含烷氧基桥联的双Schiff碱配体的双核Co（Ⅱ）配合物的合成与磁性

本文合成了二个双核钴（Ⅱ）配合物，即Ｃｏ２ＬＢｒ３·ＣＨ３ＣＨ２ＯＨ（１）和Ｃｏ２Ｌ（ＳＣＮ）３·ＣＨ３ＣＨ２ＯＨ（２）〔这里ＨＬ是由１，３－二氨基－２－丙醇与Ｎ－氧化吡啶－２－甲醛缩合而得〕。通过ＩＲ、元素分析、电导测定和ＵＶ的表征，可知这两个配合物具有一个内源桥和一个外源桥。测定了这两个配合物的变温磁化率（４Ｋ—３００Ｋ）并将实测值与Ｈｅｉｓｅｎｂｅｒｇ模型导出的磁化率方程拟合，得到两个配合物的磁参数，表明这两个双核Ｃｏ（Ⅱ）配合物具有较弱的反铁磁交换作用。     

面向临床应用的知识库平台设计

借鉴本体论及数理逻辑来表示知识模式,开发了知识通用逻辑引擎及专题知识引擎来处理应用逻辑,充分利用医院集成平台的优势,研发设计一种能够覆盖大部分临床应用需要的知识库平台体系结构,辅助医疗决策过程,并保障医疗安全.     

利用双聚类算法探测内科学知识基础及研究前沿

目的：利用双聚类算法探测内科学知识基础及研究前沿。方法：收集内科学高影响力杂志的数据,利用gCLUTO软件对数据进行双聚类分析,获取内科学领域知识基础和学科前沿。结果：近年来内科学的研究前沿表现为6个方面,临床流行病学和循证医学越来越多地与临床医学结合,成为临床研究者关注的方向。结论：双聚类算法在探测学科知识基础及研究前沿具有可行性,在未来的研究中,可以尝试将双聚类算法推广到各领域的学科发展评价中。     

面向中医证候学研究的知识服务系统研发

为探索中医证候领域的知识建模方法和知识服务模式,初步建立了一个“中医证候知识库”,并在此基础上开发了基于万维网的知识服务系统,该系统实现了知识检索、知识浏览、知识问答等功能,能支持中医证候学研究和临床决策等应用。     

人眼基底部玻璃体视网膜界面超微结构的研究

目的通过对不同年龄人眼基底部玻璃体视网膜界面超微结构的研究, 探讨基底部玻璃体视网膜界面年龄相关性变化。方法采用胰蛋白酶消化法去除11只眼库眼球基底部视网膜的细胞成分,暴露视网膜内界膜（inner limiting lamina, ILL）,扫描电子显微镜（SEM）和透射电子显微镜（TEM）观测其超微结构。结果SEM和TEM均显示,基底部ILL表面的胶原纤维束随年龄增长逐渐向ILL侵入。胶原纤维开始以发辫形式散布在ILL表面,纤维发辫逐渐散开、相互重叠,穿透ILL与玻璃体皮质纤维交织结合在一起,最终形成致密的网状结构。结论随年龄增长来自视网膜内的胶原纤维逐渐穿透ILL与玻璃体皮质纤维缠绕结合,使基底部玻璃体视网膜界面粘连延伸。     

侧颅底外科的历史与现状

侧颅底外科近年来越来越受到耳神经学科医师的重视,该文对侧颅底外科的历史、手术径路以及相关技术作一概述,使临床上对其有一个系统的认识。     

住培基地管理人员线上培训学习与启示

介绍了北京市2020年8月住院医师规范化培训（住培）基地管理人员能力提升培训班线上授课的主要内容：包括住培制度建立的背景及重要性,住培相关政策介绍;基地评估的5个一级指标、16个二级指标、39个三级指标（住培工作重点）的具体评分标准,其中包括13项核心指标,是基地建设的关键,以及基地评审注意事项;住培招录相关文件政策简介,招录实施注意事项,招录工作中常见问题与解答,招录流程的规范要求;培训轮转安排的原则：依据培训细则的规定,尽量先安排必转科室的轮转,按照分层递进式轮转安排;住培考核分为过程考核和结业考核,过程考核是重点,主要包括：日常考核、出科考核、年度考核,简要介绍出科考核小组人员构成及考核流程等;以及住培医师入院入科教育、住院医师及住院师资日常管理等内容。通过培训,提升住培师资综合素质,为提高住培质量,培养合格的临床医师奠定基础。     

The association between radiological spreading pattern and clinical outcomes in necrotizing external otitis

ObjectivesNecrotizing external otitis (NEO) is a rare infectious disease of the skull base. The purpose of this study was to determine whether clinical outcomes of NEO can be correlated to different infectious spread patterns.MethodsRetrospective chart review from 2010 to 2019 with NEO patients, who were divided into two cohorts: single spreading patterns (group A) or complex spreading patterns (group B) as diagnosed by CT. Clinical symptoms, diagnostic and treatment delay, course of disease, complications, and duration of antibiotic exposure were retrospectively collected from patient records.Results41 NEO patients were included, of which 27 patients belonged to group A (66%). The disease-related mortality rate was 12.2% among the entire cohort, no differences were found between group A and B. Higher rates of N.VII (42.9% vs 14.8% P = 0.047) and N. IX palsies were found in group B compared to group A (28.6% vs 3.7%, P = 0.039). The median duration of antibiotic use was significantly different for a complex spreading pattern, clinical recovery and hospitalizations. Complications were associated with higher diagnostic delay and with a complex spread pattern. The median duration of follow-up was 12.0 (IQR 6.0–19.5) months.ConclusionNEO is a severe disease, with significant mortality and morbidity (cranial nerve palsies). The radiological spread pattern may assist in predicting clinical outcome. Furthermore, complex spread patterns are associated with higher rates of clinical nerve palsies (N. VII and N.IX), complications, surgery rates and longer duration of antibiotic use. Diagnostic delay was associated with mortality, complications and facial palsies.Level of evidenceLevel IV.     

Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review

Background: Craniovertebral junction (CVJ) schwannomas are rare, with surgery and stereotactic radiosurgery (SRS) being effective yet challenging options. We systematically reviewed the literature on CVJ schwannomas. Methods: PubMed, Scopus, Web-of-Science, and Cochrane were searched following the PRISMA statement to include studies reporting CVJ schwannomas. Clinical features, management, and outcomes were analyzed. Results: We collected 353 patients from 101 included articles. Presenting symptoms were mostly neck pain (30.3%) and headache (26.3%), with most cranial neuropathies involving the XII (31.2%) and X (24.4%) nerves. Most tumors originated from C2 (30.9%) and XII (29.4%) nerves, being extracranial (45.1%) and intradural-extradural (44.2%). Erosion of C1–C2 vertebrae (37.1%), the hypoglossal canal (28.3%), and/or jugular foramen (20.1%) were noted. All tumors were operated, preferably with the retrosigmoid approach (36.5%), with the far-lateral approach (29.7%) or with the posterior approach and cervical laminectomy (26.9%), far-lateral approaches (14.2%), or suboccipital craniotomy with concurrent cervical laminectomy (14.2%). Complete tumor resection was obtained most frequently (61.5%). Adjuvant post-surgery stereotactic radiosurgery was delivered in 5.9% patients. Median follow-up was 27 months (range, 12–252). Symptom improvement was noted in 88.1% of cases, and cranial neuropathies showed improvement in 10.2%. Post-surgical complications occurred in 83 patients (23.5%), mostly dysphagia (7.4%), new cranial neuropathies (6.2%), and cerebrospinal fluid leak (5.9%). A total of 16 patients (4.5%) had tumor recurrence and 7 died (2%), with median overall survival of 2.7 months (range, 0.1–252). Conclusions: Microsurgical resection is safe and effective for CVJ schwannomas. Data on SRS efficacy and indications are still lacking, and its role deserves further evaluation.     

蝶枕角与颅底诸结构至耳眼平面垂直距离的纵向比较

目的:为人颅底的生长发育研究提供正常的颅底结构测量数据和参照标准;初步分析颅底生长发育趋势和特点。方法:对人不同生长发育阶段颅底标本诸结构进行观察和测量,并对其进行相互比较和纵向分析。结果:颅底在不同发育阶段各有其趋势和特点,蝶枕角随着年龄的增长逐渐变小,但性别之间无差异,颅前窝诸结构变化幅度最大,颅中窝的变化相对最小,11项测量指标在不同生长发育阶段的变化各异。结论:观察测量数据可为人颅底生长发育进一步研究提供依据,蝶枕角、耳眼(FH)平面可作为颅底生长发育的观察测量指标和参照平面。