针刀松懈术联合手法治疗脊柱侧弯的临床观察

目的:探讨针刀松懈术联合手法对脊柱侧弯的治疗有效性,并做随访记录。方法:选取2012年1月至2016年9月期间宜昌市中心人民医院收治的脊柱侧弯患者34例,并分为2组,观察组使用针刀松懈术配合手法进行治疗,对照组佩戴支具进行治疗,比较2组患者的治疗总有效,以及在治疗前后VAS评分差异和Cobb角矫正效果,对针刀松懈术联合手法使用的有效性和可行性进行深入探讨。结果:观察组的优良率为94.12%高于对照组的82.35%,且前者的治疗效果为优的患者高达70.59%远远大于后者的29.41%,P0.05;但是观察组平均评分更低为(2.6±0.5),对照组为(4.8±1.9)分,P0.05;观察组矫正率为50.4%,对照组的平均矫正率为20.7%,P0.05,2组治疗前后Cobb角比较均有统计学意义,P0.05;术后半年进行随访,观察组平均身高增加了(5.1±0.6)cm,对照组为(4.6±0.7)cm,P0.05。结论:针刀松懈术联合手法治疗不但可以有效缓解患者疼痛,还能起到一个良好的矫正效果,增加身高,提高预后,是一个可靠的、有效的治疗脊柱侧弯的方案。     

Multimodality noninvasive cardiac imaging established the diagnosis of aneurysms of Vieussens’ arterial ring

Noninvasive cardiac imagines are rapidly evolving in recent years. In this patient with Vieussens’ arterial ring aneurysm, multimodality noninvasive cardiac imaging provided sufficient information for diagnosis and surgical decision making. This report no only provides unique information leading to better understanding on aneurysms of Vieussens’ arterial ring, but also highlights the important role of multimodality noninvasive cardiac imagines in the diagnosis and management of certain cardiac emergencies.     

线上教学在急救技能操作课程中的探索和应用

目的 探索线上教学在技能操作教学中应用的教学效果和新思路。方法 选择2019年秋季学期、2020春季学期四川大学选修《生活中的急救：基本常识与技能》课程的151名学生为研究对象。2020年春季学期选修的77名学生作为试验组,2019年秋季学期选修的74名学生作为对照组。试验组依托线上平台进行急救技能线上学习,对照组采用传统教学。对比两组的教学效果和分析教学满意度。采用SPSS 23.0进行卡方检验和t检验。结果 两组学生在心肺复苏、止血包扎、骨折固定3项技能考核成绩中差异均无统计学意义[（8.65±0.81 vs. 8.69±0.90,P=0.750）; （8.10±0.50 vs. 8.12±0.61,P=0.880）;（8.21±0.89 vs.8.16±0.78,P=0.710）]。试验组参与问卷调查的学生中,59名（95.16%）学生认为本课程对处理日常生活急救有帮助,38名（61.29%）学生不希望将传统授课方式更改为线上教学。结论 线上教学在急救技能操作教学中的应用是可行的,能够达到同样的教学效果,为探索线上急救技能教学提供了新思路。     

青石止痒软膏的质量标准研究

目的:建立青石止痒软膏的质量控制标准。方法:对青石止痒软膏的原辅料进行质量标准检查,检查其装量、粒度及微生物限度;采用薄层色谱法对青石止痒软膏中青黛、苦参和黄柏进行鉴别;采用高效液相色谱法测定甘石青黛膏中靛蓝及靛玉红的含量,色谱柱为Waters Symmetry Shiled-RP18(150 mm×4. 6 mm,5μm),以甲醇-水(65:35)为流动相,流速1. 0 m L/min,检测波长285 nm,柱温25℃。结果:青石止痒软膏的原辅料、3批甘石青黛膏装量、粒度及微生物限度均符合2010版《中华人民共和国药典》的有关规定;青石止痒软膏中青黛、苦参、黄柏的薄层色谱图斑点明显,阴性对照无干扰;靛蓝在2. 35～4. 7μg(r=0. 999 8)范围内,靛玉红在0. 008 32～0. 291 2μg(r=0. 999 6)范围内,与峰面积呈良好的线性关系。结论:本实验建立的方法快速简便,准确可靠,可作为该制剂的质量控制方法。     

产妇产后母婴连结与抑郁及焦虑相关性的Meta分析

目的 系统评价产妇产后母婴连结与抑郁及焦虑的相关性,为临床进行针对性心理干预以促进母婴连结提供参考。 方法 检索Cochrane Library、PubMed、Springer Link、中国知网、维普网和万方数据库中关于母婴连结与抑郁及焦虑相关性的文献,检索时限为各数据库建库至2019年10月。文献筛选、质量评价和资料提取后,采用RevMan 5.3软件进行Meta分析。 结果 共纳入17篇文献,总样本量为6 221,文献质量总体较好。Meta分析显示,采用产后连结问卷及母婴连结量表测量的母婴连结与抑郁相关系数分别为0.41［95%CI=（0.34,0.49）］及0.24［95%CI=（0.09,0.39）］,产后母婴连结与焦虑合并相关系数为0.30［95%CI=（0.09,0.49）］。母婴连结与抑郁间相关系数随样本量的增大而增大,呈规律性变化;不同发表年份测出的相关系数不同,但变化无规律;年龄≥30岁产妇测出的相关系数大于年龄＜30岁者。在样本类型亚组中,双样本（抑郁或焦虑的临床样本/健康人群样本对照组）测得的相关系数最高,抑郁或焦虑的临床样本最小,健康人群样本居中。 结论 产妇产后母婴连结与抑郁存在弱/中相关性,与焦虑存在弱相关性,且不同样本类型、发表年份、样本量之间存在差异。进行产妇心理健康干预将会有利于改善母婴连结质量。     

Membrane technology for optimizing process optimization of small bioactive compounds in Mailuoning Injection factory effluene北大核心CSCD

Objective: To enrich small bioactive compounds from Mailuoning Injection factory effluene by polyether sulfoxide hollow fiber membrane. Methods: The retention rate of the common polymer (protein, tannin, starch, and pectin) and the permeability of the small molecule pharmacodynamic substance chlorogenic acid were the indicators, and the stop time and membrane type in ultrafiltration process were optimized. The temperature, pressure, and feed rate were investigated to determine the influence degree of each factor on the permeability and retention rate, and then the optimum process parameters of the ultrafiltration membrane process were optimized by using Box-Behnken design-response surface method. Results: The sequence of common polymer retention rate from high to low is: the influencing factor A (temperature), B (pressure), C (feed rate), and there was a negative correlation with the temperature. For the chlorogenic acid transmission rate, the influencing factor A (temperature) was larger than B (pressure), and C (feed rate) was lowest. There was a “∩” relationship between chlorogenic acid permeability and pressure at a certain temperature and rate. The results of optimized process were as follows: liquid temperature was 35 ℃, feed rate was 262 mL/min, and membrane pressure was 15.0 psi (1 psi = 6.895 kPa). The chlorogenic acid transmission rate was (91.470 ± 0.988)%, and polymer retention rate was (80.080 ± 2.296)%. The comprehensive score was (85.780 ± 1.641)% and RSD was 0.46%. There was a small difference between the two processes. Conclusion: Hollow fiber membrane, which is a sustainable and green resource utilization, has a good permeability for small bioactive compounds in wastewater, and has excellent retaining effect on common macromolecules. © 2019, Editorial Office of Chinese Traditional and Herbal Drugs. All right reserved.     

Deep learning applied to two-dimensional color Doppler flow imaging ultrasound images significantly improves diagnostic performance in the classification of breast masses: a multicenter study

BackgroundThe current deep learning diagnosis of breast masses is mainly reflected by the diagnosis of benign and malignant lesions. In China, breast masses are divided into four categories according to the treatment method: inflammatory masses, adenosis, benign tumors, and malignant tumors. These categorizations are important for guiding clinical treatment. In this study, we aimed to develop a convolutional neural network (CNN) for classification of these four breast mass types using ultrasound (US) images.MethodsTaking breast biopsy or pathological examinations as the reference standard, CNNs were used to establish models for the four-way classification of 3623 breast cancer patients from 13 centers. The patients were randomly divided into training and test groups (n = 1810 vs. n = 1813). Separate models were created for two-dimensional (2D) images only, 2D and color Doppler flow imaging (2D-CDFI), and 2D-CDFI and pulsed wave Doppler (2D-CDFI-PW) images. The performance of these three models was compared using sensitivity, specificity, area under receiver operating characteristic curve (AUC), positive (PPV) and negative predictive values (NPV), positive (LR+) and negative likelihood ratios (LR−), and the performance of the 2D model was further compared between masses of different sizes with above statistical indicators, between images from different hospitals with AUC, and with the performance of 37 radiologists.ResultsThe accuracies of the 2D, 2D-CDFI, and 2D-CDFI-PW models on the test set were 87.9%, 89.2%, and 88.7%, respectively. The AUCs for classification of benign tumors, malignant tumors, inflammatory masses, and adenosis were 0.90, 0.91, 0.90, and 0.89, respectively (95% confidence intervals [CIs], 0.87–0.91, 0.89–0.92, 0.87–0.91, and 0.86–0.90). The 2D-CDFI model showed better accuracy (89.2%) on the test set than the 2D (87.9%) and 2D-CDFI-PW (88.7%) models. The 2D model showed accuracy of 81.7% on breast masses ≤1 cm and 82.3% on breast masses >1 cm; there was a significant difference between the two groups (P < 0.001). The accuracy of the CNN classifications for the test set (89.2%) was significantly higher than that of all the radiologists (30%).ConclusionsThe CNN may have high accuracy for classification of US images of breast masses and perform significantly better than human radiologists.Trial registrationChictr.org, ChiCTR1900021375; http://www.chictr.org.cn/showproj.aspx?proj=33139.     

支气管腔内放疗治疗肺癌的疗效

目的：探讨支气管腔内后装近距离腔内放疗的方法、剂量和疗效。方法：用导丝导入法行支气管腔内放疗，可达亚段支气管。参考点20mm，单次剂量6-7GY，5-7日/间隔，2-4次/人。治疗中央型肺癌（均侵犯支气管）76例212人次。结果：病灶消失22例，缩小39例，稳定12例，进展3例，总有效率85.5％。起效时间均短于3周。结论：支气管腔内后装放疗是治疗腔内肿瘤及缓解伴随症状的有效方法。疗效及起效优于外照射和化疗。对复治患者仍然有效。     

Chinese herbal compounds containing scorpion in the treatment of epilepsy: A protocol for systematic review and meta-analysis

Background:Epilepsy is 1 of the common neurodevelopmental diseases. It can affect about 0.5% to 1.0% of the population regardless of their race and social class. Despite the development of a wide range of treatments, there remaining about one-third of patients still experience seizures. Chinese herbal compounds containing scorpion (CHCCS) have shown an outstanding curative effect on nerve protection and epilepsy. But there''s no study to assess its clinical efficacy and safety.Methods:Each data of CHCCS in treating epilepsy from related English and Chinese databases will be searched. The primary outcome is the efficacy of the CHCCS on epilepsy. And the secondary outcomes include recurrence rate and side effects. The risk of bias will be assessed, and RevMan5.3 and Stata14.0 will be performed for meta-analysis. Finally, we will assess the level of the resulting evidence.Results:The results of the study will be combined with current evidence and published in a peer-reviewed journal.Conclusions:This study will specifically investigate the effectiveness and safety of CHCCS in treating epilepsy.INPLASY registration number:INPLASY202120056.     

The meta-analysis of the effect of 68Ga-PSMA-PET/CT diagnosis of prostatic cancer compared with bone scan

Background:⁶⁸Ga-PSMA-PET/CT (positron emission tomography/computed tomography) is a promising method for prostate cancer (PC) detection. However, the ability of ⁶⁸Ga-PSMA-PET/CT to detect malignant bone lesions, and whether this method is superior to the existing bone imaging methods are still lack of systematic analysis.Purpose:To evaluate the value of ⁶⁸Ga-PSMA-PET/CT and bone scan in clinical diagnosis of prostatic cancer from the perspective of evidence-based medicine.Methods:PubMed, The Cochrane Library, EMBASE, Springer Link, Sinomed, CNKI, Wanfang database, and CQVIP database were searched to find the satisfactory studies that needed systematic review of trials and compared the value of 68Ga-PSMA-PET/CT and bone scan. All studies published from inception to March 31, 2020. According to the inclusion and exclusion criteria, 2 reviewers independently evaluated and extracted the literature. Review Manager 5.3 was applied to evaluate the included literature quality. The heterogeneity of the included literature was tested by Meta Disc 1.4, and the effect model was selected according to the heterogeneity test results, and the sensitivity (SEN), specificity (SPE), PLR, NLR and diagnostic odds ratio (DOR) were analyzed. After testing the heterogeneity results of literature by using the 95% confidence interval and the forest map.Results:A total of 4 studies were eligible for inclusion in the meta-analysis, which included 318 patients, 120 cases with bone metastasis and 198 cases without bone metastasis. The results of summary evaluation for ⁶⁸Ga-PSMA-PET/CT and bone scan in diagnosis of prostatic cancer as follow respectively: The SEN were 0.97 and 0.86; the SPE were 1.00 and 0.87; the DOR were 1468.33 and 36.23; PLR were 88.45 and 6.67; NLR were 0.05 and 0.19; and the area under curve (AUC) and 95% CI were 0.9973 (1.0000–0.9927) and 0.8838 (0.9584–0.8092).Conclusion:By comparing the diagnostic results of ⁶⁸Ga-PSMA-PET/CT and bone scan imaging diagnosis methods, the ⁶⁸Ga-PSMA-PET/CT has a higher SEN and SPE than bone scan, and it has a higher diagnostic efficiency for prostate cancer bone metastasis, which is worthy of clinical application.