应用ROC曲线评价DR后处理技术对胸部影像的影响

目的:运用ROC曲线,探讨DR胸部摄影最佳的影像后处理技术。方法:使用DR系统设置的正常胸部摄影条件,对胸部体模与专用于X线摄影的ROC曲线评价体模(TRG)进行组合并曝光。分析未使用后处理技术及使用不同后处理技术,对DR胸部摄影胸片影像的影响。结果:使用单纯噪声消除技术、噪声消除加图像反转及噪声消除加全屏放大三种后处理技术所得的ROC曲线下面积Az值依次为0.85、0.825及0.925,均明显大于未使用后处理技术的面积Az值0.6;单纯噪声消除技术获得的ROC曲线下面积略大于噪声消除加图像反转技术的面积;噪声消除加全屏放大技术获得的ROC曲线下面积Az值最大。结论:应对胸部原始影像实施后处理调节。单纯噪声消除技术可明显增加影像的信息量,若在噪声消除基础上实施全屏放大技术,可获得DR胸部摄影的最大影像信息量。     

Clinical characteristics and imaging manifestations of AIDS complicated with disseminated Penicillium marneffei infection

Objective To investigate the clinical characteristics and imaging manifestations of AIDS complicated with disseminated Penicillium marneffei （PM） infection. Methods A total of 12 patients with AIDS complicated with disseminated PM infection were collected and the symptoms, signs, laboratory examination results and image manifestations of these patients were analyzed retrospectively. Results （1） The diagnosis of PM infection in all the 12 cases were confirmed by peripheral blood culture. All the 12 cases （100%） had irregular fever （38-41℃） and enlarged lymph nodes, 8 cases （66%） had skin rashes; 8 cases （66%） had hepatomegaly; 9 cases （75%） had splenomegaly while 8 cases （66%） had anemia. （2） Imaging manifestation： Five cases manifested bilateral pulmonary disseminated miliary nodular shadows or lattice signs; 1 case showed enlarged hilar lymph node and 2 cases showed patchy shadow with pleuritis. One case presented sub-pleural curve line shadow at the posterior part of the right lower lung, and adhesion between the intestinal wall and intestinal mesentery in mass form in the abdomen by CT examination. Conclusion Patients suffering from AIDS （CD4 T lymphocytes 〈50/μ L） with impaired immunity might be susceptible to complication of disseminated PM infection, which presents mainly damage of multiple organs and symptoms such as fever; enlargement of liver, spleen and lymph nodes, as well as specific skin maculopapular rashes. Imaging manifestations in the lungs were revealed as miliary nodular shadows and lattice-like shadows. Intensified abdominal CT might reveal presence of several enlarged postperitoneal lymph nodes and intestinal adhesion in shape of ＂cakes＂.     

网络教育资源构建中Windows Media流媒体技术的应用与研究

Windows Media流媒体由于交互性强、使用方便和效率高，使得在网络教育中的应用逐渐增多。本文讨论了Windows Media流媒体技术在网络教育和资源构建中应用的优势及其在设计、制作、发布、应用等各环节的相关理论和技术细节。     

多站点综合性毕业考试的改革与实践

我校改革临床医学专业毕业考试模式与方法，在临床实习过程中组织多站点综合性考试，采用闭卷笔试方法考核临床理论知识，占70％；采用实践操作与现场口试方法考核临床技能及相关知识，占20％；采用开卷笔试方法考核医疗文书书写，占10％。实践证明，此项改革能促进医学生端正实习态度，调动实习的积极性与主动性，引导医学生在实习中重视理论学习与临床实践的密切结合，促进临床教学质量的提高。     

视场角设置对虚拟环境中目标判断的影响

目的探讨不同视场角参数对虚拟环境中目标判断的影响规律 ,找出最佳视场角参数。方法利用自行研制基于PC平台的虚拟现实 (VR)实验系统 ,选定 45名年龄在 2 3～ 5 8岁被试者并完成大小与角度判断的实验设计。首先进行 30 0人次的预实验 ,确定引起虚拟环境中目标判断差错的视场角及相应观察任务的差别等级 ,然后开始单因素、4水平的完全随机正式实验。结果方差分析表明 ,不同的虚拟环境视场角对目标判断的真实性有显著性影响 ,当视场角为 60°时 ,目标判断的正确率最大。结论利用VR技术进行载人航天器工效设计、操作训练或其它任务的研究时 ,应考虑视场角的作用 ,适合目标大小判断的视场角参数值宜取 60°,以便获得最大的工效     

Epidural hematoma following use of a three-point skull clamp.

We report an unusual case of epidural hematoma secondary to the use of a three-point skull-fixation device. Initially, a posterior-fossa brain tumor with hydrocephalus was diagnosed in a 15-year-old boy. Midline suboccipital craniectomy was performed with the patient placed in the prone position. A Mayfield (Ohio Medical Instrument Co., Cincinnati, OH, USA) skull clamp was used for fixation of the head during the surgical procedure, following which, a huge epidural hematoma developed within 6 hours of surgery, due to skull penetration and fracture at one of the clamp's pin sites located proximate to the coronal suture.     

宫颈癌合并妊娠的诊断及治疗进展

宫颈癌合并妊娠的发生率较低，但却是妊娠期最常见恶性肿瘤。妊娠期胎儿取舍问题的考虑会影响医患双方对宫颈癌治疗时间和治疗方案的选择，而宫颈癌也会影响到分娩方式的选择，从而影响围产儿的预后。近年来宫颈癌发病逐渐年轻化，如何处理两者的关系具有重要的临床意义。现综述近年来在宫颈癌合并妊娠的诊断及治疗等方面的研究进展。     

彩超引导介入治疗腘窝囊肿23例

目的探讨彩超引导下腘窝囊肿介入治疗的价值。方法在彩超引导下穿刺囊肿并抽尽囊液，生理盐水反复冲洗囊腔后注入无水乙醇，5min后抽出，反复2～3次。结果23例中22例穿刺一次治愈，1例穿刺2次治愈。23例随访6个月，无复发。结论彩超引导下介入治疗腘窝囊肿操作简便，创伤轻微，安全可靠，效果显著，可重复操作。     

甲壳素涂层PGLA神经导管修复兔面神经缺损的实验研究

目的:探讨甲壳素涂层PGLA神经导管修复兔面神经缺损的效果。方法:成年雄性新西兰兔24只,无菌条件下切断双侧面神经下颊支,制成15mm的兔面神经下颊支缺损模型。左侧用甲壳素涂层聚丙交脂-乙交脂共聚物[poly(L-lactide-co-glycolide),PGLA]神经导管修复;右侧用翻转自体神经修复作为对照。术后5周、10周和14周行大体观察、电生理检查、组织学、电镜观察评价修复效果。结果:术后5周观察到神经导管中有新生轴索通过,再生神经发育不成熟;右侧自体神经修复近段有髓神经纤维均匀疏散分布,远段未见明显再生神经束形成。术后14周左侧再生神经已通过神经导管长入远端,电生理检查结果表明自体神经修复侧再生神经质量优于神经导管修复侧,差异有统计学意义(P<0.01)。自体神经修复再生纤维密度优于神经导管修复侧,差异有统计学意义(P<0.01),但自体神经修复侧近段神经髓鞘部分空泡样变性及脱髓鞘改变,远段再生神经纤维束形成少,面肌联带运动程度较导管修复侧严重。结论:甲壳素涂层PGLA神经导管能有效修复周围神经缺损,有望替代自体神经移植。     

Paracentral Corneal Dellen： A Rare Sign of Graves Ophthalmopathy

Purpose:To report a rare sign, paracentral corneal dellen that developed in a middleaged female patient with Graves ophthalmopathy.Methods:A paracentral corneal dellen developed in the left eye in a 42-year-old woman who was diagnosed as Graves ophthalmopathy. The patient had remarkable upper eyelid retraction, upper eyelid lag and upward motility restriction. The Graves ophthalmopathy was classified as Grade Ⅳ according to NOSPECS classification.Results:Local artificial tear film and 0.3％ Tobramycin eye drops were administered to both eyes.Twenty-four hours later, the left corneal dellen disappeared.Conclusions:Graves ophthalmopathy can lead to paracentral corneal dellen because of severe upper eyelid retraction and upward motility restriction of the eye in spite of the lack of lagophthalmos. Artificial tear drop and antibiotic eye drop therapy helped even though the patient did not have corneal exposure. Eye Science 2003;19:174-175.