三种不同检查方法对早产儿脑损伤评估优越性比较

目的：探究与分析振幅整合脑电图、彩超、MRI在早产儿脑损伤中的诊断研究,旨在为早产儿的临床脑损伤提供可靠的诊断依据。方法：选取2012年8月-2014年8月本院儿科收治的120例早产儿,在其住院期间给予振幅整合脑电图、彩超、MRI检查,观察与记录三种方法的检测结果。结果：振幅整合脑电图检查结果：早产儿中有48例表现为不连续低电压或病理型图形,阳性率为40.00%（48/120）,且未能检测到成熟CY。彩超检查结果：早产儿中有33例颅内发现阳性病灶,阳性率为27.50%（33/120）,其中15例早产儿被诊断为脑室内出血,占45.45%（15/33）,另有18例早产儿被诊断为缺氧缺血性改变,占54.55%（18/33）。MRI检查结果：早产儿中有62例在颅内发现了阳性病灶,阳性率为51.67%（62/120）,其中有34例诊断为脑室内缺血,19例诊断为脑实质点状出血,占30.66%（19/62）,9例诊断为脑室内缺血合并蛛网膜下腔出血,占14.52%（9/62）。结论：MRI对于早产儿诊断的准确性及敏感性明显高于振幅整合脑电图及彩超检查,其中振幅整合脑电图可通过针对早产儿醒睡周期异常改变进行诊断,而彩超则可作为初诊及随访追踪的方法推广应用于临床工作中。     

Metachronous solitary mediastinal lymph node metastases of hepatocellular carcinoma treated by video‐assisted thoracic surgery twice: Report of a case

Solitary mediastinal lymph node metastasis of hepatocellular carcinoma (HCC) is rare. We report a case of metachronically solitary mediastinal metastases of HCC treated by video‐assisted thoracic surgery (VATS) twice. A 66‐year‐old man underwent repeated laparoscopic radiofrequency ablation or trans‐arterial catheter chemo‐embolization against HCC for more than 10 years. The level of alpha fetoprotein protein was elevated, and radiological modalities including FDG‐PET revealed solitary mediastinal tumor metachronically. VATS was performed bilaterally twice. The postoperative course was uneventful and there had no recurrence of extra‐hepatic metastases and tumor markers are within normal limits at 18 months after second VATS. VATS is a minimally invasive and useful procedure for solitary mediastinal lymph node metastasis of HCC. If primary HCC was controlled and lymph node metastasis was solitary, mediastinum lymphadenectomy using VATS might give good short and long term results.     

Video‐assisted thoracoscopic surgery can help enable the complete resection of a mediastinal tumor caused by immunoglobulin G4‐related disease and avoid the need for postoperative medication: A case report

Immunoglobulin (Ig) G4‐related disease has various clinical signs and symptoms, and steroidal therapy with corticosteroids has been found to be effective for treatment. Few cases of IgG4‐related disease associated with paravertebral tumor have been reported, and there have been no reports on complete resection of such a tumor. Here, we report a case of IgG4‐related disease associated with a paravertebral tumor that was successfully resected without the need for postoperative medication. An 84‐year‐old woman was admitted to our hospital with a paravertebral tumor. She underwent thoracoscopic surgery, and pathological examination of the tumor specimen revealed that the tumor resulted from IgG4‐related disease. After resection, there was no need for postoperative medication. Our case indicates the rare possibility of a paravertebral tumor associated with IgG4‐related disease and the potential for complete resection as a treatment for such a tumor.     

肾穿刺活检术前患者应用视频化健康教育的效果评价

目的 探讨视频化健康教育模式在肾穿刺活检术前的应用效果。 方法 选取2017年5月～12月我科行肾穿刺活检的慢性肾脏疾病患者240例,按入院先后顺序将患者分为对照组和试验组,5～8月120例为对照组,9～12月120例为试验组,对照组患者采用常规肾穿刺活检术前健康教育模式,试验组患者采用融入视频的健康教育模式进行肾穿刺活检术前健康教育,分别比较两组患者知识掌握程度、适应性训练准确率、对健康教育的满意度和护士宣教平均耗时之间的差异。 结果 两组患者肾穿刺活检知识掌握程度、适应性训练准确率和对健康教育的满意度比较,差异有统计学意义(P<0.01);护士术前宣教平均耗时比较,差异无统计学意义(P>0.05)。 结论 肾穿刺活检术前对患者采用视频化健康教育模式有利于提高健康教育效果和患者对护理工作的满意度,且不额外增加护士的工作耗时,值得在临床中推广应用。     

Average spectral power changes at the hippocampal electroencephalogram in schizophrenia model induced by ketamine

The use of ketamine (Ket) as a pharmacological model of schizophrenia is an important tool for understanding the main mechanisms of glutamatergic regulated neural oscillations. Thus, the aim of the current study was to evaluate Ket‐induced changes in the average spectral power using the hippocampal quantitative electroencephalography (QEEG). To this end, male Wistar rats were submitted to a stereotactic surgery for the implantation of an electrode in the right hippocampus. After three days, the animals were divided into four groups that were treated for 10 consecutive days with Ket (10, 50, or 100 mg/kg). Brainwaves were captured on the 1st or 10th day, respectively, to acute or repeated treatments. The administration of Ket (10, 50, or 100 mg/kg), compared with controls, induced changes in the hippocampal average spectral power of delta, theta, alpha, gamma low or high waves, after acute or repeated treatments. Therefore, based on the alterations in the average spectral power of hippocampal waves induced by Ket, our findings might provide a basis for the use of hippocampal QEEG in animal models of schizophrenia.     

BP网络在麻醉深度监测算法上的应用

麻醉是临床手术中必不可少的环节,但麻醉的过深或过浅可能给病人带来伤害,因而对麻醉深度的监测具有较高的临床价值。脑电是目前检测麻醉深度最有潜力的方法,首先通过滤波等处理方式得到较为纯净的脑电信号,分析时域和频域的特征,计算相应的参数,并将该参数作为前向反馈神经网络的输入参数,选择合适的BP神经网络拟合得到一个能够评价麻醉深度的无量纲常数。使用BP神经网络拟合结果来表征麻醉深度准确率普遍在90%以上,反映了BP神经网络在麻醉深度监测上具有较高的应用价值。     

融合多特征脑电评估孤独症儿童

孤独症是一种复杂的神经发育性脑疾病,其早期发现和精确诊断非常重要。从54名孤独症和50名正常儿童的脑电信号中提取功率谱、熵、双谱相干性以及相干性等多特征进行分析研究,并对每组特征进行独立样本t检验分析组间差异;为提高分类性能,提出融合多特征脑电进行分析,进一步采用最大相关最小冗余算法进行特征选择,最后利用支持向量机建立分类模型。结果显示,用单一特征分类,得到的分类准确率为72%,灵敏度为73.94%,特异性为67.74%,F1分数为69.74%,因此单一特征所建立的分类模型性能较差;在融合多特征进行分类时,选择前25个特征建立模型,具有较高的分类精度(93.45%±0.79%),此时灵敏度为91.73%±0.42%,特异性为94.01%±0.36%,F1分数为92.54%±0.31%,且AUC达到0.96,相比单一特征分类模型具有良好的性能。研究结果可以为孤独症的辅助诊断提供科学客观依据,为孤独症儿童后期康复提供可靠参考。     

功能锻炼视频宣教联合回馈教学应用于老年全髋关节置换术后患者的效果分析

目的：研究功能锻炼视频宣教联合回馈教学应用于老年全髋关节置换术(THA)后患者的效果。方法：选择2019年10月～2020年8月我院的老年THA患者68例,使用随机数字表法将其分为A组和B组,各34例。A组术后采用常规的健康教育,B组术后采用功能锻炼视频宣教联合回馈教学干预。对比两组的功能恢复情况、训练依从性、并发症等情况。结果：出院后一个月后B组的Harris评分、Barthel指数评分高于A组(P<0.05),B组的训练依从性(97.05%)高于A组的(82.35%)(P<0.05),B组的并发症总发生率(14.70%)低于A组的(35.29%)(P<0.05)。结论：功能锻炼视频宣教联合回馈教学能够促进老年THA后患者髋关节功能的恢复,提高日常生活能力,增加训练依从性,降低并发症。