demand for traditional Chinese medicinal materials increases in China and even the world, there is an urgent need for an effective and simple identification technology to identify the origin and quality of the latter and ensure the safety of clinical medication. Mineral element analysis and isotope finger-printing are the two commonly used techniques in traditional origin identification. Both of these techniques require the use of stoichiometric methods in the identification process. Although they have high accuracy and sensitivity, they are expensive and inefficient. In addition, near-infrared spectroscopy is a fast, nondestructive, and widely used identification technique developed in recent years, but its identification results are susceptible to samples’ states and environmental conditions, and its sensitivity is low. Hyperspectral imaging combines the advantages of imaging technology and optical technology, which can simultaneously access the image information and spectral information which reflect the external characteristics, internal physical structure, and chemical composition of the samples. Hyperspectral imaging is widely applied to agricultural product inspection, but research into its application in origin and quality identification of TCM materials is rare. Methods: In this study, the algorithm framework discriminative marginalized least squares regression (DMLSR) was used for feature extraction of frankincense hyperspectral data. The DMLSR with intraclass compactness graph and manifold regularization can efficiently learn the projective samples with higher separability and less redundant information than the original samples. Then, the discriminative collaborative representation with Tikhonov regularization (DCRT) was applied for classifying the geographical origin and level of frankincense. DCRT introducesthe discriminant regularization term and incorporates SID, which is more sensitive to the spectrum as the measurement method and is more suitable for the frankincense spectral data compared with SVM. Results: For the origin classification task, samples of all levels from each origin were, respectively, selected for three?way classification. We used 10-fold cross-validation to select a model parameter in the experiment. When obtaining the optimal parameters, we randomly selected the training set and testing set, where the training set accounts for 70% and the training set for 30%. After repeating this random process 10 times, we obtained the final average classification accuracy, which is higher than 90%, and the standard deviation fluctuation is usually small. For the level classification task, samples of each level from three origins were separately selected for multiclassification. We randomly selected the training set and testing set from each origin. The level classification results of the three origins are good on D4350 data, and the classification accuracy of each level is basically above 80%. Conclusion: Experiments and analysis show that our algorithm framework has excellent classification performance, which is stable in origin classification and has potential for generalization. In addition, the experiments show that in our algorithm framework, different classification tasks need to combine different data sources to achieve better classification and recognition, as the origin classification task uses frankincense’s D3000 data, and level classification task uses frankincense’s D4350 data.     

溯本源流论围药

箍围法是中医外科的一种独特疗法,具有悠久的历史,本文就其概念、历史沿革进行探索,以引起重视.     

生化汤源流及后世应用考

阐述生化汤源流及其功用 ,对傅氏活用生化汤的经验做了简要分析 ,从以病论方、以证论方、以药论方三方面总结现代应用生化汤的状况 ,初步探索生化汤的临床应用规律。     

前扣带束的应用解剖定位

为了提高立体定向扣带束毁损术的疗效,本文对30例(60侧)成人正常脑标本探索在大脑原点前、扣带束毁损术最佳靶点的位置、坐标值及其毗邻关系。研究结果认为最佳手术部位应选择在原点前12mm处,该束高度为4.40±4.20mm、宽度为6.60±3.06mm、中心点距x轴的坐标值为6.30±2.20mm、该处扣带束的最低点与侧脑室前角的最高点间的距离为4.00±3.40mm,供临床参考。