汉中市中小学教师教育技术应用情况的归因分析

以参加"亚行贷款灾后重建技术援助教育子项目"培训的教师为研究对象,在中小学教师教育技术能力现状调查的基础上,针对应用情况进行研究,分析了影响汉中市中小学教师教育技术应用的因素。结果显示:影响该地区教师教育技术应用的主要因素是教师信息技术能力、学校的态度政策以及对教育技术基本理论的掌握,并在此基础上提出具体建议。     

主动脉夹层术后患者心理状况及躯体症状对生活质量的影响

目的 探讨主动脉夹层术后患者心理状况、躯体症状对其生活质量的影响及作用机制，为制订干预计划提供参考。方法 采用广泛性焦虑障碍量表、患者健康问卷抑郁量表、躯体症状量表、12项简明健康状况调查表对327例主动脉夹层术后患者进行调查，根据相关性分析结果提出假设，应用AMOS软件进行结构方程模型分析。结果 主动脉夹层术后患者生活质量得分（81.56±7.36）分，焦虑得分2.00(0, 3.00)分，抑郁得分2.00(0, 3.00)分，躯体症状得分5.00(2.00, 8.00)分；焦虑、抑郁、躯体症状对生活质量有直接影响，焦虑、抑郁通过躯体症状对生活质量有间接影响（均P<0.05）。结论 主动脉夹层术后患者生活质量处于中等偏上水平，应早期对主动脉夹层术后患者的心理状况与躯体症状进行动态评估与监测，及时进行心理干预和症状管理，以改善其生活质量。     

Treatments of unruptured brain arteriovenous malformations: A systematic review and meta-analysis

Background:The best therapeutic option for unruptured brain arteriovenous malformations (bAVMs) patients is disputed.Objective:To assess the occurrence of obliteration and complications of patients with unruptured bAVMs after various treatments.Methods:A systematic literature search was performed in PubMed, EMBASE, Web of Science, and so on to identify studies fulfilling predefined inclusion criteria. Baseline, treatment, and outcomes data were extracted for statistical analysis.Results:We identified 28 eligible studies totaling 5852 patients. The obliteration rates were 98% in microsurgery group (95% confidence interval (CI): 96%–99%, I² = 74.5%), 97% in surgery group (95%CI: 95%–99%, I² = 18.3%), 87% in endovascular treatment group (95%CI: 80%–93%, I² = 0.0%), and 68% in radiosurgery group (95%CI: 66%–69%, I² = 92.0%). The stroke or death rates were 1% in microsurgery group (95%CI: 0%–2%, I² = 0.0%), 0% in surgery group (95%CI: 0%–1%, I² = 0.0%), 4% in endovascular treatment group (95%CI: 0%–8%, I² = 85.8%), and 3% in radiosurgery group (95%CI: 3%–4%, I² = 82.9%). In addition, the proportions of hemorrhage were 2% in microsurgery group (95%CI: 1%–4%, I² = 0.0%), 23% in endovascular treatment group (95%CI: 7%–39%), and 12% in radiosurgery group (95%CI: 12%–13%, I² = 99.2%). As to neurological deficit, the occurrence was 9% in microsurgery group (95%CI: 6%–11%, I² = 94.1%), 20% in surgery group (95%CI: 13%–27%, I² = 0.0%), 14% in endovascular treatment group (95%CI: 10%–18%, I² = 64.0%), and 8% in radiosurgery group (95%CI: 7%–9%, I² = 66.6%).Conclusions:We found that microsurgery might provide lasting clinical benefits in some unruptured bAVMs patients for its high obliteration rates and low hemorrhage. These findings are helpful to provide a reference basis for neurosurgeons to choose the treatment of patients with unruptured bAVMs.     

Sturge–Weber Syndrome Is Associated with Cortical Dysplasia ILAE Type IIIc and Excessive Hypertrophic Pyramidal Neurons in Brain Resections for Intractable Epilepsy

Sturge–Weber syndrome (SWS) is a rare syndrome characterized by capillary‐venous malformations involving skin and brain. Many patients with SWS also suffer from drug‐resistant epilepsy. We retrospectively studied a series of six SWS patients with epilepsy and extensive neurosurgical resections. At time of surgery, the patients' age ranged from 11 to 35 years (with a mean of 20.2 years). All surgical specimens were well preserved, which allowed a systematic microscopical inspection utilizing the 2011 ILAE classification for focal cortical dysplasia (FCD). Neuropathology revealed dysmorphic‐like neurons with hypertrophic cell bodies reminiscent to those described for FCD type IIa in all cases. However, gross architectural abnormalities of neocortical layering typical for FCD type IIa were missing, and we propose to classify this pattern as FCD ILAE type IIIc. In addition, our patients with earliest seizure onset also showed polymicrogyria (PMG; n = 4). The ictal onset zones were identified in all patients by subdural electrodes, and these areas always showed histopathological evidence for FCD type IIIc. Four out of five patients had favorable seizure control after surgery with a mean follow‐up period of 1.7 years. We concluded from our study that FCD type IIIc and PMG are frequently associated findings in SWS. FCD type IIIc may play a major epileptogenic role in SWS and complete resection of the associated FCD should be considered a prognostic key factor to achieve seizure control.     

Morphological and serum hyaluronic acid, laminin and type Ⅳ collagen changes in dimethylnitrosamine-induced hepatic fibrosis of rats

AIM: To study the morphological and serum hyaluronic acid (HA), laminin (LN), and type Ⅳ collagen changes in hepatic fibrosis of rats induced by dimethylnitrosamine (DMN).METHODS: The rat model of liver fibrosis was induced by DMN. Serum HA, type Ⅳ collagen, and LN were measured by ELISA. The liver/weight index and morphological changes were examined under electron microscope on d 7, 14, 21, and 28 by immunohistochemical alpha smooth muscle actin α-SMA staining as well as Sirius-red and HE staining.RESUJLTS: The levels of serum HA, type Ⅳ collagen and LN significantly increased from d 7 to d 28 (P = 0.043).The liver/weight index increased on d 7 and decreased on d 28. In the model group, the rat liver stained with HE and Sirius-red showed evident hemorrhage and necrosis in the central vein of hepatic 10 lobules on d 7. Thin fibrotic septa were formed joining central areas of the liver on d 14. The number of α-SMA positive cells was markedly increased in the model group. Transitional hepatic stellate cells were observed under electron microscope.All rats in the model group showed micronodular fibrosis in the hepatic parenchyma and a network of α-SMA positive cells. Typical myofibroblasts were embedded in the core of a fibrous septum. Compared to the control group, the area-density percentage of collagen fibrosis and pathologic grading were significantly different in the model group (P＜0.05) on different d (7, 14, and 28). The area-density percentage of collagen fibrosis in hepatic tissue had a positive correlation with the levels of serum HA, LN, and type Ⅳ collagen.CONCLUSION: The morphological and serum HA, type Ⅳ collagen, and LN are changed in DMN-induced liver fibrosis in rats.     

Radiofrequence ablation of liver cancers

Primary and secondary malignant liver cancer are some of most common malignant tumors in the world. Chemotherapy and radiotherapy are not very effective against them. Surgical resection has been considered the only potentially curtive option, but the majority of patients are not candidates for resection because of tumor size, location near major intrahepatic blood vessels and bile ducts, precluding a margin-negative resection, cirrhotic, hepatitis virus infection or multifocial. Radiofrequence ablation (RFA), which is a new evolving effective and minimally invasive technique, can produce coagulative necrosis of malignant tumors. RFA should be used percutaneously, laparascopically, or during the open laparotomy under the guidance of ultrasound, CT scan and MRI. RFA has lots of advantages superior to other local therapies including lower complications, reduced costs and hospital stays, and the possibility of repeated treatment. In general, RFA is a safe, effective treatment for unresectable malignant liver tumors less than 7.0 cm in diameter. We review the principle, mechanism, procedures and experience with RFA for treating malignant liver tumors.