Implementation of a nurse-led family centered engagement intervention for caregivers of extremely premature infants in the neonatal intensive care unit

ObjectiveThe objective of this feasibility study was to examine the implementation and usefulness of an intervention for extremely premature infant (EPI) caregivers.ResultsOne caregiver and five nurses provided feedback with a mean score of 4.4 out of 5 pertaining to helpfulness.ConclusionsImplementation of the Caregiver's Guide was feasible and was positively received by NICU nurses and caregivers. We recommend implementing a revised version of this tool based on nurse and caregiver feedback. The delivery of education should be divided between dayshift and nightshift nurses so that one nurse is not responsible for providing all the information. The education should be categorized by gestational age and day of life and only given when it is pertinent to the care of the child. A section should be added to include a quick reference guide for the medical jargon used in the NICU.     

主动脉出口血压对左心室血流特性的影响

采用Mimics对心脏进行三维重构，用3-matic进行模型优化以及模型误差分析，对左心室室壁运动做速度分布假设，基于UDF宏文件对左心室室壁运动编写程序，将血液视为非牛顿流体，采用动网格技术研究不同血压对左心室血液流动的影响。模拟发现当左心室收缩时，压力梯度明显，内部压力减小。当左心室舒张时，内部压力逐渐增高。二尖瓣口处的速率先增大后减小。血压升高，左心室内剪切应力持续增大，极易破坏红细胞结构，产生溶血现象，导致心脏功能紊乱。     

中西医结合治疗卵巢储备功能减退患者成功妊娠二例并文献复习

卵巢储备功能减退（diminished ovarian reserve，DOR）是卵巢因素所致不孕症的主要原因之一，西医临床治疗方法主要依赖于口服提高卵巢储备功能的药物、人工激素周期替代疗法和辅助生殖技术助孕，中医运用补肾健脾法治疗DOR具有不良反应少、疗效持久、治疗手段多样化等优势。报告2例在常规西医治疗基础上应用中医补肾健脾法综合治疗DOR患者成功妊娠的情况，强调个体化中西医结合治疗方案对于解决疑难病证的重要性，为临床应用中医药治疗DOR患者提供证据。     

保乳术后放疗中钛夹动度与乳腺大小及钛夹位置的相关性

【摘要】目的:分析保乳术后放疗患者钛夹动度，并探讨其与乳腺大小、钛夹位置的相关性。方法:随机选取保乳术后放疗患者15例，每周两次锥形束CT。测量乳腺基底面直径（D）和乳高轴（H），以瘤床质心为原点将临床靶区分4个象限。记录各象限内钛夹在左右、腹背、头脚方向动度（MLR、MAP、MSI）以及其与临床靶区最内、最前、最上的距离（DSLR、DSAP、DSSI）。结果:MLR、MAP、MSI分别为（2.2±3.0）、（-1.1±3.6）、（0.8±4.7） mm；系统误差Σ在左、右、腹、背、头、脚分别为1.7、2.2、2.0、2.4、2.9、3.0 mm，随机误差σ分别为2.4、4.0、3.2、4.0、4.7、4.7 mm；靶区对应外放5.9、8.3、7.2、8.8、10.5、10.9 mm。一象限内，当D×H<99.89 cm2，MAP和D×H强相关（r=0.805），MLR、MAP均和DSLR、DSAP、DSSI强正相关（r=0.94, 0.94, 0.91；0.87, 0.91, 0.92），MSI和DSLR、DSAP强正相关（r=0.91, 0.94）；四象限内，当D×H<90.71 cm2，MAP和DSLR，MSI和DSAP均强负相关（r=-0.96；-0.95），MLR和DSLR强正相关（r=0.91）。结论:钛夹动度有各向异性，以SI方向外扩最大，并易受乳腺大小、钛夹位置影响。     

The potential role of assisted oocyte activation in the management of a POSEIDON group 3 patient with fertilization failure: A case report and literature review

ObjectiveAssisted oocyte activation combined with ICSI (ICSI-AOA) has been reported to improve fertilization outcomes of couples with oocyte activation deficiency (OAD). Although there's no sufficient evidence to support ICSI-AOA as routine use, it might be beneficial for POSEIDON group 3 patients with suspected oocyte-related OAD.Case reportA 29-year-old female presented with a history of primary infertility for two years. She was classified as a POSEIDON group 3 patient and had a total fertilization failure history. With the help of ICSI-AOA, six oocytes were successfully fertilized. Pregnancy was later confirmed after embryo transfer. A living infant was born after 34 weeks of pregnancy.ConclusionOAD should be taken into consideration for POSEIDON group 3 patients since low Antimüllerian hormone is associated decreased quality. Further research needs to be done to understand the mechanism underlying oocyte-related OAD and the potential role of ICSI-AOA in young patients with suboptimal ovarian response.     

基于心冲击信号的心率检测方法

针对现有基于心冲击描记图进行心率检测存在的抗干扰性不足问题，提出一种鲁棒的心率检测模型，首先对原始信号中受干扰的片段进行补偿重构，然后将J峰作为特征波形，通过基于J峰频段的滤波与差分增强处理放大特征，并设计改进的峰值提取算法定位心跳点，进而得到心率估计值。实验结果表明，所用模型对于不同情形下的心冲击描记图信号均表现出良好的适应性，逐拍检测平均覆盖率为98.3%，平均准确率为98.4%。心率输出结果与金标准一致性高，误差范围控制在[±]5%以内，且运算实时性好，可以为临床或家庭保健提供良好的心率检测方案。     

放疗计划系统DeepPlan光子放疗剂量计算的临床可行性验证

目的:评估DeepPlan放疗计划系统患者计划剂量计算的准确性和临床应用的可行性。方法:剂量算法准确性评估主要是针对YY 0775号和YY/T 0889号报告中的例题内容进行测量验证。临床病例验证是基于Pinnacle计划系统设计的前列腺肿瘤患者9例、胸部肿瘤患者13例和头颈部肿瘤患者5例，试验将各病例原计划优化的子野等信息直接导入DeepPlan进行重新剂量计算，比较不同计划系统得到的靶区和危及器官剂量分布，并用PTW VeriSoft软件对两组计算结果进行全空间剂量γ分析。结果:DeepPlan光子剂量算法通过了剂量计算准确性验证，YY 0775号报告中所有测试例题误差均在2%以内。YY/T 0889号报告中所有患者计划的γ通过率均在96.8%以上，复合野的γ通过率平均值为98.1%。在病例验证中，前列腺肿瘤病例的等中心层面2D γ通过率平均值为97.6%，3D γ通过率平均值为96.9%。胸部肿瘤病例的等中心层面2D γ通过率平均值为98.7%，3D γ通过率平均值为98.3%。头颈部肿瘤病例的中间层面2D γ通过率为98.6%，3D γ通过率平均值为98.8%。结论:通过模体实际测量和临床病例测试，验证了DeepPlan光子放疗剂量计算的准确性和临床应用的可行性。