微生物分类单元聚类算法比较研究

目的 随着高通量测序技术的发展,产生了大量的微生物16S rRNA基因序列数据.对该数据进行精确的微生物操作分类单元（operational taxonomic unit,OTU）划分,有助于了解环境中微生物的种群组成及分布.方法 本文在真实数据集与模拟数据集上,对现有的7种流行OTU单元聚类算法进行了对比研究,并分析了这些算法的优缺点及使用范围.结果 序列长度、测序深度对聚类结果均有影响.结论 相同的序列相似性阈值下,不同的聚类算法聚类结果差异较大,其中CROP算法的鲁棒性和抗噪性较好.     

口腔颌面外科手术患者发生感染的病原菌特点及影响因素探讨

目的分析口腔颌面外科手术患者发生感染的病原菌特点并探讨其影响因素。方法2016年5月-2018年5月在本院行口腔颌面外科手术治疗的患者214例,采集相应临床标本进行细菌的培养鉴定并进行药敏试验;收集患者的临床资料,包括年龄、性别、体质量指数、手术时间、术中抗菌药物使用、误吸、是否发生感染及感染部位等,分析术后感染发生的相关因素。结果214例口腔颌面手术患者中发生术后感染29例(感染率为13.55%),感染部位主要为呼吸道及手术切口。29例感染患者的临床标本共分离出49株病原菌,其中革兰阴性菌占71.43%,主要菌种铜绿假单胞菌对哌拉西林及头孢唑林的耐药率为42.86%和71.43%;革兰阳性菌占29.35%,主要菌种金黄色葡萄球菌对庆大霉素耐药率为57.14%,对万古霉素敏感;真菌占6.12%。单因素分析显示,年龄、手术时间、术中抗菌药物使用及误吸等为口腔颌面术后感染发生相关因素。结论口腔颌面术后感染的主要致病菌为革兰阴性菌,且对抗菌药物有一定的耐药性。年龄、手术时间、术中抗菌药物使用及误吸为患者术后感染发生的影响因素,可为口临床提供参考。     

T90%与阻塞性睡眠呼吸暂停低通气综合征合并高血压、难治性高血压的相关性研究

目的 探讨T90%与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压、难治性高血压(RH)的相关性。方法 纳入OSAHS患者533例，依据T90%的四分位数分为M1、M2、M3、M4四组，比较各组临床资料及分析T90%与OSAHS合并高血压、RH的相关性，并根据呼吸暂停低通气指数进行亚组分析。结果 随T90%增高，男性比例、颈围、腰围、体质指数、Epworth嗜睡量表评分、AHI、高血压及RH患病率增高(P<0.05),而最低血氧饱和度及平均血氧饱和度下降(P<0.05)。回归结果显示，M3、M4组合并高血压、RH的风险随T90%增高而增加(P<0.05),M2组与M1组相比，合并高血压、RH的风险无统计学差异(P>0.05);在重度OSAHS患者中，M2a、M3a、M4a组合并高血压风险随T90%增高而增加(P<0.05),M3a、M4a组合并RH风险随T90%增高而增加(P<0.05),M2a组与M1a组相比，合并RH的风险无统计学差异(P>0.05);在非重度OSAHS患者中，M2b、M3b、M4b组合并高血压、RH风险随T90%增...     

腓动脉穿支腓肠神经营养血管游离皮瓣修复手足软组织缺损

Objective To report the operative techniques and clinical results of the free psroneal artery perforator sural neurecutanecus flaps. Methods Free sural neurocutaneous flap with a single unit of perforating veins and artery arising from the peroneal artery was designed to repair skin defects of hand or from the ankle to distal end of the foot. After the flap was transposed to the defect, the perforating artery was anastomozed with a branch of a nearby artery, and the small saphenoas vein was anastomosed with the cephalic vein or the great sapheneous vein to establish the flap's circulation. An alternative way was to anastomose the perforating vessels only. The sural nerve was anastomosed to innervate the flap. Results From Jan 2005 to Dec 2007, 12 cases were treated with the flaps with no flap necrosis. The size of the flaps ranged from 12 crux7 cm to 18 cm× 11 cm. The follow-up period was 7 to 27 months. Both the cosmetic and functional results were satisfactory. Two point discrimination was 7 ～ 12 mm. Conclusions The flap has all the advantages of the h'ee flap, the perforator flap and the neurocutaneous flap. It is easily performed with reliable blood supply. It's a good choice for repairing the skin defects of hands and feet.     

腓动脉穿支腓肠神经营养血管游离皮瓣修复手足软组织缺损

Objective To report the operative techniques and clinical results of the free psroneal artery perforator sural neurecutanecus flaps. Methods Free sural neurocutaneous flap with a single unit of perforating veins and artery arising from the peroneal artery was designed to repair skin defects of hand or from the ankle to distal end of the foot. After the flap was transposed to the defect, the perforating artery was anastomozed with a branch of a nearby artery, and the small saphenoas vein was anastomosed with the cephalic vein or the great sapheneous vein to establish the flap's circulation. An alternative way was to anastomose the perforating vessels only. The sural nerve was anastomosed to innervate the flap. Results From Jan 2005 to Dec 2007, 12 cases were treated with the flaps with no flap necrosis. The size of the flaps ranged from 12 crux7 cm to 18 cm× 11 cm. The follow-up period was 7 to 27 months. Both the cosmetic and functional results were satisfactory. Two point discrimination was 7 ～ 12 mm. Conclusions The flap has all the advantages of the h'ee flap, the perforator flap and the neurocutaneous flap. It is easily performed with reliable blood supply. It's a good choice for repairing the skin defects of hands and feet.     

小儿腹泻贴佐治小儿腹泻临床观察

目的观察小儿腹泻贴辅佐治疗小儿风寒泻和寒湿泻的临床疗效。方法将患儿随机分为两组,均常规服用思密达,治疗组加用小儿腹泻贴敷脐,连用3d为1个疗程,共1～2个疗程,观察治疗效果、治疗后主症积分、证候总积分及治愈时间。结果治疗组综合疗效、证候疗效愈显率高于对照组,治疗后主症及证候积分均低于对照组,治愈时间亦少于对照组。结论小儿腹泻贴辅助思密达治疗小儿腹泻,能够显著提高临床疗效,缩短病程,且经济方便,易于接受。     

正畸患者对牙列中线偏移的审美认知评价

目的 调查正畸患者对牙列中线偏移的关注程度与审美评价.方法 建立男女性牙列中线偏移模型,利用电子问卷对正畸患者进行调查.结果 调查样本共计 203例,男性牙列中线偏移的审美理想值、察觉值、容忍度分别为-0.012 mm、1.42 mm、2.50 mm;女性为-0.017 mm、1.31mm、2.62 mm.结论 理想值、察觉值和容忍度三个指标可以对牙列中线偏移的审美影响进行定量评价,其量化值具有一定的临床指导意义.     

由股动脉频谱异常发现髂动脉狭窄或闭塞12例

目的探讨由股动脉血流动力学异常发现髂动脉狭窄或闭塞病变。方法回顾性分析下肢动脉超声检查中由股动脉频谱异常发现髂动脉狭窄或闭塞病变12例,结合临床和其他影像学检查最终确诊病变。结果本组12例对髂动脉狭窄节段的定位全部符合临床确诊结果。其中,1例为髂动脉全段闭塞,1例髂总动脉一段闭塞,2例髂总动脉一段狭窄,2例髂总动脉及髂外动脉近段狭窄,5例髂外动脉近段狭窄,1例髂外动脉远段近闭塞。9例狭窄程度：〉75%狭窄7例,〉50%狭窄2例。9例狭窄的病例彩色多普勒表现为局部变细花色血流;2例闭塞的病变表现为彩色血流充盈缺损;1例髂外动脉近闭塞表现为管腔内极暗淡细束血流。结论超声检查下肢动脉发现股动脉频谱PSV减小,AC减低,搏动性减低等改变时应提示临床检查髂动脉等近端动脉。     

来氟米特治疗轻中型狼疮性肾炎疗效分析

目的分析来氟米特对轻中型狼疮性肾炎的治疗效果。方法 33例5≤狼疮基本活动指数(SLEDAI)≤14、0.5 g≤24 h尿蛋白定量<2.0 g的狼疮性肾炎患者,随机分为对照组16例和观察组17例,分别单用糖皮质激素及联合应用来氟米特治疗6个月,观察其疗效及治疗前后SLEDAI、24 h尿蛋白定量、抗ds-DNA抗体滴度及补体C3变化。结果观察组总有效率为88.24%,对照组总有效率为68.75%,但组间疗效比较差别无统计学意义(P>0.05)。治疗6个月后,对照组和观察组的SLEDAI评分均较治疗前明显降低,差别有统计学意义(P<0.05),而24 h尿蛋白定量、抗ds-DNA滴度、补体C3虽较治疗前有一定改善,但差别无统计学意义(P>0.05)。观察组与对照组的各项指标治疗后差别无统计学意义(P>0.05)。结论来氟米特联合糖皮质激素用于轻中型狼疮性肾炎的缓解治疗有一定的疗效。