前纵裂入路切除鞍区巨大肿瘤

背景与目的：鞍区巨大肿瘤手术难度较大，本文探索前纵裂入路切除鞍内、鞍上向单双侧海绵窦、第三脑室、蝶窦及伴颞叶发展的巨大肿瘤的手术适应症、方法与优缺点方法：总结分析2002年1月至2004年5月我科经前纵裂入路切除鞍区各部位发展的肿瘤17例。结果：肿瘤全切14例，近全切2例．部分切除1例；术后视力改善12例，无改变5例，尿崩或电解质紊乱8例，死亡1例，随访时间3～32个月，有1例复发，系巨大侵袭性垂体瘤术后，行γ-刀治疗后肿瘤基本得到控制。结论：前纵裂入路是切除鞍内、鞍上向单双侧海绵安、第三脑室、蝶窦及伴颞叶发展的肿瘤较理想的入路，利用自然脑裂的分离，手术视野、操作角度好、肓区少，有利于显露重要血管、神经及双侧海绵窦内侧壁，肿瘤全切率高。     

多排螺旋CT对回盲区癌与炎性假瘤鉴别诊断的应用研究

目的分析回盲区癌与炎性假瘤的CT征象,探讨其主要鉴别要点,提高诊断准确率,为临床提供更可靠的影像诊断依据。方法对36例回盲区实性占位的病例,采用16排螺旋CT进行平扫及3期增强扫描,薄层重建后发送到AW 4.2工作站进行图像重建并综合观察。CT诊断后追踪对比手术病理结果或其他临床治疗结果。结果36例病例中,23例为恶性肿瘤,13例为炎性假瘤,CT误诊8例。重新分析各病例CT征象及结合临床病史,寻找回盲区癌及炎性假瘤的不同CT征象及误诊原因,总结出鉴别要点。结论回盲区癌及炎性假瘤强化特点及其与邻近结构的关系等CT表现均有所不同,重视CT鉴别要点可提高诊断准确率。     

面颈部静脉畸形的综合治疗

目的:探讨多种方法综合治疗口腔及面颈部大面积静脉畸形的临床效果。方法:根据患者的年龄、病变部位、病变大小制订个体化治疗方案,采用多种药物联合注射,结合病变周围环形缝扎、激光、手术等方法综合治疗口腔颌面部大面积静脉畸形134例。结果:134例中治疗效果优79例(58.96%),良45例(33.58%),显效10例(7.46%),差0例。结论:采用多种方法综合治疗口腔颌面部大面积静脉畸形,对提高疗效、改善面部形态、维持局部功能、减少不良反应具有重要意义。     

眼针针刺脾区、胃区配合基础药物治疗难治性高血压患者93例临床观察

目的 观察眼针针刺从脾胃论治难治性高血压的临床疗效.方法 难治性高血压患者97例维持入组前口服药物品种及剂量,同时采用眼针针刺治疗,主穴脾区、胃区,辅穴肝区、肾区,每天1次,每周日休息,连续治疗8周.观察治疗前及治疗4、8周后患者偶测血压情况及治疗前后患者24h动态血压情况、血压负荷和血压变异性,并据血压改善值判定临床疗效及血压达标率.结果 试验过程中脱落4例.93例患者治疗后总有效77例,总有效率为82.79％,血压达标75例,血压达标率为80.65％.治疗4、8周后患者收缩压和舒张压都明显低于治疗前(P ＜0.05或P＜0.01),治疗8周后较治疗4周后亦有降低(P＜0.05).治疗8周后,患者24 h血压监测收缩压和舒张压水平及其血压负荷及血压变异性都明显低于治疗前(P＜0.05).结论 眼针针刺脾区、胃区配合基础药物治疗可以良好地控制难治性高血压患者的血压,从而减少对心脏、肾、脑等靶器官的损害.     

Validation of the Proximal Isovelocity Surface Area Method for Assessing Mitral Regurgitation in Children

The proximal isovelocity surface area (PISA) method for calculating volume flow through the regurgitant orifice has attracted significant attention. A number of in vitro studies and clinical studies in adults suggest that the method is accurate. However, when applying the method to children it must be noted that the absolute regurgitation volume is small, and the range of body sizes is wide. This study investigated the accuracy of the PISA method for quantitative assessment of the severity of mitral regurgitation in children. Twenty children aged 7 months to 12 years (average 4.7 years) with mitral regurgitation but without interventricular shunt or aortic stenosis were selected for this study. Underlying cardiac diseases included atrioventricular septal defects in nine, isolated mitral regurgitation in five, and association with other heart defects in six. The PISA radius (r) and the duration of regurgitation (T) were measured on color M-mode recordings, with the M line passing through the center of the PISA. Assuming that the PISA is a hemisphere, maximal regurgitant flow rate (MFR: ml/s) was calculated as MFR = 2π×~ r ²×~ V (r= maximal radius, V= aliasing velocity), and regurgitant stroke volume (RSVpisa) as RSVpisa = 2π×~ MSR ×~ V×~ T (MSR = mean square of the PISA radius during regurgitation). As a validating standard, total stroke volume (TSV) using two-dimensional echocardiography determined by the area–length volumetry method and forward stroke volume (FSV) by the pulsed Doppler method were measured, and regurgitant stroke volume (RSV_D: RSV_D= TSV − FSV) and regurgitant fraction (RF: RF = RSV_D/TSV) were calculated. A linear correlation was found between MFR, RSVpisa, and RSV_D (X) (MFR = 4.2X + 54.0, r= 0.84. RSVpisa = 1.0X + 9.8, r= 0.90), and both RSVpisa and MFR divided by body surface area (BSA: m²) revealed a significant correlation with regurgitant fraction (X) by nonlinear regression analysis (RSVpisa/BSA = 26.2 ×~ X/(1 − X) + 16.8, r= 0.85. MFR/BSA = 121.8 ×~ X/(1 − X) + 92.2, r= 0.79). It is concluded that maximal regurgitant flow rate, regurgitant stroke volume, and regurgitant fraction can be accurately predicted in children using the PISA method by Doppler echocardiography.     

Trends in Mortality from Ischemic Heart Disease in the Region of the Americas, 2000–2019

Background:In latest decades, mortality rates from ischemic heart disease (IHD) had declined steadily in most of the world as a consequence of improvements in prevention and therapy.Objective:The aim of this study was to analyze trends in mortality caused by IHD in the region of the Americas from 2000 to 2019.Methods:Estimates of the age-adjusted mortality rate (AAMR) due to IHD were extracted from the Data Portal on Noncommunicable Diseases, Mental Health, and External Causes (ENLACE), Pan American Health Organization. We used Joinpoint regression to analyze significant changes in mortality trends by country, gender, geographical sub-region, and country income, according to the World Bank classification. We also calculated the average annual percent change (AAPC) mortality rate for the overall period in the Americas as a whole and by country and sub-region.Results:In the region of the Americas, the AAMR from IHD decreased from 117.80 (95% uncertainty interval (UI)) 106.64–135.90) in 2000 to 73.64 (62.65–92.66) per 100,000 in 2019. In males, from 149.08 (95% UI 138.23–168.08) to 96.02 (95% UI 83.48–117.19) and in females 92.36 (95% UI 81.35–109.42) to 54.84 (95% UI 45.28–71.76). The AAPC mortality rate in the region decreased –2.5% (95% CI: –2.7, –2.3), with joinpoints in 2007 and 2012, –2.3% (95% CI: –2.5, –2.1) in men and –2.7% (95% CI: –3.0, –2.5) in women. According to the sub-region analysis, the highest decrease was recorded in North America, AAPC –3.1% (95% CI: –3.3, –3.0) with one joinpoint in 2011, whereas there was a stagnation of the mortality rate in Central America, Mexico, and Latin Caribbean with an AAPC of 0.1 (–0.2, 0.3) with one joinpoint in 2007.Conclusions:Age-adjusted mortality rate from IHD between 2000 and 2019 has decreased in the region of the Americas. However, different trends were observed, North America had the highest reduction in AAPC, while Central America, Mexico, and Latin Caribbean Region had a stagnation. This trend was highly influenced by country income.     

Experiment and Theoretical Investigation on Fatigue Life Prediction of Fracturing Pumpheads Based on a Novel Stress-Field Intensity Approach

Fracturing pumpheads are typical pressure vessels that experience frequent fatigue failure under the effect of notches in their cross-bore. To enhance the fatigue life of fracturing pumpheads, the study of the notch effect is indispensable and important to establish a reliable mathematical model to predict their fatigue life. In the present paper, two novel fatigue life prediction models are proposed for notched specimens. In these models, two new geometric fatigue failure regions are defined to improve the weight function. Finally, the elaborated novel stress-field intensity approach was applied to three different types of notched specimens. Experiment results indicate that the new SFI approach achieves 47.82%, 39.48%, and 31.85% higher prediction accuracy than the traditional SFI approach, respectively. It was found that the modified SFI approach provided better predictions than the traditional SFI approach and the TCD method. The II-th novel SFI approach had the highest accuracy, and the I-th novel SFI approach was more suitable for sharply notched specimens.     

上海市流通领域预包装食品标签状况调查及对策

[目的]了解上海市流通领域预包装食品标签现状,分析存在的问题,明确监管的方向。[方法]用简单随机抽样方法选取1家区域内超市(大卖场),对卖场内预包装食品整群抽样。于2007年1—5月间对预包装食品标签进行拍照,照片全部输入电脑并使用SPSS 11.5软件进行统计分析。[结果]预包装食品标签总合格率为83.7%。其中预包装普通食品标签的合格率最高,为91.4%,预包装饮料酒标签合格率为84.4%,预包装特殊膳食用食品和预包装保健食品标签合格率稍低,分别为9.0%和15.8%。[结论]上海市流通领域预包装食品标签的监督管理总体上是规范的,但对于预包装特殊膳食用食品和预包装保健食品标签的监管尚待加强。     

大鼠脑组织中抑郁症相关生化物质分析方法的建立及应用

目的建立大鼠脑组织中与抑郁症相关的生化物质的高效液相色谱-荧光分析方法,研究脑组织不同部位中相关生化物质的分布及差异。方法采用反相离子对液相色谱法,对脑组织样本前处理方法进行了考察,优化了色谱分离分析条件。将所建立的方法应用于大鼠纹状体、下丘脑、海马及皮层等不同脑组织样本的分析。结果本方法实现了对大鼠脑组织样本中多种生化物质的基线分离;经鉴别,其中7种物质与单胺递质系统密切相关。大鼠脑组织不同部位中与抑郁症相关生化物质的种类及量的分布存在一定差异。结论本文建立的分析方法专属、灵敏,可为中药复方药效及作用机制研究提供重要信息。     

气候变暖对阿勒泰地区春玉米播种期和种植布局的影响--测试文章

采用阿勒泰地区7个气象站1961—2010年逐日平均气温资料,使用线性趋势分析、累积距平、t检验并基于Kriging插值法,分析近50年日平均气温稳定通过≥10℃的初日、终日、持续日数和积温的时空变化特征,揭示春玉米播种期及种植布局的变化规律。结果表明,阿勒泰地区近50年≥10℃积温呈现初日提前、终日推迟、持续日数延长、积温增加的现象,其倾向率分别为0.3、1.3、1.6 d·10a^-1和57.1℃·10a^-1,且突变年份均发生在20世纪90年代中期。各县市春玉米播种期提前3～8 d,生长季延长6～11 d。突变前青河东部不能种植春玉米,晚熟品种不能种植或种植风险较大。随着气候不断变暖,春玉米不同熟性品种可种植区逐渐东扩,各县市春玉米在品种熟性上均发生了改变,表现为由不能种植到种植早熟、早熟向中（晚）熟、中晚熟向晚熟品种的变化。