"互联网+医疗"背景下的腰椎间盘突出症医院-家庭康复模式研究

目的 探讨基于"互联网+医疗"背景下的腰椎间盘突出症(lumbar disc herniation,LDH)医院-家庭康复模式的优势.方法 纳入本院2018年1月～2018年12月门诊收治的80例LDH患者,采用随机数字表法分成"互联网+医疗"模式组(观察组)与传统医疗模式组(对照组)各40例.观察组采用"互联网+医疗"康复治疗模式,对照组采用传统医疗康复模式.比较两组治疗前、治疗后1个月、3个月、6个月腰腿疼痛VAS评分、腰椎JOA评分,治疗后6个月临床疗效及患者满意度.结果 两组患者均完成治疗.两组治疗后各时间点腰部及腿部VAS评分、腰椎JOA评分均优于治疗前(P<0.05);观察组治疗后各时间点的腰腿VAS评分、腰椎JOA评分均优于对照组(P<0.05).观察组优良率为87.50％,对照组为62.50％,观察组优良率明显高于对照组(P<0.05).观察组满意度明显优于对照组(P<0.05).结论 基于"互联网+医疗"的医院-家庭康复模式能缓解临床症状,获得较好的疗效,提升患者的满意度,该模式为传统医疗模式的升级和转型提供了方向和依据.     

经尿道国产1470nm激光汽化术治疗<30g小体积前列腺增生的临床体会

目的探讨经尿道国产1470nm激光汽化术治疗<30g小体积前列腺增生患者的安全性、有效性和远期并发症情况。方法回顾性研究2017年10月至2018年9月我院45例<30g小体积前列腺增生患者的临床资料,其中TURP组20例,1470 nm激光组25例。详细记录两组患者的临床资料、围手术期并发症和随访情况。结果45例患者手术均成功,术后平均随访时间12.6个月(9~16个月)。两组患者年龄、前列腺体积和IPSS、RUV、Qmax和QOL基线资料差异无统计学意义(P>0.05)。TURP组和1470 nm激光组患者术后3个月IPSS、RUV、Qmax和QOL均较术前改善(P<0.05),组间比较差异无统计学意义(P>0.05)。1470 nm激光组患者手术时间([48.6±13.6)min vs(56.8±11.7)min,P=0.038]、术后膀胱持续冲洗时间[(0.8±0.5)d vs(1.5±0.9)d,P=0.001]、导尿管留置时间([2.7±0.6)d vs(4.7±0.9)d,P<0.001]和住院时间([4.2±1.2)d vs(5.2±1.9)d,P=0.036]较TURP组患者明显缩短,术前术后血红蛋白浓度变化更小([5.5±2.4)g/L vs(11.6±2.7)g/L,P<0.01]。随访发现TURP组有2例出现尿道狭窄,1470 nm激光组无尿道狭窄病例发生。结论经尿道国产1470 nm激光汽化术治疗<30 g小体积前列腺增生安全有效,与传统TURP比较术中出血少,术后恢复时间更短,无尿道狭窄并发症发生,为BPH的个体化治疗提供了新的思路。     

The Effect of a PEEK Material‐Based External Fixator in the Treatment of Distal Radius Fractures with Non‐Transarticular External Fixation

ObjectiveTo explore the effect of a PEEK material‐based external fixator in the treatment of distal radius fractures with non‐transarticular external fixation.MethodsThere were 48 patients in this prospective comparative study. They were divided into two groups according to the materials used: the PEEK group and the titanium group. Wrist dorsiflexion, palmar flexion, pronation, supination, radial deviation, ulnar deviation, grip strength of the palm on the affected side, kneading force, Visual Analogue Scale/Score (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, operation time, frequency of fluoroscopy procedures, and X‐ray results were compared between the two groups. Functional recovery was evaluated at the last follow‐up according to the wrist joint evaluation criteria.ResultsThe baseline data were comparable between the two groups, and no significant differences were found in age, sex, fracture types (P > 0.05). There was no significant difference between the two groups in the results of DASH, grip strength, and recovery of pinch force and wrist function (dorsiflexion, clavicle, ulnar deviation, deviation, pronation, and supination) (P > 0.05). Normal limb function was achieved in the two groups of patients at an average of 6 weeks after surgery, and there was no significant difference in X‐ray examination radial height (10.60 ± 1.59 vs 11.00 ± 1.53, P = 0.687), radial inclination (1.11 ± 0.24 vs 1.12 ± 0.24, P = 0.798), volar tilt (10.33 ± 2.13 vs 10.00 ± 2.08, P = 0.660), ulnar variance (20.87 ± 3.00 vs 20.38 ± 3.04, P = 0.748), and step‐off persistence (1.73 ± 0.69 vs 1.68 ± 0.72, P = 0.425) between the two groups (P > 0.05). However, the operation time (54.80 ± 12.20 vs 85.23 ± 15.14, P = 0.033) and number of fluoroscopy procedures (36.93 ± 6.89 vs 64.77 ± 9.74, P = 0.000) in the PEEK group were significantly reduced compared with those in the titanium group.ConclusionCompared with the traditional titanium external fixator, the PEEK composite external fixator has advantages, such as a shorter operation time and fewer fluoroscopy procedures when used to treat different types of distal radius fracture.     

Influences of Heavy Metals and Salt on Seed Germination and Seedling Characteristics of Halophyte Halogeton glomeratus

Bulletin of Environmental Contamination and Toxicology - Heavy metals pollution and salinization of soils are widely distributed in agricultural soils. This study investigated the effects of five...     

Occurrence,Human Exposure,and Risk Assessment of Polybrominated Dibenzo-p-Dioxins and Dibenzofurans,Polychlorinated Naphthalenes,and Metals in Atmosphere Around Industrial Parks in Jiangsu,China

Air samples were collected around industrial parks in Jiangsu, China, to allow the concentrations, profiles, and risk assessment of polybrominated dibenzo-p-dioxins and dibenzofurans (PBDD/Fs), polychlorinated naphthalenes (PCNs), and metals to be investigated. The concentrations of ΣPBDD/Fs and ΣPCNs were 1324.26–2080.98 fg/m³ (11.35–42.57 fg I-TEQ/m³) and 10,404.9–29,322.9 fg/m³ (1.32–7.19 fg I-TEQ/ m³), respectively. The highest concentration of ΣPBDD/Fs and ΣPCNs were observed at site C. PBDD/Fs were mainly dominated by PBDFs. The main contributor to the ΣPBDD/Fs in all samples was 1,2,3,4,6,7,8-HpBDF, which accounted for 25.75%–39.4%. For PCNs, the predominating homologues were tetra-, tri- and penta-CNs, which contributed 30.7%–43.3%, 24.7%–31.0%, and 10.6%–21.6%, respectively. As for metals, the pollution of As, Mn, Cr, and Ni in most samples exceeded National Ambient Air Quality Standards of China. Assessing the risk of inhalation exposure showed that there were potential carcinogenic risks to local residents.

     

肾上腺髓质微血管构筑

本文以树脂铸型扫描电镜法,观察大鼠和小鼠肾上腺髓质的微血管构筑,并特别注意髓质血管和皮质血管的相互关系;此外切片观察测量了肾上腺髓质两种嗜铬细胞的分布。肾上腺皮质集合小静脉发出侧支,分布于髓质,构成了门静脉循环特点。小鼠的肾上腺髓质,主要由这种侧支供应;而大鼠的髓质,还有多支髓质动脉供应。从血管铸型上表现出的明显局部环形缩窄推测,肾上腺髓质血液循环有若干括约装置控制。大、小鼠两种嗜铬细胞在肾上腺髓质内的分布不同,大鼠的呈随机分布;小鼠的 NA 细胞多靠近皮质,而 A 细胞多远离皮质。     

Acupoint-specific fMRI patterns in human brain

Specific central nervous system (CNS) responses to acupuncture have recently attracted attention. It is important to understand the differences in fMRI images of the brain evoked by acupuncture at an acupoint and at a nearby "sham" point. Here, we report analyses of fMRI images of the brains of 37 healthy volunteers in response to acupuncture at Liv3 (Taichong) and LI4 (Hegu) versus their sham points. We found common activation areas in response to Liv3 or LI4 acupuncture in the middle temporal gyrus and cerebellum, along with deactivation areas in the middle frontal gyrus and inferior parietal lobule, compared with the effects of acupuncture at sham points. Acupuncture at Liv3 evoked specific activation at the postcentral gyrus, posterior cingulate, parahippocampal gyrus, BA 7, 19 and 41, but deactivation at the inferior frontal gyrus, anterior cingulate, BA 17 and 18, compared with acupuncture at its sham point. Acupuncture at LI4 evoked specific activation at the temporal pole, but deactivation at the precentral gyrus, superior temporal gyrus, pulvinar and BA 8, 9 and 45, compared with acupuncture at its sham point. These observations reveal that acupuncture at acupoints induces specific patterns of brain activity, and these patterns may relate to the therapeutic effects of acupuncture.     

一种基于独立成分分析的功能磁共振数据处理方法

独立成分分析（ICA）是统计信号处理中的一项新技术，用来从混合信号的多维观测中提取具有统计独立性的成分。我们针对功能磁共振数据处理，采用先对相邻的两体元信号作ICA分离，然后与参考信号进行相关，把相关系数大于一定阈值的体元作为刺激引起兴奋的体元，从而实现刺激的功能定位。经实际脑功能磁共振数据试验，初步证明了方法的有效性。     

Histopathological features of congenital fundus lesions in familial adenomatous polyposis

We report the light and electron microscopic findings for two lesions from two patients who died of complications of familial adenomatous polyposis. In the first case microscopy of a small (100 to 200 mu), uniformly dark lesion (the commonest type seen in this condition) showed enlarged retinal pigment epithelial cells with an increased number of pigment granules. This is consistent with the term "hypertrophy of the retinal pigment epithelium", currently used to describe these lesions. In the second case we sectioned a larger (1000 to 1500 mu), oval, grey lesion from the posterior pole. The pigment epithelium was normal, but between it and outer retina was an unusual choristoma consisting largely of myelinated axons and astrocytes.     

A novel mis-sense mutation (G1381A) in the G6PD gene identified in a Chinese man

Objective　To detect new mutations among 29 glucose-6-phosphate dehydrogenase (G6PD) deficient individuals from Yunnan province. Methods　The nitroblue tetrazolium (NBT) method was used to screen G6PD deficient individuals. Mutation was identified by single strand conformation polymorphism (SSCP), amplification created restriction site (ACRS), amplification refractory mutation system (ARMS) and DNA sequencing. Results　Among 29 cases, 18 cases of G1388A, 1 case of C1004A, and 1 case of G1381A were identified. Nine cases remained to be defined. The G1381A mutation is a novel mis-sense mutation, with a substitution of threonine for alanine (A461T). The resultant G6PD had reduced enzymatic activity. In addition, G1381A caused a restriction site of Stu I to disappear, providing a rapid method for the detection of this mutation. Conclusion　A novel mis-sense mutation G1381A was found. This mutation results in a substitution of threonine for alanine, producing enzyme with reduced activity. The loss of the Stu I restriction site offers a rapid method for the detection of this mutation.