妊娠合并多诱因顽固性代谢性酸中毒1例报道

<正>1病例介绍1.1基本情况患者,女,39岁,因“发热、畏寒2 d,气促、心悸、下腹胀痛3 h”入院,G5P3 28+3周孕,既往有糖尿病病史2年,予口服二甲双胍,孕前4个月予皮下注射胰岛素（早、晚餐前20 U）。有剖宫产手术史,21年前顺产一活男婴（体健）;12年前剖宫产一活女婴（体健）;自然流产1次,难免流产1次。末次月经2021年5月28日,本次外院彩超示“宫内早孕”。     

人工破膜对诊断羊水过少的价值

目的 :探讨人工破膜在诊断羊水过少中的意义。方法 :观察组是根据人工破膜时所流出的羊水量判断羊水多少 ;对照组则用同期产前超声检查所见判断羊水多少。以产时所见羊水量作为最终诊断。结果 :人工破膜和超声诊断羊水过少的符合率分别是 79 73 %和 82 76 % ;两者无显著差异 (P >0 0 5 ) ;人工破膜漏诊率 2 84% ,超声是 6 15 % ,两者无显著差异 (P >0 0 5 )。结论 :人工破膜是诊断本病的一种有价值的方法 ,结合超声检查可作为诊断本病的依据     

B超对先天性输尿管狭窄的诊断价值

目的：研究超声诊断在先天性输尿管狭窄中的临床价值。方法：对33例输尿管狭窄病例行B超检测,并与X线、手术结果进行对比。结果：B超对输尿管梗阻定位率为93.9%,疾病诊断的符合率81.8%。结论：B超对先天性输尿管狭窄的诊断有较大的优越性和很好的临床价值。     

肢体负压对周围动脉闭塞性病变犬皮肤SP免疫反应阳性神经纤维影响

目的　观察肢体负压对周围动脉闭塞性病变犬皮肤中 SP免疫反应阳性神经纤维的影响 .方法　犬 17只 ,随机分治疗组 10只、非治疗组 5只和正常对照组 2只 ,治疗组和非治疗组均将动物制作左后肢缺血模型 ,治疗组在模型制作后 14d,开始行患肢负压治疗 10 d(15 min·次 - 1 ) ;非治疗组不做负压治疗 ;正常对照组不行缺血模型制作及负压治疗 . 3组均行左后肢趾皮肤免疫组化染色 ,检测 SP免疫反应阳性纤维 .结果　非治疗组皮肤中 SP免疫反应阳性神经纤维均较正常对照组明显增多 (P<0 .0 1) ,治疗组较非治疗组减少(P<0 .0 1) ,但仍较正常对照组增多 .结论　肢体负压疗法可促进皮肤感觉神经纤维中 SP的释放     

孤立性蝶窦病变的诊断与治疗

目的;提高孤立性蝶窦病变的诊断和治疗率。方法;总结使用鼻窦内窥镜诊治孤立性蝶窦病变１２例的全过程。结果：１２例孤立性蝶窦病变的患者的均获准确诊断,使用鼻窦镜行经鼻腔蝶窦手术,有效率为８３．３％,随访６￣２４个月,１０例无复发,复发２例二次手术后治愈;结论：孤立性蝶窦病变患者可用鼻窦内窥镜诊断与治疗。     

足底板对类风湿性关节炎患者足底压的影响

目的 :测定类风湿性关节炎病人足底压 ,评价足底板的生物力学效应。方法 :12名女性类风湿性关节炎病人和 8名健康女性进行年龄和体重匹配。用 F- Scan系统进行动态足底压测量 ,Kistler床反力平台用以校正测量精确性。测量足底峰压和垂直分力 ,评价足底板的生物力学表现。结果 :类风湿性关节炎病人中足底压明显高于健康人。使用足底板后 ,足底总的峰压明显降低 ,前足、后足峰压减低 ,中足峰压增高。而垂直分力改变不大。结论 :足底板能显著降低足底压力 ,使足底压力重分布 ,减轻类风湿足痛。特殊设计的足底板对类风湿足痛的治疗能起重要的作用     

Characterization and phylogenetic analysis of a neurovirulent Zika virus isolated from Cambodia in 2019

The geographic range of Zika virus (ZIKV) has expanded from Asia to the Americas, leading to the 2015–2016 pandemic with enhanced neurovirulence. At present, ZIKV is continuously circulating in many Southeast Asian countries. Unfortunately, the persistent evolution of ZIKV in Southeast Asia and its influence on the biological characteristics of the virus remain incompletely understood. In this study, the in vitro and in vivo properties of a new ZIKV isolate obtained from Cambodia in 2019 (CAM/2019) were characterized and compared with those of the Cambodian strain (CAM/2010). Compared with CAM/2010, the CAM/2019 virus showed similar plaque morphology and growth curves in cell cultures and induced comparable viremia and organ viral loads profiles in both BALB/c and A129 (IFNAR1^−/−) mice upon intraperitoneal (i.p.) inoculation. Remarkably, the CAM/2019 virus exhibited enhanced neurovirulence in neonatal mice compared with CAM/2010, with a 74-fold reduction in the 50% lethal dose (LD₅₀). Consistently, CAM/2019 produced higher viral loads in the brains of BALB/c neonatal mice than CAM/2010 did. Sequence alignment showed that the CAM/2019 virus has acquired 12 amino acid substitutions, several of which were found to be associated with neurovirulence. In particular, the CAM/2019 virus shared an A1204T substitution in NS2A with the Thai isolate SI-BKK02 that was isolated from a microcephaly case. Taken together, our results indicate that a ZIKV strain isolated with specific mutations has emerged in Cambodia, highlighting the need for extensive molecular and disease surveillance in Cambodia and other Asian countries.     

The acceptance of SARS-CoV-2 rapid antigen self-testing: A cross-sectional study in China

Compared with the nucleic acid amplification test (NATT), the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapid antigen self-testing (RAST) has advantages in speed and convenience. However, little is known about people's acceptance and influencing factors for SARS-CoV-2 RAST. A cross-sectional study was conducted from April 21 to 30, 2022 in China. The χ² test and multivariate logistic regressions were used to identify the influencing factors. The structural equation model was used to test the extended protective motivation theory (PMT) model hypotheses. Among the total of 5107 participants, 62.5% were willing to accept the SARS-CoV-2 RAST. There were significant differences in acceptance among different residences (p < 0.001), educational level (p < 0.001), occupation (p < 0.001), monthly income (p < 0.001), travel frequency (p < 0.05), and feelings about NATT (p < 0.001). Response efficacy (β = 0.05; p = 0.025) and self-efficacy (β = 0.84; p < 0.001) had a positive effect, while response cost showed a negative effect (β = −0.07; p < 0.001). The public's major concerns about SARS-CoV-2 RAST are its reliability, testing method, price, and authority. Overall, a moderate intention to use SARS-CoV-2 RAST was found among the Chinese population. The extended PMT can be used for the prediction of intention to accept the RAST. We need to take measures to increase people's acceptance of SARS-CoV-2 RAST.     

U-Patch GAN: A Medical Image Fusion Method Based on GAN

Journal of Digital Imaging - Although medical imaging is frequently used to diagnose diseases, in complex diagnostic situations, specialists typically need to look at different modalities of image...