既往脑梗死人群生活方式、用药情况及中医证候要素分析

目的:分析既往脑梗死人群的生活方式及用药情况,探讨其中医证候特点,为脑梗死的防治提供依据。方法:采用临床横断面流行病学调查研究的方法,于2012年12月至2013年12月在北京市丰台区方庄、花乡社会卫生服务中心收集既往脑梗死含短暂性脑缺血发作患者447例,记录其人口学特征、生活方式、用药情况及中医证候量表。结果:目前仍在吸烟男性占46.71%,女性占7.46%,经常饮酒的男性占28.95%,女性占2.71%,仍在吸烟、经常饮酒的男性数量明显大于女性(P0.01);口味偏油的男性占17.11%,女性占9.15%,男性数量明显大于女性(P0.05);常喝牛奶或酸奶的男性占29.61%,女性占43.39%,男性数量明显小于女性(P0.01);筛查人群合并高血压病的人群占72.71%,合并血脂异常的男性占54.61%,女性占68.81%,男性数量明显小于女性(P0.01),合并糖尿病的人群占31.54%;服用降压药人群与患高血压病的人群比率为85.85%,服用降脂药人群与患血脂异常的人群比率为40.56%,服用降糖药人群与患糖尿病的人群比率为84.40%;既往脑梗死人群中医证候要素分布情况:痰湿70.25%,气虚39.82%,阴虚21.25%,内火15.21%,内风8.95%,血瘀6.71%。结论:既往脑梗死人群生活方式、用药情况需要改进,存在药物使用不合理的现象。     

超声造影技术在脑灌注成像中的应用及进展

脑组织灌注是评估脑组织微循环的常用指标，在卒中、癫痫、阿尔茨海默病及颅内占位性病变等的评价中都有重要应用，超声造影脑灌注成像具有实时、便捷、过敏反应少等优点，其相关研究日趋增多。     

磁共振成像评估高血压性脑出血患者血肿中的铁水平及其临床价值

目的 探讨磁共振成像对高血压性脑出血患者血肿中的铁水平的评估及其临床价值。方法 研究对象选取本院2018年10月-2019年10月收治的高血压性脑出血患者100例,将其设为研究组,选取同期体检健康者100例,设为对照组,均对其进行磁共振成像(MRI)检查。结果 研究组收缩压、舒张压、血红蛋白、血清铁蛋白、转铁蛋白水平、NIHSS评分明显高于对照组(P<0.05); 研究组左、右基底节,左、右丘脑,左、右额颞等部位的铁沉积水平明显高于对照组(P<0.05); 左基底节、右基底节、左丘脑、右丘脑、左额颞和右额颞的角弧度值与血肿体积、收缩压、NIHSS评分呈明显正相关(0<r<0.8,P<0.05)。结论 高血压性脑出血患者血肿中的铁水平随血压、血肿体积、NIHSS评分的升高而升高,可将出血区域的角弧度值作为评估铁过量的指标     

脑卒中高危人群高同型半胱氨酸血症影响因素及中医证候研究

目的:研究脑卒中高危人群高同型半胱氨酸血症(Hyperhomocysteinemia,HHcy)的患病情况,并分析其危险因素,及与其颈动脉超声结果的相关性。方法:采用横断面流行病学调查的方法,将纳入的5 999例脑卒中高危人群分为HHcy组与无HHcy组,比较2组患者人口学资料、危险因素、生化化验结果、颈动脉超声检查结果的差异。结果:HHcy组患者脑卒中、高血压的患病率高于无HHcy组,TIA、血脂异常、糖尿病的患病率低于无HHcy组(P0.01)。多因素Logistic回归显示年龄、BMI、HDL、吸烟、饮酒是HHcy的危险因素。HHcy组颈动脉斑块形成的比例高于无HHcy组,多发斑块的比例高于无HHcy组,单发斑块或无斑块的比例低于无HHcy组。HHcy组的内火、痰湿证候要素所占的比例较高,无HHcy组的患者内风、气虚、阴虚所占的比例较高。结论:HHcy与脑卒中、高血压病有关,与颈动脉斑块形成有关,年龄、BMI、吸烟、饮酒是HHcy的危险因素。     

医师在构建和谐医患关系中的作用

近年来,我国医疗机构医患纠纷日益增多。产生医患纠纷的原因是复杂的、多因素的,既有医方因素,也有患方因素,还有社会因素等。构建和谐的医患关系,医师是主导,其不仅影响双方的心理需要和行为,而且直接影响患者疾病的治疗效果与康复状况。医师应从强化业务水平、提高沟通能力、转变服务理念等方面入手,取得患者的信任,从而在构建融洽的医患关系中发挥主导作用。     

Aspirin does not affect hematoma growth in severe spontaneous intracranial hematoma

Hematoma growth (HG) affects the prognosis of patients with spontaneous intracranial hematoma (ICH), but there is still a lack of evidence about the effects of aspirin (acetylsalicylic acid, ASA) on HG in patients with severe ICH. This study retrospectively analyzed patients with severe ICH who met the inclusion and exclusion criteria in Beijing Tiantan Hospital, Capital Medical University, between January 1, 2015, and July 31, 2019. Severe ICH patients were divided into ASA group and nASA groups according to ASA usage, and the incidence of HG between the groups was compared. Univariate analysis was performed by the Mann–Whitney U test, chi-square test, or Fisher exact test. Multivariate logistic regression analysis was used to analyze the impact of ASA on HG and to screen for risk factors of HG. In total, 221 patients with severe ICH were consecutively enrolled in this study. There were 72 (32.6%) patients in the ASA group and 149 patients in the nASA group. Although the incidence of HG in the nASA group was higher than that in the ASA group (34.9% VS 22.2%, p?=?0.056), ASA did not significantly affect the occurrence of HG (p?=?0.285) after adjusting for initial hematoma volume, high blood pressure at admission, coronary heart disease, and GCS at admission. In addition, we found that high blood pressure at admission was a risk factor for HG. Prior ASA does not increase the incidence of HG in severe ICH patients, and high blood pressure at admission is a risk factor for HG.

     

One-time sintering process to synthesize ZrO2-coated LiMn2O4 materials for lithium-ion batteries

Herein, different amounts of ZrO₂-coated LiMn₂O₄ materials are successfully prepared by one-time sintering ZrO₂-coated Mn₃O₄ and Li₂CO₃. Scanning and transmission electron microscopy results confirm that the ZrO₂ coating layer on the surface of Mn₃O₄ can still be maintained on the surface of the final LiMn₂O₄ particles even after long-term high-temperature heat-treatment. Three key factors to realize ZrO₂-coated LiMn₂O₄ materials via the one-time sintering process are as follows: (i) the Mn₃O₄ precursor is coated by ZrO₂ in advance; (ii) the ionic radius of Zr⁴⁺ is much larger than those of Mn³⁺ and Mn⁴⁺; (iii) the pre-calcination temperature is set in the reaction temperature range between Li₂CO₃ and Mn₃O₄ and lower than that between Li₂CO₃ and ZrO₂. The 3 wt% ZrO₂-coated LiMn₂O₄ material exhibits excellent electrochemical properties with an initial specific discharge capacity of 118.8 mA h g⁻¹ and the capacity retention of 90.1% after 400 cycles at 25 °C and 88.9% after 150 cycles at 55 °C. Compared with the conventional coating method, the one-time sintering process to synthesize ZrO₂-coated LiMn₂O₄ materials is very simple, low-cost, environmentally friendly, and easy to scale up for large-scale industrial production, which also provides a valuable reference for preparing other coating-type cathode materials for lithium-ion batteries.

A facile one-time sintering process was used to synthesize ZrO₂-coated LiMn₂O₄ to greatly enhance its cycling performance.     

三维超声断层成像技术评价胎儿肛门直肠发育的价值

目的应用三维超声断层成像技术（TUI）评价产前超声对胎儿肛门直肠发育的诊断价值,从而为产前超声诊断肛门闭锁提供更加丰富的诊断信息。 方法选取2017年6月至2018年7月首都医科大学附属北京天坛医院315例正常单胎孕妇,年龄23~40岁,平均年龄（29±3）岁,孕周为19~40周。应用TUI技术分别测量胎儿肛门括约肌直径（ASD）、肛管直径（ACD）及肛管长径（ACL）。各测量值与孕周之间的关系采用Pearson相关分析,取得ASD、ACD及ACL与孕周的相关性,建立回归方程及曲线。采用组内相关系数（ICC）及其95%可信区间（95% CI）观察对ASD、ACD及ACL测量的可重复性,以此评价测量的可靠性。 结果所有胎儿应用TUI技术胎儿肛门直肠部位显示率为97.8%（308/315）,Pearson相关分析结果表明,正常胎儿ASD、ACD及ACL与胎儿孕周呈正相关。回归方程分别为：ASD：Y=-0.001X²＋0.421X-1.726（r=0.83,P<0.01）;ACD：Y=0.418X-4.207（r=0.89,P<0.01）;ACL：Y=0.526X-1.062（r=0.87,P<0.01）。 结论TUI技术评价胎儿肛门直肠结构的发育可作为产前观察胎儿肛门直肠结构的一种方法,应用该方法可以提高胎儿肛门直肠结构的显示率。     

脑室外脉络丛肿瘤MRI表现北大核心CSCD

目的观察脑室外脉络丛肿瘤MRI表现。方法回顾性分析49例脑室外脉络丛肿瘤患者,包括大脑实质内肿瘤8例、幕下脑室外肿瘤30例及鞍区肿瘤11例,观察其MRI表现。结果大脑实质内脉络丛肿瘤均呈囊实性,实性部分多呈粗颗粒结节状,部分边缘呈分叶状,瘤周水肿较重,无明显脑积水。幕下脑室外脉络丛肿瘤呈实性或囊实性,实性肿块内可见囊变、钙化、出血及流空血管影,亦可伴脑积水。鞍区原发性脉络丛肿瘤可见囊腔及颗粒状壁结节,继发肿瘤则多为实性团块。结论不同部位脑室外脉络丛肿瘤MRI表现各异,有助于诊断。