氟罗沙星治疗细菌性感染的药物经济学研究

目的:评价氟罗沙星和氧氟沙星治疗细菌性感染的经济性.方法:治疗组患者35例,使用氟罗沙星0.3 g,静脉滴注,1次/d共10.5 d;对照组患者32例,使用氧氟沙星0.3 g,静脉滴注,2次/d,共10.5 d.运用药物经济学的成本-效果分析方法进行评价.结果:2种方案的成本-效果比(C/E)分别为22.87,20.43,效果(以有效率表示)分别为91%,84%(P＞0.05).结论:氧氟沙星经济性最佳,氟罗沙星市场价格太贵,建议厂商重新考虑市场的药品定价策略.     

眼减压性视网膜病变研究进展

眼减压性视网膜病变(ocular decompression retinopathy,ODR)是一种由眼压降低引起的眼底多灶性出血性视网膜病变,且无法用其他机制解释。临床上多见于青光眼术后,也可发生在造成眼压下降的其他眼科手术。多数患者无明显症状,容易漏诊。本文综述了国内外ODR的研究进展,从危险因素、发病机制、临床表现、影像表现、鉴别诊断以及治疗与预防来论述。     

氯化锂通过TGFBI促进角膜基质成纤维细胞增殖和自噬

目的：研究TGFBI和微管相关蛋白轻链3(LC3)在角膜营养不良患者中的表达,及氯化锂(LiCl)通过TGFBI对角膜基质成纤维细胞增殖能力的影响。

方法：用免疫组化和Western-blot方法检测角膜营养不良及正常角膜组织中TGFBI和LC3的表达。实验构建了TGFBI过表达载体并转染角膜基质成纤维细胞,分别以5、10、20、40mmol/L LiCl作用于突变型TGFBI转染的角膜基质成纤维细胞,检测不同时间(0、1、6、12h)后,TGFBI与LC3蛋白表达变化,并用CCK-8法检测细胞增殖活性。

结果：TGFBI和LC3在角膜营养不良患者角膜组织中显著高表达。TGFBI过表达抑制角膜基质成纤维细胞增殖活性(P<0.05)。LiCl抑制突变型TGFBI转染的角膜基质成纤维细胞中TGFBI和LC3蛋白表达,并增强其细胞增殖活性(P<0.05)。

结论：LiCl可以促进角膜基质成纤维细胞增殖活性和自噬,其作用机制与下调TGFBI和LC3的表达有关。     

聂莉芳教授临床应用生石膏及其配伍治疗慢性肾脏病的经验研究

聂莉芳教授是国家级名老中医、中医肾病专家。聂教授认为慢性肾脏病的病因病机属本虚标实,常挟热、挟湿、挟瘀,故临床遣方用药宜正邪兼顾,临床诊治时常在益气养阴的基础上加用清热利湿化瘀之品。生石膏是聂教授临床上常用的清热药之一。聂教授临床应用生石膏并灵活配伍治疗多种慢性肾脏病,疗效满意,值得后辈继承和发扬。     

Different classes of antibiotics exhibit disparate negative impacts on the therapeutic efficacy of immune checkpoint inhibitors in advanced non-small cell lung cancer patients

It has been reported that antibiotics (ATBs) have adverse effect on the efficacy of treatment with immune checkpoint inhibitors (ICIs) in cancer patients. Since different classes of ATBs have different antibacterial spectrum, we aimed to study whether all ATBs had similar or different negative effects on the clinical outcomes of ICIs in patients with advanced non-small cell lung cancer (NSCLC). Patients with advanced NSCLC who received ICIs were included in this retrospective study and grouped by the class of ATBs they had used around the ICIs treatment time. The overall survival (OS) and the progression free survival (PFS) of patients among these groups were compared using Kaplan-Meier method and Cox proportional hazards model. A total of 148 eligible patients were enrolled, and 80 patients used ATBs. The results indicated that quinolones had no significant negative consequence on the clinical outcomes, while β-lactams significantly shortened the OS and PFS of patients. Furthermore, patients exposed to the combination of β-lactams and quinolones suffered the worst OS and PFS. Moreover, the subgroup analysis of β-lactams revealed that only penicillins, but not carbapenems and cephalosporins, markedly reduced both OS and PFS. In addition to the class of ATBs used, the time frame of ATBs used also affected the clinical outcomes of ICIs therapy. Patients receiving ATBs within 60 days prior to and 30 days after the initiation of ICI treatment had significantly shorter OS and PFS compared with those who did not use ATBs. This study demonstrated that different classes of ATBs had disparate negative impacts on the clinical outcomes, and the use of β-lactams, especially penicillins, should be avoided in advanced NSCLC patients who are receiving or scheduled to receive ICIs within 60 days.     

Research on depression in Parkinson disease: A bibliometric and visual analysis of studies published during 2012–2021

Background:The diagnosis and treatment rate of Parkinson disease (PD) with depression has a low diagnostic rate, and there is no consensus on the choice of treatment mode. This study evaluates the global research trends of scientific outputs related to depression in PD from multiple perspectives, using a bibliometric analysis and visualization tool to scientifically analyze the knowledge from the literature.Methods:Literature related to depression in PD published from 2012 to 2021 was included and selected from the Web of Science Core Collection database in October 2021. CiteSpace software was used to visualize and analyze co-occurrence analyses for countries, institutions, authors, and keywords.Results:A total of 4533 articles from the Web of Science database were included. The United States made the largest contribution with the majority of publications (1215; 29.40%). Toronto University was the most productive institution. PD, depression, quality of life, dementia, nonmotor symptom, prevalence, anxiety, Alzheimer disease, symptom, and disorder would be significantly correlated with depression in PD. The current hot spots in this field focus on the following: risk factors for depression in PD, assessment scale of depression in PD, and rehabilitation of depression in PD.Conclusions:This analysis not only reveals the current research trends and hotspots but also provides some instructive suggestions on the development of depression in PD.     

基于磁共振图像的乳腺癌分子分型研究进展

在基因表达水平上,乳腺癌分子亚型的分析对评价乳腺癌的恶性程度及制定个体化治疗方案具有重要的临床应用价值.除免疫组织化学染色和基因芯片技术外,影像组学的兴起也为乳腺癌分子分型提供新的预测方式.综述基于磁共振成像的乳腺癌分子分型的研究现状.在概述乳腺磁共振成像原理和特点的基础上,分别从统计学分析及机器学习方法的角度,阐述乳...     

超声检查对宫角妊娠的诊断价值

目的探讨超声检查对宫角妊娠的诊断价值。方法分析手术及病理已证实的30例宫角妊娠超声图表现。结果根据超声图表现,宫角妊娠分为三型：胚囊型21例,不均质包块型6例,破裂型3例。结论超声对宫角妊娠早期诊断具有很高的诊断价值并为临床提供可靠的信息。     

A Numerical Measurement Method for Dynamic Granular Materials Based on Computer Vision

Granular materials are widespread in nature and human production, and their macro-mechanical behavior is significantly affected by granule movement. The development of computer vision has brought some new ideas for measuring the numerical information (including the amount of translation, the rotation angle, velocity, acceleration, etc.) of dynamic granular materials. In this paper, we propose a numerical measurement method for dynamic granular materials based on computer vision. Firstly, an improved video instance segmentation (VIS) network is introduced to perform end-to-end multi-task learning, and its temporal feature fusion module and tracking head with long-sequence external memory can improve the problems of poor video data quality and high similarity in appearance of granular materials, respectively. Secondly, the numerical information can be extracted through a series of post-processing steps. Finally, the effectiveness of the measurement method is verified by comparing the numerical measurement results with the real values. The experimental results indicate that our improved VIS obtains an average precision (AP) of 76.6, the relative errors and standard deviations are maintained at a low level, and this method can effectively be used to measure the numerical information of dynamic granular materials. This study provides an intelligent proposal for the task of measuring numerical information of dynamic granular materials, which is of great significance for studying the spatial distribution, motion mode and macro-mechanical behavior of granular materials.     

4例口服复方避孕药致假性库欣综合征病例分析

目的：研究我院收治的4例口服复方避孕药（oral contraceptive pills,OCPs）后致假性库欣综合征病例的临床特征以及复习OCPs影响皮质醇测定的相关文献。方法：回顾性分析4例因月经稀发服用OCPs的育龄期女性患者的临床特点。应用等倍稀释的方法测定OCPs与血总皮质醇之间的交叉反应,并复习相关文献。结果：4例患者在服用OCPs期间均发现血总皮质醇的升高。3例患者均在停用OCPs之后血总皮质醇降至正常。予等倍稀释的方法,在OCPs溶液中测定血总皮质醇,交叉反应小。文献中报道OCPs可能从以下两方面导致假性库欣综合征：OCPs中的雌激素增加皮质醇结合球蛋白的合成而引起血总皮质醇的升高;OCPs可能通过直接刺激下丘脑-垂体-肾上腺轴使血总皮质醇生成增多。结论：OCPs可通过多种机制导致假性库欣综合征,临床上需结合患者的临床表现、体格检查以及其他的实验室结果与库欣综合征进行鉴别,以免误诊、误治。