巴金森氏病智力损害与年龄、病程、运动障碍的关系

巴金森氏病病人的年龄、起病年龄、病程、运动障碍的严重程度与其智力损害的关系至今仍存有争议。为此用定量的临床评定方法、标准化的韦氏成人智力测验对31名连续收选的特发性巴金森氏病进行了研究。结果发现缓动的严重程度与智力损害明显相关,而震颤严重程度与智力损害呈反相关。病人的年龄、起病年龄、病程及强直的程度与智力损害无明显相关。这些结果提示引起缓动的皮层下脑损害同样可能引起智力损害,而有明显震颤的巴金森氏病可能属于该病的早期或属于智力损害较轻的一种巴金森氏病亚型。     

Least-square conformal brain mapping with spring energy

The human brain cortex is a highly convoluted sheet. Mapping of the cortical surface into a canonical coordinate space is an important tool for the study of the structure and function of the brain. Here, we present a technique based on least-square conformal mapping with spring energy for the mapping of the cortical surface. This method aims to reduce the metric and area distortion while maintaining the conformal map and computation efficiency. We demonstrate through numerical results that this method effectively controls metric and area distortion, and is computational efficient. This technique is particularly useful for fast visualization of the brain cortex.     

网织红细胞参数对遗传性球形红细胞增多症筛查价值

目的 探讨各红细胞和网织红细胞参数对遗传性球形红细胞增多症（HS）的筛查诊断价值。方法 收集本院2010年1月—2021年12月确诊的HS患者41例,设为HS组,同时收集40例自身免疫性溶血性贫血（AIHA)患者设为AIHA组,50例地中海贫血（THAL）患者设为THAL组,另选取50例健康体检者为正常对照组。运用t检验比较各组各血细胞参数之间的差异,并采用受试者工作特征（ROC）曲线分析各红细胞参数和网织红细胞参数对HS的筛查诊断价值。结果 HS组平均红细胞体积（MCV）、平均网织红细胞体积（MRV）、平均球形红细胞体积（MSCV）明显低于AIHA组,而平均血红蛋白浓度（MCHC）则明显高于AIHA组（均P<0.05）。HS组MCV、MRV、MSCV均低于正常对照组,MCHC、Ret百分率则明显高于正常对照组,差异有统计学意义（均P＜0.05）。HS组和THAL组比较,除Hb外,其余参数差异均有统计学意义（P＜0.05）。HS组MSCV低于MCV,而THAL组MSCV高于MCV。HS组MSCV-MCV与其他3组比较差异均有统计学意义（P＜0.05）。ROC曲线分析发现MCHC诊断HS的最佳截断值为338.5 g/L,其灵敏度、特异性分别为94.6%和73.7%;MRV最佳截断值为97.1 fL,其灵敏度为91.9%,特异性为86.9%,MSCV-MCV最佳截断值为-3.4 fL,其灵敏度、特异性为94.6%、89.4%。MRV联合MCHC、MRV联合MSCV-MCV ROC曲线下面积（AUC）分别为0.978、0.988,均大于MCHC、MRV、MSCV-MCV任一指标的AUC。结论 MCHC、MRV、MSCV、MSCV-MCV等指标对于HS的鉴别诊断具有重要的参考价值。MCHC不是筛查诊断HS的理想指标,MRV和MSCV-MCV具有较高的预测价值,而联合指标筛查诊断价值要优于单一指标     

Physiological correlates of perceptual learning in monkey V1 and V2

Performance in visual discrimination tasks improves with practice. Although the psychophysical parameters of these improvements have suggested the involvement of early areas in visual cortex, there has been little direct study of the physiological correlates of such perceptual learning at the level of individual neurons. To examine how neuronal response properties in the early visual system may change with practice, we trained monkeys for more than 6 mo in an orientation discrimination task in which behaviorally relevant stimuli were restricted to a particular retinal location and oriented around a specific orientation. During training the monkeys' discrimination thresholds gradually improved to much better than those of naive monkeys or humans. Although this improvement was specific to the trained orientation, it showed little retinotopic specificity. The receptive field properties of single neurons from regions representing the trained location and a location in the opposite visual hemifield were measured in V1 and V2. In most respects the receptive field properties in the representations of the trained and untrained regions were indistinguishable. However, in the regions of V1 and V2 representing the trained location, there were slightly fewer neurons whose optimal orientation was near the trained orientation. This resulted in a small but significant decrease in the V1 population response to the trained orientation at the trained location. Consequently, the observed neuronal populations did not exhibit any orientation-specific biases sufficient to explain the orientation specificity of the behavioral improvement. Pooling models suggest that the behavioral improvement was accomplished with a task-dependent and orientation-selective pooling of unaltered signals from early visual neurons. These data suggest that, even for training with stimuli suited to the selectivities found in early areas of visual cortex, behavioral improvements can occur in the absence of pronounced changes in the physiology of those areas.     

新生儿呼吸窘迫综合征肺表面活性物质治疗后肺氧合功能和尿量变化的观察

目的　探讨新生儿呼吸窘迫综合征 (RDS)予肺表面活性物质 (PS)治疗后的尿量变化及尿量与肺氧合功能的关系。方法　对新生儿重症监护病房 (NICU)行呼吸机治疗的 2 0例RDS患儿予血气监测及每小时尿量和入量监测。结果　观察组 (PS组 )最大尿量峰值出现于生后 6 0h ,与对照组比较有显著性差异 (P <0 0 5 )。尿量 /入量比值PS组于生后 48h即大于 0 8,而对照组的上述比值大于 0 8出现于生后 6 0h。尿量与动脉 /肺泡氧分压比值 (PaO2 /PAO2 )有显著相关性 (r =0 7414,P <0 0 5 )。结论　RDS病程中随着尿量增加肺氧合功能改善 ,予PS治疗后利尿期最大尿量峰值增大 ,出现时间早 ,提示在PS治疗后更应该密切观察尿量变化 ,判断病情的恢复。     

用数据挖掘技术实现多因素实验设计

目的本文介绍如何用数据挖掘技术实现同水平和混合水平多因素实验设计的方法，即独立设计；总结和讨论了独立设计的特点。方法以同水平或混合水平多因素析因设计矩阵为母体，不增加任何限定条件，仅考察各实验点对其余实验点的影响，采用“主成分分析、聚类分析和规则归纳”等数据挖掘技术相结合的方法，先将全部实验点快速分类，然后，再进行聚类，可将此矩阵分解成一系列彼此互不重叠的独立设计矩阵。结果不仅发现用数据挖掘技术实现多因素实验设计是可行的，而且，发现了除正交设计、均匀设计以外的一些可用于多因素实验设计的特殊设计。结论独立设计是一类涵盖面很宽的多因素实验设计方法，它不仅集“析因设计、分式析因设计、正交设计、均匀设计”于一身，还包含有突出“中间水平”或“极端水平”的特殊设计。与正交设计和均匀设计相比较，独立设计的适用面更宽、灵活性更大，具有极大的理论研究价值和广阔的实际应用前景。     

肝癌相关抗原kinectin基因片断的重组表达

目的:研究肝癌相关抗原kinectin基因片断的体外重组表达方法,为该抗原的生产奠定基础.方法:用PCR法扩增肝癌相关抗原kinectin的基因片断,将目的基因插入表达载体pMAL-C2上麦芽糖结合蛋白(MBP)基因下游的多克隆位点,转化DH5α菌.通过蓝白斑筛选、PCR鉴定、内切酶鉴定及DNA测序筛出正确的重组子,并用其转化TB1菌.用IPTG对重组的TB1工程菌进行诱导表达,SDS-PAGE电泳鉴定.结果:kinectin基因片断正确插入pMAL-C2载体的多克隆位点,用IPTG对工程菌进行诱导,可见目的蛋白条带出现.结论:pMAL-C2载体可用于对肝癌相关抗原kinectin的体外基因重组表达.     

多模态技术联合术中唤醒麻醉在Broca区胶质瘤患者语言功能区定位中的作用

目的探讨多模态技术联合术中唤醒麻醉在Broca区胶质瘤患者语言功能区定位中的作用和手术疗效。方法回顾性分析2011年1月至2017年12月复旦大学附属华山医院神经外科行手术切除的Broca区胶质瘤患者的临床资料,共42例。术前采用功能磁共振成像和弥散张量成像技术重建语言皮质激活区域和皮质下传导通路,术中在唤醒麻醉下通过直接电刺激技术定位语言皮质和皮质下传导通路,并在术中磁共振、实时神经影像导航系统引导下行肿瘤切除。根据肿瘤是否侵犯中央前回腹侧部(vPMC)将患者分为未侵犯vPMC(仅侵犯额下回后部)组24例,侵犯vPMC组18例,评估并比较两组患者语言功能区定位情况和疗效。结果42例患者均完成术中语言功能区定位,34例(81.0%)至少有1个阳性定位点;3例(7.1%)在定位过程中出现癫痫局灶性发作。25例患者肿瘤为全切除,17例为非全切除。术后病理学证实世界卫生组织(WHO)肿瘤分级Ⅱ级者23例,Ⅲ级者14例,Ⅳ级者5例。术后1个月内(近期)16例(38.1%)患者有语言功能障碍,其中12例3个月内恢复,4例(9.5%)未恢复。术后所有患者随访6~84个月(中位数为24个月),14例出现肿瘤进展,其中11例死亡。与未侵犯vPMC组比较,侵犯vPMC组肿瘤的WHO级别高(P=0.011),术后近期语言功能障碍的发生比率高[分别为10/18、25.0%(6/24),P=0.044],无进展生存期[分别为(28.4±5.2)个月、(80.7±3.2)个月]和总生存期[分别为(38.8±5.8)个月、(80.8±3.2)个月]均短。差异均有统计学意义(均P<0.001)。结论多模态技术联合术中唤醒麻醉治疗Broca区胶质瘤有助于在最大化切除肿瘤的同时,保护患者的语言功能。其中肿瘤侵犯vPMC比仅侵犯额下回后部者引起近期语言功能障碍率更高,预后更差。     

Biomarkers of joint metabolism and bone mineral density are associated with early knee osteoarthritis in premenopausal females

Clinical Rheumatology - Biomarkers of bone and cartilage metabolism were proposed as early diagnosis indicators for knee osteoarthritis (OA), however, which were influenced by disease stage, age,...     

Vorapaxar治疗动脉粥样硬化疾病有效性和安全性的Meta分析

目的系统评价Vorapaxar治疗动脉粥样硬化疾病的安全性和有效性。方法检索PubMed、Embase、Cochrane Central Register of Controlled Trials、CNKI全文数据库,收集自建库以来至2014年10月公开发表的有关Vorapaxar治疗动脉粥样硬化疾病的随机对照试验(RCT)。采用RevMan5.1软件进行系统评价和Meta分析。结果共纳入5项RCT,Meta分析显示:Vorapaxar组以心源性死亡(CV)、心肌梗死(MI)和卒中为复合终点事件发生率(OR=0.87,95%CI 0.81~0.93,P<0.01)、主要不良心脑血管事件(MACCE)发生率(OR=0.89,95%CI 0.84~0.95,P<0.01)、CV和MI发生率(OR=0.87,95%CI 0.81~0.93,P<0.01)、MI发生率(OR=0.85,95%CI 0.78~0.92,尸<0.01)低于安慰剂组,而出血发生率(OR=1.48,95%CI 1.39~1.57,P<0.01)以及颅内出血发生率(OR=2.36,95%CI 1.40~3.98,P=0.01)高于安慰剂组。结论在治疗动脉粥样硬化疾病时,Vorapaxar虽然在出血发生率和颅内出血发生率上显著高于安慰剂组,但能显著减少CV、MI和卒中为复合终点事件发生率、MACCE发生率、CV和MI发生率及MI发生率。Vorapaxar可成为治疗动脉粥样硬化疾病的新选择。