生成式对抗网络在医学图像处理中的应用

近年来,研究人员将众多领域方法引入到医学图像处理中。经过不断改进,医学图像处理算法的效果和效率均得到不同程度的提高。目前,生成式对抗网络(GAN)在医学图像处理领域中的应用研究发展迅速。本文主要综述了GAN在医学图像处理中的应用研究情况,介绍了GAN的基本概念,并从医学图像降噪、检测、分割、合成、重建和分类等六个方面对GAN应用研究的最新进展进行了归纳总结,最后对该领域中值得进一步研究的方向进行了展望。     

An Italian matrix sentence test for the evaluation of speech intelligibility in noise

Objective: Development of an Italian matrix sentence test for the assessment of speech intelligibility in noise. Design: The development of the test included the selection, recording, optimization with level adjustment, and evaluation of speech material. The training effect was assessed adaptively during the evaluation measurements with six lists of 20 sentences, using open- and closed-set response formats. Reference data were established for normal-hearing listeners with adaptive measurements. Equivalence of the test lists was investigated using the open-set response format at three signal-to-noise ratios (SNRs). Study sample: A total of 55 normal-hearing Italian mother-tongue listeners. Results: The evaluation measurements at fixed SNRs resulted in a mean speech reception threshold (SRT) of ? 7.3 ± 0.2 dB SNR and slope of 13.3 ± 1.2 %/dB. The major training effect of 1.5 dB was observed for the first two consecutive measurements. Mean SRTs of ? 6.7 ± 0.7 dB SNR and ? 7.4 ± 0.7 dB SNR were found from the third to the sixth adaptive measurement for open- and closed-set test response formats, respectively. Conclusions: A good agreement has been found between the SRTs and slope and those of other matrix tests. Since sentences are difficult to memorize, the Italian matrix test is suitable for repeated measurements.     

Steroid-based treatments for patients with total sudden sensorineural hearing loss

Conclusions: In patients with total sudden sensorineural hearing loss (SSNHL), oral prednisone (OP) alone or intratympanic dexamethasone (ITD) alone have comparable results. The addition of salvage ITD following OP does not seem to add over either single modality treatment. Objectives: To study the effect of steroid-based treatments in patients with total SSNHL. Methods: The medical charts of 59 patients with total loss of hearing, defined as pure tone thresholds in the profound range (> 90 dB) with an unobtainable speech reception threshold (SRT) that were treated with OP (n = 20), ITD (n = 13), or OP followed by salvage ITD (n = 26) were analyzed. Response to treatment was evaluated by means of pure tone thresholds, SRT, and speech discrimination score (SDS), immediately after treatment and on a follow-up visit. Results: Forty-nine patients (83%) responded to treatment, with mean significant improvements of 36, 34, 31, and 25 dB at 500, 1000, 2000, and 4000 Hz, respectively. The mean improvement in SRT was 33 dB, and SDS improved by 32%. There were no differences in improvement in pure tone thresholds and SRT among the three treatment groups. The late effect of OP was similar to the effect of salvage ITD.     

Longitudinal Study of Changes in Speech Perception between 70 and 81 Years of Age

As part of a large gerontological study in Göteborg, Sweden, 376 randomly selected men and women born in 1901–1902 underwent pure-tone and speech audiometry at the age of 70 years in 1971-1972. The survivors of the 1901–1902 cohort were tested again at the ages of 75, 79 and 81 years. A second group consisting of 297 men and women born in 1906 was also tested with pure-tone and speech audiometry at the ages of 70 and 75 years. We found that the median speech discrimination scores for the 1901–1902 cohort decreased moderately with increasing age: between the ages of 70 and 81 years scores decrease 10% for men and 8% for women for the worse ear and 7 and 6% for the better ear in this group. The median speech reception threshold increased 15 dB over the 11-year period for both men and women, an increase in good agreement with the increase in the pure-tone threshold over this period. Those born in 1906 had a slightly lower discrimination score (4%) when tested at the age of 70 years compared to those born in 1901 tested at the same age. As many as half of the 81-year-old persons would have a theoretical benefit from hearing aid amplification.     

A Spanish matrix sentence test for assessing speech reception thresholds in noise

Objective: To develop, optimize, and evaluate a new Spanish sentence test in noise. Design: The test comprises a basic matrix of ten names, verbs, numerals, nouns, and adjectives. From this matrix, test lists of ten sentences with an equal syntactical structure can be formed at random, with each list containing the whole speech material. The speech material represents the phoneme distribution of the Spanish language. The test was optimized for measuring speech reception thresholds (SRTs) in noise by adjusting the presentation levels of the individual words. Subsequently, the test was evaluated by independent measurements investigating the training effects, the comparability of test lists, open-set vs. closed-set test format, and performance of listeners of different Spanish varieties. Study sample: In total, 68 normal-hearing native Spanish-speaking listeners. Results: SRTs measured using an adaptive procedure were 6.2 ± 0.8 dB SNR for the open-set and 7.2 ± 0.7 dB SNR for the closed-set test format. The residual training effect was less than 1 dB after using two double-lists before data collection. Conclusions: No significant differences were found for listeners of different Spanish varieties indicating that the test is applicable to Spanish as well as Latin American listeners. Test lists can be used interchangeably.     

医院门诊处方质量控制抽样体系的研究及构建

目的：探究医院门诊处方点评过程中,科学的处方抽样方法。方法：通过引入GB/T 2828.1-2012国家抽样标准,结合随机抽样理论,采用SPSS13.0统计软件包Rv.Normal功能辅助完成抽样过程。结果：结合处方抽样实例,通过科学抽样体系,实践抽样过程,为门诊处方点评工作实现科学抽样提供理论依据。结论：该抽样方法能够提高处方抽样的科学性,使门诊处方点评结果更能体现医院处方总体质量。     

Giving and receiving social support in online substance use disorder forums: How self-efficacy moderates effects on relapse

ObjectiveIndividuals in recovery for substance use disorders (SUDs) increasingly use online social support forums, necessitating research on how communicating through these forums can affect recovery. This study examines how giving and receiving support within an SUDs recovery forum predict substance use, and considers whether effects vary according to participants’ self-efficacy.MethodsWe applied content analysis to 3440 messages that were posted by 231 participants in an online SUDs forum. Surveys assessed social support reception and substance use at three timepoints. We assessed relationships between giving and receiving support and substance use (risky drinking days, illicit drug use days), and the interactions between self-efficacy and social support in predicting substance use outcomes.ResultsReceiving more emotional support was associated with reduced illicit drug use at 6 and 12 months. For those with low self-efficacy, giving more emotional support predicted less risky drinking at month 12, whereas giving more informational support predicted more risky drinking at month 12.ConclusionThese results suggest conditional benefits of exchanging support in an online SUDs forum, depending upon type of support (informational versus emotional), the participants’ role (giver or receiver), and their self-efficacy.Practice implicationsWe discuss implications for designing and using peer-to-peer support platforms.     

阴道超声评估不孕妇女子宫内膜容受性的价值研究

目的:探讨阴道超声评估子宫内膜容受性的价值。方法:对1680例处于排卵期的不孕症患者,应用阴道超声检测卵泡大小、内膜厚度,并按照内膜超声图像分为A、B、C3型,将子宫内膜厚度、类型与妊娠结局进行对照分析。结果:A型内膜占66.07%,妊娠率12.61%;B型内膜占25.00%,妊娠率9.52%;C型内膜占8.93%,妊娠率6.67%。各组成功妊娠的内膜类型以A型为主,占73.68%(140/190)。不同子宫内膜类型的妊娠率差异有统计学意义,两两比较表明,A型妊娠率高于C型(χ2=4.4546,P=0.0348),差异有统计学意义,A型与B型及B型与C型的妊娠率均无统计学差异(χ2值及P值分别为2.8005、0.0942及2.2883、1.1275)。按A型子宫内膜厚度不同分为5组,其中厚度在8～10.9mm妊娠率最高,妊娠例数占总妊娠例数的92.86%(130/140),高于厚度<8mm组和>11mm组,差异有统计学意义。按B型子宫内膜厚度不同分为5组,其中7～8.9mm组妊娠率高于其余各组,差异有统计学意义。结论:子宫内膜适合着床的理想厚度是8～10.9mm,A型内膜更适合着床。阴道B超监测子宫内膜类型与厚度在评估内膜容受性、指导临床调整用药及自然受孕或人工助孕等方面有主要价值。     

对我院门诊病人投诉的原因分析与对策

目的通过提供良好的投诉接待服务，提高门诊医疗服务质量，进而提高病人满意度。方法回顾我院2007年上半年门诊病人的投诉情况，分析投诉产生的原因，并针对原因提出对策：结果2007年上半年共发生721件病人投诉事件。投诉主要涉及服务态度、医疗护理质量、就医流程、医疗体制、医院规章制度等方面。结论尽管医疗投诉不可避免，但通过良好的投诉接待服务能够重建病人对医院的信心，并获取改进医疗工作有价值的信息，最终使医患双方获得双赢.