胸外伤并发急性呼吸衰竭的高危因素分析

目的探讨胸外伤与急性呼吸衰竭（ＡＲＦ）的关系。方法回顾性分析６年来收治的２６４例胸外伤及合并多发伤的临床资料，ＡＲＦ为因变量，与其相关的１２项因素为自变量进行统计学分析，以确定ＡＲＦ的高危因素。结果多变量分析显示收缩压、呼吸频率、ＰａＯ２、ＰａＣＯ２、血气胸、腹内伤、骨折、呼吸系统并存病［慢性阻塞性肺疾病（ＣＯＰＤ）、肺炎］、ＩＳＳ值为ＡＲＦ的高危因素。单变量分析揭示年龄≥６０岁、肋骨骨折≥４根时与ＡＲＦ有密切相关性。结论对具有高危因素的患者应警惕ＡＲＦ的发生。     

军队特需药品研发卫勤评估灰色系统评价分析

目的对军队特需药品研发立项环节的卫勤评估指标体系进行实证检验。方法依据军队特需药品研发勤务技术指导原则及其相关管理规定,结合已确定的特需药品研发卫勤评估指标体系,运用多层次灰色分析系统评价方法,对68种军队特需药品进行量化评估。结果根据多层次灰色分析系统评价方法,计算了68种军队特需药品的灰色关联系数,并进行了比较排序。结论多层次灰色关联系数排序结果与实际入选立项的特需药品基本一致,同时该方法直观可行,能避免一定的主观性,具有较大的实际意义。     

军队特需药品研发卫勤评估灰色系统评价分析

目的对军队特需药品研发立项环节的卫勤评估指标体系进行实证检验。方法依据军队特需药品研发勤务技术指导原则及其相关管理规定,结合已确定的特需药品研发卫勤评估指标体系,运用多层次灰色分析系统评价方法,对68种军队特需药品进行量化评估。结果根据多层次灰色分析系统评价方法,计算了68种军队特需药品的灰色关联系数,并进行了比较排序。结论多层次灰色关联系数排序结果与实际入选立项的特需药品基本一致,同时该方法直观可行,能避免一定的主观性,具有较大的实际意义。     

急诊重症监护病房呼吸机相关性肺炎危险因素研究

目的探讨急诊重症监护病房(EICU)机械通气(MV)患者呼吸机相关性肺炎(VAP)的危险因素。方法对2013年1-12月期间入住我院EICU并给予气管插管或气管切开行MV时间超过48 h的127例患者进行回顾性研究。根据是否发生VAP将患者分为VAP组和非VAP组,统计两组间在相关变量上的差异。结果相关变量的单因素检验10个变量是影响VAP的危险因素,经Logistic回归分析仍保留的因素有:APACHEⅡ评分、机械通气天数、使用抑酸剂、使用镇静剂。结论在EICU中,VAP的发生与多种因素相关,应针对上述因素实施相应的对策以减少VAP的发生。     

MRI对乳腺黏液癌和纤维腺瘤的鉴别诊断价值

目的:分析乳腺黏液癌(BMC)和纤维腺瘤的MRI表现,探讨两者的鉴别诊断要点.方法:回顾性分析13例BMC的临床及MRI资料,并与39例纤维腺瘤比较.结果:BMC多为单发病灶、增强扫描早期以边缘不均匀强化为主,晚期逐渐出现整体不均匀强化或分隔中度至明显强化,可合并出血;纤维腺瘤多为多发、增强扫描早期不均匀强化或均匀强化...     

肾上腺腺瘤和非腺瘤动态增强CT曲线与微血管超微结构的相关性研究

目的 探讨肾上腺腺瘤和非腺瘤动态增强CT曲线与微血管超微结构特点的相关关系,以进一步阐明其动态增强机制.资料与方法 经手术病理证实的42例46个肾上腺肿块(腺瘤23个、非腺瘤18个、增生结节5个)均行动态增强CT检查和病理学检查,而后分析肾上腺肿块动态增强CT表现特征[时间-密度(T-D)曲线]与微血管超微结构之间的相关关系.结果 肾上腺腺瘤和非腺瘤间微血管超微结构存在显著不同.肾上腺肿块T-D曲线廓清迅速组(A、C型)与廓清缓慢组(B、D、E型)间的微血管超微结构表现特点亦不同;T-D曲线廓清迅速组微血管超微结构表现为管腔规则,无狭窄;内皮细胞吞饮泡多,窗孔多;细胞间隙增宽;基底膜菲薄,厚薄均匀,有裂口;血管外间隙窄、规则且均匀一致,基质少等,与腺瘤表现一致;由此提示动态增强CT曲线与微血管超微结构存在相关关系.结论 微血管超微结构可能是导致腺瘤和非腺瘤具有不同的T-D曲线类型的主要因素之一.     

关于已有国家标准化学原料药注册申请应重点考虑的内容

已有国家标准药品的研发和审评中关注的重点内容是药学方面的研究工作。本文结合审评工作体会就已有国家标准药品原料药申报资料中药学方面应重点考虑的内容,从合成工艺、结构确证和质量研究三个方面进行了分析,以期对规范研发、提供高质量的申报资料方面有所助益。     

肌肉内脂肪瘤的CT与MRI诊断

目的 探讨肌肉内脂肪瘤的CT与MRI表现.方法 回顾性分析16例经病理证实的肌肉内脂肪瘤患者资料,13例行MRI检查,4例行CT检查,总结其CT与MRI特征.结果 16例中,肌肉内浸润型9例,肌间浸润型7例.CT扫描肿瘤表现为脂肪性低密度,3例肌间浸润型密度均匀,1例肌肉内浸润型密度不均匀,其间可见条索状肌纤维样稍高密度影.MRI上肿瘤中的脂肪组织均呈短T1、长T2信号,脂肪抑制序列PDWI上呈低信号,8例肌肉内浸润型脂肪瘤信号不均匀,肿瘤组织与肌肉纤维交错生长,其中5例可见"羽毛征",5例肌间浸润型脂肪瘤,2例信号均匀,3例信号不均匀,于高信号脂肪组织中可见低信号线样或网状纤维间隔.结论 肌肉内脂肪瘤的CT与MRI表现具有特征性,MRI应作为首选的影像学检查方法.     

外科手术患者深静脉置管术后导管相关感染的临床特点及危险因素分析

目的 探讨外科手术患者深静脉置管术后导管相关感染的临床特点及危险因素分析.方法 分析2019年5月-2020年4月收治的193例外科手术需深静脉置管患者临床资料,根据所有患者资料,将可能影响深静脉置管术后导管相关感染的因素纳入自变量并为其赋值,经多项logistic回归分析找出影响术后导管相关感染的危险因素.结果 19...     

逐步回归分析方法中运算手续的简化

此系从一个自变量开始,把作用显著的自变量逐个引进回归方程中,把作用不显著的变量从回归方程中逐个剔除,最后应用“最优回归方程”预测环境污染程度、气象变化情况等的一种很重要的数理统计方法。介绍这种方法的专著越来越多,在医学方面的应用,越来越广泛,已引起科研工作者的重视。但由于用它作分析手段的运算手续非常麻烦,以致没有电子计算机设备的单位不敢轻于尝试。近读逐步回归分析法在预报预测污染浓度变化制定控制影响要求中的应用一文,对我们有很大的启发;并同意该文著者的观点,在变量不太多(譬如在四、五个以内)     

对乙酰氨基酚温敏凝胶的处方筛选与体外释放研究

目的筛选对乙酰氨基酚温度敏感型原位凝胶处方组成,并对其体外释药进行研究。方法以泊洛沙姆407、泊洛沙姆188为考察因素,以胶凝温度为考察指标,分别用多元线性模型、二次多项式模型描述考察指标和因素之间的数学关系,用中心组合设计-效应面法确定最优处方。采用相似因子法对优化处方与传统栓剂进行体外溶出比较。结果对乙酰氨基酚温度敏感型原位凝胶的最优处方为7.5%药物、21%泊洛沙姆407和18%泊洛沙姆188,胶凝温度为36.2℃。对乙酰氨基酚温敏凝胶与传统栓剂均在45 min内释药达80%,2 h内药物基本释放完全,且释药曲线相似（差异因子f1=2.06%,相似因子f2=68.7%）。结论优化的处方具有适宜的胶凝温度且释药符合要求。     

The effect of stimulus intensity on response time and accuracy in dynamic,temporally constrained environments

The ability to make accurate judgments and execute effective skilled movements under severe temporal constraints are fundamental to elite performance in a number of domains including sport, military combat, law enforcement, and medicine. In two experiments, we examine the effect of stimulus strength on response time and accuracy in a temporally constrained, real‐world, decision‐making task. Specifically, we examine the effect of low stimulus intensity (black) and high stimulus intensity (sequin) uniform designs, worn by teammates, to determine the effect of stimulus strength on the ability of soccer players to make rapid and accurate responses. In both field‐ and laboratory‐based scenarios, professional soccer players viewed developing patterns of play and were required to make a penetrative pass to an attacking player. Significant differences in response accuracy between uniform designs were reported in laboratory‐ and field‐based experiments. Response accuracy was significantly higher in the sequin compared with the black uniform condition. Response times only differed between uniform designs in the laboratory‐based experiment. These findings extend the literature into a real‐world environment and have significant implications for the design of clothing wear in a number of domains.     

Relationship between ankle-foot swelling and self-assessed function after ankle sprain

PURPOSE: Decreasing swelling after ankle sprain is a main focus of treatment, as it is believed that swelling is related to function. The purpose of this study was to evaluate the relationship between ankle-foot swelling and self-assessed ankle function in the early period after ankle sprain. METHODS: Thirty-six individuals were tested for ankle-foot volume and self-assessed ankle function within days of spraining their ankle. Volumetric measurements of the injured and uninjured ankle-foot segment were taken with a foot and ankle volumeter. Stepwise linear regression analysis was performed, with function being the dependent variable, and the following variables included as independent variables: gender, age, body mass index, previous history of sprain in the injured ankle, and the volume difference between the injured and uninjured ankle-foot segment. RESULTS: None of the independent variables were significantly related to self-assessed function. Pearson's correlation coefficient for the injured minus uninjured ankle-foot volume and self-assessed ankle function was -0.003. CONCLUSION: The results indicate that there is no relationship between ankle-foot swelling and self-assessed ankle function in the early period after ankle sprain injury.     

脑源性神经营养因子PLGA纳米粒的处方工艺研究

目的制备脑源性神经营养因子聚乳酸-羟基乙酸共聚物(PLGA)纳米粒,使用星点设计-效应面法对处方工艺进行优化筛选。方法以生物降解型聚乳酸-羟基乙酸共聚物为载体材料,采用复乳化溶剂挥干法制备脑源性神经营养因子PL-GA纳米粒。观察纳米粒的形态、大小和粒径分布。以PLGA的用量及形成复乳时PVA含量为考察因素,体外释放为评价指标,用线性方程和二次及三次多项式描述体外释放和两个影响因素之间的数学关系,根据最佳数学模型描绘效应面,选择最佳处方,并进行预测分析。结果各指标的三项式拟合方程均优于多元线形回归方程,建立的数学模型的预测值与实际值符合较好。结论用星点设计-效应面法优化处方工艺预测性良好。     

Is volume transfer coefficient (K(trans)) related to histologic grade in human gliomas?

PURPOSE: The purpose of this study was to examine the relationship between contrast transfer coefficient [K(trans)] and grade in gliomas. MATERIAL AND METHODS: Median values of K(trans), CBV(T1), and of the 95th percentile (95%) of the distribution (K(trans) [95%] and CBV(T1) [95%]) were calculated in 39 patients with glioma. Group comparisons and post hoc pairwise comparisons were performed. The relationship between variables and grade used Spearman rho and canonical discriminant analysis. The separation of high- from low-grade tumors was separately assessed by using Mann-Whitney U tests and logistic regression. Receiver operator curve analysis was performed for high- and low-grade tumors and grade III and grade IV tumors. RESULTS: There were significant differences between grades for all variables (P < .001). Pairwise comparisons demonstrated significant differences between grades II and III and II and IV for all variables except K(trans), which did not show significance in the grade II and III comparison, and between III and IV for CBV(T1) and CBV(T1) (95%; P < .01). All variables correlated with grade (P < .01). Discriminant analysis showed independent relation between both CBV(T1) and K(trans) (95%) and grade, and the canonical function produced a total correct classification of 74.4% of cases. Logistic regression analysis for low- versus high-grade tumors showed K(trans) (95%) and CBV(T1) to be independent factors (P < .01 and P < .05). CONCLUSION: There are strong independent relationships between both CBV and K(trans) and histologic grade in gliomas. Both measurements show good discriminative power in distinguishing between low- and high-grade tumors with diagnostic sensitivity and specificity >90%.     

On the relationship between seed‐based and ICA‐based measures of functional connectivity

Brain functional connectivity (FC) refers to inter‐regional synchrony of low frequency fluctuations in blood oxygenation level dependent functional magnetic resonance imaging. FC has been evaluated both during task performance and in the “resting” state, yielding reports of FC differences correlated with behavior and diagnosis. Two methodologies are widely used for evaluating FC from blood oxygenation level dependent functional magnetic resonance imaging data: Temporal correlation with a specified seed voxel or small region of interest; and spatial independent component analysis. While results from seed‐based and independent component analysis methodologies are generally similar, they are conceptually different. This study is intended to elucidate and illustrate, qualitatively and quantitatively, the relationship between seed and independent component analysis derived measures of FC. Seed‐based FC measures are shown to be the sum of independent component analysis‐derived within network connectivities and between network connectivities. We present a simple simulation and an experiment on visuomotor activity that highlight this relationship between the two methods. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

Deriving the Intrahepatic Arteriovenous Shunt Rate from CT Images and Biochemical Data Instead of from Arterial Perfusion Scintigraphy in Hepatic Arterial Infusion Chemotherapy

The purpose of the present study was to elucidate a method for predicting the intrahepatic arteriovenous shunt rate from computed tomography (CT) images and biochemical data, instead of from arterial perfusion scintigraphy, because adverse exacerbated systemic effects may be induced in cases where a high shunt rate exists. CT and arterial perfusion scintigraphy were performed in patients with liver metastases from gastric or colorectal cancer. Biochemical data and tumor marker levels of 33 enrolled patients were measured. The results were statistically verified by multiple regression analysis. The total metastatic hepatic tumor volume (V_metastasized), residual hepatic parenchyma volume (V_residual; calculated from CT images), and biochemical data were treated as independent variables; the intrahepatic arteriovenous (IHAV) shunt rate (calculated from scintigraphy) was treated as a dependent variable. The IHAV shunt rate was 15.1 ± 11.9%. Based on the correlation matrixes, the best correlation coefficient of 0.84 was established between the IHAV shunt rate and V_metastasized (p < 0.01). In the multiple regression analysis with the IHAV shunt rate as the dependent variable, the coefficient of determination (R ²) was 0.75, which was significant at the 0.1% level with two significant independent variables (V_metastasized and V_residual). The standardized regression coefficients (β) of V_metastasized and V_residual were significant at the 0.1 and 5% levels, respectively. Based on this result, we can obtain a predicted value of IHAV shunt rate (p < 0.001) using CT images. When a high shunt rate was predicted, beneficial and consistent clinical monitoring can be initiated in, for example, hepatic arterial infusion chemotherapy.     

重庆黑山羊体尺体重指标与胴体净肉率的相关回归分析

采用SAS软件CORR过程对重庆黑山羊成年羊体尺体重指标与胴体净肉率进行相关分析，并以成年体高X1、体斜长X2、胸围X3、胸宽）（4、胸深X5、成年体重X6为自变量，胴体净肉率Y为因变量，采用REG过程BACKwARD（后退法）的多元回归分析方法，构建了估测重庆黑山羊胴体净肉率的最优回归方程：Y=9．9370—0．0109X3—0．2184X4＋0．4914X5。     

The applicability of Kvaal methods and pulp/tooth volume ratio for age estimation of the Turkish adult population on cone beam computed tomography images

The contraction of the pulp chamber with secondary dentin apposition is a significant morphological dental age predictor in adults. The aim of this study is to evaluate the applicability of Kvaal’s method and pulp/tooth volume ratio on cone-beam computed tomography (CBCT) images and develop a valid method for the Turkish adult population. In this study, 211 single-rooted teeth, extracted for orthodontic and periodontal reasons, of 134 patients with ages ranging from 16 to 71 years, were used. Each sample was scanned using CBCT. According to the reported technique (Kvaal’s method), teeth were analysed on CBCT images. Additionally, pulp/tooth volume ratio was calculated using ITK-SNAP 3.4.0 software. The relationship between age and morphological variables was calculated by the Pearson correlation coefficient. Multiple linear regression models were established for each tooth, age as dependent variable, and morphological variables as independent variables. The determination of coefficients of the Kvaal’s modified regression models were found in a range from 0.296 to 0.550. The pulp volume and the pulp/tooth volume ratio showed statistically significant differences between age groups (p < 0,001). Pulp volume and pulp/tooth volume ratio is a significant index for age. Linear measurement and ratios on CBCT images were insufficient estimates of the age of the Turkish population.     

Implementation of a Novel Hands-on Advanced Radiology Elective

Despite the use of imaging in many medical and surgical practices, no universal mandatory radiology component is required by the Liaison Committee on Medical Education. In contrast, United States medical students are required to complete at least one core subinternship during their final year of medical school in medicine, surgery, pediatrics, or family medicine, regardless of their chosen field of interest. Students are expected to perform just below the level of an intern, performing functions such as assisting in writing notes, placing orders, and arranging for appropriate follow-up. To our knowledge, there are few institutions that offer a comparable clinical experience in radiology. In order to address this, we successfully designed and implemented a hands-on medical student advanced radiology elective, which allowed for experiential learning through independent dictation of radiographic examinations and procedure-based practice. Here, we describe the process of developing such an elective, how to implement it at other institutions, and some insight into troubleshooting any potential pitfalls should they arise. Overall, our novel hands-on elective enables a more student-centered, active learning approach, allowing for more in-depth, accurate evaluation of specialty choice while also equipping faculty and residency programs with the skills to best assess student interest, motivation, knowledge, and communication skills.