颅内动脉瘤栓塞后并发脑缺血的原因分析

1 临床资料我们总结2004-02/2004-06在第四军医大学唐都医院神经外科住院行栓塞治疗颅内动脉瘤患者27(男12,女15)例,年龄32～72岁.     

胸腹部联合损伤73例诊治分析

1临床资料 1995-07／2003-12收治胸腹联合伤73（男52，女21）例，年龄3～72（平均47）岁，急诊入院69例，受伤至急诊入院时间为1／3～16h，致伤原因：穿透伤26例，其中刀刺伤23例，枪伤3例，闭合伤47例，其中车祸38例，坠落伤9例，入院时伴休克50例，呼吸急促36例，胸痛29例，腹痛20例，胸腹联合痛14例，昏迷10例，气管移位11例，伤侧呼吸音减弱或消失17例。     

Desmoplastic fibroma of the proximal ulna

A young man presented with desmoplastic fibroma in the proximal ulna. This rare tumour was treated by curettage and bone grafting.     

Serum levels of CD14 in neonatal sepsis by Gram-positive and Gram-negative bacteria

The purpose of this study is to measure soluble CD14 (sCD14) levels in sera from newborn with sepsis, to compare it with other markers, and to study its evolution in Gram-negative and Gram-positive sepsis. Forty normal newborns were included (26 were full term and 14 were preterm infants), 20 babies had a positive blood culture (11 Gram-positive and 9 Gram-negative) and 16 cases were suspected of having sepsis based on clinical and laboratory findings, but a negative blood culture. Interleukin-6 (IL-6), sCD14, and tumour necrosis factor-α (TNFα) were measured by enzyme immunoassay, and fibronectin (FN) and C-reactive protein (CRP) by radial immunodiffusion. Neonates with a positive blood culture had increased levels of sCD14(3.20 ± 1.26μgml^-1, p < 0.001), CRP(69 ± 46 μgml^-1, p < 0.001)and IL-6 (134 ± 150 pg ml^-1, p < 0.001), and decreased values of FN (12.3 ± 6.6 mg ml^-1, p < 0.001). TNFα levels were also high (160 ± 37 pg ml^-1), but this increase was not statistically significant. Newborn infants suspected of having sepsis but a negative blood culture had similar but milder abnormalities. Soluble CD 14 levels correlated with CRP values; however, there was no correlation between sCD 14, TNFα and IL-6. Neonates with sepsis by Gram-positive bacteria had lower sCD14 levels than patients with Gram-negative sepsis (2.63 ± 1.2 versus 4.04 ± 1.0μgml^-1, p < 0.05). In conclusion, the sCD14 level is increased in newborn infants with sepsis, and this is higher in infections by Gram-negative bacteria, suggesting a different contribution of monocyte and macrophage cells. In contrast, IL-6, TNFα, CRP and FN values are similar in infections by Gram-positive and Gram-negative bacteria.     

Perceptron error surface analysis: a case study in breast cancer diagnosis

Perceptrons are typically trained to minimize mean square error (MSE). In computer-aided diagnosis (CAD), model performance is usually evaluated according to other more clinically relevant measures. The purpose of this study was to investigate the relationship between MSE and the area (A(z)) under the receiver operating characteristic (ROC) curve and the high-sensitivity partial ROC area ((0.90)A'(z)). A perceptron was used to predict lesion malignancy based on two mammographic findings and patient age. For each performance measure, the error surface in weight space was visualized. Comparison of the surfaces indicated that minimizing MSE tended to maximize A(z), but not (0.90)A'(z).     

Multifractal texture analysis of perfusion lung scans as a potential diagnostic tool for acute pulmonary embolism

A computer-assisted diagnostic (CAD) tool was developed for the diagnosis of acute pulmonary embolism (PE) in perfusion lung scans. Forty-five scans (with angiographic proof) were included in the study. The CAD tool was composed of two modules. The first module performs multifractal texture analysis on the posterior view of the perfusion scan. The second module is a decision algorithm that merges the multifractal parameters into a diagnosis regarding the presence or absence of PE. Linear and non-linear decision models were evaluated for the diagnostic task. A consensus neural network significantly outperformed all decision models including the physicians.     

医用聚乳酸类高分子材料的应用

目的:阐述医用聚乳酸类高分子材料的需求,综述聚乳酸类高分子材料在生物医学领域的应用,并对其在医学领域的应用前景进行展望。资料来源:应用计算机检索ACS美国化学学会数据库2000-01/2006-12关于医用聚乳酸类高分子材料的文章,检索词“polylactide”;利用Elsevier Science全文电子期刊数据库2000-01/2006-12进行检索,检索词“polylactide”和全文检索“Medical polymeric material”。同时利用计算机检索中国期刊全文数据库1994-01/2005-12的相关文章,限定文章语言种类为中文,检索词“聚乳酸类医用高分子材料”。资料选择:对资料进行初审,纳入标准:①关于聚乳酸类医用高分子材料的需求。②医用聚乳酸类高分子材料的合成及应用。排除标准:重复性研究。资料提炼:共收集到符合上述要求的文献100篇,排除70篇重复性研究。30篇符合纳入标准:其中6篇关于聚乳酸类医用高分子材料的需求,24篇关于医用聚乳酸类高分子材料的合成及应用。资料综合:聚乳酸是一种具有良好的生物相容性和可生物降解的聚合物,最终的降解产物是二氧化碳和水,对人体无毒、无刺激。目前,聚乳酸类材料产品在医学领域广泛用于药物控制释放载体、组织工程、骨内固定、修复、手术缝合线、人造皮肤以及三维多孔支架等。结论:医用聚乳酸类高分子材料有非常广阔的应用前景,今后研究的重点是研发高效低成本的聚乳酸制备方法,合成适应于不同医疗或其他用途的、具有优良生物相容性的聚乳酸共聚物高分子材料。     

Kinetics of peripheral blood mononuclear cell mobilization with chemotherapy and/or granulocyte-colony-stimulating factor: implications for yield of hematopoietic progenitor cell collections

BACKGROUND: Peripheral blood progenitor cells (PBPCs) are commonly collected and used to reconstitute hematopoiesis after high-dose chemotherapy. However, strategies for optimal collection and assessment of leukapheresis components are not standardized. STUDY DESIGN and METHODS: Hematopoietic progenitor cell assays were performed on 369 leukapheresis components collected from 95 patients who had received doxorubicin-based chemotherapy and/or granulocyte-colony-stimulating factor (G-CSF). Precollection patient hematologic values, leukapheresis collection values, component hematopoietic progenitor cell assays, and patient outcome measures were summarized. The kinetics of mononuclear cell (MNC) and PBPC mobilization were assessed among four patient groups. RESULTS: Patient group was a significant predictor of the peripheral blood MNC count on the day of collection (p<0.0001), and that value was a significant predictor of granulocyte-macrophage– colony-forming unit (CFU-GM) yield (p<0.0001). This relationship between the peripheral blood MNC count on the day of collection and CFU- GM yield differed according to patient group (p<0.0001). CFU-GM made up a larger fraction of peripheral blood MNCs collected from patients who received chemotherapy plus G-CSF than collected from those who received G-CSF alone. Moreover, the peripheral blood MNC count and the corresponding CFU-GM yield increased significantly on consecutive days of collection in patient groups receiving chemotherapy and G-CSF but were unchanged or decreased in patients receiving G-CSF alone. CONCLUSION: The relationship between peripheral blood MNC count and leukapheresis component CFU-GM yield differed significantly between patients who received chemotherapy and G-CSF and those who received G- CSF alone for the mobilization of PBPCs. Patient peripheral blood MNC count and component CFU-GM yield are useful for both assessing and suggesting revisions to PBPC mobilization and collection strategies.