中国第1例数字化女虚拟人的三维重建

基于真实人体解剖的数字化虚拟人体研究结合医学科学与计算机技术构建一个像真人一样的计算机模型，在数字解剖、手术计划与培训和很多非医学领域有广泛应用价值。本文简要介绍中国第一例女虚拟人的三维重建过程并给出部分三维重建图像结果。     

Automatic sorting of toxicological information into the IUCLID (International Uniform Chemical Information Database) endpoint-categories making use of the semantic search engine Go3R

The knowledge-based search engine Go3R, www.Go3R.org, has been developed to assist scientists from industry and regulatory authorities in collecting comprehensive toxicological information with a special focus on identifying available alternatives to animal testing. The semantic search paradigm of Go3R makes use of expert knowledge on 3Rs methods and regulatory toxicology, laid down in the ontology, a network of concepts, terms, and synonyms, to recognize the contents of documents. Search results are automatically sorted into a dynamic table of contents presented alongside the list of documents retrieved. This table of contents allows the user to quickly filter the set of documents by topics of interest. Documents containing hazard information are automatically assigned to a user interface following the endpoint-specific IUCLID5 categorization scheme required, e.g. for REACH registration dossiers. For this purpose, complex endpoint-specific search queries were compiled and integrated into the search engine (based upon a gold standard of 310 references that had been assigned manually to the different endpoint categories). Go3R sorts 87% of the references concordantly into the respective IUCLID5 categories. Currently, Go3R searches in the 22 million documents available in the PubMed and TOXNET databases. However, it can be customized to search in other databases including in-house databanks.     

Elevated risk of death and major cardiovascular events in subjects with newly diagnosed diabetes: Findings from an administrative database

AimsTo investigate the incidence of major cardiovascular complications and mortality in the first years of follow-up in patients with newly diagnosed diabetes.Methods and resultsWe examined incidence rates of hospitalization for cardiovascular reasons and death among new patients with diabetes using the administrative health database of the nine million inhabitants of Lombardy followed from 2002 to 2007. Age and sex-adjusted rates were calculated and hazard ratios (HR) were estimated with a matched population without diabetes of the same sex, age (±1 year) and general practitioner.There were 158,426 patients with newly diagnosed diabetes and 314,115 subjects without diabetes. Mean follow-up was 33.0 months (SD ± 17.5). 9.7% of patients with diabetes were hospitalized for cardiovascular events vs. 5.4% of subjects without diabetes; mortality rate was higher in patients with diabetes (7.7% vs. 4.4%). The estimated probability of hospitalization during the follow up was higher in patients with diabetes than in subjects without for coronary heart disease (HR 1.4, 95% CI 1.3–1.4), cerebrovascular disease (HR 1.3.95% CI 1.2–1.3), heart failure (HR 1.4, 95% CI 1.3–1.4) as was mortality (HR 1.4, 95% CI 1.4–1.4).Younger patients with diabetes had a risk of death or hospital admission for cardio-cerebrovascular events similar to subjects without diabetes ten years older.ConclusionsThe elevated morbidity and mortality risks were clear since the onset of diabetes and rose over time. These data highlight the importance of prompt and comprehensive patients care in addition to anti-diabetic therapy in patients with newly diagnosed diabetes.     

Evaluation of two dental registration-splint techniques for surgical navigation in cranio-maxillofacial surgery

BackgroundSurgical navigation requires precise registration of the pre-operative image dataset to the patient in the operation theatre. Different marker-based and marker-free registration techniques are available, each of them with advantages and disadvantages regarding precision and clinical handling. In this model study, the precision of two dental splint techniques for marker-based registration is analyzed.Materials and methodsA synthetic full-size human skull was registered with its cone beam computed tomography dataset using (a) a dentally-mounted “rapid” occlusal splint with five titanium screws directly attached to the splint, (b) an “extender”, a dentally-mounted occlusal splint with similar fiducials fixed to an extension of the splint. The target registration error was measured for 170 landmarks distributed over the viscero- and neurocranium in 10 repeats per splint type using the Vector Vision² (BrainLAB AG, Heimstetten, Germany) navigation system. Statistical and graphical evaluations were performed per anatomical region.ResultsIn the periorbital region, the rapid splint, with an average deviation of 1.50 mm (SD = 0.439) showed greater accuracy than the extender with 1.76 mm (SD = 0.525). The viscerocranial results for both splints were similar (extender 1.84 mm, SD = 0.559, rapid occlusal splint 1.86 mm, SD = 0.686). In the cranial vault region, registration with the extender (2.33 mm, SD = 0.685) proved to be more precise than with the rapid splint (2.86 mm, SD = 0.929).ConclusionsDue to the more compact dimension of the rapid occlusal splint, errors close to the splint were smaller compared to the extender technique. The advantage of greater distances between the registration fiducials on the extender is particularly important in areas such as the orbital roof, the cranial vault, and the lateral skull base.     

中成药欧盟注册分析

自2004年起,欧盟和美国分别发布了《传统植物药注册程序指令》和《植物药产品指南》,掀起了中药的新篇章,西方发达国家第一次在法律层面上认可中药作为药品的地位,现通过对欧盟植物药注册法规法律的探讨以及注册成功案例的分析,为我国中成药国际化注册提供一定参考。     

基于Hausdorff距离的CARTO电解剖图与CT曲面配准

我们提出一种全自动、高精度的CARTO电解剖图(EAM)与CT曲面的配准算法。算法首先以基于主轴的方法粗配准EAM与CT曲面,然后再以基于Hausdorff距离的方法进一步实现EAM与CT曲面精配准。实验结果表明,相对Carto-Merge配准软件以及随机配准算法,基于Hausdorff距离的配准算法能获得更稳定且更精确的EAM与CT曲面配准效果,同时算法完全自动,基于Hausdorff距离的EAM与CT曲面配准算法能很好地满足房颤消融手术的临床应用需求。     

Prolonged QTc Interval in Cancer Therapeutic Drug Development: Defining Arrhythmic Risk in Malignancy

Anticancer therapy drug development is an arduous task, taking 10 to 15 years to complete, requiring approximately 1 billion dollars, and rarely leads to Food and Drug Administration approval. Methods to predict unacceptable drug-induced toxicity, such as a prolonged QTc interval/risk of torsade de pointes, should be highly informative to quickly and accurately determine if further resources should be allocated in the continued development of an agent. Expert consensus has established guidelines to ascertain the ability of a new drug to prolong the QTc interval. Although QTc measurement is the best way to assess arrhythmic risk, it is imprecise for a variety of reasons. In addition, oncology patients have multiple risk factors for QTc prolongation at baseline. Competing interests involved in assessing arrhythmic risk of a new oncology agent include inability to precisely follow published guidelines for QTc assessment, patients' concomitant medical problems interfering with drug assessment and therefore clinical trial enrollment, patient safety concerns, general public safety concerns regarding toxicity assessment, need for discovery of more curative drug therapies, and individual patient perception of therapeutic risk vs benefit. Oncology patients are concerned about access to experimental agents, as well as early abandonment of a potentially beneficial agent because of a low estimated risk of toxicity, even if the event is catastrophic. We review the issues involved in evaluating the QTc interval-prolonging risk in new anticancer agents.     

护理缺陷登记本的设计与应用

护理缺陷是指在医疗活动中造成患者人身损害的医疗事故及其他医疗护理差错或缺点。护理工作的特殊性质决定了护理活动具有很高的风险性。在护理活动中，护士必须认真地对待每一个患者和每一项操作，稍有疏漏，就有可能在护理过程的某个环节上出现问题，导致护理差错或事故发生。能否正确认识、预防和处理这些护理缺陷，是提高护理质量的根本保证。为此，我们设计了护理缺陷登记本并应用到工作中，收到了良好的效果，现介绍如下。     

对医药代表注册制度的思考与建议

目的:促进医药流通领域健康、有序发展。方法:借鉴国内、外相关经验并提出规范医药代表行为的建议方案。结果与结论:我国应建立医药代表注册制度,规范医药代表的行为,使之发挥应有作用。     

Quality of perinatal death registration

The quality of national perinatal mortality statistics was evaluated from a survey in nine maternity hospitals in Hainaut, Belgium (total births: 7862). The overall completeness of perinatal death registration was 86%. Under-registration was especially frequent in low birth weight babies. In 69% of cases, the birth weight value reported on death certificates was in exact agreement with the value in hospital records. Using detailed categories of causes, there was, in 37% of cases, agreement between the underlying cause on death certificates and the main cause identified in hospital records. Using gross categories of causes, the level of agreement was 56%. Disagreement was mostly due to the lack of specificity of the underlying cause on death certificates. The authors suggest ways to improve the quality of registration.Abbreviation ICD International classification of diseases The study was supported by a research grant of the Fonds de la Recherche Scientifique Medicale No 3.9002.85