医院PACS的设计与实施

本文介绍了PACS的涵义、标准和发展,阐述了基于＂均衡策略下的服务器集群＂的全院级PACS架构设计、特点和实施方案。     

HZ08有关物质的色谱-质谱结构鉴定

 目的 采用色谱-质谱联用技术对HZ08的有关物质进行结构鉴定。方法 采用Sapphire C₁₈ (4.6 mm×250 mm, 5 μm)色谱柱,甲醇-甲酸醋酸铵溶液(1 L中含有甲酸1.0 mL和醋酸铵2.0 g)流动相梯度洗脱,对HZ08及其酸、碱、光照破坏的有关物质进行分离;电喷雾正离子化测定各有关物质的一级和二级质谱,进行解析鉴定。结果 HZ08中检测到1个含量超过0.1%的有关物质,酸破坏生成4个主要降解有关物质,碱破坏和光照破坏各生成1个主要降解杂质;并通过联用技术和有机反应机制解析确证它们的结构。结论 色谱-质谱联用技术能够有效的鉴定药物有关物质,HZ08有关物质鉴定结果对其质量控制和工艺优化提供了参考依据。
     

Insights into Genetic Characteristics and Virological Features of Endemic Avian Influenza A (H9N2) Viruses in Egypt from 2017–2021

From 2010 to 2013, genotype I avian influenza A(H9N2) viruses of the G1-lineage were isolated from several poultry species in Egypt. In 2014, novel reassortant H9N2 viruses were detected in pigeons designated as genotype II. To monitor the subsequent genetic evolution of Egyptian A(H9N2) viruses, we characterized the full genomes of 173 viruses isolated through active surveillance from 2017 to 2022. In addition, we compared the virological characteristics and pathogenicity of representative viruses. Phylogenetic analysis of the HA indicated that all studied sequences from 2017–2021 were grouped into G1-like H9N2 viruses previously detected in Egypt. Phylogenetic analysis indicated that the Egyptian A(H9N2) viruses had undergone further reassortment, inheriting four genes (PB2, PB1, PA, NS) from genotype II, with their remaining segments deriving from genotype I viruses (these viruses designated as genotype III). Studying the virological features of the two most dominant genotypes (I and III) of Egyptian H9N2 viruses in vitro and in vivo indicated that both replicated well in mammalian cells, but did not show any clinical signs in chickens, ducks, and mice. Monitoring avian influenza viruses through surveillance programs and understanding the genetic and antigenic characteristics of circulating H9N2 viruses are essential for risk assessment and influenza pandemic preparedness.     

综合心理干预在本科护理专业学生心理健康中的应用效果分析

目的：通过固定量表和自我设计的问卷调查本科护理专业学生心理健康状况。方法分析影响心理健康相关因素,对筛选阳性的学生实施综合心理干预,评价干预效果。结果462人中,有66名筛选阳性的学生,占14.29%。 SCL-90量表躯体化、强迫、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执和精神病性等9个因子得分均低于大学生常模,在强迫、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执和精神病性8个维度组间具有统计学差异;多元线性回归显示：心理健康状况影响因素有：锻炼、恋爱史、就业压力、同学关系、上网、学习压力、经济压力、家庭状况、心理素质、大学生活适应程度、一年住院、遇到困难诉说、同母亲关系、睡眠、家庭幸福程度、学习成绩排名、最近两周患病、身体素质、大学日常生活;针对影响因素的综合心理干预效果良好。结论在此次调查中学生心理健康总体水平检测阳性检测率为14.29%,提示我们更应关注本科护理专业学生心理健康水平,对阳性筛检的学生应实施综合心理干预措施。     

Cybersecurity for Cardiac Implantable Electronic Devices: What Should You Know?

Medical devices have been targets of hacking for over a decade, and this cybersecurity issue has affected many types of medical devices. Lately, the potential for hacking of cardiac devices (pacemakers and defibrillators) claimed the attention of the media, patients, and health care providers. This is a burgeoning problem that our newly electronically connected world faces. In this paper from the Electrophysiology Section Council, we briefly discuss various aspects of this relatively new threat in light of recent incidents involving the potential for hacking of cardiac devices. We explore the possible risks for the patients and the effect of device reconfiguration in an attempt to thwart cybersecurity threats. We provide an outline of what can be done to improve cybersecurity from the standpoint of the manufacturer, government, professional societies, physician, and patient.     

Impact of Spinal Manipulation on Lower Extremity Motor Control in Lumbar Spinal Stenosis Patients: A Small-Scale Assessor-Blind Randomized Clinical Trial

ObjectiveThe purpose of this study was to quantify the impact of a single lumbar spinal manipulation (SM) intervention on the leg movement performance of degenerative lumbar spinal stenosis (LSS) patients in a small-scale registered randomized clinical trial.MethodsParticipants with LSS (n = 14) were tested at baseline for pain, lumbar range of motion, and behavioral or kinematic motor performance (using an established Fitts’ Law foot-pointing task), then underwent covariate adaptive randomization to receive SM or no intervention. Postintervention all dependent measures were repeated. Experimenters were blinded to patient group allocation. University ethics board approval was attained.ResultsFor the primary outcome movement time, there was no significant difference between groups. As predicted by Fitts’ Law, all participants had longer movement times as task difficulty increased. Secondary kinematic outcomes yielded no significant between-group differences. Consistent with Fitts’ Law, kinematic measures changed significantly with task difficulty. Pairwise comparisons revealed the kinematic variables were more adversely affected by greater movement amplitudes than target size changes. No exploratory differences in pain or lumbar range of motion were observed.ConclusionChanges in motor performance were not observed in this chronic pain population after a single SM intervention compared with a control group. Given the sample size, the study may have been underpowered to detect meaningful differences. Fitts’ Law was observed for the lower extremity–pointing task for an LSS population and may provide an objective measure of motor performance.     

Case Report: Severe Hypercalcemia Mimicking St-Segment Elevation Myocardial Infarction

The identification of ST-segment elevation on the electrocardiogram is an integral part of decision making in patients who present with suspected ischemia. Unfortunately, ST-segment elevation is nonspecific and may be caused by noncardiac causes such as electrolyte abnormalities. We present a case of ST-segment elevation secondary to hypercalcemia in a patient with metastatic cancer.