256例重型、特重型颅脑外伤后行大骨瓣减压术患者的回顾性分析

目的探讨256例重型、特重型颅脑外伤（TBI）患者行大骨瓣减压的远期治疗效果。 方法单中心回顾性队列研究纳入自2012年7月至2016年12月济南军区总医院神经外科收治256例的因重型、特重型TBI急诊行大骨瓣减压的患者,其中重型（GCS评分6~8分）166例、特重型（GCS评分3~5分）90例,采用标准大骨瓣开颅术,减压窗面积约为12 cm×15 cm左右。术后随访18个月,预后分为良好恢复、中残、重残、植物状态、死亡;其中,良好恢复、中度病残为预后良好者,严重病残和植物状态为预后较差者。 结果恢复良好/中残患者104例（40.61%）,但其规范评估行为、心理表现与心理健康的负担未纳入此次临床评估。重残54例、植物状态38例、死亡60例,共计152例患者预后较差（59.37%）,可判断59.37%的患者存在预后不良。 结论标准外伤大骨瓣减压术是治疗重型TBI脑疝形成的有效方法。发生重型、特重型TBI的患者其临床预后差,表现为死亡、植物生存、功能损伤,需要医学界探索新的治疗策略。     

Microfluidic switching system for analyzing chemotaxis responses of wortmannin-inhibited HL-60 cells

The chemotaxis of phosphoinositide kinase-3 (PI3K)-inhibited differentiated HL-60 cells stably expressing CXCR2 was studied in a microfluidic switching gradient device that can generate stable and well-defined forward and reverse gradients. Wortmannin, a widely used PI3K inhibitor, was added during cell preparation and the experiment process. The studies quantify the chemotaxis gradient and the effects of a change in the direction of a CXCL-8 gradient on cell migration. PI3K-inhibited HL-60 cells migrated more efficiently toward the gradient before gradient switching than after, as measured by the effective chemotactic index. The inhibited HL-60 cells also showed that inadequate polarization, slower response time, and reduced cell populations can follow the gradient change. We observed that the role of PI3K in directing cellular response to gradient reversal was important in cell polarization and directional sensing associated with gradient switching.     

Dynamic sub-ontology evolution for traditional Chinese medicine web ontology

As a form of important domain knowledge, large-scale ontologies play a critical role in building a large variety of knowledge-based systems. To overcome the problem of semantic heterogeneity and encode domain knowledge in reusable format, a large-scale and well-defined ontology is also required in the traditional Chinese medicine discipline. We argue that to meet the on-demand and scalability requirement ontology-based systems should go beyond the use of static ontology and be able to self-evolve and specialize for the domain knowledge they possess. In particular, we refer to the context-specific portions from large-scale ontologies like the traditional Chinese medicine ontology as sub-ontologies. Ontology-based systems are able to reuse sub-ontologies in local repository called ontology cache. In order to improve the overall performance of ontology cache, we propose to evolve sub-ontologies in ontology cache to optimize the knowledge structure of sub-ontologies. Moreover, we present the sub-ontology evolution approach based on a genetic algorithm for reusing large-scale ontologies. We evaluate the proposed evolution approach with the traditional Chinese medicine ontology and obtain promising results.     

注意缺陷多动障碍儿童认知特点的研究

目的　探索注意缺陷多动障碍 (ADHD)儿童认知功能特点。方法　对 6 0例ADHD门诊患儿 ,以及按年龄、性别、母亲文化程度配对的 6 0名正常儿童进行认知功能评定。结果　ADHD儿童言语智商、操作智商、全量表智商及A、B、C因子 (分别为 10 4± 13,98± 14 ,10 2± 13,10 4± 13,10 0± 15 ,10 2± 15 )均低于对照组 (分别为 112± 11,10 8± 13,112± 12 ,111± 12 ,10 7± 13,116± 13) ,差异有非常显著意义 (P均 <0 0 1) ;韦氏记忆测验中 ,ADHD儿童长时、短时、瞬时记忆、记忆商及倒背数字得分 (分别为 4 0± 7,5 8± 12 ,7± 3,95± 15 ,4 2± 1 7)亦明显低于对照组 (分别为 4 9± 5 ,6 3± 10 ,8± 3,10 9± 12 ,5 0± 1 4 ) ,差异有显著意义 (P均 <0 0 5 ) ;ADHD儿童数字划消测验总分低于对照组 ,平均失误率高于对照组 ,差异有非常显著意义 (P均 =0 0 0 0 ) ;Stroop测验中 ,ADHD组A、B、C、D部分完成时间及字义干扰时明显延长 (P均 =0 0 0 0 ) ,C、D部分的错误数显著增加 (P均 <0 0 1) ;瑞文测验标准分等级也低于对照组 (P =0 0 0 0 )。结论　ADHD儿童智力、记忆力、注意力水平低于正常儿童 ,且具有选择性抑制、语音信息的工作记忆和计划的执行功能缺陷。     

卫生服务利用公平性分析方法研究

“卫生服务利用公平性分析方法研究”是卫生领域公平性系列研究的重要组成部分。借鉴国际研究成果介绍如何运用“标化”和集中指数等方法,按照“水平公平”原则分析卫生服务利用的公平状况,并讨论该方法的应用前景和政策意义。     

视觉传导路营养动脉的显微解剖及其临床意义

目的研究视神经、视交叉、视束、外侧膝状体等结构的动脉,为视力障碍和血管造影提供基础资料。方法手术显微镜下对100侧成人脑的视神经、视交叉、视束、外侧膝状体的动脉进行显微解剖观察,并做病理组织学研究。结果视神经呈分段分层供血;视交叉中央区微血管稀少;视束的后半部由脉络丛前动脉供血;外侧膝状体的血供为多来源而前外侧为单来源供血。50～70岁60侧脑标本的来源动脉88.3%有动脉硬化改变。结论视神经和视交叉中央部、视束后半部及外侧膝状体的前外侧为血供的危险区;是视野缺损的病因之一。     

Antitumor effects of polyethylene glycol-modified recombinant human interleukin-2 on mouse uterine cervical carcinomain vivo

Polyethylene glycol (PEG-8000)-modified recombinant human interleukin-2 (PEG-rIL-2) is a cytokine with prolonged circulatory half-life. In this paper, the antitumor effects of PEG-rIL-2 against mouse uterine cervical carcinoma (U₁₄) transplanted intraperitoneally or subcutaneously is reported. PEG-rIL-2 at different doses was administered intraperitoneally. The results showed that PEG-rIL-2 (4500 IU, i.p., QD×5) prolonged survival time of mice bearing ascites tumor as compared to rIL-2 (P<0.01), but PEG-rIL-2 at lower doses was without therapeutic effect In addition, compared to rIL-2, PEG-rIL-2 at different doses (1500–13500 IU, s.c, QD×5) caused significant dose-dependent growth inhibition of solid tumor (P<0.01) when the treatment started at day 4 after subcutaneous inoculation of tumor.     

变应性真菌性鼻窦炎

目的　通过总结 3例变应性真菌性鼻窦炎 (allergicfungalsinusitis,AFS)的诊断、治疗过程 ,结合复习文献中关于本病的病理、生理过程的探讨 ,提示本病的诊断、治疗特点。方法　通过对 3例病史、鼻窦CT检查、鼻窦分泌物及鼻腔检查 ,对临床怀疑变应性真菌性鼻窦炎的 3例患者进行鼻窦内镜手术。通过分泌物真菌涂片、培养 ,组织病理学检查以及放射免疫吸附试验 (radioallergosorbenttest,RAST)结果 ,明确AFS诊断。术后口服强的松 ,局部雷诺考特喷鼻及大扶康冲洗鼻腔。结果　通过上述系统治疗 ,2例术后分别随访 2 5个月和 15个月症状完全缓解 ,1例术后 6个月症状复发 ,变应性黏蛋白再次出现 ,经术腔清理及大扶康冲洗后局部症状及分泌物完全消失 ,随访 2个月无复发。结论　变应性真菌性鼻窦炎有其独特的临床发生、发展过程。慢性鼻窦炎、鼻息肉中存在着一定比例的AFS ,应对其做出及时的诊断和进行合理、完善的综合治疗 ,以降低本病的并发症和复发率。