绝经后抑郁症治疗的研究进展

研究表明女性进入绝经期阶段后,抑郁症的发病风险呈上升趋势[1].国外相关研究显示绝经后抑郁症发病率在5.7%~59.8%[2-3].生殖衰老分期(STRAW+10)[4]将绝经后分为绝经早期和绝经晚期,绝经早期是指末次月经至之后6年期间,该阶段和围绝经期存在1年重叠;绝经晚期是指在此之后阶段.     

抑郁症和双相障碍患者服药依从性及相关因素分析的多中心横断面研究

目的 对门诊抑郁症/双相障碍患者的服药依从性现状进行调查,探索服药依从性的影响因素.方法 采用多中心连续入组的方法,选取首都医科大学附属北京安定医院、南京脑科医院、昆明医学院附属第一医院、广州市精神病医院、哈尔滨医科大学附属第一医院、第四军医大学附属西京医院等6家三级甲等精神专科医院或综合医院精神科为研究中心,对201...     

眼用N-三甲基壳聚糖包衣胰岛素纳米脂质体原位凝胶的研制及体外释药研究

目的以胰岛素(INS)为模型药物,制备眼用阳离子纳米脂质体-原位凝胶(ISG),并对其相关体外性质及体外释药行为进行考察。方法采用逆向蒸发法制备INS纳米脂质体(INSL),并用N-三甲基壳聚糖(TMC60)进行包衣;根据胶凝温度筛选出泊洛沙姆407的最佳质量浓度;采用无膜溶出模型考察凝胶的体外释药行为。结果 TMC60包衣前的INSL-ISG的平均粒径为(92.36±0.20)nm,Zeta电位为(-19.50±0.30)mV;TMC60包衣后的INSL-ISG的平均粒径为(93.93±0.19)nm,Zeta电位为(13.23±0.15)mV。泊洛沙姆407的最佳质量浓度为25%,经模拟泪液稀释前后的胶凝温度分别为23.9℃和34℃。TMC60-INSL-ISG的药物释放和凝胶溶蚀均呈现良好的零级释放特征。结论 TMC60-INSL-ISG兼有阳离子脂质体和原位凝胶的优势,延缓了药物的释放,为下一步探究提高其角膜滞留性奠定了基础。     

胺碘酮联合美卡素对阵发性心房颤动复律及复律后窦性心律维持的临床研究

目的 探讨研究胺碘酮联合美卡素治疗阵发性房颤和对房颤复律后维持窦性心律的临床疗效.方法 92例阵发性心房颤动患者随机分为A组47例单用胺碘酮治疗,和B组45例（胺碘酮＋替米沙坦）治疗.观察治疗后24 h,3 d和7 d时,心房颤动的复律情况,并在复律后继续用药,随访观察1年,评价两组窦性心律的维持效果.结果 A组心房颤动患者治疗24 h,3 d和7 d时,心房颤动的转复率分别为64.80%,74.90%和85.60%,B组转复率为65.20%,81.30%和94.60%.7 d时,两个研究组的心房颤动的转复率对比,差异有统计学意义（P＜0.05）.随访1年,A组窦性心率维持率是70.30%,左心房内径是（38.25±1.30）mm.B组窦性心率维持率是88.20%（P＜0.05）,左心房内径分别是（36.13±1.26）mm（P＜0.05）.结论 胺碘酮和美卡素（替米沙坦）治疗阵发性房颤和对房颤复律后维持窦性心律均优于单用胺碘酮治疗.可能与替米沙坦抑制了肾素-血管紧张素系统,以及抑制心房的电重构和结构重构相关.     

An applied research on precise sustentacular screw placement based on anatomical division of the anterior lateral wall of calcaneus and the sustentaculum tali北大核心CSCD

Objective To evaluate our novel path based on anatomical division of the anterior lateral wall of calcaneus and the sustentaculum tali for precise sustentacular screw placement in the surgical treatment of calcaneal fractures of Sanders types Ⅱ and Ⅲ. Methods The anterior lateral wall of the calcaneus was divided into the anterior-superior zone S1, the anterior-inferior zone S2, the posterior-superior zone S3 and the posterior-inferior zone S4 for demarcation of the screw insertion points by our method of Four Zones, and into the front, middle and rear sections by our method of Three Sections for demarcation of the screw target points. The specimens were scanned by CT and modeled by Mimics. On the 3D virtual model of the calcaneus, one screw was placed from each zone of the anterior lateral wall of the calcaneus to the sustentaculum tali body. The screw placement target for S1 and S2 was the medial intersection point P1 of the front and middle sections of the sustentaculum tali, and that for S3 and S4 was the medial intersection point P2 of the middle and rear sections of the sustentaculum tali. It was observed whether the screws were placed in the bone channel. A total of 72 patients were included who had been admitted to Department of Orthopaedics, Suqian Hospital Affiliated to Xuzhou Medical University for calcaneal fractures of Sanders types Ⅱ and Ⅲ from January 2017 to January 2021. They were divided into an anatomical division group and a 3D printing group according to their screw placement method for the sustentaculum tali. In the anatomical division group of 32 patients subjected to screw placement based on our anatomical division, there were 25 males and 7 females, aged from 24 to 60 years; in the 3D printing group of 40 patients subjected to screw placement assisted by 3D printing, there were 31 males and 9 females, aged from 25 to 58 years. The disparities between the parameters of sustentacular screw placement and the actual values were compared in the anatomical division group, and the total number of screws, screws on average, distribution of screws, and accuracy of screw placement were compared between the 2 groups. Results All the screws which were virtually placed in the specimens of the calcaneus from S1 and S2 to P1 and from S3 and S4 to P2 passed through the bony channel, with no perforation into the tarsal sinus. There was no significant difference in the general date between the anatomical division group and the 3D printing group, showing they were comparable (P > 0.05). In the anatomical division group, a total of 52 screws were placed to the sustentaculum tali with an average of (1.63 ± 0.48) screws per patient, and 2 screws were placed in 20 patients, yielding an accuracy rate of screw placement of 92.3% (48/52). There were no statistically significant differences between the parameters and the actual values of screw placement in the anatomical division group (P > 0.05). In the 3D printing group, a total of 63 screws were placed to the sustentaculum tali with an average of (1.58 ± 0.49) screws per patient, and 2 screws were placed in 23 patients, yielding an accuracy rate of screw placement of 93.7% (59/63). There were no significant differences in the above comparisons between the anatomical division group and the 3D printing group (P > 0.05). Conclusion In the surgical treatment of calcaneal fractures of Sanders types Ⅱ and Ⅲ, the sustentacular screw placement based on our anatomical division of the anterior lateral wall of the calcaneus and the sustentaculum tali can lead to similar clinical accuracy as 3D printing-assisted screw placement does. © 2022 Chinese Journal of Orthopaedic Trauma. All rights reserved.     

甲状腺交界性肿瘤诊断和预后相关分子标志物的研究进展Research progress in diagnosis- and prognosis-related molecular markers of borderline thyroid tumor

甲状腺交界性肿瘤概念的提出对于减少甲状腺肿瘤的过度诊疗具有重要意义,但是利用超声和组织病理检查等传统甲状腺肿瘤诊断方法诊断甲状腺交界性肿瘤具有一定局限性。近年来,分子标志物在临床工作中的应用越来越广泛,其中细胞角蛋白19（CK19）、半乳糖凝集素3（Galectin-3）、骨髓内皮细胞标记物1（HBME-1）和甲状腺过氧化物酶（TPO）等免疫组织化学标志物以及v-raf鼠类肉瘤滤过性病毒致癌基因同源体B1（BRAF）、鼠肉瘤病毒致癌基因同源物基因（RAS）、端粒酶逆转录酶基因（TERT）和微小RNA（miRNA）等遗传学标志物被证实与甲状腺交界性肿瘤的发生发展密切相关,其在甲状腺交界性肿瘤组织中的表达水平有别于传统的甲状腺良恶性肿瘤,因此其不仅可以作为诊断的特异性标志物,还可以用于肿瘤危险度分层、治疗方案的决定、复发监测以及基因治疗等。现从免疫组织化学标志物和遗传学标志物2个方面,介绍包括透明变梁状肿瘤、恶性潜能未定的滤泡性肿瘤、恶性潜能未定的高分化肿瘤和具有乳头状核特点的非浸润性甲状腺滤泡性肿瘤在内的4种甲状腺交界性肿瘤的诊断及预后相关分子标志物的研究进展。     

阈值法在肝包虫病CT图像分割中的应用

目的 探讨阈值法在肝包虫病CT图像分割中的应用价值.方法 选择20张患有肝包虫病的病患CT图像,对CT图像进行归一化预处理,然后对其进行阈值法分割.结果 成功分割17 张,分割失败3张,分割成功率为85%,过度分割和漏分割情况较少,分割的结果 图像比较清晰饱满,光滑连通性好,基本没有线条缺损的现象.结论 阈值法适合肝包虫病CT图像的分割,基本能达到比较准确的判断.能很好地帮助肝包虫病CT图像的纹理特征、形状特征及其他特征的提取,较理想地将目标与背景分开来实现分割.     

基于生物电阻抗方法分析血液透析患者内脏脂肪面积与腹主动脉钙化的相关性研究

目的 探讨维持性血液透析(maintenance hemodialysis, MHD)患者内脏脂肪面积(visceral fat area, VFA)与腹主动脉钙化的相关性。方法 采用横断面调查法,选取2019年4月至2020年5月于首都医科大学附属北京潞河医院规律血液透析且保留完整数据的患者,进行人体成分分析,排除营养不良的患者,按照腹主动脉钙化评分(Abdominal Aortic Calcification Score, AACs)将患者按照钙化程度分成4组,比较临床特点及VFA水平;采用多因素Logistic回归法分析患者腹主动脉钙化的影响因素,并通过受试者工作特征(receiver operating characteristic, ROC)曲线分析VFA水平对腹主动脉钙化的预测价值。结果 本研究共纳入152例MHD患者,分为无钙化组(n=32)、轻度钙化组(n=45)、中度钙化组(n=54)以及重度钙化组(n=21);4组患者的血磷、全段甲状旁腺素(intact parathyroid hormone, iPTH)、高密度脂蛋白胆固醇(high density lipopr...     

加味补中益气汤对COPD模型大鼠肠道菌群的影响

目的分析加味补中益气汤对慢性阻塞性肺疾病(COPD)模型大鼠肠道菌群的影响。方法 2021年4-6月, 选取SPF级Wistar大鼠60只, 采用随机数字表法分为空白对照(BC)组、模型(Model)组、中药(CM)组、西药(WM)组, 每组15只。除BC组外均以烟熏法建立肺脾两虚型COPD模型, 造模后CM组、WM组分别以加味补中益气汤、合生元灌胃干预, Model组、BC组则以0.9%氯化钠注射液灌胃干预。7 d后收集各组大鼠粪便进行肠道菌群16S rRNA测序, 对有效序列进行聚类, 获得操作分类单元(OTU), 用于主坐标分析(PCoA)、物种组成分析、Alpha多样性分析, 分析加味补中益气汤对肠道菌群结构、多样性和丰度变化的影响。结果 CM组和WM组以厚壁菌门为主, BC组和Model组以拟杆菌属为主。各组中优势菌群主要为乳杆菌、拟杆菌属。Alpha多样性分析显示, CM组、WM组、BC组群落丰富度指数中Shannon指数分别为(3.65±0.35)、(3.65±0.36)、(3.59±0.20), 均高于Mode组的(3.37±0.26)(t=2.49、2.44、2.60...