良性与侵蚀性葡萄胎的预测及临床应用

目的 探讨扫描电镜技术在预测良性与侵蚀性葡萄胎中的应用价值。方法 运用扫描电镜技术对40例葡萄胎进行观察，其中良性30例，侵蚀性10例，同时以10例正常早期胎盘绒毛和5例早期胎盘绒毛水肿变性作对照。将患者血、尿HCG(绒毛膜促性腺激素)测定作为监测指标，当葡萄胎后12周内血尿HCG不下降至正常时视为恶性。结果 (1)30例良性葡萄胎的血、尿HCG于葡萄胎12周内降至正常，10例侵蚀性葡萄胎中的9例于葡萄胎后12周内超过正常，1例转变为子宫绒毛膜癌。(2)良性葡萄胎滋养叶细胞微绒毛扫描电镜图像呈细长，或形成“网状”，或“杵状”，或“小撮”。侵蚀性葡萄胎滋养叶细胞微绒毛融合形成“斑块状”，或“球状”、“杆状”，或“棉花团样”。结论 扫描电镜技术可用于预测良性与侵蚀性葡萄胎。     

信息熵——模糊积分决策模型的心脏病放射诊断专家系统

本文用模糊数学原理构造了先天性心脏病放射学诸征侯的隶属函数，用信息源的熵确定了诸征侯的权系数初值，从而建立了微机医学专家系统的信息熵－－模糊积分决策模型。使用微机对权系数及模糊积分算子作了最优化选择。用所建模型对经外科手术证实的１６５例先天性心脏病患者作回顾性验证，对１２２例新患者作了前瞻性考核，诊断准确率分别为８４％和９０％。     

大学生情绪预测倾向及对心理健康的影响

目的考察大学生情绪预测倾向及其与心理健康的关系。方法采用自编大学生情绪预测倾向问卷和症状自评量表(SCL-90)对424名大学生进行测查。结果在积极和消极情绪的强度和持续时间预测方面,性别(t=-3.70~-5.31,P0.001)和专业(F=12.55~29.93,P0.001)差异显著;积极情绪强度预测高估组心理健康水平好于低估组,消极情绪持续时间预测低估组心理健康水平好于高估组,预测的积极情绪强度(β=-0.28,P0.001)和消极情绪持续时间(β=0.279,P0.05)对大学生心理健康具有显著预测作用。结论女生、文科生和艺术生认为未来情绪体验会更强烈和持久;高估未来积极情绪强度、低估未来消极情绪持续时间的大学生,心理健康水平相对更优。     

子宫内膜异位症恶变未来5年发病的绝对风险预测模型研究

目的 探讨子宫内膜异位症（EMT）恶变的绝对风险模型构建及验证。方法 回顾性分析2004年2月至2016年3月于中国人民解放军联勤保障部队第九○八医院收治的228例卵巢子宫内膜样腺癌（EC）和216例卵巢透明细胞癌（CCC）患者为研究对象。依据是否存在EMT恶变将444例患者分为2组,NEM组（非EMT恶变350例）,EM组（EMT恶变94例）。采用决策树、Gail绝对风险估算原理等计算EMT恶变5年发病绝对风险。结果 决策树筛选出月经紊乱、肿瘤直径、CA125、FSH 4个变量。NEM组和EM组的发病风险概率值中位数分别为0.026%、0.223%,四分位数间距分别为0.129%、0.249%。该模型的灵敏度为0.83,特异度为0.75,精确度为l.62,准确性为0.74,AUC为0.81。结论 本研究构建的EMT恶变绝对风险模型可预测EMT恶变5年发病风险,预测变量包括月经紊乱、肿瘤直径、CA15、FSH。     

初中生时间管理倾向的影响因素初步研究

本研究以福清市音西中学的264名学生为被试,采用黄希庭等编制的《青少年时间管理倾向量表》对影响被试时间管理倾向的基本因素进行探析。结论:①初中学生的时间管理水平不高,其时间监控观受年级的影响很大。②性别对于时间管理倾向及其子维度的影响不大,年级对时间管理倾向及时间价值感、时间效能感的影响亦不大。③时间管理倾向及其各维度受是否独生子女、是否留守儿童的影响较小。     

初中生时间管理倾向的影响因素初步研究

本研究以福清市音西中学的264名学生为被试,采用黄希庭等编制的《青少年时间管理倾向量表》对影响被试时间管理倾向的基本因素进行探析。结论：①初中学生的时间管理水平不高,其时间监控观受年级的影响很大。②性别对于时间管理倾向及其子维度的影响不大,年级对时间管理倾向及时间价值感、时间效能感的影响亦不大。③时间管理倾向及其各维度受是否独生子女、是否留守儿童的影响较小。     

信息熵－模糊积分决策模型的心脏病放射诊断专家系统

本文用模糊数学原理构造了先天性心脏病放射学诸征候的隶属函数，用信息源的熵确定了诸征候的权系数初值，从而建立了微机医学专家系统的信息熵——模糊积分决策模型。使用微机对权系数及模糊积分算子作了最优化选择。用所建模型对经外科手术证实的１６５例先天性心脏病患者作回顾性验证，对１２２例新患者作了前瞻性考核，诊断准确率分别为８４％和９０％。     

基于BP神经网络的环孢素A用量预测研究

目的依据BP神经网络技术建立环孢素A用景的预测模型.方法收集服用环孢素A的肾移植病人16例.共65组样本.其中51组样本作为训练样本,14组样本作为测试样本,建立两层BP神经网络预测模型.结果 BP神经网络的仿真预测结果正确率为97.1%.结论 BP神经网络模型在环孢素A用量上能够取得良好的预测效果,具有一定的研究性.     

基于EEG模糊相似性的癫痫发作预测

本研究提出基于EEG序列模糊相似性指数方法预测癫痫发作.首先,结合复自相关法和Cao法对EEG序列进行了相空间重构;然后,计算相关积分时用Gaussian函数代替Heavyside函数,克服了Heavyside函数的刚性边界问题,使得计算相似性指数更加准确和可靠;最后,分析大鼠癫痫EEG信号,检测癫痫发作前期状态.分析结果表明模糊相似性指数方法能够比动态相似性指数方法获得更长的预测时间和更低的错误预测率.     

大型医院信息预测的灰色模型

灰色系统理论基于关联度收敛原理、生成数、灰导数、灰微分方程等观点和方法建立了微分方程模型。本文使用灰色模型预测分析医院９９ 年入院人数， 目的是为医院领导进一步提高医院科学管理提供决策依据     

11beta-Hydroxysteroid dehydrogenase activity in pregnancies complicated by hydatidiform mole

PROBLEM: 11beta-Hydroxysteroid dehydrogenase (11beta-HSD) plays an important role in regulating active glucocorticoid reaching the fetus. In normal pregnancy, placental 11beta-HSD functions primarily in oxidative direction. Placental tissue of patients with pregnancies complicated by pre-eclampsia exhibit significantly lower type 1 and 2 11beta-HSD activities and significantly high cortisol level in cord blood suggesting fetal exposure to higher level of active glucocorticoids. The activity of 11beta-HSD in gestational trophoblastic disease has not been determined. The objective of this study was to assess 11beta-HSD activity in tissue from normal second trimester and pregnancies complicated by hydatidiform mole. METHOD OF STUDY: Normal placental tissues were obtained from patients undergoing termination of pregnancy, and from patients undergoing uterine evacuation for hydatidiform mole. Both nicotinamide adenine dinucleotide (NAD)- and nicotinamide adenine dinucleotide phosphate (NADP)-dependent activities were assayed in central villous tissue. Comparison of groups was performed using Student's t-test. A P-value of 0.05 was considered significant. Data are presented as mean +/- S.D. RESULTS: Tissue obtained from five patients with pathology-proven hydatidiform mole demonstrated significantly lower 11beta-HSD activities compared with placental tissue obtained from normal pregnancies. The mean NAD-dependent 11beta-HSD activity in normal placentas was 386 +/- 109 pmol/min/g placenta and in hydatidiform mole was 74 +/- 54 pmol/min/g placenta (P < 0.01). The mean NADP-dependent 11beta-HSD activity in normal placentas was 370 +/- 120 pmol/min/g placenta and in trophoblastic disease was 68 +/- 69 pmol/min/g placenta (P < 0.01). CONCLUSION: Our data indicate significant impairment in the ability of hydatidiform mole tissue to inactivate glucocorticoids.     

Comparison of ploidy analysis by flow cytometry and image analysis in hydatidiform mole and non-molar abortion

Determination of DNA ploidy is useful in the diagnosis and classification of hydatidiform mole. Most reports of ploidy analysis in molar tissue have used DNA flow cytometry. Although image analysis cytometry offers theoretical advantages over flow cytometry, there have been few reports of ploidy analysis by image analysis in hydatidiform mole. We selected 47 cases and measured DNA ploidy by flow cytometry and image analysis cytometry in complete hydatidiform mole, partial hydatidiform mole and non-molar abortion. The two cytometry modalities were compared using kappa statistics. There was reasonable overall agreement between the two modalities (κ= 0.69) and when ploidy was stratified into diploid/polyploid and triploid categories there was near perfect agreement (κ= 0.93). Aneuploid cell populations, which were not evident on flow cytometry, were identified by image analysis in a significant proportion of complete and partial hydatidiform moles and in a small number of non-molar abortions. Flow cytometry and image analysis cytometry yield comparable ploidy information, useful in the diagnosis and classification of hydatidiform mole. Image analysis cytometry offers greater sensitivity in the detection of small non-diploid cell populations but the significance of this latter finding is uncertain.     

Differential diagnosis of chorionepithelioma of the uterus and hydatidiform mole by an immunologic test

Polysaccharide complexes obtained by Westphal's method in the modification of L. A. Zil'ber et al. from tissues of the primary tumor node and distant metastases (lungs) of a chorionepithelioma of the uterus were used for the differential diagnosis between chorionepithelioma and hydatidiform mole. The reaction to intradermal injection of polysaccharide complexes obtained from distant metastases (lungs) of the uterine chorionepithelioma possess high specificity and sensitivity: a positive reaction developed only in patients with chorionepithelioma of the uterus and it was negative in patients with hydatidiform mole. During a marked decrease in size of the metastases in the lungs in the course of chemotherapy, when the immunologic reaction for chorionic gonadotropin fell to 300–100 i.u./liter urine, the reaction to intradermal injection of the polysaccharide complexes from the metastases of the uterine chorionepithelioma still remained positive.Laboratory of Experimental Endocrinology, Department of Gynecology, Institute of Experimental and Clinical Oncology, Academy of Medical Sciences of the USSR, Moscow. Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 79, No. 1, pp. 60–63, January, 1975.     

Trizygotic pregnancy consisting of two fetuses and a complete hydatidiform mole with dispermic androgenesis

A triplet pregnancy in a 23-year-old woman was terminated at 15 weeks of gestation because of her severe hypertension, lung edema, and secondary hyperthyroidism. The pregnancy consisted of a hydatidiform mole with a 46,XY karyotype and two fetuses each with 46,XX and a 46,XY karyotype. To determine the zygosity and genetic origin of the mole and fetuses, PCR- and computer-assisted genotyping were performed at 27 CA-repeat marker loci that were distributed evenly over the genome. As a result, genotypes of the three pregnancy products were distinct from each other, indicating that the triplets were trizygotic. The mole lacked any maternal alleles but inherited both of the paternal alleles and/or one paternal allele in duplicate. This, along with the XY sex chromosome constitution, indicated that the mole resulted from dispermic androgenesis. The mother developed a persistent trophoblastic tumor thereafter. Am. J. Med. Genet. 82:67–69, 1999. © 1999 Wiley-Liss, Inc.     

Characterisation of a rare hydatidiform mole with aberrant p57 expression

Accurate diagnosis and subclassification of hydatidiform mole (HM) are important to stratify the risk of persistent gestational trophoblastic disease (GTD) and gestational trophoblastic neoplasia (GTN). A combination of histomorphology and ancillary studies including p57 immunohistochemistry (IHC) and/or molecular genotyping by short tandem repeat analysis enable subclassification of most HM into partial hydatidiform mole (PHM) or complete hydatidiform mole (CHM). Here we report a rare HM with equivocal morphology and discordant p57 expression within individual villi and divergent p57 expression across villi. Molecular genotyping of DNA extracted from laser capture microdissected (LMD) chorionic villi allowed identification of CHM and rare androgenetic/biparental mosaicism. This study exemplifies a potential diagnostic pitfall and highlights the importance of inter-disciplinary examination such as p57 IHC and molecular genetics in the diagnosis of HMs.     

Determination of DNA ploidy by fluorescence in situ hybridization (FISH) in hydatidiform moles: evaluation of FISH on isolated nuclei

In the past 20 years, the diagnosis of hydatidiform moles has become more difficult because of the widespread use of early uterine evacuation. Differentiating hydropic degeneration, partial, and complete moles is important because of their different prognosis. However, clinical diagnosis is less obvious, and the pathologist has to separate the different entities on the basis of very subtle morphologic criteria. In difficult cases, ploidy may be determined by various methods, including fluorescence in situ hybridization (FISH) on routine histological sections from paraffin-embedded specimens. However, FISH analysis is often difficult because of the presence of numerous truncated nuclei. In this context, we have tested the advantages of FISH on isolated nuclei, a well-known variant of the technique that might be more sensitive. We reviewed 24 cases of products of abortion: hydropic degenerations, complete hydatidiform moles, partial moles, and nonmolar triploidies. After histological review, FISH on isolated nuclei proved conclusive in all cases. The results could be easily interpreted thanks to the reduced number of truncated nuclei. The percentage of cells with 2 signals was always >70% in the diploid cases and >60% in the triploid cases. In conclusion, this sensitive technique seems to be a valuable tool for the diagnosis of moles.     

Partial hydatidiform mole and hypertension associated with a live fetus--variable presentation in two cases

Partial hydatidiform mole associated with live births is a rarecondition. There are not enough cases in the literature to allowthe assessment of comprehensive risks to be made and upon whichmanagement policies can be based. Several clinical dilemmasarise following diagnosis of a viable pregnancy associated withmolar tissue. We present two cases demonstrating the problemsand suggest management based on outcome and a review of theliterature.     

A case of complete hydatidiform mole in a perimenopausal woman with diagnostic usefulness of p57(kip2) immunohistochemistry and HER2 fluorescent in situ hybridization

Gestational trophoblastic disease in perimenopausal women is very rare. A 53-year-old perimenopausal woman complained about amenorrhea lasting over a period of 4months. Ultrasound showed enlargement of the uterus with a complex echogeneous area in the uterine cavity. Serum human chorionic gonadotropin was 67,611mIU/ml. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The uterus contained hemorrhagic and fragile tumor with grape-like vesicles in the enlarged endometrial cavity. Microscopic examination revealed hydropically degenerated villi with circumferential hyperplasia of atypical trophoblast and cistern formation. p57(kip2) immnostaining was negative in villous cytotrophoblasts and stromal cells. Moreover, fluorescent in situ hybridization for HER2 was scored as diploid. These findings are consistent with complete hydatidiform mole. The diagnosis of hydatidiform mole must be considered in perimenopausal women, and the combination of p57(kip2) immunostaining and HER2 fluorescent in situ hybridization seems to be a very useful testing strategy for difficult situations regarding the differential diagnosis of completed and partial hydatidiform mole.     

基于模糊聚类和改进C-V模型的冠状动脉图像分割方法

目的提出一种基于模糊聚类和改进C-V模型的新型图像分割方法,以精准和快速地提取冠状动脉CT血管造影图像中的冠脉轮廓。方法首先对原始冠脉CT造影图像进行预处理;然后利用模糊C均值聚类算法进行预分割,将获得的隶属矩阵和聚类信息耦合进改进的C-V模型中,完成对冠脉图像的分割;最后定性和定量分析本文模型与其他两种传统模型对冠脉CT造影图像的分割结果。结果定性分析结果显示,本文模型以较少的迭代次数完成了对冠脉轮廓的提取,对细小复杂的组织具有较强的分割能力,目标边缘光滑。定量分析结果显示,本文模型迭代200次耗时11.722 s、重叠率83.42%,迭代400次耗时16.493 s、重叠率85.13%。结论结合模糊聚类的改进C-V模型能以较少迭代次数完成对冠脉轮廓的提取,具有分割速度快、抗噪能力强、目标边缘光滑等特点。该方法可以用于冠脉的分割,并为后续冠脉图像的三维重建研究提供参考。     

被动吸烟对胚胎致畸作用的研究和致畸动物模型的建立

目的探讨被动吸烟对胚胎的致畸作用,并建立一个理想的被动吸烟致畸的动物模型方法采用自制的半封闭式被动吸烟染毒箱,对不同孕期的金黄地鼠以不同时间及不同剂量的分组组合,给予烟熏处理后,进行致畸效果的观察分别计数各组孕鼠的胚胎植入数活胎、吸收胎、死胎及致畸率,并进行统计学分析。结果被动吸烟对胚胎有明显的致畸作用(χ2=86.23,P<0.05或P<0.01),孕6、7、8d期间,每日3次,共6h的烟熏,其致畸率最高,为41.6%,吸收胎数相对较低,活胎平均体重最低。结论孕6、7、8d的金黄地鼠,每日3次,共6h的烟熏,致畸率高,吸收率较低,可产生严重的畸形,是一个比较理想的被动吸烟致畸动物模型。