3D打印技术在脊柱侧凸矫形中的应用效果分析

目的探讨3D打印技术在脊柱侧凸矫形中的应用效果。方法 76例脊柱侧凸患者随机分为两组各38例。两组均实施后路小切口微创分期术,对照组行常规CT或X线辅助手术治疗,观察组行术前3D打印技术辅助手术治疗。比较两组的手术效果以及并发症。结果观察组的置钉准确率高于对照组,平均置钉时间短于对照组(P <0.05)。术后,观察组的终末融合后侧凸主侧凸冠状位Cobb角低于对照组,初次平均矫正率高于对照组(P <0.05)。两组的并发症发生率无统计学差异(P>0.05)。结论术前应用3D打印技术辅助治疗脊柱侧凸,可有效提升手术效果,更好地恢复脊柱生理弯曲,提高矫形成功率。     

How Assessment-Schedule Matching Limits Bias When Comparing Progression-Free Survival in Single-Arm Studies: An Application in Second-Line Urothelial Carcinoma Treatments

ObjectivesPopulation-adjusted comparisons of progression-free survival (PFS) from single-arm trials of cancer treatments can be derived using matching-adjusted indirect comparisons (MAICs); however, results are still susceptible to bias, particularly if the trials had different tumor assessment schedules. This study aims to assess the effects of assessment-schedule matching (ASM) on the relative effectiveness on the PFS of avelumab versus approved comparator immunotherapies or chemotherapy after population matching in the second-line (2L) setting for metastatic urothelial carcinoma.MethodsThe MAIC used patient-level data for avelumab from the JAVELIN Solid Tumor trial (NCT01772004). PFS was compared with published curves for other treatments to obtain population-adjusted hazard ratios (HRs). The MAIC was repeated after conducting ASM for differences in tumor assessment scheduled first at 6 weeks for avelumab and durvalumab and at 8 or 9 weeks for other treatments.ResultsMAIC adjustment alone altered the HR estimates up to 23%, whereas MAIC plus ASM resulted in up to 32.7% reductions from naive comparisons. Even in cases in which MAIC had little effect, ASM brought an additional change of 11.1% to 15.4%. Overall, the HR range of avelumab versus other treatments changed from 0.83 to 1.25 for naive comparisons to 0.76 to 0.99 after ASM plus MAIC, numerically favoring avelumab.ConclusionsSmall variations in assessment schedules can introduce bias in unanchored indirect treatment comparisons of interval-censored time-to-event outcomes. In this study, adjusted PFS was comparable across second-line urothelial carcinoma treatment options, numerically favoring avelumab versus immunotherapies and chemotherapy agents. Correcting this bias is especially important when HRs are applied in cost-effectiveness models to transition patients between states.     

Antimicrobial Resistance: Is Health Technology Assessment Part of the Solution or Part of the Problem?

Antimicrobial resistance is a serious challenge to the success and sustainability of our healthcare systems. There has been increasing policy attention given to antimicrobial resistance in the last few years, and increased amounts of funding have been channeled into funding for research and development of antimicrobial agents. Nevertheless, manufacturers doubt whether there will be a market for new antimicrobial technologies sufficient to enable them to recoup their investment. Health technology assessment (HTA) has a critical role in creating confidence that if valuable technologies can be developed they will be reimbursed at a level that captures their true value. We identify 3 deficiencies of current HTA processes for appraising antimicrobial agents: a methods-centric approach rather than problem-centric approach for dealing with new challenges, a lack of tools for thinking about changing patterns of infection, and the absence of an approach to epidemiological risks. We argue that, to play their role more effectively, HTA agencies need to broaden their methodological tool kit, design and communicate their analysis to a wider set of users, and incorporate long-term policy goals, such as containing resistance, as part of their evaluation criteria alongside immediate health gains.     

分析核磁共振技术诊断膝关节损伤的临床效果

目的:研究关于核磁共振技术对膝关节损伤进行诊断的临床诊断效果和价值。方法:本文调查时间选择2019年1月~2020年1月,将在此期间到本院接受膝关节损伤治疗的35例患者作为研究对象,分别对所有患者选择采用核磁共振技术和CT诊断技术行膝关节损伤的诊断,并分析比较两种不同诊断方法诊断的效果和价值。结果:经过比较分析可以得出,应用核磁共振诊断技术对膝关节损伤进行诊断的准确率明显高于CT诊断手段,两组数据进行统计学分析比较,P<0.05,存在统计学差异性。结论:通过核磁共振技术对膝关节损伤进行诊断能够有效地提升诊断的准确率,可以实现对于各类损伤类型的诊断,可以及时地帮助患者提供相关的治疗依据。     

科技期刊出版运营需求调研与分析

【目的】 了解科技期刊从业人员和科研工作者对科技期刊出版技术、运营、传播的需求,探究可行的技术应用、工具开发和平台建设策略。【方法】 2020年11月,通过问卷星向科技期刊从业人员和科研工作者进行问卷调查;问卷涉及参与问卷调查人员对当今互联网技术发展、科技期刊运营模式、学术成果传播途径的了解和需求。【结果】 从402份面向科技期刊从业人员以及138份面向科研工作者的有效问卷中总结得出,参与问卷调查人员对互联网技术的应用、运营手段的丰富和传播途径的扩展有实际需求。【结论】 结合目前国际出版领域领先的出版技术与运营和传播实践,向科技期刊及相关公司机构提出技术应用、运营平台建设和传播体系搭建的相关可行性建议。     

基于眼动技术的高危孤独症谱系障碍幼儿限制性兴趣研究

目的 分析高危孤独症谱系障碍(HR-ASD)幼儿的局限兴趣眼动特征及行为指标间相关性,为ASD的亚型分类早期识别及干预提供依据。方法 选取2018年6月—2020年6月就诊于南方医科大学附属深圳妇幼保健院符合入组标准的年龄相匹配的ASD幼儿39例、HR-ASD幼儿49例及正常发育幼儿44例,采用SMI RED250便携式眼动仪、孤独症观察量表(ADOS)及盖塞尔发育量表(GDS)对患儿进行测试,比较三组幼儿关注兴趣物的眼动特征与行为指标的结果,并分析其相关性。结果 1)ASD幼儿与HR-ASD组幼儿首次注视的兴趣物分别为轮船、台灯,注视轨迹均无规律性,正常发育幼儿首次注视物为气球,注视物轨迹有规律;ASD组与HR-ASD幼儿组的兴趣物倾向相似,且较正常幼儿对各种玩具车、转椅等异常注视,差异有统计学意义(F=123.01、89.32,P＜0.01)。2)ASD组与HR-ASD组幼儿较正常发育幼儿的适应性、精细动作、语言及个人社交能力水平均差(F＝47.05、23.70、32.30、50.19,P＜0.01),但ASD幼儿与HR-ASD组幼儿一般行为能力差异无统计学意义(P＞0.05)。3)ASD幼儿、HR-ASD幼儿对动车的眼动注视时间与语言能力均呈负相关(r=-0.22,-0.43,P＜0.05);正常幼儿的语言能力与其对动车及转椅的注视均呈负相关(r=-0.17,r=-0.17,P＜0.05),对蛋糕的眼动注视时间与个人-社交能力呈正相关(r=0.43,P＜0.01)。结论 早期识别高危孤独症谱系障碍幼儿局限兴趣,对ASD的早期亚型分类及早期辅助诊断与干预有重要指导意义。     

高技术条件下战场救治的特点及医德要求

高技术条件下战争的特殊性给战场救治带来了新的挑战。通过分析高技术条件下的战场救治的特点,提出了要圆满完成战场救治任务,军队医务人员必须承担的医德责任和应具备的身心素质。     

科技进步与心血管病学的50年展望

本文主要阐述未来50年心血管病学领域内的各种进步,包括基因诊断和治疗、心脏外科手术的发展等等.     

The use of artificial intelligence and robotics in regional anaesthesia

The current fourth industrial revolution is a distinct technological era characterised by the blurring of physics, computing and biology. The driver of change is data, powered by artificial intelligence. The UK National Health Service Topol Report embraced this digital revolution and emphasised the importance of artificial intelligence to the health service. Application of artificial intelligence within regional anaesthesia, however, remains limited. An example of the use of a convoluted neural network applied to visual detection of nerves on ultrasound images is described. New technologies that may impact on regional anaesthesia include robotics and artificial sensing. Robotics in anaesthesia falls into three categories. The first, used commonly, is pharmaceutical, typified by target-controlled anaesthesia using electroencephalography within a feedback loop. Other types include mechanical robots that provide precision and dexterity better than humans, and cognitive robots that act as decision support systems. It is likely that the latter technology will expand considerably over the next decades and provide an autopilot for anaesthesia. Technical robotics will focus on the development of accurate sensors for training that incorporate visual and motion metrics. These will be incorporated into augmented reality and visual reality environments that will provide training at home or the office on life-like simulators. Real-time feedback will be offered that stimulates and rewards performance. In discussing the scope, applications, limitations and barriers to adoption of these technologies, we aimed to stimulate discussion towards a framework for the optimal application of current and emerging technologies in regional anaesthesia.     

正交试验设计结合熵权TOPSIS优选阿胶珠炮制工艺

目的 优选阿胶珠的炮制工艺。方法 采用L₉（3⁴）正交试验设计,以外观性状、水分、总灰分、特征多肽及氨基酸含量为指标,以炮制时间、炮制温度、每锅辅料用量为考察因素,结合直观分析、方差分析和熵权逼近理想解排序法（TOPSIS）对正交试验结果进行评价,优选阿胶珠炮制工艺,并进行炮制工艺验证。结果 优选的阿胶珠炮制工艺参数为炮制时间5 min、炮制温度190 ℃、蛤粉-阿胶为30∶1;验证实验中3批样品各指标的RSD为2.09%~4.91%。结论 优选的阿胶珠炮制工艺合理可行,可为阿胶珠工业化炮制生产提供参考。