Endovascular embolization for symptomatic perimedullary AVF and intramedullary AVM: a series and a literature review

Introduction  

Perimedullary arteriovenous fistula (AVF) has shunt on the spinal cord surface and it can be treated with surgery, or endovascular embolization. Intramedullary arteriovenous malformation (AVM) has its nidus in the cord and is difficult to treat either by surgery or endovascular technique. We report our experience with endovascular embolization in the treatment of perimedullary AVF and intramedullary AVM.     

三种电阻抗断层动态成像算法的仿真比较研究

三种电阻抗断层动态成像算法进行了比较研究。基于有限元仿真模型,对三种算法的图像分辨率、抗噪性能和运算速度分别进行了对比,结果表明,反投影算法具有良好的抗噪性能,牛顿一步重建法的图像分辨率最佳,灵敏度矩阵重建算法整体性能适中。     

回顾性心电门控扫描优化方案的临床研究

目的:在64排螺旋CT(Multidetector Computed Tomography,64-MDCT)冠状动脉CT成像(Computed Tomography Coronary Angiography,CTCA)扫描时采用优化的回顾性心电门控扫描,在保证图像质量的前提下,最大限度地降低辐射剂量。材料与方法:连续选取行64-MDCT CTCA检查的患者100例,将心率控制在65BPM以下,根据扫描方案将患者分为2组,每组均采用回顾性心电门控扫描,根据患者的体重指数(Body Mass Index,BMI)确定管电流及管电压。第1组曝光期相及最大毫安输出均设定为75%R-R间期。第2组曝光期相设定为75%R-R间期,最大毫安输出设定为70%-80%R-R间期。扫描结束后,对两组之间的图像质量、有效剂量(Effective Dose,ED)行统计学分析;P0.05为差异有统计学意义。结果:两组之间的图像质量无统计学意义,有效剂量有统计学意义。第1组的ED值比第2组降低了20%。结论:优化的回顾性心电门控扫描可以进一步降低辐射剂量。     

腹膜初始转运功能的流行病学研究

目的研究腹膜初始转运功能与年龄、原发病、病程、净超滤量等的关系,阐述腹膜初始转运功能的流行病学特点。方法收集在泰安市中心医院泌尿内一科进行腹膜透析置管的患者48例,采用logistic回归法分析原发病、年龄、病程与腹膜初始转运功能的关系。结果对受试患者腹膜初始转运功能的相关影响因素进行单因素有序反应变量Logistic回归分析显示腹膜初始转运功能与年龄、病程有关系(P<0.05)。将有统计学意义的相关影响因素进行多因素有序反应变量Logistic逐步回归分析,表明病程与腹膜初始转运功能有关系(P<0.05)。结论随年龄增大、病程延长,腹膜初始转运功能转为低转运与高转运的机会有增加的趋势。原发病为糖尿病肾病者腹膜初始转运倾向于高转运;原发病为高血压肾损害、慢性肾炎者腹膜初始转运倾向于平均转运。     

上海市全科医师规范化培训的进展与挑战

本文回顾了上海自20世纪90年代以来开展全科医师培训工作的主要内容,总结了上海全科医师培训工作的特色与经验,分析了全科医师培训工作中面临的挑战,并提出了政策建议。建立一支“下得去、留得住、用得好”的全科医师队伍,不仅在于培训制度本身,更重要的是要营造吸引、留住和发挥社区全科人才的政策环境。     

Derivation and validation of a prediction rule for estimating advanced colorectal neoplasm risk in average-risk Chinese

No prediction rule is currently available for advanced colorectal neoplasms, defined as invasive cancer, an adenoma of 10 mm or more, a villous adenoma, or an adenoma with high-grade dysplasia, in average-risk Chinese. In this study between 2006 and 2008, a total of 7,541 average-risk Chinese persons aged 40 years or older who had complete colonoscopy were included. The derivation and validation cohorts consisted of 5,229 and 2,312 persons, respectively. A prediction rule was developed from a logistic regression model and then internally and externally validated. The prediction rule comprised 8 variables (age, sex, smoking, diabetes mellitus, green vegetables, pickled food, fried food, and white meat), with scores ranging from 0 to 14. Among the participants with low-risk (≤3) or high-risk (>3) scores in the validation cohort, the risks of advanced neoplasms were 2.6% and 10.0% (P < 0.001), respectively. If colonoscopy was used only for persons with high risk, 80.3% of persons with advanced neoplasms would be detected while the number of colonoscopies would be reduced by 49.2%. The prediction rule had good discrimination (area under the receiver operating characteristic curve = 0.74, 95% confidence interval: 0.70, 0.78) and calibration (P = 0.77) and, thus, provides accurate risk stratification for advanced neoplasms in average-risk Chinese.     

利用细胞外基质大规模扩增临床级人脂肪间充质干细胞

背景：如何运用无血清培养体系大规模扩增处于未分化状态的脂肪间充质干细胞,并使其保持“干性”是脂肪间充质干细胞临床应用转化中急待解决的难题。目的：建立含细胞外基质的脂肪间充质干细胞体外培养系统,验证其扩增细胞的高效性、有效性及安全性。方法：在无血清培养条件下,将体外分离得到的脂肪间充质干细胞分别接种在包被细胞外基质的培养板和传统二维塑料培养板上。经过体外扩增后,比较2种条件下细胞数量、细胞表面标记物表达、细胞衰老状况以及体外多向分化能力（诱导成脂、成骨和成软骨）的差异,考察脂肪间充质干细胞在含细胞外基质的培养条件下扩增后的临床安全性。结果与结论：脂肪间充质干细胞扩增到第5代时,包被细胞外基质培养板的细胞产量已经是传统二维塑料培养板的10倍以上,流式细胞检测表明,在含细胞外基质条件下扩增的脂肪间充质干细胞仍保持了干细胞表面特定标记物的表达。细胞衰老检测结果显示,使用包被细胞外基质的培养板扩增脂肪间充质干细胞至第15代时,细胞仍几乎无老化现象,而使用二维塑料培养板扩增的细胞在第5代时已出现明显老化,传代后细胞增殖能力明显下降。体外多向诱导分化实验显示,脂肪间充质干细胞在含细胞外基质条件下扩增至第15代时仍具有成脂、成骨和成软骨的分化功能,并且与第5代时没有明显差异,同时显著优于传统培养条件下的第5代脂肪间充质干细胞。染色体核型分析及小鼠成瘤性试验结果表明,脂肪间充质干细胞在含细胞外基质条件下扩增后仍具备临床应用的安全性。以上结果证实,含细胞外基质的无血清培养系统可以更高效且安全地扩增出具有临床应用潜能的脂肪间充质干细胞。