母乳哺育支持系统对初产妇产后母乳喂养的影响

目的探讨母乳哺育支持系统对初产妇产后母乳喂养的影响。方法将69例自然分娩的初产妇随机分为观察组35例和对照组34例,观察组新生儿出生后给予持续性母婴皮肤接触1h,由母乳哺育支持团队成员提供母乳喂养护理支持,出院后哺乳顾问持续跟踪并给予帮助;对照组则行皮肤接触至产妇会阴伤口缝合并检查完毕,给予常规产后护理。比较产后不同时间纯母乳喂养率及母乳喂养率。结果观察组出院时、产后7d、4个月及6个月的纯母乳喂养率显著高于对照组(P0.05,P0.01),观察组产后7d、4个月及6个月的母乳喂养率显著高于对照组(均P0.05)。结论医院母乳哺育支持系统能有效提高初产妇产后纯母乳喂养率和母乳喂养率。     

库车坳陷东部迪北侏罗系致密砂岩气藏特征

岗位评价又称职位评价,是指在岗位分析的基础上,按照一定的标准,对各个岗位的工作性质、责任要素、复杂因素、任职要素、工作环境等方面进行综合性的评价,确定岗位相对价值的过程[1].岗位评价方案通过对一系列报酬要素的排序或评分,衡量工作的相对价值,明确各个岗位的分类、级别的高低,保证对每个岗位的工作人员进行考核、晋升、奖罚等管理时,具有统一的标准,是现代人力资源管理理论中的重要内容.本文对国内外岗位评价方法及应用现状综述如下.     

Facile synthesis and optical properties of colloidal quantum dots/ZnO composite optical resonators

We present a novel colloidal quantum dot (CQD)/ZnO whispering gallery mode microcavity composite. The whispering gallery mode emission of the CQDs induced by the ZnO microcavity is realized. The resonant properties of the composite optical cavities are systematically investigated, and the obtained results are supported by finite element method simulations. The work presents a new research platform to study light–matter interactions in such a composite microcavity.

We present a facile method of incorporating CdSe/Zn_xCd_1−xS CQDs onto the surface of a ZnO WGM optical microcavity. The whispering gallery mode emission of the CQDs induced by the ZnO microcavity is directly observed.

Quantum dots (QDs) feature a quantized energy structure, attracting considerable attention due to their narrow-linewidth emission spectra, high quantum efficiencies, and broad-energy-range size-tunable band gaps.^1,2 In this research field, great efforts have been devoted to the studies of the combination of QDs with optical microcavities, which is very important both for fundamental research on light–matter interactions and for optics- and photonics-related applications. Most of the previously described composite systems feature a distributed Bragg reflector (DBR) structure and self-assembled QDs, which have allowed great progress in the development of single-photon sources,^3,4 photodetectors,^5,6and cavity lasers.^7,8 However, the above QDs (used as gain materials in these composites) were mostly based on III–V semiconductors prepared by molecular beam epitaxy (MBE)⁹ or metal-organic chemical vapor deposition (MOCVD).^10,11 Moreover, DBR-structured microcavities are usually fabricated using MBE, MOCVD, or sputtering, additionally requiring the utilization of electron beam lithography (EBL) and other nano-etching technologies.^12–16 Thus, these sophisticated and expensive fabrication techniques and limited material availability are not conducive to the development of this research field.In contrast, colloidal quantum dots (CQDs) exhibit the advantages of high optical stability, solution processability, and emission wavelength tunability,^17,18 being well suited for use in composite microcavities. However, the hybridization of CQDs is difficult, with the main method used for this purpose also being rather complex, featuring the insertion of a CQDs layer into the DBR structure by spin coating.¹⁹ The methods like epitaxial growth have been used to synthesize and incorporate CQDs into a photonic crystal distributed feedback (PC-DFB) optical cavity,²⁰ or fabricate on-chip microdisk laser.²¹ They all require expensive equipment, e.g. plasma-enhanced chemical vapor deposition (PECVD) or RF frequency sources, and the process of them are also relatively complex. In addition, alkyl modification and drop-coating also have been used to attach CQDs to silica microbeads²² and submicron scale grating structures²³ showing good composite effect. Nano/microstructure optical cavities with regular geometric configurations are another important class of microcavities,^24–26 attracting growing interest due to their ease of synthesis, high tunability, and excellent optical confinement effect. Among these cavities, ZnO microrod hexagonal whispering-gallery-mode (WGM) microcavities are the ones most extensively studied,^27–31 allowing light confinement due to multiple total internal reflection (TIR) at resonator boundaries and thus enabling effective control of light–matter interaction. This control is essential for both fundamental physics research in the field of cavity quantum electrodynamics and the development of cavity-based optoelectronic devices, and it is therefore believed that the formation of CQDs/microcavity composites will promote further progress in the optical modulation of CQDs.Herein, we present a facile method of incorporating CdSe/Zn_xCd_1−xS CQDs onto the surface of a ZnO hexagonal microrod WGM optical cavity. The modulated emission of the CQDs induced by the ZnO microrod cavity was observed. And, the coupling properties of the CQDs/microcavity composite system have been also studied at room temperature. A whispering gallery mode (WGM) was identified by calculations based on the TIR model and further confirmed by Finite Element Method (FEM) simulations. Furthermore, the resonant properties in relation to the CQDs were studied in detail. Notably, we also demonstrate the occurrence of energy transfer between CQDs and the ZnO microcavity. Thus, our work describes a simple method of investigating optical property coupling between CQDs and nano/microstructure optical cavities.Single-crystalline ZnO microrods were grown on a silicon (Si) substrate in a horizontal tube furnace (with no catalysts, carrier gases, low pressure, or templates used) utilizing a reduction–oxidation method similar to that described in our previous report.³² Core/shell CdSe/Zn_xCd_1−xS CQDs were prepared as described elsewhere,³³ purified by centrifugation and decantation using a toluene/ethanol mixture as a solvent, and redispersed in toluene. The CQDs/ZnO microrod composite was prepared by dropcasting the above dispersion onto ZnO microrods deposited on a clean Si wafer to form a thin CQDs film, with the corresponding photoluminescence (PL) spectra recorded after solvent evaporation. The morphology, composition, and microstructures of the obtained samples were characterized by field emission scanning electron microscopy (FE-SEM, Zeiss Auriga S40), high-resolution transmission electron microscopy (HRTEM, JEOL JEM-2010), and energy-dispersive spectroscopy (EDS). The optical properties of a chosen individual ZnO microrod were determined by confocal micro-photoluminescence spectrometry (JY LabRAM HR800 UV) using a 325 nm He–Cd laser as an excitation source. FEM simulations were carried out using commercial finite element software (COMSOL Multiphysics). Fig. 1(a) shows atypical SEM image of as-synthesized ZnO microrods. A large quantity of rod-like microstructures with smooth surface was produced on the Si wafer. Most of the microrods have diameters in the range of 2–5 μm and lengths exceeding 100 μm. Microrods with smaller sizes of about several hundred nanometers were also observed. Fig. 1(b) shows the detailed morphology of a single ZnO microrod with a side length of ∼2 μm. The enlarged SEM image of the microrod exhibits a perfect hexagonal cross section and smooth surfaces, which benefit the formation of natural WGM microcavities and make such microrods ideal carriers for the study of CQDs/microcavity composites. A three-dimensional (3D) scheme of the WGM microcavity of the CQDs/ZnO microrod composite is shown in Fig. 1(c). The composite method is very simple. The CdSe/Zn_xCd_1−xS core/shell semiconductor CQDs solution were dropped on the ZnO microrod. After the solvent evaporation, it then formed a thin film of CQDs. Fig. 1(d) shows the HRTEM image of the CQDs/ZnO microrod composite. It can be clearly seen that a layer of CQDs closely covering the surface of the ZnO microrod. The interface between ZnO surface and CQDs layer was labelled with a red dotted line. The CQDs are well dispersed with a diameter of about 5 nm as marked out by red circles. Meanwhile, the well-resolved lattice fringes demonstrate the highly crystallined nature of the CQDs nanocrystals. Moreover, the EDS elemental mapping further identified the presence of ZnO in the core part and of CdSe/Zn_xCd_1−xS CQDs on the surface (Fig. 1(f–j)).Open in a separate windowFig. 1Typical SEM images of as-synthesized ZnO microrods: (a) low-magnification SEM image; (b) high-magnification SEM image revealing the morphology of an individual ZnO microrod with a hexagonal cross-section; (c) 3D scheme of a single core/shell CQDs and a CQDs/ZnO microrod composite; (d) HRTEM images of the above composite; (e) SEM image of a typical CQDs/ZnO composite; (f–j) EDS elemental mappings of O, Zn, Cd, Se, and S, respectively.The optical properties of the individual ZnO microrod were investigated by confocal micro-photoluminescence spectrometry using an excitation laser focused by a 40× objective to a ∼2 μm spot. PL spectra were recorded using a silicon charge-coupled-device (CCD) detector and a 600 line/mm grating. Photoluminescence imaging was carried out using a self-built confocal micro-photoluminescence spectrometer with a 405 nm laser. Fig. 2(a) shows atypical PL spectrum of the ZnO microrod, revealing the presence of a characteristic ZnO exciton emission in the UV range (around 380 nm) and abroad point defect emission band between 450 and 700 nm with clear modulations. The intensity of defect emission was stronger than that of exciton emission, and the absence of obvious emission resonant modes in the UV emission band were ascribed to a mode spacing too small to be resolved in the narrow UV band, with the optical absorption around the band edge region being larger. Fig. 2(b) depicts an expanded view of resonance peaks between 480 and 590 nm, clearly showing the microrod resonator for both TE (electrical component of light E⊥c-axis) and TM (E∥c-axis) polarization configurations. From the viewpoint of geometrical optics, two kinds of resonant cavity modes may form in the microrod cavity, namely simple WGM microcavities formed by multiple TIR from the six surfaces and F–P modes formed for two pairs of opposite facets. To determine the exact mode responsible for the signal, two adjacent peaks (λ₁ = 519.2 nm, λ₂ = 525.9 nm) of the TM signal were selected to calculate the path length (L) as follows:1where n is the refractive index of the medium, and dn/dλ is the dispersion relation, with Δλ (mode spacing between two adjacent peaks, also called free spectral range, FSR³⁴) = 6.7 nm, n = 2.06 (λ₁ = 519.2 nm), and λdn/dλ = −0.6 obtained using the refractive dispersion of ZnO in ref. 32. The calculated path length equaled ∼15.06 μm, and the side length (R) of the microrod used for the PL measurement equaled 2.94 μm, as determined by SEM imaging. If the resonant modes were simple F–P modes, the deduced values of L would equal 4R, i.e., ∼11.8 μm. Obviously, the calculated effective path length was much smaller than that (15.06 μm) calculated using eqn (1), which proved the above hypothesis wrong. Conversely, for the whispering gallery mode, the relevant path length was calculated as , agreeing with the theoretically calculated value given above. Thus, it was concluded that the observed resonant modes were mainly caused by the effect of the WGM microcavity. For the whispering gallery mode, the incident angle equaled 60°, with one full path featuring six TIRs. Such WGM microcavities can effectively control light emitted from ZnO itself, facilitating the research of light–matter interaction and the development of relevant optical devices.Open in a separate windowFig. 2(a) PL spectrum of an individual ZnO microrod. (b) Enlarged region of the above spectrum from 480 to 590 nm. (c) Corresponding ZnO dispersion relations. (d) Full-range PL spectra of ZnO (blue line), CQDs (blackline) and CQDs/ZnO (red line), respectively; inset shows a fluorescent image of the CQDs/ZnO composite. (e) The PL spectrum of CQDs in the range of 600–725 nm. (f) Corresponding resonator mode numbers of pure ZnO and the CQDs/ZnO composite in the range of 508–536 nm.To further explore the characteristics of the ZnO microrod WGM resonator, we identified the interference order N for TE and TM modes using the following equation:2where n is the refractive index of the ZnO sample, and N is the interference order of the resonant mode. The factor β is dependent on polarization. For TE polarization β = n, for TM polarization β = 1/n.The interference order N of the TE and TM modes were initially identified, using the refractive dispersion of ZnO microtubes.²⁶ The best fit of the interference order (N_TE = 47–66, N_TM = 48–67) was obtained by varying N systematically and the cavity length L within the experimental error. A similar fitting process has been utilized to calculate the refractive indices of ZnO microtubes.³⁵ These two series of integers are the interference orders for the relevant resonant modes between 480 nm and 590 nm. Using the obtained interference orders and the cavity length L, the accurate wavelength–dependent refractive dispersions (n_TE & n_TM) of the ZnO microrod were calculated. The dispersion relation is shown in Fig. 2(c), and the fitting Cauchy dispersion formula as follows:34It is worth noting that at a given wavelength, n_TM is larger than n_TE, with both indices decreasing with increasing wavelength.The formation of a CQDs/ZnO microrod WGM microcavity composite was confirmed by fluorescence imaging, which revealed that the ZnO microrod cavity was decorated with CQDs emitting red light with a wavelength of ∼650 nm (inset in Fig. 2(d)). To further elucidate the optical performance of the composite, we compared it with the PL spectrum of the pure CQDs and ZnO together. Interestingly, we found that some resonant peaks appear in the CQDs emission region in the CQDs/ZnO composite system. This indicates that the light of CQDs may be introduced into the ZnO microcavity and then was modulated. In fact, the thickness of the combined CQDs layer on the surface of the microcavity is critical for the optical resonance of the CQDs. If the combined CQDs layer was too thick, it will weaken the modulated light coupled in the microcavity emitted out. This phenomenon was also observed in other composite system.²⁸ In addition, it is worth noting that the CQDs emission was clearly blue-shifted after hybridization with the microcavity (Fig. 2(e)), probably due the formation of an oxidized layer on the CQDs surface under ambient conditions,²⁸ which also decreased the effective CQDs size. Fig. 2(f) shows an expanded view of resonance peaks between 508 and 536 nm, demonstrating that the resonant modes of the CQDs/ZnO microrod cavity were preferentially TM-polarized and clearly red-shifted, with TE modes being very weak and difficult to observe. This behavior was ascribed to the refractive index change of the medium caused by CQDs hybridization, as described by the following formula:³⁶5where n_CdSe is the refractive index of CQDs. The refractive index³⁷ of CQDs is n_CdSe = 1.73, which is larger than that of the air medium. For the same resonant peak, the wavelength of the resonant peak will increase with the decrease of the relative difference of the refractive index, resulting in a redshift as shown in Fig. 2(f). Moreover, the deposition of a CQDs layer on the surface of the microrod cavity mainly increases the optical loss of the TE polarization mode, complicating its detection.Interestingly, we also noticed that a broad and weak emission in the CQDs/ZnO composite microcavity appears obviously from 400 to 440 nm as shown in Fig. 3(a). And, the intensity of the exciton emission (from 370 to 390 nm) of ZnO decreases. In addition, we found that the CQDs used in our experiments also have a broad and weak emission at the same wavelength band as shown in Fig. 3(b). Moreover, the shape of the emission peak is very similar to that of the composite microcavity at the same region. This indicates there may be energy transfer between the ZnO and the combined CQDs. In fact, the broad weak emission was attributed to CdS CQDs, which synthesized along with the synthesis process of the core/shell CdSe/Zn_xCd_1−xS CQDs. From Fig. 3(c), it is clearly seen that the absorption spectrum of CdS CQDs covers the emission wavelength of the ZnO excitons at ∼390 nm. The central emission wavelength of CdS CQDs is ∼406 nm, and full width at half-maximum is 25 nm. After the CQDs attached to the surface of ZnO microrod, the distance between CQDs and microrod is close enough for fluorescence resonance energy transfer (FRET) to occur. The inset of Fig. 3(c) is the energy band structure of ZnO and CdS CQDs.^2,38 During FRET, the exciton of ZnO, initially in its electronic excited state, transfers its energy to the acceptor CdS via non-radiative dipole–dipole coupling, damping the band gap emission of the ZnO microrod and enhancing the emission intensity of CdS CQDs, which explains the PL spectra shown in Fig. 3(a). However, the above behavior was not observed when a purified CQDs solution (free of CdS CQDs) was used under the same experimental conditions (Fig. 3(d)), further verifying the occurrence of FRET in the CQDs/ZnO composite microcavity.Open in a separate windowFig. 3(a) PL spectra expanded in the range of 360–470 nm. (b) PL spectrum of CQDs in the range of 360–450 nm. (c) Absorption and PL spectra of CdS CQDs, with inset showing a FRET diagram with typical timescales. (d) PL spectra of CdS CQDs–free CdSe/Zn_xCd_1−xS core/shell CQDs, ZnO microrods, and the CQDs/ZnO composite.To clarify the nature of the resonance modes observed in the PL measurements, FEM simulations are used to study such ZnO or CQDs/ZnO microrod composite microcavity with hexagonal cross-section. Because of the two-dimensional (2D) nature of the measured optical modes, we only simulate a 2D model to simplify our calculation. In our simulations, the modeled microcavity with the same hexagonal cross-section as the fabricated microrod shown in Fig. 1(a) (i.e., a side length of 2.94 μm) is placed inside a simulation box surrounded by the well-matched layer boundaries to absorb the scattered electromagnetic fields. Here, TM polarization was chosen for comparing experimental and simulated results, and the dispersive refraction index of ZnO was therefore calculated from the PL spectrum of this material using eqn (3). The refractive index of CQDs was assumed to equal 1.73. And the dispersive refractive index of ZnO described by eqn (3) is directly imported into the software. The background medium in the simulation box was set to air or CdSe for investigating the microcavities of ZnO or the CQDs/ZnO composite, respectively. An electric current source was placed inside the 2D microcavity to excite TM-polarized optical modes. We choose a very dense mesh inside the ZnO microrod (<λ/20) and surrounding air (<λ/10) to guarantee the convergence of our results.The calculated radiation intensity spectra of the current source inside ZnO and CQDs/ZnO composite microcavities are shown in Fig. 4(b and d), respectively, revealing that if the radiation wavelength of the line source matches that of a microcavity resonance mode, its radiation is significantly enhanced, with these peaks being unambiguous signatures of the optical modes excited in the microcavity. In our calculation, the intensity of the current source was identical for all excitation wavelengths and, therefore, key information was provided only by the position of radiation peaks, with its intensity being negligible. For both ZnO and CQDs/ZnO composite microcavities, the resonance peaks of FEM-simulated radiation spectra well matched those observed experimentally (Fig. 4(a–d)), with the slight mismatch observed for CQDs/ZnO at short wavelengths attributed to the slight poor dispersion of CdSe that was ignored in our simulation (Fig. 4(c and d)). If the microcavity is surrounded by CQDs instead of the air, the resonance modes leak out of the ZnO microcavity more easily owing to the increased refraction index of the background medium, which increases the effective optical path for the resonance modes and induces their red shift (Fig. 4(b and d)). To justify these arguments, we further utilized the eigenmode analysis solver of COMSOL Multiphysics to search all eigen resonance modes supported by the two microcavities. For example, Fig. 4(e–h) show the electric field patterns of two representative resonance modes, clearly identifying the features of WGMs with N = 47 and 55. Likewise, the calculated resonance wavelengths (see insets) perfectly matched the peak positions marked by dashed lines in Fig. 4(a–d), demonstrating that N = 55 (N = 47) resonance modes shift from 547.8 nm (618.0 nm) in the ZnO microcavity to 556.9 nm (631.5 nm) in the CQDs/ZnO composite microcavity. In particular, the long-wavelength modes located in the fluorescence region of CdSe can indeed modulate the light emission of CQDs.Open in a separate windowFig. 4Measured PL spectra (a, c) and FEM-simulated radiation spectra (b, d) of a single ZnO microrod (a, b) and a CQDs/ZnO composite (c, d) with a hexagonal cross-section, and the corresponding WGM electric field distributions (e–h) at specified wavelengths.     

Heart Failure with Preserved Ejection Fraction Trials Have Heterogeneous Control Groups: a Comparison of Kaplan-Meier Curves

Purpose

Previous studies have evaluated intra-study heterogeneities of heart failure with preserved ejection fraction (HFpEF), but inter-study heterogeneities remain poorly understood. We investigate the heterogeneities of outcomes among control groups of HFpEF trials.

Methods

We included randomized controlled trials recruiting HFpEF patients with ejection fraction ≥?40% and reporting Kaplan-Meier curves for at least 36 months. The Kaplan-Meier curves of control groups were extracted and calculated for hazard ratios and 95% confidence intervals. Two virtual trials were developed to validate the reliability and accuracy of our method.

Results

Of 4161 studies, we included six trials containing 7682 HFpEF patients in control groups. The DIG trial had the highest all-cause mortality, cardiovascular mortality, heart failure mortality, and composite endpoints of cardiovascular mortality and heart failure hospitalization (all p?<?0.001). The TOPCAT trial had the lowest all-cause mortality, cardiovascular mortality, heart failure hospitalization, and composite of cardiovascular mortality and heart failure hospitalization (all p?<?0.001). Adoption of different ejection fraction cut-off values for HFpEF diagnosis did not significantly change the outcomes of control groups in the DIG trial (45% vs. 50%: hazard ratio, 1.05, 95% confidence interval, 0.97–1.13, p?=?0.271), or in the CHARM-Preserved trial (40% vs. 50%: hazard ratio, 1.01, 95% confidence interval, 0.93–1.09, p?=?0.864) during 36-month follow-up.

Conclusions

The control groups of HFpEF trials have heterogeneous outcomes. Future trials should consider these heterogeneities when designing protocols.

     

TVSSLRP术联合渐进性放松训练对低危前列腺癌术后患者生理应激反应、勃起功能及心理状态的影响

目的 探讨低危前列腺癌术后患者应用经膀胱单孔腹腔镜前列腺癌根治术(TVSSLRP)联合渐进性放松训练对其生理应激反应、勃起功能及心理状态的影响.方法 选取2018年4月至2020年4月我科86例低危前列腺癌术后患者作为研究对象,以抽签法分组.对照组43例给予TVSSLRP治疗,观察组43例增加渐进性放松训练治疗.对比两组患者生理应激反应、勃起功能及心理状态.结果 术前,两组患者焦虑自评量表评分(SAS)、抑郁自评量表评分(SDS)、国际勃起功能量表评分(IIEF)、国际前列腺症状评分(IPSS)及脉搏、收缩压、舒张压水平比较均无明显差异(P＞0.05);术后1个月,观察组SAS(42.53±5.89)分、SDS(42.57±5.09)分低于对照组(49.87±5.24)分、(50.41±5.82)分(P＜0.05);术后3个月,观察组SAS (32.04±4.50)分、SDS(30.68±3.34)分高于对照组(45.86±5.93)分、(41.52±4.69)分(P＜0.05).术后1个月,观察组脉搏、收缩压、舒张压水平均低于对照组(P＜0.05);术后3个月,两组患者脉搏、收缩压、舒张压水平比较均无统计学意义(P＞0.05).结论 TVSSLRP联合渐进性放松训练治疗能够改善低危前列腺癌术后患者勃起功能及心理状态,减轻生理应激反应.     

Decreased cortical thickness of left premotor cortex as a treatment predictor in major depressive disorder

Brain Imaging and Behavior - This study aimed to examine the cerebral cortex characteristics (thickness, surface area, and curvature) in patients with major depressive disorder (MDD), and explore...     

骨科进修生带教工作的经验与体会

进修学习是医师毕业后继续教育的重要方式,目前对进修生的教育培训工作还存在很多问题,我科根据近年来进修医生来源和需求的变化,适应学科的发展趋势,加强教育,使带教人员充分认识进修生培养的重要性;针对性采取措施,根据不同基础和需求因材施教;同时建立健全相关制度,用制度保障培养效果,使得进修生培养质量明显提高,促进了科室的良性发展。     

地塞米松鞘内注射与静脉注射在显微血管减压术后无菌性脑膜炎中的疗效比较

目的比较腰椎穿刺鞘内注射地塞米松与静脉推注地塞米松治疗显微血管减压术（MVD）术后无菌性脑膜炎（AM）的临床疗效。 方法选择自2015年1月至2020年1月于胜利油田中心医院神经外科就诊行MVD并诊断为AM的138例患者为研究对象,将患者分为对照组（68例）和观察组（70例）。对照组患者采用静脉推注地塞米松（10 mg/次）治疗,频率为按需给药;观察组患者采用腰穿放液联合鞘内注射地塞米松[60 μg/（kg·次）]治疗,频率为每日或隔日1次。比较2组患者治疗后的头痛及发热缓解情况、术后住院时间、治疗次数及激素不良反应情况。 结果治疗后8、72 h后,2组患者头痛、发热症状均明显好转,且观察组明显优于对照组,差异均有统计学意义（P<0.05）;观察组患者的术后住院时间[（7.68±2.23）d]短于对照组[（12.76±2.37）d],治疗次数[（3.5±0.6）次]明显低于对照组[（6.8±0.9）次],差异具有统计学意义（P<0.05）,2组患者均未见明显的激素不良反应。 结论腰穿放液联合鞘内注射地塞米松在治疗MVD术后AM患者中疗效确切,可有效改善患者头痛、发热等临床症状,减轻激素用量,缩短术后住院时间,具有重要的临床推广价值。     

Correlations of morphology and molecular alterations in traditional serrated adenoma

Traditional serrated adenoma was first reported by Longacre and Fenoglio-Presier in 1990. Their initial study described main features of this lesion, but the consensus diagnostic criteria were not widely adopted until recently. Traditional serrated adenoma presents with grossly protuberant configuration and pinecone-like appearance upon endoscopy. Histologically, it is characterized by ectopic crypt formation, slit-like serration, eosinophilic cytoplasm and pencillate nuclei. Although much is now known about the morphology and molecular changes, the mechanisms underlying the morphological alterations are still not fully understood. Furthermore, the origin of traditional serrated adenoma is not completely known. We review recent studies of the traditional serrated adenoma and provide an overview on current understanding of this rare entity.