数字化影像信息系统在医院的移动应用

目的：构建全套完整无线数字化影像信息系统，使各科医务人员能够操作该系统在整个医院范围内安全、快速、简便的进行医疗应用。材料和方法：基于医院现有GE Centricity PACS／RIS的企业级架构和WEB技术向临床发布影像的应用，以多台戴尔PowerEdge服务器分别用作PACS服务器、RIS服务器、HIS服务器和PACS—web服务器。网络连接设备使用戴尔Powerconnect交换机和TP—LINK无线宽带路由器。用户终端移动设备使用戴尔Latitude笔记本电脑。首先依托医院现有的有线网络构架，选择具有代表性的科室，如放射科、神经外科、神经内科、预防保健科、质控科，并将无线宽带路由器通过双绞线连接至以太网接口，设置无线宽带路由器指定IP地址、子网掩码，设置路由器工作模式，MAC地址过滤、SSID并且禁用SSID广播、频道和加密属性。建立起集中控制式无线网络。在用户终端设置无线适配器，设置为与路由器相同的SSID、频道和加密属性。测试终端移动设备和服务器之间的连接，并且交给最终用户使用。结果：用户使用终端移动设备进行医疗工作日常操作移动性便携性明显优于原系统。而医疗软什的使用与原系统相同，无须另外培训。神经外科和神经内科的临床医生可以手持终端移动设备在患者床前边查房边做病程记录，并且同时通过浏览器基于IHE规范要求优先调阅关键帧影像，通过TruRez增量传输技术降低对无线网络带宽的要求，以web浏览的形式快速从GE Centricity PACS—web服务器实时渊用患者的影像资料。预防保健科和质控科通过HIS和RIS查询进行疾病分类、例数统计，快速生成报表，进行传染病监控和质罱控制。放射科医生需要经常从PACS服务器调用大量的DICOM格式文件，由于无线宽带路由器的带宽为54M，是原有线网络100M带宽的一半，调用时间有所延长。结论：使用医用无线网络系统的通信交流方式较传统方式更加迅速便捷。各种医务人员使用终端移动设备可以在医疗机构内任意漫游、高速传输影像、报告、病历以及其他电子文档。当影像浏览信息极大丰富时（如扩展对心电信息、电生理、超声、病理等信息），正确的操作者可以在正确的时间、安全的获得正确的、完善的临床诊断应用需要的综合诊断信息。对操作者而言简单明了，能够在所有医疗通信系统中使用而无需考虑制造商的因素。     

Shine light on sleep: Morning bright light improves nocturnal sleep and next morning alertness among college students

The relationship between daytime light, especially morning light and sleep, has not been well documented. People who work in an office spend most of their time indoors and thus have less access to high-level daylight. The current study employed a field intervention approach to investigate whether exposure to 1.5 h of bright electric light in the early morning for 1 workweek would benefit sleep among students who spent most of their time in an office at the university. Twelve students (24.92 ± 1.78 years) underwent a 2 workday baseline measurement and two inconsecutive 5 workday interventions (with 1 week washout) with morning bright light and regular office light (1000 lx, 6500 K vs. 300 lx, 4000 K, at eye level). The sleep outcomes were recorded with actigraphy and a sleep diary. In addition, self-ratings of daytime sleepiness, mood, mental fatigue, perceived effort, and next morning sleepiness were measured each workday. The results showed that exposure to morning bright light versus regular office light yielded a higher sleep efficiency (83.82% ± 1.60 vs. 80.35% ± 1.57, p = 0.02), a smaller fragmentation index (15.26% ± 1.31 vs. 17.18% ± 1.28, p = 0.05), and a shorter time in bed (7.12 ± 0.13 vs. 7.51 ± 0.12, p = 0.03). Meanwhile, an earlier sleep onset time, shorter sleep latency, and lower morning sleepiness were observed after a 5 workday morning bright light intervention compared with the baseline (ps <0.05), no such benefit was found for self-ratings (ps >0.05). These findings support existing evidence that morning bright light could function as an enhancer of sleep and alertness for office occupants.     

少年犯情绪智力及共与有关个性因素的相关研究

目的 :探讨少年犯的情绪智力特点及其和有关个性因素的相关关系。方法 :在押少年犯 2 2 8人接受一份问卷调查 ,问卷包括情绪智力、自我效能感和应付方式等五个相关量表。结果 :(1)少年犯的情绪智力低于同龄的中学生 ,男 :12 7 45± 14 6/111 86± 13 9,Z =9 7,P <0 1;女 :12 8 73± 9 9/115 2±13 3 ,Z =4 4,P <0 0 1;(2 )少年犯的情绪智力和一般自我效能感 (r = 2 3 )及应付方式积极应对 (r = 41) ,消极应对 (r = 2 1)正相关 ,但和心理控制源与抑郁则没有相关关系 (P >0 0 5 )。     

五类成年女犯的人格特质及相关因素比较

目的:调查五类成年女犯(盗窃、暴力、性、毒品和职务)在人格特质、家庭环境等方面的异同。方法:采用艾森克人格问卷、家庭环境量表和Olson婚姻质量问卷对568名成年女犯施测。结果:(1)五类成年女犯在人格量表外向性上的得分(10.34～11.35),均高于女性常模(9.11),在掩饰性上的得分(12.12～13.39)均低于女性常模(14.22);在家庭环境量表的成功性上的得分(5.11～5.55)和组织性上的得分(5.45～6.09)低于全国常模(分别为:6.80,6.70);在婚姻满意度上的得分(29.56～34.07)低于对照组(37.88)。上述差异均有统计学显著意义(P<0.05-0.001);(2)除职务女犯外,其他四类女犯在神经质、矛盾性上的得分明显高于常模;在亲密度、娱乐性、知识性上的得分明显低于常模;上述差异均有统计学显著意义(P<0.01-0.001);职务女犯在上述因素上的得分与常模之间的差异均没有统计学显著意义(P>0.05);(3)女犯的年龄均集中在26-35岁;其父母的受教育程度主要在初中及以下且母亲的受教育程度低于父亲;80%以上的女犯都评价自己父母的婚姻状况良好;职务女犯比其它类型女犯受教育程度更高、年龄更大、居住地更多集中在大中城市。结论:(1)人格特质上的高外向性和低掩饰性及家庭环境上的低成功性和低组织性以及低婚姻满意度是成年女犯的共性;(2)职务女犯在人格量表的神经质及家庭环境四个分量表上的得分具有与其他女犯显著不同的特点;(3)父母的学历低可能是女性犯罪的重要原因之一。     

学生的逆境商、焦虑和抑郁的关系研究

目的: 探讨学生逆境商(adversity quotient,AQ)、焦虑与抑郁的关系.方法: 运用AQ量表、自评抑郁量表、焦虑量表对400名学生进行相关分析与回归分析.结果: (1)学生的AQ、抑郁与焦虑呈负相关(r=-O.29～-0.30,P<0.01);(2)回归分析发现,焦虑=-0.27×延伸-0.06×归因;抑郁=-0.19×延伸-0.09×控制;(3)焦虑对AQ和抑郁有显著的中介作用,部分中介效应为69.31%.结论: 焦虑对AQ和抑郁有显著的中介作用.     

血管内支架的技术与性能

血管内支架是一种治疗闭塞性心血管系统疾病的医疗器件,被植入到血管狭窄处,起到支撑和扩张血管的作用。由于支架使用过程接触到血管内壁,生物相容性是这类植入性医疗器件疗效的重要性能。我们简述了血管内支架的工艺技术现状与发展,分析其制备技术对生物相容性的影响,探索防止支架植入后血管内再狭窄的工艺技术途径。     

Genomics,epigenomics and pharmacogenomics of familial hypercholesterolemia (FHBGEP): A study protocol

BackgroundFamilial hypercholesterolemia (FH) is a genetic disease that affects millions of people worldwide.ObjectivesThe study protocol FHBGEP was design to investigate the main genomic, epigenomic, and pharmacogenomic factors associated with FH and polygenic hypercholesterolemia (PH).MethodsFH patients will be enrolled at six research centers in Brazil. An exon-targeted gene strategy will be used to sequence a panel of 84 genes related to FH, PH, pharmacogenomics and coronary artery disease. Variants in coding and regulatory regions will be identified using a proposed variant discovery pipeline and classified according to the American College Medical Genetics guidelines. Functional effects of variants in FH-related genes will be investigated by in vitro studies using lymphocytes and cell lines (HepG2, HUVEC and HEK293FT), CRISPR/Cas9 mutagenesis, luciferase reporter assay and other technologies. Functional studies in silico, such as molecular docking, molecular dynamics, and conformational analysis, will be used to explore the impact of novel variants on protein structure and function. DNA methylation profile and differential expression of circulating non-coding RNAs (miRNAs and lncRNAs) will be analyzed in FH patients and normolipidemic subjects (control group). The influence of genomic and epigenomic factors on metabolic and inflammatory status will be analyzed in FH patients. Pharmacogenomic studies will be conducted to investigate the influence of genomic and epigenomic factors on response to statins in FH patients.SummaryThe FHBGEP protocol has the potential to elucidate the genetic basis and molecular mechanisms involved in the pathophysiology of FH and PH, particularly in the Brazilian population. This pioneering approach includes genomic, epigenomic and functional studies, which results will contribute to the improvement of the diagnosis, prognosis and personalized therapy of FH patients.