帕金森病脑深部刺激术后FDG—PET／CT变化及临床意义

目的研究帕金森病（PD）脑深部刺激术（DBS）后全脑葡萄糖代谢（FDG）正电子发射断层扫描（PET）／计算机断层扫描（CT）功能影像学变化，探讨其评估手术疗效的临床价值。方法2011年2月至2011年7月，18例接受丘脑底核（STN）DBS治疗的PD患者分别在术前1w和术后6个月进行脑部18-F—FDG—PET／CT。结果术前大部分PD患者FDG影像学表现符合PD相关模式（PDRP）。术后异常代谢区域代谢趋向正常改变：纹状体区、中脑、感觉运动区和运动前区皮层的异常高代谢有明显下降；双侧前额叶、扣带回和辅助运动区皮层的异常低代谢有轻度升高。结论FDG影像对PD的诊断、鉴别诊断、病情评估和手术疗效有指导意义，但目前尚不能指导临床手术。     

基于“性状-质量标志物-生物效应”的饮片质量整体识别研究思路

中药饮片作为中医临床用药的原料，其质量控制与中医药事业的健康发展息息相关。《中国药典》2020年版对中药饮片的质量标准进一步修订完善，但仍缺乏符合中药饮片整体性与专属性特点的质量评价方法和标准。基于上述问题，通过综述性状电子检测、色谱-质谱联用、多效应生物评价等技术在中药饮片质量识别方面的研究进展，探索中药饮片“性状-质量标志物-生物效应”的关联性，为构建符合中药饮片整体性及专属性的质量识别关键技术，实现中药饮片质量识别模式的现代化转变提供参考。     

医院制剂复方甘草口服溶液质量回顾分析

目的 对医院制剂复方甘草口服溶液进行质量回顾分析,及时发现并纠正生产过程的不良趋势,保证制剂质量.方法 采用单值-移动极差控制图法和风险级别判断矩阵对中国人民解放军联勤保障部队第九〇〇医院近五年生产的复方甘草口服溶液质量进行分析.结果 2014年6月至2019年6月,该院生产的30批次复方甘草口服溶液质量符合法定标准,控制图显示该品种生产工艺较稳定,针对复方甘草口服溶液中愈创木酚甘油醚含量波动较大的问题进行风险分析并采取了有效措施控制风险.结论 控制图分析结合风险管理,更有利于我院持续、稳定地生产出质量优异的复方甘草口服溶液.     

标准化病人教学视频联合PCMC教学模式在感染科的应用

目的探讨标准化病人教学视频联合问题导向临床医学教学模式(PCMC)在感染科护理教学中的应用。方法于2018年9月—2019年1月将学校2017级42~47六个班级共计60名学生作为研究对象,42~44班为观察组(n=30),45~47班为对照组(n=30)。对照组采用标准化病人教学视频教学,观察组在上述教学模式基础上增加使用PCMC教学模式,比较两组最终考核成绩及教学满意度。结果观察组理论知识考核成绩及专业技能考核成绩均高于对照组,差异有统计学意义(P<0.05);观察组教学满意度比对照组高,差异有统计学意义(P<0.05)。结论标准化病人教学视频联合PCMC教学模式可显著提高感染科学生理论知识及专业技能成绩,提升教学满意度。     

The predictive significance of bone mineral density on postoperative pain relief in knee osteoarthritis patients after total knee arthroplasty: A prediction model

BackgroundBone mineral density (BMD) may be an important factor affecting the clinical outcomes after total knee arthroplasty (TKA). However, further information regarding BMD in postoperative pain relief is not present yet. This study aims to gain further insight into the predictive significance of BMD in postoperative pain relief in knee osteoarthritis (KOA) patients after TKA.Methods156 KOA patients treated by TKA were included in this study. Visual analogue scale (VAS) was used to measure the pain intensity in patients within one year after TKA. The patients were divided into good pain relief group (the improvement of VAS ≥ 3) and poor pain relief group (the improvement of VAS < 3). BMD and other clinical characteristics were also collected. Logistic regression analysis and receiver operating characteristic curve (ROC curve) were used to evaluate the predictive significance of BMD. Subgroup analysis was used to compare the difference of postoperative pain between High BMD group and Low BMD group extra.Results34 (21.8%) patients had poor pain relief after TKA. Logistic regression analysis indicated that age, BMD, preoperative hospital for special surgery (HSS) scores, preoperative VAS score and postoperative posterior slope angles (PSA) were the risk factors of poor pain relief (P < 0.05). Using BMD as a predictor, the optimum cut-off value of poor pain relief was T-level = ?3.0 SD in the ROC curve, where sensitivity and specificity were 73.5% and 83.7%, respectively. Based on this cut-off value, obvious pain relief was observed in the High BMD group compared with Low BMD group from the 6th month after TKA in the subgroup analysis (P < 0.05).ConclusionsBMD is an effective predictor for postoperative pain relief in KOA patients after TKA, and the poor pain relief should be fully considered especially when BMD T-level ≤ ?3.0 SD.     

Recognition of moyamoya disease and its hemorrhagic risk using deep learning algorithms:sourced from retrospective studies

Although intracranial hemorrhage in moyamoya disease can occur repeatedly, predicting the disease is difficult. Deep learning algorithms developed in recent years provide a new angle for identifying hidden risk factors, evaluating the weight of different factors, and quantitatively evaluating the risk of intracranial hemorrhage in moyamoya disease. To investigate whether convolutional neural network algorithms can be used to recognize moyamoya disease and predict hemorrhagic episodes, we retrospectively selected 460 adult unilateral hemispheres with moyamoya vasculopathy as positive samples for diagnosis modeling, including 418 hemispheres with moyamoya disease and 42 hemispheres with moyamoya syndromes. Another 500 hemispheres with normal vessel appearance were selected as negative samples. We used deep residual neural network(Res Net-152) algorithms to extract features from raw data obtained from digital subtraction angiography of the internal carotid artery, then trained and validated the model. The accuracy, sensitivity, and specificity of the model in identifying unilateral moyamoya vasculopathy were 97.64 ± 0.87%, 96.55 ± 3.44%, and 98.29 ± 0.98%, respectively. The area under the receiver operating characteristic curve was 0.990. We used a combined multi-view conventional neural network algorithm to integrate age, sex, and hemorrhagic factors with features of the digital subtraction angiography. The accuracy of the model in predicting unilateral hemorrhagic risk was 90.69 ± 1.58% and the sensitivity and specificity were 94.12 ± 2.75% and 89.86 ± 3.64%, respectively. The deep learning algorithms we proposed were valuable and might assist in the automatic diagnosis of moyamoya disease and timely recognition of the risk for re-hemorrhage. This study was approved by the Institutional Review Board of Huashan Hospital, Fudan University, China(approved No. 2014-278) on January 12, 2015.     

活血化瘀联合温阳生肌法治疗青斑样血管炎临床分析

目的分析青斑样血管炎的临床特征及中医证候特点,提高对本病的诊断及中医辨证水平。方法对12例确诊的青斑样血管炎患者的临床表现、组织病理、中医证候、中医治则、方药、预后进行回顾性分析。结果12例患者中男3例,女9例,年龄15~45岁,平均年龄20.17岁,中医药治疗时间为14~70 d,平均时间为54.60 d。12例患者均为对称皮疹,均伴有疼痛;皮损特点均为红斑、水疱、紫癜、坏死、水肿、溃疡,呈现线状或放射状分布;皮损痊愈后见色素沉着斑或线状象牙白色萎缩性瘢痕。所有患者经过组织病理确诊。12例患者均符合寒凝血瘀证。坏死期选用活血化瘀法,应用桃红四物汤加减;溃疡期选用温阳生肌法,应用自拟方温阳生肌汤加减。局部使用黄连膏换药。12例患者经中医药治疗后皮损均完全消退,溃疡愈合,遗留色素沉着斑及象牙白色萎缩性瘢痕。停药后随访6个月无1例复发。结论活血化瘀联合温阳生肌法为中医治疗青斑样血管炎提供了新的思路,并能明显降低复发率,值得进一步研究。     

新疆生产建设兵团第十师羊小反刍兽疫抗体监测与评价

为了评估新疆生产建设兵团第十师北屯市(以下简称师市)羊群小反刍兽疫强制免疫效果,应用酶联免疫吸附试验(ELISA)对2017-2020年全师8个农牧团场采集的4 010份血清进行小反刍兽疫抗体检测,并按单位、年份、类别对检测结果进行了统计分析。结果表明,2018-2020年全师8个农牧团场小反刍兽疫血清抗体平均合格率为84.69%(3 396/4 010),均符合国家农业农村部相关规定,高于平均值的三家单位是E 87.22%(157/180)、G 86.45%(268/310)、H 88.67%(798/900),合格率最低的是D 76.11%(137/180);养殖合作社的抗体合格率为84.81%(1 340/1 580),养殖大户为84.65%(2 057/2 430)均接近于平均合格率,两者差异不显著(P>0.05)。总体来看,师市羊群小反刍兽疫免疫效果较好,为确保师市辖区内重大动物疫病免疫无疫提供技术保障。     

中医药靶向调节p53介导的铁死亡机制研究进展

铁死亡是一种新发现的非凋亡调节性细胞死亡形式，以铁依赖性的脂质过氧化物及活性氧（ROS）累积为主要特征。p53是一种抑癌基因，可以通过介导多种关键细胞基因的转录调控，诱导细胞周期阻滞、凋亡、自噬和衰老，进而维持基因组稳定性。新近研究发现p53还可通过影响铁代谢、多不饱和脂肪酸（PUFAs）代谢、氨基酸代谢和烟酰胺腺嘌呤二核苷酸磷酸盐（NADPH）介导的多种细胞代谢过程，调控铁死亡，参与肿瘤、神经系统疾病、心血管疾病、肝病、肾病等疾病的病理进展。该文对p53介导的铁死亡在相关疾病转归中的作用机制及其影响因素进行了系统综述，同时追踪了中医药靶向调节p53介导的铁死亡防治肿瘤、脑卒中、急性心肌梗死、慢性心力衰竭、动脉粥样硬化、溃疡性结肠炎、佐剂性关节炎等疾病的研究进展，以期为相关疾病的防治提供新思路。