The supra-transverse intermetatarsocapital bursa: a description and its relation to painful syndromes of the forefoot

Very many painful syndromes of the forefoot remain without a satisfactory explanation; although this region contains quite specific structures, it has suffered from the application of analogies with disorders of the hand. Among these specific components, the presence of the supra-transverse intermetatarsocapital bursa provides an explanation of such clinical entities as the acute syndrome of the second intermetatarsal space and gives fresh impetus to the debate on the etiopathogenesis of Morton's metatarsalgia. On the basis of 25 dissections, the authors studied the region between the metatarsal heads, confirming the presence of these bursae and specifying their site and size and particularly their relations with the common plantar digital nerve at its bifurcation into collateral nerves.     

Linkage analysis and family classification under heterogeneity

Heterogeneity of the recombination fraction may or may not involve a mixture of two groups of elements. For the mixture situation (families with or without linkage between two gene loci), Morton's homogeneity test is compared with another test (Admixture test) with respect to significance level, power, parameter estimation and classification of families. The Admixture test is shown generally to have superior properties in this situation.     

Histological findings in Morton's metatarsalgia

MORTON'S metatarsalgia is a distinctive clinical condition characterised by paroxysmal, lancinating pain in the forefoot in the region of the metatarso-phalangeal joints. The sensation is often described as that of (walking on a hot pebble). It is worse on walking, and typically eased by rest and by taking off the shoe. Manipulating the foot also sometimes eases the pain: it can cause sudden relief, the pain being replaced by a dull burning sensation.     

Ludloff截骨修复矫治拇外翻的三维力学特点

背景：目前针对Ludloff截骨三维特点的研究甚少,且结论稍有不同,导致不能准确地理解其截骨特点。 目的：分析Ludloff截骨技术修复矫治拇外翻的三维力学特点。 方法：采用长86.56 mm、直径30.65 mm的木质圆柱体,进行Ludloff截骨矫治拇外翻的模拟试验,测量并记录数据。 结果与结论：圆柱体的长度随矫形程度的增加而逐渐短缩;无论截骨面偏向跖侧、背侧或水平,截骨的结果均导致远端内旋。Ludolff截骨矫治拇外翻的结果是使截骨远端呈内旋,这对改善第一跖趾关节生物力学有积极的作用。对于有明显跖骨痛的患者可采用偏向跖侧15°~20°的截骨面;对于Ⅰ/ⅡIMA(≥30°)的患者,应谨慎使用Ludolff截骨。     

足支撑时相跟腱不同拉力负荷时足底压力的分布

目的探讨足支撑时相跟腱不同拉力负荷过程中足底前、后部压力分布的变化。方法将6个新鲜足标本置于Bose材料试验机上,保持足标本中立位,调整垂直压力350 N不变,通过砝码分别给予跟腱0～80 kg不同级别(0、100、200、300、400、500、600、700、800 N)的拉力;分别放置两个秤在足底前、后部,记录足底前、后部在不同跟腱提拉力下的压力值。结果在跟腱不同提拉力下,前足底的压力值不断增加,后足底的压力值不断降低,前足底和后足底压力值占整个足底压力值的百分比与跟腱拉力呈线性关系(P<0.01,R2=0.996)。结论本研究模拟了人活体状态下足的支撑时相,探讨了支撑期足底前、后部压力值的变化趋势,为临床上一些由于跟腱收缩紊乱引起足底压力变化而导致的疾病(如糖尿病足底溃疡、跖骨痛)提供理论基础。     

Fossils, feet and the evolution of human bipedal locomotion

We review the evolution of human bipedal locomotion with a particular emphasis on the evolution of the foot. We begin in the early twentieth century and focus particularly on hypotheses of an ape-like ancestor for humans and human bipedal locomotion put forward by a succession of Gregory, Keith, Morton and Schultz. We give consideration to Morton's (1935) synthesis of foot evolution, in which he argues that the foot of the common ancestor of modern humans and the African apes would be intermediate between the foot of Pan and Hylobates whereas the foot of a hypothetical early hominin would be intermediate between that of a gorilla and a modern human. From this base rooted in comparative anatomy of living primates we trace changing ideas about the evolution of human bipedalism as increasing amounts of postcranial fossil material were discovered. Attention is given to the work of John Napier and John Robinson who were pioneers in the interpretation of Plio-Pleistocene hominin skeletons in the 1960s. This is the period when the wealth of evidence from the southern African australopithecine sites was beginning to be appreciated and Olduvai Gorge was revealing its first evidence for Homo habilis. In more recent years, the discovery of the Laetoli footprint trail, the AL 288-1 (A. afarensis) skeleton, the wealth of postcranial material from Koobi Fora, the Nariokotome Homo ergaster skeleton, Little Foot (Stw 573) from Sterkfontein in South Africa, and more recently tantalizing material assigned to the new and very early taxa Orrorin tugenensis, Ardipithecus ramidus and Sahelanthropus tchadensis has fuelled debate and speculation. The varying interpretations based on this material, together with changing theoretical insights and analytical approaches, is discussed and assessed in the context of new three-dimensional morphometric analyses of australopithecine and Homo foot bones, suggesting that there may have been greater diversity in human bipedalism in the earlier phases of our evolutionary history than previously suspected.     

改良Coughlin截骨术治疗Ⅲ型小趾囊炎

目的 探讨改良Coughlin截骨术治疗Ⅲ型小趾囊炎的临床效果。方法 回顾性分析2013年3月—2015年4月徐州市中心医院手足显微外科收治的22例31足Ⅲ型小趾囊炎患者的临床资料,其中男3例3足,女19例28足;年龄26～78岁,平均45.3岁。患者均采用改良Coughlin截骨术治疗,术后观察骨折愈合情况,评测第四五跖骨间夹角、小趾内翻角、第五跖骨外翻角变化、患者足部疼痛缓解及对足部外观满意等情况,并采用美国足踝外科协会小趾-跖趾-趾间关节评分系统(AOFAS)对手术治疗效果进行评价。结果 本组患者均顺利完成手术,术后所有创口均获一期愈合,未出现感染或者皮肤坏死等并发症。术后22例31足获得随访,时间6～30个月,平均17.8个月。患者术后骨折愈合时间为6～14周,平均11.6周。末次随访时,患者创口外观理想,足趾外观无畸形,未出现转移性跖骨痛以及胼胝复发。末次随访时,第四、五跖骨间夹角为5.9°±1.6°,小趾内翻角为6.1°±2.3°,第五跖骨外翻角为2.2°±1.2°,均比术前的16.3°±5.1°、10.7°±3.5°、5.8°±2.6°明显减小,差异均有统计学意义(t=10.833、6.115、7.000,P值均<0.01);AOFAS评分为(89.0±8.4)分,比术前(60.2±9.3)分明显增高,差异有统计学意义(t=12.795, P<0.01)。结论 改良Coughlin截骨术具有操作简便,手术创伤小,效果显著等优点,是治疗Ⅲ型小趾囊炎一种有效的方法。     

Toe Deformity of a Gilt-Bronze Pensive Bodhisattva Statue

I recently visited the National Museum of Korea, where I viewed two pensive Bodhisattvas in the Room of Quiet Contemplation. Among the two gilt-bronze statues, one was familiar to me since I previously wrote about Bodhisattvas’ face, which has a hint of a smile that exhibits a sense of serene concentration and gives the viewer the impression of an aura of deep thought.1 In Buddhism, any person who is on the path towards Buddhahood (the condition and rank of a Buddha, awakened one) is called a ‘Bodhisattva’. This time I focused on the cross-leg sitting and bare right foot, where I observed hyperextension of the first metatarsophalangeal joint and flexion of the interphalangeal joint of the pensive Bodhisattva (National Treasure 83, Fig. 1).Open in a separate windowFig. 1Pensive Bodhisattva (Korean National Treasure 83). Note the hyperextension of the first metatarsophalangeal joint and flexion of the interphalangeal joint of the hallux.It is well known that Siddhartha Gautama (Buddha, c. 6th to 5th century BC or c. 5th to 4th century BC) founded Buddhism. Before the expedition of Alexander the Great (356-323 BC) to the East, people in eastern Asia thought that transcendent beings like God could not be expressed as human figures. Thereafter, Buddhists did not make any statues of the Buddha; instead, they made stupas, which contained small crystals believed to be derived from Buddha’s cremated remains. There was an approximately 500-year period when the Buddha was not represented as a figure. Later, as the Greek culture was transmitted to the East, the first statue of Buddha appeared in the Gandhara region. The resulting statues were influenced by ancient Greeks’ pursuit of ideal beauty, which they perceived as arising from harmony and balance.Buddhism was transferred to China through the Silk Road in the 1^st century AD, and then to the Three Kingdoms of Korea in the 4^th to 6^th century AD. The above-described pensive Bodhisattva statue was produced in the late 6^th century in Shilla kingdom.This statue (National Treasure #83) of the pensive Bodhisattva differs from the classic contemplative pose with one leg perched up on the other knee and the fingers of one hand raised against the cheek. This pose is derived from the image of the young Indian Prince Siddhartha Gautama contemplating the nature of human life, which is quite common in Buddhist sculpture. In China, such pensive statues were most widespread in the 5^th and 6^th centuries, but in Korea they were most frequently produced in the 6^th and 7^th centuries.In both Korea and Japan, however, the pensive Bodhisattva is generally considered to depict the Maitreya Bodhisattva (known as the future Buddha). This iconography is thought to reflect the Sutra on the Descent of Maitreya, in which the Maitreya follows a similar path in life as that of Prince Siddhartha.Normally, it is impossible to hyperextend the first metatarsophalangeal joint and flex the first interphalangeal joint with the remaining toes in neutral position. In a close look, a shallow groove can be seen on the medial border of the big toe and metatarsophalangeal joint. The statue definitely shows a deformity of the right big toe, known as the hallux hammertoe (hallux malleus) or claw toe.A question then arises regarding why the artist who made this statue (600-650 AD) made a ‘deformed’ toe in a sacred statue of the future Buddha. A likely interpretation is that the model for the statue, who was believed to be a Buddhist nun or monk, had that deformity. Then, we may ask—why did that Buddhist nun or monk have a toe deformity?A recent article could provide an answer to this question. A cross-sectional survey was conducted in combination with foot and ankle examinations of monks living in northern Thailand. In the 208 monks who were included, common foot and ankle problems were callosity (70.8%), toe deformities (18.2%), plantar fasciitis (13.4%), metatarsalgia (3.8%), and numbness (2.9%). Commonly found toe deformities included hallux valgus and claw toe. Hallux valgus was found in 14.4% of Thai monks and claw toe in 4.3%. The reasons for monks’ foot deformities are as follows: 1) Thai monks usually walk without wearing shoes for long periods of time each day, causing increased pressure on the plantar surface of the foot. The push-off and heel-strike phases during barefoot walking create high pressure on the forefoot and heel, respectively; 2) Monks walk in rural areas that do not have smooth surfaces or on concrete or dirt roads. High contact pressure on the plantar aspect of the foot results in callosity; 3) Monks cease wearing shoes when they are ordained. Prior to that, their feet usually have not been accustomed to barefoot walking. Callosity and toe deformities were associated with prolonged barefoot walking over extended periods since ordainment (P < 0.05).2Based on this article, we infer that the early 7^th-century Buddhist monks, who practiced strict asceticism, walked barefoot like the Theravada monks in present-day Thailand (Fig. 2). Through the enigmatic smile, we also can conjecture that the Buddhist monks were happy and ‘awakened’ despite their foot deformity caused by their barefoot training.Open in a separate windowFig. 2Buddhist monks, who practiced strict asceticism, walked barefoot. This type of walking causes foot deformity (hallux hammertoe or claw toe).These deformities can now be improved by surgery. If the hallux hammertoe or claw toe is flexible, a tendon release may be helpful. If the deformity is rigid, joint fusion or arthroplasty may be needed to straighten the big toe.     

Afferent connections of the nucleus centralis amygdalae

Summary The central nucleus of the amygdala has been shown to be involved in cardiovascular regulation and the integration of arousal. In this study, the afferent input was investigated in cat by microinjecting horseradish peroxidase (HRP) into the central nucleus and examining retrogradely-labelled cells in the brain. Retrograde labelling was found in the cortex next to the sulcus ectosylvius anterior, fissura lateralis Sylvii, sulcus rhinicus anterior and posterior, sulcus suprasylvius, and pyriform and entorhinal cortices as well as in the insula and claustrum. Each of the sub-nuclei of the amygdaloid complex exhibited retrogradely-labelled perikarya. Labelled cells were also found in the diagonal band of Broca, nucl. lateralis septi, and nucl. proprius striae terminalis (bed nucl. of stria terminalis). In the hypothalamus the area preoptica medialis and lateralis, nucl. dorsomedialis, paraventricularis, periventricularis, arcuatus and mammilaris medialis were labelled. The nucl. subthalamicus, zona incerta, peripeduncular system, substantia nigra, and nucl. interpeduncularis contained HRP-marked cells. In the thalamus labelled cells were observed in the nucl. reuniens, nucl. centroposterior lateralis, nucl. latero-posterior, nucl. posterior, nucl. centro-anterior, antero-dorsalis, antero-medialis, antero-lateralis, centrum mdianum, nucl. reticularis, nucl. rhomboideus, nucl. parafascicularis and subfascicularis. The area tegmentalis Tsai and the corpora geniculata also contained labelled cells. In the brain stem, HRP-marked cells could be detected in the brachium colliculi inferioris, aqueductal grey matter, locus coeruleus, nucl. parabrachialis, in various nuclei of the formatio reticularis, in the nucl. retrofascialis, nucl. solitarius, nucl. commissuralis, nucl. ambiguus and nucl. dorsalis n. vagi. The results were compared to other neuroanatomical studies and to functional studies of the amygdala.     

Afferent connections of the subparafascicular area in rat

The subparafascicular nucleus and the subparafascicular area are the major sites of synthesis of the recently discovered neuropeptide, tuberoinfundibular peptide of 39 residues (TIP39). Better knowledge of the neuronal inputs to the subparafascicular area and nucleus will facilitate investigation of the functions of TIP39. Thus, we have injected the retrograde tracer cholera toxin B subunit into the rostral, middle, and caudal parts of the rat subparafascicular nucleus. We report that the afferent projections to the subparafascicular nucleus and area include the medial prefrontal, insular, and ectorhinal cortex, the subiculum, the lateral septum, the anterior amygdaloid area, the medial amygdaloid nucleus, the caudal paralaminar area of the thalamus, the lateral preoptic area, the anterior, ventromedial, and posterior hypothalamic nuclei, the dorsal premamillary nucleus, the zona incerta and Forel's fields, the periaqueductal gray, the deep layers of the superior colliculus, cortical layers of the inferior colliculus, the cuneiform nucleus, the medial paralemniscal nucleus, and the parabrachial nuclei. Most of these regions project to all parts of the subparafascicular nucleus. However, the magnocellular subparafascicular neurons, which occupy the middle part of the subparafascicular nucleus, may not receive projections from the medial prefrontal and insular cortex, the medial amygdaloid nucleus, the lateral preoptic area, and the parabrachial nuclei. In addition, double labeling of cholera toxin B subunit and TIP39 revealed a remarkable similarity between input regions of the subparafascicular area and the brain TIP39 system. Neurons within regions that contain TIP39 cell bodies as well as regions that contain TIP39 fibers project to the subparafascicular area. Overall, the afferent connections of the subparafascicular nucleus and area suggest its involvement in central reproductive, visceral, nociceptive, and auditory regulation.     

Diagnostic challenges of composite colorectal tumors of adenoma–mantle cell lymphoma type

Composite intestinal tumors of adenoma-lymphoma type are rare. To our knowledge 1 tumor showing this association has been previously reported, the histologic diagnosis being made retrospectively. We report the case of an 80-year old male patient complaining for epigastric pain, rectorrhagia, diarrhea, and weight loss. At endoscopy, a rectal lesion (3 cm) of villous low-grade dysplasia adenoma type was detected. Due to persistence of symptoms, new gastro- and coloscopies were performed, the biopsies showing low-grade dysplasia adenomas (right colon, and rectum) and an abundant lymphoid infiltrate (gastroduodenal anastomosis, small intestine, sigmoid, right and left colon, transverse colon, and rectum) of mantle cell lymphoma type, the rectal polyp being composed of both tumor types. The muscularis mucosa was focally infiltrated by the lymphoma, the bulk of the lymphoma being submucosal. After the treatment of 8 mini-cyclophosphamide, hydroxydaunorubicin, oncovin, prednisone cures, lymphoma persisted. On endoscopic ultrasound examination, after the 6 cures of bendamustine following the cyclophosphamide, hydroxydaunorubicin, oncovin, prednisone treatment, the signal of the rectal villous lesion disappeared in the peripheral layers, including of the muscular layer, suggestive of an invasive lesion or persistence of lymphoma. Biopsies confirmed the persistence of the rectal adenoma with low and high-grade adenoma, without lymphoma. In conclusion, the biopsic diagnosis of composite intestinal tumors of adenoma–mantle cell lymphoma type may be challenging, the bulk of the lymphoma being submucosal as in the present case. Although the malignant tumor treatment is the priority in such cases, the effects of chemotherapy on the evolution of benign tumors such as adenomas should be carefully assessed.     

Genetic drift. Descent, lineage, and pedigree of the Trojans in Homer's Iliad

Homer's Iliad, is an epic poem that describes the last 70 days of the Trojan War, which was waged against the city of Troy by the Achaeans. Here, the descent, lineage, and the pedigree of the Trojans are presented. In the Illiad, they are said to have originated from Zeus. Beginning with him, the Trojan pedigree comprised 17 men in 8 generations with Dardanus, founder of Dardania in the second generation; Tros, King of the Trojans in the fourth generation; and the two heroes Hector and Aeneas in the eighth generation. In the seventh generation, Priam, as King of the Trojans, had a huge family, including 50 sons: 19 children with his wife Hecabe, other sons with many different wives, and some daughters as well. Hector, the first born, became leader of the Trojans. Hector's brother, Paris, in abducting Helen of Sparta, the wife of King Menelaus, caused the Trojan War to break out.     

Investigation of trend in patients with pollinosis using web site: Comparison of these three years]

BACKGROUND: Recently, the number of patient with Japanese cedar pollinosis (JCP) has been increasing. In the last 3 years, the amount of pollen has been very volatile. In this study, we examined that whether the amount of pollen influenced symptoms and selfcare using web site. METHODS: For this examination, the questionnaire on web site was used from March 15 to April 30, 2003, 2004, and 2005 respectively. RESULTS: The rate of early treatments was high in the years when the amount of pollen was large, while the rate was low in the years when the amount of pollen was little. In the comparison of symptoms, the severity of the symptoms, in particular, nasal congestion, itchy eyes, watering eyes, and disturbance of sleep, was highly related to the amount of pollen. In addition, these symptoms were the severest in 2005. And the selfcare was also changing according to the amount of pollen. CONCLUSION: We concluded the greater the amount of pollen was, the severer the nasal congestion, eye symptoms, and disturbance of sleep were. The questionnaire survey that uses web site is a limited investigation of patient who has the access to the Internet. However, in the trend survey of JCP patients, it seemed that was extremely meaningful.     

Septation and valvar formation in the outflow tract of the embryonic chick heart

There is no agreement, in the chick, about the number of the endocardial cushions within the outflow tract or their pattern of fusion. Also, little is known of their relative contributions to the formation of the arterial valves, the subpulmonary infundibulum, and the arterial valvar sinuses. As the chick heart is an important model for studying septation of the outflow tract, our objective was to clarify these issues. Normal septation of the outflow tract was studied in a series of 60 staged chick hearts, by using stained whole-mount preparations, serial sections, and scanning electron microscopy. A further six hearts were examined subsequent to hatching. At stage 21, two pairs of endocardial cushions were seen within the developing outflow tract. One pair was positioned proximally, with the other pair located distally. By stage 25, a third distal cushion had developed. This finding was before the appearance of two further, intercalated, endocardial cushions, also distally positioned, which were first seen at stage 29. In the arterial segment, the aortic and pulmonary channels were separated by the structure known as the aortopulmonary septum. The dorsal limb of this septum penetrated the distal dorsal cushion, whereas the ventral limb grew between the remaining two distal cushions, both of which were positioned ventrally. The three distal endocardial cushions, and the two intercalated endocardial cushions, contributed to the formation of the leaflets and sinuses of the arterial roots. The two proximal cushions gave rise to a transient septum, which later became transformed into the muscular component of the subpulmonary infundibulum. Concomitant with these changes, an extracardiac tissue plane was formed which separated this newly formed structure from the sinuses of the aortic root. Our study confirms that three endocardial cushions are positioned distally, and two proximally, within the developing outflow tract of the chick. The pattern of the distal cushions, and the position of the ventral limb of the aortopulmonary septum, differs significantly from that seen in mammals.     

Reparative egeneration of liver with experimentally induced cirrhosis

Summary Cirrhosis of the liver, accompanied by ascites, was induced in rabbits by subcutaneous administration of carbon tetrachloride, and one-half of the liver was subsequently removed. A marked reduction in the amount of connective tissue, with the structure of the liver approaching normal, was observed during regeneration of the cirrhotic liver. The weight of the liver was restored to normal.Animals with experimentally induced cirrhosis of the liver, and not subjected to partial resection, perished. At various stages of the regenerative process, biochemical analysis of liver tissue, blood, and bile were carried out. Some of the biochemical indices became normal, whereas the glycogen, fatty acid, and cholesterol content of the liver was not restored to the normal level even by the end of the month. After excision of one-half of the cirrhotic liver, regeneration of hepatic parenchyma is evidently greater than the connective tissue proliferation.(Presented by Active Member AMN SSSR, N. N. Zhukov-Berezhnikov) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 51, No. 1, pp. 74–79, January, 1961     

2010年广州市越秀区中小学校直饮水机直饮水卫生状况调查

目的了解2010年广州市越秀区中小学校直饮水机卫生状况。方法随机抽取42所学校作为调查对象。其中中学20所、小学22所,共设监测点54个。每个监测点分别采集管网分梢近端水、入机自来水、直饮水各1份水样。每份水样均检测浑浊度、臭和味、色度、肉眼可见物、pH值、挥发酚类、总大肠菌群、耐热大肠菌群、耗氧量、锰、铅、三氯甲烷、砷、四氯化碳、亚硝酸盐等共15个项目。结果检测管网分梢近端水、入机自来水、直饮水共162份水样,臭和味、色度、肉眼可见物、挥发酚类、总大肠菌群、耐热大肠菌群、锰、铅、三氯甲烷、砷、四氯化碳等共11项全部合格,耗氧量、亚硝酸盐、pH值、浑浊度等4项均存在不合格的情况。结论越秀区学校直饮水机总体情况良好,直饮水的主要不合格项目为耗氧量、亚硝酸盐、pH值和浑浊度,总合格率需进一步提高。     

A histochemical study of the development of the neurones of the supra-optic nucleus of the hypothalamus and posterior hypophyseal lobe in rats

Summary In the development of the supra-optico-hypophyseal system of rats, changes in the chemical composition of the neurosecretion, the cellular elements, and the cytoplasm occur. On the 20–22nd day of embryonic development the cytoplasmic reaction of protein containing tyrosine, tryptophane, and histidine, and of the carboxyl group proteins is intensified, as is also the chromatophilia.These changes seem to be associated with the development of the neurosecretory mechanism. The chemical properties of the neurosecretion continue to change with age. While the pituicytes are developing, at the same time that the neurosecretion appears, the cytoplasmic ribonucleoproteins in the posterior hypophyseal lobe disappear, and vacuoles develop in the peripheral parts. Fat droplets accumulate in the cytoplasm during pituicyte development. There is more fat and neurosecretion in the pituicytes in the ventral part of the posterior lobe than in the dorsal part.Presented by Academician, V. N., Chernigovskii Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 58, No. 8, pp. 114–116, August, 1964     

Evaluation of the RIM-N, Gonochek II, and Phadebact systems for the identification of pathogenic Neisseria spp. and Branhamella catarrhalis.

Methods for identifying Neisseria spp. include conventional and modified carbohydrate degradation procedures, chromogenic enzyme substrate tests, and immunologic coagglutination tests for Neisseria gonorrhoeae. In this study, we evaluated the abilities of the RIM-N carbohydrate degradation system (American MicroScan, Campbell, Calif.), the Gonochek II enzymatic identification system (Du Pont Co., Wilmington, Del.), and the Phadebact Gonococcus coagglutination test (Pharmacia Diagnostics, Piscataway, N.J.) to identify pathogenic Neisseria spp. and Branhamella catarrhalis. Both stock strains and clinical isolates, including 176 N. gonorrhoeae, 173 Neisseria meningitidis, 48 Neisseria lactamica, and 12 B. catarrhalis strains, were tested. The RIM-N identified 98% of the gonococci, 99% of the meningococci, 94% of the N. lactamica strains, and 100% of the B. catarrhalis strains within 1 h. The Gonochek II system identified 99% of the gonococci, 97% of the meningococci, 100% of the N. lactamica strains, and 100% of the B. catarrhalis strains within 30 min. Phadebact coagglutination provided clearly positive results for only 77% of the N. gonorrhoeae strains, producing negative or equivocal results with 23% of the strains. The RIM-N and Gonocheck II tests generally produced clear-cut reactions. An additional advantage of the Gonocheck II system was the small inoculum required for the performance of the test compared with the other systems, thus allowing the identification of N. gonorrhoeae directly from the primary isolation medium.     

基于纵向不完整数据联合深度集成回归预测阿尔茨海默病临床评分

阿尔茨海默病(AD)是一种进行性神经系统退行疾病,具有不可逆性,需要医生密切监测患者的病情,并根据病情发展及时调整治疗计划。研究表明,临床评分是医生进行疾病评估的最有效依据,且磁共振成像(MRI)数据也非常适合用于预测阿尔茨海默病患者的临床评分。传统研究中,学者们大多是基于单一时间点的MRI数据进行临床评分预测。提出建立一个探索MRI数据与临床评分之间关系的模型,并使用纵向MRI数据预测未来时间点的临床评分。该模型包含3个部分:首先基于相关熵正则化联合学习进行特征选择;然后基于深度多项式网络进行特征编码;最后利用支持向量回归。回归过程在两种情形下进行,情形1是使用基线数据预测未来时间点的临床评分,情形2是结合被测时间点之前的所有数据预测该时间点的临床评分。与此同时,情形2还可填补缺失评分,解决了数据的不完整问题。在情形1中,通过所提出的模型对未来5个不同时间点的临床评分进行预测,获得的平均绝对误差值为2.01、2.06、2.06、2.27、2.00以及皮尔森相关系数值为0.70、0.69、0.56、0.65、0.67。在情形2中,所提出的模型在未来4个不同时间点获得的平均绝对误差值为0.14、0.10、0.09、0.08以及皮尔森相关系数值为0.72、0.75、0.78、0.74。通过以上实验证明,所提出的回归框架不仅可准确描述MRI数据与评分之间的关系,而且可以有效地预测纵向评分。     

千伏级锥形束CT与兆伏级电子摄野影像系统在鼻咽癌影像引导放疗的对比研究

目的:分析千伏级锥形束CT与兆伏级电子射野影像系统用于测量鼻咽癌调强放射治疗的摆位误差,评价两种技术在鼻咽癌调强放疗摆位修正中的应用价值。方法:选取施行IMRT的鼻咽癌患者21例,于放疗实施前先进行EPID正侧位片的拍摄,再进行KV-CBCT的扫描。将EPID拍摄的正侧位片与数字重建射线影像(DRR)配准,得出x、y、z三个线性方向的摆位误差值,同时将扫描的CBCT图像与计划CT图像进行自动的骨性配准,得出x、y、z三个线性方向和绕x轴、y轴和z轴的三个旋转方向的摆位误差值;最终对EPID和CBCT获得的两组数据进行分析比较,分别计算摆位误差以及计划靶体积(planning target volume,PTV)边界;两种技术校正前后的结果进行配对t检验;两种技术的残余误差进行配对t检验结果。结果:CBCT组校正前x、y、z轴的MPTV分别是:3.30 mm、2.58 mm、2.99 mm,校正后分别是1.71 mm、1.71 mm、1.98 mm,t检验有统计学意义(P<0.05);EPID组校正前x、y、z轴的MPTV分别是:2.56 mm、4.02 mm、3.40 mm,校正后为校正前后各个方向0.9 mm、2.37 mm、4.23 mm,t检验有统计学意义(P<0.05)。CBCT与EPID残余误差的数据有统计学意义(P<0.05)。结论:与EPID相比较,CBCT在校正后能使MPTV缩小至2 mm,大大提高了放疗精度,通过残余误差的比较发现CBCT校正误差的能力优于EPID。