2016-2018年湖南省冠心病患者住院费用结构分析

目的 分析2016-2018年湖南省冠心病患者住院费用结构变动情况,为有效控制住院费用的增长速度,实现医疗资源的优化配置提供依据.方法 采用多阶段分层抽样的方法,获取2016-2018年湖南省44家医疗卫生机构的25 430例冠心病患者住院数据.通过灰色关联分析法对各单项住院费用的关联程度进行分析;采用结构变动度分析法...     

A 7-Tesla MRI study of the periaqueductal gray: resting state and task activation under threat

The periaqueductal gray (PAG) is a region of the midbrain implicated in a variety of behaviors including defensive responses to threat. Despite the wealth of knowledge pertaining to the differential functional roles of the PAG columns in nonhuman and human research, the basic functional connectivity of the PAG at rest has not been well characterized. Therefore, the current study utilized 7-Tesla magnetic resonance imaging (MRI) to characterize PAG functional connectivity at rest and task activation under uncertain threat. A sample of 53 neurologically healthy undergraduate participants (M_age = 22.2, s.d._age = 3.62) underwent structural and resting state functional MRI scans. Supporting previous work, voxel-wise analyses showed that the PAG is functionally connected to emotion regulation and fear networks. The comparison of functional connectivity of PAG columns did not reveal any significant differences. Thirty-five participants from the same sample also completed an uncertain threat task with blocks of three conditions—no shock, predictable shock and unpredictable shock. There were no robust activity differences within the PAG columns or the whole PAG across conditions although there was differential activity at the voxel level in the PAG and in other regions theoretically relevant to uncertain threat. Results of this study elucidate PAG connectivity at rest and activation in response to uncertain threat.     

如意珍宝丸对偏头痛大鼠下行痛觉调节通道的影响

目的:研究藏药如意珍宝丸对硝酸甘油致偏头痛模型大鼠下行痛觉调制通道中心区域中脑导水管内神经生长因子(Nerve Growth Factor,NGF)、酪氨酸激酶A(Tyrosine Kinase A,TrkA)、瞬时感受器电位香草酸受体1(Transient Receptor Potential Vanilloid Receptor 1,TRPV1)的表达影响,探究该药干预神经源炎性痛敏性偏头痛的作用机制。方法:以颈部皮下注射硝酸甘油方法复制大鼠偏头痛模型,以如意珍宝丸为药物实验组,琥珀酸舒马普坦为阳性对照组,采用ELISA和Real-Time PCR法检测外周血清及中脑组织NGF、TrkA、TRPV1蛋白及基因表达水平,观察藏药如意珍宝丸对硝酸甘油致偏头痛模型大鼠下行痛觉调制系统的影响。结果:与空白组比较,模型组血清NGF、TrkA、TRPV1蛋白表达显著上升(P0.05);中脑NGF、TrkA、TRPV1基因表达差异性升高(P0.05)。与模型组比较,如意珍宝丸预防组可降低NGF、TRPV1蛋白表达(P0.05);如意珍宝丸观察组能使NGF、TrkA蛋白表达和NGF、TrkA、TRPV1 mRNA表达均降低(P0.05或P0.01)。结论:NGF、TrkA共同参与了下行疼痛调控中TRPV1介导的偏头痛发生;藏药如意珍宝丸可降低NGF、TrkA对TRPV1的上调作用,起到抑制神经源炎性痛敏性偏头痛的作用。     

基于熵权TOPSIS法和灰色关联度分析筛选桔梗最佳采收期

目的 完善桔梗药材质量评价方法,研究3年生桔梗药材不同采收期下药材质量差异,确定桔梗药材最佳采收期。方法 以桔梗药材浸出物、灰分、水分、折干率以及所含6种皂苷类活性成分含量作为质量评价的检测指标,借助数理统计学方法,对不同采收期桔梗药材之间的差异进行表征。并结合熵权法、灰色关联度分析、TOPSIS法3种数学模型对桔梗药材质量评价指标进行统计分析,获得不同采收期桔梗药材质量排名信息。结果 采收期是影响桔梗药材质量差异的重要因素,不同采收期下3年生桔梗药材质量评价指标之间差异明显。所增加的多指标检测完善了桔梗质量评价体系,增强了药材的“性-效”联系。结合质量评价模型结果显示,3年生桔梗以10月21日(霜降)前后采收的桔梗药材综合指数得分最高。结论 为保证桔梗药材质量,结合药材外观性状特征与药材物质基础综合考虑,确定以“霜降”节气前后作为3年生桔梗的最佳采收期。     

Right inferior frontal gyrus: An integrative hub in tonal bilinguals

Right hemispheric dominance in tonal bilingualism is still controversial. In this study, we investigated hemispheric dominance in 30 simultaneous Bai‐Mandarin tonal bilinguals and 28 Mandarin monolinguals using multimodal neuroimaging. Resting‐state functional connectivity (RSFC) analysis was first performed to reveal the changes of functional connections within the language‐related network. Voxel‐based morphology (VBM) and tract‐based spatial statistics (TBSS) analyses were then used to identify bilinguals' alterations in gray matter volume (GMV) and fractional anisotropy (FA) of white matter, respectively. RSFC analyses revealed significantly increased functional connections of the right pars‐orbital part of the inferior frontal gyrus (IFG) with right caudate, right pars‐opercular part of IFG, and left inferior temporal gyrus in Bai‐Mandarin bilinguals compared to monolinguals. VBM and TBSS analyses further identified significantly greater GMV in right pars‐triangular IFG and increased FA in right superior longitudinal fasciculus (SLF) in bilinguals than in monolinguals. Taken together, these results demonstrate the integrative role of the right IFG in tonal language processing of bilinguals. Our findings suggest that the intrinsic language network in simultaneous tonal bilinguals differs from that of monolinguals in terms of both function and structure.     

Partial‐volume modeling reveals reduced gray matter in specific thalamic nuclei early in the time course of psychosis and chronic schizophrenia

The structural complexity of the thalamus, due to its mixed composition of gray and white matter, make it challenging to disjoint and quantify each tissue contribution to the thalamic anatomy. This work promotes the use of partial‐volume‐based over probabilistic‐based tissue segmentation approaches to better capture thalamic gray matter differences between patients at different stages of psychosis (early and chronic) and healthy controls. The study was performed on a cohort of 23 patients with schizophrenia, 41 with early psychosis and 69 age and sex‐matched healthy subjects. Six tissue segmentation approaches were employed to obtain the gray matter concentration/probability images. The statistical tests were applied at three different anatomical scales: whole thalamus, thalamic subregions and voxel‐wise. The results suggest that the partial volume model estimation of gray matter is more sensitive to detect atrophies within the thalamus of patients with psychosis. However all the methods detected gray matter deficit in the pulvinar, particularly in early stages of psychosis. This study demonstrates also that the gray matter decrease varies nonlinearly with age and between nuclei. While a gray matter loss was found in the pulvinar of patients in both stages of psychosis, reduced gray matter in the mediodorsal was only observed in early psychosis subjects. Finally, our analyses point to alterations in a sub‐region comprising the lateral posterior and ventral posterior nuclei. The obtained results reinforce the hypothesis that thalamic gray matter assessment is more reliable when the tissues segmentation method takes into account the partial volume effect.     

基于小波分析和灰度纹理特征的乳腺X线图像微钙化点区域的提取

目的乳腺癌的早期发现对患者意义重大。为帮助医生进行乳腺癌的早期检查和诊断,本文提出利用小波分析与图像纹理特征提取相结合的方法来提取乳腺X线图像微钙化点区域,在提高检查准确性的同时避免漏检误检。方法首先利用灰度共生矩阵所提取的能量、熵、对比度、相关性以及小波分解后得到的各层高频系数的方差、能量作为图像的特征向量,然后利用支持向量机进行训练建立最优分类模型。最后利用建立的最优分类模型实现乳腺X线图像微钙化点区域的提取并利用检出率和误检率对结果进行评估。结果使用临床数据进行验证,结果表明利用小波分析与图像纹理特征提取相结合的方法能有效提取乳腺图像中的微钙化点区域。结论基于小波分析和灰度纹理特征的乳腺X线图像微钙化点区域的提取方法比单一的图像纹理特征提取或小波分析等方法,提取的效果更好。另外,该方法设计简单,更易于实现乳腺癌的自动化诊断。     

脑皮质梗死慢性期非流利性失语症灰质体积的改变

目的 探讨脑皮质梗死慢性期非流利性失语症患者灰质体积的改变及其与语言功能的关系。