超声结合BP神经网络技术诊断女童中枢性性早熟

目的探讨超声结合人工神经网络技术在女童中枢性性早熟诊断中的应用价值。方法选用170例性早熟女童进行常规超声检查子宫、卵巢,以其中130例的子宫体积、卵巢体积以及双侧卵巢最大卵泡内径为输入变量,以中枢性性早熟或非中枢性性早熟为输出变量,建立反向传播(BP)神经网络,并对另40例性早熟病例分类。结果利用BP神经网络结合常规超声检查对中枢性性早熟诊断的敏感性、特异性和准确率分别为95.0%、85.0%、90.0%。结论神经网络结合超声检查对中枢性性早熟的诊断和鉴别诊断具有较大的价值。     

慢性疼痛患者生活质量及其相关因素分析

目的:了解慢性疼痛患者的生活质量状况,并分析其相关影响因素。方法:选取就诊于解放军总医院疼痛科门诊慢性疼痛患者为研究对象,研究工具包括一般资料调查表、简式Mc Gill疼痛问卷(short-form of Mc Gill pain questionnaire,SF-MPQ)及生活质量指数(quality of life index,QL-Index)。结果:1慢性疼痛患者生活质量总分与SF-MPQ总分、感觉项总分、情感项总分、视觉模拟评分(visual analogue scale,VAS)、现时疼痛强度(present pain intensity,PPI)、感觉项计数、情感项计数均呈显著负相关(r=-0.195~-0.433));2多元线性逐步回归分析模型可解释慢性疼痛患者生活质量指数改变的88.8%,情感项总分、感觉项总分、VAS评分、感觉项计数、情感项计数、PPI评分对患者生活质量改变有影响,尤其以目前疼痛强度评分对患者生活质量的影响最为显著。结论:慢性疼痛患者的生活质量受其疼痛特征的多重影响,患者目前疼痛强度对其生活质量的影响最为显著。     

家庭访视对肾病综合征患儿遵医行为的影响

目的：探讨家庭访视对肾病综合征患儿遵医行为的影响,以期对家庭访视进行评价。方法随机选取40例肾病综合征患儿为研究对象且按随机数字表法和1：1的比例将其随机分为观察组和对照组,每组各20例。两组患儿均建立随访档案,其中对照组采取出院常规指导、接受电话询问、定期复诊,观察组采取家庭访视,同时对两组患儿的遵医行为和肾病综合征复发率进行观察与对比。结果观察组患儿按时按量服药、合理饮食、按时复诊、定期检查等遵医行为优于对照组,差异具有统计学意义（ P＜0．05）;观察组复发率低于对照组,差异具有统计学意义（ P＜0．05）。结论家庭访视能显著提高肾病综合征患儿的遵医行为,降低其复发率,值得临床推广运用。     

Abnormal inter- and intra-hemispheric integration in male paranoid schizophrenia: a graph-theoretical analysis

Background

The human brain is a complex network of regions that are structurally interconnected by white matter (WM) tracts. Schizophrenia (SZ) can be conceptualized as a disconnection syndrome characterized by widespread disconnections in WM pathways.

Aims

To assess whether or not anatomical disconnections are associated with disruption of the topological properties of inter- and intra-hemispheric networks in SZ.

Methods

We acquired the diffusion tensor imaging data from 24 male patients with paranoid SZ during an acute phase of their illness and from 24 healthy age-matched male controls. The brain FA-weighted (fractional anisotropy-weighted) structural networks were constructed and the inter- and intra-hemispheric integration was assessed by estimating the average characteristic path lengths (CPLs) between and within the left and right hemisphere networks.

Results

The mean CPLs for all 18 inter-and intra-hemispheric CPLs assessed were longer in the SZ patient group than in the control group, but only some of these differences were significantly different: the CPLs for the overall inter-hemispheric and the left and right intra-hemispheric networks; the CPLs for the interhemisphere subnetworks of the frontal lobes, temporal lobes, and subcortical structures; and the CPL for the intra- frontal subnetwork in the right hemisphere. Among the 24 patients, the CPL of the inter-frontal subnetwork was positively associated with negative symptom severity, but this was the only significant result among 72 assessed correlations, so it may be a statistical artifact.

Conclusions

Our findings suggest that the integrity of intra- and inter-hemispheric WM tracts is disrupted in males with paranoid SZ, supporting the brain network disconnection model (i.e., the ^‘connectivity hypothesis^’) of schizophrenia. Larger studies with less narrowly defined samples of individuals with schizophrenia are needed to confirm these results.     

TCRS与TCIS治疗中隔子宫患者的效果对比

目的比较经宫颈宫腔镜下子宫中隔切除术(TCRS)与经宫颈宫腔镜下子宫中隔切开术(TCIS)治疗中隔子宫患者的效果.方法选取本院2011年6月～2013年3月收治的83例中膈子宫患者,根据患者选择的不同手术方式分为TCRS组43例和TCIS组40例,比较两组患者术中及术后恢复的一般情况.结果TCRS组手术时间长于TCIS组,术中出血量多于TCIS组,差异有统计学意义(P＜0.05);TCRS组术后并发症发生率为62.8％,高于TCIS组的35.0.％ (P＜O.05);TCRS组患者正常妊娠率为39.5％,低于TCIS组的70.0％ (P＜O.05).结论与TCRS相比,TCIS可明显缩短患者的手术时间及术后恢复时间,减少术中出血量,降低并发症发生率,提高术后正常妊娠率.     

天然产物对毛发色素的调节作用研究进展

毛发的颜色不仅受年龄、环境因素的影响,还受到众多因子的调控,其中主要有阿黑皮素原(POMC)、黑色素细胞刺激素(α-MSH)、黑色素1受体(MCIR)、小眼畸形相关蛋白因子(MITF)、酪氨酸酶(TYR)、酪氨酸相关蛋白酶1(TRP-1)、酪氨酸相关蛋白酶2(TRP-2)、刺鼠信号蛋白(ASIP)等。毛发颜色的异常常被认为是衰老的特征,给患者带来巨大的心理压力,但相关的治疗药物目前尚属空白。总结了天然药物对毛发颜色的影响程度和作用方式,以期阐明天然药物在治疗须发早白方面可能的作用途径及靶点,为从天然产物中寻找发掘新的药物奠定基础。     

煤矿工人慢性疼痛现况及其影响因素

目的了解煤矿工人慢性疼痛现况及其影响因素。方法采用便利抽样法对某矿业集团所属煤矿720名工人进行问卷调查,内容包括自行设计的一般情况调查表、简明疼痛程度量表和抑郁自评量表等。结果煤矿工人的慢性疼痛患病率为56.5%,慢性疼痛的最常见部位为腰背部(70.2%)、膝关节(27.1%)、胃部(22.3%)、肩部(17.7%)。班制、性别、营养状况、吸烟等为煤矿工人慢性疼痛患病率的主要危险因素。结论煤矿工人慢性疼痛发生率较高,应该引起广泛的关注,管理者应积极开展职业防护教育并加大保护措施,做好其预防保健工作。     

液基薄层细胞学及荧光定量聚合酶链反应技术与P16蛋白联合检查在宫颈癌早期诊断的研究

目的研究液基薄层细胞学(TCT)、荧光定量聚合酶链反应技术(FQPCR)、P16蛋白联合检测在宫颈癌早期诊断中的价值,为宫颈癌的早期防治提供参考。方法对2012年10月-2013年10月1 786例宫颈异常女性进行TCT、FQPCR检查,监测人乳头状瘤病毒(HPV)感染情况,检测P16蛋白表达,采用SPSS 17.0进行统计分析。结果 1 786例患者中检测HPV阳性198例,阳性率为11.09%;其中高危型HPV占38.38%、低危型占61.62%;P16蛋白随着CINⅡ级、CINⅢ级、SCC变化表达率逐渐升高,比较差异有统计学意义(P<0.05)。结论宫颈异常患者HPV阳性检出率高,P16蛋白表达率随着宫颈病变的加重而提升,FQPCR、TCT、P16联合检查有助于宫颈癌及其癌前病变的筛查。     

Clinical and endoscopic features of ischemic colitis

OBJECTIVE: To review the clinical and endoscopic features, and outcome of ischemic colitis. METHODS: Sixty cases with the diagnosis of ischemic colitis were retrospectively analyzed. All the patients were under observation in hospital and most of them underwent colonoscopy at least twice: once for diagnosis and then follow‐up after treatment. The demographic data, presenting symptoms, endoscopic findings, laboratory tests, and treatment were reviewed. RESULTS: Fifty‐two of the 60 cases were over 50 years old (87%; mean age, 59.9 years): 40 female, 20 male (2 : 1); 76.0% of these patients had a coexistent disease such as a cardio‐cerebrovascular disorder, diabetes, hematologic diseases or a previous history of abdominal surgery. Abdominal pain (57/60, 95%), hematochezia (55/60, 91.7%), and diarrhea (26/60, 43.3%) were the main complaints. Lesions seen on colonoscopy were more commonly located in the left colon (46/60, 79.3%) and rectum (5/60, 8.6%), and were characteristically segment‐distributed, including hemorrhagic edematous mucosa, erosions, ulcerations, pseudopolyps, and stricture. Ultrasonography revealed colonic wall thickening in 13 cases (13/55, 21.7%), and small to moderate ascites was detected in 4 cases (4/55, 7.3%). In this cohort, most of the patients recovered (49/60, 81.7%) or improved (10/60, 16.7%) after conservative treatment. Only one patient who had a myocardial infarction prior to the onset of the ischemic colitis, died from peritonitis complicated with septic shock. Progress and outcome were associated with the patient's age, severity of the lesions, clinical course, underlying diseases and the complications. CONCLUSION: Colonoscopy is safe and helpful in the early diagnosis of ischemic colitis. Nongangrenous colonic ischemia usually requires only medical management and is associated with a good prognosis.